Hydrogen Sulfide Gas

As I prepare for the beginning of fall classes, I reflect upon how grateful I am to have had the last six weeks to really focus on my health and scour the internet and books for insight into my condition.  I have been doing so much research and feel like I have made substantial headway in my healing process.

One of the sources of my research was a six-hour recorded webcast by Dr. Mark Pimentel and his colleagues at Cedar-Sinai Medical Center who hosted the Global IBS Symposium (the cost is about $100, but the money goes to a good cause- IBS research).  The key piece of information that I took away from this recording was that there is a third type of gas (in addition to methane and hydrogen) produced by bacteria that they know much less about: hydrogen sulfide.

When you hear about the lactulose breath test for SIBO, the results are either that you have elevated hydrogen, elevated methane, both, or neither.  Typically, individuals with hydrogen-producing bacteria experience diarrhea, while those with methane experience constipation.  Patients with breath tests showing both gases typically alternate between constipation and diarrhea.  However, my test results and symptoms do not match up with this trend.  My lactulose breath test showed high levels of hydrogen and ZERO methane and I only experience constipation, not diarrhea.  One of my doctors suspected that this could be the result of the breath test not being sensitive enough to pick up low levels of methane that were still causing problems.  However, we have now pretty much ruled out this theory out.  I took Allimed herbal antibiotic (in combination with Neem Plus herbal antibiotic) which is supposed to help with methane, but experienced no relief at all.

Hydrogen sulfide fits like a perfectly-shaped missing puzzle piece in my SIBO puzzle.  Here’s why:

  1. Hydrogen sulfide gas produces the characteristic “rotten egg” smell of “silent, but deadly” flatulence.  I experience increased amounts of this when eating high-sulfur (free thiol) foods such as eggs and broccoli.  See a full list here.  Additionally, the foods that came up on my IGG/IGA allergy test last year almost all fall under this category (the exceptions are blueberries & cranberries): eggs, green beans, sesame seeds, coffee beans, and kidney beans.  I used to think that these were such random allergies, but it appears they are not random at all.
  2. Hydrogen sulfide gas appears to be linked with CFS (chronic fatigue syndrome) and Fibromyalgia.  I have been suspicious about whether my onset of fatigue in May was a result of CFS.  Also, although I do not have full-fledged fibromyalgia, I do have severe muscle pain in my scapula which is one of the fibromyalgia trigger points.  I also have a lot of muscle tightness in my hips and buttocks.  My scapula muscle pain/tension began around the same time that my digestive symptoms got really bad.  My grandmother (who has suffered from digestive issues much of her life) believes that she suffers from fibromyalgia.
  3. According to Dr. Pimentel and his team, nearly all cases of SIBO/IBS are caused by acute gastroenteritis.  I ordered my medical records from all of my visits to the emergency room and learned that while I did have acute gastroenteritis in 2008, many of my symptoms actually began well before that incident and therefore it was unlikely the root cause of my gut dysbiosis (however, each subsequent case of acute gastroenteritis can worsen symptoms and cause further dysbiosis).
  4. I had colic as a baby, which is said to indicate digestive distress.  Gut flora is passed from mother to child and digestive issues stem back along my matriarchal heritage as far as I can trace them.  Therefore, my microbiome was primed for disaster as soon as I came out of the womb.  Add in all the sugar I ate, antibiotics I was prescribed, NSAIDS I used for headaches and migraines, and contraceptive pills that were handed out like candy and my gut is probably chalked full of pathogenic critters.  My extreme gut dysbiosis would also explain why I got staphylococcus aureus toxic shock syndrome in 2008 even though I was vigilantly responsible and never broke any of the tampon rules that cause you to get the very rare, life-threatening condition.
  5. The only medication on my medical charts that it says I am allergic to is “sulfa drugs”.
  6. My maternal grandmother is extremely sensitive to mercury.  While I do not completely understand how hydrogen sulfide gas forms in the body and creates issues, I have learned that it creates a heavy metal toxicity that is believed to be the cause of conditions such as fibromyalgia and CFS.  This is as a result of improper methylation processes.
  7. Excessive hydrogen sulfide in the gut damages the gut wall and leads to leaky gut/ intestinal permeability.

