SIBO - another antibiotic along with Rifaximin

[WonMore]

I'm trying to do my homework before starting my SIBO treatment, I've been struggling with it for 9 years already and now I'm making another attempt to strike it. I've tried a lot of natural antibiotics throughout these years with no success, so now I decided to go with Rifaximin. I went with course of Rifaximin I think in 2013, so in the begging of my journey,, and I remember the week I was taking it I felt very well with literally no symptoms. After stopping it immediately my symptoms went back, but I was still eating back then all the food, which, I'm convinced, had gave me a SIBO in first place, i.e. all the grains, starch etc. Also I think the dosage was too little.
So now I have 140 tablets of Xifaxan 200mg, so I could do for example 2-weeks course with 2000mg daily. I know approach here is rather to take antibiotics in shorter courses with smaller dosage, but I think stubborn SIBO is the case where going all the way up might not be unreasonable, especially as Rifaximin is considered pretty "mild".
And here's my question: I'm wondering if I should maybe add some other antibiotic for better efficacy, and if so, which one would be the most complementary to Xifaxan? My reasoning is that it would maybe target any potential dysbiosis in colon, if present, since Xifaxan allegedly operates only in small intestine; also treatment might covered broader spectrum of bacteria. Ray recommends tetracyclines and penicilin, some people reported success with amoxicillin and azithromycin, I've also heard that gentamicin and vancomycin, although highly toxic, are non-absorbable taken orally, which may be safer overall. The argument in favor of cyclines would be their anti-inflammatory character, which may plays a role assuming theory about autoimmunity of SIBO is true.
The separate question is: how to take it? Together, or one after another?
Any advice appreciated

 

[mostlylurking]

I'm trying to do my homework before starting my SIBO treatment, I've been struggling with it for 9 years already and now I'm making another attempt to strike it. I've tried a lot of natural antibiotics throughout these years with no success, so now I decided to go with Rifaximin. I went with course of Rifaximin I think in 2013, so in the begging of my journey,, and I remember the week I was taking it I felt very well with literally no symptoms. After stopping it immediately my symptoms went back, but I was still eating back then all the food, which, I'm convinced, had gave me a SIBO in first place, i.e. all the grains, starch etc. Also I think the dosage was too little.
So now I have 140 tablets of Xifaxan 200mg, so I could do for example 2-weeks course with 2000mg daily. I know approach here is rather to take antibiotics in shorter courses with smaller dosage, but I think stubborn SIBO is the case where going all the way up might not be unreasonable, especially as Rifaximin is considered pretty "mild".
And here's my question: I'm wondering if I should maybe add some other antibiotic for better efficacy, and if so, which one would be the most complementary to Xifaxan? My reasoning is that it would maybe target any potential dysbiosis in colon, if present, since Xifaxan allegedly operates only in small intestine; also treatment might covered broader spectrum of bacteria. Ray recommends tetracyclines and penicilin, some people reported success with amoxicillin and azithromycin, I've also heard that gentamicin and vancomycin, although highly toxic, are non-absorbable taken orally, which may be safer overall. The argument in favor of cyclines would be their anti-inflammatory character, which may plays a role assuming theory about autoimmunity of SIBO is true.
The separate question is: how to take it? Together, or one after another?
Any advice appreciated

Please read this article: When SIBO & IBS-Constipation are just unrecognized thiamine deficiency

Hypothyroidism will also cause very slow transit time through the gut and will also make gut repair/regeneration slow or nonexistent. Bacteria thrives in this environment. Both hypothyroidism and thiamine deficiency block metabolic energy production, causing multiple severe health issues. Many antibiotics cause thiamine function blockage which has the same symptoms as severe thiamine deficiency.

 

[AdoTintor]

why carpet bomb at 2000mg? why not take baby steps and try the usual protocal of half doses for a couple of weeks and follow up with the non-starch diet, carrot/bamboo shoots, cascara tea, to avoid any relapse. If that doesn't work then mincyline, then try Camphosal, then maybe carpet bomb and take the risk of a fungal infection.

