The SIBO Doctor – Dr Jason Hawrelak – Pre and Probiotic Use in SIBO

In this episode, Dr Nirala Jacobi is in conversation with Dr Jason Hawrelak on the topic of all things gut.

Head on over to our podcast page, The SIBO Doctor to listen in to this fascinating conversation.

Dr Hawrelak is a researcher, lecturer, naturopath, and nutritionist with over 16 years of clinical experience.  He also practices at Gould’s Natural Medicine – a 135-year-old natural medicine apothecary and clinic in Hobart, Tasmania, Australia.

Dr Hawrelak completed his PhD examining the capacity of probiotics, prebiotics, and herbal medicines to modify the gastrointestinal tract microbiota.  He is currently the senior lecturer in Complementary and Alternative Medicines at the University of Tasmania’s School of Medicine where he coordinates the evidence based complementary medicines programs.  Dr Hawrelak also teaches the gastrointestinal imbalances unit, within the Masters of Science and Human Nutrition, and Functional Medicine Program at the University of Western States, in Portland, Oregon.

Pre and Probiotic Use in SIBO

Listen to the podcast

 

The SIBO Doctor – Dr Denise Furness – SIBO, Genomics and Methylation

SIBO, Genomics and Methylation

In this episode, Dr Nirala Jacobi is in conversation with Dr Denise Furness, molecular geneticist, registered nutritionist, and registered exercise professional

 

Today’s discussion centres around nutrigenomics, methylation, and digestive health.

Dr Furness completed her PhD at CSIRO Human Nutrition and a postdoctoral fellowship at the University of Adelaide’s Research Centre for Reproductive Health.

Her research focused on folate, nutrigenomics, methylation and DNA damage in relation to pregnancy outcomes.  She has published her work in peer-reviewed medical journals and regularly presents at national and international conferences.

In 2012 Dr Furness shifted from an Academic Research position to a consulting role at Your Genes and Nutrition, helping patients understand the role of nutrigenomics and genetic testing in relation to various health outcomes.

Dr Furness is passionate about helping couples achieve optimal health and wellness to improve their chances for natural conception and healthy pregnancy outcomes.  She also holds regular educational seminars and workshops discussing the links between our genes and our environment, and how these impact on our health throughout all stages of the life cycle.

Topics discussed in this episode include:

– Overview of methylation.

– What to look out for with patients with ongoing digestive symptoms, and how can we utilise some of the genomic testing that’s available?

– Methylation as being responsible for switching genes off and on – the epigenetic component, as well as neurotransmitters, detoxification, and many other functions.

– How do we truly test methylation?

– Genetic terminology suggestions.

– How is methylation important in digestive issues?

– How SIBO relates to methylation variations.

– Nutritional cofactors implicated in the wider picture of methylation.

– Dr Furness’s most recent collaboration project with Bioceuticals.

– Clinical services

– Genetic Testing options

– Guidance with further testing

– Which genetic testing service will serve your needs the best?

– FUT2 gene variants and the link to a digestive disorder.

– FUT2 secretors and non-secretors, and the direct influence on the gut bacteria altering levels of Bifidobacterium and B12.

– Detoxification (CYP450) systems and their prevalence in the gut versus the liver.

– CYP polymorphisms, upregulation, and the resulting impacts on the digestive system.

– Glutathione S-transferase (GST) phase 2 deletions and the requirement for detoxification support in light of the body using different, slower pathways.

– Catechol-O-methyltransferase (COMT) as the safe pathway to process catechol oestrogen metabolites.

– Nutrients that support COMT and methylation, such as magnesium and b vitamins, respectively.

– Monoamine oxidase (MAO) enzyme system that helps to clear neurotransmitters.

– Why support COMT and methylation during times of stress and anxiety.

– Why to never just start with folate supplementally – The Folate Trap.

– Why the gut is the first port of call for systemic health.

– Dr Furness’s dosing inclinations.

– B12 deficiency in the presence of oxidative stress (due to gut issues), the recommendation towards hydroxy B12 supplementation over any other forms of B12, and why.

Various testing that Dr Furness recommends.

