From SIBO to Restored Gut Health

Where she started

Priya is a foodie. Or she used to be.

One of the things she loved most about her life was the food. She loved exploring new food, cooking, and eating out. "I would just like to have that back," she said during our first appointment. "Just my normal self again, like when I was eating everything and nothing bothered me."

By the time she came to see me, she felt like she was a shell of her normal self.

For close to two years, eating had become something to manage, plan around, and brace for. She had chronic bloating every day, sometimes reaching a 7 out of 10 in terms of discomfort. She was dealing with a list of food sensitivities that kept growing: dairy first, then avocados, chickpeas, eggplant, potatoes. Then garlic. Then black pepper. Every year, more foods became unreliable.

Every time she went out, she was calculating what she could order, whether there was a bathroom nearby, and whether tomorrow would be a bad day.

"Anytime I go outside I have to watch what I'm eating, I have to watch where I'm going. And that has started affecting my mental health."
— Priya

Her fatigue was the other layer. "Most of the times I plan things out and then I'm so tired, I'm not able to do it."

She had an IBS diagnosis, but that explains nothing about what's actually wrong or why. She'd tried dietary eliminations on her own, adjusted her routine, and added supplements, but nothing resolved her issues.

What makes Priya's case harder than most is how it started.

A few years prior to our consultation she had a medical event while visiting family abroad: emergency surgery for appendicitis and an ovarian cyst. To make matters worse, it happened just 15 days before she had to fly back to start a full semester alone at college. They loaded her with antibiotics to make sure she healed fast enough to travel. She had no post-surgical care, no probiotics, and nothing to help her gut recover from what had just happened to it.

"When I came back, I absolutely couldn't eat dairy at all," she said. "I had no post-surgery care, nothing. So probably that affected, I don't know."

She knew, but nobody had confirmed it. Not in two years.

What was actually going on

When I ran the full workup, what we found was a chain reaction that traced directly back to that surgery years prior.

The surgery itself disrupted her gut and the aggressive antibiotics did lasting damage.

Nobody gave her anything to help restore what had been wiped out. And over the years that followed, the stress of daily life kept her immune system elevated and her gut dysfunctional.

Here's what we tested and what it showed:

• SIBO breath test: strongly positive for hydrogen SIBO. The bloating, the alternating constipation and diarrhea, and the expanding food sensitivities were largely due to small intestinal bacterial overgrowth. Simply put, she had bacteria in the wrong place, producing gas, disrupting digestion, and creating inflammation.
• Genova stool analysis: dysbiosis confirmed, secretory IgA elevated. Her immune system had been chronically activated by the bacterial imbalance and food reactivity for years.
• MRT food sensitivity panel: dozens of reactive foods — wheat, dairy, soy, garlic, black pepper, cumin, corn, most beans. For someone who grew up cooking South Asian food, where garlic, cumin, and black pepper are the base of almost everything, this was extremely problematic.
• Ferritin: 3. Critically low. Hemoglobin 11.5. The fatigue she'd been living with was due in large part to her body running on near-empty iron stores.
• Thyroid peroxidase antibodies elevated at 46, consistent with early Hashimoto's thyroiditis — a condition with deep connections to gut health and immune dysregulation.

"I've been waiting for a diagnosis for two years," she said when we reviewed the SIBO results.

After two years of confusion, doctors overlooking the signals, and slapping on the IBS label, she now confirmed the root cause in a day.

These findings weren't unrelated. The surgery, the antibiotics, the dysbiosis, the food sensitivities, the leaky gut, and the Hashimoto's antibodies was all one connected story.

For the first time, she had the whole picture.

The gut healing plan we implemented

We approached her treatment in layers, because you can't fix everything at once, and trying to is a recipe for two good weeks followed by a slow slide back to where you started.

The first priority was treating the SIBO.

Startign with two weeks of Rifaximin, which is a gut-specific antibiotic she had actually brought from India, prescribed proactively by a GI doctor there who told her to use it if she tested positive in the US.

We followed that with a month of oregano oil to continue clearing the overgrowth and break down any bacterial biofilm.

At the same time, we started the MRT elimination diet. For the first two months, she ate only from the low-reactivity foods on her results. No garlic. No black pepper. No wheat. No dairy. No soy. Limited beans. For a self-described foodie from a cooking tradition built on those exact ingredients, this was genuinely hard. But she did it through home-cooked meals, sushi without soy sauce, cashew milk, mung beans instead of the lentils that caused problems. She only cheated twice in six weeks.

To prevent SIBO from coming back, we added a natural motility activator — artichoke and ginger — to keep the intestines sweeping between meals the way they're designed to.

She researched the migrating motor complex on her own and started keeping a six-hour gap between meals. She added daily ileocecal valve massage and scar tissue work around her surgical site.

For the fatigue, we addressed the iron deficiency directly — chelated iron with vitamin C, beef liver capsules, and more red meat and fish worked into her regular meals. Selenium and zinc for the Hashimoto's. Magnesium threonate at night to support sleep, anxiety, and motility all at once.

She also found an acupuncturist on her own who specializes in gut and nervous system work. She'd been dealing with constant tinnitus, a ringing that had started after a severe illness abroad and was disrupting her sleep and her peace of mind. Within five or six sessions, it was completely gone.

This is what it looks like when a patient really commits.

She came to every appointment with research, theories, and well thought out questions. She tracked her bloating scores, her Bristol stool types, her water intake, and her deep sleep minutes.

She did the work. That made everything easier to build on.

The big shift for Priya

By the third visit, the difference was significant.

Her bloating had dropped from a daily 5–7 out of 10 to 2–5, with some days completely bloat-free for the first time in years.

Her Bowel movements had normalized and she was hitting Bristol type 4, which is ideal.

But what struck me most with Priya was the sleep.

After starting magnesium threonate, her deep sleep had gone from 25–36 minutes per night to 45–60 minutes.

She woke up calmer, and that led to a significant drop in her anxiety.

"After starting to take magnesium L-threonate, I have seen a lot of difference in my mood. I'm really positive, calm, and my anxiety has reduced a lot."
— Priya, Visit 3

She was eating real meals again and eating three times a day, feeling actual hunger.

She was exercising daily. And when she ate plain grilled chicken, she felt good. Happy, even.

"Whenever I do chicken, I feel really good. Like I feel happy." That's what it looks like when a body starved of iron and amino acids finally starts getting what it needs.

The tinnitus she'd been managing for months was now gone. "For me, it's 100% gone. I did like five, six sessions and it's gone."