Are there any iron supplements safe to take with SIBO? Given the bacteria sequester iron for their needs. I ask because I frequently have female patients, often with low thyroid, who have low iron and ferritin. And in many of these cases, iron supplements don’t bring up their levels. Ferrochel Designs for Health. This makes me suspect SIBO, among other causes. If they do have SIBO, how do you raise iron without making SIBO worse, especially if they won’t eat liver?

Chris Kresser: So, yeah, very interesting question. Iron is used by beneficial bacteria as well, and I don’t know that iron is as much of a concern in SIBO as it is in like an infection like H. pylori because SIBO, the bacteria are not pathogenic. They’re commensal bacteria that’s in the wrong place, and I don’t know that iron is going to change that or affect that. We haven’t seen a big change in SIBO test results in patients that are taking iron or not taking iron during the protocols. I have something in my throat and I don’t have any water here. So yeah, it’s an interesting question.

Clinically, we haven’t seen much of a connection there. In terms of patients that don’t respond to iron supplements, in many cases that’s because they’re not taking a heme form of iron. And we’re going to talk about this in the iron. I guess that that content was just released this week. So we talked about Proferrin as my favorite iron supplement because it’s a heme form of iron or IRONsmart, which is liposomal iron. And these are much, much better absorbed than any other kind of iron supplements, and I’ve seen them turn patients around who haven’t responded to even high doses of plant-based forms of iron. So that’s often the case. But yes, SIBO could certainly impair iron absorption, and in that case you may want to address the SIBO first, and then go in with Proferrin and/or IRONsmart afterwards.