DUTCH testing

8-Hydroxyguanosine as a marker of DNA damage and oxidative stress

Endotoxicity and lipopolysaccharides (LPS) and how this can affect certain genes

Low homocysteine and what this can mean.

Gut issues and the relationship with oxidative stress.

Where to start with a client who has genetic complexities and oxidative stress issues.

Methylation education necessities for practitioners.

Dr Furness’s plan for upcoming workshops in Melbourne, and online offerings for clinical application.

The transsulfuration pathway and what can go wrong here.

The Cystathionine Beta Synthase (CBS) SNP as the first step in transsulfuration pathway, which pulls homocysteine into the pathway, and the CBS impact in detoxification.

Sensitivities with sulphur and the relationship to CBS.

How one SNP does not provide the whole picture – look at the diet, lifestyle, symptoms, and testing, using an integrative picture to address the issue.

How B6 works to speed up the transsulfuration pathway, pulling homocysteine down into it.

 

Resources

Dr Denise Furness

Consults available at Your Genes & Nutrition, Brighton, Melbourne

Consults available at Your Health, Brighton, Melbourne

 

Genetic Testing Services

Smart DNA

Fit Genes

DNA Life

23&Me

 

Microbiome PCR testing

Ubiome

Dr Furness’s 1000 kit free link

 

Dr Anderson

DUTCH testing

8-Hydroxyguanosine as an indicator of DNA damage and oxidative stress

Doctor’s Data

8-Hydroxyguanosine as an indicator of DNA damage and oxidative stress

 

 

SIBO SOS: Day 4 Here’s what’s on tap:

Have you been able to watch any of the SIBO SOS?

  • Dr Allison Siebecker’s Fundamentals session focuses on how diet directly affects SIBO. (Is it a cure after all?)
  • Leonard Weinstock takes on SIBO, Rosacea, RLS (Restless Leg Syndrome) and LDN (Low Dose Naltrexone) it could be a game changer for you. It was for me.
  • Our own Nirala Jacobi of SIBOTest.com exposes the mysteries surrounding SIBO including salicylate intolerance and SIBO connections – we are including the Bi-Phasic Diet on the page.
  • Angela Pifer shows you the RIGHT choices to make when starting SIBO treatment with her food ideas and tips.
Then Sylvie McCracken rounds out Day 4 with her inspirational get-up-and-go success story on how she dealt with “2+ weeks of hard” to finally being well with the elemental diet.

Click here for Day 4 of The SIBO SOS™ Summit!

I simply can’t believe we’re already on Day 4!
So much incredible valuable information has been shared, and we’re getting close to the finish line!

P.S. Remember, there’s still time for you to grab the “event only” special! Unlimited access to the videos, MP3 recordings of all the interviews, and speaker bonuses. Click here

P.P.S. Day 3 Sessions are available for another few hours. These include sessions with Dr Siebecker, Dr Ruscio, Dr Rahbar, Larry Wurn & Katie Caldwell.

Click here to access the Day 3 Sessions.

 

 

Fighting SIBO in Silence? No Longer!

I wanted to tell you about this new SIBO event where I’m speaking – the first SIBO SOS ™ Summit – a new free event starting NEXT WEEK!

If you have SIBO your life has been dramatically altered.

Not only do you feel sick and tired, bloated and constipated and all the other symptoms that come with SIBO, you might feel something else entirely…

Lonely, isolated and maybe even anxious and frustrated!

Even though SIBO affects millions of people across the country, it’s one of the least known chronic conditions in today’s modern World.

It can be a rocky road to be diagnosed with something nobody’s ever heard of. It can be super tough to find the right resources to help you truly heal too… until now!

The SIBO SOS Summit is happening online June 24 – June 28 – and it’s going to change the way you look at your condition forever.

SIBO SOS ™ Summit is 5 Full days packed with some of the most brilliant minds researching and treating SIBO today.  You’ll learn about the most cutting edge nutrition, treatment and healing options directly from the mouths of this exciting panel.

Hosting are Shivan Sarna and Dr. Allison Siebecker – and together they’ll show you just how many options you have to get your life back on track and kick SIBO to the curb once and for all!

