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SIBO and L. reuteri

May 23, 2020 By Dr. William Davis

As the Undoctored experience with both small intestinal bacterial overgrowth, SIBO, and our Lactobacillus reuteri yogurt grow, we are learning new lessons about the interaction between the two.

Recall that SIBO is a peculiar but exceptionally common situation in which unhealthy bacterial species such as E. coli, Shigella, Campylobacter, and Pseudomonas have proliferated, then ascended from the colon up the 24-feet of ileum, jejunum, duodenum, and stomach. Exposure to excessive quantities of sugar, glyphosate in wheat and grain products, drugs like Prilosec and naproxen, and antibiotics reduce the number of beneficial microbial species that allows unhealthy species to proliferate, adding up to trillions more bacteria that live and die in the 30-feet of your gastrointestinal (GI) tract.

It means that, if you underwent upper endoscopy and a sample of intestinal contents was obtained from the duodenum, it would be teeming with microbes, a place that should have few bacteria.

Enter L. reuteri, a unique microbial species carried by hunter-gatherers and most humans up until around 1960. Modern lifestyles have eradicated L. reuteri from the microbiome of most twenty-first century people, as only 4% of people continue to carry this species. You were supposed to obtain L. reuteri via breastfeeding as an infant and/or passage through your mom’s birth canal. You may have, if your mother harbored the species, but modern life has eradicated it.

L. reuteri has characteristics that make it important in our SIBO management efforts:

  • L. reuteri is unique among probiotic species in that it “prefers” to colonize the upper gastrointestinal tract, i.e., the stomach, duodenum, jejunum, and ileum, rather than the colon as most other probiotic species do.
  • L. reuteri is a vigorous producer of bacteriocins, natural antibiotics such as 3-hydroxypropionaldehyde that are effective against the bacterial species of SIBO.
  • L. reuteri is probably a “keystone” species, i.e., a bacterial strain that supports the proliferation of other desirable bacterial strains. Just as mangrove trees along the ocean protect the coastline from erosion and provide a safe habitat for many species of fish and other animals, and loss of these trees would be catastrophic, so L. reuteri supports the proliferation of other healthy species. Without it and you have lost more than just L. reuteri.

But there’s an added twist that was proposed by one of our Undoctored Inner Circle Members, Ashraf, who, annoyed by blowing scores of 10 on his AIRE device despite three courses of herbal antibiotics, finally asked whether the upper GI-tract colonizing habits of L. reuteri could be responsible for yielding hydrogen gas. L. reuteri does indeed convert prebiotic fibers to hydrogen. Of course, hydrogen production per se is not harmful, but the timing of hydrogen gas release after consuming prebiotic fiber acts as a “radar” for locating where in the GI tract hydrogen-producing microbes are dwelling. Ashraf and some others experiencing the same dilemma stopped the L. reuteri yogurt for two weeks and re-tested: lo and behold, negative H2 gas readings.

Could the loss of L. reuteri from modern guts be at least part of the reason for the explosion in SIBO? Could it also be responsible for the surge in (pre-pandemic) social isolation, suicides, and divorce? I believe that we have tapped into concepts that hold enormous potential to change our health and life.

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Filed Under: DIY Healthcare, Health Information Tagged With: diy health, diy healthcare, diyhealth, diyhealthcare, dr william davis, probiotic, reuteri, small intestinal bacterial overgrowth, undoctored

About Dr. William Davis

William Davis, MD, FACC is cardiologist and author of the #1 New York Times bestselling Wheat Belly series of books. He is also author of the new Undoctored: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor.

Reader Interactions

Comments

  1. Jan

    May 23, 2020

    Love the power of Undoctored members joining forces to make new discoveries without waiting for the powers that be to decide it is worth funding a study!

  2. Veronica

    May 23, 2020

    Tune in, turn on, lose weight! L. reuteri is the new acid! Spike the punch & dump it in the water supply! 🙂

    • Bob Niland

      May 23, 2020

      Veronica wrote: «Tune in, turn on, lose weight!»

