A client came into her first consultation with me carrying a shopping bag. Inside were seventeen different supplements she’d bought online after spending hours Googling “SIBO cure” and “IBS relief.” She’d spent over $800 in three months. Most hadn’t helped. A few had made her symptoms noticeably worse.
“I just don’t know what I’m doing wrong,” she said.
The problem wasn’t her effort or commitment. The problem was that she was trying to fix a specific issue with a generic approach. SIBO and IBS aren’t one-size-fits-all conditions, and neither are the supplements that might actually help.
After twelve years of working with clients across Australia dealing with complex digestive issues, I’ve learned that the right supplement at the right time can make a genuine difference. But so can the wrong supplement at the wrong time, which is why throwing everything at the problem rarely works.
This article covers which supplements have solid evidence behind them, when to use them, and how to avoid wasting money on things that won’t help your specific situation.
The Frustrating Reality: Not All SIBO and IBS Are the Same
Here’s what makes this complicated: the supplement that transforms one person’s digestion can trigger bloating, pain, or diarrhea in someone else.
Why? Because SIBO and IBS aren’t single conditions with single causes.
SIBO can be hydrogen-dominant, methane-dominant, or both. Each responds differently to treatment. IBS can present as diarrhea-dominant, constipation-dominant, or mixed. The mechanisms driving symptoms vary from person to person, involving motility issues, visceral hypersensitivity, altered gut microbiota, immune activation, or combinations of all of these.
Research consistently shows that IBS is a heterogeneous disorder with multiple underlying mechanisms. This is why cookie-cutter protocols fail so often.
When I’m working with someone, I need to understand their specific pattern before recommending anything. Otherwise, I’m just guessing.
Key Point: There is no single supplement that fixes everyone with SIBO or IBS. The most effective approach matches specific supplements to your specific subtype and symptoms.
If you’re dealing with persistent IBS symptoms, understanding your pattern is the first step toward actually improving things.
The Supplements I Actually Recommend (And When)
For Inflammation and Gut Lining Support
Zinc (carnosate or picolinate)
Zinc plays a crucial role in maintaining intestinal barrier function. Research shows that zinc deficiency impairs tight junction proteins that hold your gut lining together, potentially contributing to increased intestinal permeability.
I typically work with doses ranging from 30-50mg elemental zinc daily, usually taken with food to reduce nausea. The form matters. Zinc carnosate has specific evidence for gut lining support, while zinc picolinate has good absorption.
One important caution: high-dose zinc supplementation for extended periods can deplete copper. If you’re taking zinc long-term, monitoring is sensible, or consider a formula that includes a small amount of copper.
L-glutamine
Glutamine is the primary fuel source for enterocytes (the cells lining your intestine). Multiple studies have examined its role in supporting intestinal barrier integrity, with some evidence showing benefits for intestinal permeability.
I typically suggest 5-15 grams daily, split into 2-3 doses, taken away from meals.
Here’s something I warn clients about: some people feel worse initially when starting glutamine, particularly if they have issues with glutamate metabolism or histamine sensitivity. If symptoms worsen within the first week, it’s worth pausing and reassessing rather than pushing through.
Slippery elm or marshmallow root
These are demulcent herbs, meaning they create a soothing, protective coating along the digestive tract. While the research is limited compared to some other interventions, they’re generally well-tolerated and can provide symptomatic relief for people with irritated gut linings.
I find these particularly useful for clients who react to everything. They’re gentle, calming, and rarely cause problems.
Timing matters. These are best taken between meals or before bed, as they can potentially interfere with the absorption of other supplements or medications if taken together.
For Motility (Getting Things Moving)
Ginger
Ginger has been used traditionally for digestive complaints for centuries, and modern research backs this up. Studies show that ginger can accelerate gastric emptying and has prokinetic properties.
Fresh ginger tea, ginger extract, or capsules can all work. I generally suggest 1-2 grams daily, though this varies based on tolerance and response.
One thing I’ve noticed clinically: ginger seems to work better for people with slower motility and constipation-predominant patterns. It’s less consistently helpful for diarrhea-dominant IBS.
Magnesium (specific forms)
Not all magnesium is created equal when it comes to digestive effects.
