When it comes to figuring out what type of SIBO you have, it is important to get tested! Getting the breathe test down is super simple. If anything, it is a bit time consuming, but 100% worth it. Learning about the types of SIBO can help you figure out what your next steps will be.
Even before you get tested, you can usually figure out what type you have. This doesn’t get you off the hook for testing, though! This is one of the top mistakes people make. However, I wanted to break down the different types of SIBO, the symptoms that can occur, and possible treatment options.
the 3 types of sibo
Methane-Dominant
This one has truly changed my life forever. This is one of the trickier types of SIBO to heal from. The reason is not only are you removing the hydrogen-producing bacteria, but also the archaea.
Archaea is another form of bacteria that eats up the Hydrogen to produce Methane gas. This is not present for those with the other two forms of SIBO. This is signified when Methane gas is elevated after drinking the solution.
This may blow your mind, but you don’t have an overgrowth of bacteria, but an overgrowth in archaea. This is a type of methanogen. But to have an overgrowth of the archaea, you need the bacteria to generate the hydrogen.
Hydrogen-Dominant
This is another very common type of SIBO. Unlike the methane dominant form, there are no archaea to worry about. You will know if you have hydrogen dominant by an elevated amount of hydrogen after drinking the solution/at baseline.
Since there are no archaea to eat up the hydrogen gas, it will remain in the body. It often speeds up the process of digestion, which can lead to diarrhea. This is caused by food not progressing through our digestion, effectively causing it to sit. During that time is when it ferments, causing hydrogen gas.
Hydrogen Sulfide
However, if you take your test, it comes back as a negative, but you still have symptoms? This is when hydrogen sulfide SIBO comes into play. This is a very new type of SIBO.
A major flag of this type of SIBO is that your test comes out negative, or it is completely flatlined. This means neither you hydrogen nor methane was not elevated after drinking the solution.
Unfortunately, there is no test for hydrogen sulfide gas. The way is diagnosed by the flatlined breathe test and the continuation of the symptoms. This is a bit trickier to treat the lack of research on the topic.
Symptoms and Treatment
A lot of the symptoms can overlap with the types of SIBO. However, some stand out more than others. Below I will last out all the symptoms and point on which ones are more prominent for each type.
The same goes for all the treatment methods. However, the treatment is very individualized. We are also so unique that one method may not work for someone else due to co-infections, deficiencies, hormone imbalances, and so on.
Symptoms
You’re going to notice a lot of similarities in symptoms. That is why it is important to get tested to know what specific overgrowth you have. The common symptoms are:
- Excessive Gas
- Flatulence that Smells Like Rotten Eggs – Hydrogen/Hydrogen Sulfide
- Flatulence that Smells Like A Barn – Methane
- Bloating
- Heartburn/GERD
- Constipation -Methane
- Diarrhea – Hydrogen/Hydrogen Sulfide
- Abdominal Discomfort
- Abdominal Cramping/Pain
- Joint Pain
- Fatigue
- Sudden Food Sensitivities
- Vitamin Deficiencies (especially B12)
- Anemia (Iron Deficiencies)
- Headaches
- Acne/Eczema/Rashes
- Weight Loss
- Weight Gain
Co-Infections
Unfortunately, with SIBO, there is some co-infection. These co-infection(s) can be the cause of your SIBO or a result of having SIBO. It is a very vicious cycle that you don’t want to be in. This is a list of common co-infections:
- Leaky Gut – VERY COMMON
- Vitamin Deficiencies
- Epstein-Barr Virus
- Autoimmune Disease
- Hypothyroidism (i.e., Hashimoto’s)
- Low Stomach Acid
- Heavy Metal Toxicity
- Clogged Up Gallbladder (i.e., lack of bile production)
- Liver Dysregulation (i.e., toxic overload, depleted enzymes)
- SIFO (Small Intestinal Fungal Overgrowth)
- Candida (Yeast Overgrowth)
- Parasite (i.e., Hookworm, Pinworm, Giardia, C.Diff)
- H. Pylori
I am sure there are some that I am missing (or don’t even know about). However, it is essential when getting to test to get tested for other things. A lot of doctors will do this to rule other conditions out. Some tests I recommend are blood tests for Celiac, H. Pylori, Epstein-Barr, Thyroid Antibodies, Hormone Panel, and lastly, a comprehensive stool test.
Treatment
When it comes to treatment, there are a lot of supplements. These supplements, along with lifestyle and dietary changes, can ensure you don’t relapse. Below are the supplements I have used/researched:
Antibiotics
- Rifaximin – Hydrogen/Hydrogen Sulfide
- Neocyin and Rifaximin – Methane
- Rifaximin and Metronidazole
- Biotics Dysbiocide and FC Cidal
- Metagenics Candibactin-AR and Candibactin-BR
- Combination of Allicin, Oregano, Neem, Cinnamon, Berberine
Post Antibiotics
Some of these supplements can be used during your antibiotics phase. This is especially true if you have co-infections that need to be healed as well. However, these are some supplements you doctor/physician/nutritionist/health coach may recommend:
- Atrantil
- Digestive Enzymes
- HCL with Pepsin (for very Low Stomach Acid)
- Iberogast (for slow MMC)
- Ginger (for slow MMC)
- Low Dose Naltrexone (for slow MMC and Autoimmune Disease)
- Interface Plus (Disruptor of Biofilms)
- GI Revive (for Leaky Gut)
- Beta Plus and Beta-TCP (Improving Fat Absorption)
- Colostrum (for Leaky Gut)
- Just Thrive Probiotic (Spore-Based Probiotic)
- Specific Vitamin and Minerals (i.e., Iron, B12, Magnesium)
- Vital Nutrients Multi-Vitamin/Prenatal (depending on if you have your period or not)
- Monolaurin (for EBV)
- Liver Detox
As you can tell, there are so many! You don’t have to use all of them! Honestly, the goal is for you to use any of them barely. However, these are good things to have in your toolbox. Along with this period of healing is an elimination diet to stop fueling the bacteria fire.
Some common ones are Low FODMAP, Specific Carbohydrate Diet, GAPS, and so on. I want to dive into each of these in later posts.
I truly hope this helps you understand the types of SIBO that are out there! But also to give you peace of mind that there are steps you can take to feel better. The most important thing is to TEST, NOT GUESS!
I would love it if you’d share this with friends, loved, or anyone else to help heal their gut for good. Thank youu so much for reading!
XOXO,

Disclaimer
**This information is not meant as medical or nutritional advice. Always check with your qualified healthcare professional before incorporating new supplements or nutritional changes into your routine. A Primal Health Coach (PHC) is trained to evaluate nutritional needs and make recommendations of dietary changes and nutritional supplements. A PHC is unable to diagnose, treat, or cure any disease or medical condition. I cannot guarantee any specific result from recommendations as we are all bio-individually different. If you are under the care of a healthcare provider, it is important that you contact them and alert them to any changes in your lifestyle in regards to nutrition and supplements. A health coach may be a beneficial addition to more traditional care, and it may also alter your need for medication, so it is important you always keep your physician informed of changes in your nutritional program.
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