Dr. Sarah Myhill on Eliminating Upper Gut Fermentation with Diet and Supplements

Addressing Upper Gut Fermentation

• 🎯 The primary goal is to eliminate the upper fermenting gut through a two-pronged approach: starving the microbes with a low-carb ketogenic diet and actively killing them.
• 💡 Three inexpensive and effective tools are recommended for killing microbes in the upper gut.

Key Supplement Interventions

• 🍊 Vitamin C: Recommended at 5 grams daily, taken as a single dose on an empty stomach in warm water. It's suggested that humans, unlike most animals, cannot produce their own Vitamin C, and a high dose can kill microbes in the stomach and esophagus.
• 💧 Iodine: Suggested as three drops of 15% Lugol's iodine in water, taken separately from Vitamin C. It also contact-kills microbes in the upper gut and is well-absorbed, not reaching the lower bowel.
• 🌿 MSM (Methylsulfonylmethane): A sulfur compound that is cheap, safe, and multitasking. It kills microbes in the oxygenated upper gut but acts as a prebiotic in the anaerobic lower gut, feeding beneficial bacteria.

Supplementation Strategies and Rationale

• 💊 Vitamin C is recommended to be taken in one bolus for maximum effect on an empty stomach, and it's suggested to be well-stored in the system.
• 🦷 After taking Vitamin C, it's advised to rinse the mouth or brush teeth to protect dental enamel from acid.
• 💰 Ascorbic acid is preferred over more expensive food-based Vitamin C sources due to affordability for patients, particularly those with fatigue syndromes.
• 🦠 The upper 25 feet of the gut should be near sterile, while the microbiome resides in the last 5 feet. Vitamin C and iodine are absorbed systemically and do not reach the microbiome, while MSM acts as a prebiotic in the lower gut.

Addressing Supplement Controversies and Dosing

• 🚫 Controversies around supplements like iodine are attributed to "big pharma" aiming to keep people sick.
• ⚠️ Iodine is essential for many bodily functions beyond the thyroid, including the brain, immune system, and mucous membranes. While temporary thyroid overactivity might occur, it usually self-corrects.
• 🐢 For iodine and MSM, it's advised to "start low and go slow," especially for those who are very sick, to avoid a "healing crisis."
• ⚖️ A target for MSM is 30 grams, three days a week, for six months, followed by a maintenance dose. It's recommended to take mineral supplements on the days off from MSM to replenish friendly microbes and minerals.
• 🌍 Heavy metal poisoning is a pervasive issue due to environmental factors and medical/dental practices, and MSM is highlighted as a tool for detoxifying these metals.