Today is the day I begin sharing this journey with you with Healing SIBO for Good Volume 1.

At the end of Where There’s a Will, I stated, “And I’m going to share with you (exactly) how, too so that you know where there’s a will there is always a way.”

Click HERE for Healing SIBO for Good Volume 2, and click HERE for Healing SIBO for Good Volume 3.

Update as of April 2017: I am thriving and my SIBO is almost gone completely.

Update as of 2020: I am healed.

Healing SIBO for Good Volume 1

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Healing SIBO for Good Volume 1

I have every intention of fully healing my SIBO.

I refuse to live this way, and if you have SIBO and/or anything else like it then you should refuse to live this way as well.

For anyone who says the gut-brain axis is not real, just ask my husband what the past few weeks at our house have been like.

It is real, and it is real awful.

I went months and months with feeling phenomenal, and getting back to that place, forever, is my goal.

It truly was unlike anything I have known in years.

To say I had a new lease on life would, at this point, be an understatement.

How I Relapsed

We can’t move forward until we understand the past.

They don’t know for sure why people relapse, but like I’ve mentioned several times before, most people do relapse. I made it so long that I was almost certain I was going to be an exception.

The main reason people relapse is that the underlying issue is not addressed. With SIBO, there is always something more severe happening typically.

My underlying issue is motility, or lack thereof (MMC dysfunction). I have extremely low levels of stomach acid and impaired gut motility which means that food moves at far too slow of a pace through my digestive tract. The slower transit time then causes fermentation in the small intestine, leading to SIBO and other gut problems.

I failed to really work on the motility, and thus I relapsed.

For me, this happened because I was not working enough on my stomach acid levels. Couple that with stress, and my levels decreased even further. And finally? While I was well enough to train for my first Spartan, I do believe that training that hard and running that much (for me) was the straw that broke the camel’s back. I began to fail quickly in early November, right after Spartan. Sigh.

Healing SIBO for Good Volume 1 Medications


The Rifaximin hasn’t arrived yet (I imagine it will today or tomorrow), so as soon as it arrives, my medications will consist of:

  1. Rifaximin.

    I am on a high dose, and I don’t think this is normal for most. But for me, it’s going to look like this: 3 pills per day for 21 days. I will take the doses at or around 8 am, 2 pm and 8 pm, each time with food.

  2. Neomycin.

    2 pills per day for 10 days. I will take the doses at or around 8 am and 8 pm, each time with food.

  3. LDN (Low Dose Naltrexone).

    This is the prokinetic agent that I have been taking for quite some time. I know it’s helping with motility. It’s taken nightly before bed.

I am doing everything in my power to avoid all NSAIDs.

Healing SIBO for Good Volume 1 Supplements


  1. Betaine HCL

    With each higher protein meal I consume, I’ll take 8 Betaine HCL pills. Seem high? It is, and I cannot recommend that amount for anyone. I have worked to arrive at this amount with my doctor. My goal is to quickly get back down to 1-2 pills per meal.

  2. L-Glutamine

    1-2 tablespoons per day.

  3. Gelatin

    1 tablespoon per day. (Best Gelatin)

  4. Vitamin D

    5-7,000 IU’s per day. I take this via liquid drops.

  5. Herbal Supplements.

    Instead of antibiotics, you can take an herbal antimicrobial supplement. Because my SIBO was so severe this didn’t work for me initially, but after this round of antibiotics, I may take it with the hopes of continuing to eradicate any final bugs. This is still TBD.

  6. Perma-Clear. I take 3 of these twice per day to help with gut healing.
  7. Calcium, Magnesium, Zinc.

    I take 3 of these twice per day to help support various levels, deficiencies, and leaky gut.

  8. Cod Liver Oil. I take 1 teaspoon daily. (Samarah, Ryan, and Isaiah all take it as well.)

You just looked at that list and thought, “She needs a probiotic.” I don’t. In fact, until I get better and I’m certain the overgrowth has halted, I won’t add probiotics (in pill form) back into my routine.

And finally, these are some other supplements I take from time-to-time, depending on my current state and/or to fill any other necessary gaps: Oregano Oil, Berberine, Lauracidin, DHEA, Ox Bile, Cytozyme and Licorice root.

