Gut Health

Gut Health

Gut-Brain Axis: How Nervous System Dysregulation Fuels SIBO Symptoms

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Ever feel like your gut just didn't get the memo?

You're eating clean, avoiding gluten and dairy like the plague, and popping the "right" supplements… you even went through an elimination protocol, but you're still bloated, gassy, or running to the bathroom (or worse—not going at all).

Maybe you've been diagnosed with SIBO (Small Intestinal Bacterial Overgrowth) or IBS (Irritable Bowel Syndrome). Maybe your food sensitivities are multiplying faster than you can say "elimination diet."

Here's the truth no one talks about enough:

It's not just about what you eat. It's about how your body and your nervous system feel when you eat.

That's right. The state of your nervous system could be the reason your gut hasn't fully healed, no matter how many gut protocols, probiotics, or low-FODMAP recipes you've tried.

In this blog post, I'm going to dive deep into the gut-brain connection, how nervous system dysregulation fuels gut dysfunction, and the often-overlooked role of the vagus nerve in digestive health. Most importantly, you'll learn what you can do about it—starting today.

Affiliate Disclaimer:

This blog post contains affiliate links to products and services, such as the Primal Trust Academy. If you click on these links and make a purchase, I may receive a small commission at no extra cost to you. This helps support my website and allows me to continue providing valuable content. I only recommend products and services that I believe will be helpful to my readers.

gut-brain axis - nervous system support for SIBO

The gut-brain axis

Imagine your gut and brain as two best friends texting each other all day long. That constant stream of messages—about hunger, stress, emotions, and immune responses—is called the gut-brain axis. And the phone line they use? That would be your vagus nerve.

The vagus nerve is like your body's internal Wi-Fi network—an information superhighway that connects your brainstem to your heart, lungs, and digestive tract. It tells your stomach to release acid, your intestines to move food along, and your immune system to stay calm.

Here's the kicker: This communication is bi-directional. That means…

  • A stressed-out brain can send danger signals to the gut, slowing digestion and triggering inflammation.
  • And a troubled gut—say, with dysbiosis (imbalance between the beneficial and pathogenic gut flora), SIBO, or leaky gut—can send distress signals back to the brain, contributing to anxiety, brain fog, and mood swings.

This is why you can't "out-supplement" or "out-diet" chronic gut issues if your nervous system is stuck in fight-or-flight mode. Healing your gut starts with helping your body feel safe.

What really happens when you're stuck in survival mode

Let's take a moment to talk about stress, not just the obvious kind like deadlines or family drama, but the sneaky, chronic type your body may have normalized over the years.

  • Emotional stress (e.g., work pressure, grief)
  • Past trauma (e.g., violence, accidents)
  • Chronic illness (e.g., autoimmune diseases, infections)
  • Physiological stress (e.g., nutrient deficiencies, over-exercising, undereating, physical injury)
  • Environmental stress (e.g., noise, pollution, mold exposure)

They all keep your body in a sympathetic state, or "fight or flight." When you're in that mode, digestion is the last thing your body wants to deal with.

Think about it: if a lion is chasing you, your body doesn't care about digesting your kale salad—it wants to run.

Here's what stress does to your digestion

Slows gut motility:

When you're calm and relaxed, your digestive system creates rhythmic contractions called the migrating motor complex (MMC) that get activated between meals in a fasted state. Think of it like a gentle wave that sweeps through your intestines, keeping things moving and clean.

But under chronic stress, these contractions slow down—or stop altogether. Food lingers too long in the small intestine, giving bacteria time to ferment it and multiply where they shouldn't be. That's how Small Intestinal Bacterial Overgrowth (SIBO) starts.

Lowers stomach acid & digestive enzyme output:

Stress diverts your body's energy to muscles (for fighting or fleeing), not digestion. One of the first casualties? Stomach acid and digestive enzymes.

Without enough stomach acid:

  • Food doesn't break down properly.
  • Proteins ferment instead of digesting—leading to bloating, gas, and discomfort.
  • You can't absorb essential nutrients like vitamin B12, iron, magnesium, and zinc.
  • And you lose your body's natural first line of defense against harmful microbes.

Low enzymes = poor breakdown of carbs, fats, and proteins → indigestion and malabsorption. And guess who loves leftover, undigested food? Yep, bad gut bugs.

