258: Sarah Kay Hoffman on Beating SIBO, IBS, & Histamine Intolerance

Katie Wells Avatar

Reading Time: 34 minutes

This post contains affiliate links.

Click here to read my affiliate policy.

Beating SIBO, IBS, and Histamine Intolerance with A Gutsy Girl Sarah Kay Hoffman
Wellness Mama » Episode » 258: Sarah Kay Hoffman on Beating SIBO, IBS, & Histamine Intolerance
The Wellness Mama Podcast
The Wellness Mama Podcast
258: Sarah Kay Hoffman on Beating SIBO, IBS, & Histamine Intolerance
Loading
/

Sarah Kay Hoffman is the founder of A Gutsy Girl, a website I’ve been following for a long time. She’s created an amazing online community geared towards women who are looking for a reasonable approach for healing things like IBS, IBD, SIBO, hormonal problems, acne, and more. Sarah got her start when trying to heal her own health problems years ago. Now she’s a gut health researcher and journalist who speaks out highly detailed information and then condenses it into digestible ways for women worldwide.

Sarah is also a mom to three absolutely adorable children, so I’m sure we’ll talk all things motherhood today as well!

Episode Highlights With Sarah Kay Hoffman

  • How Sarah’s colitis diagnosis changed her life dramatically 10 years ago
  • The ongoing health issues she tried to figure out for years that all stemmed from a gut infection
  • Symptoms of SIBO and why it’s so hard to get rid of when you have it
  • A natural protocol for healing SIBO once and for all
  • How the GAPS diet works to allow the digestive system to rest and heal
  • Why there are so many approaches to healing SIBO, and how to know which one is right for you
  • The key principles of a FODMAP diet
  • Sarah’s approach giving her kids a good foundation for digestive health
  • And more!

Resources We Mention

More From Wellness Mama

Did you enjoy this episode? What questions do you have about SIBO or other gut-related illnesses? Please drop a comment below or leave a review on iTunes to let us know. We value knowing what you think and this helps other moms find the podcast as well.

[toggle title=”Read Transcript”]
Child: Welcome to my Mommy’s podcast.

This episode is powered by Ritual Vitamins which are specifically designed just for women. Ritual contains nine essential nutrients that most women don’t get enough of from just from food: vitamin B12 (as methylcobalamin), folate, vegan D3, vitamin K2, vitamin E, omega-3 fatty acids, boron, chelated iron and a proprietary form of magnesium. Ritual supplies them in forms that are easily absorbed and utilized, and all the capsules are vegan, gluten-free, allergen free and non-GMO. They have both a prenatal and a regular women’s multivitamin both designed specifically for women and synergistic for women hormones. Did you know that 40% of women can’t properly use folic acid due to an MTHFR gene variation? Ritual contains a natural form of folate and synergistic nutrients so the entire multi is more effective. In pregnancy especially, folate is vital… According to OBGYN Dr. Jason Rothbart, “most women don’t find out they are pregnant until around 4-7 weeks pregnant, which is past the first 28 days. In the first 28 days, the organs are rapidly forming. The neural tube (which becomes the central nervous system and vertebral column) is almost completely formed and closed by the end of 28 days.” The essential nutrient Folate helps promote healthy development neural tube.* THis is why many doctors recommend taking a quality prenatal for several months before trying to get pregnant. Ritual makes it easy with both a prenatal and regular women multivitamin. Learn more about both at: https://wellnessmama.com/go/ritual/

This episode is brought to you by Kettle and Fire bone broth and soups. I’ve used these products for years and always keep my pantry well stocked with their products. They have chicken, chicken mushroom and beef bone broths, which are great as a base for soups or even just sipped on their own, but they now also have tomato, butternut and miso soups which are often part of meals at our house. Their newest products, chili and thai chicken soup are whole meals on their own and make last minute dinner so easy at my house! Their broths are made from grass fed and pastured animal bones and are a great source of collagen and amino acids like proline and glycine. I incorporate collagen in some form every day, and Kettle and Fire makes it tasty. Go to kettleandfire.com/wellnessmama; and use coupon code wellnessmama20 for 20% off.

Katie: Hello, and welcome to “The Wellness Mama Podcast.” I’m Katie from wellnessmama.com, and I’m here today with someone I was so excited to meet recently. Sarah Kay Hoffman is the founder of A Gutsy Girl which is a website I’ve been following for a long time. It’s an online community geared towards women who are looking for a reasonable approach for healing things like IBS, IBD, SIBO, hormonal problems, acne, and more. She is a gut researcher and a journalist who speaks out highly detailed information and then condenses it into digestible ways for women worldwide. And her writing style is so conversational and fun, and I feel like I know you so well already, even though we only met recently, and you’re also the mom to three absolutely adorable children. So we’ll talk a little bit about motherhood today too, but welcome. Thanks for being here.

Sarah Kay: Thank you, Katie. I feel like I’m on a celebrity podcast today and so exciting because I’ve followed your work for years now, so I’m really excited to be here with you.

Katie: Oh my gosh, I’m excited you’re here, and I feel the same way. I followed you for so long and I’m a little bit like star-struck today. And a name like A Gutsy Girl, I feel like that’s where we have to start. So I’m sure like my thyroid journey, for instance, it’s probably a long journey, but I would love to hear your gut health journey and just your story because I know this has been a research topic for you for a while.

Sarah Kay: I have pretty much been on this journey for over 10 years now, well over 10 years, but I think my journey pretty much started in 2008 when I was diagnosed with colitis, and it was shortly before my wedding and I knew something was off and we couldn’t really figure out what so I decided that we should probably just do the colonoscopy and endoscopy. And they found that I had colitis. I had a pretty mild form of it called proctitis which affects the lowest part of the colon, the rectum. And my journey began then, but I don’t really consider it to truly have begun until 2009 when I came upon the GAPS diet. So from 2008 to 2009, I just tried everything. I worked with a nutritionist, I just trialed and errored everything that I could on my own. And, you know, at the time, I would just read articles that would tell us, you know, what things were healthy for the gut, you know, more vegetables, fruits, just whole grains, probiotics, prebiotics, you know, all the things, and I just couldn’t get better.

