Herbal antimicrobials for SIBO
Herbal antimicrobials for SIBO
Medically reviewed by:
Dr John Freeman
A natural and effective treatment option for SIBO
One of the major advantages in treating Small Intestinal Bacterial Overgrowth (SIBO) is that there are two clinically supported treatment pathways, antibiotics
and herbal antimicrobials.
If you prefer to take the natural route, herbal antimicrobials have been found to be equally effective as antibiotics at treating the small intestine bacterial overgrowth. Physicians at Johns Hopkins and the University of Pittsburgh showed that SIBO treatment using herbal antimicrobial supplements was as effective as the most studied and effective treatment method by mainstream medicine.[1] Herbal medicines have the added benefit of treating other dysbiosis issues, such as fungal overgrowth, parasites, and overgrowth of bacteria in the large intestine. So they might be better for some individuals.
The literature concluded that patients with SIBO can choose antibiotic or herbal therapy depending on their preferences, with similar response rates and safety profiles. In addition, patients who are refractory to antibiotics can receive herbal therapy as a potential rescue therapy with equivalent results to triple antibiotics. The decision is left at the treating physician’s discretion and the patient depending on the clinical setting and the patient’s preference.[2]
Potential challenges when choosing herbal antimicrobials
While pharmaceutical antibiotics are highly regulated and consistent, herbal supplements vary dramatically in quality, purity, potency, and bioavailability.
Here are the key concerns patients should be aware of:
1. Inconsistent Regulation
In the USA, UK and Australia, supplement regulations are significantly less strict than pharmaceutical standards. This means many products reach the market without adequate:
Ingredient verification
Clinical testing
Stability testing
Contaminant screening
Bioavailability analysis
As long as a supplement is not directly harmful, it can be legally sold—even if it provides no therapeutic benefit.
2. Variable Bioavailability
A supplement label may claim “100% of ingredient X,” but that does not guarantee that the body can absorb or utilise it.
Some formulas deliver 0% practical bioavailability, making them essentially ineffective.
3. Lack of Medical Oversight
Most supplement brands do not involve:
Medical doctors
Clinical microbiologists
Gastroenterology specialists
Pharmacologists
This leads to products that are poorly formulated or unsuitable for specific conditions like SIBO.
4. Risk of Worsening Symptoms
Some supplements can actually exacerbate SIBO, especially if taken at the wrong time. For example:
Probiotics can worsen symptoms in untreated SIBO by adding more bacteria to an already overpopulated environment.
Certain herbs may irritate the gut lining or worsen motility issues if improperly combined.
This is why clinical guidance matters.
Why Professional-Grade Formulations Matter
For SIBO, the effectiveness of herbal therapy depends heavily on:
Correct antimicrobial combinations
Correct dosing
Correct timing
Treatment length
Proper identification of the dominant gas type (hydrogen, methane, hydrogen sulfide)
We strongly recommend using clinically validated protocols developed by medical professionals and supported by published research, rather than generic store-bought supplements.
Using the wrong herbal protocol can:
Fail to treat the overgrowth
Disturb the gut microbiome
Prolong symptoms
Increase the risk of relapse
When treating SIBO, precision matters.
Chedid et al. “Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.” Global Advances in Health and Medicine. 2014.
Rezaie et al. “ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth.” American Journal of Gastroenterology. 2017.
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