The Herbal SIBO Toolkit

The Ultimate Guide to Herbal SIBO Solutions: How to Target Your Symptoms and Get Relief

SIBO (Small Intestinal Bacterial Overgrowth) can be incredibly frustrating, with bloating, gas, and discomfort that just won’t quit.

But did you know that research has revealed certain herbs that target specific types of SIBO symptoms?

These aren’t just “old wives’ tales”﹣many of these herbs have scientific support to back their effectiveness, and the right combinations can make a huge difference in how you feel.

In this guide, you’ll find well-researched herbal options that match different SIBO types, from hydrogen to methane to hydrogen-sulfide. Whether you’re tackling hydrogen-related bloating, methane-driven constipation, or tricky sulfur-related symptoms, this guide will give you insights into the best herbs to help.

And remember: working with an IFM-certified functional medicine doctor like me, can be the key to finding a customized, effective plan. Let’s dive in!

Hydrogen-Dominant SIBO: Herbs to Fight Bloating and Gas

Hydrogen-dominant SIBO can cause painful bloating, cramping, and gas. For these types of bacteria, the following herbs are top choices:

- Berberine: Known for its antimicrobial power, berberine is effective against hydrogen-producing bacteria. It’s often used in combination with neem or oregano oil for extra support. Be careful, though. Many people are sensitive to this herb and it can cause or worsen diarrhea. Also, you don't want to repeatedly use this antimicrobial because it is also effective at killing off the "good guys", especially if used for longer than a few months.

- Oregano Oil: With broad-spectrum antimicrobial benefits, oregano oil targets various bacteria involved in hydrogen-dominant SIBO. It’s potent and can help reduce the bacteria causing uncomfortable symptoms﹣typically E. Coli & Klebsiella.

These herbs work well together to reduce hydrogen gas production, giving relief from bloating and gas.

Methane-Predominant SIBO: Constipation and Methane Busters

Methane-dominant SIBO, or IMO (Intestinal Methanogen Overgrowth), often leads to symptoms like constipation and a sense of fullness. For this type of overgrowth, you’ll want to focus on herbs that target methane-producing microbes, known as methanogens, including Methanobrevibacter smithii:

- Allicin (from Garlic): Allicin is one of the most effective options for methane-predominant SIBO. It directly targets methanogens and is even better when combined with oregano oil or neem for a one-two punch.

- Neem: Neem is known for its ability to tackle methane-producing organisms, making it a powerful herb to add to an IMO protocol.

Together, Allicin and Neem create a strong combination that can help reduce methane levels, offering relief from constipation and bloating.

- Atrantil: this blog article wouldn't be complete if we didn't give some mention to this very important supplement developed by a gastroenterologist for IBS with constipation. Technically, this article is focusing on herbs, and while Atrantil has a couple of herbs in it, including horse chestnut and peppermint, its main ingredient is quebracho extract from a hardwood tree indigenous in South America.

Hydrogen-Sulfide SIBO (ISO): Herbs to Help with Sulfur-Driven Symptoms

If you’re experiencing “rotten egg” smelling gas, or you are having systemic symptoms like headaches, muscle soreness, malaise, and profound fatigue, you might be dealing with hydrogen-sulfide SIBO. As of 2024, hydrogen-sulfide SIBO has been reclassified as ISO, or Intestinal Sulfide Overproduction. These sulfur-producing bacteria, namely Desulfovibrio and Fusobacterium varium, need special attention. Here are the best herbs for hydrogen-sulfide issues:

- Uva Ursi: Uva Ursi is particularly useful for hydrogen-sulfide-producing bacteria and helps ease the sulfur-based symptoms without causing extra irritation. Like the warnings with Berberine, you don't want to be on Uva Ursi longer than a couple of months because it can have profound impacts on your healthy bacteria as well. Just because it's an herbal, doesn't mean it won't deplete your good guys!

Additional options like Bismuth Subsalicylate and Silver can also be helpful in hydrogen-sulfide SIBO. Bismuth binds sulfur, helping to neutralize it, while Silver provides broad antimicrobial effects, specifically targeting sulfur-reducing bacteria while being gentler on beneficial gut bacteria.

A word of caution with silver: use only purified silver like that found in Designs for Health Silvercillin. Other forms of silver can build up in the body and cause toxic effects like agyria, otherwise known as blue-man syndrome. Blue-man syndrome is exactly what it is says it is and no one wants to look like a Smurf...admittedly, they were cute, but only in a cartoon.

Mixed SIBO: Combination Therapies for Multiple Overgrowth Types

Mixed SIBO can involve both hydrogen and methane overgrowths, requiring a combination approach. Here’s what works best:

- Berberine + Neem + Allicin: This combination targets hydrogen, methane, and potentially hydrogen-sulfide-producing bacteria, providing broad-spectrum support for mixed SIBO cases. If this feels like a lot, many patients do very well on the combination of just Neem + Allicin, or Neem + Atrantil.

- Oregano Oil + Allicin: This powerful pairing targets a variety of bacteria and archaea, making it especially effective for those with overlapping symptoms from multiple SIBO types.

Combination therapies like these are often ideal for stubborn or mixed cases, covering a wider range of bacterial types and helping to bring faster relief.

Final Thoughts: Find the Right Guide on Your SIBO Journey

Herbs can be a powerful part of SIBO treatment, but it’s important to work with someone who understands the unique needs of your body and symptoms. Sometimes, the can be used solely for treatment, or can be used in combination with pharmaceuticals, like Xifaxan.

Consulting with a functional medicine doctor, especially an IFM-certified practitioner, is a smart step toward finding a personalized plan that includes the right combination of herbs and lifestyle changes for lasting relief.

With the right guidance, you’ll feel more confident managing your SIBO symptoms and taking control of your digestive health. Working step-by-step with a professional can ensure you’re choosing the most effective, safe options for your unique needs. This is especially important to consider as most cases of SIBO require multiple rounds of treatment and are not cured with just one treatment.

Additionally, your SIBO type can morph and can change with treatment. This can make it important to treat for more than one type of SIBO at a time, especially in cases of IMO as the first round of treatment will lower methane-producing bacteria﹣all while unmasking hydrogen producers that may not have shown up as numerously because their hydrogen was being used to make methane.