This year, you might hear “berberine” more than ever. However, before jumping right in, you may want to become more familiar with this plant alkaloid, how it promotes gut health, and how berberine benefits those with small intestinal bacterial overgrowth (SIBO). 

Eastern medicine touts berberine benefits for metabolic health and treatment for chronic disease. In fact, many believe that berberine is one of the most effective natural compounds in Eastern medicine. Berberine benefits include promoting healthy blood pressure, and supporting blood glucose and cholesterol levels.1

Functional medicine has known about berberine’s benefits for decades. In my clinic, I recommended berberine to my patients with SIBO. Berberine promotes gut health by killing or inhibiting the growth of intestinal microbes. I’ll talk more about that in just a second. 

Here’s what you need to know about berberine’s benefits and how it can help with SIBO by promoting balanced gut microorganisms. First, let’s look more into this potent alkaloid. 

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What Is Berberine?

Berberine is an alkaloid, which means it contains one nitrogen atom. The nitrogen atom allows it to neutralize hydrogen, a common gas caused by SIBO. 

This potent herb has a yellow color and is often used as a dye. However, berberine has a long history of use in Chinese medicine. Conventional medicine has confirmed berberine’s benefits for many health issues.2

Many plant species contain berberine, including alkaloid barberry (Berberis vulgaris), tree turmeric (Berberis aristata), and Oregon grape (Berberis aquifolium).

After you ingest berberine, it is broken down in your digestive tract and absorbed into your bloodstream, where it binds to your cells. One of berberine’s immediate actions is that it “turns on your metabolism” by activating the AMPK (AMP-activated protein kinase) enzyme. The AMPK enzyme regulates your metabolism.3 

Berebaine’s benefits do not end with your metabolism. As I mentioned earlier, berberine promotes gut health and supports healthy blood pressure, cholesterol levels, and blood glucose levels. Let’s dive further into berberine benefits, particularly with SIBO.   

Berberine’s Benefits for SIBO

SIBO, also known as Small Intestinal Bacterial Overgrowth, is what the name describes. The bacteria in your small intestine get unbalanced and overgrow instead of living in a balanced state.  

Picture your microbiome as a rainforest, with many species living harmoniously. Together, these species play a vital role in your immune system, thyroid function, bone health, and overall health. Most of your gut bacteria live in your large intestine and colon. Here they help break down food, synthesize vitamins, and eliminate waste. However, medications or a poor diet can cause your rainforest to become unbalanced. 

When the rainforest becomes unbalanced, the bacteria normally found in the large intestine and colon overgrow and colonize in your small intestine, leading to SIBO symptoms, including increased hydrogen and methane gas production. Here’s how it works. 

How SIBO Produces Hydrogen and Methane Gas

While colonizing in your small intestine, the group of overgrown bacteria can thrive by feeding off the undigested food passing through. This process of fermenting carbohydrates produces hydrogen gas. Hydrogen can feed the single-celled organisms in your small intestine called archaea, producing methane gas. 

All that excess gas in your gastrointestinal tract contributes to the severe bloating people experience while dealing with SIBO

As I mentioned earlier, berberine is an alkaloid. The small molecules contain nitrogen used as a defense against herbivores and pathogens. Nitrogen also neutralizes hydrogen and methane gas. Berberine also works to kill harmful bacteria to disrupt the biofilm created from the bacteria overgrowth. I’ll go into more detail about berberine and how it factors into my three-step protocol for treating SIBO in just a minute.

Before I get into that, let’s discuss the difference between hydrogen and methane gas and their relationship to SIBO. 

Hydrogen vs. Methane

As I explained earlier, when you have an overgrowth of bacteria in your small intestine, the carbs you eat can ferment before they get broken down. This fermentation process releases hydrogen gas, so people who experience SIBO symptoms, such as flatulence, bloating, and diarrhea, often exhibit elevated levels of hydrogen in their GI tract. This is why the breath test is the gold standard for testing for SIBO. I recommend the Lactulose Breath Test from Aerodiagnostics.

Hydrogen SIBO

Hydrogen dominant or hydrogen SIBO gets diagnosed by a sufficient rise in hydrogen on a breath test. This form of bacterial overgrowth is also referred to as diarrhea-prone SIBO, as the byproducts of carbohydrate fermentation create an osmosis-like effect, drawing water into the bowel and causing diarrhea. 

Moreover, hydrogen SIBO can cause damage to your gut’s mucosal lining, creating a lactase deficiency. Lactase is the enzyme we use to break down and digest lactose. This is another reason why sudden food intolerances indicate an underlying gut infection.

Methane SIBO

SIBO can also cause an increase in methane levels. As the hydrogen feeds single-cell organisms in your gut called archaea, they produce methane. This can reduce your hydrogen levels which explains why you can have a false negative hydrogen breath test result and still have methane SIBO.

