Patient 4: Resolving SIBO and Systemic Inflammation in a Young Woman with Bloating, Constipation, Fibromyalgia, and Hormonal Imbalance
Patient Background
This is the case of a 27-year-old woman who presented with multiple chronic complaints, including bloating, constipation, body aches, skin flares, and hormonal irregularities. She had previously been diagnosed with fibromyalgia, and her symptoms had been attributed to chronic pain of unknown cause.
She experienced:
- Bloating and irregular bowel movements
- Body pain flares after consuming sugar, dairy, or wheat
- Diffuse hair thinning, particularly at the temples and in pubic and underarm areas (with episodes of regrowth)
- Irregular and heavy menstrual periods
- Significant PMS symptoms, including headaches for a week prior to her period
- Facial puffiness and red, burning skin episodes
- Generalized fatigue and 8 pounds of unintentional weight gain over the prior year
Her symptoms suggested an underlying gut–immune–hormonal axis disturbance that had not been previously addressed.
On physical examination, her abdomen was moderately distended and had mild diffuse tenderness to palpation.
Her prior IgE food allergy test showed many Class 1 and Class 2 allergies including Class 2 allergy to almonds, oats, egg whites, and peanuts.
SIBO Breath Testing
Lactulose breath testing revealed:
- Hydrogen (H₂): 35 ppm at 90 minutes, rising to 88 ppm at 120 minutes
- Methane (CH₄): 24 ppm
This confirmed a mixed-type SIBO with both hydrogen and methane elevations.
Treatment: Implementing Dr. Rajsree’s SIBO Protocol
We initiated Dr. Rajsree’s SIBO Protocol, focusing on restoring motility, reducing microbial overgrowth, and improving systemic inflammation.
Phase 1-2: Promote Motility and Reduce Gas Levels
- Essential Magnesium 2-4 capsules (bedtime) adjust to bowel habits
- Motility Activator 1 capsule (bedtime)
- Digestive Enzyme Pro (1-2 capsule before or after meals)
Dietary Strategy:
She began a low FODMAP / low lectin SIBO diet, with specific instructions to practice meal spacing:
- Avoid snacking between meals
- Maintain 4–5 hours between meals
- Maintain a 12-hour overnight fast between dinner and breakfast
Phase 3-4: Reduce Inflammation and Targeted Herbal Antimicrobials
In the next phases of the protocol, we introduced Spore Probiotics and targeted herbal antimicrobials to address bacterial and methanogen overgrowth:
Addition of:
- Spore Probiotic IgG (3 capsules in the morning on an empty stomach)
- Berberine Pro, Oregano Oil, and Allicidin (1 capsule of each after every meal for 6 weeks)
Outcomes
After 6 weeks of herbal antimicrobials, repeat breath testing showed:
- Hydrogen (H₂): reduced from 88 → 12 ppm
- Methane (CH₄): reduced from 24 → 9 ppm
Clinically, she experienced profound improvements:
- Bloating: almost completely resolved
- Bowel habits: normalized with daily, complete movements
- Menstrual cycles: returned to a regular monthly pattern with significantly less PMS
- Fibromyalgia symptoms: dramatically improved with reduced pain and inflammation
- Energy levels: noticeably improved
- Weight: lost 8 pounds without calorie restriction
- Skin: facial puffiness and rashes resolved
- Hair: stabilized, with reduced shedding
Maintenance Plan
To support long-term remission and microbiome rebuilding, she was advised to:
- Transition to Probiotic 100 Billion
- Continue taking Essential Magnesium and Motility Activator at bedtime
- Continue Digestive Enzyme Pro as needed after meals
- Gradually reintroduce foods while monitoring for symptom recurrence
Key Insights
This case highlights how SIBO and intestinal dysbiosis can manifest beyond the gut — contributing to:
- Systemic inflammation and fibromyalgia-like pain
- Hormonal imbalances (irregular cycles, PMS, skin flares)
- Immune reactivity and skin symptoms
By addressing the root cause through a structured, herbal protocol, this patient achieved resolution of bloating and constipation, improved hormone regulation, better skin health, and restored energy and wellbeing.
