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Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (1:37)

This is where you rise. Get ready. We're about to disrupt everything you thought.

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You knew about thyroid and hormone health.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (1:45)

Let's go.

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If your labs are normal, but you're exhausted, you're foggy, gaining weight, or you just don't feel like yourself, listen to me. Most women are told they're fine based on one number.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (2:02)

Tsh.

Dr. Amy Myers (2:04)

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Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (3:12)

Your call today. In almost 600 episodes, we have not talked about something that I get questions on all the time. I see comments in the just fixture thyroid Facebook group from members asking about this. This disease with four letters. It's called sibo. It is spelled S I B O. It stands for small intestinal bacterial overgrowth. And this is one of those really elusive. I don't even want to call it a disease state because we're going to unpack that today. This is one of those elusive terms that suck people in and pull them swiftly down a rabbit hole that maybe they shouldn't be going down. It's a distraction rabbit hole. It's a misinformation rabbit hole. And while the health of our gut is obviously important, especially as it relates to thyroid and hormone balance, sometimes people go too far. Now, sometimes this little thing called sibo makes a difference. It matters, but our approach to it needs to be a little bit more nuanced. We need more information. So that's why I brought on my dear friend and colleague Angela Pfeiffer, because she knows sibo. She's the sibo guru. She's been doing this forever. She's a functional medicine nutritionist, and she goes deep into gut dysfunction, digestive dysfunction, dysbiosis, all those dis things that we hear about with our gut in addition to sibo. So, Angela, you know my excitement for this podcast because I'm like, we need to clear the confusion. What if it's not sibo? We need to clear the confusion. So thank you so much for being here.

Angela Pfeiffer (5:04)

Oh, I a joy. Thank you so much. I can't wait to dive in.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (5:08)

Well, girl, you're doing great work in the world. Really, really educating people on this. So let's start. Let's start high level. I said what SIBO stands for, but give me a little bit more detail. What is this small intestinal bacterial overgrowth? How does it occur? Why is it overlooked or misdiagnosed? Just like the thyroid in both conventional and functional medicine?

Angela Pfeiffer (5:30)

Yeah, right. So basically it's small intestinal bowel overgrowth, but they have changed some of the terminology now. I have called it Small intestinal bacterial overgrowth forever. Because I feel like that's a little bit more reflective of what it is. Basically you can get an overgrowth of commensal bacteria that should be there, but they're in the wrong spot. Right. So they're just raising to too high of numbers. In the small intestine. We can get an overgrowth of proteobacteria, which are the ones that are really most strongly linked with C. And as we look at proteobacteria that reside in the lungs, on the skin and in the mouth, we do have a little bit in our intestinal tract, but that's because they're in our mouth. And every time we swallow them down, we're getting a, you know, a little bit keeping that colony going down there. But our stomach acid should be killing off all the proteobacteria that's coming down. So every single time you swallow, I mean, you're swallowing trillions of bacteria all day long, right. So you really should be good robust stomach acid clearing off what is coming down. Then those proteobacteria don't have the ability to colonize at higher levels in the intestinal tract. So we get colonization of those. We have Klebsiella estro coli. They're gram negative bacteria. They, you know, at higher numbers they're definitely pathogenic. And then we can get some migration from the large intestine up into the small intestine. If there is just incredibly incredible stalling, really stalled peristalsis and probably ileocecal valve dysfunction happening at the same time. That ileocecal valve being the last section of the small intestine and the, then the start of the large intestine. And that valve is, you know, we want it to close and open only to allow things through and then close again. Just like our esophageal sphincter. We don't want this staying open. That that's going to allow some acid to come back up so you can get a little backwash. But really the main, main driver from a functional perspective of Sibo is going to be those Klebsiella that are colonizing. We have lower stomach acid allowing it. We have vagus nerve dysregulation causing the lower stomach acid. And we have to figure out what's causing the vagus nerve dysregulation.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (7:41)

Okay, that, that's complex. So let's, let's unpack this even further for people to really understand from, you know, kind of beginning to end. So let's go back and you've kind of explained like how we get a sebum, we can swallow anything and then it produces the. Or, or it contains, and then contains the bacteria and then grow, grows it right in our small intestine. But are there, I guess, you know, going back to the beginning, is there anything we can do to protect us? Or is this kind of a one of those crapshoot things that some people are going to be affected and some people aren't, but we're all exposed.

Angela Pfeiffer (8:25)

So it's such a great question, right, because we all swallow bacteria, right? We all are going to, from time to time, probably have a little bit lower stomach acid. But it, you know, why is it affecting some and not others? We do see from some studies that anxiety is a traitor that precedes the setup of like a food poisoning event. Because again, you, you expose 100 people, not all 100 people get sick, right? Some better, some have more robust immune systems, more robust stomach acid, better bile flow, better motility, moving things down. And their system can handle it. Probably more diversity, you know, in the of the bacteria in their intestinal tract and good balance. And then you have the other people who get sick. I remember one time my husband and I went out on a date. We sat at a bar. The bar was like six inches deep, right? I mean, it was just a tiny little bar that we were sitting at. And I've never had steak tartare. Never had it. Thought this would be a really good idea to try. We ate off the same plate with the same fork. Okay, Two in the morning, I'm up walking to the bathroom going, I have to stop drinking. I only had a drink. But that whole toxic effect that you get when you get a food poisoning event, oh my goodness, my husband did not even burp. So, you know, it's probably load, but it's also immune system robustness and everything else that comes with it. So we also know that people that go on from a food poisoning event to get post infectious ibs, which is sibo, from a food poisoning event, also have the trait of anxiety. So we have to think about, is that altering the immune system? Is that affecting motility? What else is that affecting? Is it slowing down thyroid? Is it interfering with the vagus nerve? Because when we're anxious and stressed, vagus nerve is not kicking us back down into parasympathetic. It's not in doing so, supporting all of those chemicals top down that we use to digest from saliva and enzymes and stomach acid and, you know, bioflow, all of that so we have to look back at really correcting those steps to protect ourselves. It's interesting as we look at this field because I think it's, you know, it's a point at a point. Someone gets diagnosed, they are immediately told, space out your meals, don't snack. You can't eat these foods. We have to treat, treat, treat. Eating consistently across the day does not cause sibo.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (10:58)

Okay?

Angela Pfeiffer (10:58)

Food did not cause sibo. You could get a food poisoning event. It's totally different. It wasn't the food, it was the cross contamination of some sort. Somebody didn't wash their hands that was serving you or cross contamination of a knife onto what you're eating or a cutting board. You know, that's not a food. You know, I ate potatoes and now I have sibo.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (11:18)

Right.

