You might have landed on this article after doing a search for Methane SIBO to see if it explains your symptoms. Read on for a comprehensive overview all about methane gas, how it affects our health and how to test and treat Methane SIBO. I've previously written about my personal SIBO experience, outlined the many underlying causes of SIBO, and given an overview of how I treat SIBO as a Naturopath.
If you're struggling to get help, I'm happy to help you with SIBO testing and treatment. Read more on the Work with me page.
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What is methane and where does it come from?
Methane is a gas produced by microbes known as methanogens, which fall in to the category of Archaea. Archaea are not bacteria, but often function in similar ways. Our bodies do not make methane. The human digestive tract is full of microbes, from bacteria, to viruses, to fungi to archaea. The gut is a complex ecosystem, and all microbes play a role. Archaea that produce methane are known as “methanogens”. Because methanogens are not bacteria, a newer term “IMO” - Intestinal Methanogen Overgrowth - is proposed instead of SIBO.
While there is a lot of focus on reducing methane by killing off methanogens, they actually have an important role to play in the gut ecosystem. This means that getting the microbiome back in balance is key.
In humans, archaea can be found in the gut, skin, vagina and mouth. The main methanogen is Methanobrevibacter smithii, although there are a handful of others including known pathogens. It represents 10% of the anaerobes in the human gut and has been identified in 95% of people. The abundance of methane remains relatively stable with dietary change.
Both Methanobrevibacter smithii and Methanosphaera stadtmanae are considered to be recognised by our immune systems and can contribute to a pro-inflammatory state. The latter is prevalent in IBD subjects.
Role of methane and association with disease states
Research on the role of methanogens in the human gut microbiome is ongoing, but here is what we know so far:
- Believed to play a role in ammonia turnover
- Extremely sensitive to oxygen and sensitive to free radicals
- Methanogens are believed to be either beneficial or detrimental to human health
- They are known to consume trimethylamines which may be harmful to health in particular contexts via conversion to TMAO, implicated in atherosclerosis
- Methanogens consume hydrogen which plays a role in many IBS symptoms such as bloating
- Higher methane levels are associated with obesity, with the theory that methanogens promote higher calorie uptake/extraction from food
- Higher methane levels are also associated with anorexia, perhaps as an adaptive mechanism to extract more calories from the reduced food amount consumed
Why does methane production become excessive?
There are various reasons for high methane production, including:
- eating disorders (past or present)
- background production of excess hydrogen gas which the methanogens then use to make methane - this is why when someone has methane SIBO, they also have hydrogen SIBO (it may just be hidden or downplayed on the breath test results)
- high volume endurance training
- oxidative stress
- poor digestive function
- chronic constipation - high methane can be both cause and consequence of constipation, a real vicious cycle
- low levels of butyrate (a short chain fatty acid - SCFA) have been associated with methane production in a small study. Apart from other roles, butyrate is essential for colonic motility.
- methane is known as a sink for hydrogen production - one of its roles is to consume hydrogen. So, it could be that methane overgrowth occurs in later stages of SIBO when the hydrogen gas production reaches a tipping point.
What are the typical symptoms of methane SIBO or IMO
Constipation is the classic symptom of methane SIBO, but there are cases where constipation doesn’t exist or an individual may have diarrhoea. This is because there are so many influences on stool formation and movement.
Other symptoms that may be experienced include nausea and bloating.
Secondary effects of methane SIBO or IMO may include weight gain, due to increased caloric extraction, diverticulosis, gut inflammation, and impaired Phase 3 detoxification (due to reduced number of bowel movements).
Testing for methane SIBO or IMO
I always recommend clients test all 3 sugars initially - glucose, lactulose and fructose - because invariably they may test positive for only one of the 3. So, if they had only ordered one sugar, it may be the sugar that doesn’t result in elevated gas production and therefore they would have a false negative result, thinking they don't have SIBO.
Importantly - excess methane production can be an issue in both the small intestine and large intestine (colon). Small intestine methane production is assessed by breath test and a stool test for the large intestine will indicate levels of Methanobrevibacter smithii rather than report on the gas level.
A high baseline level of methane on a breath test may be indicative of large intestine methane production, although more recently there has been discussion that a baseline reading of methane equal to or greater than 5ppm may in fact be methane SIBO rather than gas coming from the large intestine. As with all things SIBO, new research sheds light and can result in changes to how we interpret results.
A rise of over 10-12ppm of methane compared to the lowest preceding value in the first 100 minutes are considered a positive result for methane SIBO.
High methane levels coming from either the small intestine or large intestine are treated quite similarly, so even if there is debate about what a high baseline methane means, we can still successfully treat it.
Overall natural treatment of methane SIBO
Firstly, it’s important to understand that when someone has methane SIBO or IMO, they also have hydrogen SIBO in the background that may be visible on the test or not. If the methanogens are particularly efficient at converting hydrogen to methane, then less hydrogen will be reported.
Also, 4 hydrogen molecules are required to make 1 methane molecule. So, if someone has methane SIBO or IMO, then there is a decent amount of hydrogen production occurring in the background.
When treating methane SIBO or IMO, because it is a vicious cycle with constipation, both the constipation AND the methane must be treated.
So with that in mind, here is how methane SIBO or IMO is best treated naturally/ naturopathically.
- Herbal Antimicrobials - including hydrogen-specific herbs and allicin (garlic extract) for the methane
- Atrantil, a special herbal formulation may be used
- Probiotics - selected probiotic strains can inhibit the growth of methanogens and also be used to enhance motility or reduce visceral hypersensitivity
- Herbs for symptom relief - herbs can be used for the constipation, bloating, abdominal pain and nausea
- Fibre and prebiotic fibre - specific ones can be used to address the constipation and also reduce methane. The right ones can also help to stimulate butyrate production, which has been found to have an inverse relationship with methane.
- For those taking a medical route, the combination of rifaxamin and neomycin is usually used. Rifaxamin can also be used alongside allicin if neomycin isn’t desired. As always, it’s a good idea to add in naturopathic treatments alongside medicines as mentioned previously in this article.
Work with me
Struggling with chronic digestive symptoms? Have a tough case of SIBO? Relapsed after treatment? I'm here to help you. Find out more about how I treat SIBO as a Naturopath and Nutritionist.
I have completed Advanced SIBO training with The SIBO Doctor and have also undertaken courses presented by Jason Hawrelak, PhD. I also have personal experience successfully treating hydrogen and methane SIBO in myself.
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References
https://pubmed.ncbi.nlm.nih.gov/29497795/
https://www.tandfonline.com/doi/full/10.1080/08910600601048969
https://www.clinicaleducation.org/resources/reviews/butyrate-improves-bowel-transit/
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