And then in 2009, I stumbled upon the GAPS diet, and I actually brought it to my nutritionist because it was something that was so different than anything that I had ever thought of or tried. So I’m sure you’re familiar with the GAPS diet, right?

Katie: Yeah, absolutely. We have experienced that in the past as well.

Sarah Kay: Yeah. So the GAPS diet just…for anyone listening, is just the Gut And Psychology Syndrome. It’s developed by Dr. Natasha Campbell-McBride and basically the foundation of it was a lot of meats, broths, fats, you know, very little carbohydrates or anything that could really like sit in the gut and ferment and I started it, and within days, I felt better, and it was the first time in my entire life I felt like I could actually heal and that diet was playing, you know, into me getting better or prohibiting me from getting better. So I did that. I did that in 2009 and I stayed on it for quite a long time. I talk a lot about the GAPS diet today as far as it changed my life, the book changed my life, everything about it changed my life but the problem was I stayed on it for far too long.

And so I kind of went on and off it from 2009 until December of 2014. I just played around with different things. I would feel well and then I would not and the cycle just kind of kept going. So what happened in 2012 kind of right in the middle of there, is I went through a very vicious cycle of IVF, and for anyone out there that’s listening that’s gone through that, you know what it means. It’s a lot of different shots and hormones and really like manipulating everything about your cycle and I think, you know, it all played into my deep already rooted hormonal issues and then also my gut issues.

And so at the end of 2012, when that failed, that IVF cycle, my husband and I took a trip to Sedona and it was there when I just had this whole revelation, if you will. Like I just wanted everything about my life to change. I wanted to get well. I didn’t want to dwell any more in, you know, infertility or not having children. I really just wanted to turn my life around, make things like as positive as possible. And I really devoted my time and my energies in Sedona at that moment to researching and learning everything and spinning it positive. So it was there that A Gutsy Girl was born because it would play into this whole idea that I’m sitting here with all these gut issues and my stomach is just in misery. And now, I’ve just, you know, gone through a really long intense period of IVF and infertility.

And I made it my mission that with A Gutsy Girl, obviously, it’s a play on gut with gutsy, but also just to, you know, build this community, this support community for women that were going through all the things I was…and what I learned then and what I’ve learned since then is that women typically that have IBS or IBD, it always goes along with something else. So, you know, low thyroid or infertility or skin issues, or…I mean, it always goes along with all these other things, but all of these other things are very isolating, and you can feel so alone. So A Gutsy Girl was born, and then yeah, like you said, I just kept researching, kept learning.

December of 2014, well, actually about a year after that, we ended up…this is a whole another part of my story, too, but we ended up adopting our first daughter, and she was a micro preemie. And so when she was two months old by the time we got her, she was still only 5 pounds. So I was up. I was already sick still, but I was up almost like 24/7. I think I maybe got three or four hours of sleep a night for months and months on end, just, you know, the cycle of feeding and sleeping and feeding and sleeping and all of that. So it was about November of 2014 when I just absolutely hit rock bottom. I have blog posts on my site that you can see my face. My perioral dermatitis was the worst it’s ever been in my entire life. Was covered, my face was covered. My stomach was bloated and then, you know, things would go through me and I could not catch a break, it seemed like.

So at that point, I started seeing a functional practitioner in California and that’s where we lived at the time. And he really changed my entire life because instead of just doing, you know, the test, the colonoscopies, the endoscopies, the regular blood test, he dug into every last thing that he thought could be going on. And we found out that I had SIBO which is Small Intestinal Bacterial Overgrowth, I’m sure you know, and that has kind of been the start to my real journey, I think, even though the colitis diagnosis and everything, but I believe that it’s really been the SIBO that’s been my underlying issue, the bottleneck to all of everything. And so, once I was diagnosed with that, then at the beginning of 2015 is when I really believe I started to heal.

Katie: Wow, yeah. I hear so much of my own story in your story, mine was related to thyroid, but just that long process of having to very much like figure it out on your own. And thankfully, there are great practitioners that we can bring in and have in our corner, but that’s something I’ve learned so much through my own journey is at the end of the day, we can’t outsource our health. And it seems like you found this out as well, that you can learn from so many different sources, but truly, the end is figuring out that personalized information and applying it to yourself. And I think that’s something that you do so well on your website, is to give people the tools and empower them to go down that road and figure out their own steps and their own things.

And one thing else that I loved in what you just said was about starting A Gutsy Girl for the community side because I think that is one of the most overlooked aspects of health, and I talk about it all the time now because I think it’s so important. It’s something that’s missing so much in our modern world, is true community, and I love that you were working and are working to build this community for women who are all in this journey together. I think that’s so beautiful. And you mentioned SIBO. So some listeners may know, we had a journey with this as well in our house. My husband, in 2012, his appendix ruptured, and the secondary infection from that, which required lots and lots of antibiotics and I think he had a flesh-eating bacteria. It was a pretty severe thing, but it led to him getting SIBO. And so this is something I also had to kind of figure out how to tackle as well.

So I’d love if we could talk about it, because I suspect there are a lot of people suffering with some version of SIBO, even if it’s a very mild case, that may not even know because for him, it was a couple of years before we finally put the pieces together and got a diagnosis. And the testing they do for SIBO is not like common testing you would get in a regular lab panel. So a lot of people may have it and it kind of fly under the radar. So walk us through maybe how you found out you had SIBO and then how you started to tackle that?

