Dr. Amy Nett: Oh, this is a great question, and I get it from my patients all the time. They say, “Which supplement is causing the constipation?” And it sounds like you did the right thing, which is have them add the supplements in one at a time and say, “When do you start noticing the constipation?” So, oftentimes I’ll say, “Start the supplements separated by five days. When you see the constipation, which supplement did you add most recently?” If you’ve done that, and you still can’t identify which supplement is causing it, I would agree MegaSporeBiotic could in some patients, but I don’t think it’s any one of these that necessarily is causing constipation. I think this is an individual reaction.
So, in that case, I think you have a couple of options. One, you could add in some supplements that might help with constipation. You could layer in magnesium glycinate, Natural Calm, FiberMend, Ageless Hydro-C. You could do—my last resort is Intestinal Movement Formula. That gets almost everyone going. I would think about if you can use some supplements that are fairly safe. Like I don’t want you using a laxative or something on a daily basis to get them through this, but I think that there are potentially a lot of options. Again, make sure they’re getting enough magnesium glycinate. Maybe add some Natural Calm on that.
Generally the Lauricidin, the NCA, biofilm disruptors, those aren’t generally constipating. I would say what the constipation is most often due—what I think it’s due to in most of my patients is we’re disrupting the microbiome, right? We’re shifting around the microbes. We’re changing the makeup of the microbial diversity, and we’re intending to do that because, in this case, you have SIBO, so you want to kill off some of those bacteria. You want to do this, but there are going to be some unexpected changes, and as we’re making these transitions, I think you’re going to see changes in motility. I normally tell people constipation is normal as part of this treatment. I don’t want you staying constipated. We need to find supplements or an approach to get you through this. If patients are open to it, I don’t necessarily discourage a low coffee enema, like a small volume that doesn’t go high up into the colon. I have some patients who have done that maybe once or twice per week just to get them through that. Not everyone is open to that, and I completely appreciate that. That’s fine, but just a lot of options to get them through.
I’m wondering like how long has this patient been on the SIBO protocol? Because if you can get them through this, they might sort of come to the other side, and again, this is just shifts in the makeup of the microbes. If you’ve been at this for like three months, they’re getting really frustrated, and it’s not working, then shift to a different protocol. Instead of GI-Synergy and Lauricidin, maybe instead do FC Cidal, Dysbiocide, CandiBactin-AR, and CandiBactin-BR. There are definitely different options in terms of what you could do. So, sometimes patients just get frustrated, and I get it. In that case, try something else. Maybe you want to do rifaximin, but I would let them know that the constipation is possible, but it’s not due to a particular supplement. It may actually just be due to the fact that you’re purposely trying to change the makeup of the microbes. I wish I had a clear answer in terms of which supplement I thought it was. I don’t know, and if you can’t separate it out, then layer in supplements to help with constipation. If that doesn’t treat it, then either try an alternate antimicrobial protocol such as FC Cidal, Dysbiocide, CandiBactin, or go to rifaximin and see if that helps with motility. Hopefully that helps. You’re welcome.