Have you been diagnosed (or believe you should be) with Small Intestinal Bacterial Overgrowth (SIBO) and are also experiencing constant and persistent fatigue? Have you been wondering if maybe the two are connected? Well I’m hoping this article can breakdown the possible connection between your infection and your fatigue.
First, let’s talk about how your intestines are supposed to work.
What Does a Healthy Gut Look Like?
Your digestive system starts in your mouth and continues through your esophagus, stomach, small intestine and finally your large intestine. Other organs, such as the pancreas, liver, and gallbladder supply enzymes and other materials essential for breaking down and absorbing nutrients so they can be used throughout the body. This is a complex process that we won’t go into detail about here, but we do want to focus on the small intestine (1).
In a healthy system, the small intestine contains a relatively small amount of bacteria compared to the large intestine, or colon (2, 3). This is because the colon is responsible for bacterial fermentation of the remaining dietary fiber, resistant starches (such as grains, seeds, legumes, and unripe bananas) and small proteins that survive earlier digestion. This leads to better water and electrolyte absorption, among other essential functions (4).
On the other hand, the small intestine is the primary site of nutrient breakdown and absorption, which does not require as many types of bacteria (5). In fact, our bodies have several defense mechanisms that prevent bacteria from other parts of the digestive tract from invading the small intestine (2, 6).
SIBO occurs when one or more of these mechanisms fails.
What is SIBO?
SIBO is the presence of a higher than normal amount of bacteria in the small intestine. Simple, right? Wrong…
The symptoms of SIBO are so prevalent in so many conditions that it can be hard to identify SIBO as the cause.
- Constipation, diarrhea or both
- Food sensitivities or intolerances
- Nutrient deficiencies
- Abdominal pain or cramping
- Weight loss
There are also certain risk factors that put you at a higher risk of developing SIBO. These include: (7)
- High levels of stress
- Crohn’s Disease
- Prior bowel/abdominal surgery
- Celiac Disease
- Multiple courses of antibiotics
- Previous bouts of food poisoning
- Narcotic medications
- Long-term use of medications that decrease stomach acid to control heartburn
Finally, there is growing evidence to show the following cognitive symptoms may also be related to your gut infection (8):
- Brain fog
- Chronic Fatigue
If you fall within one or more of these risk factor groups, are experiencing any combination of these symptoms AND haven’t been able to find relief on your own or with your doctor, it’s worth looking into whether you have SIBO.
It’s important to work with an experienced practitioner. This is because they can help you identify which diagnostic test is best suited for you, help you interpret the results and monitor you through a treatment plan.
Now that we’ve broken down how a heathy small intestine works, what SIBO is and the primary symptoms and risk factors, it’s time to talk about the connection between SIBO and fatigue.
What Exactly is the Link Between SIBO and Fatigue?
You may be asking yourself, how is it possible for our gut to have any influence over our energy levels?
One possible connection is Vitamin B12 (9).
B12 is an essential vitamin, meaning we can only get it through our diets. It has several functions in our body, one of which is red blood cell formation. Red blood cells are what carry oxygen throughout our bodies and help provide us with energy. B12 is also only absorbed in one place, which is at the end of the small intestine (9).
Therefore, in a severe enough case of SIBO, over a long enough period of time, it is possible to develop a vitamin B12 deficiency (10). Because B12 is so important in the formation of red blood cells, which transport oxygen, not absorbing enough B12 can result in low energy and fatigue (9).
Another connection is that people with chronic fatigue syndrome (CFS) have been shown to have bacterial imbalances in their gut (8). This likely means that those who suffer from CFS are more likely to suffer from irritable bowel syndrome (IBS). In addition, emerging research is considering CFS to be in the same disease family as IBS (11).
What Can You Do About Your SIBO Fatigue?
We now find ourselves in a “what came first, the chicken or the egg?” situation. Do we treat the SIBO as the root cause of the fatigue or do we treat the chronic fatigue in hopes of clearing up our digestive issues?
I wish I had the magic answer for everyone, but unfortunately that’s not how our bodies work. Most importantly, you should be working with a trusted medical professional, including a doctor and/or a registered dietitian, in order to identify what is at the root of your issues and what the best course of action should be from there.
For instance, here is a quick overview of what to expect with SIBO treatment:
- Prescribed antibiotics or herbal antimicrobials
- Elemental Diet
- Preventing reoccurrence via dietary changes and/or supplementation
In addition, a potentially helpful supplement for alleviating fatigue is:
- Rhodiola rosea
Rhodiola rosea is an ancient herb grown in parts of Europe and Asia and has been scientifically shown to:
- Decrease stress
- Fight fatigue
- Help decrease symptoms of depression
- Improve brain function
- Improve exercise performance
- Help control diabetes
- Possibly have anticancer properties
Are you experiencing gas, bloating, constipation and/or diarrhea AND feeling exhausted all of the time? SIBO fatigue may just be the answer you’ve been looking for. Our bodies are amazing interconnected systems that can do so many things, but unfortunately this also means that if one system isn’t working correctly, the systems around it will be affected as well. The SIBO and CFS connection is a perfect example of this.
All in all, the only way to find relief is to start digging deeper with the help of a trusted healthcare provider or team in order to track down the ROOT cause (or causes) of your symptoms.
- Mahan lK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Care Process. 13th ed. St. Louis, MO: Elsevier Saunders; 2012: 2-3.
- Mahan lK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Care Process. 13th ed. St. Louis, MO: Elsevier Saunders; 2012: 10-13.
- Mahan lK, Escott-Stump S, Raymond JL. Krause’s Food and the Nutrition Care Process. 13th ed. St. Louis, MO: Elsevier Saunders; 2012: 9.
- Gropper SS, Smith JL, Groff JL. Advanced Nutrition and Human Metabolism. 5th ed. Belmont, CA: Wadsworth Cengage Learning; 2009: 358-362.