      Well, although L.reut can help with remediation of dysbiosis, down-regulation of appetite, and thus non-trivially contribute to weight management, it’s only part of a wider set of adjustments that are mainly about unwinding the metabolic drivers.

      re: «L. reuteri is the new acid!»

      No hallucinations so far reported. Vivid dreams within improved sleep aren’t uncommon, though.

      re: «Spike the punch & dump it in the water supply!»

      That will kill it in short order — no substrate & temp too low.

      But your remark does hint at a real question here, suggested by the “…carried by hunter-gatherers and most humans up until around 1960…” in the article, which is: just what is the natural reservoir of the key natural strains? If ancestral humans were the sole reservoir, passed along the maternal line, modern humans are potentially in bigger trouble with each new generation.
      ________
      Blog Associate (click for details)

  3. Lori Philpott

    May 23, 2020

    Anyone consider the effect of “chlorinated water” on the microbiome? My husband and I were having trouble with loose stools including multiple bouts of diarrhea daily for myself. The gastro after thorough testing diagnosed me with IBS. Finally after suffering for years I bought a Berky water filter and ran all water for oral use through it and wahla we’re both cured. We live in a small town and after speaking with the supervisor of the water treatment he assured us of no other complaints other than taste.

    • Bob Niland

      May 24, 2020

      Lori Philpott wrote: «Anyone consider the effect of “chlorinated water” on the microbiome?»

      Absolutely. Here on the blog:
      Beware: What’s in that glass of water?

      re: «We live in a small town and after speaking with the supervisor of the water treatment he assured us of no other complaints other than taste.»

      Did you get any clarity on whether the agent was classic chlorine, or the much more persistent chloramine?

      I’ve also written (public) articles for the Inner Circle site on the scope of the problem:
      Drinking Water, Calcium & Non-Native Halogens
      and one thing to do about it:
      A Domestic RO Water System
      ________
      Blog Associate (click for details)

  4. Sergen Tuncer

    May 28, 2020

    Hi,

    Does strain make any difference when it comes to making the yogurt? L. reuteri DSM 17938 is the only strain that I can find in my country.

    • Bob Niland

      May 28, 2020

      Sergen Tuncer wrote: «Does strain make any difference when it comes to making the yogurt?»

      It makes all the difference.

      re: «L. reuteri DSM 17938 is the only strain that I can find in my country.»

      What country is that? If Canada, for example, there are resellers who offer products not on Biogaia’s official list for the region.

      You can make a yogurt with just ‘17938, but we don’t know if it confers the same range of effects as one which also includes the ATCC PTA 6475 strain in the Gastrus®.

      If I could only get ‘17938, I might be tempted instead to use Lactobacillus reuteri NCIMB 30242, which is more widely available.
      ________
      Blog Associate (click for details)

      • Sergen Tuncer

        May 28, 2020

        There are three BioGaia products in Turkey and for some reason all three of them contain only ‘17938. Some other products contain trivial amount of Lactobacillus reuteri but doesn’t specify which strain it is.

        I came across the combination of Lactobacillus reuteri (RC-14®) and Lactobacillus rhamnosus (GR-1®). I assume that wouldn’t work too. It is for vaginal microbiota.

        • Bob Niland

          May 28, 2020

          Sergen Tuncer wrote: «There are three BioGaia products in Turkey and for some reason all three of them contain only ‘17938.»

          This commonly has to do with local regulatory approvals, as these are principally juvenile products.

          I don’t suppose supplement tourism is an option?

          re: «combination of Lactobacillus reuteri (RC-14®) and Lactobacillus rhamnosus (GR-1®).»

          Those are trademarked strains of Chr. Hansen Holding A/S, Denmark, for which the Wheat Belly and Undoctored program have no data or advice insofar as general intestinal use, or fermented food use. They cannot be presumed to have any of the effects seen for the suggested species and strains. There seems to be a lot of science for their use in vaginal health, however.
          ________
          Blog Associate (click for details)

          • Sergen Tuncer

            May 29, 2020

            This definitely has to do with local regulatory approvals. In Turkey, there are some limitations regarding probiotic supplements (no more than 10 billion organisms per capsule).