Magnesium citrate draws water into the bowel, which makes it excellent for constipation-dominant IBS or SIBO with severe bloating and stagnation. Doses typically range from 300-600mg daily, adjusted based on bowel response.
I specifically avoid recommending magnesium citrate for anyone with diarrhea-dominant IBS. It will make things worse.
For those cases, magnesium glycinate is a better option. It provides magnesium without the laxative effect, which matters if you’re dealing with anxiety, muscle tension, or sleep issues alongside your digestive symptoms.
5-HTP or L-tryptophan (with caution)
About 95% of your body’s serotonin is produced in the gut, and serotonin plays a significant role in gut motility and visceral sensation. Alterations in serotonin signaling have been implicated in IBS.
I occasionally explore 5-HTP (50-200mg daily) or L-tryptophan (500-2000mg daily) with clients who have both mood concerns and digestive issues, particularly constipation-dominant patterns.
But here’s the critical part: do not take these if you’re on SSRIs or other serotonergic medications without medical supervision. The risk of serotonin syndrome is real. I also avoid these in anyone with a history of eosinophilic disorders.
For SIBO-Specific Support
Antimicrobial herbs (oregano, berberine, neem, allicin)
Despite being called “natural antibiotics” in marketing materials, these herbs don’t work the same way as pharmaceutical antibiotics. But they do have antimicrobial properties, and research supports their use in SIBO.
A randomized trial published in Global Advances in Health and Medicine found that herbal therapy was as effective as rifaximin for SIBO, with 46% of participants achieving a negative breath test after one course of herbs compared to 34% with rifaximin.
I typically use rotation protocols rather than single herbs, changing formulas every 2-4 weeks to reduce the chance of resistance and target different organisms.
Should you try antimicrobials without testing? My honest answer: it depends. If you have clear SIBO symptoms (persistent bloating, gas, distension that worsens after eating, especially carbohydrates) and limited access to breath testing, a trial of herbal antimicrobials can be reasonable. But going in blind means you won’t know if it worked, and you might miss other issues entirely.
Biofilm disruptors
Bacterial biofilms are protective matrices that bacteria create around themselves, making them harder to eradicate. In SIBO, biofilms can contribute to treatment resistance and recurrence.
Common biofilm disruptors include:
- N-acetylcysteine (NAC): 600-1200mg daily
- Serrapeptase: 80,000-120,000 SPU daily on an empty stomach
- Nattokinase or lumbrokinase: Dosed according to product specifications
I typically start these 1-2 weeks before antimicrobial treatment and continue through the protocol.
Realistic expectations matter here. Biofilm disruptors aren’t magic, and the evidence in SIBO specifically is mostly theoretical and clinical observation rather than robust human trials. But in treatment-resistant cases, they’re worth considering.
Prokinetics (motility support post-treatment)
Even if you successfully reduce bacterial overgrowth, SIBO often recurs if the underlying motility problem isn’t addressed. Impaired migrating motor complex function is a common predisposing factor for SIBO.
Natural prokinetic options include:
- Ginger (as mentioned above)
- Artichoke extract
- Iberogast (a herbal formula with good research behind it)
The prescription option is low-dose naltrexone or prucalopride, but those require medical oversight.
I generally introduce prokinetics after antimicrobial treatment rather than during, to avoid driving bacteria further down the small intestine during eradication.
Key Point: SIBO treatment isn’t just about killing bacteria. Supporting motility, addressing biofilms, and repairing gut barrier function are all part of preventing recurrence.
For Symptom Management
Digestive enzymes
Not everyone needs digestive enzymes, but for some people, they make a noticeable difference.
Enzymes can help with specific deficiencies (lactase for lactose intolerance, alpha-galactosidase for beans and legumes) or provide broader digestive support with full-spectrum formulas containing protease, lipase, and amylase.
I find them most helpful for people who feel heavy, bloated, and uncomfortable after meals, particularly those with low stomach acid, pancreatic insufficiency, or gallbladder issues.
Important: enzymes manage symptoms; they don’t fix underlying problems. If you need enzymes indefinitely to digest food, something else is going on that deserves investigation.
