Breathing and GI Health with Mim Beim

In this episode of The SIBO Doctor podcast, Dr Nirala Jacobi is in conversation with Mim Beim about the effect of the breath on the digestive tract. Mim has 30 years of naturopathic experience, she has authored books, and is a respected naturopathic voice in the media. Mim has also held lecturing positions at the Australian College of Natural Therapies (ACNT) and has two practices.

Topics discussed include:

  • Mim’s story and how she came to Buteyko breathing.
  • Physiological effects of Buteyko breathing.
  • What actually happens with Buteyko breathing?
  • Overbreathing – chronic hyperventilation (breathing more than we metabolically need) and the effect of losing too much carbon dioxide.
  • What are the effects of increasing carbon dioxide in the body in minuscule amounts?
  • Digestive conditions and the breath.
  • What improvements and symptomatic relief has Mim seen with Buteyko breathing with SIBO and digestive conditions?
    • Nitric oxide improving the functioning of sphincters and how this affects the digestive tract.
  • An example of a Buteyko breathing exercise – a live exercise

Tune in to this fascinating talk over at The SIBO Doctor podcast page

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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.



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



Microbiome PCR testing


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



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.

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


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.



  • 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

The SIBO Doctor Podcast – Dr Bradley Bush – Neurotransmitters and SIBO Part 2

In this episode Dr Nirala Jacobi continues the conversation with Dr Bradley Bush, with a focus on case presentations around chronic SIBO cases and inflammatory concepts.

Dr Bush received his Naturopathic Doctorate degree from the National College of Naturopathic Medicine.  He is co-owner and clinic director of Natural Medicine of Stillwater and its online consumer direct website for practitioners,

The Bush practice focuses on fatigue, insomnia, GI disorders, mood disorders, and lyme disease. Dr Bush has over 16 years of industry experience. He is the owner of Natural Health Insights, providing consulting services to the naturopathic products and laboratory testing industry.

Dr Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology, and lyme disease.  Dr Bush sits on two non profit boards, The Naturopathic Education and Research Consortium, and Compass Centre for Health.

The format of this episode is slightly different. In it Dr Bush discusses three different SIBO cases, diving into the variability and complexity of each presentation.


Case 1 – SIBO with associated fibromyalgia and chronic fatigue – 65 y/o female.

  • Incremental approaches with complex cases.
  • The gut being the epicentre of health, without which SIBO associated presentations will not rectify.
  • Polypharmacy approach and the compounding effect of this on the patient.
  • Analysis of basic chemistry.
  • Myeloperoxidase (MPO), the enzyme secreted by neutrophils, and the indications for testing and tracking this in treatments. (MPO elevation has associations with lipopolysaccharides (LPS), chronic infections, irritable bowel disease (IBD), and immune induced leaky gut)
  • The neurotransmitter imbalances that can be sustained by chronic inflammation (hint – upregulated indoleamine dioxygenase enzyme, precipitating downregulated synthesis of serotonin, among others)
  • Yeast association with SIBO.
  • Weaning off polypharmacy.
  • Metronidazol for rifaximin resistant SIBO, and C. diff.
  • An indication on how many rounds of rifaximin are required to attend to chronic versus acute SIBO.
  • Eating disorders prompted by therapeutic diets taken on for too long.
  • Botanicals vs conventional medicine for SIBO treatment, or a combination use approach?
  • Probiotic use as immunological modulators rather than massive impactors for floral diversity in the GI microbiome.
  • Botanicals that Dr Bush uses in SIBO treatment.
  • Mediherb gut flora complex – immune regulating capability, IBD modulation, mucosal affinity.
  • Dr Nirala Jacobi’s therapeutic recommendation – Mediherb Bacto-Cand GI.


Case 2 – SIBO with associated constipation, acne, halitosis – 20y/o male

  • Traumatic brain injury due to sporting event.
  • Tricyclic antidepressant therapy introduced in his recovery plan and his subsequent experience of anxiety and spacey feelings.
  • Naturopathic neurotransmitter production therapy alongside conventional antidepressant use.
  • Serotonin syndrome and the potential for it to be induced by dual therapy use.
  • Methane Protocol – rifaximin and neomycin combination for methane dominant SIBO treatment.
  • Anxiety caused by SIBO, key indications being:
    • Treatment resistant anxiety
    • Treatment resistant insomnia
  • Anxiety as a manifestation resultant of SIBO chemicals interrupting neurotransmitter signalling.