Angela Pfeiffer (11:18)

But all of a sudden, on the other side of this, restrict, restrict, restrict, kill, kill, kill. And by the way, you're going to have it forever. And you can only eat two meals a day, maybe three. You definitely have to fast. And it's. None of that really is true.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (11:33)

Well, now, I mean, now you're, you're singing like angels to the people out there with SIBO who have been in that repetitive loop cycle of treatment. But before we get there, because we're gonna, we're gonna go deep there because just what you said, that's what I see as well in my patients that come in that have been working even in the functional medicine space space, the integrative medicine space, with practitioners who keep them in that loop actually, and keep the misinformation going. So before we get there as to what we do about it, let's back up, because you said something about low stomach acid and, and I'm piecing this together with the anxiety component and Hashimoto's. So what do we know about Hashimoto or any thyroid disorder? It's going to affect our brain. We're going to be more prone to anxiety and depression and have a less. A lowered stress resilience overall to stress that we're exposed to. In addition, we also know that with Hashimoto's we have low betaine hydrochloric acid. So do you see Sibo kind of hit the Hashi people as well? Is that another subset in addition to anxiety that you would say? Yeah, they're probably going to respond. Whereas Susie Q over here, who does not have a thyroid problem whatsoever, might skirt by with the same exposure.

Angela Pfeiffer (12:54)

Yeah, not everyone with Hashimoto's is going to get sibo. But I would say that I Do observe a tight correlation with them because we have to look again from a functional perspective. When SIBO is set up, what factor or factors are setting it up. It's always multifactor. It's, you know, never going to be one thing unless, hey, my appendix burst. It caused adhesions over time. Everything else is perfect prior to. There are, you know, a clear passage out of Florida, Great company to go to to to work on clearing adhesions. You know, that's a very one dimensional, you know, treatment plan to me. Like, we know what's causing it, let's treat it. But if we're looking from a functional perspective, I'm just going by in life, all of a sudden I'm bloating like crazy. Where did this come from? I can adjust my food and maybe calm it down a little bit, but it's still there. Why is all this happening? This doesn't feel good. More functional in presentation. We have to look at so many things being connected. There's a vagus nerve inhibition issue. We probably have an imbalance of bacteria that's in the intestinal tract. We probably have a slowdown of digestion, a slowdown of motility because of the vagus nerve and all of that can, you know, oxidative stress building up interferes with thyroid pathways, inflammation interferes with thyroid pathways, and then you're kicking up autoimmune cause the system's not feeling great, which is going to attack thyroid more. So it's just a whole. We got to look at everything kind of, to me, in a cycle and a lot of things being interconnected there. So strong, strong connections there just because of what thyroid does driving the effect on the gut and then what the gut does in driving the effect with thyroid.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (14:31)

Oh, and there's a huge, huge connection. So if not sibo, I at least hear my patients, my audience talk about dysbiosis and IBS and food sensitivity. So how do we tell? Like what, how do we properly diagnose SIBO and differentiate it from these other gut issues?

Angela Pfeiffer (14:54)

Yeah. So I'd say first and foremost, bloating is not always sibo. And I would say even if you're running a SIBO test and you have a positive SIBO test, bloating is not always sibo. So. So just know that first and foremost. Because I think at this point, most patients are presenting and that is their biggest complaint, because, I mean, this can affect men and women alike. But my gosh, when a woman cannot button her pants, hell hath no fury like a woman who Cannot button her pants. So they go, and you know, gosh, you know, I've got this bloating. I can't take care of it. What is happening? And so this just an immediate jump to, ah, bloating. Connect sibo, this must be. And then it seems like just that pathway, people are going down. And I, I'm, I'm being very respectful of all providers out there and all modalities. I think we all can get into, all of us get into our little bit of rut of like, I see this, it mostly means this. So just be careful from a sibo perspective, because if sibo. Sibo is a downstream collection of symptoms, it's not a primary condition. This is not an infection. So if we can all hold hands on that first and then say, okay, this person is complaining of these symptoms. You know, they've got bloating, food maybe sits like a rock. They're getting constipated, they're getting, you know, a more chronic loose stool. Maybe it's mixed, things have changed. And they have chronic onset of symptoms digestively. So you want to assess all of it. Sibo might be part of that, but we still have to look at everything. Run a good digestive stool test, look at leaky gut, figure out six months prior to all of this new change in symptoms, what was happening. Have your. Have your patient go through and write up a really detailed health history timeline of the six months prior to this. That, I mean, it kind of helps, right? What was happening? Food poisoning events, did you get sick? Major stressors in the family. Like, you know, where's the onset? What gives us a clue of what this could be? Because even if you get that test done and it comes back that sibo is positive, my first question is, well, what's dysregulating the vagus nerve? What's the loading piece? What's loading the system here? That's really where we need to go with this versus aha, block bloating. Let's do a sibo test immediately. Okay, it's positive and we go treat, treat, treat. Because we haven't set the terrain to correct for all of this to begin with. So say you do take an antibiotic and you haven't corrected stomach acid and bio flow and motility. You. You might temporarily knock things down and feel a little better. You might. Maybe you get three months out of it, okay? But slowly but surely, things start to shift back and then sibo is recurrent because we really haven't reset what allowed this to step up in the first place. And then what's loading the vagus nerve? What's loading the system is this mold, toxins, parasites. We just have a lot of dysbiosis, maybe pathogenic dysbiosis going on here. We have to figure that out as practitioners and look upstream versus sibo, which is downstream. Sibo is important to look at. I'm not saying it's not a real diagnosis. The way it's being treated, I feel strongly, is setting up the recurrence.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (18:25)

Well, now, I. I am not a sibo expert. I don't Play 1 on TV. This is why you are here. So I'm just going to spew out the information that I learned in my functional medicine training, and I want you to unpack it because you've already alluded to it. I remember learning that the only way to test SIBO is with a breath test.

Angela Pfeiffer (18:46)

Because.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (18:46)

Because we're testing what, like some methane or something that comes off the breath? But then I'll hear patients say, well, my doctor tested me for seba. I go, how'd they do that? Oh, well, you know, it was a stool test or was a blood test. And I'm like, oh, maybe there's something I'm missing here because I'm not in the gut space.

Angela Pfeiffer (19:02)

That's fine.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (19:03)

Other thing. And I'll let you unpack both of these. The other thing I always heard was, well, really, the only way to treats, even in the functional space, well, really, the only way to treat SIBO is through rounds of antibiotics. And you know what? It's probably going to come back. That's it. That's what we've learned. So can you unpack those two statements, Angela?

Angela Pfeiffer (19:23)

Yeah. Well, let's just start with the antibiotic piece real quick. So 15 years ago, I, you know, I've been in practice 20 years. First five years, I worked with a lot of IBS and emotional eating, very good at stabilizing IBS. Eventually, Sibo reared its head. That was just a population I was working with. And so I had to change gears to figure out why. What I know to do is not working as much. And what do we need to do now? At the start, we were all putting people on antibiotics. We were all putting people on a kill em diet, starve them out diet. That is what we knew. But a couple years in, when I started to see recurrence, recurrence, recurrence, I immediately was like, okay, well, this isn't working. We need to change gears here because I'm not going to keep doing this. Year after Year after year after year and come up with the same conclusion. It just doesn't, that doesn't make sense. So initially they were looking at rifaximin or xifaxim to treat hydrogen alone. If there was a methane issue. Or now they're calling it intestinal methane overgrowth, they're using that. But eat up with neomycin or a metronidazole. So flash forward. Oh, gosh, I think it was six, seven years ago. We have a new treatment algorithm that has come out. And basically the SIBO treatment algorithm is you have sibo, take one of these antibiotics, if you still have sibo, go.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (20:49)

Back to the top and start taking more antibiotics.