 

[WonMore]

Please read this article: When SIBO & IBS-Constipation are just unrecognized thiamine deficiency

Hypothyroidism will also cause very slow transit time through the gut and will also make gut repair/regeneration slow or nonexistent. Bacteria thrives in this environment. Both hypothyroidism and thiamine deficiency block metabolic energy production, causing multiple severe health issues. Many antibiotics cause thiamine function blockage which has the same symptoms as severe thiamine deficiency.

Thank you for the link. Didn't know about this theory. The question is if by SIBO they mean only SIBO with constipation or both types. Because I'm rather in the diarrhea category. Unfortunately, the expected cited references are omitted :P I'll check this TTFD still.
My thyroid function is actually a big question mark for me at the moment, as I'm getting some conflicting signs. But I'm working on determine the situation and trying to improve nevertheless. For example, after incorporating some peating, coming from keto/carnivore, my TSH went up from 0,021 ulU/ml to 8,456 in about month and a half! But on the other hand it's easier for me now to sustain constant energy level throughout the day. Also, I think my pulse increased, although I never measure it regularly before.

why carpet bomb at 2000mg? why not take baby steps and try the usual protocal of half doses for a couple of weeks and follow up with the non-starch diet, carrot/bamboo shoots, cascara tea, to avoid any relapse. If that doesn't work then mincyline, then try Camphosal, then maybe carpet bomb and take the risk of a fungal infection.

I'm leaning towards carpet bomb because I'm still not so sure about antibiotic resistance - I know there are cases when people reported they were taking Rifaximin repeatedly and it stopped working after a while. And my experience so far is that I rarely notice any side effects of things (except of food ) - there's no improvement usually, but also no deterioration (outside of digestive system at least). I'm still open to suggestions though, I'm not 100% sure that my thinking is proper. I'm just more afraid of being still stuck in the place I am than anything else.
Carrot salad etc. I plan to use as well. I think Georgi in one of the podcasts said that tetracyclines protects from fungi? I might be mistaken though. I'll check Camphosal, it looks promising, thank you for suggestions.

 

[Perry Staltic]

What is the reasoning behind the expectation that nuking the gut microbiome will produce good results without replenishing it with things that are known to have beneficial characteristics? There is no such thing as a sterile gut, impossible to achieve, so relying on gut carpet bombing alone may provide temporary benefits, but maybe not an enduring self-sustaining gut symbiosis.

 

[Markr2d2]

Good luck, i have been dealing with sibo for quite awhile. I was unable to get my doc to prescribe rifaxamin so intried a combo of cipro and flaygl with ultimately no long term success. I did find take a decent amount of caprylic acid daily helps a lot with symptoms as well as a zero starch/fiber diet of course. About the only fibers i eat come from apple sauce (skinless) and cocoa. High sat fat in general seems to help. I do worry about the lack of fiber feeding the bacteria that make butyrate but not enough to actually eat fiber. I did try a probiotic/prebiotic protocol from red fern and it made things exponentially worse so i dont think that is the answer.

 

[Perry Staltic]

I did try a probiotic/prebiotic protocol from red fern and it made things exponentially worse so i dont think that is the answer.

I can't find that product. Curious to see what's in it. I did find a Silver Fern probiotic though?

 

[mostlylurking]

Thank you for the link. Didn't know about this theory. The question is if by SIBO they mean only SIBO with constipation or both types. Because I'm rather in the diarrhea category. Unfortunately, the expected cited references are omitted :P I'll check this TTFD still.
My thyroid function is actually a big question mark for me at the moment, as I'm getting some conflicting signs. But I'm working on determine the situation and trying to improve nevertheless. For example, after incorporating some peating, coming from keto/carnivore, my TSH went up from 0,021 ulU/ml to 8,456 in about month and a half! But on the other hand it's easier for me now to sustain constant energy level throughout the day. Also, I think my pulse increased, although I never measure it regularly before.

