SIBO Begone: 5 Easy Ways to Keep Your SIBO From Coming Back
One of the things I always warn every SIBO patient about is the tenacity of SIBO and its cousin SIFO (small intestine fungal overgrowth). If you’re dealing with chronic constipation, diarrhea, gas and bloating, you may have gotten a diagnosis of Irritable Bowel Syndrome or IBS. However, studies are showing that one of the major causes of IBS is Small Intestine Bacterial Overgrowth or SIBO.
SIBO is when there are too many bacteria in the small intestine. Contrary to what you may be thinking, we’re actually talking about the good, friendly bugs that we love – just too darn many of them. This overgrowth of bacteria, and sometimes fungus, can lead to all the symptoms of IBS.
While we have great treatments for SIBO/SIFO, a vital part of holistic SIBO/SIFO care is doing everything we can to keep these overgrowths from coming back. Let’s get into five easy ways to do just that!
The Migrating Motor Complex
Motility is Everything
One of the first things I think about as a cause of SIBO is slow digestive or gastric motility. Gastric motility refers to the movement of food, bacteria and toxins through the GI tract and out of the body as stool. Often, when we have slow motility, there can be problems with the Migrating Motor Complex (MMC). Not supporting the MMC is a major reason that SIBO recurs.
What is the Migrating Motor Complex and Why Does It Matter?
The MMC, more properly known as Migrating Myoelectric Complex, is thusly named for the series of electrical waves in the gut. The MMC is the housekeeping motor of the gut; it sweeps out the stuff we don’t want in there and moves it down to the colon where it can be excreted.
Phases of the Migrating Motor Complex
The MMC is usually divided into four different phases. Each of these phases plays a role that is important for the next phase of the process.
One MMC starts in your stomach and travels through the small intestine. The second MMC starts at the duodenum and moves down to the ileocecal valve in the large intestine, which is at the end of the small intestine where it meets the colon or large intestine. The process plays a critical role in digestion.
This cycle gets started between two meals, as well as during sleep. When you eat the MMC process is interrupted1. If the MMC doesn’t get a chance to do its job, food and bacteria can back up. This leaves you feeling heavy, like your food doesn’t move after you eat it (because it doesn’t). This also sets the stage for bacterial and fungal overgrowths, as the food left in the intestines is perfect food for bacteria (ewww).
Signs of MMC
That rumbling in your tummy when you’re hungry is caused by the MMC – say hello and thank you the next time you hear it! It’s a good thing and it’s helping you out. A lot of folks with SIBO never hear their tummy make noise!
The MMC is different from peristalsis, which starts when you eat, taste or think about food. Fasting is the trigger for the MMC, which occurs in the stomach and small intestine. Dealing with diarrhea? Don’t be scared of stimulating your MMC – the movement stops at the end of the small intestine and doesn’t move into the large intestine
Why is Slow Digestion an Issue?
Without a properly functioning MMC, gastric contents, the stuff we eat may stay in the stomach and small intestine longer than is healthy. This can feel really lousy; you’ll feel a heaviness after eating, too-full feeling even if you only have a small meal. Again, a slowed MMC leads to bacteria and fungus staying in the gut, or GI tract, for too long, leading to bacterial or fungal overgrowth3. Hormone imbalances can be sparked by a slow MMC as spent hormones need to be moved along and pooped out too.
Studies have shown that people with IBS tend to have disruptions to their MMC. Science doesn’t know yet just how these changes happen. Some theories point to food poisoning or other bacterial infections leading to changes in the gut microbiome2, which then messes with how the flora signal the MMC to start and stop. Eating inflammatory foods or foods you’re sensitive or allergic to can cause nerve damage in the gut. Subsequently, these nerves then can’t signal the MMC properly.
Triggers for a Slowed MMC
Stress, trauma and elevated cortisol can also do a number on the MMC. Finally, the old story that we need to eat every hour or two to “regulate our metabolism” can keep the MMC from moving things along.
Regardless of why your MMC isn’t working appropriately, getting it back on track is vital for beating SIBO, IBS, depression, anxiety and other mental and physical health concerns
How to Support a Healthy Migrating Motor Complex
1. Reduce Your Stress Levels
Studies show that stress messes with digestion. Stress can slow digestion down leading to constipation and a slowed MMC. Stress can also speed digestion up, like when you have the jitters before a big conversation. You may get looser stools, which doesn’t mean you’re having a full MMC sweep-out of the small intestine. This can also mean less absorption of nutrients from your food.