Weakens the gut lining:

Your gut lining is like a finely tuned security system, only allowing in nutrients and keeping out unwanted intruders. But when you're in a constant state of stress, the tight junctions in your gut wall loosen. This condition is known as intestinal permeability or leaky gut.

What slips through? Undigested food particles, toxins, and pathogens. Your immune system sees these as threats and mounts an inflammatory response, leading to:

This is the reason why people under stress suddenly "react" to foods they've eaten for years.

Disrupts the gut microbiome:

Your microbiome—the trillions of bacteria living in your gut—is incredibly sensitive to stress. Under normal conditions, beneficial bacteria help regulate digestion, mood, and immunity.

But stress is like a natural disaster in the gut:

  • It kills off beneficial strains of Lactobacillus and Bifidobacteria
  • It allows opportunistic pathogens (like Candida, H. pylori, or certain Clostridium species) to take over
  • It increases gut pH, which changes the environment and allows the "bad gut bugs" to thrive

The result? More bloating, poor nutrient absorption, and increased inflammation. Plus, an imbalanced microbiome means your gut can't support hormone detox or healthy neurotransmitter production.

Dysregulates neurotransmitters:

You've probably heard that your gut is your "second brain"—and it's true. Your gut bacteria help produce critical neurotransmitters, like:

  • Serotonin (mood stabilizer and feel-good hormone—90% is made in the gut!)
  • Dopamine (motivation and reward)
  • GABA (calm, anti-anxiety)

When your gut is inflamed or out of balance, the production of these chemical messengers drops. That's why so many people with digestive issues also struggle with:

  • Anxiety
  • Depression
  • Brain fog
  • Sleep issues
  • Emotional ups and downs

It's not "just in your head"—it's happening in your gut-brain axis.

The Vagus nerve: your digestive system's on/off switch

Think of your vagus nerve as the thermostat of your nervous system. It helps you shift from fight-or-flight (sympathetic) into rest-and-digest (parasympathetic). If your vagus nerve isn't working properly—what we call low vagal tone—you'll struggle to stay in that rest-and-digest state long enough for healing to happen.

Low vagal tone can lead to:

  • Bloating and gas
  • Constipation or diarrhea
  • Slow gastric emptying
  • SIBO relapses
  • GERD or acid reflux
  • Anxiety, brain fog, and insomnia
  • Histamine intolerance or MCAS symptoms
  • Poor heart rate variability (HRV)
  • Trouble swallowing or shallow breathing​​

If you've ever felt like your body is "stuck in high alert," or you can't relax no matter how tired you are, chances are your vagus nerve needs support.

Vagus nerve and SIBO

Nervous system dysregulation and SIBO

SIBO (Small Intestinal Bacterial Overgrowth) happens when bacteria that should stay in the large intestine start growing in the small intestine. Since the small intestine is designed for nutrient absorption—not fermentation—this overgrowth can cause major digestive issues.

Common SIBO symptoms:

  • Bloating (especially after eating)
  • Gas and distension
  • Diarrhea, constipation, or both
  • Nutrient deficiencies (B12, iron, fat-soluble vitamins)
  • Abdominal pain and discomfort
  • Brain fog and fatigue
  • Muscle and joint pain
  • Skin issues (eczema, rosacea, acne)

SIBO isn't just about bacteria. It's about what allowed those bacteria to overgrow in the first place.

And one of the biggest root causes? Impaired gut motility, which is often driven by a dysregulated nervous system.

When you're stuck in sympathetic dominance:

  • Your migrating motor complex (MMC)—the "housekeeping wave" that cleans your small intestine—doesn't work properly.
  • Your body underproduces digestive juices, leading to poorly digested food that ferments and feeds the wrong bugs.
  • You lose natural antibacterial defenses like stomach acid and bile.

So, yes—herbs, antimicrobials, antibiotics, and diets can help temporarily. But if you want lasting SIBO relief? You have to support your nervous system and vagal tone.

How to heal the nervous system-gut axis naturally

The best part? You don't need a fancy device or endless supplements to start improving your nervous system health.

