SIBO, antibiotics, acid drops, and Herxheimer reactions

[hb8847]

Hi, do any of you have any experience with SIBO-related Herxheimer reactions (i.e. "die off" reactions) following antibiotics, specifically Rifaximin and/or Neomycin?

I have been struggling with SIBO for some time and have been given a plan of action by my specialist doctor who I like, which includes dietary adjustments, stomach acid droplets, and antibiotics (the full plan I've described below).

The issue I've got is that I've barely been able to make any progress because I'm already getting such strong Herxheimer reactions from the stomach droplets, let alone the antibiotics. I'm meant to get up to 20 droplets before each meal - right now I'm not able to even take more than two.

I'm considering going ahead and trying to take the antibiotics first, in the hope they'll give me less of a Herxheimer (I've read some accounts of people not reacting to them).

Does anyone have experience of this? Is there anyone who has had such a low tolerance to acid droplets or gut medications? I feel it's crazy how overladen with SIBO I appear to be. I have a hunch my Herx might be being made worse by the fact I'm already on methylation supplements which will be upping my inflammation. I also worry that I may also have candida even though this didn't show up on my recent stool test.

Anyway, any input would be greatly appreciated. Thanks in advance.


P.S. Here's the full plan

1. Follow strict FODMAP & no sugar diet (have already been doing this for years - I eat mainly veggies, seeds, meat, nuts, some fruit)

2. Digestive enzyme before each meal

3. Take stomach acid drops before each meal (I also have very low stomach acid which has probably contributed to my SIBO), starting at 5 x 3 meals and slowly working up to 20 x 3.

4. Once taking 60 drops daily begin a course of antibiotics. Specifically Rifaximin and Neomycin, together, for 2 weeks.

5. Then take Microbinate, a natural antibiotic for 2-4 months.

6. Begin taking Probiotics as soon as the course of antibiotics is done.

PPS. I originally posted this in the "Gut" section but seeing as it cuts across lots of different areas (methylation, autoimmunity) I thought I'd post it here in the hope of getting more traction. Hope that's OK.

Hugo

 

[ljimbo423]

The issue I've got is that I've barely been able to make any progress because I'm already getting such strong Herxheimer reactions from the stomach droplets, let alone the antibiotics. I'm meant to get up to 20 droplets before each meal - right now I'm not able to even take more than two.

This issue of die-off symptoms is extremely common in ME/CFS. I get big die-symptoms from relatively small amounts of antibiotic herbs even after treating sibo for 3 years. Because I can't tolerate high enough doses of herbs to wipe out sibo fairly quickly. I've been slowly chipping away at it.

I didn't have any bad reaction to Rifaximin at all. Just some mild loose stool one day.

I feel it's crazy how overladen with SIBO I appear to be.

The reaction you are having doesn't nessesarily mean you are overladen with SIBO. Instead, I think it's our body and brains OVER-reaction to the lipopolysaccharides (toxins) that are dumped into our bloodstream from killing off inflammatory bacteria in our gut.

The plan you have in place looks like a good one. Probably your biggest challenge will be dealing with the die-symptoms from killing the overgrown bacteria in your gut.

 

[hb8847]

Thanks Jimbo. I feel like you're constantly helping me out with stuff on this site, so thanks again. I really appreciate all the advice you've given.

The reaction you are having doesn't nessesarily mean you are overladen with SIBO. Instead, I think it's our body and brains OVER-reaction to the lipopolysaccharides (toxins) that are dumped into our bloodstream from killing off inflammatory bacteria in our gut.

Surely that's proportionate to the amount of toxins that are being dumped in the body though (which is itself proportionate to the amount of bacteria?) Like, regarding my stomach acid issue, the advice from both the supplier and my doctor is to begin at 5 drops per meal and increase to 20. I can't even do 2 without suffering an intense Herx that lasts a couple of days.

Note this is just stomach acid - it's what we all have in our stomach anyway and I'm just redressing the balance of something that should naturally be far higher. And this is already flooding my body with enough bacterial toxins to be giving me an intense Herx on its own. It's all a bit demoralising.

Plus, while I understand the rationale behind going slowly, I am 5 years into this game and evidently haven't made much progress. If it's just a case of my body overreacting than why bother going slowly, why not just take the full whack of antibiotics / acid drops and let my body deal with the outcome? Presumably getting rid of a lot of SIBO will improve my health after doing so? Is there any risk to one's health doing this?

I didn't have any bad reaction to Rifaximin at all. Just some mild loose stool one day.

...

The plan you have in place looks like a good one. Probably your biggest challenge will be dealing with the die-symptoms from killing the overgrown bacteria in your gut.

See this is the temptation for me. If there's any way I can kill this bacteria without enduring the Herx reactions (which Rifaximin seems to achieve), then why not just do that and be done with the stomach acid stuff/microbial stuff that pushes me into Herx?

Thanks
Hugo

 

[ljimbo423]

Thanks Jimbo. I feel like you're constantly helping me out with stuff on this site, so thanks again. I really appreciate all the advice you've given.

Your welcome! Happy to help.

Surely that's proportionate to the amount of toxins that are being dumped in the body though (which is itself proportionate to the amount of bacteria?) Like, regarding my stomach acid issue, the advice from both the supplier and my doctor is to begin at 5 drops per meal and increase to 20. I can't even do 2 without suffering an intense Herx that lasts a couple of days.

Sorry, I didn't word what I said regarding this very well. Yes, the amount of toxins from die-off and our body and brains over-reaction to them, both are what create such horrific symptoms.

Have you heard Jarred Youngers' theory of "sensitized microglia" in the brain causing brain inflammation and our symptoms? I think these sensitized microglia get activated by the toxins released from our gut and the more toxins released, the more activated the microglia become and the worse we feel. Because they are sensitized, these microglia over-react, causing a lot of inflammation in the brain, from very little stimulation.

Note this is just stomach acid - it's what we all have in our stomach anyway and I'm just redressing the balance of something that should naturally be far higher. And this is already flooding my body with enough bacterial toxins to be giving me an intense Herx on its own. It's all a bit demoralising.

I use to get a worsening of symptoms from almost any supplement (not even related to the gut), even taking the tiniest of doses. Yes, it really is very demoralizing!

Plus, while I understand the rationale behind going slowly, I am 5 years into this game and evidently haven't made much progress. If it's just a case of my body overreacting than why bother going slowly, why not just take the full whack of antibiotics / acid drops and let my body deal with the outcome? Presumably getting rid of a lot of SIBO will improve my health after doing so? Is there any risk to one's health doing this?

I don't know if there's any risk to your health doing that. If you can tolerate that, you will have jumped the biggest of hurdles in my experience. I've tried it and I get so sick I can't take care of myself and I live alone. So for myself, it's not an option.

See this is the temptation for me. If there's any way I can kill this bacteria without enduring the Herx reactions (which Rifaximin seems to achieve), then why not just do that and be done with the stomach acid stuff/microbial stuff that pushes me into Herx?

Actually it's the 2 courses of Rifaximin I took first, that allowed me to take bigger doses of antibiotic herbs, with little die-off, as long as I didn't go crazy with them.

So this might be a good plan for you. Although some people do have a bad reaction to Rifaximin, they seem to be in the minority. Most people tolerate Rifaximin very well.

 

[EddieB]

As I posted elsewhere, xifaxin made me horribly ill. I think Rifaximin is the same. Hopefully it will help you.