I have worked with hundreds of SIBO clients and talked to even more SIBO sufferers via social media. I often see the same mistakes over and over again.
I know how frustrating it can be to invest lots of time, energy and money into SIBO treatments that don’t work! I went through some soul crushing disappointments when I had SIBO. I went into protocols with enthusiasm and hope, only to be let down hard when I made no progress. I fell into ruts during my SIBO treatment that were counterproductive and it took years to dig myself out of. Obviously, I want to save you the heartbreak!
Let’s get one thing strait! If you are reading SIBO blogs like mine, you are probably dedicated to your health journey. But, you only have a finite amount of energy, money and time to spend on your health. I often see my SIBO clients mis-allocating their finite resources during healing. I want to prevent you from making the same mistakes.
In this blog, I will discuss the 5 biggest mistakes that I see my incoming clients making. By avoiding these mistakes, you can better allocate your resources to progress more efficiently.
Failing to meet nutritional needs (undereating)
When you are asked to be on a strict SIBO diet that removes tons of foods, it can be impossible to meet your nutrient needs. You can not heal if you are chronically undereating.
Making sure my clients are able to nourish their bodies is top priority to me. If you have SIBO and you are following a restricted diet, it is key to check in to ensure you eating enough. Restrictive dieting may be preventing you from meeting your needs.
The SIBO sphere facilitates food fears by labeling foods as good or bad. These fears can become self-sabotaging. Being afraid of foods can make you react to foods. There are no good or bad foods. Context and individual factors matter!
Not to mention that the philosophy behind SIBO diets is flawed. Starving the gut of fibers may help reduce symptoms in the short term, but it can be disastrous in the long term. It can starve good gut bugs and create more imbalances. Restricting fiber is also not going to address digestive insufficiency and impaired motility which are the main drivers of SIBO.
If you are so wrapped up in avoiding a never ending list of foods, it can be easy for nourishing your body to take a back seat. You only have a finite amount of energy. Restricting and fearing foods can deplete your resources with no long term payoff.
Usually, the more restrictive my clients have been the worse they become. Then, we have to dig them out of a bigger malnourished hole.
If your restrictive diet is preventing you from meeting your needs, you should expand your diet slowly. Working with a health practitioner during this time can be imperative because reintroduction can be tricky.
Instead of abiding by an arbitrary list of yes and no foods, you should also work with a practitioner to help you avoid inflammatory foods and your personal triggers. Avoid unnecessary restrictions. The only way to truly figure out what is right for your body is to experiment.
Failing to eat enough carbohydrates
In the process of fiber avoidance, many of my clients are also are eating keto or lower carb diets. This drop in carbs can negatively affect hormonal health, which then in turn worsens gut health.
Low carb diets prompt HPA axis activation which raises levels of our stress hormone, cortisol. Higher cortisol levels will halt digestion and motility. Therefore, high cortisol create a pro-SIBO environment.
In addition, low carb diets can lead to suboptimal levels of active thyroid hormones. Motility is heavily dependent on adequate thyroid hormones. Therefore, low thyroid hormones will delay motility leading to another pro-SIBO environment.
Eliminating too many carbs for too long can also lead to negative shifts in gut bacteria. Fibers feed good gut bacteria that fight off pathogens, seal the gut lining, promote MMC activity and keep systemic inflammation at bay. These bugs need to be fed for your gut to thrive. Low carb diets fail to adequately feed your good gut bugs.
Adequate carb intake is crucial for keeping your hormones and gut happy. If you have dipped low in carbs and are not progressing or feeling worse, try adding in more carbs.
It is also important to recognize that everyone has different carb needs. But, typically I see people with SIBO/IBS doing well with 30-40% of their diet coming from carbs. Some people that are more active might need a bit higher than that and some people may be ok with slightly under that. Identifying carb is another area where an registered dietitian could really help!