So, what am I going to do about this new discovery?

  • Follow a low sulfur (in addition to low FODMAP, AIP) diet for 10 days while taking molybdenum (to help clear sulfur pathways).  If this helps my symptoms, it should be a pretty clear indication of my sulfur intolerance.  I’m not sure what the protocol will be from there.

**UPDATE: I only lasted 4 days low sulfur, low FODMAP, AIP and I took molybdenum for two of those days (150 mg three times per day with food).  A couple of days later, I no longer got super itchy when eating grains and other items that previously made me itch.  I have been on a successful bout of food reintroduction for three weeks.  Coincidence?  I doubt it.  I also got a nutrient IV around this same time, but I have gotten those before without my itching improving.  One of my doctors suggested that it could be a combination of factors relating to an immune system boost.

  • I already had blood work testing done for MTHFR.  The results should be out in about a week.

**UPDATE: I tested negative for the C677T mutation in the MTHFR gene.  I tested positive for the A1298C mutation, but my doctor said that one really isn’t all that detrimental or important.

  • I plan to do 23andme.com gene mutation testing.  It appears that a certain gene mutation creates difficulties with the methylation cycle.  It would make a lot of sense considering my family history of related issues.  My doctor will be interpreting the results for me.
  • I will never stop trying to figure out what is going on and improve my situation!

49 thoughts on “Hydrogen Sulfide Gas

  1. What a nice article. Thank you for the highlighted red updates! I tested negative for both methane and hydrogen….and my gas does smell a fair amount like rotten eggs. That’s the basis for my guess that I have hydrogen sulfide?! Did you struggle at all with low body weight? Also, do you have any suggested resources for hydrogen sulfide sufferers?? Any of your articles pertaining to your exact treatment protocols? Are you willing to share which doctors advised you on your journey and how are you doing today still improving/recovering?

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    • There aren’t a whole lot of good resources on hydrogen sulfide. But one of the gems I did come across in my research was this patent. It’s a lengthy read but contains so much good info!

      I tend toward a leaner body size, but it only became problematic when I severely restricted my diet to reduce gastrointestinal symptoms.

      I do not have any articles with my exact protocol because I do not think that what worked for me will necessary work for everyone so I am reluctant to put something out there as I know others will try to follow it exactly. I have also learned a lot through the process and would not necessarily recommend doing everything I did.

      I am happy to talk more about which doctors advised me and how I am doing today- I think we are chatting in a few weeks, so perhaps we can talk more then 🙂

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  2. This is totally embarrassing, but I have a severe case of Hydrogen Sulfide SIBO. Question, have any of you guys experienced symptoms of H2S being expelled through the lungs causing noticeable reactions from others?? It’s a reality that I face on a daily basis.

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  3. Hi Riley, great blog. What dosage of VSL #3 are you taking for best results? And is there a probiotic substitute with similar ingredients in the market? VSL can get costly.

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    • Hi James, I was taking between 2 and 6 capsules per day based on symptoms. Now I only need 2 capsules every few days or so. I haven’t found a substitute that gives equivalent results. Costco has a great price or you can look online for discount codes to bring to the location where you get it.

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  4. Hi Riley! Love your blog and recipes! I see you mentioned a variety of things that helped your recovery in the comments – just wondering which you attribute the most to resolving the hydrogen sulfide situation? I was prescribed a sulfur antibiotic for SIBO and am now struggling to overcome to repercussions – extreme inflammation and pain accompanied by the sulfide smell. Ugh! Thanks in advance for any advice 🙂

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    • Thank you for your kind words! I am sorry to hear that the sulfur antibiotic caused issues for you! I would say the biggest factor in resolving my hydrogen sulfide situation was the probiotic VSL#3. Hope that helps!