The best part? It’s absolutely free for you to join and participate!

Early Bird ends 24 June, so you’d best be quick!

Take a minute right now and check out the full expert line-up and get your seat secured today!

Click here to grab the early bird pass

 

I’ll see you there!

Dr Nirala Jacobi ND

P.S. There are so many people suffering in silence from SIBO and its symptoms, if you think a friend or loved one could be a part of it, feel free to share this link with them and let them get the relief they need too – Get signed up right here!

Roast Pumpkin, Fennel, and Carrot

‘Nothing beats gorgeous roasted vegetables, and this trio of vegetables work perfectly with roast meats, fish and poultry.  They are the perfect partners to a big Sunday roast lunch or dinner.’ Rebecca Coomes

Classification: Phase 1 – Restricted, GF, V, LF

4 serves

Pre-heat the oven to 180oC/355oF.

Ingredients

  • 2 cups pumpkin, sliced or chunks
  • ½ tsp ground cumin
  • 1 tsp salt
  • 1 tbs olive oil

Method

Place the pumpkin in a large bowl. Sprinkle with the cumin and salt and drizzle with olive oil. Stir to combine.  Line a baking tray with baking paper then place the pumpkin on it.  Place in the oven and roast for 45 – 60 minutes, or until the pumpkin is golden brown and cooked through.

Thyme roasted carrots

Ingredients

  • 2 bunches baby carrots, trimmed and washed
  • ½ bunch thyme, leaves picked
  • 2 tbs ghee, melted
  • ½ tsp salt
  • ½ tsp pepper

Method

Place the baby carrots in a large bowl. Drizzle with melted ghee, and sprinkle with the thyme leaves, salt and pepper. Stir to combine.  Line a baking tray with baking paper then place the carrots on it.  Place in the oven and roast for 45 – 60 minutes, or until they are golden brown and cooked through.

Roast fennel

Ingredients

  • 2 fennel, quartered
  • 1 lemon, sliced
  • 2 tbs olive oil
  • Salt and pepper to taste

Method

Line a baking tray with baking paper then place the fennel on it.  Drizzle with olive oil, scatter with lemon slices, and sprinkle with salt and pepper. Place in the oven and roast for 45 – 60 minutes, or until the fennel is soft and cooked through.

Rebecca Coomes is an author, entrepreneur, passionate foodie and intrepid traveller. She transformed her health after a lifetime of chronic illness, and today guides others on their own path to wellness. She is the founder of The Healthy Gut, a platform where people can learn about gut health and how it is important for a healthy mind and body. Rebecca is also the author of the world’s first cookbooks for people treating Small Intestinal Bacterial Overgrowth (SIBO) and the host of the SIBO cooking show and The Healthy Gut podcast.

Rebecca Coomes SIBO

The SIBO Doctor – Dr Michael Ruscio – Gut-Thyroid & SIBO

In this episode, Dr Nirala Jacobi is in conversation with Dr Michael Ruscio about the gut-thyroid SIBO connection.

Dr Ruscio is a functional medicine practitioner, chiropractor, clinical researcher, and host of the Dr Ruscio Radio Podcast.  Dr Ruscio and Dr Jacobi both recently presented and connected at the Integrative SIBO Conference 2017 in Chicago.

Topics discussed in this episode include:

How Dr Ruscio became interested in SIBO.

What is the gut-thyroid-SIBO connection?

Discussion of 4 main areas:

1. The way the gut affects thyroid autoimmunity
2. The way the gut affects thyroid hormone absorption.
3. The way the gut can cause hypothyroid-like symptoms, even when thyroid hormone levels are normal.
4. Those on thyroid medication and/or have hypothyroidism, are at increased risk of SIBO.

Being hypothyroid, or being on Levothyroxine as presenting an increased risk for SIBO, and why this may be.

The SIBO-H.Pylori relationship and the increased risk of SIBO after conventional H.Pylori treatment.

The relationship between H.Pylori and thyroid autoimmunity.

Does Dr Ruscio treat H.Pylori even if the patient is asymptomatic?

