Sharing is caring!

I spent 4 years with SIBO. I relapsed 5 times.

And I tried a lot of supplements.

Some made a real difference. Some were a waste of money. A few I’d never go without.

I haven’t relapsed since 2018. These are the supplements I’d reach for again, in the order I’d use them, with what the research says about each one.

Click HERE to save this article for later.

Before you buy anything

Confirm SIBO with a breath test first. Bloating has a lot of causes, and SIBO supplements won’t help if SIBO isn’t the problem. Start with my Buyer’s Guide to SIBO Tests.

Work with a practitioner. Your test type (hydrogen, methane, or hydrogen sulfide), health history, and medications all change which supplements make sense.

Remember what supplements can and can’t do. They support each phase. They don’t replace finding the underlying cause. Read When SIBO Keeps Relapsing for more on that.

New to SIBO? Read Printable SIBO Diet and my SIBO Diet guide first.

SIBO supplements by phase

Phase 1: Clear the overgrowth

This is the “kill” phase. It’s usually done with prescription antibiotics, herbal antimicrobials, or both.

Clear Plus + Digest Plus (my Herbal Stack)

These are my 2 SIBO herbal formulas, made to be taken together.

• Clear Plus: French tarragon, Indian tinospora, horsetail, thyme, pau d’arco, stinging nettle root, and olive leaf
• Digest Plus: dill seed, stemona, wormwood, java brucea, Chinese pulsatilla, Jamaica quassia, cutch tree, and hedyotis

In a 2014 Johns Hopkins study, 46% of people on herbal protocols had a normal breath test afterward, compared with 34% on rifaximin. (source)

Make note: the study tested Biotics Research’s Dysbiocide + FC-Cidal and a Metagenics pair. Clear Plus and Digest Plus use the same herbal ingredients as the Biotics pair, but the study didn’t test my formulas themselves.

Digest Plus contains wormwood. Read the safety section below before taking it.

Go deeper:

• Herbal Antibiotics for SIBO (all 13 herbs and the evidence for each)
• Herbal SIBO Support vs. Rifaximin

Berberine

Berberine comes from plants like barberry and goldenseal and is one of the most common SIBO herbs.

A trial comparing berberine with rifaximin for SIBO has been designed, but I couldn’t find published results yet. (source)

Berberine can lower blood sugar and interacts with several medications, so check with your doctor first.

Allicin

Allicin is the active compound in garlic. Garlic compounds lowered methane production in animal studies (source), which is why allicin is often used for methane-type SIBO (IMO). It hasn’t been tested in people with SIBO.

I used Allimax, which you can purchase through my Fullscript Online Dispensary.

Oregano oil

Oregano oil is a common herbal antimicrobial and is part of the Metagenics pair from the Johns Hopkins study. Never take oregano essential oil straight or beyond what a product label says.

Phase 2: Support digestion

This is where most people stop too soon. These supplements support the things that help keep SIBO from coming back: digestion, stomach acid, and motility.

Break Down (digestive enzymes)

Break Down is my digestive enzyme formula. Enzymes help break down protein, fat, and carbohydrates, so less undigested food is left over in the small intestine.

There’s no SIBO-specific research on enzymes. I use Break Down because it made a noticeable difference for my own post-meal bloating.

Increase Now (Betaine HCl + pepsin)

Stomach acid kills many bacteria before they reach the small intestine. Low stomach acid, including from long-term acid-reducing medications, raises SIBO risk. (source)

Betaine HCl is a supplemental form of stomach acid. In a small study of 6 healthy volunteers whose stomach acid had been lowered with medication, 1,500 mg of betaine HCl brought stomach pH down within about 6 minutes, and the effect lasted a little over an hour. (source)

Increase Now has 750 mg of Betaine HCl with pepsin.

Read more in my Ultimate Guide to Low Stomach Acid for Women.

Move Now (motility support)

Your small intestine clears itself between meals with a wave called the migrating motor complex. Research links a missing cleanup wave to SIBO. (source)

For me personally, slow motility was the main reason my SIBO kept coming back. Supporting motility after treatment was one of the biggest changes I made.

Move Now is my motility formula.

Read more in Prokinetics for SIBO.

Phase 3: Support the gut lining

These are traditional gut-lining supports. None of them have been studied for SIBO specifically, so think of this phase as optional.

• L-glutamine: an amino acid the cells lining your gut use for fuel. Read L-Glutamine Dosage for Leaky Gut.
• Slippery elm and marshmallow root: plants that form a gel-like coating when mixed with water. Ask your doctor about timing if you take other medications.
• DGL (deglycyrrhizinated licorice): licorice with most of the glycyrrhizin removed, the compound linked to blood pressure side effects.

Phase 4: Rebuild with probiotics

Yes, probiotics can be part of SIBO care.

A review of 18 studies found probiotics cleared SIBO in about 63% of people, lowered hydrogen levels, and eased abdominal pain. They didn’t prevent SIBO. (source)

While probiotics are subjective, I found great success with them after I had cleared the overgrowth.

Read Should You Take a Probiotic with SIBO? for the full breakdown.

Other SIBO supplements worth knowing about

• PHGG (partially hydrolyzed guar gum): in one trial, adding PHGG to rifaximin raised the SIBO clearance rate from 62% to 85%. (source)
• Biofilm disruptors and ox bile: used by some practitioners. Ask yours whether they fit your protocol.

Who should NOT take these supplements without a doctor

SIBO supplements FAQ

What is the best supplement for SIBO?

There isn’t one best supplement. The strongest research is for herbal antimicrobial combinations (46% normal breath test in a 2014 Johns Hopkins study) and probiotics (about 63% SIBO clearance in a review of 18 studies).

Can you take probiotics with SIBO?

Yes, for many people. A 2017 review found probiotics cleared SIBO in about 63% of people and lowered hydrogen levels, but they didn’t prevent SIBO.

Does low stomach acid cause SIBO?

Low stomach acid is one of the known risk factors. Stomach acid kills bacteria before they reach the small intestine, and long-term acid-reducing medication raises SIBO risk.

What should I take after SIBO treatment?

Many people focus on motility support, digestion support, and probiotics after treatment. Work with your practitioner to choose based on your test results and what caused your SIBO.

If you liked this post on the best supplements for SIBO, you might also enjoy:

1. Herbal Antibiotics for SIBO
2. When SIBO Keeps Relapsing
3. Prokinetics for SIBO

Xox,
SKH

This post contains affiliate links, and Clear Plus, Digest Plus, Break Down, Increase Now, and Move Now are my own products. I only share products I use and trust.

These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

This content is for education only and isn’t medical advice. Please work with your doctor before starting or changing any supplement.