An alarming number of patients with SIBO and IBS come back with major vitamin and nutritional deficiencies. SIBO diets like Low FODMAP,  Elemental diets, low Histamine diets are often helpful short term, but long term, they cause serious vitamin and nutritional deficiencies.  I’m seeing an alarming number of vitamins, minerals, amino acids and antioxidants deficiencies in my patients. Ironically, these nutritional deficiencies are some of the causes if not the sole causes behind depression, anxiety, sleeping problems and brain fog.

If you struggle with IBS and SIBO, leaky gut Crohn’s, Colitis or any other kind of GI problem, you probably have given much thought into some of the nutritional or vitamin deficiencies that may exist in your body and how those deficiencies are causing, contributing and PREVENTING your gut from healing.

I’ll say that another way- you have become so fixated on the symptoms that you have forgotten about the underlying root causes.

Every day I get phone calls from men, woman, young adults and parents who are in tears, they have given up smoking, drinking alcohol, gone gluten free, dairy free, sugar free, they have given up all sweets, no longer drink soda, coffee, they started working out, The only thing they are drinking and eating is bone broth, kombucha and fermented vegetables because their intestines are on fire and they don’t understand why they still feel so sick.

If that’s you, you need to watch today’s video.

If you know anything about my practice philosophy, then you know that I believe you need to look at the “BIG Picture” when it comes to GI problems. You are not going to get better by simply taking a probiotic and digestive enzymes and drinking bone broth all while following a Low FODMAP SIBO diet.   There is so much more to this picture.

These may be important things in your healing journey, but the reason why many of you are still struggling and not getting better is that you are missing some of the other “bigger pieces” of the puzzle.

In some people these other “Pieces Of The Puzzle” may be nutritional deficiencies, infections, inflammation, pancreatic malabsorption, bile acid insufficiency or malabsorption of these bile acids, in others it may be imbalances in your sex hormones or your thyroid hormones or your cortisol levels- in others, it may be food sensitivities, leaky gut, excess histamines from those fermented foods, or you may have an autoimmune disease-

It may be all the things you see here lying under the tip of the iceberg- These are the pieces of your individual health struggle and they vary from person to person. but in all cases, no matter who you are, or the diagnosis you have been given- vitamin deficiencies are a common denominator in SIBO, IBS and other GI related problems.

So in today’s video I want to share with you those nutritional deficiencies the vitamins that are so important for people suffering with SIBO and IBS. You either have these nutritional  and vitamin deficiencies from restricted diets or you have them because you can’t absorb them. Either way-These need to be addressed and should be considered a foundational piece when it comes to healing the Big Picture of SIBO.

Ok, so let’s unpack some of most common nutritional deficiencies that exist and why they are important to those that suffer with GI problems.

#1 B-Vitamins-  

There are actually 8 B vitamins and they are all essential for digestive health in one way or another. Since they are water-soluble vitamins, you can’t store them in fat cells or tissues. Therefore, you must get a regular supply either from making them or from the foods you eat or from a dietary supplement. B vitamins are incredible important for digestion. In general, they help move energy obtained from food into the tissue cells, where it is needed. In particular, vitamin B1 (thiamine) helps convert carbs in the diet into energy. This fuels your cellular metabolism and helps regulate your appetite. Do you feel tired and run down? Do you have brain fog, this could be due to a B1 deficiency-

Vitamin B2 (riboflavin) helps keep the mucosal lining of your digestive tract in good shape. It also helps to break down proteins, fats and carbohydrates in the foods you eat. Without vitamin B2, you may have trouble digesting food. And converting the nutrients into energy. Vitamin B2 is used in combination with other B vitamins, which make up the “B Vitamin Complex”. In fact, B2 must be present in high enough amounts in the body to allow other B vitamins including B6 and folic acid to properly do their jobs- And B6 deficiency can be one of the causes of mental health problems including anxiety. Low B2 can also cause tongue and mouth sores and swelling.

Malabsorption A common Culprit of Vitamin and Nutritional Deficiencies.