I lived through at least 20 years with SIBO, IBS, leaky gut, and strong gluten sensitivity. I alternated with constipation/diarrhea. High dose thiamine (2 grams/day) has "cured" me. I'm using quotation marks because I'm pretty sure if I stop the thiamine regimen my symptoms will return. Thiamine deficiency/functional thiamine blockage damages the autonomic nervous system including the nerves that make the gut work; moving food along the digestive tract and properly applying digestive enzymes. If the food is not moving along, bacteria population explodes. There is a strong correlation between gut disbiosis and Parkinson's Disease. Many Parkinson's Disease patients have a history of gut disbiosis. Both issues are resolved with high dose thiamine. HDT Therapy

I do not understand the numbers you supplied for TSH. The goal is for TSH to be under 1. Is the energy you feel metabolic energy working properly or is the energy you experience from stress hormones (adrenaline)?

If you will keep a diary of your temperature and pulse you will have a better understanding of your situation. You may find this download helpful: http://sozocomplete.com/assets/files/Thyroid Basal Temperature and Resting Pulse Test copy.pdf I've found that digital thermometers are not reliable; the glass/mercury thermometers work if you can find one.

You may find Elliot Overton's youtube channel helpful: https://www.youtube.com/channel/UCFqXidfUsI0vm73xsBMIQdQ TTFD has more side effects than thiamine hcl. I chose to stick with thiamine hcl because TTFD gave me a headache. the hcl has poorer absorption in the gut so the dose is a lot higher.

Here's a link to a search on PubMed: gastrointestinal beriberi - Search Results - PubMed

 

[Jkbp]

I lived through at least 20 years with SIBO, IBS, leaky gut, and strong gluten sensitivity. I alternated with constipation/diarrhea. High dose thiamine (2 grams/day) has "cured" me. I'm using quotation marks because I'm pretty sure if I stop the thiamine regimen my symptoms will return. Thiamine deficiency/functional thiamine blockage damages the autonomic nervous system including the nerves that make the gut work; moving food along the digestive tract and properly applying digestive enzymes. If the food is not moving along, bacteria population explodes. There is a strong correlation between gut disbiosis and Parkinson's Disease. Many Parkinson's Disease patients have a history of gut disbiosis. Both issues are resolved with high dose thiamine. HDT Therapy

I do not understand the numbers you supplied for TSH. The goal is for TSH to be under 1. Is the energy you feel metabolic energy working properly or is the energy you experience from stress hormones (adrenaline)?

If you will keep a diary of your temperature and pulse you will have a better understanding of your situation. You may find this download helpful: http://sozocomplete.com/assets/files/Thyroid Basal Temperature and Resting Pulse Test copy.pdf I've found that digital thermometers are not reliable; the glass/mercury thermometers work if you can find one.

You may find Elliot Overton's youtube channel helpful: https://www.youtube.com/channel/UCFqXidfUsI0vm73xsBMIQdQ TTFD has more side effects than thiamine hcl. I chose to stick with thiamine hcl because TTFD gave me a headache. the hcl has poorer absorption in the gut so the dose is a lot higher.

Here's a link to a search on PubMed: gastrointestinal beriberi - Search Results - PubMed

I’d like to try the thiamine therapy for my SIBO. Do you take 1 gram twice a day or 2 grams once? With food? Thanks!

 

[mostlylurking]

I’d like to try the thiamine therapy for my SIBO. Do you take 1 gram twice a day or 2 grams once? With food? Thanks!

I'm following Dr. Costantini's protocol. see here: HDT Therapy More info, some of it a little conflicting, is here: FAQ

His information recommends using thiamine hcl, taken twice a day, morning and afternoon before 3:00pm. Taken later in the day can cause insomnia. Taken earlier in the day improves sleep. He says to take it dissolved in water, not juice. He says you can take it before a meal or you can take it after a meal. I try to space eating and taking the thiamine at least 30 minutes apart.

I started low dose and worked my way up to 2 grams/day taken in 2 divided doses. Not everybody is the same. Many of Dr. Costantini's Italian patients took more, normally 4 grams/day; he found that people of Anglo Saxon heritage needed less, more like 2 grams/day. When I increased my dose to 2.5 grams/day I got the negative side effects mentioned in Dr. Costantini's information so I backed off the dose to 2 grams/day. I've been on this dose for 2 months.

