Principles:
Antimicrobials are used in conjunction with probiotics and targeted nutrients to help reestablish a healthy gut microbiome. Based on your specific test results and symptoms, we will tailor a combination of some but not all of the supplements described below.
- Antimicrobials (GI Synergy and Lauricidin) should be taken at least one to two hours before or after taking the probiotics.
- InterFase Plus or Biofilm Defense is used to disrupt biofilm, making microbes more susceptible to the antimicrobials.
- For your probiotics, Prescript-Assist and Ideal Bowel Support may be taken on an empty stomach, but MegaSporeBiotic is best taken with or just after a meal.
- PHGG, or partially hydrolyzed guar gum, is a prebiotic (think of this as food for the GI microbes) that is generally well tolerated and may increase treatment efficacy.
- Iberogast and MotilPro may also be recommended as part of your treatment plan to help support normal bowel motility (normal muscular contractions of the gut help to sweep bacteria through the small intestine, treating or preventing overgrowth).
Start out slowly with the supplements and gradually increase your doses as tolerated. (Please see specific dosing recommendations below.)
Symptoms of microbial die-off are varied, and may include any of your usual symptoms in addition to digestive distress, skin rash, and fatigue. If you experience any of these symptoms, reduce the antimicrobial doses for a time before increasing. You do not want to exceed your body’s detoxification capacity.
As you increase your probiotics, if you experience gas, bloating, or undesired changes in stool frequency, then decrease the dose until the symptoms pass. You may then either continue on at the lower dose or try increasing to two capsules daily. Keeping in mind the above principles, there is flexibility in timing your antimicrobials and probiotics. If you are taking activated charcoal as part of your treatment, it can be taken at any time when it will be at least 90 minutes before or after other treatments.
Here is one example of how to time your therapies, based on eating three meals a day.
- This sample protocol is designed for the maximum doses. Please note that as you start your healing, you will not be taking your treatments at the frequency described.
- Your specific combination of supplements will vary depending on several factors.
In this example, the following antimicrobials are used; InterFase Plus (more specifically this is a biofilm disruptor), GI Synergy, and Lauricidin. The following probiotics are used: Prescript-Assist and MegaSporeBiotic. This example also includes ox bile, Digestzymes and Betaine HCl (since SIBO is often associated with low stomach acid and decreased digestive capacity).
Sample Day
| On rising | InterFase Plus Prescript-Assist |
| Breakfast (at least one hour after taking InterFase Plus) | Ox Bile (pre-meal) Digestzymes and Betaine HCl Lauricidin GI Synergy |
| Lunch | Ox Bile (pre-meal) Digestzymes and Betaine HCl Lauricidin MegaSporeBiotic |
| Late afternoon (at least one hour before dinner) | InterFase Plus |
| Dinner | Ox Bile (pre-meal) Digestzymes and Betaine HCl Lauricidin GI Synergy PHGG |
| Before bed | Prescript-Assist |
Specific dosing information:
Antimicrobials
Interfase Plus may be started with one capsule twice daily, on an empty stomach. Then slowly increased to three capsules twice daily. Dose increases should be gradual and only as tolerated based on your symptoms. Specifically, this is a biofilm disruptor and can be taken with probiotics.
Lauricidin pellets may be started from a 1/4 teaspoon to one full teaspoon, two to three times daily. Increase up to one full teaspoon three times daily, with meals, as tolerated. Taking these doses in conjunction with a cool liquid is also beneficial
GI Synergy may be started at one pack daily with breakfast, and then increased up to one pack twice daily, with breakfast and dinner.
Probiotics
Prescript-Assist is best started with one capsule per day. After one week, increase up to two capsules daily. If you develop uncomfortable symptoms, such as gas and bloating, decrease the dose until your symptoms resolve, and then increase to one capsule twice daily, or maintain one capsule daily, depending on your symptoms and goals.
MegaSporeBiotic can be started with one capsule daily and increased up to two capsules once daily. This is best taken with or just after a meal.
Ideal Bowel Support (containing Lactobacillus plantarum) may also be used if you have high methane gas on your SIBO breath test. We recommend L. plantarum based on research indicating that this specific strain of Lactobacillus may help address methanogen overgrowth. Please take one capsule of Jarrow Ideal Bowel Support twice daily for two months, then decrease to one once daily for at least one more month or as recommended. This can be taken at the same time as Prescript-Assist.
MotilPro
MotilPro supports healthy gut motility, or muscular contractions, by supporting the neurotransmitters in the gut. Take two to three capsules of MotilPro twice daily between meals. MotilPro is not necessary nor is it recommended for patients with diarrhea.
Iberogast
Iberogast is a herbal formula that improves GI motility and can be thought of as an adaptogen. This means that it increases bowel motility in people with constipation and decreases motility in people more prone to loose stools. During the first 30 days of treatment, about 20 drops of Iberogast should be taken at the beginning of meals. Iberogast may be used beyond treatment to support normal motility and prevent SIBO recurrence with a maintenance dose of about 20 drops before bed.
Digestive Enzymes and Betaine HCl
Digestive Enzymes and Betaine HCl supplements can be taken at the beginning of meals to improve digestion and nutrient absorption. Bacterial overgrowth is often associated with low stomach acid and impaired production or secretion of digestive enzymes. You can experiment with the dose of Betaine HCl that is right for you, but no more than six to seven capsules per meal should be used. You may find that with smaller meals you need less of this digestive support.
Partially Hydrolyzed Guar Gum (PHGG)
Partially Hydrolyzed Guar Gum (PHGG) is a water-soluble, non-gelling fiber that can be used for therapeutic purposes as a prebiotic. It is generally very well tolerated and may increase the microbial production of short-chain fatty acids, as well as help support the beneficial bacteria, specifically Lactobacillus and Bifidobacterium. Take one full scoop mixed in water once per day with or without food.
Ox Bile
Ox Bile supplementation is used to improve fat digestion and absorption. It is particularly useful in patients who have had their gallbladders removed. It is taken right before meals in doses from 100 to 500 milligrams.
Dosing Info;
Interphase Plus
– 3 pills upon rising
– 3 pills late afternoon (at least 1 hour before dinner)
A bottle will last you 20 days at the above dose
Prescript Assist
– 1 pill upon rising
– 1 pill before bed
– if possible, swallow capsule
A bottle will last you 30 days at the above dose
Megaspore Biotic
– 2 capsules with lunch
– ensure this is taken with food
A bottle will last you 30 days at the above dose
Lauricidin
– 1 scoop with breakfast
– 1 scoop with lunch
– 1 scoop with dinner
– A bottle will last you 25 days at the above dose
GI Synergy
– 1 packet with breakfast
– 1 packet with dinner
A bottle will last you 45 days at the above dose
Candibactin BR
– 2 tablets upon rising
– 2 tablets late afternoon (at least 1 hour before dinner)
A bottle will last around 22 days at the above dose
Betain HCL
– taken immediately before any large meal (breakfast, lunch, dinner)
A bottle will last around 50 days at the above dose