Pylori as an indicator of overall gut health.

Pylori pathogenesis v.s. commensalism with the host.

Recalibrating the gut microbiota in light of H.Pylori, with natural treatments such as:

  • Probiotics
  • Herbal antimicrobials
  • N-acetylcysteine

Testing for hypothyroidism

    • What is true hypothyroid?
    • What is subclinical hypothyroidism?
    • TSH high
    • T4 normal according to the reference ranges.
    • When to treat hypothyroidism, and when not to.

The relationship of gut inflammation to thyroid autoimmunity.

    • Switching focus from treating the lab values, to treating the person and the underlying causes of disease.

What testing does Dr Ruscio use diagnose thyroid issues?

Thyroid antibodies and the response to diet and lifestyle adjustment.

    • TPO antibodies between 100-300 and Dr Ruscio’s interpretation of this and patient care suggestions.
    • TPO antibodies over 500 and the correlation to thyroid autoimmunity.

Intestinal permeability and the link to autoimmunity.

What are the other links between Hashimoto’s and SIBO?

Implicated elements include:

    • Impaired bile production.
    • Impaired phase 3 detoxification.

What are Dr Ruscio’s preferred treatments for Hashimoto’s Thyroiditis?

      • Vitamin D
      • Combined selenium, CoQ10
      • Magnesium

Best therapeutic duration for selenium supplementation discussed.

How exogenous thyroid hormone facilitates thyroid repair.

Dr Ruscio’s thyroid medications and whether to use a T3, T4 combination, or a liquid thyroid medication, and which medication to consider in light of chronic digestive conditions.

Roasted tomato and capsicum sauce

‘This sauce is so easy to make and is incredibly versatile.  It can be used with poultry, meat, fish, or vegetarian dishes.  It can be used as a sauce or a condiment, and served hot or cold.  You will never reach for the commercially made tomato sauce again once you’ve tasted this version.’ Rebecca Coomes

Classification: Phase 1 – Restricted, GF, DF

Makes 5 cups

Ingredients

  • 10 roma tomatoes, quartered
  • 2 red capsicum, seeds removed, quartered
  • 1 leek, quartered
  • 4 tbs olive oil
  • 1 tsp salt
  • 1 tsp pepper
  • 2 tbs tomato paste
  • ½ bunch basil, chopped

Method

Pre-heat the oven to 200oC/390oF.

Place all of the ingredients for the sauce, except the tomato paste and basil, in a large roasting tin.  Mix to combine the olive oil, salt and pepper evenly across the vegetables.  Place in the oven and roast for 1.5 – 2 hours, or until all of the vegetables are soft and roasted.  Remove from the oven and cool slightly.

Place the roasted vegetables, tomato paste and basil into a blender and blend until combined and any lumps have been removed.

Pour the sauce into a large sterilised jar.  Tip upside down to form a seal and then cool.

The sauce will keep in the fridge unopened for several months.  Once opened, consume within a few days.

Rebecca Coomes is an author, entrepreneur, passionate foodie and intrepid traveller. She transformed her health after a lifetime of chronic illness, and today guides others on their own path to wellness. She is the founder of The Healthy Gut, a platform where people can learn about gut health and how it is important for a healthy mind and body. Rebecca is also the author of the world’s first cookbooks for people treating Small Intestinal Bacterial Overgrowth (SIBO) and the host of the SIBO cooking show and The Healthy Gut podcast.

Rebecca Coomes SIBO

Spice rubbed beef brisket

‘Beef brisket is a wonderful cut of meat and is melt in your mouth tender when cooked long and slow. The spice rub adds a wonderful element and leftovers are great for lunch the following day.’ Rebecca Coomes

Classification: Phase 1 – Restricted, GF, DF

4 -6 serves

Ingredients

  • 1.6 kg beef brisket
  • 2 tsp smoked paprika
  • 2 tsp sweet paprika
  • 2 tsp ground cumin
  • 1 tsp chilli powder
  • 1 tsp salt
  • 1 tsp pepper
  • 4 large carrots, sliced lengthways
  • ½ cup beef stock, see SIBO Family Favourites recipe page 141

Method

Mix the smoked paprika, sweet paprika, cumin, chilli, salt and pepper together in a small bowl.  Rub the spice mix thoroughly over the brisket, then refrigerate for at least 6 hours, or preferably overnight.

