Do I have Hydrogen Sulfide SIBO? One Week Low Sulfur Dietary Trial By Dr Ruscio



Josie's Experience

February 2021


My nutritionist suggested that I had a look into hydrogen sulfide SIBO (HS SIBO) and recommended a one-week trial diet. I had looked into HS SIBO before and listened to a number of podcasts but ruled it out based on the fact most people were diarrhoea dominant and I was constipation dominant. Plus that your farts can smell like rotten eggs which mine did not.


I ran a SIBO breath test in March 2020 before seeing my current nutritionist as some people on my nutrition course were suggesting it was something to have a look into based on my symptoms. I had a look into SIBO breath testing and decided to go with the Invivo lactulose test as it would provide me with a reading for a longer section of the digestive tract. I was aware of the pros and cons of the test but with money tight it felt like the best option for me.


I was a bit suprised when the results came back not as I had anticipated anticipating the levels at baseline would be 0, increase between 20 to 80 minutes and then I did not really know what to expect past the 80 minute mark.



Having stuck to the diet strictly the raised baseline was a bit of a confusion and from what I can tell it means that my gut could possibly have still been fermenting something/levels were just really high. There were signs of bacteria producing hydrogen and metane gases in the small intestine as seen between 20 to 80 minutes but not a significant amount and not really suggesting SIBO. Then between 80-180 minutes once it is thought to be entering into the large intestine levels rose significantly pointing towards lower intestinal bacterial overgrowth (LIBO).


I took the test to a nutritionsit as I knew I had some bacterial overgrowth to work on and after 2 rounds of antimicrobials became much less bloated and was able to eat onion and garlic once more. However, I was still reacting to some foods, having SIBO symptoms plus anxiety and fatigue so further investigation was evidently needed.


My nutritionist sent me some information on hydrogen sulfide SIBO something like I said before had ruled out based on the typical symptoms not matching up with mine. I was reluctant at first to even look into it and plus seeing another diet that I would have to try was not initially keen. However, having a look at the diet a bit further saw that it was just 7 days with some yummy foods still allowed on the menu so I thought I might as well just try it.


Meal Planning


I sat down with the list of foods I was allowed to eat and avoid and then wrote out the list again this time only including the foods I was not intollerant to and the ones I actually liked eating. As I have already cut out coffee, alcohol, eggs, dairy and gluten it was not too much of a jump for me but I could certainly imagine it being quite hard if you did on top of everything else. I also imagine that you would need to cut those things out one week before the diet just so you knew what was a reaction to removing those vs the sulfur. I am also use to cooking most things from scratch at this point something else someone might have to overcome.


Once I had my list I then attempted to make a meal plan that looked something like that I would usually eat and looked really yummy so it was not a horrible thing to do. I have put my meal plan and recipes at the bottom of the page.


How Was The Diet?


The diet was a little bit harder than I expected based on the fact it was slightly difficult to get the intensitiy of flavour I was used to and I had to keep remembering to stick to it. While I was able to salt food and use herbs, missing out the onion, garlic and white sugar did make things a tiny bit less exciting but was not the worse diet I have tried.


I found the biscuits that I made (recipe below) a bit boring as well, but found by the last few days they were better with dairy free spread and honey on top or broken up into my morning porridge. The two things that were able to set off my taste buds and make me happy were a bowl of raspberries and blueberries and plain ready salted crisps, without these I may have struggled.


Cooking extra veg with each meal was also a good idea as it meant that I had leftovers to go with a jacket potato and extras I could add to my lunch to make things more interesting. The hashbrowns I would recommend frying rather than putting them into the oven as they became a bit dry.


I also noticed that I ate quite alot on the diet but this was because my protein and fat levels dropped based on what I could and could not eat. For one week I didnt really mind as it was just all about getting through.


Did I Noticed Any Improvements?


Having read some blog posts of other peoples experiences I assumed that my symptoms like theirs would have got worse in the first few days and for me nothing really happenend. However, on day 4 I developed a headache one symptom I rarely ever get and this persisted until I reintroduced the sulfur. Headaches can be a sign you are struggling to detox properly and I am assuming it could be because I was no longer feeding the bacteria that rely of the sulfur rich foods. The bacteria were either having a paddy and sending out messaged/toxins or dying off leading to a possible toxin overload. However, it could have been something else.


The next change that I thought was really interesting was that I slept through the night all 6 nights when on the low sulfur diet and then on day 1 of the reintroduction kept waking up again every couple of hours......interesting!


Digestive wise I did not think much really happened as I still felt gas pressure moving around in my GI tract but there were not any major amounts of bloating, flatulance or belching.


What Happened When I Reintroduced Sulfur?


I choose on day 7 and 8 to reintroduced just the sulfur rich foods and not the grains to see if that pointed anything out to me. With breakfast and lunch of day 7 I did not notice much of a difference other than the fact by lunchtime my headache was going. However, when I ate my roast dinner with cabbage, cauliflower and sprouts I did notice a difference. About 4.5 hours after the meal I noticed that the gas levels inside of me were growing and there was more movement and pressure especially just below my ribs. While I was able to relieve this pressure there was a slightly continuous build up and release that continued. On day 8 I also noticed that a feeling like something was in my throat returned which always comes along with a pressure just below my ribs highlighting that I was reacting to the sulfur rich foods.