Here's what I recommend to my gut clients:

Vagus nerve activation techniques

These help shift your body into parasympathetic mode (rest-and-digest):

  • Deep belly breathing (especially 4-7-8 breathing before meals)
  • Gargling or humming—stimulates throat muscles linked to the vagus nerve
  • Cold exposure (like splashing your face with cold water)
  • Singing or chanting (yes, it works!)
  • Meditation and loving-kindness practices
  • Yoga and tai chi—especially poses like legs up the wall

Somatic & mind-body healing

You can't "think" your way out of chronic stress. You have to feel your way out. These help discharge stored stress from the body:

  • Somatic tracking and interoception (noticing internal sensations)
  • EFT tapping (Emotional Freedom Techniques)
  • TRE (tension and trauma release exercises)
  • Grounding and time in nature
  • Co-regulation with others (safe connection is healing)

Brain retraining & nervous system programs

If your symptoms are deeply entrenched, consider working with structured programs like:

  • Nerva App – a gut-directed hypnotherapy program clinically proven for IBS/SIBO relief
  • The Gupta Program – rewires limbic and vagus nerve dysfunction
  • Primal Trust™ – blends somatics, trauma work, and nervous system education for deep healing​​

I am currently participating in the Primal Trust program, learning to regulate my nervous system better, process and release stored emotions, and ultimately cultivate a sense of peace and resilience in my life. This is also something I regularly recommend to my clients.

Primal Trust Academy offers a comprehensive approach to help individuals release stuck emotions and regulate their nervous systems. This can be particularly beneficial for those dealing with the long-term effects of trauma.

Here's how the academy can support you:

  • Somatic practices: Techniques that focus on body awareness and movement to release stored tension and emotions.
  • Mind-body integration: Programs that integrate mindfulness, meditation, and breathing exercises to calm the nervous system.
  • Emotional processing: Guided exercises to help recognize, process, and release trapped emotions.
  • Community support: Access to a supportive community where you can share experiences and gain insights from others on a similar journey.
Check out the Primal Trust Academy

Nervous system-supporting eating tips

  • Eat in a calm, seated environment. No phones, no rushing.
  • Take 3–5 deep breaths before each meal.
  • Chew your food thoroughly (20–30 times per bite!).
  • Don't eat in fight-or-flight—go for a quick walk or breathwork break if needed.
  • Don't under-eat—undereating = a major stressor for the nervous system.

You're not broken—your body's just trying to protect you

Let me remind you of something important:

If your body is stuck in stress mode, it's not because you've failed.

It's because your body is trying to protect you.

Maybe from trauma. Maybe from overexertion. Maybe from years of ignoring symptoms because life demanded it.

But guess what? You can teach it something new. You can help it feel safe. You can restore trust between your brain and your gut.

Healing your gut means healing all of you.

If you're tired of the food fears, bloating, and constant worry over what's going to trigger your next flare, know this:

Healing your gut isn't just about food. It's about feeling safe in your body.

Healing starts with the nervous system.

So next time you're tempted to add another supplement or cut another food, pause and ask yourself:

  • Am I actually feeling safe and calm when I eat?
  • Is my nervous system supported in this healing process?

Because once your body feels safe, everything else—digestion, hormones, energy, mood—starts to fall into place.

 

 

Disclaimer: 

The information provided on this site is for educational purposes only, is not intended as medical advice, and does not claim to diagnose, heal, treat, or cure any conditions Always consult with a healthcare professional before starting any dietary regimen, supplement, or lifestyle changes, especially if you have underlying health conditions or are taking medication. 

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3 reasons why you have constant bloating: SIBO and more

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Bloating is a discomforting and often embarrassing symptom frequently attributed to overeating or diet. However, the causes of bloating can be much more intricate, primarily when related to Small Intestinal Bacterial Overgrowth (SIBO) and other chronic gut issues. Today, I'll explore the phenomenon of bloating, common triggers, and potential root causes behind this symptom. I'll also share some short-term solutions to manage bloating symptoms effectively.

Understanding bloating: what's the norm and the exception

Bloating is a sensation of fullness or swelling in the abdomen that may be accompanied by increased flatulence (gas). It's an uncomfortable feeling and a struggle when you have a pregnant belly look and your jeans feel tight around your belly. You may feel discomfort from trapped gas in your abdomen that can't leave your body, sometimes contributing to abdominal pain.