Case 3 – Lyme and SIBO – 25y/o female

  • Chronic fatigue, constipation, bloating, neuralgia, catatonic staring episodes.
  • Lyme testing.
  • The effectiveness of the paleo diet for symptomatic control, noting that the issue still exists, even though the bugs are simply not being fed and therefore symptoms abating.
  • SIBO as a concomitant condition with Lyme, and/or as a condition that can mimic the various presentations of Lyme.
  • The Lyme/SIBO overlap as discussed by Dr Farshid Rahbar at the 2017 SIBO Integrative Conference, and the methane association.
  • The clinically noted neuralgia and methane dominance link.
    • Methane endotoxins produced by SIBO bacteria theorised to contribute to neuralgia.
  • Constipation and methane dominance perpetuating each other.
  • Methane dominant SIBO moving from constipation to diarrhoea during treatment and why this can occur.



The SIBO Doctor Podcast – Dr Bradley Bush – The Gut-Brain Axis: Neurotransmitters and SIBO

In this episode Dr Nirala Jacobi speaks with Dr Bradley Bush about the fascinating and complex world of neurotransmitters.

Dr Bush received his Naturopathic Doctorate degree from the National College of Naturopathic Medicine.  He is co-owner and clinic director of Natural Medicine of Stillwater and its online consumer direct website for practitioners,

The Bush practice focuses on fatigue, insomnia, GI disorders, mood disorders, and lyme disease. Dr Bush has over 16 years of industry experience. He is the owner of Natural Health Insights, providing consulting services to the naturopathic products and laboratory testing industry.

Dr Bush speaks nationally and regularly publishes on the topics of neuroimmunology, brain-gut connections, neuroendocrinology, and lyme disease.  Dr Bush sits on two non profit boards, The Naturopathic Education and Research Consortium, and Compass Centre for Health.

In this episode topics discussed include:

– Who are the major players in the enteric nervous system for neurotransmitter regulation?
– Does low serotonin in the gut mean low serotonin in the brain?
– The sympathetic-parasympathetic rhythm, and how important this is in calibrating the smooth muscle movement in the gastrointestinal tract.
– Underlying factors to sympathetic dominance in a person, such as chronic infection, dysbiosis, and/or inflammation.
– The complex presentations of sympathetic overdrive, ranging from anxiety and insomnia, to exhaustion, and why this is.
– Why increased norepinephrine in conjunction with normal or low epinephrine is a worse situation than just high epinephrine, due to the lack of counter balance for inflammation and an upregulated innate immunity.
– Repercussions of high epinephrine in conjunction with low norepinephrine.
– The multiple actions of cortisol, epinephrine, and norepinephrine in the body and their roles in acute and chronic conditions.
– Urinary transmitter analysis, stability, and recommended labs.
– Nutrients used to support synthesis of the various neurotransmitters.
– L-dopa v.s. tyrosine use, and the various benefits of each.
– Clinical indications for L-dopa use.
– How depleted catecholamines can be related to low secretory IgA.
– Genetic mutations (MTHFR) and how this relates to neurotransmitter dysfunction.
– Does serum C-reactive protein (CRP) directly correlate to SIBO activity?
– Myeloperoxidase measurement as a marker of neutrophil activity, and how it can be a useful monitoring tool for irritable bowel syndrome (IBS) and irritable bowel disease (IBD) patients.
– How does inflammation turn down the synthesis of serotonin and catecholamines?
– How the indoleamine 2,3-dioxygenase enzyme (IDO) conducts “The Tryptophan Steal” as an outcome of chronic inflammation, and the implications of this.
– What solutions are there to address the tryptophan steal?
– The benefit of using supplemental 5-HTP over tryptophan in light of chronic inflammation and impacted adrenal health.
– Doses, dose timing, and length of time to use 5-HTP.
– SIBO as a common underlying factor for the inflammatory state that can drive neurotransmitter dysfunction.
– What is the role of glutamate?
– Glutamate versus glutamine, and how is this relevant to supplementation.
– How is glutamate measured, what do high levels indicate, and how does it impact the nervous system?
– Glutathione as the biggest byproduct of L-glutamine metabolism.
– Powder V.S. tablet for L-glutamine use, and the dose recommended.
– What is urinary neurotransmitter testing reflecting?
– The blood-brain barrier, and how the brain is not a closed system.
– MTHFR and COMT genetic testing as indicated by low monoamine neurotransmitters and high catecholamines on urinary neurotransmitter panels.
– What to do with patients on medications being used to conventionally regulate neurotransmitters?
– Tactics of improving neurotransmitter markers prior to SIBO treatment in order to offset the flaring of the symptoms during die off.


