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SIBO and Lyme Disease

Another great eye opening presentation was give by Farshid Rahbar MD. Dr. Rahbar founded LA Integrative Gastroenterology & Nutrition, where he combines Eastern and Western medicine to create a unique, “whole-person” approach to caring for the body, designed to optimize and improve a patient’s health. Dr. Rahbar has become one of Los Angeles’ most sough-after and beloved gastroenterologists, with a highly successful ability to treat a wide variety of disorders affecting the gut.

He began his lecture with the disclaimer indicating the information and evidence he is presenting at the 2016 SIBO Symposium, is based only on observation collected through his Los Angeles GI Practice.

Presentation Highlights

Dr. Rahbar said that about 65% of his patients that tested positive for a tick borne illness also had an abnormal SIBO test result.

Some of his patients do not recall exposure to a tick bite. Perhaps due to a very good immune system. It is possible that patients may remain in an immunological homeostasis for years, until they are exposed to the following which would create an imbalance in the immune system :




-lack of sleep

-mycotoxins or mold (water leak, water damage)

Top 10 Symptoms

1. Bloating/ gas

2. Tire easily/fatigue

3. Anxiety

4. Abdominal pain

5. Sleeplessness

6. Constipation

7. Food Intolerance

8. Irregular Bowel Movements

9. Weight loss/ Weight gain

10. Joint Pain

Some RED Flags

1. Use of Cannabinoids -self directed or under supervised use of medical marijuana

2. A noted trend in the practice suggests in favor of high methane being associated with a tick borne disease

3. GERD cases that are hard to treat

4. SIBO- reoccurring SIBO, abnormally high methane, abnormally high hydrogen, intractable SIBO (not responding to treatments, hard to treat SIBO, long treatment required. Lack of history of food poisoning . Lack of structural issues in the body (adhesions, etc).

5. Yeast Candida overgrowth -persistent or hard to treat female. When a male presents this scenario.

6.Hard to eradicate parasites

7. Multiple food sensitivities

7. Leaky Gut - hard to treat intestinal permeability

8. Self-imposed food restrictions with out systematic relief

9. Hypochlorhydria, especially in a young person

10. Severe dysbiosis

11. Unexplained chronic Diarrhea

12. Presence of Mold antibodies or mycotoxins

13. Failure to thrive/ anorexia/ weight loss

14. Gastroparesis, especially a young person

15. Cyclical vomiting

16. Chronic Nausea

17. Hard to control constipation

18. Laxative dependency

19. Headaches/ insomnia

20. Cerebral Vasculitis

21. Urinary Symptoms

22. Persistence of IBD

23. Presence of Melanosis Coli & colitis together

24 Fluoroquin toxicity

25.Excessive non- allergic antibiotic sensitivity

26. Myofacial Pain

27. Hypercoagulable state - blood clot disorder

28. Abnormal Labs

Abnormal Labs

-High or low Platelets, WBC

- unexplained liver enzymes elevations

- Iron marker abnormality without typical iron deficiency

-positive auto-immune markers

-positive markers of systematic inflammation

- antibodies to brain tissues

Lyme Specific Lab Tests

No single test establishes diagnosis. Multi level testing improves accuracy. 1 The Lab tests that Dr. Rahbar runs on each patient are as follows:

-Lyme Culture

-CDC Western Blot

-Ellispot "rescue"

-Traditional Reference Lab Western Blot

- All other diagnosis tests

He analyzes all of these results together to make an assessed conclusion (some could be negative and others still positive).

Stool Testing :

If you notice opportunistic fungi in stool other than Candida Albicans Fungi, consider testing for a tick borne illness.

Another Major Player is Dysautonomia

Dysautonomia- when the autonomic nervous system (ANS) does not work correctly. Dysautonomia is a type of neuropathy affecting the nerves that carry information from the brain and spinal cord to the heart, bladder, intestines, sweat glands, pupils, and blood vessels 2. Lyme commonly affects the nervous system and is cause of small fiber neuropathy which causes damage to nerve fibers ( C Fibers : skin, peripheral nerves and organs)

Dysautonomia symptoms

Excessive fatigue


blood pressure fluctuations

Distention of Abdomen



Sweating Issues

Dry Mouth

Rapid Heart Rate

Blurry Vision

Sexual Problems


When the patient eats, the stomach expands to make room (in the fundus) which prevents reflux. If those nerves around the fondus are not working, that pressure rises up and causes reflux. The vagus nerve accommodates this action so think out of the stomach and check the nerves and consider testing for Lyme.

Contact your Practitioner

I hope these highlights from Dr Ruhbar's SIBO Symposium lecture gives you a general idea of some of the Lyme Disease symptoms to ponder if your SIBO has been difficult to treat. If you suspect that your reoccurring SIBO could be due to Lyme Disease, contact your practitioner for further inquiry. Keep in mind that Dr Rahbar indicated that multi testing was important because you cannot rely on one signal test.

Wishing you a symptom free day,

Sibo Warrior


Dr. Ruhbar SIBO Symposium presentation, June 5, 2016, NCNM

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