Angela Pfeiffer (20:53)

Cycle it, just cycle it. Right. Maybe you need two rounds, maybe you need three rounds. Maybe you need to be on antibiotics for a period of time. And what, how is that making sense? So now the treatment algorithm includes ciprofaxin and Bactrim. So is the reason that we still have sibo, that that's recurrent and very hard to treat because we didn't have strong enough antibiotics? Because if those came out and did work, would we still be here talking about it like nothing's changed in the field? True. Feel this. Still you're going to take these antibiotics, it's probably going to come back. This will be temporary. Right. Why are we giving them? Shouldn't we look at this a little different? This feels honestly like, and I love GI doctors, we need all modalities here, but it kind of feels like you have some symptoms. Here's a ppi. Maybe you need to be on it lifelong. That calms your symptoms down. But don't worry about the side effects that can come by taking that PPI long term. I don't mind a PPI for a couple weeks. That's not going to immediately set SIBO up. It's not. This is a long term alteration. Just like the, you know, onset of autoimmune averages, you know, 10, 11 years. This not saying it takes that long for Sibo, but Sibo did not, you know, day one, day two, Sibo. Right. So, yeah, that just gets interesting. That's why I feel like why are we hitting this with so such strong antibiotics? And then in real fine print, you'll like see, know, find root cause at the top of the, at the edge of the algorithm. So I, I, I have an aversion to that because I, I want to protect antibiotics and not increase resistance.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (22:38)

Right.

Angela Pfeiffer (22:39)

I feel like in this field antibiotics are readily handed out, whether you're mainstream or functional or integrative which really concerns me. Um, I, you know, I go to a lot of conferences. I love em and, you know, speakers will always have conversations. And they're up there showing a study they had. They had Lyme and co infections. They had heavy metal and Babesia. They had, you know, all these different things. Oh, they all happen to have sibo. And I started them all out with an antibiotic first. And then like, could you just kind of flip that upside down and say, okay, we've got Lyme and co infections, treat that, stabilize the gut. There's things that we can do to help people stabilize and feel better without doing antibiotics and then see if SIBO even needs to be treated at the end. Because I see a lot of parasites with sibo from a functional perspective. I see a lot of mold with sibo from a functional perspective. When I clear people of mold, I don't have to treat sibo. They feel better, they're stable, everything settles down because we've worked on vagus nerve and supporting digestion the whole way through, and they feel better. So I don't have to do an antibiotic at that point. Right. So to go back to any. Anything else to kind of follow back up on that and then I'll jump into the testing.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (23:59)

Well, I, I just want to mention because you. You said it so beautifully and it. And it hit me even so I know it hit the audience when you're giving the example of.

Angela Pfeiffer (24:12)

Of.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (24:12)

Okay, let's just say somebody has, oh, I don't know, let's say you have a UTI and you get some backdrop. That's a great one for UTIs. But you know what, Sally? You're probably going to get this UTI over and over again.

Angela Pfeiffer (24:30)

So, you know, just.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (24:31)

Just plan on being on this, you know, for the rest of your life. And it's like, wait, wait, wait, wait. What is causing this uti? Can we get to that, please? When you said it that way, it makes sense. It's almost like when you're in the sibo world or the gi doc world even talking about Sibo, we just all kind of nod our head and go, yeah, yeah, you know, antibiotics. But we're not stepping back to think, wait a minute, antibiotics are supposed to be a one and done. You kill, you move on, you reinoculate the gut from what you just destroyed and. And you call it a day. It shouldn't be something that's a temporary blanket for that's. And we're going to say, oh, this is just going to keep coming back you know, it just doesn't make sense. I mean, you're, you're kind of opening my mind in saying that because it just doesn't make sense. And I think also I want to expand on and mention. This is a great time to mention. We're going to mention at the end too. But down in the show notes, Angela has put together this entire summit on cbo. Tons of experts, including myself. You are going to want to register and learn from this summit, I promise you. This is not your normal summit. You are going to get high level information in the. I am so impressed with how this woman put together this summit. I've been on a lot of summits and I know this information is going to be key for my audience, key for my patients. One of the things that you and I talked about when you interviewed me, Angela, was exactly that. We, we need to wait. We need to treat the thyroid. Because if you treat the thyroid, if you treat mold, if you treat these things up here at the top, sometimes you don't even need to treat SIBO. You don't need 10,000 rounds of antibiotics for the rest of your life. That's to going to destroy your gut and make you antibiotic resistant. So I love that you're mentioning that, like with the mold, with the other things that you've seen and then for me, even with the thyroid, like treat this up top, then you might not even have to worry about the SIBO down here. So I just wanted to throw that out. The link is in the show notes. We'll mention it again at the end. But y' all want to sign up for and listen to this summit? Okay, go ahead with question number two.

Angela Pfeiffer (26:55)

Yeah, absolutely. And thank you for that. Yeah. The summit has been just a Labor of Love. 53 one to one and a half hour interviews, kind of more long form interviews. So it's not a, you know, what got you into medicine? So it's. Yeah, it'll be great. So. So then we go back to how to test for sibo. The only way to test is through breath testing that is done on a Quintron machine.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (27:20)

Okay.

Angela Pfeiffer (27:20)

As the only validation hard stop of any breath testing for sibo. So there are stool testing, digestive stool tests that will mention sibo. And what they're doing with that is basically saying observationally, there's certain bacteria that might be a little higher here that could be associated with sibo. It is not an any way shape or form a diagnosis can infer. It can't do anything with it all. It's meant to do is say, as a provider looking at that, should I, should I look at this? I've seen plenty of digestive stool panels that say, hey, this links with intestinal, sorry, inflammatory bowel disease. They don't have an ibd. So why are we just jumping all of a sudden to, oh, you've got, you've got sibo. But I'm not going to pay attention to that other, you know, observation and saying you have, you know, an inflammatory bowel disease. So it just, it gets kind of interesting. I think people want. It's a, unfortunately, it's kind of a soup du jour topic right now in the medicine, you know, medical world. And I think it's maybe not being addressed as it should be. So, so basically, you have to drink, you have to only eat certain foods for the first part of the day. The second part of the day is a fast. You get up in the morning, you wait an hour, you don't eat anything, you don't exercise, you take a standard baseline breath. And that first number is supposed to tell the lab that you prepped correctly the day before you prepped correctly, and then you drink the substrate and then either 15 minute or 25 minute intervals, you track those across the day. And then we're looking up to the 90 minute mark for hydrogen production, and it really should be after the second marker. Do you see a rise in hydrogen of 20 parts per million or more up to and including the 90 minute mark? And then for intestinal methane overgrowth, that could be anywhere throughout the entire test. And depending on what camp you're in, you know, it's 10 to 12 parts per million. If you're following North American consensus or European data standards, or if you're in Pimentel's group, it's three parts per million. And I respect him greatly. But I feel like we would be treating a lot of people if it's three parts for a million. So I go to 10 to 12 and, you know, just look at it and say, okay, I've got a methane issue here. What do I need? What do I know? To kind of counterbalance that a bit. How do I stabilize them? Let's get their bowels moving. Let's get their digestion supported. Now, why is this here? Because methane production isn't always an issue. We have studies out of Africa showing very high methane production and they don't have constipation.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (30:11)

Okay.

