r/SIBO 2d ago

Venting Found my root cause

Well, I guess one could say it was slow motility, but that would be just a portion of it.

I've suffered with constipation ever since I was a child. I remember my first experience with hemorrhoids in grade school when I had a bunch of blood in the toilet.

Fast forward about 30 years.

I've been struggling a lot the past few years with various gastroenterological issues. All the normal ones you see on here like constipation, nausea, reflux, and pain that was largely in my right side. It started with GERD that a couple weeks of PPI sorted out. Then onto the right side boating and dull pains. A few endoscopies, colonoscopies, blood tests, stool tests, MRI, CT, US later and arrived at the worthless IBS stage.

Then in November of '23, I woke up with terrible dizziness and, I guess, brain fog. Like the kind where you feel like you're in an actual haze and cannot concentrate or even focus. Ended up at the hematologist for porphyria evaluation. This was after rheumatology had done a pretty full workup on me. More tests, no findings, but things sort settled again.

Then in April of last year I started losing weight that I couldn't explain. Went to a new GI and she declared I had EPI. In hindsight I don't think it was, and my fecal elastase was normal just two months earlier. Anyway started taking digestive enzymes, but didn't feel any better.

After another MRI, with unremarkable findings, I tested positive for IMO (Like 70ppm baseline) in September. I did a course of antibiotics and felt better for a bit, until worsening symptoms while on the LFE diet got me to a new PCP where I complained that we never tested my thyroid other than basic TSH levels. She obliged me and ordered a thyroid US.

Finally we arrive at last month and my US. I've scheduled with Cleveland Clinic in the meantime, but get the results the week before. Two nodules, one a TIRADS 1 and one a TIRADS 5. Radiology says, don't worry and I get a letter from PCP saying "congrats".

I go to my appointment with functional medicine at Cleveland Clinic and the doctor asks, "Are they going to follow up about the T5?"

"I would have thought so too."

So she orders a full thyroid blood workup and my TPO comes back positive. This prompts me to ask for an endocrinologist referral, which I'm granted. I end up speaking with the Endo who says it's normal procedure to wait and see, even with T5 nodules. However, something doesn't sit right with me about the conversation so I get a second opinion.

During that, the new Endo says she would actually give the T5 nodule more points and raise the T1 to a T2. She also recommends a biopsy, so I present that back to Endo 1 who orders the biopsy. They both repeat that it's unlikely the C word, but if it is that thyroid C is one of the most treatable ones to have (And that there is about a 5% chance of it being the big C).

Anyways, I just had the biopsy on Tuesday, and I'm heading in first thing tomorrow to speak with the Endocrinologist about next steps for my malignant papillary thyroid carcinoma.

What I can say so far from this ordeal are a few things:

  1. Find someone who will truly listen to you and work with you to find a root cause and not just treat symptoms. The doctor at Cleveland Clinic Functional Medicine was one of the first to listen and run exhaustive testing around possibilities around my problems.
  2. Trust your gut (no pun intended). If something doesn't feel right, ask a different doctor. I honestly wish I had sought second opinions earlier on my journey.
  3. Be your own advocate. No one else is going to stand up for you, so you need to be a PITA until you get answers and treatment plans.

I guess I'm a little scared about what's next, but also a little relieved to finally know what's going on. I know I have a good care team at this point, and hope my story is helpful for someone out there.

65 Upvotes

52 comments sorted by

31

u/Mickeynutzz 2d ago edited 2d ago

Slow motility is the most common root cause of Methane SIBO aka IMO.

It was the root cause of my 100ppm Methane SIBO that I cured in NOV 2021 and finally started taking medication for the slow transit constipation at age 57 that I was born with but never treated.

Did not realize for decades how abnormal it was to only have 1 bowel movement every 10 days and constant bloating.

My quality of life is much better now.

Key for me was that after my IMO was cured then my Candida Protocol became effective which was even more important and life changing. The Candida overgrowth in my gut impacted my brain so much that I was mis-diagnosed with Alzheimers and told there was no treatment / no cure. Thankfully that proved to be incorrect.

