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SIBO - another antibiotic along with Rifaximin

Brooks Esq.

Member
Joined
Oct 26, 2016
Messages
97
Location
Delaware
My life went downhill because of K.pneumonae.

It went back uphill thanks to this combo.
I am happy it worked for you and that you did not have an extreme reaction to such a multitude of antibiotics all at once. How long ago did you complete this treatment and did you do a follow up stool panel to see if the treatment worked?
 
T

TheBeard

Guest
I am happy it worked for you and that you did not have an extreme reaction to such a multitude of antibiotics all at once. How long ago did you complete this treatment and did you do a follow up stool panel to see if the treatment worked?

The only proof I need to see if it worked is how good I feel.
I didn't "complete" the treatment, it's a combo you have to periodically keep taking.
 

Sam321

Member
Joined
Jan 27, 2021
Messages
652
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
Pairing with neomycin seems to be good for hydrogen/methane sibo.
 

Motif

Member
Joined
Nov 24, 2017
Messages
2,757
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
Success meanwhile ?
 

WonMore

Member
Thread starter
Joined
Mar 27, 2021
Messages
28
Yes I shall update, I waited for some groundbreaking success, but really nothing like that had happened, at least not digestive-wise. I dived deeply into Peat's stuff last months and if I think I repaired my metabolism back which I had managed to **** up previously trying to heal my guts (by fasting, keto etc.), but still stuck with SIBO altough I feel like I already have thrown everything but kitchen sink at it. Maybe I'm too impatient with things, but I suppose that at least for immediate dysbiosis something should help right away, like Xifaxan back then. Xifaxan no longer works, as well as other antibiotics I've tried. I'm now experimenting with low dose azithromycin, to stimulate migrating motor complex. By fixing my thyroid (I went down from TSH 22 microIU/ml, but who knows how high it acutally was, so I was massively hypothryoid, but no wonder when I had done 20-days water fast...) I have some additional resources for fighting, but long term I'm really tired of all this and start to losing hope, there seems to be no way out. I think I stopped shredding, at least it looks like that so far. Ox Bile seems to help with symptoms, so maybe I have some issues with gallbladder or liver. I feel well right now, except these damn intestinal problems (and metnal as a result)
 

Vins7

Member
Joined
Feb 23, 2020
Messages
743
Yes I shall update, I waited for some groundbreaking success, but really nothing like that had happened, at least not digestive-wise. I dived deeply into Peat's stuff last months and if I think I repaired my metabolism back which I had managed to **** up previously trying to heal my guts (by fasting, keto etc.), but still stuck with SIBO altough I feel like I already have thrown everything but kitchen sink at it. Maybe I'm too impatient with things, but I suppose that at least for immediate dysbiosis something should help right away, like Xifaxan back then. Xifaxan no longer works, as well as other antibiotics I've tried. I'm now experimenting with low dose azithromycin, to stimulate migrating motor complex. By fixing my thyroid (I went down from TSH 22 microIU/ml, but who knows how high it acutally was, so I was massively hypothryoid, but no wonder when I had done 20-days water fast...) I have some additional resources for fighting, but long term I'm really tired of all this and start to losing hope, there seems to be no way out. I think I stopped shredding, at least it looks like that so far. Ox Bile seems to help with symptoms, so maybe I have some issues with gallbladder or liver. I feel well right now, except these damn intestinal problems (and metnal as a result)
I'm on the same path as you I have recently paid for a metagenomic microbiota analysis and a nutritional consultation with an expert to interpret the analysis and prescribe a treatment (500€ all).

I don't know if it will really help, but just like you I have been restricting food for periods of time, or restricting calories or forcing myself to fast without much success.

Changes that have made some improvement in digestion mean a worsening of metabolism and energy level ...
 

Vins7

Member
Joined
Feb 23, 2020
Messages
743
Yes I shall update, I waited for some groundbreaking success, but really nothing like that had happened, at least not digestive-wise. I dived deeply into Peat's stuff last months and if I think I repaired my metabolism back which I had managed to **** up previously trying to heal my guts (by fasting, keto etc.), but still stuck with SIBO altough I feel like I already have thrown everything but kitchen sink at it. Maybe I'm too impatient with things, but I suppose that at least for immediate dysbiosis something should help right away, like Xifaxan back then. Xifaxan no longer works, as well as other antibiotics I've tried. I'm now experimenting with low dose azithromycin, to stimulate migrating motor complex. By fixing my thyroid (I went down from TSH 22 microIU/ml, but who knows how high it acutally was, so I was massively hypothryoid, but no wonder when I had done 20-days water fast...) I have some additional resources for fighting, but long term I'm really tired of all this and start to losing hope, there seems to be no way out. I think I stopped shredding, at least it looks like that so far. Ox Bile seems to help with symptoms, so maybe I have some issues with gallbladder or liver. I feel well right now, except these damn intestinal problems (and metnal as a result)
Have you read the information about B1 and sibo that some people is sharing here? Sorry I dont know if your sibo was causes by an dangerous antibiotic cycle or not...
 