 

[Birdie]

I have been using Dr Costantini's protocol for my husband who has Parkinson's symptoms. He uses Dr Clark's brand Thiamine HCl and my understanding is that Dr Costantini recommended taking it just before or after a meal. We have been working on his dose for about 9 months. Right now he is taking 500mg with some magnesium before breakfast and 1000mg + magnesium with lunch.

@mostlylurking thank you for the thiamine SIBO connection. My husband has SIBO too.

 

[Brooks Esq.]

I'm trying to do my homework before starting my SIBO treatment, I've been struggling with it for 9 years already and now I'm making another attempt to strike it. I've tried a lot of natural antibiotics throughout these years with no success, so now I decided to go with Rifaximin. I went with course of Rifaximin I think in 2013, so in the begging of my journey,, and I remember the week I was taking it I felt very well with literally no symptoms. After stopping it immediately my symptoms went back, but I was still eating back then all the food, which, I'm convinced, had gave me a SIBO in first place, i.e. all the grains, starch etc. Also I think the dosage was too little.
So now I have 140 tablets of Xifaxan 200mg, so I could do for example 2-weeks course with 2000mg daily. I know approach here is rather to take antibiotics in shorter courses with smaller dosage, but I think stubborn SIBO is the case where going all the way up might not be unreasonable, especially as Rifaximin is considered pretty "mild".
And here's my question: I'm wondering if I should maybe add some other antibiotic for better efficacy, and if so, which one would be the most complementary to Xifaxan? My reasoning is that it would maybe target any potential dysbiosis in colon, if present, since Xifaxan allegedly operates only in small intestine; also treatment might covered broader spectrum of bacteria. Ray recommends tetracyclines and penicilin, some people reported success with amoxicillin and azithromycin, I've also heard that gentamicin and vancomycin, although highly toxic, are non-absorbable taken orally, which may be safer overall. The argument in favor of cyclines would be their anti-inflammatory character, which may plays a role assuming theory about autoimmunity of SIBO is true.
The separate question is: how to take it? Together, or one after another?
Any advice appreciated

Hello, these are very valid concerns you have. From my understanding you have a reoccurring case of SIBO even after the use of herbal remedies as well as Rifaximin. I understand your contention relating to the temporary benefit of Rifaximin which was ever so transient.

You have provided clues and I think I might have an idea for you. What your story tells me is that you have an overgrowth of a pathogenic bacteria of a specific type, perhaps one that is resistant to standard antibiotics. I will give you an example (for example only). Klebsiella is a known culprit in many SIBO cases in the United States, Klebsiella is also a very hard form of bacteria to kill. In fact, it might surprise you to know that some Pubmed studies show that Rifaximin would cause Klebsiella to multiply; exacerbating the underlying problem. It is my personal theory that cases of treatment-resistant SIBO are actually due not to slowed intestinal motility, but by the failure to adequately treat the pathogenic bacteria causing the issue. Science is unfortunately behind on this area, however.

If your doctor has ordered a hydrogen breath test for SIBO and it did in fact come back positive, the next thing I would recommend doing is talking to your doctor about ordering the GI MAP test so you might get an idea of the exact culprit. The GI MAP includes not only a measurement of the specific bacteria strains in your gut, but also a readout of the antibiotic resistance genes within those bacteria. We mentioned Klebsiella before, if that particular strain is what is in excess, then you may require some bigger guns. I would be especially careful with the antibiotics you mentioned before (i.e. gentamycin, vancomycin) as they come with a range of side effects.

Once you and your doctor have selected the correct antibiotic for you, also discuss with your doctor whether you should take S. Boulardii (which is antibiotic resistant) along with your antibiotic regimen. That way you not only kill off the bad bacteria, you also create a protective defense in your gut to prevent reoccurrence in the future.

Good luck,

Brooks

 

[Markr2d2]

I can't find that product. Curious to see what's in it. I did find a Silver Fern probiotic though?

Oh yea. thats it. It was basically three or four clinically tests strains of bacteria including s.boullardi and the a prebiotic fiber blend and some digestive enzymes.