According to the USDA, a Vitamin B2 riboflavin deficiency is not very common in western, developed nations, most likely because many refined carbohydrates are fortified with riboflavin. But….. If you are a person who has malabsorption, leaky gut or you have eliminated grains because you have non celiac gluten sensitivity, then this could be a very serious deficiency. Vitamin B6 is another B Vitamin deficiency I see very often when working with patient who suffer with GI problems as well as anxiety or depression. B6 or P-5-P (pyridoxine) Can protect the body — and the gut — against dangerous levels of inflammation and homocysteine levels. Researchers found that people with the lowest levels of vitamin B6 in their blood had the highest levels of chronic inflammation, and those with the most vitamin B6 circulating in the bloodstream had the least amount of inflammation.

Several studies have also shown that low vitamin B6 status is associated with rheumatoid arthritis and chronic inflammatory bowel diseases, both of which hold an underlying chronic inflammatory condition. B6 is one of those vitamins that I also think is so important for people who find themselves suffering with symptoms of excess glutamate. Symptoms of excess Glutamate include headaches, seizures, increased pain, restlessness, ADHD symptoms and depression.

B6 is an important vitamin deficiency often seen in IBS and SIBO. B6 is so important because it activates the enzyme that converts Glutamate to GABA. Glutamate is an excitatory neurotransmitter and GABA is a calming neurotransmitters. If you have low levels of B6 that glutamate will not get converted and you will be stuck in that excitatory state.

Most people who have IBS or SIBO can relate to anxiety, depression, loss of focus and feeling tense most of the time.

This is the B6 Complex I recommend. Another B vitamin deficiency seen in people who suffer with IBS, SIBO and Inflammatory bowel diseas is Biotin. Biotin also known as B7– is the hair, skin and nails vitamin- One of the biggest benefits of biotin is that it helps stimulate hair growth, causing hair to thicken and look healthy.

 

If you are person who has struggled with any kind of GI problems for years- then you know that sick and unhealthy hair is a common side effect of poor gut health. Biotin can also help hair look healthier while growing more quickly. While people with healthy digestive systems can absorb some biotin simply by eating a healthy diet, those who suffer from digestive disorders struggle to absorb adequate vitamins and nutrients. Those diagnosed with malabsorption problems like leaky gut syndrome, celiac disease, and Crohn’s disease often require elevated nutrient levels in order to receive the vitamins and minerals they need to stay healthy. Other symptoms of biotin deficiency include depression, fatigue, hallucinations, and tingling in the arms and legs. If you are a cigarette smoker- There is some evidence that cigarette smoking may cause biotin deficiency. Folate deficiency is another common vitamin deficiency that plays an important role in gut health. The bacteria in our gut specifically lactobacilli species and bifidobacteria species are two of the most important families of good bacteria that populate our gut micriobiome.

It turns out that these bacteria and specifically Lactobacillus plantarum are responsible for producing many of the B vitamins including Folate. Unfortunately, blood testing for a folate deficiency is almost useless and when it does show up as a deficiency- you have a major deficiency- Folate and folic acid works with vitamins B6 and B12 and other nutrients to control blood levels of the amino acid homocysteine.

High levels of homocysteine are associated with heart disease, and inflammatory conditions. Other blood markers I like to run because I don’t have a lot of faith in the standard folate biomarker is homocysteine, methylmalonic acid or (MMA) and a test for a gene mutation called the MTHFR gene

If you have elevated homocysteine levels, but your MMA levels are normal this would indicate a folate or B6 deficiency. If you have homocysteine and MMA levels ( if these are both elevated) you have a B12 deficiency. Another way that I like to evaluate folate deficiency is the Formiminoglutamate (FIGLU) marker. This marker combined with homocysteine and MMA levels. If you are a person with Crohns, Celiac disease or other gut markers indicating inflammation, ask you doctor to run a Homocysteine test along with MMA marker– Homocysteine is a maker of vascular inflammation and I often see this elevated with many of my GI patients. Also, levels above 7 are problematic.

The labs list levels at upper limit being 15- but this is way too high! If your levels are this high your brain and nerves is being bathed in toxins and are dying. If you have low levels 6 or below, you will have problems with glutathione production as well as the production of SAMe.