Angela Pfeiffer (30:12)

So it can be compensatory, you know, methanogens or the archaea that produce methanogens. They will take up 4 hydrogen to make a methane. So it could be just like everything competes down here. If you have methanogens, which most people do, you know, methanogen producers, methane producers, if you have those in your intestinal tract, perhaps they're coming up and taking up a niche because there's a lot more hydrogen around and now they can make methane. So it just might be compensatory. It also slowed down, you know, if we look back of what might have helped us as hunter gatherers and not so much today, back at. In hunter gatherer times, it would have slowed down motility a little bit. So we have more of an opportunity to get nutrition from the food that's moving through us. So. But nowadays, you know, maybe it's not helping as much in the right individual. So there's. I think there's a lot to look at here. And there is one talk with Dr. Neural. Excuse me, Dr. Neurologicobi, that is out of Australia. She's known as a SIBO doctor. She is fantastic. And we have a whole conversation around methane as a compensatory.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (31:19)

Interesting. So we can have, essentially what you're saying is we can have these gases or even the. We'll say the promoters of these gases, the makers of the gases in our guts, and maybe that's not an issue. So just because someone blows high on methane on a SIBO breath test, that doesn't necessarily mean they have SIBO. Or is the breath test diagnostic to 100%? It's just the stool test that you're talking about that may or may not point towards sibo.

Angela Pfeiffer (31:53)

Yeah. There is no blood test, nor stool test that can diagnose. Diagnose SIBO in any way, shape or form. So.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (32:00)

But the breath was 100% diagnosed. Yes.

Angela Pfeiffer (32:02)

You were died. Yeah.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (32:03)

Okay.

Angela Pfeiffer (32:03)

Breath test is the most accurate test that we have for identifying sibo. And we still need the clinical assessment, we still need that. We need to be able to look at it, match it up with the patient. What else in their history or current presentation could account for why these symptoms are happening? Does this match? Right. Because I can get someone really, really like a gentleman I was just speaking to earlier today. Very stable for three to four months all of a sudden, unfortunately. And so, sadly, major stress in the family. I get the email, oh, my gosh, I'm in a SIBO flare. I go, tell me what's going on. We walked back through it and like, well, your nervous system just took the biggest hit of its life.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (32:51)

Yeah.

Angela Pfeiffer (32:52)

We don't need to treat Sibo. We need to calm your nervous system down, which will then settle things down again. Because he has a massive mold issue that we're addressing, among some other things, and that's our target. We're just finished up with the remediation process on his house and the cleaning of his house, and now this hit him and it's just like, oh, it's just so sad. Right. But it's not. I would be ignoring all of that and going, oh, my gosh, Sibo. It's flared. Yes, that sounds exactly like what's happening. Here's an antibiotic.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (33:23)

Yeah.

Angela Pfeiffer (33:23)

And he even had gone and started herbals again. And I said, whoa, hang on a second. Even if this is Sibo in a box, this is absolutely Sibo. It is flaring up. This is our target. Where's the momentum? Their system is so dysregulated by his nervous system right now that no matter what we do, we're not going to get the momentum and healing things. The nervous system is the target, and I think the nervous system and the vagus nerve are the target in most people. Like, really most people. And for him, again, it was the mole piece. But he came to me and said, I have Sibo. I need you to tell me how to fix Sibo. And I did the full onboard and found all this other stuff, which he already knew most of. But I'm like, yeah, but all of this, all of this is what we need to go after and I can stabilize you. Which we got to a point where he was feeling pretty good, that the mold was causing him to not sleep. Total vagus nerve shut down. At that point, how are you going to heal your gut? Is it really Sibo or is it all the other stuff going on for this poor guy? Right. And we need to fix that.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (34:35)

Right?

Angela Pfeiffer (34:36)

Yeah. Breath testing, get back into. So we have some studies that show us that 30% of healthy individuals have a positive Sibo test. So our field says, yeah, but if they have a positive test and they have chronic symptoms, then we need to just assume that that's, you know, that then that's positive. And obviously that doesn't make any sense to me. There's still going to be some nuances there. There's case studies presented where, ah, this person had Sibo and this is their symptoms, and we went through treatment. Here's a negative Sibo test. The symptoms are still there. Well, symptoms were from something else. Now we need to go figure that out. I feel strongly that that's the downstream approach. We need to look upstream and fix it because SIBO most often can go away on its own. Now, if this is diabetic neuropathy, you have an adhesion, that's a physical tug on that small intestine. You have creating a pocket and a slowdown. You have resectioning. Maybe your ileocecal valve is gone. You know, there's reasons why you could have this chronic, chronic presentation, but you still should be in maintenance and support and tuning down. I give, I give people with short bowel syndrome prebiotic fibers all the time to slow down their motility, stabilize their nutrient absorption. There might be some alterations we need to do food wise, just because that can, you know, you're going to have fast moving stool going through there and they're stable. Why are we going through rounds of antibiotics with them? It's just going to be this, you know, this push, pull. I just don't think that that's fair. So let's touch on, if we may, just real quick, lactulose versus glucose. Just because there's a little bit of controversy around that. So this is kind of an east coast, west coast thing. It's a gang thing. On the east coast they want to do glucose and on the west coast they want to do lactulose. And I'm sure there's people in between. So basically we kind of said there's no other test you can do except the breath test. Inpatient, sedated. In studies, they can go down and pull up an aspirate of the, of the small intestine and culture it. Okay. And they're going to look for how much, how much bacteria is there? Is there too many? Too many bacteria. And they can. That is really the gold standard for sibo. But we can't do that with everybody. It's so invasive. So then we have our breath testing. So they can only get so far down into the upper small intestine. Right. Just because they're trying to scope up there you've got 20ft of small intestine, Right. When you drink the glucose substrate that absorbs in the upper one third. So when we're looking at SIBO results and studies, that glucose substrate would most closely correlate with the aspirate. So that's why it's considered the gold standard. Then you've got a lot of people on the west coast side is, you know, basically saying, yeah, but I want to see all the 20ft of small intestine and lactulose. If you take lactulose, it's non absorbing. It goes all the way through. And we can see the response of the bacteria as they're consuming that and producing the gases that they're going to produce. Those gases, some will exchange over into the blood and come out the lungs. And that's how we're measuring on a breath test. But the aspirate's not going to match up as well with lactulose because lactulose might identify SIBO further down in the small intestine. Right. So. But that. That's the differences between the two. They both have their place. They both have their place. One's not better, one's not worse. It just depends on you, how you practice and what you want to do.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (38:19)

Okay. Okay. No, thank you for Clari clarifying that, because I hadn't heard that either. I. If you're in the sibo community, you're probably nodding your head, knowing exactly what Angela's talking about. But, no, I've never even heard of that difference. Differentiation. So now, we already mentioned this, but let's come back to it. The recurrence of sibo, and this is when you just get more and more and more and more antibiotics. But why? Like, what's driving the relapses?