 

[Markr2d2]

Hello, these are very valid concerns you have. From my understanding you have a reoccurring case of SIBO even after the use of herbal remedies as well as Rifaximin. I understand your contention relating to the temporary benefit of Rifaximin which was ever so transient.

You have provided clues and I think I might have an idea for you. What your story tells me is that you have an overgrowth of a pathogenic bacteria of a specific type, perhaps one that is resistant to standard antibiotics. I will give you an example (for example only). Klebsiella is a known culprit in many SIBO cases in the United States, Klebsiella is also a very hard form of bacteria to kill. In fact, it might surprise you to know that some Pubmed studies show that Rifaximin would cause Klebsiella to multiply; exacerbating the underlying problem. It is my personal theory that cases of treatment-resistant SIBO are actually due not to slowed intestinal motility, but by the failure to adequately treat the pathogenic bacteria causing the issue. Science is unfortunately behind on this area, however.

If your doctor has ordered a hydrogen breath test for SIBO and it did in fact come back positive, the next thing I would recommend doing is talking to your doctor about ordering the GI MAP test so you might get an idea of the exact culprit. The GI MAP includes not only a measurement of the specific bacteria strains in your gut, but also a readout of the antibiotic resistance genes within those bacteria. We mentioned Klebsiella before, if that particular strain is what is in excess, then you may require some bigger guns. I would be especially careful with the antibiotics you mentioned before (i.e. gentamycin, vancomycin) as they come with a range of side effects.

Once you and your doctor have selected the correct antibiotic for you, also discuss with your doctor whether you should take S. Boulardii (which is antibiotic resistant) along with your antibiotic regimen. That way you not only kill off the bad bacteria, you also create a protective defense in your gut to prevent reoccurrence in the future.

Good luck,

Brooks

Do you have any thoughts on if it is klebseilla? Because it just so happens that i have an overgrowth of klebseilla and also diagnosed with anklosing apodylitus.

 

[WonMore]

What is the reasoning behind the expectation that nuking the gut microbiome will produce good results without replenishing it with things that are known to have beneficial characteristics? There is no such thing as a sterile gut, impossible to achieve, so relying on gut carpet bombing alone may provide temporary benefits, but maybe not an enduring self-sustaining gut symbiosis.

I don't believe we know enough about gut ecology to engineering it effectively anyhow. All of the attempts seem to be hit or miss. I eat greek yogurt, thinking about phages also, apart from that honestly I don't know what may work and don't provide adverse effects.

Good luck, i have been dealing with sibo for quite awhile. I was unable to get my doc to prescribe rifaxamin so intried a combo of cipro and flaygl with ultimately no long term success. I did find take a decent amount of caprylic acid daily helps a lot with symptoms as well as a zero starch/fiber diet of course. About the only fibers i eat come from apple sauce (skinless) and cocoa. High sat fat in general seems to help. I do worry about the lack of fiber feeding the bacteria that make butyrate but not enough to actually eat fiber. I did try a probiotic/prebiotic protocol from red fern and it made things exponentially worse so i dont think that is the answer.

Ray in podcast Jodellefit listed butyrate in one line with lactic acid. I don't think he perceive SCFA as overall positive and it would be in line with the SIBO experience, you might want to check this (it starts somewhere in about 31 minute, but the whole episode is worth listening):

I lived through at least 20 years with SIBO, IBS, leaky gut, and strong gluten sensitivity. I alternated with constipation/diarrhea. High dose thiamine (2 grams/day) has "cured" me. I'm using quotation marks because I'm pretty sure if I stop the thiamine regimen my symptoms will return. Thiamine deficiency/functional thiamine blockage damages the autonomic nervous system including the nerves that make the gut work; moving food along the digestive tract and properly applying digestive enzymes. If the food is not moving along, bacteria population explodes. There is a strong correlation between gut disbiosis and Parkinson's Disease. Many Parkinson's Disease patients have a history of gut disbiosis. Both issues are resolved with high dose thiamine. HDT Therapy

I do not understand the numbers you supplied for TSH. The goal is for TSH to be under 1. Is the energy you feel metabolic energy working properly or is the energy you experience from stress hormones (adrenaline)?