Peppermint oil (enteric coated)
Peppermint oil is one of the better-researched natural interventions for IBS. A meta-analysis in the American Journal of Gastroenterology found that peppermint oil significantly improved IBS symptoms compared to placebo.
The enteric coating is essential. It ensures the oil releases in the small and large intestine rather than the stomach, which both improves effectiveness and reduces the risk of heartburn.
Typical dosing is 180-200mg of enteric-coated peppermint oil, 2-3 times daily before meals.
One caution: peppermint relaxes the lower esophageal sphincter, which means it can worsen reflux or GERD in susceptible individuals. If you have reflux, start cautiously or skip it entirely.
Fiber: psyllium husk or partially hydrolyzed guar gum
Fiber is tricky in SIBO and IBS. Some types make things significantly worse.
Psyllium husk is a soluble fiber that can help normalize bowel movements in both constipation and diarrhea. Research shows it’s beneficial in IBS, though individual tolerance varies.
Partially hydrolyzed guar gum (PHGG) is a low-FODMAP, soluble fiber that tends to be better tolerated than other fibers in SIBO and IBS.
Start low (1-2 grams daily) and increase slowly. If bloating and gas worsen significantly, it may not be the right time to add fiber. In active SIBO, I often wait until after antimicrobial treatment before introducing supplemental fiber.
The Probiotic Question: It’s Complicated
People expect me to automatically recommend probiotics for gut issues. I don’t.
Here’s why: in SIBO, you already have too many bacteria in the wrong place. Adding more bacteria, even “good” ones, can sometimes make symptoms worse.
That said, specific probiotic strains have evidence for specific IBS types:
- Bifidobacterium infantis 35624: Shown to reduce IBS symptoms across multiple studies
- Saccharomyces boulardii: A beneficial yeast (not bacteria) that can help with diarrhea-dominant IBS and doesn’t contribute to bacterial overgrowth
- Lactobacillus plantarum 299v: Some evidence for IBS symptom improvement
I’ve seen probiotics help some people and cause significant worsening in others. The difference often comes down to timing.
My typical approach:
- If someone has confirmed SIBO, I generally wait until after antimicrobial treatment before introducing probiotics
- If someone has IBS without SIBO, I might trial specific strains based on their symptom pattern
- If probiotics cause worsening bloating, gas, or discomfort within the first week, I stop them rather than pushing through
Soil-based probiotics (Bacillus species) are sometimes better tolerated in SIBO, as they don’t colonize the small intestine the same way traditional probiotics do. But again, individual response varies.
Supporting gut barrier function and addressing inflammation (like with leaky gut protocols) often matters more than which probiotic you choose.
Key Point: Probiotics are not automatically beneficial for SIBO and IBS. Specific strains, timing, and individual tolerance all matter. When in doubt, test first or wait until after treating bacterial overgrowth.
What I Skip (And Why You Might Too)
After years of practice, I’ve developed a clear sense of what’s worth trying and what’s not.
Supplements I rarely recommend:
- Generic “gut health” blends with 20+ ingredients: You can’t tell what’s working, what’s not, or what’s causing side effects. If something goes wrong, you have no idea which ingredient is the problem.
- Collagen for gut healing: Despite the marketing, the evidence for collagen specifically healing the gut lining is weak. If you want to take it for skin or joints, fine. But don’t expect it to fix IBS or SIBO.
- Activated charcoal for bloating: It might reduce gas temporarily, but it also binds to nutrients and medications. It’s a band-aid, not a solution.
- Apple cider vinegar: Popular on social media, minimal evidence for IBS or SIBO. Some people find it helpful for reflux (counterintuitive but true), but it’s not a core intervention I rely on.
The “more is better” trap
I once had a client taking 32 different supplements. She couldn’t remember what half of them were for. Her monthly supplement budget was over $600.
We cut it down to six targeted supplements. Her symptoms improved more than when she was taking everything.
Why? Because she could actually be consistent. She knew why she was taking each thing. And we could clearly see what was working.
Compliance, cost, and clarity all matter. Taking 20 supplements at once isn’t better. It’s just overwhelming.