Patients who have diarrhea as in the case of Inflammatory bowel disease, hydrogen dominant SIBO, these water soluble vitamins are going right through you and you are becoming increasing vitamin/mineraldeficient.

I recommend everyone at a minimum take a high-quality B Supplement and if possible get testing that can more precisely evaluation your nutritional deficiencies.

#2  Iron Deficiency and SIBO

Iron deficiency anemia is a common problem and occurs frequently in people who have SIBO, Crohn’s disease, Ulcerative Colitis, H.pylori infections, Celiac disease and even Non-Celiac gluten sensitivity.

Bacteria can damage the mucosal lining and tight junctions- and these toxins or the increase in gut permeability, can further exacerbate absorption rates or iron. The good news is that testing for this is super easy easily and it can be done by any lab.-

There Are 6 Bio markers that Should Be Done When You Struggle with Fatigue and symptoms Of Anemia.

1. serum iron test
2. hemoglobin
3. hematocrit
4. ferritin
5. TIBC and
6. Iron saturation

This test is so easy to have done and I can’t think of a single good reason why you shouldn’t if you have IBS, SIBO or IBD. It has become a routine test when I work with a patient who has any kind of GI problem. One thing I want to stress is that while identifying the iron deficiency is important, even more important is understanding why the iron deficiency exists.

Iron anemia is usually coming from a few places, dietary deficiency as in the case of vegans and vegetarians, or its coming from injury, infection or inflammation to the intestinal lining or its caused by Internal bleeding- a woman with heavy menstrual cycle, fibroids, stomach or intestinal ulcers/irritation or even frequent bleeding hemorrhoids. Any time we injure the mucosal lining, we create oxidative stress, free radicals, and cellular damage- this can among many things can impair iron absorption. If you have an iron deficiency, but you eat red meat or seafood, or take a multivitamin, the problem probably isn’t too little iron, it’s bad absorption.

Adding more iron to a body that cannot absorb iron-will not help iron levels, in fact all it does is cause more stomach pain, and it feeds microbes and helps them create biofilms.

So you might have heard that eating more spinach and green leafy vegetable is the answer and so while many plants are high in iron, some contain iron-absorption inhibitors, such as Phytates, polyphenols and oxalates. And these can impact iron absorption or “bind up” the non heme iron in the digestive tract. Also the iron found in plants, milk, eggs (non heme iron) just does not get absorbed as well in the body as does iron found in red meats.

One other thing I want to point out, If you are iron deficient and you are drinking green tea – you want to stop that for all the reasons I just mentioned.

Before I leave the topic of iron deficiency-

1. If you are iron deficient and taking Iron causes more abdominal pain- your probably have a malabsorption issues on your hand- so it becomes super important to find out the cause of this malabsorption
2. Eat more red meat, beef liver or other sources of heme iron- Cant stomach the thought of eating Liver? I don’t blame you- but try this instead. Take vitamin C, lactoferrin and avoid foods high in phytates, oxalates and poly phenols.
3. Identify if your low iron is from internal bleeding- ie ulcers, fibroids, hemorrhoids, esophageal erosion, etc

By doing these things- there shouldn’t be any reason your iron levels don’t come back up to normal

This is the Iron I recommend here

If you levels are routinely low and you are having trouble getting your iron levels up, I use this with many of my patients. Another common deficiency I see very often in patients is a Zinc deficiency.

#3 Zinc Deficiency and SIBO

Studies are confirming that zinc deficiency alters the makeup of bacteria found in the intestine.

But that’s not all zinc does. The recent literature also shows zinc alters and influences the leakiness or the permeability of the gut and barrier function.

In a past video and several articles I’ve talked a lot about Leaky gut and how researchers are calling a leaky the biological door into autoimmunity diseases and cancer.