Sarah Kay: Yeah, so my prediction, I’ve been saying this for quite some time now is that, you know, when I was diagnosed with it in 2014, I was like, “What’s SIBO?” And now it’s becoming even more common, but my prediction is that within the next few years, it’s going to be a very common thing that even Western doctors are going to be doing testing for and people are going to be diagnosed with it left and right because I think it is so common and it’s such an under…well, see, the thing is it’s such an underlying thing, like you said, when your husband’s appendix ruptured, that came along with it, and it’s an underlying thing, but usually, there’s also an underlying thing with SIBO. So it’s just like this maze and this mess but SIBO goes hand in hand with so many other conditions that I just see it’s gonna completely increase in the diagnosis with it.

So I was diagnosed with it in 2014, and I would have never known had I not gone to that doctor who kind of specialized and he specialized in…he’s actually Chris Kresser’s doctor at the California Institute for Functional Medicine. And he studied a lot about SIBO and Lyme disease, which those go hand in hand a lot as well. So I think he was already, you know, kind of looking for that, and maybe I just got lucky that I happened to see him but my symptoms were very, very classic SIBO symptoms. I could eat one thing and be so bloated. So to put into perspective, at the height of the whole infertility journey, I remember I was in the airport, and a woman came up to me and said, “Oh, when are you due?” And I just started crying, but I was like, “I’m not, I have SIBO. Thank you. And I’m infertile.”

But yeah, so bloating. It’s just this like horrible awful…I always said it felt like the Gremlins are like pushing against your stomach and trying to get out. That was one of my big symptoms. My other one was the acne. So I got perioral dermatitis so badly, it covered almost my entire face, all around my nose, my chin, really scaly rash. And then the other very classic symptom I had was I was always…like I could eat a four-course meal and within 10, 15 minutes, I was starving again. I could never eat enough, and it wasn’t that I gained a lot of weight or a lot of people will lose a lot of weight with SIBO. I just kind of maintained because I was very, very deficient in a lot of nutrients. By the time I was diagnosed, I was so severely deficient in B12 that he started me on injections to my stomach immediately.

I had a lot of joint pain. You know, we always thought that it was from gluten which it may have been, but I had a lot of joint pain. I was very, very tired. I mean, I would say that’s probably one of the symptoms that looking back for years now, very tired. And then the other classic symptom, I think, which people don’t like to talk about, but it’s true is I could be in a room and barely any gas would come out of me but the entire room would just smell so bad because what happens with SIBO is there’s just so much bacteria that stays in your small intestine. The small intestine is supposed to have bacteria but you’re not supposed to have that much. Like food ferments there and it’s almost like it feels like it’s rotting. That’s kind of what your insides feel like. And so I, because I had so many classic symptoms, and I could communicate this to him, he tested me for it with the breath test right away, and sure enough, that’s what I had.

So that was kind of my journey with it and how I knew, but having said that, SIBO is…and I’m not sure what your husband’s experience has been like with it, but SIBO is one of those things that is so hard to get rid of. Most people, you don’t just do a course of, you know, the herbal antibiotic or the antibiotic, or both, and you’re better and it’s done. I mean, most people, it keeps going and going and going until, which is what I figured out, you really start to address whatever is underlying.

Katie: Yeah, we had the exact same experience and some of those classic symptoms as well, especially the bloating. And to be honest, I feel bad, but for a few months, I kind of like downplayed it or didn’t really…I was like, “Well, stop eating so much at a meal. I don’t know why you’re bloated.” Or, “Take some HCl or whatever.” And I didn’t really understand just how uncomfortable that really can be. And then once we got the diagnosis, it was such a long process, you’re right, because like a lot of stuff, you can figure out remedies were pretty easily. And this, I felt like we were just doing battle with this thing that every time we would cut off its head, it would come back bigger. And it was one of the more frustrating things we’ve ever had to deal with. And I’m curious what the things were that helped you. And again, this is all I know, very personalized. So I don’t think either of our cases is going to be prescriptive, but I think you can learn from some of the commonalities that help people.

So for him, he actually did a 21-day elemental diet with…he was like essentially fasting with like very specific protocols. And then we did this like a long, very careful diet after that with the herbal antibiotics and a lot of supplements, but I’m curious, what kind of finally stuck and what works for you.

Sarah Kay: Okay, so in the beginning, I was very adamant that I did not want to take any antibiotics because I kept telling myself, “Well, this was part of the problem why I got here in the first place. I grew up on antibiotics. I was chronically ill my entire junior year of college that ended up in a tonsillectomy.” So I was really adamant. So my doctor, he completely agreed and we tried the herbal antibiotic route. I mean, everything from Neem, Berberine, Allimax. I mean, combinations. He gave me different…I think it was called GI Synergy and it was just kind of like a bunch of different herbs and one pill and I would, you know, whatever. I did all of the things, and I tried that religiously for, I don’t know, a few months, and I wasn’t getting any better. In fact, I was getting worse. And so he said, “I think you’re going to need the antibiotic.” You know, in hindsight, what I learned about the SIBO antibiotics is that they stay localized to the small intestine, and it doesn’t really disrupt your entire gut.

I say I’m the queen of justification. If I’m going to justify it, it’s going to be that, but I knew regardless, at that point, I just wanted to feel better. So when I was first diagnosed with it, I was just diagnosed with the hydrogen version. So I’m not sure what your husband was, but there’s hydrogen and there’s methane dominant. So in the beginning, it was just hydrogen. So the antibiotic that I took right away was Rifaximin, and my doctor, I am so thankful, he always was able to get me 21 days to 28 days. What I’ve learned and what I’ve heard from other people’s experiences is when they’ve only had the two-week course, they relapse within days of being done with it. And it makes sense to me too, because I never felt well until about day 21. I almost would give up on even the antibiotics and all of a sudden, it was like some magic happened on day 21, I feel so much better.