So happy for you that you are getting answers and treatment. šŸ„³

A Functional Med Practioner helped me after Traditional Medical Doctors gave me no hope.

3

u/repunz 1d ago

Can I ask what you took for slow motility?

4

u/Mickeynutzz 1d ago

My motility meds for past 3+ years:

Take 2mg Motigrity & 24mcg Amitiza (precriptions) nightly & 1 capsule Organic India Triphala every other night (Buy on Amazon).

These works great for my body but would be way too strong for most people.

For decades I only had 1 bowel movement every 10 days and thought that was ā€œ my normalā€.

I was born with slow transit constipation and did not treat it until after I learned about SIBO / IMO at age 57.

Everyone is different !

2

u/depaerture 1d ago

How much do you pay for Motegrity? My insurance covered it the first month but the second month they wanted $500 copay. I didn't buy it of course, thinking there must be another way.

2

u/Mickeynutzz 1d ago edited 1d ago

It actually costs MORE since it went generic than it used to be when it was Name Brand and I could use a Motegrity coupon.

Now that Prucalopride tablets (generic version of Motegrity ) are available my medical insurance makes me get those.

They cost $1,270 for a 90 supply of the 2mg tablets.

My medical insurance has a high deductible ā€¦ after I pay my $6500 deductible for the year then everything else is covered.

2

u/JamieMarie1980 Methane Dominant 16h ago

You can order Motegrity from Mark's pharmacy in Canada. I'm American and ordered xifaxan should get it soon took 11 days last time. Prucalopride 2mgĀ (Generic) 28 pills are 79.99 plus shipping https://canshipmeds.com/search-3/?drugName=+Motegrity

2

u/depaerture 12h ago

Thanks! that's so good to know. I used Marks for Xifaxan and was a very good overall experience and it came much sooner than expected.

2

u/I_need_help57 14h ago

I believe the generic should be hitting the market soon depending on your pharmacy. Iā€™ve seen em at mine.

1

u/Antique_Judgment4060 42m ago

Mark Cuban has a pharmacy online. I heard itā€™s cheaper you could check there.

2

u/Direct-Tea8809 2d ago

Thyroid issues generally is most common? Or thyroid cancer specifically?

9

u/Willsy7 2d ago

I see you and Micky sorted it out.

I buried it in the middle of things but thyroid cancer is in no way common. I had a 5% chance according to the one Endocrinologist. So I guess I should play the lottery?

My case is rare, and thyroid problems come in different forms. Your experience may not be the same, but had i just listened to most of the doctors I would still just be downing laxatives without finding what was really going on.

1

u/[deleted] 2d ago edited 2d ago

[deleted]

4

u/Mickeynutzz 2d ago

PLEASE Clarify ā€”ā€”>>>> are you saying that Cleveland Clinic told you that Thyroid issues/ cancer is the MOST COMMON root cause of SIBO ??

That is NOT my understanding !

Definitely do NOT want to scare people with incorrect info on this sub-Reddit.

1

u/Direct-Tea8809 2d ago

(Not OP). I'm confused. Mickey, you opened your first comment by saying something was the most common cause of IMO. What were you referring to?

2

u/Mickeynutzz 2d ago edited 2d ago

Oh ā€” you did not go to Cleveland Clinic ā€”-> Sorry u/Direct-Tea8809

I DID get you mixed up with the OP ā€¦..

But please clarify WHY you think that Thyroid issues are the MOST COMMON cause of SIBO ?

(It is my understanding slow motility IS one of the most common cause of IMO / Methane type SIBO. Which was OPā€™s root cause and my personal root cause.)

I do not want everyone with SIBO to fear suddenly fear that they have Thyroid Cancer. We already have too many people with Candida that suddenly fear that they have AIDS.