            Supplement tourism might be an option in the future.
            Until then, I could use a probiotic supplement that contains several organisms (including l reuteri) with your yogurt making technique. ( https://n11scdn.akamaized.net/a1/org/spor-outdoor/saglik-destek-urunleri/newvit-probiyotik-30-kapsul-skt012021__1137241461422355.png )

            Btw, I’m in my late 20’s. If I remember correctly Dr. Davis had said young people shouldn’t follow his L. reuteri yogurt recipe.

            I really appreciate your help. I find your comments really helpful.

          • Bob Niland

            May 29, 2020

            Sergen Tuncer wrote: «In Turkey, there are some limitations regarding probiotic supplements (no more than 10 billion organisms per capsule).»

            That certainly argues for yogurt-making, where suitable initial cultures can be obtained.

            re: «…use a probiotic supplement that contains several organisms (including l reuteri)…»

            The questions (and likely problems) include:
            • Is there a common fermentation temperature for all?
            • Is there a common substrate for all?
            • Do they all reproduce at the same rate?
            • Do some destructively compete with others?
            • Are any differences exacerbated at extended ferment times?
            • Are any fungi present? Saccharomyces cerevisiae, for example, has alcohol as a metabolic byproduct, which will both kill off the bacteria, and make beer, not yogurt.

            That Supplement Facts panel you linked to raises all of the above questions, less fungi, but plus another (that I also encountered with a different probiotic yesterday) — strains are completely absent, such as for the Lactobacillus reuteri. Even if that L.r. thrives in a yogurt made with that probiotic, what benefits might it have?

            re: «…I’m in my late 20’s. If I remember correctly Dr. Davis had said young people shouldn’t follow his L. reuteri yogurt recipe.»

            See: I was wrong: Young people SHOULD obtain L. reuteri
            ________
            Blog Associate (click for details)

  5. Andrew

    May 30, 2020

    Can someone post the link to the most current recipe using the BioGaia product? I’m seeing different recipes in the book, blog, and undoctored site. Thanks.

    • Bob Niland

      May 31, 2020

      Andrew wrote: «Can someone post the link to the most current recipe using the BioGaia product? I’m seeing different recipes in the book, blog, and undoctored site.»

      Although there are more recent postings on the subscription sites, none are appreciably different from the basic details found here at: Troubleshooting L. reuteri yogurt-making

      Are you having any particular problems?
      ________
      Blog Associate (click for details)

      • Andrew

        May 31, 2020

        Thanks for the reply. Just trying to figure out which one to start with.

        • Bob Niland

          May 31, 2020

          Andrew wrote: «Just trying to figure out which one to start with.»

          I presume “one” refers to recipe, and that you’ve already decided to start with Biogaia® Gastrus® culture (vs. the more recent L.r. NCIMB 30242, or the L.casei(Shirota) from Yakult®

          Be sure to perform a dry (well, wet, really) run using just water, to verify that your device/setup can hold 95-105°F for 36 hours.
          ________
          Blog Associate (click for details)

  6. Andrew

    May 31, 2020

    I just bought the Biogia Gastrus per the prior blog post. Can you direct me to where I can read up on the nuances of making this? Thanks.

    • Bob Niland

      June 1, 2020

      Andrew wrote: «I just bought the Biogia Gastrus per the prior blog post.»

      This recipe looks like it’s current:
      Making L. reuteri yogurt

      re: «Can you direct me to where I can read up on the nuances of making this?»

      There really isn’t any FAQ on it, although I probably could write one. What device are you planning to use? Do you have a source of half&half, or milk+cream, that lacks junk ingredients (such as carageenan, preservatives, vitamin D₂)?

      What prebiotic are you planning to use?
      ________
      Blog Associate (click for details)

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