High methane is indicative of an overgrowth of methane producing “archaea” (aka methanogens), there is nothing else in the gut that can produce methane. Archaea are microbes similar to bacteria, but do not respond to antibiotics or most of the traditional kill supplements. The most common archaea in the human gut is Methanobrevibacter smithii (m.smithii). M.Smithii is also commonly found in cows and sheep. In both cows and humans m.Smithii produces methane. Methane in humans causes a slowing of motility (moving stool along), constipation and bloating. The bloating is caused by the methane getting trapped behind hard stool. Though humans can absorb methane (and hydrogen), we do so at a much slower rate than CO2 (produced by beneficial bacteria). In cows m.Smithii is also responsible for producing methane and is thought to be a large contributor to atmospheric greenhouse gases. (btw: Researches and doctors are now starting to call SIBO-C “IMO” or Intestinal Methanogen Overgrowth).
Methanogens consume hydrogen and hydrogen sulfide (H2S) gas as an energy source. Their growth rate is hindered (sometimes significantly) if these gas producers are eliminated. This is why someone who shows high for methane on a SIBO breath test will often see hydrogen or H2S levels go up and down in unison with methane, or even no hydrogen at all if the archaea consume it all. Though they may test negative for hydrogen producing SIBO (SIBO-D), they may actually be producing a lot more hydrogen than what shows on the test (this is a known limitation of the SIBO breath test). This is where a standard kill phase can be helpful. Hydrogen is a food source for archaea, and since it too causes bloating, reducing hydrogen (or H2S) producing bacteria can often help both reduce archaea and bloating symptoms.
Besides reducing H2 and H2S producing bacteria, what else can help reduce methane producing archaea? Competition. Archaea are like every other microbe in the gut, they are very susceptible to competition. Increasing beneficial bacteria numbers (CFUs) and diversity can, over time, help get archaea under control. Some bacterial strains also apparently directly try to low archaea numbers, by releasing bactericides that can kill them or interfere with their life / reproductive cycles. Building a very strong bacterial microbiome, that is low in hydrogen / H2S producing bacteria, will not only deprive methanogens of the hydrogen they need, but will also introduce very strong competitive pressures. A strong microbiome will also improve motility which will also reduce archaea levels.
If you test high for methane, unless your doctor tells you otherwise, you should focus on building up the beneficial bacterial microbes of the gut. A broad-spectrum kill of bacteria will do just the opposite, and these should be avoided. You want as much diversity and good bacteria as possible. The standard treatment for SIBO-C, antibiotics, do not actually kill archaea; the rifaximin / neomycin antibiotic combination kills bacteria (in both the small intestine and the colon), this reduces hydrogen production, but it also completely alters the microbiome in the process. This often leads to a quick relapse after antibiotics are completed, it can also cause a host of opportunistic infections (including a c.diff infection). If you have recently taken this combination of antibiotics for SIBO-C you should focus on rebuilding the microbiome as quickly as possible, while simultaneously selectively killing bad bacteria.
There are other causes chronic constipation. Often it can just be inflammation caused by hydrogen or hydrogen sulfide producing bacteria. Several people have had success simply fighting it just like SIBO-D. This why a SIBO Breath Test can be important. Chronic constipation can also be caused by the endocrine system, such as low thyroid. There is even a possibility of a blockage or twisted intestine. If you do not have evidence of methanogens (e.g. a SIBO breath test) you should check with your doctor about other possible causes before simply assuming.
Reversing SIBO-C is usually harder than SIBO-D and will take longer (especially if you have high methane). A multi-pronged attack will be necessary. Here are the current recommendations.
- For more information on selectively killing hydrogen and hydrogen sulfide producing bacteria see Chapter 1 of The Gut Health Protocol.
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For more information on rebuilding the microbiome see Chapter 2 of The Gut Health Protocol. Especially the need for soluble fibers, which both help get things moving, and helps build a strong / healthy microbiome.
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Phage Complete is a probiotic / prebiotic / phage supplement that plays a significant role in building a strong and healthy microbiome. The phage complex kills unwanted e.Coli bacteria (and we all have some) which produces a very beneficial prebiotic food for beneficial bacteria throughout the gut. E.Coli is also a histamine and hydrogen producer. Re-balancing the microbiome is an important part of this effort. This can also reduce inflammation from lipopolysaccharides (LPS) which can sometimes be very helpful on its own (inflammation of the gut can cause either constipation or diarrhea). This all helps to reduce the amount of hydrogen produced and hydrogen is a primary food source for methane producing archaea. Reduce hydrogen production and you reduce methane production. Though this may not directly eliminate methanogens, it can severely handicap them; for some people this is enough to show some real progress (especially when combined with l.Reuteri and other strategies listed here). This is actually what the Xifaxan / Flagyl (Metronidazole) or neomycin antibiotics do, they reduce the hydrogen producing bacteria (methane producing archaea are bacteria, so antibiotics do not directly kill them).