If you have small intestinal bacterial overgrowth and are dealing with constipation as your main symptom, you likely have methane SIBO. You ideally want your lab testing to identify which type (hydrogen or methane SIBO) you have, as the two respond differently to different treatment options.

This can be done through a breath test, comprehensive stool test, or a urine test to look for byproducts of yeast or bacteria. Your functional medicine practitioner can order these tests. 

Berberine’s benefits to SIBO and neutralizing hydrogen and methane gas are just the tip of the iceberg for this potent alkaloid. Here are some of the other berberine benefits. 

berberine benefits – infographic – Amy Myers MD®berberine benefits - infographic - Amy Myers MD® benefits – infographic – Amy Myers MD®

Other Berberine Benefits

In addition to berberine’s benefits for gut microbiota, it has many other benefits. Researchers have found that berberine can help facilitate healthy blood glucose levels, promote optimal weight due to its metabolism-supporting properties, supports heart health by promoting healthy cholesterol levels, and promotes a healthy inflammatory response. 

Remember, tree turmeric contains berberine. Turmeric has a long history of use in eastern medicine. It has been used topically on the skin for wounds, acne, and parasitic infections; administered orally for colds and urinary tract diseases; and even inhaled for chronic rhinitis and inflammation in the nose due to hay fever.

Curcumin is one of the three main active compounds, or curcuminoids, that gives turmeric its bright yellow color, alongside demethoxycurcumin and bisdemethozycurcumin. Curcumin supports a healthy inflammatory response

Now that you know all the benefits of berberine and how it helps with SIBO, let’s talk about how it factors into my three-step protocol for treating SIBO. 

My Protocol for Treating SIBO

As a medical doctor, I used a three-step approach to treating thousands of patients. Treat your bacterial overgrowth with this 3-step approach that eliminates the overgrowth and restores your gut’s natural balance.

Step 1: Starve the Overgrown Bacteria

Starve the overgrown bacteria by removing the foods that feed it from your diet. This means cutting all sugar and alcohol and limiting carbohydrates such as fruit, starchy vegetables, grains, and legumes. 

You can reintroduce some of these foods after keeping your gut balanced. I recommend a SIBO diet that ditches gluten and dairy for good, particularly if you have an autoimmune or thyroid condition.

Step 2: Attack the Bacteria

In my clinic, I typically used antibiotics Xifaxan and Neomycin to attack the harmful bacteria. Xifaxan is more effective with hydrogen-dominant SIBO and Neomycin with methane SIBO. These antibiotics kill the pathogenic bacteria with the least amount of disruption to the good bacteria in your microbiome.

If starving the overgrowth and attacking the bacteria have little effect on your SIBO symptoms, it could be because a biofilm has formed around the overgrown bacteria, making it more challenging to eliminate. In these cases, I recommend treating bacterial overgrowth with a biofilm disruptor such as Microb-Clear®

When formulating Microb-Clear®, I made sure to include berberine to attack the bad bacteria and inhibit the growth of intestinal microbes. Due to its neutralizing properties, berberine is effective in counterbalancing the hydrogen and methane gasses that feed harmful bacteria. 

The ingredients in Microb-Clear® are not as harsh as broad-spectrum prescription antibiotics, which can wipe out good and bad bacteria. Microb-Clear® is a natural and gentle way to support the good bacteria in your gut microbiome and disrupt the biofilm caused by SIBO.

Step 3: Restore Your Good Bacteria

The final step is to restore the good bacteria in your gut. This will help support a strong immune system, optimal digestion, and nutrient absorption. Moreover, you want to be particularly careful when it comes to small intestinal bacterial overgrowth. Certain probiotics can add fuel to the fire and exacerbate your SIBO symptoms.

The Problem with Most Probiotics

When you have an overgrowth of bacteria in your small intestine, it is often a lactobacillus or bifidobacterium species. Most probiotic supplements contain these species, so using them adds to the bacteria in your small intestine. Consequently, one clue that you may have small intestinal bacterial overgrowth is that probiotics containing lactobacillus or bifidobacterium exacerbate your symptoms.

Soil-based probiotics don’t colonize the small intestine or feed the growing bacteria. In short, they do not contain lactobacillus or bifidobacterium strains, yet they provide all the benefits of a probiotic.

The Final Word

Conventional medicine is catching up with what functional medicine has known for years– Berberine’s benefits make this potent alkaloid a valuable tool to fight SIBO and support optimal health. It’s why I included berberine when formulating Microb-Clear® to create a favorable environment for beneficial probiotics in the gut. By using my three-step approach to treating SIBO, you can combat your symptoms of SIBO and take back your health.