One week on I am now having to reduce the amount of garlic and onion I am eating, most of the time choosing to remove it completely. Once I worked out that if I ate it for dinner I would feel bloated, have gas, a lump in my throat and wake frequently in the night I decided eating them just was not worth it. I am eating most of the other sulfur foods still but avoiding or reducing my consumption of garlic, onion and crusifferous veg until I see my nutritionist next week or read the book The Devil in the Garlic by Gregory Nigh to see what the solution is.


Diet Explanation and Foods


Click here for the low sulfur diet that I followed and was recommended by my nutritionist.


Take time in advance of the 7 days to write yourself your own list with only the things on it that you can or want to eat. Then write yourself a meal plan and shopping list ready for when you want to start.


Josie's Meal Plan


I mapped out the meal ideas and then have based potions on who in the family would also be eating that meal. Therefore, do not take the amount of each ingredient too seriously and adapt it around who you are cooking for.


Breakfast Ideas:

  • Rice Flakes, Homemade Rice Milk (recipe below), Blueberries, Honey

  • Salmon (2), Tomatoes (8), Mushrooms (8), Homemade Hashbrowns (recipe below)

Lunch Ideas:

  • Salad: Cooked Chicken (Sunday Leftovers), Beetroot (2), Grated Carrot (2), Cucumber (1), Lettuce (1), Tomato (8)

  • Soup: Carrot (4), Sweet Potato (2), Butternut Squash (1/2) Courgette (1), Herbs, Salt, Filtered Water

  • Leftovers

Dinner Ideas:


Monday

  • Salmon (2), Roasted Sweet Potato Discs (2), Carrots, Mushrooms

Tuesday

  • Mashed Potato (DF Butter Ok), Roasted Veg: Bamboo Shoots, Pepper (1), Carrot (2), Aubergine (1), Mushrooms (6), Courgette (1)

Wednesday

  • Chicken (2), Sweet Potato Puree (2), Tomatoes (12), Mushrooms (8), White Rice.

Thursday

  • Stir Fry with Rice Noodles: Bamboo Shoots, Pepper (2), Carrots (3), Mushrooms (6), Courgette (1), plus a DIY sauce (I made the DIY sauce according to ingredients I could have and looking at other recipes online its base was olive oil and then I threw in all sorts of random herbs and spices available to me i.e. lemon grass, salt, pepper, mild chilli powder, mixed herbs, honey, cumin, etc.

Friday

  • Jacket Potato with Random Mix of Leftover Veg

Saturday

  • Lemon and Herb Chicken (2), Sweet Potato Fries (2), Mushrooms (9)

Sunday (I decided on this day to stop the diet and reintroduced sulfur foods minus grains but have left it here as an option you could try)

  • Roast Potatoes, Chicken (1), Parsnips (3), Carrots (3), Sweet Potato Mash (1)

Snacks

  • Leftovers, Plain Crisps, Apple, Berries, DIY Biscuits (Recipe Below)

Drinks

  • Herbal Tea

  • FILTERED WATER ONLY! EVEN FOR COOKING!!!!!!


Recipes

Here are some of the recipes that I made ready for the one week diet with some hints and tips.


Homemade Rice Milk

This was a bit of a pain to make and only just about made enough to make my porridge for 5 days. You may be able to buy your rice milk with just rice, water and salt but I decided to give it a go. The main thing that I struggled with was to squeese it through my muslin without it going all over the walls and actually getting the liquid through the material. When I realised that there was not enough milk I poured some more filtered water on top of the rice pulp, mixed it and strained it again to get a bit more out of it and that worked. I chose pour in a bit of honey into the milk rather than the date and did not put in any berries or chocolate powder to make sure it matched the diet plan.

Click Here For The Recipe


Baked Vegan Hash Browns

These were pretty easy to make but next time I would fry them rather than put them in the oven as they dried out and without baked beans to go with them were a little tough. They were however a nice change from the porridge. Make sure to miss out the onion.

Click Here For The Recipe


Biscuits

I knew I would need something more than the sweet taste of fruit to get me through the week so opted for these biscuits and adapted them. I hope over the years I can find something a little more exciting for my clients to make but for now this is what I have found. These were super easy to make and all I did was swap the coconut flour for rice flour. The first time I made them with just the three ingredients but the second time I played around with some spices such as cinnamon, ginger and nutmeg along with vanilla essense and some salt. Now they were not amazing but they were better than nothing. If I did them again I might have made some homemade berry jam to go with them but as the recipe is so basic I am sure there is alot of different things you could play around with. If your not great at coming up with ideas though bake them as they are an the spread some dairy free margarine and honey on top and they taste better. While it would be good to be super healthy sometimes you just need a little naughty treat to get you through.

Click Here For Recipe (Coconut Flour Cookies)


What About The Other Recipes?

All of the other dishes that I made I adapted from a mixture of recipes. For example with the soup I looked at butternut squash soup recipes online and checked what herbs and spieces they used, check in the cupboard and added the amount I thought would taste nice. This is a skill I have learnt over a year of cooking more and getting use to what tastes good with what and how much of an ingredients is suitable for a certain portion of food. If you are struggling pick one recipe you like the look of an then if you have to avoid a certain ingredient or do not have it in your cupboard then use an interent search engine to ask 'what can I use instead of ...?'. Good Luck!

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