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l.Reuteri – This is a strain that has been shown in scientific research to benefit people with chronic constipation and high methane. Phage Complete will amplify this bacteria throughout the intestines (where otherwise it might die off before reaching the end of the colon). You can also make a delicious yogurt that is high very high in l.reuteri bacteria, this page also includes links to its benefits and research studies. I have personally tried this along with Phage Complete (for about 6 months) as I wanted to make sure it didn’t bring up any negative side effects (it did not), several other people in the group have tried it as well (with benefits). ⇒
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Red and Brown seaweed – this has been shown to reduce methane in cattle and should work the same way in humans (the research was in conjunction with lowering green house gasses / climate change). The supplement recommended here is a capsule containing “laminaria japonica”, or kombu. I recommend taking 3 capsules per day. It contains about 1.1 mg of iodine, per capsule (from my calculations of kombu iodine content). For 99% of people 3-5 mg of iodine per day is beneficial, but someone with Hashimoto’s (a thyroid autoimmune disease) needs to discuss this with their doctor. Iodine does NOT cause Hashimoto’s, but can sometimes worsen it (Hashimoto’s may actually be in part due to a lack of iodine, but once it gets started iodine might worsen it). There are MANY health benefits to seaweed and brown seaweed supplements, including immune system improvements. I take this myself for the immune system benefits. ⇒ ⇒ ⇒ ⇒
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Medicinal mushrooms – They selectively feed beneficial bacteria and modulate the immune system. This helps the immune system target invaders that do either do not belong in our gut, or that have grown beyond what they should. Much like how adaptogens help us deal with stress, mushrooms help our immune system do its job far more effectively. There is even a lot of evidence that they can help our immune system prevent cancer and avoid disease! This is the product that I take daily. ⇒
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Icelandic Moss – This one was recommended to me by one of the group’s long term members. She swears by it. Since then I’ve been recommending this to other people with chronic constipation and many of these people have mentioned that it helped them as well. My guess is that it works similar to the way brown seaweed works. Because Icelandic Moss is much lower in iodine it should be fine to take this along with brown seaweed. It is recommended that you purchase the cut herb/tea and make tea from it. The capsules and tinctures do not seem as effective. ⇒
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Lovastatin – This is a prescription drug for lowering cholesterol, the same chemical can be found in several natural substances. I don’t recommend taking this unless you’re at your wits end, and of course, in consultation with your doctor. The highest natural sources of lovastatin can be found in oyster mushrooms and red yeast rice. Please see the Wikipedia page for information regarding possible side effects. Because the supplement Red Rice Yeast contains lovastatin this might also help. Be sure to take a CoQ10 if taking Red Rice Yeast or lovastatin as they can reduce this important nutrient. ⇒ ⇒
- IBSRELA – This is a prescription drug that treats the symptoms of IMO. It is not known to help fix the underlying issue, an overgrowth of methanogenic bacteria. However, it does seem to help a lot of people feel better, have more regular bowel movements, and even help the intestinal lining heal. Because of the overgrowth still needs to be addressed I recommend The Gut Health Protocol and Phage Complete.
Avoid
- Alcohol – Sorry, but I’m just the messenger. ⇒⇒
- Lactose and Fructose – both have been strongly correlated with IBS/SIBO-C ⇒
- Cellulose – Restrict how much cellulose you consume. Cellulose is found in many vegetables, including (but not limited to): ⇒
- root and leafy vegetables
- legumes
- fruits such as pears and apples
- algae
- Supplements – The below ingredients are common in nutritional supplements:
- microcrystalline cellulose,
- powdered cellulose,
- methyl cellulose,
- ethyl cellulose,
- hydroxypropyl cellulose,
- hydroxypropyl methyl cellulose,
- ethyl methyl cellulose,
- sodium carboxy methyl cellulose,
- enzymatically hydrolysed carboxy methyl cellulose
- cross-linked carboxy methyl cellulose
- hypromellose
All of these have been shown to feed methanogens. If you already have high methane levels I would try to limit the number of supplements you take that contain these additives. Probably try to limit this to no more than 6 capsules per day that contain one or more of these ingredients. Cellulose is normally healthy for us and only people with verified high methane levels need to cut back.
(note: Phage Complete does contain a small amount of micro cellulose. But because it is important to kill the bacteria that feed methanogens this should not stop you from using it)
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