Healing SIBO for Good - Volume 1 Diet


  1. Let’s not restrict.

    At least not for now! The day I start this protocol (= day 1 Rifaximin), I will have zero restrictions with starch and FODMAPs for the antibiotics duration (21 days). The last time I took Rifaximin, I was off all FODMAPs (and most starches) for the first 2 weeks. I stayed miserable. I was frustrated and sort of gave up, eating all the things. Like “magic” I healed. I would later learn that you must be eating as many FODMAPs and starches as you can handle while taking the antibiotic. Otherwise, the bad little bugs will go into hiding and there will be no way to zap them. Does this excite me? Ah. yeah.

  2.  Post-Antibiotics Diet.

    I don’t know. I seriously have no idea. And honestly, I’m not making plans for it today. This will be decided around day 20-ish likely. Depending on my state, I’ll know what I need to do. My doctor has recommended a version of low-FODMAP, Paleo, SCD, GAPS. This is, of course, very low carb, and I don’t believe that’s right for me. Low-FODMAP, Paleo, SCD, and GAPS are also all kind of contradictory in many ways, so when the time comes I’ll figure out the diet protocol that will work for me.

  3. More tea, less coffee.

    I’m still not willing to completely quit, but I am going to reduce to 1 cup per day and then hit the tea hard. This shouldn’t be too much of a struggle because I am currently obsessed with THESE teas.

  4. Natural (food) Prokinetics.

    Ginger and garlic (I’ll try, even though it’s high FODMAP – it worked before!).

  5. Just be nutrient dense.

    Bone broth, need I say more? Sardines, liver (just bought my organic chicken liver again) and more.

  6. No alcohol.

    I rarely drink, but I think I’ll completely avoid all alcohol for a few months (post 21 days at least).

Healing SIBO for Good - Volume 1 Workouts


Last night I got the FitBit ChargeHR. I made the responsible, though not desired decision, that for the next year I will not do any kind of half-marathon or Spartan.

This decision crushed me because I had every intention of doing the Super Spartan in San Francisco in July, and this time I was going to do it for time.

But these past few weeks filled with nausea and massive bloat have left me with a stronger desire than ever to completely kick this.

If I can survive for a year, I do believe I will be in the clear, and 34 will still be young enough to PR any course!

The next year will look like this:

  1. Walking

    45-60 minutes of walking on most days of the week. This helps with motility and with stress. Besides, it’s beautiful out almost always in Northern California and we love it outside! (I got the new FitBit for extra motivation with overall steps and movement.)

  2. 2-3 workouts per week – max!

    First I take away Spartan, and now I’m even taking away any excess time in the gym. But every time my gut has been off and I have pushed it, even a little too much, with gym workouts, I flare badly. I don’t go to the gym to sit around, chat and vanity workout. I get in, workout super hard and get out. But with that comes stress on the body. Research indicates that for short amounts of time, and as long as there is an appropriate resting period afterward, this is okay (and can even help with motility). I will continue on with the style of workouts I’ve been doing. (We start a new 3-day workout this week, which I’ll hopefully be able to share soon.)

  3. Pool.

    Our pool should be open in April or May, so this gives me something to look forward to from a low-impact, low-stress workout standpoint. I can’t even wait!

  4. Biking

    . Ryan got me a Schwinn bike, which is no road-racing bike, so I’ll hook up Samarah’s Burley Trailer and we’ll leisurely stroll around….because this is fun, peaceful and stress-free.

  5. Bikram.

    I miss Bikram. I have to be real careful with it because I’m hypermobile, but I think I’ll go back a couple times a month to help with stress and overall body movement.

Healing SIBO for Good - Volume 1 Lifestyle


The lifestyle component, even if you think it’s not real, might be the most critical component for healing.

This is the piece to the puzzle that, when it’s all said and done, if you haven’t figured out might be the last piece for true healing.

I focus a ton on this these days, and when I work with women to help with their own SIBO and other digestive issues, we always dig in here.

  1. Journal

    I love a pretty journal. You do, too. But this time, for this part of my journey, I decided to keep it super simple and scrappy, documenting in a new way. Regardless, the more we transfer thoughts to paper, the less stress we feel, so this will be at the top of the list daily.


  2. Breathe

    Find my breath more, and remember to just breathe.

  3. Massage

    I am trying to get one full massage plus one foot massage monthly.

  4. Decisions

    I just made a huge one that will greatly reduce my stress levels. Again, this is not something I am ready to share yet, but you’ll know when I do. Making the decision lifted a million bricks from my shoulders already.

  5. PSOAS-SIBO Connection

    This one can fit in exercise or lifestyle, but along with being hypermobile, my sports doctor said that one of the main issues is with my PSOAS. The connection runs deep between the PSOAS and SIBO, so I will need to research more about it and address ways for strengthening it.