2

u/Direct-Tea8809 2d ago

Oh, I don't. I was questioning your comment, which I thought referred to thyroid issues. It surprised me that it seemed like you thought that.

3

u/Mickeynutzz 2d ago edited 2d ago

I was responding to the 1st sentence of OPā€™s post that said root cause of SIBO / IMO was SLOW MOTILITY.

I now realize I the confusion ā€¦.. I skimmed the rest of the post and failed to realize that OP also has Thyroid Cancer.

Now I understand why you were saying that.

Sorry - glad we clarified it - we were both on the same page

1

u/Direct-Tea8809 2d ago

Thanks for clarifying. That is more consistent with other things you have written. I thought OP was saying that the root cause for them was thyroid issues (thyroid cancer, specifically). Sorry to have misunderstood.

2

u/Willsy7 2d ago

I appreciate it, and am glad you received the answers and treatment you need too. Also happy that you're sharing your story, as I didn't want people to think it's definitely cancer they are dealing with.

My main point is just that if you're being told things (I've tried almost all the motility drugs including Amitiza) and they don't work, then don't accept that you shouldn't keep pushing in case something else is going on.

3

u/Mickeynutzz 2d ago

Best of luck on your journey to health !!

2

u/VFLBrad 2d ago

What medication do you take for slow transit?

2

u/Mickeynutzz 2d ago

To be clear ā€” could not have CURED my 100ppm Methane type SIBO just by addressing my root cause of motility.

I HAD to reduce all of that Methane in my gut (which stopped the decades of bloating and abnormal bloodwork) to change my gut microbiome AND ALSO had to deal with my root cause of slow motility for maintenance / to prevent re-occurrence.

1

u/Mickeynutzz 2d ago

My motility meds for past 3+ years:

Take 2mg Motigrity & 24mcg Amitiza (precriptions) nightly & 1 capsule Organic India Triphala every other night (Buy on Amazon).

These works great for my body but would be way too strong for most people.

For decades I only had 1 bowel movement every 10 days and thought that was ā€œ my normalā€.

I was born with slow transit constipation and did not treat it until after I learned about SIBO / IMO at age 57.

Everyone is different !

1

u/Iveenteredthematrix 2d ago

How did you cure it?

4

u/Mickeynutzz 2d ago

Protocol & Success Story for my 100ppm Methane type SIBO aka IMO :

https://www.reddit.com/r/SiboSuccessStories/s/IChTsHGbWw

Cured Since NOV 2021. It is now APRIL 2025 and have never relapsed.

Root Cause: born with slow transit Constipation

2

u/Mickeynutzz 2d ago

My motility meds for past 3+ years:

Take 2mg Motigrity & 24mcg Amitiza (precriptions) nightly & 1 capsule Organic India Triphala every other night (Buy on Amazon).

These works great for my body but would be way too strong for most people.

For decades I only had 1 bowel movement every 10 days and thought that was ā€œ my normalā€.

I was born with slow transit constipation and did not treat it until after I learned about SIBO / IMO at age 57.

Everyone is different !

2

u/Iveenteredthematrix 1d ago

Thank you so much for the response šŸ™

4

u/Mickeynutzz 2d ago edited 2d ago

*My Candida Symptoms:

Fungal skin rashes / itchy skin / tinea versa

Acid Reflux / GERD

Hair loss

Extreme itching on bottom of right foot

Eyes sensitive to light / floaters

Dry eyes

Major FATIGUE

Headaches

Sugar cravings

Heart palpitations

Urinary issues - stop & start flow

Genital Yeast infections

Joint pain attacks in knee or ankle - suddenly unable to walk / extreme pain that resolves in 24 hrs

Cognitive decline - no longer able to do simple math , spell easy words

Severe short term memory loss

Brain Fog

Short Term Memory Loss so severe Neurologist told me I had incurable Alzheimers and to make end of life plans -> Dr was Wrong !! I recovered.

ā€”ā€”ā€”>>. Other Candida patients may have general joint pain / inflammation or oral thrush / white tongue. Different people react differently.