How I Actually Build a Supplement Plan with Clients
Here’s my typical process:
Step 1: Gather information
Before recommending anything, I want to understand:
- Symptom pattern (when symptoms occur, what triggers them, what helps)
- Previous testing (if any)
- Current diet and lifestyle
- Medications and existing supplements
- Health history
Step 2: Testing (when appropriate)
For SIBO, a hydrogen/methane breath test provides clarity. For broader gut issues, comprehensive stool testing can reveal parasites, pathogenic bacteria, inflammatory markers, and digestive function.
Testing isn’t always necessary, but it takes the guesswork out of treatment.
Step 3: Start strategically
I typically begin with 3-5 targeted supplements, not 15. Usually:
- Something for gut barrier support (zinc, glutamine, or demulcents)
- Something for symptom management (peppermint oil, enzymes, or targeted fiber)
- Something addressing the root cause (antimicrobials if SIBO, specific probiotics if appropriate, motility support if needed)
Step 4: Timeline and reassessment
- Weeks 1-4: Initial response. Are symptoms improving, worsening, or unchanged? Any side effects?
- Weeks 4-8: Continued progress or plateau? Time to adjust doses, add something, or remove what’s not working.
- Beyond 8 weeks: Reassess the need for ongoing supplementation. Some things are short-term tools (antimicrobials). Others might continue longer (motility support, targeted probiotics).
The goal isn’t to take supplements forever. It’s to address underlying issues so you eventually need less support, not more.
The Non-Negotiables That Matter More Than Supplements
I’ll be direct: supplements alone won’t fix SIBO or IBS.
The foundations that actually move the needle:
Diet modifications
Whether it’s low FODMAP, specific carbohydrate diet, or a personalized elimination approach, what you eat matters enormously. I’ve seen people improve 70-80% from diet changes alone before adding any supplements.
Meal spacing and portion sizes
Eating every 2-3 hours keeps your migrating motor complex from doing its job (sweeping bacteria through the digestive tract). This contributes directly to SIBO recurrence.
I encourage clients to aim for 4-5 hours between meals when possible, and to avoid snacking late into the evening.
Stress management and nervous system regulation
Your gut and brain are in constant communication via the gut-brain axis. Chronic stress alters gut motility, increases intestinal permeability, and changes the microbiome.
Vagal tone exercises, diaphragmatic breathing, or even just regular walks can make a measurable difference in digestive function.
If you’re dealing with chronic stress alongside gut issues, addressing both simultaneously matters. That’s where stress and mental health support becomes part of the digestive puzzle.
Sleep and circadian rhythm
Poor sleep disrupts everything: gut motility, immune function, inflammation, stress hormones. I see this constantly. Someone’s gut symptoms worsen dramatically during periods of poor sleep.
Prioritizing 7-9 hours of quality sleep isn’t optional if you want lasting digestive improvement.
Key Point: Supplements are tools that work best when combined with dietary changes, meal timing, stress management, and sleep optimization. Foundation first, supplements second.
Where to Buy Quality Supplements in Australia
Not all supplements are created equal, and in Australia, quality varies significantly.
Practitioner-only brands vs retail
Practitioner-only brands (like Metagenics, BioCeuticals, Designs for Health, Thorne) typically have:
- Higher quality control standards
- Third-party testing for purity and potency
- Better bioavailability (forms of nutrients that actually absorb well)
- More targeted, evidence-based formulations
Are they always necessary? No. But for complex conditions like SIBO, quality matters. I’ve seen people spend months on poor-quality supplements with minimal results, then switch to professional-grade options and notice significant improvement.
TGA regulations and what they actually mean
In Australia, supplements are regulated by the Therapeutic Goods Administration (TGA). Products listed on the Australian Register of Therapeutic Goods (ARTG) have met certain manufacturing standards.
Look for an AUST L number on the label. This indicates the product is listed with the TGA.
However, TGA listing doesn’t guarantee effectiveness, only that the product meets basic safety and quality standards.
Red flags when shopping online
Be cautious of:
- Products shipped from overseas without ARTG listing
- Claims that sound too good to be true (“cures SIBO in 7 days!”)