So I did the antibiotic, and I stayed feeling well after that for quite some time. What I did from a dietary standpoint at that time was I did during the antibiotic, I would always be eating FODMAPs, and I didn’t really…I wasn’t really concerned too much about, you know, what I was eating. But then afterwards, so that all of the bacteria could come out to play, that’s the theory and then you “can target it with antibiotic.” And then after the antibiotic, I would follow like a pretty strict diet, like a lower FODMAP diet mixed with some GAPS or some SCD. You know, I just kind of knew what my body…what worked and what didn’t work.

And the problem with that, there’s no…I think that’s a great protocol. I think any protocol that you do with this elemental diet, which by the way I’ve never done, I’ve always been very interested in it, but I’m too afraid to not eat anything for 21 days or longer. I think whatever protocol you’re going to do can work and is fine, but I kept relapsing. So I think that since 2014, I relapsed either three or four times. And each time I relapsed, I either had hydrogen, methane dominant or both. So whenever the methane came into it, then I was not only on Rifaximin for 28 days, but then you also have to add another antibiotic called Neomycin, and I think that’s always like for 14 days, but I would do that. And again, I would feel better for quite some time and then I would relapse until it was about this last year, last March was the last time, so about a year ago, that I ever relapsed.

I did the antibiotics again, I did the food thing again, but what changed was that we really started to focus on why was I relapsing so much? And I believe that until you do that, it will never go away. And for me, I had barely any stomach acid. So you had mentioned the HCl. So adding in and doing the HCl appropriately was critical and to this day is critical for me. So I am very religious to the HCl, to my digestive enzymes. Those are the two biggest things every single day that I make sure I keep up with with my stomach, but beyond the supplements and the medication, the biggest thing was the lifestyle. What I found was every single time I relapsed, it was always during high stress periods. And I had to really like dig deep and try to figure out what was causing all of this stress and anxiety, and it took far more than diet and supplements. It took therapies, it took journaling.

Like it sounds so woo-woo, but I have been feeling the best I have in my entire life for over a year now. And so I think when you’re talking about healing SIBO, it’s just so important to know like really what’s going on underneath so that you can…I view food now and supplements and therapies and anything else you want to do as tools. They’re just tools to keep you well.

Katie: Yeah, absolutely. And I think you made a couple of really important points in your response just now. One being that the antibiotics used with SIBO are very unique. Like for instance, my kids have never had antibiotics, it’s because they’ve never needed it. But I absolutely think there’s a time and a place for certain antibiotics. I mean, certainly, I think we can agree that they’re perhaps overused in some scenarios, but this is like one of those scenarios that if you need them, you need them, period. And so I love that you shared your story on that and brought that up because I think especially in this natural health world, there’s a tendency to like, “Oh, antibiotics are always bad,” and they’re definitely not always bad. So I love that you shared that part of your story, and also that you mentioned HCl. This was so key for him as well, and he also to this day takes HCl. I think this is actually another area where we’re going to see like growing awareness about this. I think a lot of people have that. Even if it’s like a very subclinical, like they wouldn’t necessarily notice until they started taking the HCl and then they noticed how much better they feel.

So I’m curious for you, like how did you find out that that was a key and then just curious, like what your daily regimen looks like with that because, like I said, it’s been life-changing for him too.

Sarah Kay: Yeah. So as we age, you naturally decrease the amount of stomach acid you have. So that’s kind of like one problem with the whole stomach acid thing. The other part is that traditional doctors, they’ll see like a problem like GERD or any kind of like stomach acid issues as, oh, you have too much, so let’s reduce it when that might not actually be the case. So then you are reducing what was already too low of stomach acid into even lower stomach acid. And the thing is that I wrote a blog post about the pH of the stomach. The stomach needs to be very acidic, that’s what helps break down the food. The problem with SIBO is your food doesn’t break down in the small intestine. So if you don’t have the adequate stomach acid in order to break that down, it just sits there and it ferments and that’s when all the problems arise.

So for me, with the stomach acid, I’m very, very open about this to this day. It’s something that I was not very open about for a long time, but, you know, earlier in my days, you know, high school, I probably started in high school, college, even up through my wedding, when I was diagnosed with colitis in 2008, I always followed very strict diets. I was always on some kind of diet. I can’t even tell you all of the crazy diets I’ve done in my entire life and it’s why I’m really, really a proponent of this idea that gut healing is not a diet because I think too many women are trying to make it into this, you know, restrictive diet, but I have been on those diets and that’s what got me so sick in the first place.

So my doctor, that’s kind of how we stumbled upon the idea that I probably had, you know, ruined a lot of…depleted a lot of my stomach acid. And so the way that we tested it is just that it’s…it was just an at-home test with the HCl pills. So there’s a tutorial on my website and how you do it, but I mean, it was very simple. It was with a lot of protein, meaning, you know, half cup or more, I would take one HCl pill, I felt nothing. Then I would take…the next time I tried it, I would take two with protein. Felt nothing. Until I got all the way up to like, I think at one point, like 13 HCl pills, and I still wasn’t feeling anything. But at that point, what happens is it becomes very counterproductive to go up more because then you’re drinking so much water while you’re eating your meals in order to take these pills, and we should never be drinking that much water while we’re eating. That also like is not good for digestion.

So my doctor, what we decided to do is I think…and also, I was never going to be taking 10 or more pills in one sitting, even if it’s HCl. So I think what we did was we just kind of normalized it. I think he had me taking in the beginning five or six HCl until the day I felt a little burning sensation. That means that then you’re producing enough stomach acid and you don’t need that many anymore. So I did that for a very long time. I mean, I stayed at five or six, I don’t even know, probably for a couple years. And then today, I’m down to like two, one or two. I could probably do without, but I’m just so overcautious, I don’t feel anything at two. And so yeah, that’s just kind of the process that we went through.

And again, I have a tutorial how to do it, but I did it holding hands with my functional practitioner because I needed so many of them. I feel like if you really have that low stomach acid, you have to be really careful and you should work with your doctor and what’s the right place to start and just stay consistent with that amount until you’re ready to reduce.

