Pepsin/HCL drops causing SIBO "die off" reaction?

[hb8847]

Recently I was diagnosed with SIBO following a stool test and my doctor has prescribed a number of treatments.

Further down the line are antibiotics (rifaximin and neomycin) as well as probiotics but to begin with he has recommended Pepsin/hcl drops to be taken with food to ensure my stomach acid is at an appropriate pH.

Specifically, the product is called "Guttae Pepsin" and contains the following ingredients:

Purified water
Glycerol
Hydrochloric acid HCl 37%
Pepsine

The doctor recommended to start with 5 drops x3 meals and then to gradually work up to 20x3.

Yesterday I tried it for the first time at just 3 drops per meal out of precaution. I didn't notice any reaction at the time but today I woke up with the most intense aching of my joints and have spent the day completely wiped out and in bed.

I suspect this is some sort of "die off" reaction, where the Pepsin solution has killed off some of the SIBO in my upper intestine and this has overwhelmed my immune sytem.

I'm wondering if anyone has experience of something similar?

I'm also a bit concerned I might be suffering from a fungal overgrowth in addition to the SIBO - nothing showed up on the recent stool test but it did on a previous one, and I have experienced very similar "die off" reactions to antifungal medication in the past.

 

[Mary]

@hb8847 - I think it could very well be a die-off reaction from the pepsin/HCL drops. You might try cutting the dose even more until it's tolerable.

In 2004 or so I took virgin coconut oil for candida. It was extremely powerful, I had a very strong herxheimer reaction so had to cut my dose, but stuck it out and gradually worked up to 2 tablespoons a day and after about 11 days, the die-off reaction stopped, and so did my candida symptoms.

I've been taking betaine HCL with pepsin capsules for many years with my meals. Many people with ME/CFS have low stomach acid, which can contribute to SIBO and other digestive issues. Since I've started taking the betaine HCL with pepsin, my digestion is way better and a SIBO test 4 years ago was negative.

 

[wabi-sabi]

Have you considered this is not a "die off" reaction, but that the medication itself is somehow making you sicker i.e. it's not the correct med for you? That would be my first thought if t were me.

 

[Wayne]

I've been taking betaine HCL with pepsin capsules for many years with my meals. Many people with ME/CFS have low stomach acid, which can contribute to SIBO and other digestive issues.

I take Betaine HCL as well, but also supplement with Magnesium Oil, which is made from Magnesium Chloride. Apparently, the Magnesium Chloride can easily be converted to HCL to help with digestion. I've also read that applying Magnesium Oil topically and having it absorbed transdermally is the quickest way to correct a magnesium deficiency. For a while, I got into the habit of putting some on my abdomen for digestion and absorption, but I got pretty tired of that routine after just a short while.

 

[hb8847]

Have you considered this is not a "die off" reaction, but that the medication itself is somehow making you sicker i.e. it's not the correct med for you? That would be my first thought if t were me.

I'm leaning towards it being being a Herxheimer because I had no immediate reaction whatsoever. The symptoms were only felt the following morning, and were very reminiscent of the die-off symptoms I used to get when taking antifungals a few years back (aching joints, just generally wiped out). Also the contents of the solution are pretty anodyne so I think a reaction to them is low risk. Thanks though for the suggestion, I'm not ruling anything out yet.