Psychological stress may also impair the function of the Migrating Motor Complex and can lead to a higher risk of complications like bacterial overgrowth3.
How to Combat Stress
Meditation and other relaxation techniques such as deep breathing or yoga are really helpful for supporting gut health and MMC function. These ancient techniques can help in reducing the amount of cortisol circulating in the body and may improve MMC function.
Our adrenals produce a stress hormone called Cortisol. While normal levels are vital for survival (like not getting hit by a car,) too much cortisol can thin the gut lining leading to more leaky gut and more digestive troubles.
2. Most Grown Ups Shouldn’t Snack
Remember that the MMC cycle is activated by having an empty stomach and naturally occurs every 90-120 minutes. It then takes about 1 hour 45 minutes for the MMC to go through all 4 its phases. This process is interrupted as soon as you eat something.
To give your MMC the best chance to do its housekeeping job, it’s optimal to wait a minimum of at least 3 hours 45 minutes between meals – that means no snacking between cleanings!
To be safe, I give my digestion 5 hours between eating. This means no snacks, coffee with creamer or sugar – just herbal teas and water.
Note that babies and children need to eat much more often because they’re growing, so this advice applies only to grownups who are not pregnant. If you’re pregnant, eat what you need to, and think about the MMC later. Folks with diabetes may also need to eat more often as they work to balance their blood sugar.
Hungry Between Meals?
If you feel the rumble and want to munch between meals, work backwards. Instead of snacking, make each meal really count! Make sure you’re getting enough fat, protein and a healthy vegetable carbohydrate and fiber-containing vegetables at each meal. Just having grains (like toast or oatmeal) will leave you hungry throughout the day and much more likely to reach for a snack. Fiber and fat keep you feeling full, so make sure to enjoy them with every meal.
Incorporate these into your meals to keep you full:
- avocado and some eggs on your morning toast (if you’re eating grains)
- a smoothie with protein powder, nuts, and whole fat coconut milk instead of just fruit
- sweet potato and a big salad with lots of yummy extra virgin olive oil or coconut oil with your steak or chicken
3. Overnight Fast (don’t panic! this isn’t scary)
A 12-hour (minimum) fast overnight allows the digestive system to take a break from constantly having to digest and process food. This gives the MMC a chance to work more effectively without being interrupted constantly.
Start with finishing eating at 7 pm or 8 pm and don’t eat while you’re asleep (chocking hazard and whatnot). Wait to break your fast until 7 or 8 am the next morning. 12 hours! Boom.
Other Benefits to Fasting
Overnight fasting can also help you connect in with your hunger better. Are you eating later at night because you’re actually hungry or is it a habit that may not be great for your health longterm?
Fasting has also been associated with several useful health benefits, ranging from improvements in heart health to improved metabolic balance (keeping diabetes at bay) and reducing cancer recurrence, which is pretty amazing.
4. Vagus Nerve Support
The Vagus nerve is the longest nerve of the cranial nerves and runs from the brain throughout your body. In addition to having an effect on organs like the lungs, heart, liver, gallbladder, and even the pancreas, this nerve is also known to affect the MMC’s functionality. I’ve noticed in the last decade that my patients who put the effort in the support their Vagus nerve are often those who are most likely to beat SIBO and IBS and to not having it come rearing back.
Viva la Vagus
There are many simple, free and easy ways to activate and support the Vagus nerve. While you may or may not inherently feel changes from supporting your Vagus, your cells and nerves will totally feel the difference.
Deep breathing, meditation, yoga, probiotic supplements are just a few options to consider4 for nerve support.
Learn more about simple things you can do for free, at home to support your Vagus nerve here.
5. Supplements^
There are many supplements and herbals that may assist in supporting the MMC. These are called prokinetics, and there are drugs that do a similar thing.
I recommend that my patients start these as soon as they’ve completed SIBO treatment and should be completed for a minimum of 6 months after treatment. Remember to speak with your own licensed healthcare provider before starting any supplements or other treatment plan!
Some good options options include:
- Medicinal bitters: herbs that stimulate the bile system and start digestion. Typical dosing: 30 drops of Swedish Bitters or similar before bed.