We also know that a leaky gut has been shown in many diseases including depression, diabetes, obesity and asthma, psoriasis, Thyroid disease, and heart disease –

If you take a look at this diagram that come from the World J Gastrointest Pathophysiol. 2014 Nov 15; 5(4): 496–513. you can see that zinc deficiency is caused by proton pump inhibitors, low dietary intake of zinc and high dietary phytates (grains and beans) but the most important thing you see here is how a deficiency in zinc compromises the gut barrier-and when you compromise the gut barrier you end up with food allergies, malabsorption (SIBO) celiac disease, diarrhea, and GI cancers. Studies have found that even a very mild and temporary zinc deficiency can impair digestion, without any of the typical symptoms such as skin problems or fatigue.

This is the zinc I recommend Here

#4 Vitamin A and SIBO

Another common vitamin deficiency seen in people with SIBO/IBS is Vitamin A. Vitamin A along with vitamin (D, E and K are our fat soluble vitamins) These vitamins play a crucial step in something called immune tolerance.

Vitamin A has a profound effects on the gut mucosal immune system and I have seen a huge difference in my patients who benefited from supplemental vitamin A when they are deficient.

It’s been said by many researchers that Vitamin D and Vitamin A are essential co-partners in immune system stabilization, and protection against pathogens or disease causing germs.

Without immune tolerance we have a complete breakdown in our mucosal barriers. Immune tolerance is lost in people who react to environmental chemicals such as perfumes, or soaps and detergents, lotions, etc , every day there is new food they can’t eat because their immune system is reacting to it. These are the people who walk past the perfume counter and get headaches and get dizzy or are breaking out in rashes when their skin touches a certain fabric.

Without immune tolerance we develop a shift in the balance of our immune system leading to a variety of autoimmune disease.

Vitamin A is also of fundamental importance for energy homeostasis. New research finds that retinol is essential for the metabolic fitness of mitochondria.

If you suffer with fatigue, brain fog and feeling exhausted? Well within each and every cell of your body are energy producing powerhouses called Mitochondria. Their job is to produce cellular energy, without this ATP- your cells can’t repair, can’t heal and cant regenerate. Vitamin A and specifically retinol plays an important part in all of this.

This is the Vitamin A I recommend.

#5 Vitamin D Deficiency and SIBO

Another common vitamin deficiency seen in people with gastrointestinal disease is Vitamin D. Today’s video wouldn’t be complete without talking about the importance of vitamin D. Many studies link low levels of the vitamin D with a higher risk of colon cancer.

Not only does low vitamin D increase your risk of many types of cancer, deficiency also increases your overall death rate. We now know that men and women who live farther away from the equator, in latitudes where the sun is weaker, develop Irritable Bowel Diseases (IBD) much more frequently. We also know that vitamin D plays a role in taming inflammation. And regulating the immune system.

So it only makes sense that people who have Crohn’s disease and ulcerative colitis, (both inflammatory bowel problems), would benefit from optimizing their vitamin D levels. The cells along the mucosal surfaces of your body are constantly in contact with foods, microbes and toxins.

These cells make immunological decisions every moment you take a breath—these decisions are what we refer to as immune tolerance. Immune tolerance is the essence of good health and a strong robust immune system. Without immune tolerance our bodies lose their ability to detect friend from foe.

Like mentioned earlier, without immune tolerance, our immune system may hyper react to food we once previously ate without problem or overreact to tissues of our body causing an autoimmune disease.

I recommend this Vitamin D 

So in rapping up today’s video we learned about the different kinds of vitamins and minerals that people with GI diseases often suffer with and supplements I recommend.

1. If you suffer with leaky gut, SIBO, IBS, H.pylori its best to get the functional testing done so that you know what you are deficient in and to what degree. We Can help you with this.
2. Don’t give up- even if your doctor’s have told you that everything is normal- chances are they don’t practice functional medicine, nor have they really investigated the nutritional piece of why you are sick
3. If you are not familiar with function medicine– visit my website and watch the video I did titled, “Dr Hagmeyer explains functional Medicine”

I hope you enjoyed today’s video- and I hope you learned a few things that may make a huge difference in your health.

Our Personal SIBO/IBS Recovery Program Is A Great Place To Start

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• To See If a Free 15 minute consult is right for you start here
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Testing for SIBO