What Causes Hydrogen Sulfide SIBO?

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In this blog I explore the potential causes of hydrogen sulfide SIBO. You may also like to read:

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‘:

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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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What Causes Hydrogen Sulfide SIBO?

An overgrowth of sulcate-reducing bacteria leads to an excessive production of hydrogen sulfide gas. This might be caused by a low fibre, high animal protein/fat diet. Dr. Nigh also feels that hydrogen sulfide SIBO might be caused by toxicity, contributing to a deficiency of sulfur in the body (a key compound for optimal detoxification). This deficiency it is thought then leads to an adaptive response in the microbiome, via an increase in bacteria that product hydrogen sulfide as this gas can then be converted to sulfur.

The consequences of excess hydrogen sulfide are unfortunate however and include:

Diarrhoea or constipation, chronic fatigue, halitosis (bad breath), abdominal pain, Hives, Hot flashes, Dermatitis, Brain fog, Inflammatory bowel disorders, Hypertension, Atherosclerosis, Heart failure, Diabetes, Cirrhosis, Inflammation, Neurodegenerative disease, Erectile dysfunction, Asthma….to name a few.

Anecdotally ‘rotten egg’ smelling flatulence has been associated with hydrogen sulphide SIBO.

Watch my interview with Dr. Siebecker on SIBO, hydrogen sulfide and prokinetics:

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How Do I Lower Hydrogen Sulfide?

There is no universal answer to this and a personalised approach will be required, taking in to consideration all the different elements of your health history, and lifestyle. However some of the most common condiserations include:

  • Prebiotics such as GOS.
  • Probiotics.
  • A high intake of dietary fibre from a. wide variety of different plants (fruit, vegetables, herbs, spices, legumes, lentils, pulses, beans, nuts, seeds)
  • Fermented foods such as kefir, sauerkraut, kombucha and kimchi
  • Bismuth such as the product Pepto Bismol


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Alex is a certified Functional Medicine Practitioner (IFMCP) and has a MSc in Personalised Nutrition. He is also a breathwork facilitator with a background in personal training and massage therapy. He also runs The Resiliency Program - a 24 week program aimed at building physical, mental, emotional, and spiritual resilience.

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