Angela Pfeiffer (38:49)

Well, again, it's the upstream. What? It's. It's. It's mostly that, you know, what factors led to this. So again, the vagus nerve, 80% of its function is to listen to messages coming up, afferent messages coming up from our digestive tract and thoracic, you know, organs, and to send those messages up to the brain. And if the. If those messages coming up are, holy heck, we're inflamed. What's this stuff? Is this toxic? Is this pathogenic? Why are we getting slowed down? Something's wrong. My God, help us alone from the stress that somebody might be under, for whatever various reasons, it's going to send the signals to inhibit the vagus nerve. The vagus nerve cannot then kick us back down into parasympathetic, which innervates all of digestion. So if all of this is stalled and I have an overgrowth of bacteria in the wrong place, I'm going to stick something to kill them and expect that they're going to stay. That I have preferentially only killed what I wanted to. First of all, which is a whole topic I'd love to get into. And then second of all, I'm just assuming it's all going to just move on, right? That's going to miraculously fix why my vagus nerve is dysregulated and reset the terrain. I, all of a sudden have good stomach acid levels because I took an antibiotic. I mean, that doesn't make any sense.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (40:19)

No.

Angela Pfeiffer (40:19)

So they haven't fixed the issue. They haven't fixed the underlying issue. And I. We can't have a treatment algorithm when this is a symptom cluster, because. A symptom cluster. If this were a primary condition, it would be so much easier to treat. It would be a fairly linear way of treating it. It's not. And yet that's what's being used. So, again, it just means that it's a. It's a collection of, you know, we kind of know the different factors that can set it up, but it's a crapshoot among those factors, what each individual is going to have. And that individual needs a. An individual individualized.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (40:57)

Yep, yep. Okay, so that makes sense, basically, based on the patient that you were talking about. Yeah, he's got stress going on. He's got a mold issue that he's still working on. So that would be the drivers of that recurrence of sibo. And it might not be that grandiose for people where it's like, bam, just right there, obvious in their face. But this is. Again, this is what you talk about on the summit. This is what we're diving into a little bit more here. It might be something that you're not even thinking. Like, you might even not think that your thyroid issue is driving recurrence of sibo, that the home that you live in and maybe you don't even know if there's mold in it, is driving the recurrence of sibo. So it's not that you're antibiotic deficient and you need more antibiotics. It's that you need to work on just the full picture all at once.

Angela Pfeiffer (41:48)

Yeah, yeah, absolutely. And I think to go deeper, too. So we have. You know, anyone in the SIBO realm should be very familiar. If not, please go get familiar with the reimagine studies coming out of cedar cyanide. They invented a sterile catheter, so when they go down and do the respiratory, it's not getting contaminated with anything as it's coming up and coming out of the oral cavity, too. Okay. So they're able to do really pristine studies on what is in the small intestine, and they're mapping out the small intestine for the first time in the last six years. Before that, we have digestive stool test. And forever, it is inferred that that Digestive stool test is representative of everything from nose to anus. It's the entire thing, guys. It's not. It's only large intestine. It's only large intestine. So we've got 20ft of small intestine. It's where it is so metabolically active you assimilate vitamins, minerals, macronutrients. So much is happening in that area. And then we've got your five feet of large intestine. They're on different planets. That is how we, we learned this at last year, 20 years ago. But for some reason it's interesting looking at studies where it's just like, yeah, no, it's everything. So they, lots of studies being done with reimagine. They're basically looking and comparing sibo patients versus non sibo patients. What they found was the proteobacteria is coming down and colonizing the upper small intestine. It's pushing down the firmicutes, which is fairly dominant in that area. Now in a stool test, we look at bacteroides and firmicutes as the two dominant phyla. Bacteroideides is a, is a pin drop in the small intestine. So we're looking at balance of that just again, we can't infer it all the way up the small intestine. So basically proteobacteria are coming in, they're pushing down firmicutes and then we've got lower diversity in the upper small intestine. It's competitive, lower diversity. You take an antibiotic, we've got, we've got firicides, among other bacteria, single cell bacteria, much more susceptible to the antibiotics, especially the broad spectrum. The second you're getting into Cipro, bactrum, metronidazole, neomycin, you are dropping the beneficial stuff greatly. But you have to, in their world, you have to because the gram negative bacteria, the proteobacteria have a double cell wall, harder to get to. Okay, so you're knocking down the beneficial stuff more. You're knocking down what is considered the more pathogenic. But then we all know what happens. The resistance stuff stays and the resistance stuff comes back up and takes the niche. Because it is pathogenic, it is better at coming back up and taking the niche. So in my view also, these recurrent antibiotics are dropping diversity more and just building more and more resistance in an area that we should be rebalancing and bringing back up into where it needs to be versus going after this with a kill, kill, kill. We need to look at recovery and rebalancing with the intestinal tract. We should not be looking at kill phases unless something's going to kill you. If that is a true infection, save your life. Antibiotics all the way. My God, thank God we have them. Thank God we have them. But this idea of, I'm dealing with chronic bloating, and I understand, it's so debilitating. This is not an easy thing to say at all. I know, but if the treatment isn't going to stick, why are we doing it? And what I hear from providers a lot is, well, this is just what we assume. A third of people are going to take an antibiotic and walk away. A third of people are going to need multiple antibiotics and probably get into, like, a recurrence. And a third aren't going to be helped by antibiotics. They have a stronger root cause. And I'm like, okay, so antibiotics out of the gate are having a negative effect on two thirds of that population. Why are we doing that? Right. And I kind of feel, too, if you have a patient that presents in one round of antibiotics and they go on their merry way and everything is fixed, I really question whether they had sibo. I just do. Where's the momentum? Where's the terrain? Reset. Did that antibiotic knock down something else? Did it happen to hit a parasite they had? Was it placebo? Did some people just get better? Cause I'm taking this, I'm better. Maybe that calms their brain down, thinking that I've got the treatment, I'm moving on. I don't know. But that just is such a. Knowing the mechanisms, how is that helping them recover?

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (46:45)

Yes, 100%. Okay. That all makes sense, the way that you're describing that.

Angela Pfeiffer (46:49)

It.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (46:50)

It just. It helps me, and it helps the audience just better understand this whole process. You're. You're doing this beautifully. Okay, now talk to me about sibo's effect on hormones, like thyroid health, obviously, but what about estrogen balance, cortisol? How does it affect that?