It's essential to differentiate between occasional, normal bloating and chronic bloating, which might indicate underlying health issues.

normal vs chronic bloating

You might occasionally experience bloating after a hearty meal or consuming gas-inducing foods like beans, cauliflower, or too many raw vegetables in one sitting. Bloating is almost guaranteed if you overeat, don't chew your food thoroughly, or drink carbonated drinks with your meal. These could be normal if bloating resolves on its own and subsides within a few hours or maybe a day.

However, suppose you're constantly feeling bloated even during fasting periods or after every single meal or your bloating is accompanied by other symptoms like nausea or changed bowel movements interfering with your daily activities. In that case, it's not normal and needs to be investigated.

Triggers for bloating

While diet and eating habits are often blamed for bloating and gas, these factors might not be the only primary culprits in chronic bloating cases. For instance, overeating, consuming fatty foods, or drinking fizzy beverages are known triggers for bloating. However, these factors generally cause temporary discomfort.

Continual bloating symptoms often indicate underlying health issues. Stress, anxiety, and lack of physical activity are frequently blamed, but these usually exacerbate the existing problem rather than cause it directly.

Three reasons behind constant bloating: a deeper dive

Several functional reasons could contribute to chronic bloating. Here are some of the main ones:

Insufficient digestive juices

Several glands in the digestive system secrete digestive juices to aid in digestion. These juices contain enzymes that help break down food into smaller parts and different nutrients. The organs that release digestive juices include the salivary glands, stomach, liver/gallbladder, pancreas, and small intestine. (1) These digestive juices also serve as your body's natural defense barrier against infections.

Here is a short overview of some of the digestive juices, their functions, and possible issues:

Salivary glands

Digestion starts in the mouth. When you take a bite of food, enzymes in your saliva, called amylase, start breaking down carbohydrates. Poor oral health, including gum disease, cavities, and missing teeth, can disrupt this critical step, leading to less effective digestion and potential gut issues.

Stomach

Glands in the stomach lining make stomach acid and enzymes that break down food. Muscles of the stomach mix the food with these digestive juices. The stomach secretes proteases to function as the initial site of protein digestion. The stomach has a very acidic environment, with a pH ranging from 1.5 to 3.5. (2)
The higher the number goes, the more alkaline it becomes, which we don't want because an adequate level of acid is required for:

  • Protein digestion
  • Activating pepsin (enzyme)
  • Proper sphincter function (so the valve stays closed and food doesn't reflux back)
  • Stimulating other digestive juices to be released further down your digestive tract
  • Mineral absorption
  • Killing unwanted bacteria and parasites in the food (preventing SIBO or food poisoning)
  • Activating intrinsic factor that is needed for vitamin B12 absorption (3)

Stomach acid production can be negatively impacted by chronic stress (4), Helicobacter pylori infection (5), chronic inflammation, autoimmune disorders (6), and aging (acid levels decrease as we get older). (7) Proton pump inhibitors (PPIs) and antacids are commonly prescribed or purchased medications that lead to low stomach acid production. (8)

Low stomach acid, also known as hypochlorhydria, can cause a wide range of digestive symptoms (9):

  • Heartburn, nausea, acid reflux symptoms, GERD
  • Trouble digesting meat
  • Gas and bloating after eating, early fullness
  • Food allergies and intolerances
  • Nutritional deficiencies (iron, vitamin B12, Magnesium)
  • Hair loss, thinning hair, or brittle fingernails
  • Undigested food particles in the stool
  • Constipation or diarrhea
  • Skin problems, such as acne or eczema
  • Overgrowth of bacteria and yeast (Candida albicans)

Liver

The liver makes a digestive juice called bile that helps digest fats and some vitamins. Bile ducts carry bile from the liver to the gallbladder for storage between meals or to the small intestine for use when food is present.
But bile has other roles besides food digestion. It serves to maintain the intestinal environment clean with its antimicrobial properties. Bile keeps the bacteria in check and prevents them from colonizing the small intestine.
Bile also plays a vital role in removing toxins from the body. Toxins from liver detoxification processes are secreted into bile and eliminated through feces (bowel function). (10)

Stagnant or sluggish bile flow, also known as cholestasis, can be caused by various factors. Some of the causes of stagnant or sluggish bile flow can be drugs, sex hormones, bile duct obstruction (like gallstones), low-fat diet, etc. (11)

Here are some signs of poor bile flow:

