It turns out I was wrong. My SIBO testing results showed that I actually did in fact still have SIBO.

Somehow I only saw that I tested negative for Hydrogen.

I did not see the place that showed positive for Methane.

This version is a beast to get rid of, but I now have a plan for moving forward and a methane dominant SIBO protocol.

After expressing extreme frustration to my doctor via our portal, he immediately wrote my Rifaximin prescription but said that before I did anything we needed to have a quick call.

So after those 8 weeks, we will re-test and then….

Let’s get this very clear and out of the way before I share with you the conversation we had and my protocol moving forward. I stopped him dead in his tracks when he said that.

“No, no I will not be re-testing in the near future nor maybe ever again,” I said.

He immediately took back his words and said, “You are absolutely right. I am sorry. We need to move forward with you based on symptoms.

Methane Dominant SIBO Protocol

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Methane Dominant SIBO Protocol #sibo #guthealth #guthealing

What you want to know right now is what I will be doing, yes?

Methane SIBO Antibiotics and Herbals:

  • 4 weeks Rifaximin (it will take awhile to get here because if you remember, I get it from Australia)
  • Followed by 4 weeks Dr. Siebecker Herbs (Learn more about natural antibiotics via herbs HERE.)
  • Followed by 4 weeks of a supplement to starve the Methane producers

Diet to accompany Methane Dominant SIBO

The diet falls in line (mostly) with my post on how to starve gut bacteria.

The only difference now is that when I’m on the Rifaximin I will resume eating all the FODMAP foods.

  • From now until a few days before the Rifaximin arrives I’ll keep Low-FODMAP plus SCD. In fact, if you want the truth, yesterday I did GAPS Intro. The day was hard, but as I knew it would, left me sans-100 gut symptoms.
  • A few days before Rifaximin through Rifaximin and the Dr. Siebecker Herbs (8-weeks total), I’ll be back to a High-FODMAP diet (will still remain SCD). Bring on the garlic, cauliflower, onion, broccoli….(I’m seriously counting down the days!)
  • Once I reach the final 4 weeks, I’ll go back to Low-FODMAP.
  • At the point when I’m feeling phenomenal again (which, the reality is that it will likely be a long time before this point in the game), I will add in FODMAP-by-FODMAP food, watching for reactions and making sure I’m flourishing.

Are you reacting to FODMAP foods, even? If so, how? And are you a hydrogen and/or methane producer? You can actually find out at home with a tiny device.

My doctor feels bad that I was an unlucky one to relapse post substrate. I, too, was extremely frustrated until it hit me that maybe now is my chance to finally put SIBO to rest for a very, very long time.

This has forced me to look at other areas in my life, supplements, workouts and general lifestyle from a more microscopic viewpoint.

  • I began a Healing Bullet Journal 
  • Decided to find a local gym where I could bring both children so that I can take that time back for myself
  • Realized that I relapsed the first time after too much workout and then this last time with almost zero workouts (in other words, the correlation, for me, is not that strong)
  • Acknowledged that the state of my stomach acidity levels is still not anywhere near it needs to be in order for appropriate motility to occur
  • Am realizing some friendships and relationships are just not helping my healing process
  • Beginning to accept that there are so many things I cannot do on my own, and therefore, I have begun researching and seeking out additional help for them
  • Hired an awesome part-time nanny, one I can really count on, who give us the consistency we need in our lives (also allows me to do all the Nutiva projects I love and when there is extra time, work on my book, blog, etc.) and who the babies call “Auntie” because her name is too hard for any of us to say 🙂

There is nothing easy or fun about Methane dominant SIBO.

UPDATED IN 2022 TO ADD: I BEAT it! I’ve been SIBO-free and symptom-free since I fully healed my gut in 2018.

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Methane Dominant SIBO Protocol

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  1. Hi Sarah –

    Are you telling your doctor that you don’t want to retest the SIBO because the test is so expensive and SUCH a pain/hassle as well? Or, are you deciding to just not retest and go off of how you’re feeling for other reasons?

    I’m so curious because I’m on my 3rd round of antibiotics for SIBO and have successfully killed methane after two rounds, but the third SIBO test showed that after killing the methane, the hydrogen levels increased, so now I’m trying to kill hydrogen.