- Artichoke (Cynara cardunculus) 6-11: stimulates flow through the liver/gallbladder and digestion. Typical dosing: 1 dropperful of tincture before meals and with dinner or right before bed.
- Acetyl-l-carnitine: Supports a healthy neurotransmitter balance and motility nerve signaling, and healthy levels of acetycholine. Typical dosing: 500 mg before bed
- Ginger (Zingiber officinale)6-11: modulates serotonin signaling, supports gastric emptying, motility in the good, and is soothing to the upper GI system. Can be used as a tea, 1-2 tsp powder in your smoothies or in a motility blend. Best when taken with lunch and dinner.
- 5-HTP: stimulates neurons in the gut and is converted to serotonin, which helps with gut motility. Typical dosing: 50 mg with lunch and dinner*
*NOTE: please do not use 5HTP if you are on antidepressant (SRRI) drugs. This can be very dangerous. Also note that prolonged use of 5HTP (beyond 6 months) needs to be balanced with the amino-acid L-tyrosine the next morning.
The MMC plays a vital role in ensuring undigested foods and other substances, including bacteria, can be moved through the gastrointestinal tract and out of the body, where they belong. This helps to keep toxins and bugs from hanging out in the gut too long, which can lead to serious symptoms, like bloating, gas, constipation, diarrhea, IBS and SIBO.
Ready to finally beat your SIBO once and for all? Make sure you’re taking good care of your Migrating Motor Complex!
References
1. E. Deloose, P. Janssen, I. Depoortere, J. Tack. The migrating motor complex: control mechanisms and their role in health and disease. Natures Reviews: Gastroenterology & Hepatology. 27 Mar 2012. https://www.ncbi.nlm.nih.gov/pubmed/22450306
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3093005/#B68
3.T. Takahashi. Mechanism of Interdigestive Migrating Motor Complex. Journal of Neurogastroenterol Motility. Jul 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3400812/
4 .T. Takahashi. Interdigestive migrating motor complex – its mechanism and clinical importance. Journal of Smooth Muscle Research. 21 Mar 2014. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5137267/
5. V. Albina. Hack Your Vagus Nerve to Feel Better: 14 Easy Ways. Victoria Albina – Functional Medicine & Life Coach. 5 Jul 2018. https://beatrizalbina.com/2018/07/vagusnerve/
6. Giacosa A, Guido D, Grassi M, et al. Effects of Ginger (Zingiber officinalis) and Artichoke (Cynara cardunculus) Extract Supplementation on Functional Dyspepsia: A Randomised, Double-Blind, and Placebo-Controlled Clinical Trial. Evid Based Complement Alternat Med. 2015;2015:915087.
7. Micklefield GH, Redeker Y, Meister V, et al. Effects of ginger on gastroduodenal motility. Int J Clin Pharmacol Ther. 1999 Jul;37(7):341-6.
8. Holtmann G, Adam B, Haag S, et al. The effect of artichoke leaf extract in the treatent of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial. Aliment Pharmacol Ther. 2003 Dec;18(11- 12):1099-105.
9. Lazzini S, Polinelli W, Riva A, Morazzoni P, Bombardelli E. The effect of ginger (Zingiber officinalis) and Artichoke (Cynara cardunculus) extract supplementation on gastric motility: a pilot randomized study in healthy volunteers. Eur Rev Med Pharmacol Sci. 2016;20(1):146-9.
10. Ghayur MN, Gilani AH. Pharmacological basis for the medicinal use of ginger in gastrointestinal disorders. Dig Dis Sci. 2005 Oct;50(10):1889-97.
11. Kirchhoff R, Beckers C, Kirchhoff GM, et al. Increase in choleresis by means of artichoke extract. Phytomedicine. 1994 Sep;1(2):107-15.
^ These statements have not been evaluated by the Food & Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.
Hi Ms Victoria I am a 56 year old Pediatric Anaesthesiologist from India. I am one of those SIBO victims suffering for the past 4 years. What I have observed is that sweets, honey and sugar are the worst offenders that keep SIBO alive. SIBO gives one the feeling that all the doors to healing are closed and there is no hope left. You are doing a great job by creating awareness and offering solutions to sufferers like me. Please keep continuing this great service of yours for the benefit of people like me. I pray for you and your family. Thank you so much.
