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"All disease begins in the gut." - Hippocrates

My first experience with Flagyl/Metronidazole and the Herxheimer reaction/die off of SIBO (Small Intestine Bacterial Overgrowth):

10-day course of Flagyl/Metronidazole treatment for the eradication of SIBO started on 7/1/2014:

7/1/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am)
7/2/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am)
7/3/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am)
7/4/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am)
7/5/14 1000mg/day (missed one dose; don't know which one)
7/6/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am)
7/7/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am) started feeling weak (beginning of Herx)
7/8/14 1500mg/day (1 - 500mg tab every 8 hrs) (8am, 4pm, 12am) feeling extremely weak; very lightheaded when I stood up (Herx); after midnight dose, woke up at 5am feeling like I was going to vomit; did not, but kept a trash can by my bedside. This feeling weak and then nauseous must be when I had reached a saturation/tipping point with the Flagyl and consequently, the Herxheimer peak.
7/9/14 1000mg/day (1 - 500mg tab every 12 hrs) Cut dosage back to 500mg every 12 hrs. (12pm, 12am) Began feeling better.
7/10/14 500mg/day (1 - 500mg tab every 24 hrs) Continued feeling better after cutting dosage back.
7/11/14 500mg/day (1 - 500mg tab every 24 hrs) Last dose taken @ 12noon. Actually feeling pretty good and able to think straight & getting some work done. Excited about getting my health back again. I could actually feel that my body was no longer under that parasitic, vampiristic, 'my-body-is-eating-itself' feeling. I felt like I was close to being able to resume a healthy lifestyle again, complete with swimming, lifting weights and running. There is no way I could have considered any of that seriously in the last four years with SIBO, especially since I really didn't know what it was and couldn't get it diagnosed properly, either.

7/12/14 Course of Flagyl is done, so now not taking it anymore. Still feeling good; getting some work done, but still tire a little easy (not back to my old work-a-holic self yet), and when I sleep, I can still feel and hear the SIBO producing gas. I don't think it's been entirely eradicated yet, so I'm getting some more Flagyl and maybe some Rifaximin if I can afford it (it's twice the price, but is considered to be the best antibiotic and only works in the small intestine).

7/18/2014 (UPDATE) My GI doc also prescribed a 30-day course of probiotics (Nutriclean Probiotics), which I DID NOT TAKE per adamant recommendation by frantic1980 in his post, but I suspect NOT taking the probiotics may have been a mistake. It's clear that the SIBO is not entirely cured, although I do generally feel better than before I took the Flagyl. Perhaps a good thing to keep in mind is that Dr. Pimentel's book 'A New IBS Solution' was published in 2006, so it's 8-year old information now in 2014.

Dr. Pimentel does not particularly advocate the use of probiotics following the course of antibiotics (he state this in the book and I also got a verbal confirmation over the phone with his office; when he does recommend probiotics, it's 'Align'.

My GI doc supposedly has a 'working relationship' with Dr. Pimentel and has attended various seminars and conferences with him, but she prescribes a different protocol; metronidazole (Flagyl) for 10 days followed by the probiotic for 30 days. Different, but maybe more up-to-date. (END UPDATE)

I think the advantage to using a systemic antibiotic (which Flagyl/Metronidazole is) is that it kills the pathogenic anaerobic bacteria in the lymph tissues (b/c of its systemic reach) in addition to just the GI tract. I noticed that after I had reached the Herx peak and started feeling better that I sweat easily, which is remarkable for me, because ever since my teenage years, it was very difficult for me to sweat; I'd run track in 100°F+ temps for hours and really not sweat much. I'd have to sit in a dry sauna for a long time before I'd just barely start to sweat.

Once I more recently started using a dry sauna for the purpose of detoxing my lymph tissue, I could break a good sweat in about 15-20 minutes and later about 10 minutes, but after the Herx peak, I could sweat at the drop of a hat, which I think is supposed to be how perspiration flows once all the lymph tissue is detoxed and cleaned out.

One thing that I think would be of great benefit to anyone about to take a course of antibiotics for SIBO/IBS is a natural liver & kidney cleanse/flush. This is 100% natural with ingredients you'll find at your local grocery store, most of which are going to be in the produce department. It takes three days to complete, so if you have a three day weekend coming up or can at least take the last/third day off, you'll be good.

Liver Cleanse

The reason you want to flush/cleanse/detox *before* you take your course of antibiotics is that when you take your course of antibiotics, your detoxification pathways will be inundated with toxins that will be released by the bacteria as the antibiotic is killing them. This will result in what is generally considered to be an overwhelming of the detoxification pathways which include your entire lymph system which is all over your body, your skin, lungs, blood, liver, kidneys and probably more.