Gut-Healing Fast Track

At the end of the day, these all fall into my method for the gut-healing fast track. But I now know that there is nothing fast (or easy) about healing SIBO. If you’re not working daily on the root issue, relapse is imminent.

Healing SIBO for good is not going to be easy, but the only way to arrive at a rainbow is to walk through the rain.

If you liked this post, you might also enjoy:

    1. What is Low Dose Naltrexone
    2. Healing Blooms from Within
    3. Should I Do the Low-FODMAP Diet?


Healing SIBO for Good - Volume 1

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  1. Thank you Sarah! This was amazing. I’m starting my second round of SIBO anti-fungals today too (ironically) and am trying to stay positive about the journey. I thought I was going to be done after my first round, but sadly, no. It’s hard to keep going when you feel like you’ve been doing this for so long (not including all of the money I’ve spent on healing this darn overgrowth). I actually learned a lot reading this article – I’m bookmarking it to refer back to. I had no idea it was actually strongly encouraged to eat as many high-fodmap and starchy foods during the antifungals so that the bugs come out and we can kill them. My ND told me there were no restrictions and to eat what I want (within the paleo diet that works well for me) but I didn’t know that I should be loading up on sweet potatoes, plantains, plantain chips, yucca etc. That makes me happy! I definitely thought that might’ve contributed to not killing all of the bugs during the first round (hence, my second dose of antifungals) but it seems like it’s not.

    I would LOVE more of these types of posts moving forward. Super helpful and makes me feel like I’m not alone in what I’m going through. Thank you!! 🙂

    1. You are most welcome. And yes, do eat all the things, BUT also keep in mind that you shouldn’t have to make yourself super miserable. Go to the extent you are comfortable with.

  2. ((((Sharing)))) but I’ve been carrying those words around with me like a mantra in work fitness friendships sistering daughtering—everything.
    Cannot cannot move forward until we understand the past.

  3. Its so funny – just last night I pulled out my pool bag to start swimming again (since it’s been so warm the past few days!).

    I just saw my new dr today and I got so unexpectedly emotional (that is NOT me) but I finally felt like I was being heard and a weight was being lifted off of my shoulders. I’m really optimistic that I will finally learn what my underlying issues are.

    Also, I have no idea if this is something related to what your sports dr has talked to you about, but I listen to Dr Ruscio’s podcast and this episode might be something of interest to you, if you haven’t already listened to it:

  4. Hi Sarah!
    I just finished my second round of herbals and mailed my breath test off yesterday, so…
    Curious about your thyroid meds…you said you are going off of them? Would you mind explaining your reason behind that decision? I take Naturethroid, but have no thyroid due to cancer. I know getting my dose optimized is crucial to motility.
    Thank you for writing about this. I will be following closely.

    1. I do not recommend people just go off of their meds without consulting a doctor. The reason I did, though, was because my thyroid was never that bad to begin with, and what I was hoping the meds would help with didn’t. Because I’m taking so many things currently, I went off of it. I’m trying to remove as many things as possible:)

  5. rolfing will help your psoas best of like to you and youve got to check out restore Im not affiliated but when I get with it with technologies Ill spread the word again God Bless
    sincerely Caroline

  6. I healed my SIBO and I will give you some advice:
    1. Do NOT stop the thyroid because it is vital to keeping motility going!
    2. Do not eat high fiber foods
    3. Give yourself at least 5 hours between meals.
    4. After you do the rifaxamin, make sure you start a good probiotic like Now gr8dophilus enteric coated and Fluorastor for both bacterial and yeast rebuilding of your microbiome. If you don’t do it right away, you will be back to the same sad state.
    Best of luck!!!

  7. Why would you be stopping the WP thyroid? I am on it now after previously being on a combo of Nature Throid and Tirocint and I think it’s actually aggravating my SIBO. I hope it’s not the inulin, although a teeny dose.

  8. Hi Sarah, I have methane & hydrogen SIBO. My functional medicine doctor prescribed me herbal antimicrobials for 2 months (Candibactin AR, Candibactin BR, atrantil); my GI provider prescribed me Neomycin and Rifaxamin. We are still waiting to see if the rifaxamin gets approved by my insurance. I am weery to go the herbal route only after hearing that it did not work for you. What do you know about trying to do herbal and the anbiotics? Should I start both at the same time or start one and then the other after? Thanks!

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