Leaky Gut, SIBO, Candida, or a combination?

Commented on October 16, 2015
Created September 16, 2015 at 6:36 PM

I'll try to make this concise..
In college I had a bout with "rosacea". I dealt with it for a while, finally saw a derm. Went on Doxycycline for 6+months, and then Tetracycline for close to a year. Used Tetracycline a while longer for short duration when i'd see flare-ups.

Fast forward ~7 years after last use of Tetracycline and I'm having some troublesome food sensitivities and reactions. Technically I had them all along but have only really paid attention to them for a few years. I started eating Primal ~ 5 years ago. Initially, when I did a lot of stewing and experimented with low carb, no alcohol, no dairy, my skin cleared up, I got lean. Since adding in heavy lifting a few years back, I've added in potatoes, rice, some random dairy(mostly cheese occasionally). I've had alcohol sporadically, for a period it was fairly often, but I didn't see reactivity to it.

Now I'm in full blown panic mode. The rosacea has reduced itself to spots that are isolated to my nose and ear lobes. When I have alcohol, pustules form in these spots, typically starting as deep, under the skin swelling. I also have the same happening on the top of my scalp. It's been diagnosed as folliculitus, and given how it occurs, I think that's what's happening on my face also, but the scalp is the worrisome one. I've got pustules and scabs up there, and my hair is not happy. It's thinned quite a bit in the last year.

I approached a naturopath and we went forward trying to treat it as a Candida problem. Stool test came back completely negative for yeast, and the bacteria panel said I had no overgrowths(though the results are isolated to the Large Intestine) and my food sensitivity panel came back as only being sensitive to Peanut Butter. I did have low levels of Bifidobacterium and Lactobacillus bacteria, otherwise the naturopath said it looked fairly normal.

I started a course of antimicrobials(Candibactin BR & AR, and Neem) and took them for a month while being very low carb/low Fodmaps. No true improvement until I go super strict on fodmaps and basically eat meat, fat and spinach. This is difficult to sustain from an energy level perspective. Well, the super strict diet let me see a clear scalp for 3 days, before I tried a little cheese(like a bite) and a little sushi rice. Now I've got 1-2 spots on my scalp.

Through all this my digestion was never amazing. BMs have always been soft, and semi-loose, but not really close to full on diarrhea. I get gas, GI pressure, but no heartburn or pains, just pressure and discomfort. I'm about to take a SIBO breath test, but I'm thinking now this is all indicative of a leaky gut. I'd love to know it's reversible and that I can grow my hair back(no family history of hairloss on either side), and I'd love to have normal digestion again. What's crazy is that I've gotten the strongest I've ever been in spite of these issues. I'm not excessively muscular, but 5'8'', 160lbs, 8-9% bodyfat.

I've done the HCL test, with Betaine HCL+Pepsin pills and I was able to take up to 7 with no burning or pain, but I did notice my gut felt "off" after, and I might experience some gas/gurgling in the GI tract, so I've backed off on those.

I think the antifungals/microbials may have been harsh on my intestines, and while possibly ridding me of bad bugs, may have caused my system to be even more sensitive. Possible? Does this sound like a leaky gut? Diet alone has never helped, so I'm looking at taking a Prokinetic(Ginger root extract), and a few amino acid supplements, NAG, NAC and L-Glutamine while also taking a probiotic.

Edit: I should say I'm currently taking these supplements-
Omega 3's(2g EPA/day, starting a few days a back, prior to that was a lower dosage)(Carlson Labs)
Multivitamin with CoQ10, lots of bio-available forms of nutrients(Pure Encapsulations O.N.E.)+Biotin
Digestive Enzyme(Now Foods, only started yesterday)
25billion Probiotic(HLC Intensive, would do kimchi, but if SIBO it's not advisable)
Starting NAG, NAC, L-Glutamine, Ginger Root when it all gets here.



on October 06, 2015
at 12:17 PM

So, I recieved the results from my leaky gut test.


Lactulose %Recovery - 0.61
Mannitol %Recovery - 12

Lactulose/Mannitol Ratio - 0.05

Summary says that I have normal gut permeability.  But I'm still getting red eyes, styes, headaches, rosacea, and folliculitis.  Digestion is ok.  I suppose SIBO is still a possibility and I took the breath test yesterday, waiting on results now.

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2 Answers

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on October 06, 2015
at 06:46 PM

Even though your antibiotic use was years ago, there is a strong likelyhood of dysbiosis. Anytime there are skin issues, regardless of where they come from, in both Easten medicine & Functional medicine we look towards the gut. 

Mind you this is a very very basic template of how I would approach this clinically, please consult w/ your doctor.

Step 1. Remove any food sensitivies 

Step 2. Re-populate gut w/ good bacteria & organisms 

Step 3. Address any nutrient deficieces you migth have. When there are any type of skin issues - I always look at: fatty acid metabolism, vitamin's A, C, E, K2, B5, B12. 

Step 4. I always add in a liberal amount of turmeric/curicumin to address any inflammation that is lingering. 




on October 06, 2015
at 07:55 PM

Thank you for the reply, I appreciate any suggestions I can get!


1-So, I have been doing just that.  I removed alcohol, removed grains(been wheat free for years, but ate oats up until April), removed nightshades, removed simple carbohydrates, removed fruits, removed most vegetables that ferment.  I still seem to react to even a bite of sauerkraut, or a few berries.  Granted, the only thing my blood panel showed immune response to, was peanuts.  So all of these sensitivities must be caused by something else, no?

2- I've been on a probiotic for as long as my naturopath has suggested I be on one.  


3- As far as nutrient deficiencies, is there a specific test for that? I've been supplementing with fish oil, and a very good multivitamin that contains all the vitamins you list for quite some time now(months).

4- I've recently started taking curcumin(2-3 weeks ago, 400mg of longvida curcumin).  In the last week, the most offensive "cheat" i've had was a spoonful of mashed sweet potato with cinnamon. Otherwise my food journal shows the only non-meat things I've had as a bite of an unsweetened dried pineapple, spoonfuls of sauerkraut, and some cabbage. Still, I'm more inflammed in my face than I've been in a while, and I react to more foods now than I ever did.  I don't know if the curcumin is helping, or if it's telling me I have a sulfur/thiol sensitivity. I suppose I could just add a lot of turmeric to things and see if my inflammation comes down at all?





on October 16, 2015
at 07:27 AM

You can investigate leaky gut. I tried antifungal and antibacterial with little effects too, I started making progress when I introduced foods for gut health like zinc supplement, chicken broth. Some antinflammatory herbals helped a lot too in my case : Curcuma, marshmallow, licorice root. You can also try activated charcoal and clay. Best of luck !



on October 16, 2015
at 12:04 PM

I took the leaky gut test, and I am just outside the nominal range, so both the test results and my naturopath think it isn't leaky gut.  I did test positive for Methane producing SIBO.  Not a strong result, but my baseline showed Methane, which implies an overgrowth.

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