Katie: That’s great advice, and I will make sure we link to your post about that so that people can read for themselves and I echo your encouragement to always find a practitioner you can have in your corner because it’s great to have someone that has been there and you can ask advice, too. And you mentioned FODMAPs a few minutes ago. So I’d love for you to walk us through what those are and how they come into play.

Sarah Kay: Yeah, I actually just released an e-book all about the low FODMAP diet, not really about the low FODMAP diet, but about how if you have SIBO and you’re following a low FODMAP diet to be able to eat more things and still heal. So FODMAP stands for Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. So they’re just things that are found in our food and the thing with FODMAPs is that…I’ll never forget. I went to see an aunt in Southern California once and I got there, was shortly after my SIBO diagnosis. And she told me that she was making some meal for dinner, it had apples and onions and garlic in it. And I said, “Don’t worry about me. I’m just going to go down the street to grab something and I’ll make my own food.” And I remember she made the comment to me, “What? Now you can eat healthy things like apples, onions, and garlic?”

And that’s the thing about the FODMAPs is that they are healthy things and “healthy things” that, you know, we think normal people should be able to eat all the time and in abundance because they’re so good for us. But the problem is that they contain some, you know, FODMAP in some way, shape or form and it doesn’t ferment right for people that have SIBO. So, yeah, they’re just classifications of food pretty much. And they are a collection of short chain carbohydrates that are not absorbed properly in the gut. And when they’re not absorbed properly in the gut, they can trigger symptoms in people with IBS.

Katie: Got it. And I know something else that comes into play sometimes with these particular conditions is things related to histamine intolerance. So I’m curious if you have personal experience with that and what you’ve learned about that, if so, during your journey.

Sarah Kay: Yeah. So I actually don’t have anything with histamine intolerance. Not that I know of. I mean, obviously, once you start going down one rabbit hole, I could find myself going down so many other ones, I’ve just chosen not to. That said, I have written about histamine intolerance before because so many people with SIBO do have a histamine intolerance and can’t do a lot of thing or can’t eat a lot of things. And I know like a lot of the histamine intolerance, I’m not sure what your symptoms are like, but it’s a lot of like hives, red eyes, nasal congestion, headaches, runny nose, things like that. I’ve never had anything like that.

So, I know that it’s very common with people that have SIBO which also then limits their diet even more, unfortunately. And also, I know that you and I are on the same page with this, but that’s one thing I love about the Thrive probiotic, is that there are no histamines in it and there are in a lot of probiotics. So the way that I tell people really to approach SIBO mixed with a low histamine diet is to…I always say, whatever you’re really trying to address most, do that first and then add to it. So, for me, like with SIBO and colitis, or SIBO…no, I’ll take SIBO and the low thyroid. My main goal there was to heal the SIBO because then, you know, it’s a trickle effect, everything else starts healing as well.

So healing the SIBO for me meant to follow, you know, low FODMAP, this, that, and the other, but if I also wanted to, you know, then compound it with the thyroid, then I would try to add foods in that would also work with low FODMAP to help the thyroid. So the same thing goes for when people ask me about a low histamine diet with a low FODMAP diet. So if SIBO is the most important thing to you, start there, and then you take, you know, there’s low histamine diet with like, you know, eggs. Eggs are a low FODMAP, so great. Keep it there. That’s how I think it works best when you have a combination of a lot of things going on.

Katie: Yeah, that’s great advice. And yeah, definitely, we’re on the same page with the probiotics. And that brings up another good point, because probiotics can be a really confusing topic if you have any kind of gut issue, I feel like, and I know on the GAPS diet, when we did that, there were very specific probiotic recommendations and the probiotic I now use, also Just Thrive, it was not even available back then. And so there’s so many different options now, but do you have any like general guidelines for that? Because from what I’ve read, and from our experience with my husband’s SIBO, some probiotics can actually make things worse if you are just kind of throwing probiotics at it.

Sarah Kay: Yep. I write a lot about this on my blog, but one of my favorite posts I ever wrote about this was, “Should I take a probiotic with SIBO?” That is before I met Just Thrive. But even still, I do still take this very same approach because it is such a subjective topic in the healing SIBO world. And I think what it really comes down to is what stage are you in and what kind of probiotic are you taking? So, you know, I don’t remember exactly which probiotic it was, it doesn’t really matter, but I was taking it when I was trying to…like along with my antibiotics and also this stuff and I couldn’t figure out why I kept being so bloated. So my doctor said, “Just try cutting the probiotic for a while and see what happens.” And sure enough, I started feeling much better. So whatever was in that probiotic was not working in that stage, that particular stage of healing.

So a lot of times, once I would feel better and my symptoms were kind of had really diminished, I would start taking the probiotic again so that I could repopulate anything that I needed to continue repopulating, you know? I think that, yeah, it’s just such a tricky topic. I have been taking Just Thrive for a couple months now. And it’s been incredible for me, and I know other people that have active SIBO are taking it and they say that it’s working for them as well.

I think when it comes down to probiotics, you really have to look at the strains and the species. In addition to my…I really feel like a lot of supplements are so much snake oil at this point because there’s just…the market is just flooded with them and you really have to…I have a new blog post too about gut healing with minimal supplements, you know, and there’s just like a few that I take now because the more supplements we take, the less we know really what’s working and what’s not. And then the less we’re able to really investigate and to know what is in that capsule, you know, what are we taking, what are what their tests? How do they test it? Where are the sourcing their ingredients? You know, like there’s so many different things. Like a probiotic is not just a probiotic. I was thinking about that old Activia commercial where they talked about, you know, how that yogurt is so great for you, has got these probiotics. I’m like, “But look at the ingredients,” and I just feel like that with all probiotics and then especially if you have SIBO and choosing the right probiotic.