Thank you so much doctor! I could not agree more that sugars can be a big culprit in keeping a SIBO/SIFO overgrowth well fed and happy – and folks with these overgrowths suffering. Thank you for your kind words! All the best to you and yours 🙂
The MMJ function is so critical to healing SIBO, and this is great insight. Thank you for sharing!
Thanks so much Kathleen! Attending to the Migrating Motor Complex is the part of SIBO treatment that is so often forgotten. xo!
Hi Victoria, great article!
I was wondering what your thoughts were about whether supplements/meds interrupt the MMC? I almost always get a 12 hour overnight fast and I also space my meals 4-5 hours apart. Sometimes I do an even longer fast up to 16 hours. However, I do take a magnesium supplement and a prokinetic right before bed about 4 hours after I have eaten. I also take my thyroid medication first thing in the morning. Is this interrupting the MMC? Is it interrupting my fast? Also often times antimicrobials need to be taken on an empty stomach between meals. I’m also wondering if that is interrupting my MMC? . I can never seem to get a very good answer on this. What are your thoughts?
Hi Amber! Alas, it appears that these things Do in fact interrupt the MMC. LE SIGH. From a harm reduction perspective, I choose to take my supplements even if it means a small disruption of the 12-hour MMC fast. For me it’s worth it to get what I need and to do my best to get as close to 12 hours fasted as possible. Hope that’s helpful and thanks for writing in!!
Dear Victoria
Do elemental shakes like Vivonex etc also stop the Migrating Motor Complex like solid meals? Or because it’s a predigested liquid meal it not interfere with the MMC?
Hi Michael,
Thanks for writing in! I don’t know the Vivonex product, but I do recommend the elemental diet when needed for SIBO treatment.
From what I know, the Elemental Diet would still have an effect on the MMC, and a full 12-hour fast is optimal meaning one might want to have their shake before, say, 8 pm if you want to have breakfast at 8 am.
Hope that helps!
Victoria
Hi!
I have a question that my practitioner can’t answer:
I was born C-section and hence I have less beneficial bacteria (a total lack of Enterococcus spp responsible for breaking down carbohydrates etc), and because of that several commensal/imbalanced bacteria as seen in a CCAP stool test. I wonder are these deficiencies linked to a slower MMC – which I’ve always had? If so they will prevent me from full recovery of SIBO since relapses occur very often with too slow and rare bowel moves. Are there Any chance for me to get a normal MMC when I’ve been constipated whole of my life – if so what should I do?
Hopeful for some insights, Marika
Hello my love! Thank you for reaching out and asking this question. The answer is complex in that the science is still nascent in many of these areas – we just don’t know all we need to know yet. The simple answer is that yes, the human body is infinitely heal-able, and it takes more than the right probiotic, prebiotic and immune support – it’s so vital to look at the role your emotional wellness plays in your gut health. So often our energy can get stuck, our cortisol gets highjacked by anxious thoughts, resentment, lack of self-confidence, worry… and shifts our physiology, the composition of our microbiome and thus, our gut motility. So I would start with the emotional and mental work to shift your thoughts to help your body heal, plus check out the Breathwork that I offer – it was a GAME CHANGER for my own digestion.
Meanwhile, I love things like artichoke and ginger to help the MMC, things like Triphala and magnesium to support the large intestine, along with supporting the vagus nerve, which is so vital. And don’t forget pelvic floor and abdominal physical therapy! So important in SIBO
Start to remind your perfect human body that you are loved, that you are safe, that you can process your food – it might sound cheesy, but the science of neuro plasticity is SO real – our thoughts literally change and create our physiology!
big hugs to you on your journey, and do reach out if you want to do some life coaching and breathwork with me – I’m here for you!
– Victoria
Thanks for the great article. You mentioned taking ginger as a prokinetic with lunch and dinner. I’ve often heard to take it at bedtime. My GI really didn’t want me to take one at all because she feels my root cause is my rapid gastric emptying. But everything I read says everyone should take a prokinetic. Thoughts?
Hi Kathy! Thanks for reaching out. It’s hard to weigh in without knowing all the details of your story.
So to speak generally, ginger and artichoke (and bitters in general) affect the MMC, and not so much the peristaltic wave that control emptying through the large intestine.
