Mastering SIBO: New Treatments, Testing Options, and Prokinetics with Dr. Allison Siebecker

In this episode, Dr. Eric Osansky welcomes SIBO expert Dr. Allison Siebecker to explore the latest developments in understanding and managing small intestinal bacterial overgrowth (SIBO). Drawing on more than 15 years of experience specializing in SIBO, Dr. Siebecker discusses emerging research involving a delayed-release combination of rifaximin and N-acetylcysteine (NAC), designed to improve antimicrobial access to bacteria in the small intestine. She also reviews a newer herbal antimicrobial formula containing allicin, neem, and pomegranate, including preliminary findings on hydrogen and methane levels. Throughout the conversation, she explains why treatment needs to be individualized and why promising early results don't necessarily translate into the same outcomes for everyone.Dr. Siebecker and Dr. Eric also explore the elemental diet and why it remains an important treatment option for certain difficult SIBO cases, despite the challenges of following it. They discuss the FoodMarble handheld breath-testing device, the differences between lactulose, fructose, and glucose breath tests, and why comprehensive stool testing cannot replace breath testing when evaluating SIBO. The conversation then turns to probiotics, including research suggesting that certain probiotics may improve antimicrobial treatment outcomes, even though some people experience increased bloating or other symptoms. Dr. Siebecker also discusses Saccharomyces boulardii, spore-based probiotics, and the potential role of prokinetics such as prucalopride, ginger and artichoke formulas, Iberogast, and low-dose naltrexone in supporting intestinal motility and reducing recurrence. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky explores how the autoimmune component of Graves’ disease and Hashimoto’s thyroiditis may contribute to bone loss, even when thyroid hormone levels are well controlled. While hyperthyroidism is known to increase bone turnover and the risk of osteoporosis, Dr. Eric explains why thyroid autoimmunity itself deserves attention. He also shares his personal experience of discovering low bone density on a DEXA scan in 2024, years after achieving remission from Graves’ disease, and why he wishes he had evaluated his bone health sooner.Dr. Eric reviews research examining the relationship between elevated thyroid antibodies, chronic inflammation, and bone metabolism. He discusses how TPO antibodies and TSH receptor antibodies may be associated with reduced bone mineral density and increased fracture risk, along with the roles of inflammatory cytokines, regulatory T cells, Th17 cells, and the balance between osteoblasts and osteoclasts. He also explains why the research is not entirely consistent and why an association between thyroid antibodies and bone loss does not necessarily prove that lowering those antibodies will improve bone density. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky welcomes back Dr. Stephanie Gray to discuss her latest book, Your Hormone Blueprint, and her approach to hormone replacement therapy, hormone optimization, and healthy aging. Drawing from her experience in functional medicine and her personal journey through perimenopause, Dr. Stephanie explains why she believes hormone therapy deserves a more individualized approach. She discusses the history of concerns surrounding hormone replacement therapy, the Women’s Health Initiative study, and the importance of understanding the potential benefits and risks of treatment rather than assuming hormones are appropriate for everyone.Dr. Stephanie and Dr. Eric explore the differences between hormone replacement therapy (HRT) and hormone optimization therapy (HOT), along with the role of blood testing and DUTCH testing in evaluating hormone levels and estrogen metabolism. They discuss estrogen, progesterone, testosterone, cortisol, and thyroid hormones, including how stress, nutritional deficiencies, gut health, and lifestyle factors may influence hormone balance. Dr. Stephanie also shares her perspective on breast cancer concerns, bioidentical hormones, and the potential role of nutrients such as NAC, glutathione, resveratrol, and DIM in supporting estrogen metabolism. The conversation also covers hormone changes in men, fertility considerations with testosterone replacement, and why symptoms of perimenopause can overlap with those of Graves’ disease. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky explores T3-predominant Graves’ disease, a less common form of Graves’ disease in which T3 levels are disproportionately elevated compared to T4. While most people with Graves’ disease have elevated levels of both thyroid hormones, some experience persistently high T3 with normal or even low T4. Dr. Eric explains how the thyroid normally produces and converts these hormones, why increased TSH receptor stimulation may contribute to this unusual pattern, and how genetics and thyroid-stimulating antibodies may also play a role.Dr. Eric discusses why T3-predominant Graves’ disease can be particularly challenging to manage with antithyroid medications such as methimazole. In some cases, treatment may lower T4 too much while T3 remains relatively high. He shares an example from his practice involving fluctuating TSH levels and explains how stimulating and blocking TSH receptor antibodies may contribute to changes in thyroid function. He also reviews research suggesting that long-term remission with antithyroid medication alone may be more difficult in people with T3-predominant Graves’ disease, while emphasizing the importance of considering the underlying autoimmune process.In the post-episode chat, Dr. Eric expands on T4-to-T3 conversion, the different types of TSH receptor antibodies, limitations of antibody testing, and whether natural agents such as bugleweed and L-carnitine may have a role. He also explains why a single thyroid panel isn't enough to identify a persistent pattern and why treatment decisions need to be individualized. If you want a clearer, more balanced understanding of T3-predominant Graves’ disease and why T3 and T4 don't always respond to treatment in the same way, you'll get a lot out of this episode.  Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky is joined by urogynecologist and pelvic health expert Dr. Betsy Greenleaf to explore the vaginal microbiome and its connection to gut, hormone, and thyroid health. Dr. Betsy shares how her frustration with repeatedly treating urinary tract and vaginal infections without addressing why they kept returning led her to investigate the microbiome. She also explains how vaginal microbiome testing has evolved from traditional cultures and PCR testing to next-generation sequencing, along with some of the limitations that still exist when interpreting these results.Dr. Betsy breaks down the important role of Lactobacillus, estrogen, and healthy vaginal tissue in maintaining an acidic vaginal environment. She explains why declining estrogen during perimenopause and menopause can change the vaginal microbiome, why vaginal probiotics may not be enough on their own, and how gut dysbiosis may contribute to recurrent vaginal and urinary problems. Dr. Eric and Dr. Betsy also discuss vaginal lasers and other regenerative approaches, gut microbiome testing, recurrent UTIs, the relationship between thyroid hormones and vaginal health, and why thyroid imbalances can disrupt menstrual cycles.The conversation also takes a closer look at low libido and why simply adding testosterone may not address its underlying causes. Dr. Betsy discusses the roles of the brain, stress, sleep, hydration, inflammation, gut health, hormones, and relationship dynamics in sexual desire. If you want a clearer, more balanced understanding of the vaginal microbiome and how it connects with your gut, hormones, thyroid, and overall health, you’ll get a lot out of this episode. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky explores a connection that often gets overlooked: how thyroid imbalances may affect oral health. While previous episodes have examined whether dental issues such as mercury amalgams could influence thyroid health, this conversation looks at the relationship from the other direction. Dr. Eric explains how both hypothyroidism and hyperthyroidism may affect the mouth, including salivary flow, tissue repair, bone metabolism, and periodontal health.He discusses why hypothyroidism may contribute to dry mouth, altered taste, and burning mouth symptoms, while hyperthyroidism may affect bone turnover and the tissues supporting the teeth. He also explores the possible relationship between Graves’ disease, Hashimoto’s, inflammation, and gum disease, while emphasizing that an association does not prove causation. Along the way, Dr. Eric covers the oral microbiome, nutrient deficiencies, thyroid medications, and warning signs that deserve professional attention. In the post-episode chat, he shares his experience with bleeding gums caused by a nickel crown and discusses cavities, vitamin D, fluoride-free toothpaste, and red-light toothbrushes.The takeaway is that thyroid health may be one piece of the oral-health puzzle, but persistent dental symptoms still need to be evaluated on their own merits. If you want a clearer, more balanced understanding of the connection between thyroid imbalances and oral health, you’ll get a lot out of this episode. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky welcomes back naturopathic doctor Dr. Erin Kinney to discuss her new book, The Cortisol Cure, and a different way of thinking about stress and adrenal health. Drawing from her own experience with burnout and years of working with patients struggling with fatigue, hormone imbalances, thyroid issues, and chronic stress, Dr. Erin introduces her Cortisol Bank Account Framework. Instead of viewing all stress as something that needs to be eliminated, she explains how to think about the activities that “spend” cortisol and the restorative practices that help you make deposits back into your account.Dr. Erin and Dr. Eric explore low versus high cortisol, adrenal fatigue and HPA axis dysregulation, and the connections between cortisol, thyroid hormones, sex hormones, blood sugar, sleep, and gut health. They also discuss why exercise can be beneficial while still acting as a stressor, how small relaxation practices can train your nervous system to shift out of fight-or-flight mode, and why adequate sleep may be one of your most important cortisol “deposits.” Dr. Erin also shares her thoughts on intermittent fasting, balanced blood sugar, meditation, adrenal-supportive nutrients and herbs, and why supplements can’t make up for a chronically dysregulated nervous system.In the post-episode chat, Dr. Eric expands on adrenal fatigue, low versus high cortisol, exercise and stress management, meditation apps, sleep, gut motility, and considerations around ashwagandha for those with hyperthyroidism. If you want a clearer, more balanced understanding of cortisol and how your daily habits may influence your energy, thyroid health, hormones, and resilience to stress, you’ll get a lot out of this episode. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky sits down with Dr. Roseann Capanna-Hodge to explore nervous system dysregulation and why it has become increasingly common in both adults and children. Dr. Roseann explains what happens when the nervous system has difficulty shifting from a stress state back into a calm, regulated state, and introduces her “stress cup” analogy for understanding how everyday stressors can accumulate until the nervous system becomes overwhelmed.Dr. Roseann discusses how sleep deprivation, chronic health challenges, financial concerns, relationships, travel, sensory stressors, and even positive excitement can add to the body’s overall stress load. She also explains how living in a sympathetic-dominant state may affect the immune and endocrine systems and why nervous system regulation can be an important piece of the puzzle for people who feel stuck in their healing journey. Most importantly, she shares simple strategies that can be incorporated throughout the day—including diaphragmatic breathing, Tai Chi, somatic techniques, prayer, grounding, and other “micro resets”—and explains why consistency matters more than spending long periods of time on stress-management practices.Dr. Roseann also discusses co-regulation in children, why parents’ nervous systems can influence their children, and how creating more capacity in the nervous system can help both adults and children respond more effectively to stress. In the post-episode chat, Dr. Eric expands on Epstein-Barr virus, thyroid health, Tai Chi, cortisol, insulin, and how frequently to practice nervous system regulation. If you want a clearer, more practical understanding of nervous system dysregulation and how small daily practices may help you become more resilient to stress, you’ll get a lot out of this episode. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky explores mushrooms and thyroid health, with a particular focus on Graves’ disease and Hashimoto’s. One common concern is whether mushrooms “boost” the immune system and therefore should be avoided by people with autoimmune conditions. Dr. Eric explains why it may be more accurate to think of mushrooms as immune modulators and discusses how their polysaccharides, beta-glucans, and other compounds may influence regulatory T cells and Th17 cells involved in autoimmunity.Dr. Eric also looks at the potential benefits of mushrooms for the gut microbiome and compares culinary mushrooms with concentrated medicinal mushroom supplements. He takes a closer look at reishi, cordyceps, lion’s mane, maitake, chaga, shiitake, and turkey tail, including research suggesting cordyceps may have potential benefits for thyroid antibodies. He also discusses what to consider when choosing a mushroom supplement, including extracts versus powders, third-party testing, fruiting bodies versus mycelium, beta-glucans, and precautions for certain individuals.Ultimately, mushrooms shouldn’t be viewed as a treatment for Graves’ disease or Hashimoto’s or as a replacement for identifying triggers, healing the gut, and addressing other underlying factors. However, both culinary and medicinal mushrooms may have a place in a whole-body approach to supporting gut and immune health. Tune in to better understand mushrooms, thyroid autoimmunity, and what that connection really means. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/ 

In this episode, Dr. Eric Osansky sits down with fitness expert Debra Atkinson, founder of Flippin’ 50 and host of Flippin’ 50: The Stronger Way podcast, to discuss how women can stay strong and fit during menopause. Drawing on more than four decades in kinesiology and strength and conditioning, Debra explains why one of the biggest exercise mistakes is simply not moving enough—while women who do exercise can run into the opposite problem of doing too much without allowing adequate recovery.Debra breaks down what an effective midlife exercise routine can look like, beginning with walking as a foundation and adding resistance training and appropriately dosed high-intensity exercise. She and Dr. Eric also explore the relationship between chronic stress, cortisol, blood sugar, and stubborn belly fat; why muscle becomes increasingly important as estrogen declines; and how nutrition—particularly adequate protein—supports strength and recovery. Debra also shares practical advice for progressing with resistance training and explains the potential benefits and limitations of weighted vests, rebounders, and whole-body vibration for supporting fitness and bone health.Throughout the conversation, Debra emphasizes that exercise during menopause doesn’t have to mean spending hours in the gym or pushing yourself to exhaustion. The goal is to find the right amount and type of movement for your body, recover well, and build habits you can sustain for years to come. If you want a clearer, more balanced understanding of how to exercise for strength, metabolism, bone health, and longevity during menopause, you’ll get a lot out of this episode. Free resources for your thyroid healthGet your FREE Thyroid and Immune Health Restoration Action Points Checklist at SaveMyThyroidChecklist.comHigh-Quality Nutritional Supplements For Hyperthyroidism and Hashimoto’ s Have you checked out my new ThyroSave supplement line? These high-quality supplements can benefit those with hyperthyroidism and Hashimoto’s, and you can receive special offers, along with 10% off your first order, by signing up for emails and text messages when you visit ThyroSave.com. Do You Want Help Saving Your Thyroid?Get free access to hundreds of articles and blog posts: https://www.naturalendocrinesolutions.com/articles/all-other-articles Watch Dr. Eric’s YouTube channel: https://www.youtube.com/c/NaturalThyroidDoctor/videos Join Dr. Eric’s Graves’ disease and Hashimoto’s group: https://www.facebook.com/groups/saveyourthyroid Take the Thyroid Saving Score Quiz: https://quiz.savemythyroidquiz.com/sf/237dc308 Read all of Dr. Eric’s published books: http://savemythyroid.com/thyroidbooks Work with Dr. Eric: https://savemythyroid.com/work-with-dr-eric/