If you will keep a diary of your temperature and pulse you will have a better understanding of your situation. You may find this download helpful: http://sozocomplete.com/assets/files/Thyroid Basal Temperature and Resting Pulse Test copy.pdf I've found that digital thermometers are not reliable; the glass/mercury thermometers work if you can find one.

You may find Elliot Overton's youtube channel helpful: https://www.youtube.com/channel/UCFqXidfUsI0vm73xsBMIQdQ TTFD has more side effects than thiamine hcl. I chose to stick with thiamine hcl because TTFD gave me a headache. the hcl has poorer absorption in the gut so the dose is a lot higher.

Here's a link to a search on PubMed: gastrointestinal beriberi - Search Results - PubMed

Now you've got my interest, there's so few cases of anybody reporting to somehow managed SIBO that I will definitely check it all out, I've started already. Two questions straightaway if I may, until I wrap my head around it:
1. How long have you been suplementing and no symptoms?
2. Is serum level of B1 any reliable indicator of deficiency? Is it worth to check it?
Yes, I know it's strange, I had barely noticeable TSH level eating less to no carb and now it's over 8, so too much. Doctor was shocked, she never saw anything like this in her life, haha. Anyway, it's hard for me to differentiate where this energy is coming from, only explanation for now that I came up with is that I actually was constantly in high adrenaline state before (I had prolonged period with very high stress in my life), which perhaps masked my underlying thyroid issue (if it's physiologically possible at all) and only now, after some changes, it's seen in the labs.
I don't trust digital thermometers either, that's why I haven't started monitoring it yet. I'm from Poland and here's mercury thermometers are banned, so I have to do some gimnastics to get one.

Hello, these are very valid concerns you have. From my understanding you have a reoccurring case of SIBO even after the use of herbal remedies as well as Rifaximin. I understand your contention relating to the temporary benefit of Rifaximin which was ever so transient.

You have provided clues and I think I might have an idea for you. What your story tells me is that you have an overgrowth of a pathogenic bacteria of a specific type, perhaps one that is resistant to standard antibiotics. I will give you an example (for example only). Klebsiella is a known culprit in many SIBO cases in the United States, Klebsiella is also a very hard form of bacteria to kill. In fact, it might surprise you to know that some Pubmed studies show that Rifaximin would cause Klebsiella to multiply; exacerbating the underlying problem. It is my personal theory that cases of treatment-resistant SIBO are actually due not to slowed intestinal motility, but by the failure to adequately treat the pathogenic bacteria causing the issue. Science is unfortunately behind on this area, however.

If your doctor has ordered a hydrogen breath test for SIBO and it did in fact come back positive, the next thing I would recommend doing is talking to your doctor about ordering the GI MAP test so you might get an idea of the exact culprit. The GI MAP includes not only a measurement of the specific bacteria strains in your gut, but also a readout of the antibiotic resistance genes within those bacteria. We mentioned Klebsiella before, if that particular strain is what is in excess, then you may require some bigger guns. I would be especially careful with the antibiotics you mentioned before (i.e. gentamycin, vancomycin) as they come with a range of side effects.

Once you and your doctor have selected the correct antibiotic for you, also discuss with your doctor whether you should take S. Boulardii (which is antibiotic resistant) along with your antibiotic regimen. That way you not only kill off the bad bacteria, you also create a protective defense in your gut to prevent reoccurrence in the future.

Good luck,

Brooks

I never had breathe test as it always struck me as inconclusive, also my symptoms fits perfectly with SIBO and reaction to Xifaxan back then as well. Similar with detailed stool test, there's concerns about if it is at all representative for cultures in small intestine or just for colon. I didn't know though that there's antibiogram performed within it, if so then indeed it might be worth to look at it.
Tried S. Boulardii when I was trying some natural agent, not noticing much difference. But I still got some of it with valid date, I'll try it with my current regimen. Thinking also about phages.

 

[Perry Staltic]

Oh yea. thats it. It was basically three or four clinically tests strains of bacteria including s.boullardi and the a prebiotic fiber blend and some digestive enzymes.