The SIBO Doctor Podcast – Dr Farshid Rahbar – SIBO and Lyme Disease

Dr Farshid Rahbar, holistic and integrative gastroenterologist in Los Angeles, joins Dr Nirala Jacobi today to speak about Lyme disease and Tick Borne Disease (TBD) in relation to SIBO and other digestive disorders.

Dr Rahbar is the medical director at the LA Integrative Gastroenterology. In 2007, he completed the integrated medicine training, achieving ABIHM status.  Dr Rahbar also undertook training in anti-aging, functional, and regenerative medicine, achieving board certification through A4M.  He then completed further training through IFM – The Institute for Functional Medicine, and ILADs training.

In 2013 he delved into the relationship between tick borne Lyme disease with a special interest in gastrointestinal (GI) manifestations.  Since this time he has witnessed clinical patterns involving the role of infections, acute and chronic, in causing ongoing GI related conditions and symptoms.

Dr Rahbar’s special interest areas include dysbiosis, SIBO, leaky gut, and measures that help these conditions. Like many other experts, he believes that GI integrity is crucial to the treatment of Lyme.  Further, both Dr Rahbar and Dr Jacobi recently presented at the 2017 Integrative SIBO Conference held in Lombard, Illinois.

In this episode:

– How Dr Rahbar got into the field of integrative gastroenterology with a specialty in Lyme.

– An overview of what Lyme disease is.
– Tick Borne Disease (TBD) and how borreliosis is one amongst many possible infections.
– Testing for Lyme and TBD and the political discord surrounding this.
– Unexplainable chronic inflammatory conditions and how they may require testing for TBD.
– What are the core clinical presentations of Lyme and co-infections that Dr Rahbar sees in his practice?
– Key presenting components that may indicate TBD – such as fatigue, and neurological dysfunction.
– Anxiety, medical marijuana use, and body aches in young people, and how these may indicate chronic inflammation and warrant TBD investigation.
– Autoimmunity and how Bartonella infection can be implicated.
– What is the connection between Lyme and SIBO?
– SIBO as a phenotypic presentation of underlying TBD infection.
– Testing options for Lyme and coinfections and how accurate these are, and options for referral to experts.
– Mould, mycotoxicity, and chronic inflammatory response syndrome (CIRS) and how presentations for this can be similar to TBD infections, and chronic immune compromisation.
– How lifestyle factors and certain genetic profiles can increase risk factors and susceptibility to TBD, CIRS, and immune conditions.
– Speculation on nose cultures indicating the possibility of post nasal drip at night, with concomitant hypochlorhydria and/or immune dysregulation, being a risk factor for dysbiosis and SIBO.
– Lyme, mycotoxicity, stealth infections, and the theory that the chronic immune issues and how the microbiome decimation of the last 50 years can be impacting the ability to regain health.
– High methane levels in Lyme patients and how this can be related to immune suppression.
– Dysautonomia and small fibre neuropathy in the stomach itself, and the relationship to Lyme.
– GERD as a risk factor for SIBO.
– The lower esophageal sphincter (LES) and why dysfunction may occur when the autonomic nervous system is affected.
– The constellation of autonomic neuropathy, dysbiosis, pyloric valve insufficiency, and bile reflux and how any and all of these may lead to GERD.
– How is dysautonomia diagnosed, and is it only related to Lyme, TBD, and coinfections?
– Gastroparesis and how it may be related to dysautonomia, Lyme, and other TBD.
– Inflammatory cytokine release and how this cascade may relax the LES and contribute to SIBO.
– The tightness of the fundus and how it could contribute to reflux oesophagitis.
– Methane dominant SIBO and retrograde motility leading to symptoms such as burping, and nausea.
– Dr Rahbar’s clinical pearls for SIBO patients.