Once the brisket has marinated, pre-heat the oven to 180oC / 355oF.

Place the carrots in a large roasting tray, then place the brisket directly on top.  Pour in ½ cup water then cover tightly with foil.  Place in the oven.  Immediately reduce the temperature to 150oC / 300oF and cook for 3.5 – 4 hours or until the meat is very tender.

Increase the temperature to 180oC / 355oF and uncover the brisket for the final 20 minutes of cooking.

Once the brisket is cooked, remove it from the roasting tray and set aside to rest for 30 minutes.  Cover it with foil.

Drain the liquid from the roasting tray and pour into a saucepan along with the beef stock.  Bring to a boil then reduce heat slightly, keeping the liquid at a rolling boil until it has reduced by half.

To serve, slice the brisket thickly, and serve drizzled with the reduced sauce.

Works well with SIBO Family Favourites recipes

Roasted carrots, see recipe page 97

Roasted pumpkin, see recipe page 97

Roasted fennel, see recipe page 97

Rebecca Coomes is an author, entrepreneur, passionate foodie and intrepid traveller. She transformed her health after a lifetime of chronic illness, and today guides others on their own path to wellness. She is the founder of The Healthy Gut, a platform where people can learn about gut health and how it is important for a healthy mind and body. Rebecca is also the author of the world’s first cookbooks for people treating Small Intestinal Bacterial Overgrowth (SIBO) and the host of the SIBO cooking show and The Healthy Gut podcast.

Rebecca Coomes SIBO

The SIBO Doctor – Chris Gebhard – SIBO and Constipation

SIBO and Constipation

Today, Chris Gebhart joins Dr Nirala Jacobi to speak about SIBO and constipation.

Chris works at Resonance Complementary Therapies in Melbourne, Australia, and has been working with SIBO for 3-4 years.  Chris graduated as a Naturopath from the Southern School of Natural Therapies in 1995, has done post graduate studies in Japanese Acupuncture.

Chris works with his partner, Natalie Cruttenden, also a Naturopath and SIBO practitioner.  Chris introduced Dr Jacobi to the use of the herbal medicine, pomegranate, in SIBO treatment, which is also touched on today.

Topics discussed in this episode include:

  • Chris’s journey to becoming a SIBO treating practitioner.
  • Methane dominant SIBO and the constipation relationship.
  • Chronic constipation beyond SIBO treatment – what is Chris seeing in his clinic with constipated patients who remain constipated even though methane levels are dropping?
  • Post SIBO treatment therapies to support healthy digestion throughout the entire digestive tract.
  • Resetting and stimulating peristalsis in the large intestine.
  • The importance of supporting bowel movements during the antimicrobial SIBO treatment phase .
  • The theory that high methane on baseline that remains elevated throughout the test reflects IBS-C and not necessarily SIBO (via SIBO breath testing).

Chris’s clinical pearls for treating constipation, and supplemental supports:

 

Prescript Assist

  • Partially Hydrolysed Guar Gum (PHGG)
  • Herbal based laxatives
    • Metagenics laxatone
    • Mediherb cascara complex
  • Xymogen Probiomax Plus Sachets
  • Bioceuticals Ultra Biotic 500 in later phases of SIBO treatment.

Dr Jacobi’s supplement supports for peristaltic action

– Bifidobacterium Lactis HN019
– Found in Probiomax, and Orthoplex Multigen Biotic.
– Mutaflor – beneficial E.coli

  • Repair work to consider after Neomycin use.