  • Greasy, foul-smelling, and light-colored stools
  • Nausea
  • Bloating
  • Diarrhea or constipation
  • Vitamin deficiencies (fat-soluble)
  • Fatigue
  • Migraines
  • Skin problems such as acne or eczema
  • Jaundice
  • Mood swings
  • Liver inflammation

Pancreas

The pancreas makes digestive juice with enzymes that break down carbohydrates, fats, and proteins. The pancreas delivers the digestive juice to the small intestine for proper digestion. The main types of pancreatic enzymes include:

  • Lipase: breaks down fats into fatty acids
  • Protease: breaks down proteins into amino acids
  • Amylase: breaks down carbohydrates (starch) into sugars

Food may not be broken down properly without enough pancreatic enzymes, leading to pancreatic insufficiency or exocrine pancreatic insufficiency (EPI), producing digestive issues such as gas and bloating, feelings of fullness, abdominal pain and cramps, and diarrhea. Sometimes, insufficient pancreatic enzymes can lead to malabsorption and malnutrition. (12)

Small intestine

The small intestine makes digestive juice, which mixes with bile and pancreatic juice to complete the breakdown of proteins, carbohydrates, and fats. Bacteria in the small intestine produce some of the enzymes needed to digest carbohydrates.

If the small intestine cannot absorb the nutrients and fluids, we may talk about malabsorption syndrome. This issue may involve symptoms such as chronic diarrhea (undigested food passes through the digestive system too fast), weight loss (not being able to absorb the nutrients needed for the body), abdominal pain and bloating; pale, bulky, and smelly stools; fatigue, etc. (13)

SIBO (Small Intestinal Bacterial Overgrowth)

Another reason for chronic bloating can be Small Intestinal Bacterial Overgrowth (SIBO). SIBO is a condition when an unusually high number of bacteria grow in the small intestine, where the bacterial population should be relatively low compared to the large intestine. These bacteria in the wrong place ferment carbohydrates and produce gases, leading to bloating, flatulence, discomfort, constipation and/or diarrhea, abdominal pain, nausea, and fatigue. Still, it can also impact your skin, hormones, joints, etc. (14) You can read more about the various types of SIBO here.

But even if you are diagnosed with SIBO, it is still important to dig deeper and discover why you have SIBO. There could be a few reasons behind SIBO bloating, such as low stomach acid, gut motility issues (that hinder the movement of the gut (MMC) to sweep out remaining food particles and waste toward the colon), medications, and adhesions. Learn more about how to tackle the most common causes of SIBO.  

Imbalance in the gut microbiome community

Trillions of microbes like bacteria, viruses, and fungi live in your colon, known as the gut microbiome. The microbiome consists of microbes that are beneficial for us and those that are potentially harmful. The gut microbiome plays a crucial role in digesting food, absorbing and synthesizing nutrients, affecting the immune system, controlling brain health, influencing metabolism, and many other functions. (15)

However, certain factors can disrupt the balance between the microbes, causing digestive symptoms like bloating and gassiness, constipation and/or diarrhea, and other symptoms.

These factors may include the following:

  • Medications like antibiotics can kill both harmful and beneficial bacteria in the gut. (16) While these medications could be life-saving in several cases, they are prescribed way too often, creating a huge imbalance that may take years to restore.
  • Western diet is typically high in processed foods, sugar, and inflammatory seed oils that may feed pathogens in the gut. (17)
  • Particular lifestyle and environmental factors can also negatively impact the gut microbiome, such as chronic stress, trauma, smoking, lack of quality sleep, sedentary lifestyle, environmental toxins, etc. (18)

The consequence of an imbalanced gut microbiome community (dysbiosis) commonly results in symptoms like bloating.

6 things that harm your gut microbiome

How to test for the causes of bloating?

Identifying the root causes of bloating is vital to managing it effectively. The good news is that various diagnostic tests can help pinpoint the causes. I want to clarify two of the most popular tests that could be useful in your bloating healing journey.

