If you have been suffering from SIBO, then you are probably feeling a lot of different things. Gas, bloating, abdominal pain, diarrhea and/or constipation are typical SIBO symptoms. But how are your energy levels? You might feel dead on your feet, even if you’re sleeping well at night. And emotionally, you might feel helpless, frustrated, or even lost.
SIBO fatigue is a common and persistent symptom of SIBO and it sure is a drag. In this blog post, we will explain the possible connections between your SIBO and fatigue as well as discuss some tricks and tips to support your recovery.
First off: what is SIBO, exactly?
What is SIBO?
SIBO, or small intestine bacterial overgrowth, is a condition in which bacteria from the large intestine migrate to the small intestine and cause symptoms. These are normal bacteria that are expected to be in your digestive tract, they’re simply too many of them hanging out in the wrong place.
There are many possible causes of SIBO, including having abdominal adhesions (such as scar tissue after abdominal surgery), history of food poisoning or traveler’s diarrhea, which can cause slow motility. SIBO can also be caused by a lack of pancreatic enzymes, bile salts, or stomach acid and more.
SIBO is typically diagnosed with breath testing. For a comprehensive overview of SIBO, click here.
Next up: what does SIBO feel like?
Because your digestion is not working at its peak performance, the symptoms of SIBO can be far and wide. And the longer you have SIBO, the further reaching your symptoms can be.
Common symptoms of SIBO include:
- Bloating, belching, and flatulence (gas)
- Indigestion, constipation, and diarrhea
- Abdominal pain and distension
- Nutrient deficiencies and weight loss
The longer you have SIBO, the more likely you’ll have other symptoms related to malabsorption, including nutrient deficiencies (anemia, for example) and weight loss.
One common SIBO symptom is fatigue. Why is that?
What causes SIBO fatigue?
SIBO can cause fatigue for a number of reasons. Because SIBO itself can be caused by so many different factors, the reason that your SIBO is causing fatigue can vary as well.
Not enough energy
The first reason is that SIBO can cause a chronic energy deficit which means that the amount of energy available for you to use throughout the day has been significantly reduced. When your digestive system is inflamed, it is unable to absorb the nutrients from your food as well.
Even though you might be eating a balanced diet and enough calories, it doesn’t necessarily mean that you’re able to absorb all of the nutrients from your food.
Another cause of not having enough energy is a reduced appetite. Bloating is a common symptom of SIBO; if you feel crummy after eating, or feel full too quickly, it can be difficult to actually eat enough throughout the day.
Diet is an important part of resolving SIBO, but it is not a “cure.” Finding a long-lasting solution to prevent SIBO relapses is key. For more info on diet, visit our full post on the topic: What is the SIBO Diet?
Not eating a balanced diet
This is the number one reason we see for SIBO fatigue. Our clients may be skipping breakfast or eating a light breakfast consisting mostly of carbohydrates. If coffee and a bagel sounds like a complete breakfast to you, think again.
Skipping breakfast can cause SIBO fatigue because you are not fueling your body at a time when it’s primed for food. This can cause a drop in blood sugar and an increase in cortisol, one of your stress hormones. As a result, you can feel hangry, shaky, brain fog, get headaches and have low energy. Further, the stress this puts on the body can make your SIBO symptoms even worse.
And for those eating their typical breakfast consisting of just carbohydrates alone are causing the same situation. The lack of protein and fats in the meal can cause the blood sugar to drop resulting in the same issues with fatigue, low energy, brain fog and more. Further, we see these clients are hungry again within a couple of hours and having increased cravings for carbs because their body is crying out for fuel it didn’t get earlier.
So how do you prevent a drop in blood sugar? We recommend protein at every meal. Not only does this help you to have more stable blood sugars (and therefore more consistent energy), it also provides more of the specific nutrients that are crucial to your energy, such as iron and vitamin B12.
If you tend to be on the carb train for breakfast, or skip breakfast, please give these two articles a skim:
- Why Fat is SO Important on a Gut-Healing Diet for IBS, SIBO & IBD
- How Much Protein Do You Need & When Should You Eat It?
When your gut is inflamed and you have an overgrowth of the small intestine, you are not able to absorb as much of the vitamins and minerals from your food as you usually would. This can lead to deficiencies of key nutrients that your body needs for energy such as iron, and B12 (1). Your doctor can order tests to check for these deficiencies.