Angela Pfeiffer (47:10)

Yeah, you know, I don't really see. I feel, again, SIBO downstream. I think a lot of things can be correlated with it. If you have things that are setting up your body's ability to set up sibo, you have issues. There's stuff happening. You're probably going to have some hormone imbalance. You're probably going to have some inflammation. I see leaky gut in a lot of patients, but we don't have any studies at all saying SIBO causes leaky gut. I think it's just a downstream issue. You happen to have leaky gut. There's other stuff happening. And, hey, sibo's here too. Just like we wouldn't say, hey, you've got a candida issue. It's causing leaky gut. We'd say, no, you have a lot of immune imbalances that allowed this yeast issue to take hold in the first place. We need to treat that and, you know, treat the underlying cause. That's, you know, allowing us to get set up. So, you know, depending on where a woman is along her cycling and perimenopause and menopause, when we see a lot more, you know, say, estrogen dominance or progesterone dropping, we definitely can have issues leading to leaky gut, leading to more inflammation in the intestinal tract. I see it more connected that way. But it's not like sibo is directly causing a change in hormones. Now, from a cortisol perspective and a stress hormone perspective, cortisol is very regulatory. We need it for so many things. But when that kicks over into as a stress hormone, having sibo is stressful, the traits that allowed this to take, you know, maybe take hold in the first place, they were a little bit more anxious. They might lean more on that stress side. They might be more of kind of a type A, gotta do everything right person, which sometimes builds up just enough stress to kind of keep you in that state, even though you might not feel outwardly stress. You know, I have so many people say I'm not stressed. Okay, Right. So let's talk about it. Yeah, let's talk about it. Yeah, yeah. So. So I look at more. Look at it more that way. It's. It's a downstream symptoms. But again, just for us providers looking at it all, do they have hormone dysregulation? Do they have massive toxin load? Is there a mold exposure? We look at all of those pieces more. So, and I think getting. Getting women on hormones is a really good idea in perimenopause to stabilize. Yeah. One thing I think can connect again, if leaky gut and we're not detoxing. Well, you're not going to detox your estrogens. Well, you might be getting reabsorption with those, but it's. It's just. It's the imbalance cycle that's happening.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (49:48)

Yeah, no, that makes sense. That makes sense. So now, I mean, you work one on one with. With individuals. So in addition to cracking the SIBO code summit that we've been talking about, we'll talk about it more. You also work individually with people so what do you see in your client population as the biggest mistakes people make? Now, you had mentioned earlier about cutting out food. Cutting out food. Cutting out food. Is that one of the mistakes people over. Over eliminate their food down to nothing. And, and then on that topic too, I'm wondering, what foods are SIBO people taught to eliminate? But yeah, what are the biggest mistakes people are making?

Angela Pfeiffer (50:27)

Yeah, yeah, absolutely. So I think multiple, I'd say from a food perspective, basically the low fodmap diet was created to help people calm symptoms with ibs.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (50:42)

Okay.

Angela Pfeiffer (50:42)

You'll see a lot of stats out there saying, you know, of the IBS population, which is large, anywhere from, say, 30 to 73%, I think it is of those IBS patients, depending on the study, actually have SIBO. The study that showed that the 70%, you know, IBS patients have SIBO actually used too much lactulose in their test. So when we look at these studies, we really have to look at if you're going to use too much substrate, you're getting. Going to get more fermentation. That test, you're going to get too many false positives. I throw that one out. I'd say it's probably in the 30% realm. So as we're looking at the low fodmap diet, basically it's a collection of foods, a long laundry list of foods that coulda, woulda, shoulda, mighta caused symptoms in somebody with ibs. We adapted that over very early on to say, if you go on this long list of foods, lo and behold, you're gonna starve out these organisms. You can't, you won't. They will outlive you. I promise. They will figure it out. They will consume other things. They have a survival piece. If you will starve yourself out a hundredfold before you're going to starve them out.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (52:02)

I think that's important though, because people are into extremes, girl. I mean, you know that. I think that's important for people to hear.

Angela Pfeiffer (52:09)

And I think they're really equating. If I eat something and I have a reaction that's making SIBO grow.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (52:17)

Yeah.

Angela Pfeiffer (52:17)

And they got this visual of I have SIBO on a petri dish. I put some food on and it just bubbles over and keeps going.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (52:23)

Right, right.

Angela Pfeiffer (52:24)

It's not. Wherever your overgrowth is, in the small intestine, you have sent something down they really like and they're consuming it and producing some gases. And as soon as that food moves through and all the symptoms settle down, it's. You're still where you are. This food did not cause sibo. So pulling food, to me makes no sense, especially in light of the reimagine studies showing that we've got lower diversity in people dealing with sibo. Right, right. So you're going to pull these prebiotic fibers that would be more supportive at creating a more acidic environment in the small intestine and large intestine. You know, throw. Throw the large intestine out with the bathwater because we're just focusing small intestine here. And I think forever large intestine got all the focus and the small intestine didn't, you know, prior to sibo rearing up. So it's gone both ways. But basically you're. You're not looking, you know, you're. You're dropping fibers, you're not acidifying. You're not creating an environment that is more ripe for your beneficial flora to out compete the pathogens. You're creating more of an environment that would allow to me, the pathogens to form, thrive. Okay. So that's a huge concern for me. We also know from studies, people that have sibo that would be more, you know, a responder to the low fodmap diet have low diversity. So I'm trying to do everything I can to build diversity. There are absolutely positively prebiotic fibers that SIBO people can take. Absolutely. Partially hydrolyzed guar gum, phgg, xos, gos we can do, which are oligosaccharides. We can do acacia fiber, like Heather's tummy fiber. That's a really good one. We can do psyllium. Psyllium's a little hard because it doesn't blend well, but there are prebiotic fibers that we can take. And I mean, they can dip a toothpick in, tap it on their tongue, drink some water. We can go very slow with that. I usually don't have to because. Try a tiny pinch. Add this up over time. We can titrate people onto it pretty easily. We have to rebalance. We have to acidify the gut. We have to acidify the gut 100%, full stop. Can't not. So you're dropping fibers in a gut that's already imbalanced. You're going to make it more alkaline. You're not sending down what they need to fuel off, which we need. The diversity and balance of our gut microbiome gives us our health, it gives us our endurance, it gives us our resilience. And the more you knock this down, the worse it's going to Be.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (55:06)

Yep. Yep. Well, I'm also thinking, so teach me on this one.

Angela Pfeiffer (55:13)

I.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (55:13)

Is there a correlation? So when I'm thinking about the small intestine, I'm thinking about celiac, because we essentially lose the. The villi in our small intestine when we have celiac. Is that that shrinking of those nice little fingers that have a job to do and they shrink down to nothing, and then people have celiac disease? Is there any correlation between SIBO and celiac? Like, what I'm thinking of is if we crush our immune system, we know autoimmune begets autoimmune. So Hashimoto people often have celiac. If there's a connection between celiac and sibo, then Hashimoto people will naturally, kind of, going back to one of the questions I asked you in the beginning, be a little bit more prone to sibo since they're more prone to celiac, or is there no. No correlation whatsoever?

Angela Pfeiffer (56:04)

There's definitely a correlation. And I would say that the correlation to me is if you have celiac, you need to treat celiac, and SIBA will almost always go away.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (56:15)

Ah.