- Unknown brands with no third-party testing
- Suspiciously cheap prices (quality ingredients cost money)
Price vs quality: what’s worth paying extra for
You don’t need the most expensive option for everything. But for certain nutrients, form and quality matter:
- Magnesium: Citrate, glycinate, or threonate are worth the extra cost over oxide
- Zinc: Carnosate or picolinate over cheaper forms
- Probiotics: Strains with actual research behind them, proper CFU counts, and evidence of stability
- Herbal antimicrobials: Standardized extracts with verified potency
Generic fish oil? Probably fine if it’s molecularly distilled and tested for heavy metals. Generic curcumin? The cheap stuff doesn’t absorb well. Quality matters more for some things than others.
When to Get Professional Support
Some situations are straightforward. Many aren’t.
Signs you need more than supplements:
- You’ve tried multiple approaches for 6+ months with minimal improvement
- Symptoms are severe and significantly impacting quality of life
- You’re losing weight unintentionally
- You have blood in stool, severe pain, or other red flag symptoms
- You’ve had multiple rounds of antibiotics or antimicrobials without lasting improvement
- You’re overwhelmed and don’t know where to start
What testing can show that guesswork can’t:
A comprehensive stool test can identify specific infections, inflammatory markers, pancreatic enzyme output, and fat malabsorption. A SIBO breath test tells you if bacterial overgrowth is present and which gases are elevated. Food sensitivity testing (when appropriate) can guide dietary changes.
Testing removes ambiguity. Instead of trying everything and hoping something works, you have specific targets to address.
How naturopathic support works for complex gut issues:
Working with someone who understands the nuances of SIBO and IBS means:
- Personalized protocols based on your specific subtype and symptoms
- Adjustments based on response rather than generic timelines
- Integration of diet, lifestyle, and supplements in a coherent plan
- Support when things aren’t working and troubleshooting is needed
If you’d like to understand more about how this process works, I walk through the consultation structure and what to expect.
Final Thoughts
Supplements are tools. They’re not magic bullets.
The best supplement protocol is the one tailored to your specific gut issues, your symptom pattern, and your individual tolerance. What works brilliantly for someone else might do nothing for you, or worse, trigger the exact symptoms you’re trying to resolve.
Small, strategic changes beat throwing everything at the wall. Start with clarity (testing when possible), focus on foundations (diet, stress, sleep), and add targeted supplements that address your specific issues.
You don’t have to figure this out alone. After twelve years of working with clients dealing with frustrating, complex digestive issues, I can tell you this: improvement is possible. It just requires the right approach at the right time, not more supplements taken desperately in the dark.
Frequently Asked Questions
Can I take all of these supplements together?
No, and you shouldn’t try. Taking 15+ supplements simultaneously makes it impossible to know what’s helping, what’s not, and what might be causing side effects. Start with 3-5 targeted supplements based on your specific needs, assess response over 4-6 weeks, then adjust.
How long until I see results?
It depends on what you’re addressing. Symptom management supplements (peppermint oil, enzymes) might help within days to weeks. Gut barrier repair (zinc, glutamine) typically takes 4-8 weeks. SIBO antimicrobial protocols usually run 4-8 weeks, with motility support continuing for months after. Realistic expectations matter.
Do I need testing before starting supplements?
Not always, but it helps. If you’re dealing with straightforward IBS symptoms and want to try basic interventions (peppermint oil, fiber, magnesium), testing isn’t mandatory. But if symptoms are severe, you’ve failed multiple treatments, or you want to target SIBO specifically, testing removes the guesswork and saves time and money in the long run.
Can supplements cure SIBO or IBS permanently?
Supplements don’t “cure” SIBO or IBS, but they can be part of an effective treatment strategy. SIBO can be eradicated with antimicrobials (herbal or pharmaceutical), but recurrence is common if underlying motility issues, structural problems, or other predisposing factors aren’t addressed. IBS is more about management and symptom reduction, though many people achieve long periods of minimal symptoms with the right approach.
What if supplements make my symptoms worse?
Stop taking them. Worsening symptoms are your body telling you something isn’t right. This could mean the supplement isn’t appropriate for your situation, the dose is too high, or you have an underlying issue (like histamine intolerance) that makes certain supplements problematic. Don’t push through worsening symptoms hoping they’ll improve. Reassess with professional guidance.