Katie: Yeah, I agree completely. And that’s what I loved about these specifically as them being spore based, they’re so much less reactive. Like you said, they don’t have the histamines or dairy, or a lot of the things that if you have any kind of special condition, you may be avoiding. And so I’ve heard the same thing for my readers, just it’s helped so many people. And it sounds a lot like you, my husband takes HCl and those probiotics daily, and then everything else kind of as in rotation, or as needed, but those are his two nonnegotiables.

This episode is powered by Ritual Vitamins which are specifically designed just for women. Ritual contains nine essential nutrients that most women don’t get enough of from just from food: vitamin B12 (as methylcobalamin), folate, vegan D3, vitamin K2, vitamin E, omega-3 fatty acids, boron, chelated iron and a proprietary form of magnesium. Ritual supplies them in forms that are easily absorbed and utilized, and all the capsules are vegan, gluten-free, allergen free and non-GMO. They have both a prenatal and a regular women’s multivitamin both designed specifically for women and synergistic for women hormones. Did you know that 40% of women can’t properly use folic acid due to an MTHFR gene variation? Ritual contains a natural form of folate and synergistic nutrients so the entire multi is more effective. In pregnancy especially, folate is vital… According to OBGYN Dr. Jason Rothbart, “most women don’t find out they are pregnant until around 4-7 weeks pregnant, which is past the first 28 days. In the first 28 days, the organs are rapidly forming. The neural tube (which becomes the central nervous system and vertebral column) is almost completely formed and closed by the end of 28 days.” The essential nutrient Folate helps promote healthy development neural tube.* THis is why many doctors recommend taking a quality prenatal for several months before trying to get pregnant. Ritual makes it easy with both a prenatal and regular women multivitamin. Learn more about both at: https://wellnessmama.com/go/ritual/

This episode is brought to you by Kettle and Fire bone broth and soups. I’ve used these products for years and always keep my pantry well stocked with their products. They have chicken, chicken mushroom and beef bone broths, which are great as a base for soups or even just sipped on their own, but they now also have tomato, butternut and miso soups which are often part of meals at our house. Their newest products, chili and thai chicken soup are whole meals on their own and make last minute dinner so easy at my house! Their broths are made from grass fed and pastured animal bones and are a great source of collagen and amino acids like proline and glycine. I incorporate collagen in some form every day, and Kettle and Fire makes it tasty. Go to kettleandfire.com/wellnessmama; and use coupon code wellnessmama20 for 20% off

Katie: As we’ve been talking, like I said, I hear so much of my story. Mine was thyroid related, but just that journey of having to figure out what was wrong and then that slow journey of healing. And something that’s always top of mind for me is how can I do as much as possible to give my kids a foundation so that they never have to deal with problems like this? And I know as a mom, that’s probably something that you’ve thought through a lot as well and you write a lot about your family and, you know, raising a healthy family.

So I’d love to kind of switch gears a little bit and transition into the head, and I’m just curious if there are any things you do with your kids specifically, just to give them a really good healthy, solid foundation in life.

Sarah Kay: Well, first of all, I have to say that I wrote it down immediately that your children, all of your children, have never had antibiotics. That is incredible. That is just so fascinating to me. And I need to have offline conversation with you about that. My children have had antibiotics, but again, I just have to take out, you know, anything that I feel about that. So all three of my children are adopted, and all three, we’ve adopted all three of them from the foster care system, and they came to us all as babies, pretty much as babies, but they were all prematurely born and were born into the world under less than ideal circumstances. And so people say that it’s just…it was perfect. You know it was so meant to be that I got the children that I did because I actually have a tab on my website called Gutsy Children because all three of my children have some sort of gut or another issue that is playing into their gut issue. So like my oldest has severe eczema and my middle child was just diagnosed with intestinal parasites, and he also has low stomach acid, it’s crazy, and enzymes. And then the baby, well, she’s not a baby anymore, she’s almost three but she definitely has a lot of stomach issues and we’re just treating her as if she had intestinal parasites because my middle child is her biological brother. And they have very, very similar like everything, like they get really bloated and they just…so we’re treating them the same.

But what I do for them is I approach their diet and their lifestyle as sanely as possible, but without normalizing it, if that makes sense. So, you know, I feel like it’s so normal for kids to wake up and eat sugary cereals and, you know, live off of that stuff all day and my children don’t and I think that’s okay. We have treats. Of course we do like any other family when they’re out, you know, in public and at school, whatever, it’s okay. We have to be very, very, very careful with gluten and dairy. None of them are supposed to have gluten and dairy, so we’re pretty strict on that now. In fact, my middle child, the one that has the parasites, he got into gluten on Sunday and had rashes all over his face. So it’s just another, you know, confirmation from you, why we live like this.

I really like make things fun. For example, instead of like normal Ketchup with their stuff, I get the Sir Kensington’s Ketchup and we always call it Mommy Special, whatever. So Mommy Special ketchup or we do coconut amino, so it’s Mommy Special sauce and they think that’s fun. I just make things fun for them and like it’s really, really things taste normal to them, everything does. People just can’t believe that, you know, they want to eat vegetables and they want to eat, you know, potatoes and fruit, and that’s just because children do as they see, you know, they want to be like us, they want to mirror the things that we’re doing and that’s just how we live. You know, I’m not trying to be this, you know, outstanding mother of the year with how I feed them and the things that we do, I’m just trying to set them up for a healthy life because I know in my research and in my own life that taking care of the gut and taking care of yourself, it has incredible impacts on your life because so much of the immune system lies in your gut. If I don’t take care of it for them and help them and teach them why it’s important, you know, I don’t know what could lie ahead for them.

So I think that’s why I’m so passionate about it. They take enzymes before they eat. We do the Just Thrive probiotic, I open the capsule and put it in their food. They take maybe like half of one obviously instead of a full one. And then they take their fish oil and beyond that, I mean, I’m pretty…it’s pretty normal.