SIBO Breath test

Since chronic bloating is one of the leading symptoms of SIBO, a breath test seems like a logical choice among testing options. A breath test for SIBO is a non-invasive test that measures the amount of gases produced by bacteria in the small intestine. The test can be performed at home, and it involves consuming a sugar solution (usually lactulose or glucose) and then measuring the levels of hydrogen and methane (or hydrogen sulfide) in the breath samples at specific intervals. If bacteria are abundant in the small intestine, they ferment the sugar solution by creating gases that the breath test can capture. The breath test aims to determine what type of SIBO and how much overgrowth you have because each type requires a different, tailored treatment plan. (19)

Comprehensive stool test

A comprehensive stool test is a non-invasive diagnostic assessment that can help identify imbalances in the large intestine by assessing the balance of bacteria, yeast/fungus, and other organisms present. The test measures key markers of digestion, absorption, inflammation, immune response, and intestinal function. The test can give us an excellent overview of your intestinal health and help pinpoint the causes of digestive symptoms like bloating.

Managing bloating in the short-term

While long-term solutions are essential, managing immediate bloating symptoms can significantly improve comfort.

Here are a few things you can do:

  • Try dietary changes if you have chronic bloating due to SIBO: Limiting temporarily high FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), foods can help manage symptoms related to SIBO and other digestive disorders. These foods include wheat, onions, garlic, many of cruciferous veggies, dairy products, legumes, etc.(20) Read more about the SIBO and low-FODMAP diet here. Remember that diet alone will not resolve the causes of your SIBO, and it should only be used short term.
  • For those who fight bloating regularly, opting for cooked food instead of raw foods could be a better option for digestion.
  • Practice mindful eating habits by making sure you take the time to sit at the table to eat and chew your food properly. Allowing time to consume your meal in a relaxed manner can help reduce bloating. Not to mention, slow eating can prevent overeating as well. (21)
  • Consider natural remedies like peppermint oil (avoid if you have reflux symptoms or GERD), ginger, and chamomile tea are known for their anti-bloating properties. Other herbs such as cumin, dill, parsley, and basil may be beneficial to reduce flatulence. (21)
  • A gentle exercise routine can help stimulate intestinal contractions, expel gas, and reduce bloating. Walking, yoga, Pilates, and tai chi are all great options. (22)
  • If you experience massive bloating after eating, that is also painful; activated charcoal can help bind excess gas in the intestines and reduce bloating as a quick fix. An important note with activated charcoal is to take it at least 1 hour (but rather 2 hours) away from food, medications, and supplements as it binds to not just toxins but everything else. (23)

Remember, these are temporary measures. It's essential to seek professional help if you experience chronic bloating. Unraveling the root causes of your discomfort is the key to creating a long-term, effective strategy for bloating relief.

Bloating isn't just an inconvenience; it's a signal from your body that something isn't quite right. By understanding the underlying issues, you can address bloating at its root and reclaim your comfort, health, and well-being.

 

This post is only for informational purposes and is not meant to diagnose, treat or cure any disease. I recommend always consulting your healthcare practitioner before trying any treatment or dietary changes.

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SIBO and Thyroid dysfunctions

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Gut SIBO thyroid dysfunctions hypothyroidismAre you suffering from symptoms such as fatigue, brain fog, mood swings, dry skin, slow bowel movement, and even weight gain? These could also be a sign of thyroid dysfunction. (1, 2, 3, 4, 5, 6) Your thyroid is responsible for controlling your metabolic processes. If it is under-functioning (in the case of hypothyroidism), it pushes the brake pedal and slows down the body's metabolic processes. In the case of hyperthyroidism, it pushes the gas pedal and makes the process run faster.

Even though you may have thyroid dysfunction, your thyroid-like symptoms can actually stem from your gut. On the other hand, low functioning thyroid could also be a risk factor for Small Intestinal Bacterial Overgrowth (SIBO). It means that SIBO can lead to a hypothyroidism state, but hypothyroidism can also result in bacterial overgrowth.

The gut-thyroid connection

Some studies have found that thyroid symptoms improved after treating the gut. These gut issues can come from Helicobacter pylori (7,8), parasites (9), fungal infection (Candida) (10), SIBO (11), or food intolerances (12), etc.

Studies estimate that around 30% of people with hypothyroidism have low stomach acid (13). Stomach acid is essential to kill pathogens and prevent the overgrowth of bacteria. If this protective mechanism fails, then it can easily lead to SIBO. (14) This is why using stomach acid blockers (Proton-pump inhibitors) unnecessarily can be problematic and may also lead to SIBO. Here you can read more about the types of SIBO.