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  5. Hi- – i have had 3 negative SIBO breath tests. last one the highest methane value was 1 and highest hyrdogen was 7. i just repeated again today but i did a little experiment and used both lactulose and glucose. I staggered the dosage and extended the test to 3.5 hrs. i had a lot of gurgling around hour 2 so i am wondering if i may be able to finally get a positive result. we shall see. if its negative again could it be H2S? my gas doesnt smell too sulfury so my last guess would be candida. how did you know you had H2S and what did you do to treat it? Happy new year! 🙂

    Jason

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    • Hi Jason,

      It is certainly always possible that H2S is present when the breath test is negative, but what I have heard is that H2S is usually indicated by a complete flat line of hydrogen sulfide. However, my hydrogen was elevated, and my doctor and I both firmly believed that hydrogen sulfide was a piece for two reasons: distinct rotten egg smelling gas & intolerance to sulfur foods. There is not currently a test available for patients to check their H2S levels, but a study has been conducted, so I believe it is on the horizon! I have also heard there can be a connection between H2S and candida, but personally, I never had candida show on a stool test. Treatment for me involved a variety of things- herbal antimicrobials, various probiotics, prokinetics, diet, addressing gallbladder dysfunction, and more I am probably forgetting!

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      • yup Me too…no candida on any of the tests. i just did the DRG test a few months ago and it was negative for candida. i was considering the blood antibody test but i think its pretty useless. i really dont know what i have and right now am literally only eating 7 foods cause i am sensitive to everything..i have intolerances to histamine, dairy, gluten, soy, eggs, possibly corn, nuts and seeds and spices and many supplements. I am 23 lbs underweight and if i go on a candida diet i will lose more which i really cant afford to. I have chronic bloat, constipation and a condition called geographic tongue which flares even when i eat a pinch of anything with histamine. i repeated my SIBO test and am waiting on results and in the meantime my doc wants me to try clotrimazle lozenges for my tongue. On top of everything else i have minor kidney damage so need to be careful with animal protein. which herbals/probiotics/prokinetics/diet have you tried? have you improved? thanks 🙂

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      • That definitely sounds rough & I can relate! There was a time when I was reacting to nearly everything as well. It has been several years now since I was that sick, but I have recovered immensely. I still avoid gluten/dairy/soy pretty religiously, and am cognizant of my other triggers, but otherwise can eat a nutritious and fulfilling diet. I have tried so many different herbals/probiotics/prokinetics/diets that it would just be too long to type. But some that have helped the most include neem, vsl3, and resolor (not yet available for men). I am a nutritionist now and offer consultations if you would be interested in talking more. You can also see my more recent posts on http://www.bridgetownnutrition.com

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      • Thanks already working with a few doctors and specialists right now but I appreciate it. Have you ever tried Linzess or Amitzia? i am reluctant to take any pharmaceutical products and would prefer natural remedies but if its something short term i am open and as long as it doesnt cause other problems

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      • I have not tried either of those. I tried both natural (ginger, iberogast, trifal) and pharmaceutical (resolor, low dose erythromycin, low dose naltrexone) and find that the pharmaceutical are just way more potent. At first, I was really hesitant to take any pharmaceuticals as well, but am so glad that I eventually decided to because I find resolor to be critical for keeping me able to eat a somewhat normal diet and therefore not develop nutritional deficiencies. Nutritional deficiencies can cause health issues long term also so it is kind of a lose-lose scenario. So far, I have not noticed any side effects…knock on wood!

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      • Thanks. Also when you say a flat line hydrogen is indicative of hydrogen sulfide do you mean that all the readings were at 0 ? My Hydrogen readings were 6, 7, 4,5,5, 7, 3 ,5, 6, 5 ppm

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  6. I just started with the sulfur smell after the last time I ate eggs. Here are a few things that helped me colostrum IF you don’t have auto immune.

    Goldenseal is the strongest antibiotic herb that I know of. And pulsium husk. I would highly recommend colonics also.

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    • Hi Matt, Thanks for sharing your thoughts. I no longer experience sulfur issues, but hopefully this can help others! Psyllium husk is not something I tolerate well, but goldenseal and colostrum were both helpful for me. I am curious why you say no colostrum with autoimmune? Alternatively, I find it helps with my autoimmune condition (psoriasis) and in theory this makes sense since colostrum stimulates t regulatory cells which could help tame an autoimmune response.