Katie: Yeah. That’s awesome that you are their mom because it sounds like that is a perfect match, and thank goodness that they have you. And I think that’s also so important that you mentioned, you know, trying to keep that mindset sane because we also definitely don’t want to raise our kids with kind of any kind of issues surrounding food or like any kind of like long complex that’s going to last into adulthood. So it sounds like you’re taking an amazing approach. And I also love that you brought up eczema because that’s something that in our time with the GAPS diet, of course, you learn that skin health is so tied to gut health. And I hear from a lot of moms, I think eczema is also on the rise, but a lot of moms whose children are struggling through that, and that was something I had to learn too, is it doesn’t matter necessarily what you put on top of the skin. If eczema is happening, there’s something inside the body that’s also going on, so you have to address both of those. So are there things that you’ve found especially helpful on the eczema side because I know a lot of parents are in that right now?

Sarah Kay: Yeah. That’s the thing with…you know, I love skincare, Beautycounter is my jam, whatever. But I think too many people are trying to say like for adults and for kids and for everyone that, you know, all these topical things, it’s going to just turn your life around, your skin’s going to be great in three days. And that’s just not the case. My perioral dermatitis was never going to go away no matter what kind of product I used, it all came back to my gut. When my SIBO was healed, it just “magically went away.” And the same thing happened with my daughter that has eczema. She got it so badly, it was not too long ago and it just started popping up on her hands. And then we would find like little bumps. Everything started as like little bumps almost that just expanded into like large rashy things on her hands and her back and all over her face. In fact, one Sunday morning, it was on my birthday, she said her heart was kind of beating fast and because she had these rashes all over, I got so worried. I took her into the emergency room right away and she had had this eczema going on for quite some time. And so, of course, their solution was a topical steroid. So I was not in favor of that but at that point, she had gotten so bad, so we used it just for a couple days not for very long but at that point, immediately, I cut…she had been basically living on dairy, she loves dairy. I mean, what kid doesn’t?

So I did all the things from a dietary standpoint because I knew from my own experience of perioral dermatitis that the topical stuff is just…that wouldn’t matter if we help everything else. So to cut the dairy and I cut the gluten, and she started drinking more bone broths. I would have her do enzymes before she ate, fishy oils, which she calls it, that’s also like pretty soothing. And then it just really started to go away on its own. I mean, I don’t think…so that was in February. I don’t think she’s had any dairy or gluten since then. I don’t want to keep that out of her diet forever. And so we’re trying to get her blood tests to see like really what she’s intolerant to. She’s currently in the process of doing a stool sample too to see if there’s something going on. But the functional doctor that we’re working with thinks that it’s probably some food that’s really causing eczema.

So the other thing that they a lot of times will tell you to give up would be like eggs, and nuts. For me, I have a hard time giving up all the things for children just because I do not want to set them up for, you know, a lifetime of fear with food or anything like that. So I chose to…she doesn’t do many eggs to begin with. So that’s why I didn’t take it out, but I just chose dairy and gluten for right now and it helped. I mean, she’s perfect now again. Her skin is completely clear. We put, you know, just like gental lotion on it, keep it hydrated. I tell her, I have to make sure she’s drinking more water. We reduce a little bit more of like the unnecessary sugars. We got a note from the doctors so that both she and her brother can…we bring our own snacks to preschool, which has helped a lot because, you know, there’s no dairy or gluten in it. And yeah, I think that’s the biggest thing.

Katie: That’s awesome. Yeah, I think it sounds like you’re doing an amazing job, and I think that’s going to be so helpful to so many parents who are listening. And I also can’t believe how quickly our time has flown by because I could talk to you all day long. But a couple of questions I’d love to ask at the end. The first being, if there is a book or a couple of books that have really changed your life and if so, what they are and why.

Sarah Kay: Okay. So I’ve mentioned it already before, but I have…I mean, there could be so many fun books that I share and a lot of like life-changing books, but honestly, I was thinking about this and the book that has truly changed my life was “The GAPS Diet,” or the “Gut And Psychology Syndrome” book by Dr. Natasha. And while I don’t believe in it for any long-term solution, I believe in the foundation of what she’s saying. You know, the gut and psychology syndrome, it’s not just gut stuff but all the other things that go along with it: autism, dyslexia, depression, schizophrenia, ADD, all these things, and we don’t realize how much the gut and the brain work together. And I have read this book, I can’t even tell you how many times, I have little bookmarks everywhere in it. It’s just a really great book that truly changed my life because had it not been for that book and me learning the art of making my own bone broth in 2009, I would never probably be where I am today. So I’m very grateful for that book.

And then the other book that I just honestly think that changes my life all the time I read it is the Bible. It’s a book that not a lot of people would say, but it does. You know, like I said, on this journey, I have had so many ups and downs, like so many awful things, so many great things, but the one thing that’s just stay consistent is me reading the Bible. And I know that’s such a topic that people don’t talk about these days, but I have to say it because it truly is. So those two books.

Katie: Awesome. And lastly, any closing advice that you would give to parents, to someone suffering with gut issues, or just in general?

Sarah Kay: Well, I think the best piece of advice I give to everybody is to test and not guess. So I feel like we have access to so much information these days on the internet, you know, with just like, open up a browser and you can diagnose yourself with advanced stage four cancer today. But the reality is that you have got to just go to the doctor and get tested, and Dr. Google is not an appropriate test for you. I have a blog post on my site, it’s a beginner’s guide to digestive health testing, and it really takes people through the process because I think that there’s different steps to testing. You know, you decide that you’re going to get tested versus self-diagnosing. And then you decide, are you going to go the Western doctor or functional and integrative doctor.

And then, you know, there’s steps that you should and can take to prepare for your first appointment, and you can use Dr. Google for that. You know, like see different symptoms that make sense, different things that you want to bring up with your doctor, different tests that your doctor might not, you know, automatically test you for but you feel like you want…you’re in charge, and so you get to go to them and you get to tell them, “I would like to be tested for X, Y, Z. Here’s my symptoms. This is what’s going on. This is what I think. If you have additional, you know, thoughts to add to it, great, let’s work together.” But that’s my biggest piece of advice, is to just know what’s wrong before self-diagnosing and doing all the diets and all the supplements and medications and it’s just your…people always ask me, “How long will it take to heal my gut?” And I tell them, “As soon as you have an accurate diagnosis, and then you get on the path to healing the root cause of that diagnosis.” That’s how long it’s going to take you.

