First test results were high positive 120 peak for methane, and then after three weeks of rifaximin, neomycin, and then 10 weeks of herbal protocol, retest showed great improvement, but both methane and hydrogen present with combined peak of 30. As there had been an improvement, would you continue herbal protocol for another month and retest or now switch to two weeks of elemental diet? Do you often find that it takes longer than three months for high test levels to reduce?

Chris Kresser: Great question and, yes, 120 is very very high, so you would expect a longer treatment protocol to be necessary in that circumstance. I think the way that you sequenced it already has made a lot of sense and obviously has been quite effective, so yes, I would continue with the herbal protocol for another month and then retest. You could consider the elemental diet, which is reasonable and has been shown to be effective, but I might be more likely to recommend something like a ketogenic, very low-carb, low-starch diet and see if you can tackle it that way perhaps in conjunction with the herbal protocol because that’s another way that you would be significantly reducing the substrate that’s available for the organisms in the small intestine. Great job with that, and I think you could just keep it up.