    I thought about saying the same thing to my doctor. I DON’T want to retest again, but would rather just treat my symptoms. I don’t know how well my doctor would receive that though…

    1. No, I told him no because the last time I did the test it made me relapse, if you remember. Sometimes that can happen, and he apologized. By the way, at the end of the day, doctor’s are just people like you and I. Your doctor doesn’t walk a day in your footsteps so if you think the test might not be for you, then mention it.

  2. Interesting timing! I feel like the rifaximin did not work for me this time- I started allicin and berberine (can’t do neem because of my transplant meds), and so far so good! It’s been about 5 days on them. I started the LDN like we talked about and my insomnia was HORRIBLE!! Did you experience that when you started? Any way, keep me posted. Glad you finally got through to the doc! xoox

    1. No, I did not experience that, but my 2 thoughts: 1. I know how much you’re taking, and that could be your issue. We started with just 1.5mg, and increased from there so as to monitor the insomnia. And 2. LDN just might not be for you (but I’d consider point #1 first).

  3. That’s what I was thinking. Going to try to half the dose and see how it goes. I do have to say, the allicin and berberine are helping so far. I don’t even mind my garlicky burps. Lol.

  4. Did you try using the coupon on the Xifaxin (rifaxamin) website? I used that, plus my insurance and it was free! I feel like I need to share that info!! Hope this next round helps!

  5. I hate to be a debbie downer.. but why does the doctor continue to write prescriptions for Rifaximin if you’re methane dominant. Its been shown that Rifaximin is for hydrogen only. Methane needs neomycin, or allicin.

    1. No, I completely get it. Instead of the Neo, he is doing the Siebecker herbs. The Rifaximin WORKS for me because I do still have a little hydrogen, and we need to make sure we kill it all. You are correct, though:)

      1. Thanks.. I am pretty much in the same boat as you. I didn’t per se have a relapse as much as my symptoms are not getting better. Its been 3 years since my initial diagnosis and I’m just starting to look at other causes (candida, hypo). But if nothing comes up.. I don’t even know what to do. I have a graveyard of supplements in my kitchen. SIBO is a beast.

    2. And also.. your third bullet was “Followed by 4 weeks of a supplement to starve the Methane producers”. Can you share what supplement this is, other than the herbals?

  6. Hello Sarah,

    First off let me start by saying reading your blog has given me some sort of hope with my SIBO. I’ve been suffering with this for the past 4 months (it first surfaced when I was doing hardcore exercise and an extreme diet) then got a little better once I stopped. I was put on Flagyl which had zero effect then on Rifaximin which helped a little but I relapsed right after I stopped. I believe I also have methane based SIBO and was wondering how many courses of antibiotics did it take you to heal & what supplement did you take to starve the bacteria? I’ve been on the low fodmap diet for the past 2 months with no avail.

    Appreciate your response on this

    1. Hi, Sara! If you put in “SIBO” on my search bar, you will see all the posts where I mention SIBO. I am currently working on the 3.0 version of my main e-book, which will include ALL this information (it’s already over 500 pages!). So stay tuned! In the meantime, I took 3 courses of antibiotics. Throughout the time, I have taken so many different supplements. My main supplement page can be found here -> BUT I believe that what I’m currently doing is having the most positive effects. You can find that tool box here -> All my best!

  7. I too have methane dominated SIBO. When you say you drink broth, do you mean bone broth or meat broth ?
    I have been drinking heaps of bone broth daily all my life but am thinking of doing chicken meat broth instead, as I have read that bones are muculiginous, thus feeding the bacteria. I have also stopped adding gelatin to my broth.

    Great point you made about relationships too, but difficult to execute I bet.

    Thanks for your article.

  8. Hey Sarah,
    I was recently diagnosed with methane SIBO and my insurance won’t cover the Rifaximin. Which is so disheartening. I have been struggling with GI issues for years and I finally have some type of answer. I will try the neomycin and herbal treatment but just afraid it is going to keep coming back. I am on a low FODMAP diet, recently cut out nut butter fully . I still have gluten free oatmeal and white rice so not sure if I will have to take those out.
    Again thank you for the tips and guidance! Hope everyone gets healed soon

  9. Hey what supplement are you using after the rounds of regular and herbal antibiotics? I’m about to start my own treatment for methane protocol as well. Just trying to get some more direction.

  10. HI there,
    I am curious as to why you go on the low fodmap diet before and after abx treatment. why not stay on it always ? wouldn’t it also help starve off the bacteria causing methane?

      1. ah ok. I get it. So going on the Low FODMAP Diet before would be just to help with reducing symptoms leading up to the treatment period?

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