Inside: What is SIBO (Small Intestinal Bacterial Overgrowth); How to test and How does it contribute to chronic fatigue. 5 ways research shows SIBO contributes to Fatigue.

Small intestinal bacterial overgrowth ( SIBO )  is such a common condition but often underdiagnosed. There are good and bad bacteria in our gut but there has to be a balance between the good and the bad bacteria.

Majority of your bacteria should stay in the large colon but in SIBO there is an overgrowth of bacteria especially in the small intestine.

With the advantage of easy testing now most people can be easily tested but most physicians are ignorant about this condition.

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How to Test SIBO?

The SIBO test that you should be getting is called Lactulose Breath test to correctly identify if you have SIBO or not.

One of the most common symptoms that people have with SIBO is fatigue, brain fog, dizziness and it is one of the important causes of chronic fatigue now. Most people associate gut symptoms like constipation, diarrhoea, bloating, gas, abdominal pain with SIBO but not fatigue.

But now we have research which supports that people with chronic fatigue syndrome have more chances of SIBO and gut dysfunction. 

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Why SIBO Can Cause Fatigue

Now the bigger question is — How does SIBO cause fatigue?

SIBO which is basically an overgrowth of bacteria in the small intestine can impair digestion and absorption of several nutrients and can thus contribute to the fatigue even after eating food.

Here are 5 Research-Backed ways SIBO contributes to chronic Fatigue

Vitamin B12 deficiency

We all know that vitamin B12 deficiency can cause fatigue in people and SIBO can be the reason behind B12 deficiency. In SIBO as there is an overgrowth of bacteria, this bacteria actually use B12 from the food and you don’t have much available to absorb. Also, the overgrown bacteria binds to B12  and interferes with its absorption. Because of both these reasons SIBO causes B12 deficiency [ 1,2 ] and contribute to fatigue.

Fat malabsorption

The excessive bacterial overgrowth leads to deconjugation of bile acids in your gut. Now bile acids are part of your bile which is produced by the liver and stored in the gallbladder. Bile is important for fat digestion and absorption. So with this bile acid deconjugation and impaired absorption, it ultimately leads to malabsorption of fats [3,4].

Now good fatty acids are building blocks of our cells and also important for energy production. So the impaired fatty acid absorption contributes to our fatigue even more. 

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Fat-soluble Vitamin deficiency

There are several fat-soluble vitamins, and they are absorbed in your intestine with the help of bile acids. So with impaired absorption of bile acids because of SIBO the fat-soluble vitamins are also not absorbed properly [4,5]. The fat-soluble vitamins are vitamin A, D, E, K. Deficiency of these vitamins also contributes to fatigue. 

Protein malabsorption

There is also impaired absorption of amino acids in the intestinal lumen because of SIBO. This is because of the inactivation of pancreatic enzymes which helps with the uptake of amino acids [6]. Proteins are the building blocks and if they are low that also causes issues with fatigue too. 

So as you see the SIBO fatigue is real and there is an underlying reason for it. SIBO causes not only gut symptoms but also causes malabsorption issues.

The excessive bacteria interfere with the digestion of not only carbohydrates but also proteins and fats which are very important for the normal functioning of your body.

Deficiency of several vitamins is also seen in cases of SIBO specially Vitamin B12 which makes the fatigue worse. Other fat-soluble vitamins like A, D, E, K which are also mal-absorbed contributes to this SIBO fatigue too. So treating SIBO is not only important from the gut perspective but is also important for your overall health. And we do see improvement in patients fatigue after the treatment of SIBO. 

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SIBO/IBS Diet Plan

Is SIBO real? & Is SIBO cause of your IBS.

Everything You Need To Know About Leaky Gut

The Comprehensive Gastroesophageal Reflux Disease (GERD) Treatment Protocol.

GERD Diet Plan

FAQ

1. How does SIBO lead to nutrient deficiencies that worsen fatigue?

SIBO interferes with nutrient absorption by damaging the small intestine’s lining and altering the gut microbiome. The growth of bacteria disrupts nutrient absorption within the body particularly the vitamins like B12, iron, and magnesium which are essential components of energy metabolism. The derisomeness leads to chronic fatigue, brain fog and weakness. In functional medicine, the individualised nutrition plan and the gut balance restoration are the significant steps to cure the SIBO and the fatigue simultaneously. Restoring the gut to a healthy state inverts both nutrient absorption and energy levels to their normal state.

2. Why do some people with SIBO feel worse after eating certain carbohydrates?

During SIBO, fermentation of carbohydrates by bacteria of the small intestine in specific amounts occurs, especially fermentable fibres (also known as FODMAPs) (Fermentable Oligo-, Di-, Mono-saccharides and Polyols). The resultant fermentation of this leads to the production of gases and toxins that cause bloating, pain and fatigue. These symptoms are exacerbated when people have a high-FODMAP diet which includes beans, onions, or certain fruits. The process of the functional medicine treatment is characterised by the use of the low-FODMAP or specific carbohydrate diet to limit the intake of bacterial food and heal the gut. To relieve the digestive stress, this can be done by identifying and temporarily avoiding such trigger foods which also enables the gut to rest well.

3. Can treating SIBO reduce fatigue and improve energy levels?

Yes. SIBO treatment helps in the overgrowth of the bacteria and the decrease of inflammation and normal absorption of nutrients which are important in combating fatigue. Once the gut lining is fully healed and the nutrient levels become harmonised, most of them report feeling an increase in energy and an alertness of mind. The functional approach to medicine is also not restricted to antibiotics as the objective is to re-establish equilibrium between the gut flora as well as the health of mitochondria, and identification of underlying causes of thyroid malfunction or adrenal malfunction. A lasting digestive functionality and energy production are restored upon reinstating gut health.

4. How long after SIBO treatment can one expect improvement in fatigue symptoms?

The time will depend on the extent of the overgrowth, according to the diet, and comorbidity. During the course of 4 to 8 weeks, many individuals are likely to experience a higher energy level as a result of specific SIBO treatment. Nevertheless, recovery could be delayed in case of nutrient deficiencies or chronic inflammation. The functional medicine approach focuses on the slow approach to healing--in favour of detoxification, healing the gut wall and replacing necessary vitamins and minerals. Adherence to the planned plan and change in diet will guarantee long-term, more sustainable outcomes and it will ensure further episodes of fatigue and SIBO symptoms do not recur.

5. Are there specific diets that help reduce fatigue in SIBO patients?

Yes, diet is a very important way of reducing fatigue caused by SIBO. The gut-healing functional medicine diets, the specific carbohydrate diet (SCD) and the low-FODMAP diet implement less bacterial fermentation and inflammation. The diets attempt to increase energy metabolism with a strong emphasis on food categories that are easy to digest, sufficient protein, and vegetables that are high in nutrients. Functional medicine experts tend to customise such a diet by taking into account food allergies and providing sufficient amounts of micronutrients. With time, regulating the intestinal microflora and maximising the effect with the correct nutrition system, energy and good health are restored naturally.