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J Clin Endocrinol Metab 89 : 35433553 Huang Y et al

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Treatment typically involves vitamin B12 supplementation, either through oral supplements or injections, depending on the severity of the deficiency and underlying causes.

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Options include: Prescription antibiotics: Rifaximin (for hydrogen SIBO) Rifaximin + Neomycin (for methane SIBO) Herbal antimicrobials: Oregano oil Berberine Neem Garlic extract (allicin) Candibactin-AR and Candibactin-BR (Xymogen) Elemental diet: A liquid diet of pre-digested nutrients that starves bacteria while nourishing the host Recommended Supplements: Berberine: Antibacterial, antifungal, and improves gut barrier function Digestive Enzymes: Help break down food and reduce fermentation Immuno-30: Immunoglobulin G binds toxins and reduces inflammation Phase 2: Repair the Gut Lining After reducing bacterial load, the focus shifts to repairing damage to the gut lining and restoring the mucosal barrier