I wanted to touch on one of the less fun aspects of treating SIBO, die off. Unfortunately, the SIBO die off stage comes before all the great things living SIBO free life brings. SIBO die-off can happen with both antibiotics and antimicrobial treatment (I have done both).
During my very first round of treatment, when I discovered I had SIBO, I was so unwell for the first day or two. I thought everything was getting so much worse and my treatment was triggering my SIBO. It was just part of the die-off, but I nearly aborted the mission.
Find out more here: Die-off symptoms during treatment
Here is how SIBO die off feels:
1. Symptoms got worse:
For me, my symptoms got much worse in the first few days before they got better. My stomach started to make a real racket. It was loud, and I felt like my treatment was making everything worse. I was having real trouble not pooping my pants. My farts also had some extra punch (and that was saying something).
2. I was sweaty and got night sweats:
Not everyone experiences this, but I had night sweats every time I underwent treatment. The night sweats usually hit in the first few nights then vanished as treatment went on.
3. Mood and anxiety:
On the first two days of treatment, I had terrible anxiety. I felt very on edge, and everything overwhelmed me.
4. Brain fog:
SIBO can give you brain fog. SIBO die-off can give you so much brain fog you forget where you were going with that sentence you just started. That was usually at its worst on day 2.
5. Feeling like I had the flu:
In the first three or four days, I felt like I had the flu without the cough or sore throat. The body aches were real.
6. Headaches:
I experienced headaches every time.
7. Exhaustion and fatigue:
I could not carry out my regular daily exercise routine during my first days of treatment. I just wanted to lay on the couch and stare at a wall. That was mentally and physically about as much as I could tolerate. No amount of coffee would rescue me and gave me crippling levels of anxiety, so I don’t advise this strategy.
8. Insomnia:
SIBO die off is just the gift that keeps giving. I was exhausted but I had trouble sleeping because of all the above symptoms. I felt restless and tossed and turned feeling too hot or too cold. I was strangely wired yet exhausted.
9. I was not fun to be around:
This probably goes without saying. Bless my partner’s kind and patient soul.
10. My food cravings changed abruptly:
I haven’t heard this spoken about so it might just be me. But every time I had treatment my food cravings would change. My first round I started craving things I never usually did like salmon and nuts over carbs (these are things I didn’t think I liked). I also lost interest in other foods I use to really crave. It was strange and obvious, so I thought it was worth mentioning.
Here is the medical explanation of what is happening at the start of your treatment:
If you have SIBO, you have too many bacteria living in your small intestine. If you undergo treatment, the aim is to kill the overgrowth off.
Bacteria, per se, are in a little self-contained bag of stuff (think of it as a Case). As humans, we can (and do) react to things on the surface of these cases (which is the bacteria’s cell wall).
We also react to toxins that these bacteria release. When these bacteria get killed during effective SIBO treatment, the cell walls get chopped up into bits. More bits = more reaction, and we can feel this.
When these bacteria die, their content or “insides” get outside. As a result, all toxins are released at once. That can feel awful. It’s also one of the key reasons symptoms often worsen before they get better.
Finally, as well as toxins that are normally released, the entire “guts” of the bacteria is released as we destroy them, which may (or may not) contain stuff to which we or other nearby bacteria react. That can cause an immune response that can leave us feeling ick.
When infected with a virus (say a cold), most of our symptoms are not caused by the virus itself. Many of the symptoms we experience are caused by our immune system kicking into gear to fight off the virus.
So, next time you get the flu and get all those yucky symptoms, be happy your body is working hard to make sure that virus doesn’t do some serious long-term damage while it sits back and watches the virus roam!
(The technical medical description for that process is the Jarisch Herxheimer reaction. If you want to know about it in more detail you can learn about it here Wikipedia – Jarisch Herxheimer reaction)
Takeaway about SIBO die off:
Treating your SIBO will honestly give you your life back.
When you have been battling gut issues for so long, finally getting the right treatment and getting worse might cause some to abort the mission and give up. Recovery with many things often isn’t linear and this is the case for SIBO. That’s why I have written this post, in hopes to give you some comfort is this is your reality right now.
I wish you luck on your journey.
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