IMO three in that product (clausi, coagulens, subtilis) are really good because they are L-lactate producers. I haven't formed an opinion yet on S. boulardii, but Pediococcus acidilactici, which I've never heard of, would give me reason for concern. Under anaerobic conditions it converts L-lactate to D-lactate, which in my mind is worse than a probiotic that produces D-lactate. D-lactate is neurotoxic and hard to metabolize, so conceivably it can accumulate causing problems. L-lactate is easily metabolized.

 

[TheBeard]

Here are the antibiotics that are widely available, relatively side effects free, and cover a broad spectrum of bacteria:

Augmentin (amox + clav)
Azithromycin
Rifaximin

@Markr2d2 you don't need to wait for a doctor's prescription, Xifaxan is widely available online:
Farmacias del niño
Tiromel.cc

 

[mostlylurking]

I have been using Dr Costantini's protocol for my husband who has Parkinson's symptoms. He uses Dr Clark's brand Thiamine HCl and my understanding is that Dr Costantini recommended taking it just before or after a meal. We have been working on his dose for about 9 months. Right now he is taking 500mg with some magnesium before breakfast and 1000mg + magnesium with lunch.

@mostlylurking thank you for the thiamine SIBO connection. My husband has SIBO too.

You're welcome.

Because Dr. Costantini pointed out to NOT take the thiamine in juice or add lemon juice to it and to just dissolve it in water I got the impression that it would be a good idea to space my orange juice and other carbs a short distance away (minimum 15 minutes). I wait until 3:00pm to take my second dose because I have had a lot of symptoms at night. But now that I think about it, I think that those symptoms (inflammatory pain) have improved.

I found this article written by Dr. Costantini to be very helpful:

https://www.liebertpub.com/doi/full/10.1089/acm.2011.0840

snippets:
"Objectives: To demonstrate that fatigue and other disorders related to ulcerative colitis and Crohn's disease are the manifestation of an intracellular mild thiamine deficiency and not due to malabsorbtion, augmented requirements, or nutritional factors, and that this dysfunction is curable with high doses of thiamine administered orally or parenterally."

"The dosage was defined empirically for this study as follows: first administration was 600 mg/day for each patient. Every two days, there was a consultation with the patient to assess the therapy. In those cases in which the regression of the fatigue was not satisfactory, an increment of 300 mg/day of thiamine was prescribed in addition to the 600 mg/day.

This last step—consultation with the medical doctor regarding the condition of the patient—has been the most important calibration tool for this research. Patients weighing 60 kg responded to the therapy at doses of 600 mg/day. Proportionally, patients weighing 60+ kg responded to the therapy accordingly to higher doses (up to 1,500 mg/day for patients weighting 90 kg). In general, this is the rationale for the following dosage calibration used in this study."

Female patients:

Patients weighing <60 kg→10 mg/kg/day of thiamine

60–65 kg→14 mg/kg/day of thiamine

65–70 kg→17 mg/kg/day of thiamine

70–75 kg→20 mg/kg/day of thiamine

75–80 kg→23 mg/kg/day of thiamine

For male patients, the doses need to be increased by one-third compared to females:

Patients weighing <60 kg→14 mg/kg/day of thiamine

60–65 kg→18 mg/kg/day of thiamine

65–70 kg→23 mg/kg/day of thiamine

70–75 kg→30 mg/kg/day of thiamine

75–80 kg→35 mg/kg/day of thiamine

For patients whose weight is higher than 80 kg, our team suggests switching to an intramuscular therapy with one 100 mg/ml vial every 7 to 10 days. This is due to patients' reluctance to ingest the large number of pills necessary for those weighing more than 80 kg."

 

[Brooks Esq.]

Do you have any thoughts on if it is klebseilla? Because it just so happens that i have an overgrowth of klebseilla and also diagnosed with anklosing apodylitus.

