How Do You Treat Hydrogen Sulfide SIBO?


Welcome to my blog, “How Do You Treat Hydrogen Sulfide SIBO?” where I explore nutritional, lifestyle and supplement considerations for lowering hydrogen sulfide in the body.

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What Is Hydrogen Sulfide SIBO?

Hydrogen Sulfide SIBO is the term used when someones SIBO breath test results come back with extremely low levels of both hydrogen and methane gas, throughout the three hours of the test.

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How Do You Test For Hydrogen Sulfide SIBO?

There are two options to consider when seeking to understand the cause of symptoms associated with IBS and poor gut health:

  1. A SIBO Breath Test
  2. A comprehensive stool test

A sample of a SIBO breath test is shown above. In stool testing, we can assess the levels of sulphate-reducing bacteria and thus understand whether hydrogen sulfide might be contributing to symptoms. An example is shown below from Healthpath’s ‘Advanced Gut Health Test‘:

You can see in the middle of this page of the report the sulphate reducing bacteria (categorised under ‘H2S production’). However there are many other bacteria that have been discussed in the research to contribute to hydrogen sulfide levels. Read my blog Hydrogen Sulfide: The good, the bad and the misunderstood to learn more.

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How Do I Treat Hydrogen Sulfide SIBO?

Now, I apologise here guys. I have no fancy perfect answer for you. I am not going to tell you that I have an exact answer and if you follow this process in this order you will be fine. It just doesn’t work like that.

Firstly then, the key is to try and understand the mechanism that caused the imbalance in the first place.

We need to take a personalised approach, alongside considering some of the more general interventions that can be considered.

Sometimes hydrogen sulfide issues can be caused by something as simple as someone whose been on a high protein low fibre diet for too long. Other times, based on Dr. Greg Nigh’s theory, it can be related to glyphosate toxicity, there really is no one cause for this specific imbalance in the microbiome.

What Diet Is Best For Hydrogen Sulfide SIBO?

I honestly don’t think there is one diet to consider here (no matter what you might read!). Options you will find discussed include:

  • A low sulfur diet.
  • A low FODMAP diet.

Both diets can help in certain circumstances.

One study showed that increased consumption of Brassica vegetables was linked to a reduced relative abundance of sulphate reducing bacteria, and therefore may be potentially beneficial to gastrointestinal health. The high-Brassica diet consisted of six 84 g portions of broccoli, six 84 g portions of cauliflower and six 300 g portions of a broccoli and sweet potato soup. This is an interesting study as many will talk about brassica vegetables being a significant source of inorganic sulphate in the diet, and thus it conceivable that diets rich in these vegetables may encourage the growth of sulphate reducing bacteria. This doesn’t seem to be the case.

A low protein diet, or certainly if you’re going to consume a moderate-high protein diet a high intake of fibre is also needed to offset it. In both human and animal studies, a high protein diet results in fecal microbiota changes that increase H2S production and decrease SCFA production.

High carbohydrate availability in the colon, as noted above, promotes microbial groups able to utilize carbohydrate substrates, but also affects other aspects of microbial metabolism and especially impacts protein degradation. The addition of fermentable fiber to healthy human feces in an in vitro setting drastically reduces H2S production from any source (e.g., cysteine, sulfate). Lower pH associated with microbial carbohydrate fermentation also leads to inhibition of dissimilatory aromatic amino acid metabolism. Interestingly, stool pH is lower in vegan and vegetarian individuals relative to omnivores, consistent with greater abundance of carbohydrates in the proximal colon, faster colon transit, and higher delivery of SCFA to the distal colon. This finding underscores the importance of overall diet composition when considering the relative proportions of different end-products of microbial metabolism.

Consumption of processed foods expose individuals to additives such as phosphates, nitrates, and emulsifiers, which have been shown to influence the composition of microbiota, mucin layer thickness, and intestinal inflammation.

And in fact another paper (15) concluded that:

 These results suggest that the use of dietary interventions alone may be insufficient for rapid therapeutic targeting of SRB

Which may lead us in to the next question arounds supplements that may aid dietary changes.

Supplements For Treating Hydrogen Sulfie SIBO:

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  1. Jennifer Pichette and Jeffrey Gagnon (2016) Implications of Hydrogen Sulfide in Glucose Regulation: How H2S Can Alter Glucose Homeostasis through Metabolic Hormones
  2. Tomasova et al., (2016) Gut Bacteria and Hydrogen Sulfide: The New Old Players in Circulatory System Homeostasis
  3. Teigan et al., (2019) Dietary Factors in Sulfur Metabolism and Pathogenesis of Ulcerative Colitis
  4. Carbinero et al., (2012) Microbial pathways in colonic sulfur metabolism and links with health and disease
  5. Wallace et al., (2018) Hydrogen sulfide: an agent of stability at the microbiome-mucosa interface
  6. Wang R. Physiological implications of H2S: a whiff exploration that blossomed
  7. Fu M, Zhang W, Wu L, et al. Hydrogen sulfide (H2S) metabolism in mitochondria and its regulatory role in energy production
  8. Yao et al., (2018) Modulation of colonic hydrogen sulfide production by diet and mesalazine utilizing a novel gas-profiling technology
  9. Suarez et al., (1998) Bismuth subsalicylate markedly decreases hydrogen sulfide release in the human colon
  10. Webster et al., (2019) Influence of short-term changes in dietary sulfur on the relative abundances of intestinal sulfate-reducing bacteria
  11. Sing & Lin, (2015) Hs2 in Physiology and Diseases of the Digestive Tract.
  12. Linden, (2014) Hydrogen Sulfide Signaling in the Gastrointestinal Tract
  13. Huang et al., (2015) A cardioprotective insight of the cystathionine γ-lyase/hydrogen sulfide pathway
  14. Consumption of a diet rich in Brassica vegetables is associated with a reduced abundance of sulphate-reducing bacteria: A randomised crossover study (click here)
  15. Influence of short-term changes in dietary sulfur on the relative abundances of intestinal sulfate-reducing bacteria: click here
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