The other reason is that overgrowth of bad bacteria can lead to issues with the conversion of thyroid hormones, namely T4 (inactive form) to T3 (active form). (15) Much of the thyroid hormone is released by the thyroid gland in the inactive type known as T4 (thyroxine), but it must be converted to an active form known as T3 (triiodothyronine) for the cells to use it. (16) Around 20% of T4 can be converted to T3 in the gut by good gut bacteria.

But most of the conversion is done by the liver, which can also be sluggish for many reasons. A sluggish liver and gallbladder cannot remove hormones efficiently, such as estrogen. Elevated estrogen levels can also negatively influence the conversion rate of thyroid hormones. (17)

The other issue can be when T4 converts to reverse T3 (rT3), the inactive form. A higher level of reverse T3 can be produced if someone went through a major life event, a trauma (emotional or physical stress like a surgery), or having chronic stress (illness, inflammation). (18,19) In some cases, other factors such as diet, not just a diet high in sugars and processed foods, but also a ketogenic or very low carb diet, can cause elevated levels of rT3. (20, 21)

So making sure that you have a well-functioning gut and liver, the gallbladder is vital to ensure proper conversion of thyroid hormones.

The immune system-thyroid connection

There are 70% of the body's immune cells located in the gut. The immune response in this part of the body is called GALT, or gut-associated lymphoid tissue. The GALT contains several forms of immune cells, such as T and B cells, that detect and respond to antigens as potential threats that trigger immune system reactions.

Problems arise when any one of these intestinal barriers is weakened. When the small intestine's tight junctions loosen (in case of "leaky gut syndrome"), undigested food particles, microorganisms, toxins, or larger proteins enter the bloodstream. The immune system sees these particles as unwanted intruders and starts an inflammation process to rid of them. Leaky gut can be one of the underlying causes of autoimmune diseases, such as Hashimoto-Thyroiditis, an autoimmune form of hypothyroidism. If you have a leaky gut, the immune system can keep attacking the thyroid and cause continued problems. (22, 23)

What might help to support your body?

Focusing on gut health is an essential part of any treatment process as it is also connected to your immune system and thyroid autoimmunity, and thyroid functions. But concentrating on the thyroid function is also crucial.

If you are experiencing symptoms of thyroid dysfunction and SIBO, you can do the following steps:

  1. Do the necessary testing to find out what the issue is behind your symptoms: ask for a SIBO breath test and a full thyroid panel from your Practitioner
  2. Taking thyroid medication may help with motility and considering eliminating SIBO or other infections if present
  3. Choose a customized diet that eliminates inflammatory foods such as sugar, processed foods, gluten, refined carbohydrates, refined oils, artificial sweeteners, etc.
  4. Eat a whole food diet – including organic meats, vegetables, fruits, nuts, seeds based on your tolerance
  5. Apply lifestyle changes that help you manage your daily stress
  6. Take intestinal lining healing nutrients, boost motility

 

 

*This post is only for informational purposes; and not meant to diagnose, or treat any disease. I advise consulting with your healthcare practitioner regarding any treatment options or dietary changes.

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Consider SIBO testing if you suffer from constant bloating

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SIBO testing

What is SIBO & SIBO testing?

First of all, what is SIBO? SIBO stands for Small Intestinal Bacterial Overgrowth. It is defined as the presence of excessive bacteria in the small intestine. The problem is that there are too much bacteria and/or the wrong type of bacteria present in the wrong place.

Symptoms can be excess/trapped gas, bloating, diarrhea and/or constipation, abdominal pain or cramping, food sensitivities, chronic fatigue, brain fog, and the list goes on. (1)(2)

Before getting tested

Before getting to SIBO testing, many people try different methods to relieve their symptoms. These approaches may include lifestyle changes (e.g., reducing sugar/junk and processed food consumption; stress; getting more sleep) or eating more fiber, prebiotic foods, and herbs. However, if these changes don’t bring the expected results or make the current symptoms worsen, then it might be time to visit the GI doctor to have some tests.

Although having the symptoms mentioned above doesn’t mean that you have 100% SIBO. It is crucial to rule out other diseases (like endometriosis, Crohn’s/ Colitis) and get a proper diagnosis by your healthcare practitioner. There can be many different diseases, which could cause the same symptoms.