I am a huge fan of prokinetics in general, and I typically advise folks to give things a try to see how their perfect human body reacts and responds. That is – a trial of a week on an artichoke/ginger blend to see how it effects things. If the effect is positive, one could continue, and should one get diarrhea, for example, the experiment ends and we have evidence that the prokinetic isn’t one’s friend.
Hope that’s helpful! Thanks again for reaching out and asking for support – love that!!
Hi, how much l-tyrosine should be taken in the morning? Thanks. Looking forward to trying all these approaches!
Hi love! I cannot prescribe here, so I can’t tell you what the right dose is for YOU or what you should take. Most folks start with 500 mg in the morning. Remember to consult your own medical care team before starting any new supplement. All the best! – Victoria
Great article! I can’t seem to find an answer so hoping you can help. Does drinking broth between meals stop the MMC cycle? Also, you said drinking tea between meals was ok, how about water with lemon?
Thanks
Ardelle
Hi Ardelle,
So… this is an area of ongoing research and I don’t think anyone can give you a 100% answer. That said, yes, anything caloric will trigger the MMC. Some experts say that even water triggers it, but ummm… what?! Im gonna drink water and that’s gonna be okay! 😉
Hope that’s helpful!
Victoria
Victoria, It is always encouraging when i find any good info about SIBO, as i have been suffering with this for 2 years and seem like i have tried everything. I was wondering if starting the supplements that you recommend to support the MMC is bad if i still may have SIBO, is it only effective if you have already gotten rid of SIBO, it is such a complex thing that i feel lost at this point, i have tried many different things, natural approach and antibiotics and nothing seems to work , my stomach hurts all the time and i try ti stay with the SIBO recommended diet for the most part, i take a thyroid suppost as i was detected with Hypo right after i was told i had high levels of hydrogen and methane in my system (SIBO), still fighting to try and figure this out and still seeking a Dr. that knows how to help me get rid of this, The thyroid meds seem to bother me but so does anything else i take, i am currently taking a multi vitamin, omega 3 fish oil, vitamin D, also 5HTP (not sure how much to take or how often or at all ) but need something for mood as i have suffered from anxiety and sleep disorders before and seem to have depression that surfaces, just overall feel like crap and am frustrated, Also totally not sure weather to take pro biotics or pre biotics yet or at all??? Any info is totally appreciated at this point, i just want my life back. Also i go back and forth between constipation and diareha
Hi love! Gosh, I’m sorry you’re struggling so much with this.
I would recommend finding a skilled Functional Medicine provider to help you out to answer all of these great questions.
I would also highly recommend Breathwork Meditation as a way to support the vagus nerve and to shift into parasympathetic dominance while your medical team sorts out why your SIBO keeps coming back. victoriaalbina.com/breathwork
Consider the IFM.org website and Chris Kresser’s provider referral network to find someone to help you – you deserve much more in-depth and personalized help than I could provide in a blog comment 🙂
Big hugs to you!
Victoria
I am confused about the Vagus nerve/parasympathetic system. When should I do the exercises to impower the vagus? Isn’t digestion during the para sympathetic phase thus garguling or singing to strengthen would stop the MMC.
THx,
Pam
Hi Pam! Great to hear from you. It’s not that cut and dried – you’re not going to stop the MMC by singing or gargling. The thing is to tone the vagus nerve, and that’s what these exercises do. If you’re concerned with timing, which I’m not, but if you are, I’d do the vagus tone supports away from meals, such as at 10 am or 2-3 pm. Hope that helps!
All the best,
Victoria
I think the Sibo itself as gone with help of antibiotics. I am finding out that I have food sensitivities that I didn’t have before after five months of this condition. By reading your articles I see I am the worst offender of eating constantly and over eating as well.
The problem is that I eat breakfast at 7 or 7 30 and am very hungry at 10 or 10:30. I am allergic to diary, so no eggs or diary, no oatmeal either. My food options are now limited. I get very hungry at 10 AM and I do need to eat something. Will and organic protein drink be a better solution than the almond butter and multigrain bread?
A great article, thanks so much for your time spent researching and supporting people with your replies. I have SIBO and found your article while trying to find info on 5-HTP, which I am just about to start taking. I am lucky to have found a supportive integrative practitioner here in Sydney, but still find it interesting to research things. Regards.