Dr Jacobi’s bowel retraining techniques:

  • – PHGG use
  • – Flaxseeds, chia seeds, and dietary adjustment to support bowel movements for patients with high methane production in the large intestine.
  • – Anatomical squatting position for best evacuation alignment.
  • SIBOtest’s Resource – Retraining a Sluggish Colon

  • Coffee enemas – Chris and Dr Jacobi’s opinions for therapeutic use.
  • Kinesiological testing for the function of sphincters of the abdomen.
  • Sphincter work and what type of constipation patients may respond better
  • Chris’s seed blend for moving the bowels – chia seeds, linseeds, pumpkin seeds, sunflower seeds, almond.
  • Methanogen specific herbal support
  • Removing Methanobrevibacter smithii by moving the bowels.
  • Testing available for high baseline methane and high methane throughout, and when to use this test – Methane Spot Test.
  • Pomegranate – when to use it, what form to use, how often to use it, and Chris’s results from using it.
  • Other herbs for treating SIBO and Small Intestinal Fungal Overgrowth (SIFO), including Usnea and Horopito.
  • The Biphasic Diet and reintroducing FODMAP foods.
  • The damage to the villi in light of SIBO and repercussions of this.
  • SIBO relapse, and how to integrate a repair phase to lessen the occurrence of this, either post treatment, or pretreatment (as indicated in the The Biphasic Diet)
  • Chris’s treatments for gut repair:
    – Prebiotic rotation.
    – Lactulose
    – Bimuno galacto-oligosaccharide (GOS)

Fibre integration
– Soluble
– Insoluble

Probiotics

Colonic foods (polyphenols)
-Green tea

 

  • Dr Jacobi’s gut repair program

– Vitamin A
– Zinc – 60mg
– Bimuno GOS

– Stress as a factor in sluggish bowels.
– Supporting serotonin for gut motility.

Resources

 

  • Dr Jacobi’s supplement supports for peristaltic action:

– Bifidobacterium Lactis HN019
– Found in Probiomax, and Orthoplex Multigen Biotic
– Mutaflor – beneficial E.coli
– Squatty Potty
– Easy Stool

Succulent lemon and thyme roast chicken

‘The addition of the herbs under the skin of this chicken transforms it into a taste sensation, while the ghee keeps the meat juicy and tender. The carrots absorb the flavours from the chicken and herbs and pair with it perfectly.’ Rebecca Coomes

Classification: Phase 1 – Restricted, GF, LF

Serves 4

Ingredients

  • 1 whole free range chicken
  • 4 tbs ghee, softened
  • 1 lemon
  • 1 bunch thyme
  • 2 tsp salt
  • 2 tsp pepper
  • 1 tbs olive oil
  • 1 bunch baby carrots, washed and trimmed

Method

Pre-heat your oven to 180oC / 355oF.

Place the softened ghee in a bowl.  Zest the lemon and add it to the bowl.  Set the lemon aside.  Remove about 1 tablespoon of thyme leaves from the bunch and chop lightly.  Add to the bowl.  Add 1 teaspoon each of salt and pepper.  Stir to combine.  Set aside.

Rinse and pat dry your chicken.  Carefully separate the skin away from the meat on the breast and leg meat, by sliding your finger under the skin and gently pulling it away from the meat.  This will allow you to create a pocket for the flavoured ghee.

Taking a spoonful at a time, slide the ghee mixture under the skin, being careful not to pierce the skin.  Insert ghee to cover the breast and leg meat.  Place the lemon inside the cavity along with half of the thyme. Secure the legs together with kitchen string.  Rub olive oil over the chicken, then sprinkle with the remaining salt and pepper.

Place the remaining thyme on the base of a roasting tray.  Place the chicken on top of it.  Add the carrots around the chicken.  Place in the oven for 1 hour, or until the chicken is cooked through.  If the chicken is browning too quickly, cover it lightly with foil.

Once cooked, remove from the oven and let rest for 15 minutes before carving.  Serve with roasted carrots.

Rebecca Coomes is an author, entrepreneur, passionate foodie and intrepid traveller. She transformed her health after a lifetime of chronic illness, and today guides others on their own path to wellness. She is the founder of The Healthy Gut, a platform where people can learn about gut health and how it is important for a healthy mind and body. Rebecca is also the author of the world’s first cookbooks for people treating Small Intestinal Bacterial Overgrowth (SIBO) and the host of the SIBO cooking show and The Healthy Gut podcast.

Rebecca Coomes SIBO