Focusing solely on clearing and not on repairing/rebuilding the gut
Most SIBO protocols are focused on clearing the SIBO. But, there is little focus on what to do following the clearing of the SIBO. In my mind, clearing is the easier part, but the repairing/rebuilding stage is what takes the most time and energy. The repairing and rebuilding leads to long term relief, while the clearance phase is a short term solution.
Because so much of the focus is on clearing in the SIBO space, practitioners tend to overtreat SIBO. They blast the gut with round after round of antimicrobial treatment to try to eliminate bloating and symptoms. But, most of the time, antimicrobials can not totally eliminate symptoms until root causes are repaired and the gut is rebuilt.
If you do back to back rounds of strong antimicrobials: you never give the gut a chance to rebound, you make gut repair tougher and you are not addressing root causes.
I went through some aggressive clearing phases during my journey. It made long term healing an uphill battle. I see this aggressive treatment having the similar effects on my clients as well.
More aggressive is not better. I like to start with more conservative approaches with clearance to begin with and then move to more aggressive therapies as needed.
When you are focusing solely on clearance, you can ,again, use your finite resources poorly. Most of your investment should be put towards root focused strategies that repair your gut. That includes interventions like
- circadian rhythm repair
- stress management (getting out of fight or flight)
- optimizing movement
- sleep hygiene
- vagus nerve strengthening
- gut bug restorative diet (not gut starving diet like low FODMAP)
- consistent meal times
- blood sugar stability
- optimizing bile flow/liver function
- increasing stomach acid levels
- supplement strategies to rebalance the gut
Throwing Supplements at the Problem
Most of the above gut repair strategies are lifestyle shifts. While supplements can be helpful, you also can not throw supplements at the problem and expect your gut to heal. It takes a multifaceted approach to heal and there is no magic bullet.
I am guilty of this during my own gut health journey. I was always cycling through new supplements with amazing claims. I was bogged down trying to manage when and how to take them.
If supplements are not paired with lifestyle change, they will not make much of a difference. For instance, adaptogens may help your body balance stress hormones better, but unless you address sleep, stress management and circadian rhythms your body is going to remain stressed out!
Supplement overload is another way to misuse your finite resources especially your money. If you are overwhelmed with supplements, try to narrow down the amount you are taking. You can always add a supplement back in if need be. But, removing supplements can be a good way to test if you are actually benefitting from the supplement.
Many practitioners also tend to go overboard with supplements. I would be wary of this since many profit from supplement sales. Supplements should be used responsibly and not abused.
Healing becoming a full time job and living taking a back seat
When I was moving through my own healing journey, it consumed my thoughts 24/7. I didn’t care about my job, seeing my friends/family or making time for my hobbies. Every free second was dedicated to getting better.
Being too laser focused on healing actually may prevent healing. This was the case for me and many of my clients. You should not forget to live while you are healing.
You might still struggle to live life to the fullest if you are not at 100% but you can still make time for connection, engage in hobbies and accomplishing work tasks. If you isolate yourself from the people and activities you love, your health will suffer and you can become stuck.
Obsessing about getting well is a constant reminder that you are not well. If you are constantly ruminating that you are sick, you are creating beliefs that you are sick and that can effect your biology.
As Dr. Bruce Lipton writes in his amazing book, Biology of Belief, “Cells, tissues and organs do not question information sent to the nervous system. Rather, they respond with equal fervor to accurate life affirming perceptions and to self-destructive misperceptions. Consequently, the nature of our perceptions greatly influences the fate of our lives.”
To sum up this quote, if you believe you are sick or broken, you could stay sick and broken. Continuing to live your life can prevent you from slipping into toxic “sick” belief patterns.
And you can not heal if you have removed all pleasure from your life. Humans need play, touch and hobbies to ignite us. Your body can slip into a fight or flight state if you are not prioritizing enjoyment daily.
Use your finite resources wisely. Diversify your intervention strategies. And don’t forget to live your life.