Antibiotics are the most common treatment doctors prescribe for small intestinal bacterial overgrowth (SIBO), a condition characterized by uncomfortable digestive symptoms and excess bacteria in the gut.
Unfortunately, Western Medicine practices tend to overlook the intricacies of SIBO. While antibiotics may help in the short term, they don’t prevent SIBO from re-emerging and may even worsen symptoms.
Ask any gut health expert, and they will tell you that herbal SIBO supplements are the better approach, especially for those wanting to address their symptoms naturally. Read on to learn about which supplements to consider.
Benefits of Taking SIBO Supplements
The steps to improve SIBO include a three-phase process, and natural supplements can help every step of the way. Find out which herbal therapies to consider during each phase of the SIBO treatment process next.
Manage SIBO Symptoms
People with chronic gastrointestinal (GI) issues like constipation, diarrhea, and gas often suffer from a lower quality of life. With that in mind, the first phase in addressing SIBO is to get these symptoms under control.
Much of this phase involves diet, as carbohydrates can be fuel for these digestive symptoms. Small intestinal bacteria, in particular, enjoy feasting on simple carbohydrates, which are often found in highly processed foods.
Motility supplements, vitamins and minerals, and other herbal remedies also support GI symptom management. Improving motility can help with diarrhea or constipation, while vitamins and minerals are essential for proper digestion.
Treat Gut Bacteria Overgrowth
The small intestine has a microbiome or a diverse array of bacteria and other microbes. The large intestine has an even bigger, more diverse microbiome. Normally, the microbes living in the small and large intestines support healthy digestion, breaking down foods into nutrients the body needs.
When bacteria and archaea in the large intestine migrate into the small bowel, they may feed on undigested food particles that weren’t broken down in the mouth or stomach. With so much food available, these bacteria begin to multiply. The result is an overgrowth of bacteria in places they shouldn’t be.
Herbal antimicrobials can selectively target and kill overgrown small intestinal bacteria, which is the goal of the second phase when addressing SIBO. In studies comparing the effectiveness of natural antibiotics vs. pharmaceuticals, herbal antimicrobials are at least as effective for SIBO, if not more so.
Support Beneficial Gut Bacteria
Having bacteria in the small intestine is normal. Beyond that, these microbes are essential for optimal digestion. However, there must be a diverse array and perfect balance of microbial species to benefit our health.
Killing off overgrown gut bacteria is not a selective process. All species will die off, whether overgrown or not. The final phase, when addressing SIBO, aims to restore ideal balance and diversity to the small intestinal microbiome.
Probiotics are one of the best ways to support beneficial gut bacteria. These supplements contain live cultures of different bacterial species that can help restore diversity and balance and prevent future SIBO flare-ups.
The Best Supplements for SIBO
Picking the best supplements for SIBO depends on the phase and type of SIBO someone is diagnosed with. A gut health expert may recommend one or more of the following based on these and other factors.
Digestive Enzymes for SIBO
Gut bacteria and other microbes are not the only way food gets broken down in the GI tract. Digestive enzymes also play a role in this process. The mouth, stomach, small intestine, and pancreas, especially, produce digestive enzymes.
Digestive enzymes can help people manage their SIBO symptoms in multiple ways. For one, they break down carbs, fats, and proteins, leaving little food left to feed overgrown small intestinal bacteria.
Taking digestive enzymes can also support healthy bowel movements. The best digestive enzymes for SIBO contain alpha-galactosidase enzymes, which can also help break down galactooligosaccharides that cause gas and bloating in some people.
Digestive bitters are herbal or botanical extracts that are bitter in taste. They’ve been used for centuries to support digestion by stimulating the production of digestive juices such as stomach acid, bile, and enzymes. Bitters work by triggering taste receptors in the mouth, which then signal the digestive system to prepare for food.
When it comes to SIBO management, digestive bitters play a foundational role. People with digestive issues find that incorporating digestive bitters into their routine can offer relief by improving overall digestion. They might support digestive processes and, indirectly, help alleviate some discomfort associated with SIBO symptoms.