With this in mind, it is important to be mindful of your dietary habits to provide yourself with as many nutrient-dense meals as possible. Not only can you boost the vitamins and minerals available for your body to absorb, but you can also help to calm down inflammation in your digestive tract and the rest of the body. Less inflammation allows your digestion to absorb nutrients better.
What foods are rich in iron and B12? High-protein foods! One more reason to enrich the carb-only breakfast with eggs and other high-protein foods. Meat, fish and poultry are also rich in iron and Vitamin B12.
A good night’s sleep is absolutely essential for the best possible digestion. Sleep is our “rest and repair” cycle and this important work is not to be missed. Adults typically need 7-9 hours of sleep each night to feel their best, even if you’ve been able to survive on less.
If you are a night owl or don’t have the best sleep habits, please check out: Is Poor Sleep Causing Your Digestive Symptoms?
Toxins released by SIBO
Did you know that the bacteria that are overgrown in SIBO can release toxins? This can happen all the time but can increase as you begin treating your SIBO with antibiotics or herbal antimicrobials. This is known as SIBO die-off.
As your SIBO resolves, sometimes you can feel worse for a bit as those organisms die off. This is definitely no fun but can be minimized with the right approach. We recommend you review our SIBO Die-off Symptoms Explained (Plus How to Minimize Them) for our best strategies to minimize these symptoms on your road to recovery.
Hypothyroidism is a risk factor for SIBO and one of the symptoms of low thyroid function is fatigue. Be sure to ask your doctor to test your thyroid function by asking for a thyroid panel with your next blood work.
If you have hypothyroidism and you are taking medication such as Armour or Levothyroxine, the inflammation in the small intestine caused by SIBO can interfere with absorption of your medication.
Further, iron, zinc and selenium are essential for normal thyroid function. Deficiencies of these nutrients, which are common with SIBO, can contribute to low thyroid function.
SIBO Fatigue Case Study
Katrina came to us with SIBO and Hashimoto’s disease, which is an autoimmune condition causing low thyroid function. She wasn’t sleeping well and naturally, was experiencing fatigue.
After reviewing her lab work, it turns out she was low in zinc, which is required for normal thyroid function. Her vitamin B12, which is required for physical energy and mental clarity, was less than optimal.
Further, her low carbohydrate diet was not providing enough fuel to meet her energy needs.
After Katrina was treated for SIBO, we worked with her to address her nutrient deficiencies and recommended a more balanced diet to meet her energy needs. In just 3 months, Katrina experienced:
- Improved bloating, gas and resolution of constipation
- Better and more restful sleep
- Increased energy and fewer incidents of brain fog
- Reduction in antibodies associated with Hashimoto’s disease
As you can see, we need to take a multifactorial approach to resolve a multifactorial condition. It’s important to resolve SIBO and address nutrient deficiencies to heal the gut in order to improve thyroid function and reduce autoimmunity.
How can I nurture my SIBO relief?
As much as we wish we could offer you a quick fix, that isn’t possible.
Getting an accurate diagnosis of SIBO and identifying the actual root cause (or root causes) does take time and the support of a knowledgeable healthcare professional.
Healing SIBO may involve antibiotics, dietary changes, herbal antimicrobials, stress management, getting a better night’s sleep, and even exercise. Our bodies are complicated and all of our organ systems are intimately connected. Finding healing and balance in your digestive system can involve optimizing more than just your digestion!
Key Takeaways: SIBO Fatigue
SIBO fatigue can make every day feel like you’re walking through thick mud. Struggling with fatigue is demoralizing: it stinks to not have enough energy just to get through the workday, let alone muster up the energy to be able to do the daily tasks that you usually love on top of that. When was the last time you felt good enough to exercise or whip up a delicious meal? It can seem so defeating!
And while fatigue can seem like a simple symptom, the possible reasons that you’re feeling SIBO fatigue are complicated. If you’re looking for expert, step-by-step guidance to get to the bottom of your SIBO, please check out our Solving SIBO group program.
Sara Kahn, MS, CNS, CDN is a board-certified nutritionist specializing in digestive health conditions like SIBO, IBS, acid reflux and more. She’s the founder of Belly Bliss Nutrition and the Solving SIBO Program.