WonMore

Member
Thread starter
Joined
Mar 27, 2021
Messages
28
I'm on the same path as you I have recently paid for a metagenomic microbiota analysis and a nutritional consultation with an expert to interpret the analysis and prescribe a treatment (500€ all).

I don't know if it will really help, but just like you I have been restricting food for periods of time, or restricting calories or forcing myself to fast without much success.

Changes that have made some improvement in digestion mean a worsening of metabolism and energy level ...
Have the test and nutritionist showed you something promising?
I managed to get my SIBO under control in the past for at least a few months (to the point I only had symptoms when I stuffed myself with something I shouldn't), when I also was eating more keto-ish, I don't know if it subsided just with time, or I did something specific (because I also was doing a lot of things at the time), but I caught some food poisoning and it all went back to square one.
Have you read the information about B1 and sibo that some people is sharing here? Sorry I dont know if your sibo was causes by an dangerous antibiotic cycle or not...
Yes, actually B1 was one of the few things that had any effect on me whatsoever: when I started taking it, for a few days I felt euphoric boost. This effect no longer appears, and I haven't seen any improvement in digestion, but I only went up to a few hundred miligrams and not as long as a few months, maybe I need more. I've got "D" type rather than "C" type, so I'm taking about 500mg a day niacinamide, which is also mentioned here in this context, but it haven't cured me.
I'm sure I took metronidazol as a teenager, but I don't think it's direct cause of my SIBO, maybe it's contributor. In the first place it was eating according to food pyramid, a lot of grains and starchy foods.
 

Birdie

Member
Joined
Aug 10, 2012
Messages
4,694
Location
USA
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:
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."
An update: My husband asked to increase his thiamine dose. It's been a 2000mg for a while now. So, he is taking 1000 before breakfast (on arising). Then he upped his later dose to 1500mg after lunch (30 minutes after approximately).

I'd been thinking that's a lot for a 123lb male, however I hadn't taken into account that his grandparents came over to the US from an area nearer Italy where the dose needed is higher. I'd forgotten about that until I was reading your comments today. Thank you.

At any rate, he's been on 2500mg for a couple of weeks with some improvement, and no symptoms of overdose.

I am re-reading what everyone said on this thread.
Thank you @WonMore for starting such an excellent thread.
 

mostlylurking

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Joined
May 13, 2015
Messages
1,591
Location
Texas
An update: My husband just asked to increase his dose. It's been a 2000mg for a while now. So, he is taking 1000 before breakfast (on arising). Then he upped his later dose to 1500mg after lunch (30 minutes after approximately).

I'd been thinking that's a lot for a 123lb male, however I hadn't taken into account that his grandparents came over to the US from an area nearer Italy where the dose needed is higher. I'd forgotten about that until I was reading your comments today. Thank you.

At any rate, he's been on 2500mg for a couple of weeks with some improvement, and no symptoms of overdose.

I am re-reading what everyone said on this thread.
Thank you @WonMore for starting such an excellent thread.
You may have found a key re. the family origin/genetics! It does seem like a lot for his weight, but if you see improvement and no side effects then it seems to be the right thing to do. Great news!
 

Birdie

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Aug 10, 2012
Messages
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Location
USA
You may have found a key re. the family origin/genetics! It does seem like a lot for his weight, but if you see improvement and no side effects then it seems to be the right thing to do. Great news!
Thank you and so far so good.
 

Birdie

Member
Joined
Aug 10, 2012
Messages
4,694
Location
USA
Update: Husband is still taking 1000mg thiamine HCl on arising and 1500mg after lunch with good results. And he continues the 50mg of lipothiamine (TTFD) at bedtime which he feels helps his sleep.
 

James b

Member
Joined
May 10, 2018
Messages
2,146
B1 before bed I'm sure would keep me awake. I'm surprised it helps with sleep?
 

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