Apple Cider Vinegar for SIBO
Apple cider vinegar (ACV) is often touted as a cure-all. It is an excellent source of antioxidants, may boost metabolism, lower blood sugar, and reduce cholesterol, and has antibacterial properties against bacteria like Salmonella.
People also report finding relief from digestive symptoms with ACV. Though most of the evidence is anecdotal, the theory is that vinegar may promote stomach acid production, reduce gas and bloating, and improve motility.
Additionally, ACV’s antibacterial properties could aid in killing off overgrown small intestinal bacteria. People who decide to try this natural remedy should be careful to always dilute it, as raw vinegar can harm the GI tract.
SIBO Motility Supplements
Motility, or the movement of digested food and waste through the GI tract, is regulated by a process known as the migrating motor complex (MMC). When dysfunctional or absent, the MMC can lead to or worsen SIBO.
Spacing out meals and not snacking between them is one way to reset the MMC. Herbal over-the-counter supplements can also help. The best natural supplements for motility include:
- Prokinetics containing high amounts of ginger (>1,000 mg)
- Healthy fats, such as ghee and coconut oil
- Magnesium citrate or magnesium oxide
These supplements impact the MMC in various ways, from helping food pass through the GI tract more smoothly to stimulating the MMC after ingesting a meal.
SIBO Herbal Supplements
SIBO herbal supplements can be used in combination with or in place of traditional antibiotics like Rifaximin, which can cause or worsen SIBO. These supplements contain ingredients with antimicrobial properties.
Antimicrobials are natural killers of microbes, including bacteria. Sometimes, they can work for people whose symptoms do not respond to pharmaceuticals. The most effective herbal antimicrobials to try include:
- Berberine and oil of oregano (more on these later)
- Thymus vulgaris
- Coptis root
- Red thyme oil
- Indian Barberry root extract
- Equisetum arvense L.
- Olea europaea
The best herbal antimicrobial depends on someone’s SIBO type, symptoms, and other factors. A gut health expert can help individuals find an herbal regimen tailored to their unique needs.
Homeopathy for SIBO
Homeopathy is based on the theory that the body can treat itself with the help of natural substances. Medicines are prescribed individually but may include treatments that bring about digestive symptoms in healthy people who do not have SIBO.
78% of people diagnosed with irritable bowel syndrome (IBS) test positive for SIBO, hinting at a potentially shared underlying cause. Studies have supported the benefits of homeopathic medicine for IBS. These findings support the belief that homeopathy can also help with SIBO.
There is also evidence that homeopathy is advantageous for GI disorders in general. Dysbiosis (i.e., an unbalanced gut microbiome), hormesis, and gastroesophageal illnesses are GI conditions homeopathic medicines can potentially improve.
Small intestinal bacteria, whether overgrown or not, don’t just float around this organ freely. Instead, they exist as biofilms, or layers of organisms that stick to the gut lining.
Biofilms are protected from the immune system. Antibiotics don’t work on them. Luckily, biofilm-disrupting supplements could target and destroy overgrown biofilm bacteria.
Unfortunately, research has yet to show promising results from natural biofilm disruptors. Manufacturers may need to make them more bioavailable for better results.
Berberine is an herb used in traditional Chinese medicine. Today, it has been studied as a safe and effective supplement for treating type 2 diabetes, high cholesterol, and high blood pressure.
As an alkaloid, berberine also has implications for SIBO symptoms. Berberine can neutralize hydrogen and methane gasses. These gasses are released by the overgrown bacteria characteristic of Hydrogen-dominant and Methane-dominant SIBO.
In addition to helping with SIBO symptoms, berberine could also aid in directly killing off overgrowth bacteria. An upcoming clinical trial will investigate this claim by comparing the effects of rifaximin vs. berberine on 180 SIBO patients.
Partially Hydrolyzed Guar Gum
Partially hydrolyzed guar gum (PHGG) is a prebiotic. Prebiotics are supplements containing gut bacteria’s fuel source of choice. PHGG helps beneficial gut bacteria flourish while limiting the growth of harmful gut microbes.
Additionally, PHGG is known to help with dysmotility, a common symptom of SIBO. In a 2010 clinical trial, researchers combined this prebiotic with an antibiotic (Rifaximin) to treat SIBO. They found that participants’ symptoms responded better to antibiotics plus PHGG than Rifaximin alone.