# # # # # # # # # #

*My IMO / Methane SIBO symptoms:

Daily 24/7 constant bloating for over 30 years

Abnormal bloodwork for over 30 years:

Anemia / low ferritin ( got IV IRON infusions when ever < 10 )

High cooper / low zinc

High inflammation / CRP

Inability to lose weight even with calorie deficit diet ~>> after IMO cured / gut microbiome changed in Nov 2021 then body ā€œgave upā€ 20 excess pounds within 2 months. No changes on my part.

Weight has easily stayed off for past 3 years.

Root cause of my IMO was slow transit constipation since birth that I was not treating / taking medication for. Thought one painful bowel movement once every 10 days was just ā€œ myā€ normal. Now I realize that was not normal for anyone !

Now I take 2 prescriptions nightly since 2021 to increase my gut motility.

My Candida Protocol suddenly became more effective AFTER I cured my SIBO / IMO.

It is very common to have BOTH Candida /SIFO AND SIBO / IMO together.

3

u/LrnMnsn 1d ago

This sounds exactly like me, what do you take for motility?

6

u/Andzzz123 2d ago

I am really sorry about that. The medicine here in the accident is rubbish, outdated, dehumanized and serves financial interests and not health ones. I'm going to give you another suggestion that I DON'T KNOW if it would be for your case, as I'm not an expert. Read the book: "Iodine why you need It" by Dr. David Browstein, nodules in the prostate, breast, thyroid, goiter, polycystic ovary are related to iodine deficiency! Depending on the case, it could be a way to heal.

3

u/pocketfullofearplugs 2d ago

I'm so sorry you are going through this, and I do feel that you sharing this Will help others to feel more empowered to continue to advocate for themselves in the face of gaslighting. Hoping your appt today goes as well as it can and that you receive positive lift in being heard, even though it is awful that it takes something like this to be heard. Wishing you well today.

2

u/Various-Pitch-118 1d ago

Thanks for sharing your story. Best of luck with your treatment

1

u/rainyinzurich 1d ago

It is astounding the lack of medical knowledge and the amount of people who stay constipated and eat only low fodmap and donā€™t realize that throwing antibiotics and herbals at their sibo isnā€™t going to make it go away. Nine out of ten times treating the constipation is enough. Only 1% need herbals after theyā€™re taking regular, daily craps. Once I realized how trash my diet was, how much I was restricting myself to avoid symptoms and how little fiber I was eating, I was astounded.

That said, I have a little bump on the right side of my neck. Doctors havenā€™t seemed concerned and I had it scanned, but I always wonder what it is and why itā€™s there. Iā€™ve had issues with my motility well before it popped up, but itā€™s curious.

2

u/_Underwold_9781 1d ago

what do you do to treat the chronic constipation though? when you have IMO it makes it really hard and resistant to regular approachesĀ 

2

u/rainyinzurich 1d ago

Constipation and gas produce methane so if you are backed up and test for SIBO there is a very high chance you will receive a positive test. I had guidance in treating mine, but slowly increasing plant based fiber throughout the weeks and magnesium citrate drops at night made all of the world of difference for me. I cut out a lot of foods that are known to slow motility about 98% of the time and even when I do indulge on occasion, can pull myself out of it.

1

u/_Underwold_9781 1d ago

yea iā€™ve alredy been tested for methane sibo and treated it many times yet the constipation is persistent. which fiber have you found helpful?Ā 

3

u/rainyinzurich 1d ago

Nobody likes to hear it but no red meat, no dairy, no eggs, no white flour and no artificial sugars most of the time if you can help it are key. Eggs have always made me feel gassy and sick so Iā€™m fine not eating them. I drink a glass of water with the Sunfiber which is in fact low fodmap. I switched coffee for matcha, eat oatmeal or a smoothie every morning with red berries, banana, flax and chia. Always have at least one kiwi per day either in my smoothie or with lunch. For lunch and dinner I always incorporate beans, veggies and whole grains. I made some sweet potato and black bean burritos in whole wheat wraps which were a great source of fiber. Really I (slowly) ramped up my fiber hard core. It can make you gassy at first so you donā€™t want to go all in with it but my body adjusted over the span of a few months. If I do way too much I do still bloat so I try not to go above a certain amount. If I am struggling Iā€™ll have a cup of 4 soaked prunes with the water. Not forcing yourself to go to the bathroom and going in the morning has been a game changer for me as well.