Angela Pfeiffer (56:16)

I have people who have celiac who are not fully stabilized and in remission with. With celiac. I keep having symptoms. I don't know where these symptoms are coming from. I ran a breath test, which can be more of a false positive if you have something like celiac. I ran a breath test. Look at this as positive. They want, you know, antibiotic, antibiotic, treat, treat, treat, kill, kill, kill. And I still have it. I can't get rid of it. And I'm looking at what they're doing to really stabilize celiac, and they are not where they need to be. That's the target. That's the target. Why are we. And even. I mean, do we want to cause more dysregulation of bacteria in the intestinal tract? When somebody has an autoimmune condition.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (57:03)

Right, exactly.

Angela Pfeiffer (57:06)

Especially something like celiac, where they're going to be more hindered from an absorption perspective. They always have to be on top because, you know, for everyone listening their autoimmune, their immune system's attacking their gut, they're attacking the lining, and really breaking those little microbilli down that move like little sponges on the bottom of an ocean to, you know, touch everything and absorb things. That's where we make our DOW enzyme to help us convert histamine to histidine. It's, you know, where we make lactase to help us break down our lactose. You know, among Other things, we need all of those intact to help us break our foods down. And yeah, we, it's. I would treat the bigger issue. Okay. Stabilize in other ways. I wouldn't go at this with an antibiotic, but I would treat the bigger issue.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (57:57)

Okay, beautiful. Now, last question before we talk about the summit. You had also mentioned some herbals like your one guy, your one patient was doing, possibly going to throw on some herbals.

Dr. Amy Myers (58:07)

What?

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (58:07)

It just kind of made me think in my mind, like, oh, yeah, berberine is antibacterial, antifungal, antiviral, anti parasitic. I mean, are you using things like berberine or what other herbals do people go to and are those safer than antibiotics or can they have that same impact of dysregulating the gut flora if they're used over and over again? Ongoing.

Angela Pfeiffer (58:31)

Yeah. We have studies that show just berberine by itself for a fairly short course can cause extinction in six to seven species.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (58:42)

Wow.

Angela Pfeiffer (58:42)

So I think that it, we just. It's not that I've never used herbals or quote antibiotic, you know, supplements by any means. Not that I haven't. We just have to be very careful with them because I, I think people attach to those as these are natural, these will be easier on my system. And yes, they can be from taking Cipro, adp, oregano, biotics. Love it. Cipro. Way stronger. Thousandfold. Right. But however people will, if it's used controlled and concisely and downstream from correcting everything upstream and you've got to root cause and you clear that and they might still have symptoms and you feel as provider, that's your next step.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (59:30)

Great.

Angela Pfeiffer (59:31)

But it's in a short period. It's not month after month after month after month that a lot of people are doing. A lot of people are feeling like, well, I just take my oregano to keep it at bay. I hear that constantly. Constantly. And so, and I think that goes back to, to one of your, you know, your, your prior question asking you about mistakes that people are making. People are treating themselves. They're looking for different protocols out there. Oh, that person tried that protocol that, you know, I'll, I'll load this one up. Load this one up. And again, it's, it's causing, you might get some temporary relief here and there, but I feel like long term it's going to cause that drop in endurance and we need to rebalance and recover and not keep thinking that we have to kill. Yeah, that's a big one. And then I would just say we've got to for even the providers listening, we have to flip the treatment algorithm on its head. We just have to. It's absolute last resort. Absolute last resort. Looking at even, even rifaximin, even Xifaxim. We. What was that study? There was a. There was one study. I can see if I can find the link for you. But it basically was looking at how much a shorter course increase systemic yeast in to where they had to stop the study. And I'll get that. But it was a really. It was good. So, again, what's interesting to me, Dr. Pimentel, I respect him greatly. He has added so much to this field. We've, you know, he's out of cedar cyanide, Dr. Mark Pimentel, he's a gastroenterologist that has done so much work around sibo. And then we've got the reimagined studies out of cedar cyanide that are associated with. Dr. Pimentel is on the board with Salix who makes rifaximin and Xifaxim. He's the one of the authors of the SIBO treatment algorithm, which I think is interesting. And then we kind of step back and go, well, we haven't seen a study published yet using rifaximin. With the reimagine study, I'd like to know what rifaximin is doing in the small intestine. Because the talking points on this are, hey, it doesn't get absorbed. It only stays in the small intestine. So it's safe.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (61:50)

Okay. Yep.

Angela Pfeiffer (61:52)

It's an antibiotic. Okay. It's not absorbed, but it's having the effect on the small intestine. And its effect is it's more active where bile is. Bile flow is coming down the small intestine, so that's why it's more effective there. But I still would like to know, what is this doing? What is it knocking down? How fast do things recover? We need those studies. And so I just find it. I, I haven't seen it. I really like that done. I don't know why that hasn't been done, but I think we, we might need a little bit more information on there. And I, I feel like, yes, rifaxima might be a little better than Cipro. Knowing all the side effects with Cipro, but I still. It's not water.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (62:31)

Yeah, yeah, exactly. No, it's not. It will have an effect on your body. Anything we put in our bodies is going to have some kind of effect, be it a supplement or a very, very strong antibiotic. I, I love that. Comment. It's not water. It's not. It's not. So you put your heart and soul into cracking the SIBO code summit. So what, what, what inspired you? What can listeners expect if they do tune into this? Which I'm going to encourage that they do, because like I said, this is not like all the other summits out there. Like Angela said, she actually goes deep. This isn't a. Oh, we'll give you a little taste of what you can do. And then, you know, you'll have to go find that person and follow them and listen to five more hours of them talking to even unpack what they mentioned on the summit. These are hour plus long interviews where you're actually going to get the information that you need along with a boatload of beautiful resources.

Angela Pfeiffer (63:32)

Again, you.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (63:33)

You're not going to download like a recipe book. You're going to download resources that all the speakers designed just, just for this event so that you can walk away with tangible, doable protocols that you can start implementing right now. My God, even just from this interview, you've up leveled your knowledge on sibo. And you know, if you're listening, the mistakes that you're doing right now with what you think is your sibo. So sorry, Angela, that was really long. But tell me more about, tell me a little bit more about the summit.

Angela Pfeiffer (64:07)

Take it away. I love it. So, I mean, for all the reasons that we've been talking on all the topics, that's why I created this. It's just, you know, anytime I go to conferences or talk to colleagues, they are always like, oh, my God, that's so refreshing. You're just looking at this so different. And finally I'm like, God, we just have to get. We have to all get together. We have not had a SIBO conference or summit in. Six years.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (64:33)

I was gonna say ever, but okay, six years.

