I’ve spoken with many people who know that they have been diagnosed with SIBO but don’t know their SIBO numbers or what they mean. It’s not only important information to have when talking with health practitioners but also helpful to know and understand yourself. Additionally, it’s important to advocate for a retest or decide when taking a testing break is what you need.
KNOWING YOUR NUMBERS
- Knowing your SIBO results can help you decide on a treatment. If you have higher numbers, doing the elemental diet might be more helpful since it tends to reduce SIBO numbers further than pharmaceutical or herbal antibiotics. For herbal and pharmaceutical antibiotics, your numbers may go down anywhere between 15-40 points. For the elemental diet, numbers may go down 70-100 points. While these ranges won’t be true for everyone, it can be helpful to have an expectation.
- Your numbers may correlate to your symptoms. Positive hydrogen numbers often correlate with a diarrhea symptom picture while methane numbers usually correlate to a constipation picture. This isn’t true for everyone and sometimes people’s dominant numbers will change over time or with treatments. Higher numbers overall tend to mean worse and more diverse symptoms, though it’s also important to take other health issues into account. Higher numbers or unaddressed issues for a longer period may be related to more food sensitivity or supplement intolerance.
- SIBO test numbers and symptoms can help you decide to treat a negative test. Many labs view methane numbers of 12 and under as a negative test and the 2017 breath test consensus views methane numbers of 10 and under as negative. However, when a patient has symptoms that include constipation, many doctors will consider methane numbers of 3 and above as positive.
- A Flat line test with SIBO symptoms may indicate Hydrogen Sulfide SIBO. Test results with very low and consistent numbers throughout a test showing a flat line may be viewed as a negative test. But if you are having SIBO symptoms, it may also indicate hydrogen sulfide SIBO. If symptoms are not fully indicative of Hydrogen Sulfide SIBO, many doctors recommend trying the least invasive treatments first, such as trying a low FODMAP diet to see if it mitigates symptoms.
WHEN TO RETEST
- Retesting shows how you reacted to a specific treatment. Retesting will indicate how you reacted to herbal or pharmaceutical antibiotics or an elemental diet and how far your numbers were lowered. A larger drop in test numbers will correlate with a greater effectiveness of treatment.
- Retesting will determine if the overgrowth is gone. I have heard from several clients that their doctor prescribe one round of antibiotics and then declare that the overgrowth is gone. Everyone reacts to treatments differently so it’s important to retest to see where you are, especially if you have higher numbers to start.
- Seeing a negative test can be hopeful. There can be great relief in seeing a negative test. If you relapse, which some people do, it’s also helpful to know that you were able to get to a negative test. In the case of relapse, it may be time to take another look at your underlying cause or concurrent health issues.
WHEN TO LET GO OF THE NUMBERS
- If testing makes you ill. Lactulose produces laxative effects in many people and for some it can have really negative health effects. Or some people can’t follow the prep outline without detrimental health ramifications. If this is your case, you can speak with your doctor about the possibility of treating the symptoms without a test result.
- When it causes anxiety. Many people have longer or even lifelong cases of SIBO or digestive distress. They come to an understanding of their symptoms and their ongoing treatment and the numbers don’t necessarily matter. In fact, they may cause additional anxiety. Sometimes it can be helpful to take a break from testing or speak to an additional practitioner to look at your case in a different light. I’m in no way saying; “Just give up!” because there’s always hope for improvement, both emotionally and physically. However, it’s important to know and honor yourself and, with your health practitioner, decide when testing is right for you.