Hi Karen! I’m so glad this was helpful. I love 5HTP for MMC support.
All the best!
Victoria
Dear Victoria,
I really enjoyed this informative article along with all the references that you included. I never heard about MMC until you talked about it. I’ve had IBS for about a year along with high levels of stress. A few months ago I was diagnosed with SIBO. I have a question: how long does it take to develop SIBO? Thank you for your time and all the valuable information you have provided!
Hi! thanks for writing in and for the kind words.
While I can’t give specific medical advice on a blog and don’t know your story, SIBO is one of those things that’s different for everyone. SIBO often develops after food poisoning, but is also so deeply linked to trauma and early childhood stress that the stage can be set for susceptibility to SIBO many many years before infection. If this is of interest to you, check out my podcast, Feminist Wellness, to learn more about the Nervous System and mental/physical health: victoriaalbina.com/podcast.
Hi Victoria,
thanks for writing this article. Answered a few question for me! But I do have one more:
Is the 3.45 – 5 hour MMC process after a meal influenced by the calorie intake of the meal? i.e. does a bone broth of 30 – 50 calories take the same time to process as a full meal of 600 calories? Or for that matter how does that compare to a 1500-2000 calorie dine out occasion?
Regards,
Adrian
Hi Adrian,
Alas, all calories can pause the MMC. Some researchers believe that even an noncaloric beverage like tea can pause the MMC…
Best!
Victoria
Hi Victoria, interesting article and very helpful. If non-caloric intake like tea can interrupt the MMC, you mention drinking water is OK? How can we explain water will not interrupt the MMC?
Appreciate your advice.
God Bless:
Maria
Hi Maria,
Alas, water may in fact disrupt the MMC. Sigh. We all get to do the best we can, right?
Best!
Victoria
Hello Victoria
Thank you so much for your time and writing this article !!!!! How long after/between meals should I take a prokinetic to help support the mmc? I think I readed 4 hrs at least? Do taking the prokinetic before meals as efficient as in between? Or I guess I should try it out to see what works best for me? I only take it at night so far.
Hi Monica,
Talk with your own functional medicine/holistic medical team to figure out what is best for YOU specifically 🙂
And yes, playing around with it is often a great way to go
Be well!
Victoria
Great article thank you!
Which probiotics do you recommend please?
There is no one probiotic I recommend, it’s case specific, so I recommend you work with a licensed health care provider to find the right probiotic for you 🙂
Hello Victoria. Do you think its possible that I have SIBO as the result of an unintentional overload of fibrous shakes and supplements 6 months ago? I’ve had a CT scan with contrast, a colonoscopy, a HIDA scan and a small bowel follow through study that all show normal. I tested one point away from positive on the methane SIBO test and was treated first with probiotics, which helped for a few weeks, then with antibiotics that didnt help much. I’m trying a low fodmap diet next. I have discomfort toward my lower back that is worse in the morning and I’m losing hair way more than I normally ever did. Do you think the low fodmap diet along with probiotics will help and do I have to eat low fodmap forever?
Hi Kris,
I would recommend that you work 1:1 on with a licensed, experienced Functional Medicine provider to get the root cause of your symptoms and to create a treatment plan, just for you! I can’t give individual medical advice on a blog 🙂
Be well,
Victoria
Hi Victoria,
I read a lot of articles and I feel that you have really summed it up thoroughly here. Everyone is so different, but each of these is so crucial. So I have methane dominant SIBO (I’m working with a naturopath and an acupuncturist). I never thought to ask about my stomach noises. I get so many of them! That is what actually indicated to me that something was going wrong with my gut. Are you aware of another way that indicates the health of one’s MMC?
Hi Mari!
So glad this article resonated for you and that you’re getting the help you need for your SIBO.
I believe that my own MMC is functioning optimally these days because my digestion moves with ease, and I have easy daily bowel movements without urgency or straining, and heartburn and gas are a thing of the past, generally speaking.
As you pointed out, everyone is different, and you get to trust your intuition and your deep inner knowing that your vagus nerve and MMC are doing what yhey were built to do!
be well!
Victoria
Hi Victoria – thanks so much for such thorough info. It is actually more comprehensive than I have seen written by some NDs. What are your thoughts on doing bone broth fasting for 2 weeks instead of the elemental diet? And/or coconut oil fasting?
Thanks,
Heather