Katie: I love that and such a perfect place to end. I know that you are a busy mom and businesswoman and I’m so appreciative that you took the time to be here today. This episode was amazing. I think it’s going to help a lot of people. And I appreciate you so much.

Sarah Kay: Thanks so much, Katie.

Katie: And thank you to all of you for listening and for sharing your most valuable asset of your time with us. We’re so grateful for you and I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.
[/toggle]

Read Transcript

Thanks to Our Sponsors

This episode is brought to you by Ritual Vitamins, which are specifically designed just for women. Ritual contains nine essential nutrients that most women don’t get enough of from just from food: vitamin B12 (as methylcobalamin), folate, vegan D3, vitamin K2, vitamin E, omega-3 fatty acids, boron, chelated iron and a proprietary form of magnesium. Ritual supplies them in forms that are easily absorbed and utilized, and all the capsules are vegan, gluten-free, allergen free and non-GMO. They have both a prenatal and a regular women multivitamin both designed specifically for women and synergistic for women hormones. Did you know that 40% of women can’t properly use folic acid due to an MTHFR gene variation? Ritual contains a natural form of folate and synergistic nutrients so the entire multi is more effective. In pregnancy especially, folate is vital… According to OBGYN Dr. Jason Rothbart, “most women don’t find out they are pregnant until around 4-7 weeks pregnant, which is past the first 28 days. In the first 28 days, the organs are rapidly forming. The neural tube (which becomes the central nervous system and vertebral column) is almost completely formed and closed by the end of 28 days.” The essential nutrient Folate helps promote healthy development neural tube.* This is why many doctors recommend taking a quality prenatal for several months before trying to get pregnant. Ritual makes it easy with both a prenatal and regular women multivitamin. Learn more about both at https://wellnessmama.com/go/ritual.

This episode is brought to you by Kettle and Fire bone broth and soups. I’ve used these products for years and always keep my pantry well stocked with their products. They have chicken, chicken mushroom and beef bone broths, which are great as a base for soups or even just sipped on their own, but they now also have tomato, butternut and miso soups which are often part of meals at our house. Their newest products, chili and thai chicken soup are whole meals on their own and make last minute dinner so easy at my house! Their broths are made from grass-fed and pastured animal bones and are a great source of collagen and amino acids like proline and glycine. I incorporate collagen in some form every day, and Kettle and Fire makes it tasty. Go to kettleandfire.com/wellnessmama and use coupon code WELLNESSMAMA20 for 20% off.

Katie Wells Avatar

About Katie Wells

Katie Wells, CTNC, MCHC, Founder of Wellness Mama and Co-founder of Wellnesse, has a background in research, journalism, and nutrition. As a mom of six, she turned to research and took health into her own hands to find answers to her health problems. WellnessMama.com is the culmination of her thousands of hours of research and all posts are medically reviewed and verified by the Wellness Mama research team. Katie is also the author of the bestselling books The Wellness Mama Cookbook and The Wellness Mama 5-Step Lifestyle Detox.

Comments

3 responses to “258: Sarah Kay Hoffman on Beating SIBO, IBS, & Histamine Intolerance”

  1. Alanna Avatar

    Hi!!!!

    I have been dealing with intense bloating for the last 8 years and this has only increased as I’ve gotten older – and I’m only 23 years old! Lately, it’s gotten so bad that I blow up like a balloon and stay that way for weeks on end! I feel like if you took a balloon and pointed it at my stomach, you’d pop it!

    I recently got tested for SIBO, but apparently my test indicated a very low amount of sibo… which doesn’t make sense due to the level of bloating and constipation I experience. Oddly, the only diet that has helped me so far is the all-meat carnivore diet, and I’m concerned about this as i’m lacking fruits and veggies (my favourite foods) and other important components of a healthy diet. If i eat any other food I experience horrible bloating!

    I’m concerned about going with rifaxamin and the other supplements as I’ve read all a sorts of negative reviews about them. I also experience extreme bloating with probiotics – even soil based ones – and so I dont really want to have these as they increase discomfort… I started trying neem, but I stopped as I read somewhere it doesn’t work…

    My question is: is doing the carnivore diet for a short time safe? and can such a diet starve out SIBO?

    Thanks

    PS: Katie, I’ve been reading this site since I was 18! thank you for posting a link to Sarah’s website. That’s what inspired me to get my SIBO test!

  2. Catherine Avatar
    Catherine

    Hi Katy,
    This was a great podcast, very helpful! I have been dealing with SIBO for the past 3 years and am currently going into my third week of the elemental diet. Would you be willing to share how your husband transitioned back to food after the ED? I know you mentioned it was a long process, but what was his diet like? Thanks for any insight!

  3. Marcia Avatar
    Marcia

    Hi. I’ve been on your mailing list for some time now and generally read the emails. When I received this email, I eagerly anticipated learning how to beat SIBO, IBS, IBD. Also, eager about the GAPS diet, the FODMAP diet, and MTHFR. Honestly, I ran into more abbreviations than I was comfortable with. (I must admit that I am familiar with ‘OBGYN’.) Did I overlook something? I am not familiar with SIBO, IBS, IBD, GAPS, FODMAP, or MTHFR. I believe I could have learned something from this article, but the abbreviations were overwhelming for me. There might be a community of people who know all of these abbreviations–I don’t. However, I’m hoping that I could have learned enough to share with someone who might be facing these challenges. I think it is proper to spell out the abbreviation before using them.

Leave a Reply

Your email address will not be published. Required fields are marked *