This Type of SIBO Might Be Hard to Diagnose

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The Pure TheraPro Team

The Pure TheraPro Education Team is comprised of researchers from diverse backgrounds including nutrition, functional medicine, fitness, supplement formulation & food science. All articles have been reviewed for content, accuracy, and compliance by a holistic integrative nutritionist certified by an accredited institution.
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SIBO, or Small Intestinal Bacterial Overgrowth, is a common gut disorder that occurs when bacteria either overgrows in the small intestine or is composed of too many of the wrong type of bacteria, creating an imbalance. These bacteria are traditionally methane or hydrogen dominant, meaning that the bacteria produce either of these two gases. Depending on the type of bacteria, different symptoms are present. Both methane and hydrogen dominant SIBO can be tested with a SIBO breath test and usually respond well to treatment and a low-FODMAP diet. 

A new type of SIBO, however,  not easily diagnosed with traditional testing, will also not respond to the same treatment protocol as the other two types of SIBO. Hydrogen sulfide dominant SIBO is a bacterial gut imbalance where bacteria produces too much hydrogen sulfide. 

Symptoms of Hydrogen Sulfide SIBO include nausea, weight loss or weight gain, diarrhea or constipation (both have been reported), skin issues (acne, psoriasis, rosacea), joint pain, restless leg syndrome, joint pain, brain fog, chronic fatigue, headaches, gas and bloating, heartburn, high cholesterol, blood sugar fluctuations and more. This type of SIBO is also associated with mood disturbances (depression, anger, anxiety, mood fluctuations), heavy metal toxicity and methylation issues and fibromyalgia and/or chronic fatigue syndrome. A tell-tale sign that you have it is a sulfur intolerance and exacerbation of symptoms when you eat high sulfur foods. One unique characteristic of this type of SIBO is extremely foul-smelling (rotten egg) flatulence which increases after consuming high sulfur foods. 

Hydrogen sulfide is actually beneficial to the body, toting anti-inflammatory and detoxifying effects. It’s an issue, however, when this gas is present in high concentrations, as is the case with Hydrogen Sulfide dominant SIBO. Excess hydrogen sulfide can cause systemic damage and negatively impact the nervous system and mitochondria. This gas can also exacerbate inflammatory bowel disease and increase the risk of bowel cancer.

So, how do you fix Hydrogen Sulfide SIBO? The first step is to go on a low-sulfur diet, which should almost immediately relieve symptoms. Keep in mind that a low-FODMAP diet will not be beneficial for you if you have this type of SIBO. 

Sadly, many foods that are extremely good for you are high in sulfur, which may surprise you when you look at the list of foods to avoid. 

These foods include cruciferous vegetables, garlic, onions, radishes, asparagus, lean meats, legumes, wine, quinoa, dairy products and eggs.

You should also steer clear of certain supplements for awhile, such as NAC, glutathione, turmeric, milk thistle and ALA. Anyone with any type of SIBO or gut issue should use caution when consuming artificial sweeteners and stevia

Some foods that are low in sulfur include: Avocado, squash, bell pepper, celery, cucumber, carrots, beets, artichokes, eggplants, mushrooms, potatoes, almonds, gluten free bread, rice milk, jasmine rice (avoid wild rice), dark poultry meat, certain seafood, pumpkin, sesame seeds and cucumber. 

Keep in mind that this diet is not forever--- generally, people with Hydrogen Sulfide SIBO simply need to adhere to a low sulfur diet for a few weeks coupled with other natural interventions in order to resolve symptoms and rebalance the gut microbiome. 

Along with a low-sulfur diet, Hydrogen Sulfide SIBO responds to high-dose oregano supplementation, as this herb has antimicrobial properties and can kill colonies of bad bacteria that are creating the higher-than-normal levels of hydrogen sulfide in your system. 

Bismuth is also effective at reducing symptoms of Hydrogen Sulfide SIBO. Long-term use of Pepto Bismol, however, is not recommended, as it contains many adjuvants as well as salicylate, which can be harsh on the gut lining. 

Green tea is well documented with research showing it reduces hydrogen sulfide gas by 30%. Although it doesn’t treat or cure SIBO, green tea may help manage the uncomfortable symptoms. 

Codonopsis root is a Chinese herb that is similar to ginseng and has been used in Chinese medicine for centuries. This herb helps eliminate some of the  hydrogen sulfide-producing bacteria, such as desulfovibrio and alistipes while promoting the flourishing of beneficial bacteria. 

Some other supplements that may help with all types of SIBO include:


Our Leaky Gut Defense contains ingredients that help address gut inflammation and promote the self-repair of the mucosal lining. Ingredients such as licorice root (DGL) can target various parasites and bacteria, including h. Pylori, which can be the root cause of heartburn and digestive issues that are also associated with SIBO. Arabinogalactan (larch tree bark) naturally creates a gut environment conducive to "good" bacteria proliferation. 


Research has shown that Saccharomyces boulardii may help manage SIBO. Saccharomyces boulardii helps fight off pathogenic strains of bacteria and reduce inflammation. It’s important to remember that as a beneficial yeast, it is transient and does not colonize in the gut. This is why many with SIBO may need to take Saccharomyces boulardii coupled with a probiotic.


Our Saccharomyces 10B (strain DBVPG 6763) survives stomach acid to colonize in the intestinal tract while acting as a temporary flora to protect the beneficial organisms of the intestine. Additionally, it works with the body to re-establish the microflora, thereby helping to maintain and support healthy immunity, digestion and gut health.


For managing SIBO, beginning with our Leaky Gut Defense along with dietary changes (going “low and slow”) and then adding the Saccharomyces 10B (low and slow), followed by long-term use of a probiotic that takes residence in the gut, such as our Power Probiotics, has demonstrated successful outcomes with many of our customers.

Our Power Probiotic Daily provides four researched strains of useful bacteria, including the extensively studied HN019 strain of Bifidobacterium lactis. These live microorganisms have proven health benefits and well-established safety, and have been tested for epithelial cell adhesion and/or resistance to low pH. These strains have demonstrated to increase gut transit time and help support optimal immune function.