Importantly, people with SIBO should not start using a prebiotic until the final phase of their improvement plan. Using prebiotics too soon can feed the overgrowth, worsening symptoms.
Peppermint oil may help with SIBO in a few ways. First, it is known to benefit IBS symptoms and digestive health in general. Second, it has antimicrobial properties that could target bacterial overgrowth.
We don’t have any research on the benefits of peppermint oil for SIBO specifically. However, experts have found that up to 78% of people with IBS also have SIBO.
Regarding its effects on IBS, a 2014 review compiled nine studies of 726 people. These studies all investigated the benefits of peppermint oil for IBS. They found that peppermint oil was significantly more effective for IBS symptoms than a placebo.
A 2002 case study gives credence to peppermint oil’s antimicrobial benefits for SIBO. The patient reported subjective improved symptoms and reduced hydrogen levels on a breath test after using enteric-coated peppermint oil.
Oil of Oregano
Oregano oil is an herbal supplement derived from the oregano plant. It is one of the many herbal remedies recommended in the 2014 study, showing equal effects to Rifaximin antibiotic treatment.
Carvacrol and thymol are the active ingredients in oregano oil. It’s carvacrol that offers antimicrobial benefits. This natural compound kills off bacteria by rupturing their cell membranes.
Thymol offers similar benefits to digestive enzyme supplements, as it can stimulate the release of natural digestive enzymes. The result is improved bowel movements and more effective digestion.
Probiotics are supplements containing live cultures of bacteria and other microbes that live in the gut. When introduced too early in t, they may exacerbate bacterial overgrowth. The better strategy is to incorporate them during the last phase of addressing SIBO
The best probiotics for SIBO are soil-based. Also known as spore-based probiotics, these supplements contain unique strains of bacteria and yeasts that can survive long enough to populate the large intestine.
Vitamins and Minerals
A long-term symptom of untreated SIBO is malnutrition. Particularly common in SIBO types predominantly featuring chronic diarrhea, malnourishment can happen as a result of the fast transit time of waste through the GI tract.
Even before that, someone with SIBO may become deficient in vitamins and minerals. What vitamins does SIBO deplete? The most common vitamins and minerals people with SIBO are deficient in may include:
- Vitamin A
- Vitamin D
- Vitamin K
- Vitamin B12
Taking a vitamin or mineral supplement can greatly improve deficiencies before they progress. Additionally, vitamins and minerals are beneficial for a healthy gut and digestion, in general.
These Are the Best Supplements for SIBO
If someone with SIBO doesn’t want to take antibiotics for their symptoms, they have options. Herbal supplements are safe and effective for managing SIBO symptoms, killing off overgrown bacteria, and supporting future gut health.
Do you need help finding the best supplement for your SIBO symptoms or figuring out the proper daily dose to take? The gut health experts at Revolution Gut Health are here to assist you.
Schedule a consultation with one of our practitioners for advice on SIBO supplements you can’t find elsewhere.
SIBO Supplement FAQ
Before you go, here are some frequently asked questions we get from clients. Find the answers you’ve been searching for below.
Is Apple Cider Vinegar Good for SIBO?
Yes, apple cider vinegar is good for SIBO. It has antibacterial properties and may promote stomach acid production, reduce SIBO symptoms, and improve motility.
Do SIBO Herbal Treatments Have Side Effects?
Yes, SIBO herbal treatments can have side effects, though nowhere near as severe as those of antibiotics and other pharmaceuticals.
The primary risk with natural SIBO supplements is die-off symptoms. These symptoms include GI issues that happen as a result of gut bacteria dying. The good news is that they are temporary.
What Is the Best Supplement for Methane SIBO?
Berberine is one of the best supplements for methane SIBO, as it can neutralize methane gas. Neutralizing methane gas should result in a reduction in symptoms.
Methane SIBO can be particularly difficult to improve because archaea, not bacteria, cause it. It doesn’t respond well to antibiotics. Antimicrobials like berberine and oil of oregano may work better for this SIBO type.