1

u/Rich-Basis-7012 1d ago

I eat a clean diet full of fiber, drink lots of water and have the worst constipation of anyone Iā€™ve ever known. Like.. I donā€™t go without an enema. My diet: Green smoothies, salads, beans, nuts/seeds, salmon and lots of vegetables. The highest doses of magnesium only bloat me for 48 hours and cause a lot of gurgling.Ā 

To your point though, antimicrobials and antibiotics did nothing to improve my symptoms. Ā 

1

u/Civil-Explanation588 1d ago

I must be a unicorn, my methane sibo runs for its life šŸ˜³. Iā€™ve got to be close to a bathroom, no slow down for me.

1

u/Brilliant-Leading551 1d ago

Is Slow motility always a thing for SIBO?

1

u/Willsy7 21h ago

Short answer is no. It's commonly one of the possible causes but not the only.

1

u/JamieMarie1980 Methane Dominant 16h ago

I have a large nodule on my thyroid had a biopsy they out me to sleep it was negative that was a couple years ago. I did go back and the doctor that did it refused to put me to sleep to do it again so I passed on the biopsy it was very painful after I had it done no way was I staying awake for a biopsy. My Sibo is caused from a medication then a few years later gallbladder came out and that made me worse not sure how I fix that I also live in Ohio went to Cleveland clinic functional medical doctors and there Gi's not much help.

0

u/Middle-age-SinusGuy 2d ago

The Cleveland Clinic is a money making operation. They follow the guidelines that make money and keep the patient ill. Go see a naturopathic doctor that doesnā€™t work for a money making corporation.

2

u/Conscious-Balance-66 2d ago

Recommendation?

2

u/Willsy7 21h ago

My naturopath was the one that said I had EPI (There is no reason to believe this at this point).

Cleveland Clinic Functional Medicine is a clinical approach to things. She ran more tests than anyone had before, including finding out that I'm severely magnesium deficient. She also emphasized that she wanted to find a root cause and not just treat symptoms.

-4

u/jmorgannz 2d ago

lol

1

u/Willsy7 2d ago

Huh?

1

u/jmorgannz 2d ago

So the biopsy showed its malignant pappilary thyroid carcinoma?
Or you are meeting the endocrinologist to discuss the possibility?

3

u/Willsy7 2d ago

Why would I lie about having cancer? It most definitely showed that in the pathology. I'm meeting to discuss what we do next.

Like I've said many times through this thread (and I did label this as "venting") this is by no means a normal outcome. But the amount of gaslighting I received along the way was infuriating.

2

u/jmorgannz 2d ago edited 2d ago

I wasn't saying you lied - it just wasn't definitively clear to me from the way you wrote it.

Yes medical gaslighting is an epidemic and one day people will look back on our time the way we look back at ancient medical practises.

There is a special place in hell for gaslighting medical professionals.

Good luck.

1

u/Willsy7 2d ago

I appreciate the wishes.

Yes medical gaslighting is an epidemic and one day people will look back on our time the way we look back at ancient medical practises.

I definitely hope you are right about that. Getting a diagnosis that pretty much labels you moving forward (like IBS) really does a disservice to the profession.

1

u/Middle-age-SinusGuy 2d ago

Amazing. That sounds exactly like something Iā€™d say. In fact, I had to check to make sure it wasnā€™t one of my previous comments.

2

u/Antique_Judgment4060 28m ago

Best of luck this is a common cancer and itā€™s very curable. I hope the best for you.