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  7. I concur with much of this post. Both my mother and I have suffered from the rotten egg gas, excessive flatulence, and are prone to constipation not diarrhea. I was also a colicky baby and then labelled a picky eater for most of my young life. Many foods just made me nauseous but noone realized I could have an underlying digestive issue. My UBiome results show 2x normal amount of Desulfovibrio bacteria which could be the culprit. No archaea taxa/methanogens present to blame the constipation on. They take up hydrogen gas and combine it with sulfur to produce H2S.

    My mother used to react severely to eggs (which I didn’t eat then) but I don’t really react to thiol-foods. I get symptoms from a lot of prebiotic/soluble fibers like FOS added to probiotics, jerusalem artichoke, potato starch, guar gum, dried apricots/figs, as well as sugar alcohols like mannitol (that was from my negative H.pylori test). Makes it hard to feed the good bacteria. As well herbal antibiotics like berberine, neem, and oregano oil have not had an effect. All it takes is the offending food and I’ve got symptoms a few hours later.

    I haven’t done all the testing you have but also suspect some MTHFR involvement. Many of my “other” long-standing symptoms (including fatigue) fall under hypothyroid and low adrenal functioning although standard labs look fine. I am also prone to vitamin deficiencies despite an excellent diet. Right now I’m treating my severe non-anemic iron deficiency that took the 4th doctor in 8 years to finally run a ferritin test!

    I will look more into your suggestion of Molybdenum. Is it the high dose that is important because I do take a chelated multi-mineral away from my iron that contains 10mcg of Mb. Thanks for your experience.

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    • Thanks for sharing your story! Based on what I have read, yes, a higher dose of molybdenum is needed if the issue is conversion of sulfites to the less harmful sulfates. The dosage I have seen is closer to 500 mcg.

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  8. Hi! I have the sulfite gas and it is awful. I did neomycin and xifaxan together about a month ago to help with sibo and followed low fodmap diet. Unfortunately the gas is back. I am thinking it must be related to sulfur intolerance. I bought yucca root to help but that gave me stomach pain. I now am going to try molybdenum. Do you still use that? I will look into vsl3 too, I am just not sure when to introduce as I don’t want to feed bad bacteria. Any insight would be helpful. I am only able to see a functional md who takes our insurance who has the best intentions of helping but just doesn’t understand. We are saving up for a natural doctor who actually gets all this stuff but it’s gonna be awhile :/ thanks so much! Hope you are still feeling well.

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    • Hi Rebekah, I am sorry you had a return of symptoms after the neomycin & xifaxan. I see this very commonly and I had this happen as well until I got the right pieces in place to keep my symptoms at a low level for good. Just wanted to give you some hope! There were so many things that have helped along the way, but some of the things I still use currently to keep my symptoms away include VSL3, Fish oil, Resolor (as a prokinetic), an adrenal supplement & occasionally magnesium at night. I do not take molybdenum anymore because it gave me a weird nausea/dizziness sensation one day when I took 1,000 mcg- plus I have since learned that it is in lots of foods so it is pretty hard to be deficient. I had the same concern about introducing probiotics because I was afraid they would worsen my symptoms, but for me VSL3 works as strongly as an antibiotic or antimicrobial. It isn’t as much of a miracle for everyone, but I am glad I tried it. Doctors can order samples of it to give to patients which can save you the cost of having to buy a whole bottle if you are not sure it will work. Best of luck!!

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      • Thanks so much for the hope! Sometimes it does seem hopeless. I will look into vsl3! I was excited to see your practice has opened. When do you think you will do remote clients? I would love to talk with you and see if we would be a good fit. It seems you have had similar issues and treated them with success which is obviously awesome but then you also understand what it is like, which I think is so helpful. Also… I LOVE your chimichurri sauce. I make it frequently and it makes the diet not so bland!!! Everyone I serve it to loves it too. I am looking forward to trying some of the new recipes you emailed too! Thanks for all your work and being willing to share!

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