Hello, what method did you use to determine you had an overgrowth of Klebsiella? and there is a correlation between Ankylosing Spondylitis and Klebsiella overgrowth. I have to admit, although there are many of the naturopathic doctors out there that claim to treat these types of infections with herbal remedies, however, I am skeptical of these claims. Klebsiella is highly resistant to almost every oral antibiotic out there with the exception of a few, and it is having rapid resistance to several heavy IV antibiotics as well. I am skeptical that an herbal remedy would suffice. Especially in your case where you have the Spondylitis which tells me it is a deep-seated infection.

In your case, I would discourage the use of herbal remedies as I think you may kill off only the weaker bacteria leaving only the strongest bacteria to repopulate inside you. Pubmed studies on this topic are usually not reliable sources if they are a few years old as this strain rapidly multiplies. Here is the Statpearls Pubmed page for Klebsiella Pneumonia:

Ashurst JV, Dawson A. Klebsiella Pneumonia. [Updated 2021 Feb 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: Klebsiella Pneumonia - StatPearls - NCBI Bookshelf

I would take S. Boulardii during antibiotic treatment (to prevent C. Diff and to act as a protective barrier to prevent reoccurrence of the underlying Klebsiella infection). If you are bent on trying natural stuff for your deep-seated infection, here are some links:

Klebsiella pneumoniae – prevention and treatment | FX Medicine

Increasingly, some strains of Klebsiella pneumoniae have developed resistance to certain classes of antibiotics such as carbapenems, by acquiring a gene mutation that helps them to produce an enzyme that creates a resistance to the strongest of antibiotics.

www.fxmedicine.com.au

Upper Gut Dysbiosis: Is Ammonia the Cause?

When someone is suffering from dysbiosis, imbalances within the body can easily occur and make people ill. Ammonia is one such imbalance.

www.fixyourgut.com

 

[Brooks Esq.]

I don't believe we know enough about gut ecology to engineering it effectively anyhow. All of the attempts seem to be hit or miss. I eat greek yogurt, thinking about phages also, apart from that honestly I don't know what may work and don't provide adverse effects.


Ray in podcast Jodellefit listed butyrate in one line with lactic acid. I don't think he perceive SCFA as overall positive and it would be in line with the SIBO experience, you might want to check this (it starts somewhere in about 31 minute, but the whole episode is worth listening):



Now you've got my interest, there's so few cases of anybody reporting to somehow managed SIBO that I will definitely check it all out, I've started already. Two questions straightaway if I may, until I wrap my head around it:
1. How long have you been suplementing and no symptoms?
2. Is serum level of B1 any reliable indicator of deficiency? Is it worth to check it?
Yes, I know it's strange, I had barely noticeable TSH level eating less to no carb and now it's over 8, so too much. Doctor was shocked, she never saw anything like this in her life, haha. Anyway, it's hard for me to differentiate where this energy is coming from, only explanation for now that I came up with is that I actually was constantly in high adrenaline state before (I had prolonged period with very high stress in my life), which perhaps masked my underlying thyroid issue (if it's physiologically possible at all) and only now, after some changes, it's seen in the labs.
I don't trust digital thermometers either, that's why I haven't started monitoring it yet. I'm from Poland and here's mercury thermometers are banned, so I have to do some gimnastics to get one.


I never had breathe test as it always struck me as inconclusive, also my symptoms fits perfectly with SIBO and reaction to Xifaxan back then as well. Similar with detailed stool test, there's concerns about if it is at all representative for cultures in small intestine or just for colon. I didn't know though that there's antibiogram performed within it, if so then indeed it might be worth to look at it.
Tried S. Boulardii when I was trying some natural agent, not noticing much difference. But I still got some of it with valid date, I'll try it with my current regimen. Thinking also about phages.

There are other ailments other than SIBO that cause SIBO-like symptoms (i.e. SIFO) which is why I ask. And S. Boulardii is more of an add-on to an antibiotic than a treatment in and of itself. I doubt it would do anything for SIBO on its own. And the GI MAP is probably one of the best stool tests out there as it uses dna analysis and is proposed to be one of the most accurate, although I cannot find much on Pubmed validating this claim. If I were you, I would want to get an idea of what I was dealing with exactly, like I said, each strain is treated differently.