I felt extremely weak after about one week on Flagyl and the next day, in addition to the extremely weak feeling, I became nauseous and felt I might very well vomit. You want to make sure you flush/clear out your detox pathways as much as you can before you start the course of antibiotics, because then you'll minimize the severity of the Herxheimer/die-off effect of flooding your body with toxins being released simultaneously by billions of dying bacteria throughout your entire body.

It's an unpleasant experience as it is, but don't go looking to make it worse by continuing to consume those things you know you shouldn't such as any form of sugar, artificial sweetener (I hear Stevia is ok), or refined carbohydrates or starches (I had issues with white potatoes). So, don't feed the thing while you're trying to kill it and cleanse your detox pathways before you take your antibiotics.

If you've been frustrated and this thing has been ruining your life, take heart; this really works, but it's best that you be informed about what to expect before you pull the trigger, because as much research as I had done prior, you just can't really be prepared except by reading about someone else's experience in detail, which is what I hope to provide here, and doing the liver/kidney cleanse first.

The other great thing about the Liver Cleanse is that by doing it once or twice a year, you'll never have to worry about gall stones, kidney stones or biliary (liver) stones. If you've got one, you've got them all. It's just build up in the organs; when they get clogged, you start having symptoms of various scary-sounding 'dis-eases' that doctors will try to convince you are unrelated, no known cause & no known cure. Don't believe any of it. They don't create cures; they create customers.

They're not healers with whom you should entrust your health (or your children's), but businessmen seeking to treat symptoms and manage disease. You have to educate yourself (and your kids) because your health (and that of your kids) is your responsibility and if they misdiagnose your condition, YOU (or your kids) will pay the price for a 'doctor's' malpractice/ignorance, in the form of paying a lot of money for essentially nothing or being subject to unnecessary surgical procedures such as kidney stone surgery (or worse, organ removal; who's your doctor? Frankenstein?). Totally unnecessary.

Even the pain of waiting for a kidney stone to 'pass' is totally unnecessary. Do the three day liver cleanse. 100% natural, so cheap it's almost free, 100% effective, 100% painless (a little discomfort for about an hour toward the end in the form of intestinal bloating, but way worth it).

Liver Cleanse

That's about all I have to say on the subject for now, as I feel I'm on the brink of puting this single worst experience of my life (it was life-changing, for sure) in the rear-view mirror, but I wanted to pay it back and forward because I was off base with my self diagnosis for 3.5 years until I read a post by frantic1980, bought Dr. Pimentel's book 'A New IBS Solution' and had the hydrogen breath test done to confirm SIBO before treatment.

The original forum post by frantic1980 that started me on the path to curing SIBO/IBS:

This is the cheapest place I've found this book online: $10 delivered to your door (as of 7/1/2014):

Book: 'A New IBS Solution' by Dr. Mark Pimentel, Cedars-Sinai Medical Center, Los Angeles, CA

If you have gone through hell with SIBO/IBS, please don't just cure it and disappear. Not nearly enough people suffering with this every day know about what it really is and most doctors have never heard of it and are so arrogant that they will not listen to anything they weren't taught in 'medical school'.

You have to understand that all publicly-funded schools (public schools & all colleges & universities that accept federal financial aid) have their curriculum dictated to them by the U.S. and various state Departments of Education (Indoctrination) and the federal government receives kickbacks from the medical and drug industry which is the heart and soul of the multi-billion dollar a year so-called 'health care' INDUSTRY (why do you think the feds keep trying to take over/nationalize 'heath care'?).

That's right; it's not the 'medical community' (that term is very misleading); it's an INDUSTRY, exactly the same as the manufacturing or any other industry. Their products are drugs and their services are consultation (most docs see a different 'patient' (customer) every 10-15 minutes, all day every day), testing (expensive), procedures (very expensive; I was quoted between $1600 to $5100 for an endoscopy which was totally unnecessary) and surgeries (extremely expensive; can be 5 or 6 figures, depending on the procedure).

So again; if you've been suffering with SIBO and you cure it, congratulations! You've overcome the beast. But please pay it forward and try to help someone else by recording the details of your efforts to cure your illness.

As you're probably aware, doctors are just out for your money; your health is really only a secondary consideration to them and how much business do you think they'll have if everyone is 100% healthy? None.

Preventing you from being 100% cured is just good business for their practices (businesses). Don't be a sucker; take personal responsibility for you health and that of your kids.

One last note; research vaccinations and immunizations BEFORE you allow anyone to expose your children to them. *KNOW* what is going into your child's body rather than merely trusting people you don't even really know, who probably don't know themselves what is in vaccines and immunizations.
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