Angela Pfeiffer (64:35)

Yeah, yeah, yeah, We've had some, definitely, but. But not since. And we really all, I think, need to get together again and have this conversation. I'm presenting topics in a brain to bowel sequence. Over the seven days, we bring in speakers who I think aren't usually included. Dr. Joseph Mesto, who started Microbiology DX. And we're, you know, looking at the sinuses. So much of conversation revolves around like, okay, now we're going to talk about the oral microbiome, but what about the sinuses? Because you have overgrowth here that's causing issues down too. I've got a lovely woman out of the UK speaking on bladder and interstitial cystitis. And issues with the microbiome and that linking with sibo. So we're really looking at how do we reset things top down and how do we get to root cause. And this is. I wanted to do more long form conversations because I didn't want to do the topical. Give me three questions and I'll ask you. I basically laid all the topics out and said, hey, I love you, will you speak on this? And I mean we went in deep, right? So I'm looking at mechanisms. What do you see? How do we connect all these pieces? What would make the give someone the most bang for their buck in terms of suggestions here? That's how this is all presented. And so you're going to get so much fantastic info. I really feel there's something for everybody because as you're coming on and there might be seven speakers on a day, you're probably not going to sit there and watch every single talk on that day. However, there might be three people that you follow or gosh, I haven't been able to sleep well, I'm telling you now, if you're not sleeping with good restorative sleep, you're going to have a very difficult time fixing your gut because that's going to disregard your dysregulate your vagus nerve. Right. So I feel that people coming on can kind of pick some of the topics that speak most to them. And then of course, which is great. Right now it's only $67 to own the entire thing. 53 plus one hour to one and a half hour talks with the entire, you know, 2400 in bonuses. We're releasing a brand new way to treat SIBO that's non pharmaceutical. It's amazing. It's amazing. 67 bucks. It's like a bucket talk. So consider, please, just purchasing it, supporting us all. And I just. So I really, really hope for patients and providers and consumers alike that it just starts the wheels turning on. Wait a second, maybe the next step isn't the antibiotic because I think for a lot of people dealing with this too, one of the mistakes that they make is I'm going to start up with a new provider because I'm not getting help from my old one. Yep, that new provider onboards them. They're presenting with their SIBO symptoms. They have all the stuff going on, but out of the gate, well, I know what to do for sibo. Here's an antibiotic and I want you to do these tests and come back. They take the antibiotic, they don't get Better, Right. You don't know it. They haven't just checked back in. They moved on to somebody else. And so they're trying. It's not doctor hopping, so to speak, but they kind of are provider hopping, trying to find that one kill phase that's going to make a difference because they don't feel well. That is not the best approach. It should be, this antibiotic's not working. Could we look at this in a different way? What's causing my sibo? Can we go after that instead? That's what we need to work with providers and patients alike, just one on one. So that's my biggest take home with this, is if we can work on resetting terrain, if we can teach you how to do that, if we can teach you maybe a different way of treating sibo, that's not going to be a kill phase. That has really great results with it. If we can help you, maybe walking through a health history timeline and the beauty of what that brings and the insights it brings, get to root cause. I have helped you. Right? So that's what I'm trying to do here.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (68:43)

That is beautiful. And that is what is needed, Angela. That's what's needed. So every single person within the sound of my voice, if this resonates with you, if you have Steve, if you have a loved one with sibo, if you think you have sibo, if you have gut issues, gut issues in general, if you're going, I don't know why it's placebo or not, but I got all kinds of bloating, and I was told I have ibs and maybe I do have celiac, too. You want to listen to this summit, because just like Angela said, she's working from top down. She's heading every single system. And I promise you, one of these 53 interviews, five of these 53 interviews, 10 of these 53 interviews are going to resonate with you and give you the answer that you need to move forward with your health. And I've never known a summit to be able to deliver that, but this one will. So you're going to check the show notes below. We have a registration link down there. Like Angela said, right now you can purchase the whole thing for $67. Now, Angela, I'm assuming that once this kicks off. So the start, the official start day, where people can start watching the Summit is when? February 4th.

Dr. Amy Myers (69:55)

Correct.

Angela Pfeiffer (69:55)

Goes live on February 4th. It's February 4th through 10th. If they purchase, they have instant access.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (70:01)

You can watch it right now. Okay. Y. Yep.

Angela Pfeiffer (70:04)

Yeah. And Then honest. Yeah.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (70:07)

The people bonuses.

Angela Pfeiffer (70:10)

Yeah, Correct. This is for people. The summit is for people who have chronic gut issues. If you have chronic symptoms, you are likely going to get help by the summit because it's called cracking the sibo code. The tagline is, what if it isn't sibo? So we are working to correct chronic gut issues top down. Because not everything, but a lot of things nowadays like, oh, it's sibo, it's sibo. That's still sibo. It's like once you have a sibo diagnosis, or even if you don't have the diagnosis and your doctor is like, you have sibo, maybe they don't want to run the breath test, which I think they really should, there's still going to put everything into that little bucket. Sibo is the cause of all of these symptoms now. All of them, no matter what comes up, even though we have all these other things going on. So we really have to look at, like, just for the health of a person. How do you reset your circadian rhythm? How do you figure out how to get your sleep back in order? How do you know if something's going on sinus wise or oral? How do we support digestion top down? How do we work on vagus nerve innervation? I mean, if people just did that, 60% of your symptoms will probably go away. Like, just those pieces are just so foundational. And we breeze past those and say, like, oh, all of that dysregulatory stuff's happening, but we'll just try to keep nailing away at the gut because eventually, hopefully, this is going to work.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (71:39)

Yep. Yeah, Yep. Perfect.

Angela Pfeiffer (71:42)

Perfect.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (71:42)

Well, thank you so much for doing this. Thank you for allowing me to be a part of it, because I think this is just. I. I had that same reaction when you came to me telling me what this summit was going to be about. I was like, yes, we're not talking about this enough. That's amazing. So, Angela, thank you for your time, your love, your effort, and putting this together. Summits are hard for our listeners out there. Listening summits are hard to do. They literally take your soul. So I'm not kidding. So Angela has given not just her heart, but her entire soul to all of you. So please support her. Because, I mean, it's not just about support, it's about helping you. So click the link below and register. Be a part of this summit. Tons of bonuses. Thank you, Angela. Thank you so much.

Angela Pfeiffer (72:28)

Share it with your friends. Share it with your providers. Absolutely.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (72:32)

Yeah.

Angela Pfeiffer (72:33)

Your providers too.

Host (possibly a co-host or interviewer associated with the Thyroid Fixer Podcast) (72:34)

We gotta educate them too. Share with your doc, share with your provider, your health coach, your nutritionist, your naturopath. We all need to learn. We all need to learn here. So once again, thank you. Thank you for your time, Angela, and.

Dr. Amy Myers (72:47)

Thank you all for listening. The information shared on the Thyroid Fixer Podcast is intended solely for informational and educational purposes. It is not a substitute for professional medical advice, diagnosis or treatment. Always consult with your physician or other qualified healthcare provider with any questions you may have regarding a medical condition treatment or before making changes to your healthcare regimen, including medications, supplements or other therapies. Use of the information provided in this podcast does not establish a doctor, patient or client provider relationship between you and the host or between you and any other healthcare professionals featured on the show. Any medical opinions or statements made by guests are their own and do not necessarily reflect those of the host or affiliated parties. Statement regarding dietary supplements or health related products mentioned in this podcast have not been evaluated by the fda. These products are not intended to diagnose, treat, cure, or prevent any disease. Some episodes of the Thyroid Fixer Podcast may include sponsorships or affiliate links. The host may receive compensation for discussing or promoting certain products or services. Any such sponsorships or affiliations will be clearly disclosed during the episode. All opinions expressed are those of the hosts or guests and do not necessarily reflect the views of any sponsors. The inclusion of a product or service does not imply endorsement by any healthcare professional featured on this podcast.