Suppose you have already been diagnosed with IBS (Irritable Bowel Syndrome). In that case, it is definitely worth getting SIBO testing because, according to a study, up to 84% of patients with IBS actually have SIBO. (3)

It may also happen that a person thought SIBO was causing the symptoms, but then the culprit turned out to be Celiac disease. (4) If you start using an antimicrobial treatment for assumed SIBO without any proper diagnoses, then it may cause more harm than good. So testing is essential, which can help define the treatment plan.

SIBO testing method #1: SIBO breath test

The three-hour lactulose or glucose breath test is generally used for diagnosing SIBO, which detects the different types of gases that bacteria produce in the small intestine. It checks for hydrogen and methane gas. (5) There is now a new test available in the US: the TrioSmart test that can detect the third type of gas: hydrogen sulfide. (6) I wrote about the different types of SIBO.

The bacteria in our intestines ferment specific carbohydrates, and they produce gases as a byproduct. The breath test involves drinking a sugar solution (lactulose or glucose, a type of carbohydrate) that feeds the bacteria in the gut, and they start making gases. Then these gases are absorbed in the intestines and get into our blood, from where the gases are delivered to our lungs and exhaled in our breath. That is what the breath test intended to capture.

The breath test is done for 3 hours, while breath samples are taken at 20-minute intervals. The first two hours represent the small intestine, and the last hour is usually the large intestine. Measuring the level of those gases is also important to determine how severe the bacterial overgrowth is and what treatment would suit the best.
Be aware that a prep diet is required to be followed before SIBO testing. It involves following a low-fiber diet and fasting for 14 hours. (When you order a test, you should receive instruction on the prep diet). (7)

A hydrogen breath test is also used for testing carbohydrate malabsorption issues when dietary sugars are not absorbed well, such as lactose (sugar in milk), fructose (sugar in fruit), sorbitol, and sucrose. (8)

 

Can you trust the SIBO breath tests?

While the breath test is considered the most practical SIBO testing method, it certainly has its limitations.
A meta-analysis of the breath test accuracy showed that lactulose substrate might provide a higher number of false-positive results than the glucose test. Glucose breath test seems to work better than lactulose breath test for diagnosing SIBO. It seems glucose testing has better sensitivity and specificity. (9) (10) In this case, clinicians may need to evaluate the results more carefully before giving out a diagnosis, and it would be worth doing a test for both types of substrates.

Other problems can be:
• the missing consensus on the interpretation of breath test results
• Individual’s motility can influence the test results – transit time may differ from person to person (11)

Other types of tests

If you have IBS-D or IBS-M/SIBO-D, you experience mainly diarrhea symptoms; then an IBS-SMART test is available to diagnose post-infectious IBS (PI-IBS). It is a blood test that looks for the markers of food poisoning (one of the leading causes of SIBO), which is the result of auto-antibodies forming in a lot of people and starting an auto-immune process. The antibodies measured in the blood are anti-CdtB toxin and anti-vinculin. These antibodies can attack the nerves of the gut and impair the cleaning wave, the Migrating Motor Complex. (12)(13)

What tests are not suitable to diagnose SIBO?

  • Stool tests because the results represent mainly the end of the large intestine, although they might indicate some issues in the small intestine but cannot diagnose SIBO. Overgrowth of bacteria in a stool can show dysbiosis.
  • Organic Acid Tests (OAT) check the urine for byproducts of yeast or bacteria in the small intestine, which can be very useful but cannot tell whether your SIBO is hydrogen/ hydrogen-sulfide or methane-dominant. (14)

Conclusions

Using SIBO testing (a breath test) has its advantages and disadvantages, but it can still be the most practical approach to diagnosing SIBO. Metanalysis showed that a glucose breath test might provide a more accurate diagnosis than a lactulose breath test. Having a SIBO diagnosis can be crucial as it can define the best treatment options (each type of gas requires different strategies).

Bear in mind that diagnosing SIBO might be just the first step because it will not tell you what caused SIBO in the first place. However, finding the underlying cause is crucial to prevent relapsing.

If you have questions regarding SIBO or need help finding out your root cause and support on your healing journey, then feel free to book a free consultation call!

 

 

* This post is only for informational purposes and not meant to diagnose or treat any disease.  I advise consulting with your healthcare practitioner regarding any treatment options or dietary changes.

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