Patient Background
This is the case of a 27-year-old woman who presented with multiple chronic complaints, including bloating, constipation, body aches, skin flares, and hormonal irregularities. She had previously been diagnosed with fibromyalgia, and her symptoms had been attributed to chronic pain of unknown cause.
She experienced:
- Bloating and irregular bowel movements
- Body pain flares after consuming sugar, dairy, or wheat
- Diffuse hair thinning, particularly at the temples and in pubic and underarm areas (with episodes of regrowth)
- Irregular and heavy menstrual periods
- Significant PMS symptoms, including headaches for a week prior to her period
- Facial puffiness and red, burning skin episodes
- Generalized fatigue and 8 pounds of unintentional weight gain over the prior year
Her symptoms suggested an underlying gut–immune–hormonal axis disturbance that had not been previously addressed.
On physical examination, her abdomen was moderately distended and had mild diffuse tenderness to palpation.
Her prior IgE food allergy test showed many Class 1 and Class 2 allergies including Class 2 allergy to almonds, oats, egg whites, and peanuts.
SIBO Breath Testing
Lactulose breath testing revealed:
- Hydrogen (H₂): 35 ppm at 90 minutes, rising to 88 ppm at 120 minutes
- Methane (CH₄): 24 ppm
This confirmed a mixed-type SIBO with both hydrogen and methane elevations.
Treatment: Implementing Dr. Rajsree’s SIBO Protocol
We initiated Dr. Rajsree’s SIBO Protocol, focusing on restoring motility, reducing microbial overgrowth, and improving systemic inflammation.
Phase 1-2: Promote Motility and Reduce Gas Levels
- Essential Magnesium 2-4 capsules (bedtime) adjust to bowel habits
- Motility Activator 1 capsule (bedtime)
- Digestive Enzyme Pro (1-2 capsule before or after meals)
Dietary Strategy:
She began a low FODMAP / low lectin SIBO diet, with specific instructions to practice meal spacing:
- Avoid snacking between meals
- Maintain 4–5 hours between meals
- Maintain a 12-hour overnight fast between dinner and breakfast
Phase 3-4: Reduce Inflammation and Targeted Herbal Antimicrobials
In the next phases of the protocol, we introduced Spore Probiotics and targeted herbal antimicrobials to address bacterial and methanogen overgrowth:
Addition of:
- Spore Probiotic IgG (3 capsules in the morning on an empty stomach)
- Berberine Pro, Oregano Oil, and Allicidin (1 capsule of each after every meal for 6 weeks)
Outcomes
After 6 weeks of herbal antimicrobials, repeat breath testing showed:
- Hydrogen (H₂): reduced from 88 → 12 ppm
- Methane (CH₄): reduced from 24 → 9 ppm
Clinically, she experienced profound improvements:
- Bloating: almost completely resolved
- Bowel habits: normalized with daily, complete movements
- Menstrual cycles: returned to a regular monthly pattern with significantly less PMS
- Fibromyalgia symptoms: dramatically improved with reduced pain and inflammation
- Energy levels: noticeably improved
- Weight: lost 8 pounds without calorie restriction
- Skin: facial puffiness and rashes resolved
- Hair: stabilized, with reduced shedding
Maintenance Plan
To support long-term remission and microbiome rebuilding, she was advised to:
- Transition to Probiotic 100 Billion
- Continue taking Essential Magnesium and Motility Activator at bedtime
- Continue Digestive Enzyme Pro as needed after meals
- Gradually reintroduce foods while monitoring for symptom recurrence
Key Insights
This case highlights how SIBO and intestinal dysbiosis can manifest beyond the gut — contributing to:
- Systemic inflammation and fibromyalgia-like pain
- Hormonal imbalances (irregular cycles, PMS, skin flares)
- Immune reactivity and skin symptoms
By addressing the root cause through a structured, herbal protocol, this patient achieved resolution of bloating and constipation, improved hormone regulation, better skin health, and restored energy and wellbeing.