– Dr Rahbar’s phases for SIBO treatment:
– Preparatory phase
– Attack phase

– The place of nystatin in lower bowel dysbiosis and fungal overgrowth.
– Biofilm disruptors for TBDs.


The SIBO Doctor Podcast – Dr Nirala Jacobi – Breath Testing For SIBO

In this episode, Dr Nirala Jacobi (ND, USA) discusses SIBO breath testing.

Dr Jacobi’s experience ranges from professional practitioner education, product development, naturopathic mentorship, and serving on the board of directors for the American Association of Naturopathic Physicians (AANP), to running her own private clinical practice for over 20 years.

Dr Jacobi is the founder and medical director of SIBOTest, and is a highly sought after specialist for the treatment of functional digestive disorders.

Stay tuned at the end of this episode for a conference update with Dr Audra Mehan, conference director CME for the Integrative SIBO Conference in Lombard Illinois. Dr Jacobi is one of the many high calibre featured speakers for this event, set to be held on March 25th and 26th 2017.

Topics discussed in this episode include:

– What is SIBO Breath testing?
– What gasses we are testing for?
– How does a person perform a SIBO breath test at home?
– Preparation protocol, the diet involved, and supplements, herbs, and   medication to avoid in the preparation period.
– How to know which test to give to a patient – Lactulose, Glucose, or Fructose.
– Hydrogen sulfide – are there testing options for this gas, what patterns on a SIBO breath test may indicate an overgrowth of bacteria that produce hydrogen sulfide, and what symptoms could indicate hydrogen sulfide dominance?
– What organisms produce hydrogen sulfide, and what do they feed on?
– How can children perform the SIBO breath test?
– What to ask your SIBO testing facility to ensure the highest testing quality.
– What constitutes a positive SIBO test result, and what constitutes a borderline SIBO test result?
– How to read and interpret a SIBO breath test result.
– Diarrhoea and constipation during SIBO breath testing and how this can affect test interpretation.
– High methane on baseline compared to methane that rises, and what this means.
– The relationship of hydrogen to methane, and how hydrogen producing bacteria can cause a rise in methane gas production.
– Reference ranges for SIBO gases.
– How to know when to retest, and whether to retest.
– The SIBO treatment algorithm.
– The methane spot test, and when it is indicated.
– Questions from listeners
– Visceral manipulation therapy – what it is, and how it may complement SIBO treatment.
– Is there a role for fecal microbial transplant into the small intestine for the resolution of SIBO?

  • Dr Audra Mehan, conference director CME, discusses the phenomenal speaker line-up for the Integrative SIBO Conference 2017, set to be held in Lombard Illinois on March 25th and 26th 2017.

Attend this event.

Follow up:

The SIBO Doctor Podcast – Heidi Turner – Mast Cell Activation Syndrome

In this episode, Dr Nirala Jacobi speaks with Heidi Turner on the topic of Mast Cell Activation Syndrome.  Heidi is a medical nutrition therapist at the Seattle Arthritis Clinic at Northwest Hospital UW Medicine in Seattle, Washington.  She specialises in food intolerances, SIBO, and other digestive disorders, addressing the digestion in order to balance all body systems.

Topics include:

– Using diet to decrease inflammation in the body and improve pain markers for autoimmune patients.

– Mast cell activation syndrome (MCAS) and the diverse array of signs and symptoms with which it can present.

– SIBO and how it relates to mast cells disorder and MCAS.

– What mast cells are and what responses they create within the immune system.

– Predisposing factors for MCAS

– The physiological relationship of stressors, and/or emotional trauma to the development of MCAS and other conditions in the body.

– Histamine and its diverse roles in the body.

– Intolerance symptoms.

– How intolerance can develop.

– High histamine foods.

– How to best assess patients for histamine intolerance.

– Antihistamine supplements.

– Diamine Oxidase (DAO) and SIBO related histamine dysregulation.

– How to navigate probiotic treatment for highly digestively sensitive patients.

– Various treatment options for stabilising mast cells, and MCAS specific support.


Dr T C Theoharides

Mast cell cytosis society


Heidi Turner