
Connecting the dots–it’s our jam. There’s nothing we love more than sharing the what and the why. Today we’re going to connect the dots between two conditions we see here a lot at Minneapolis Integrative Medicine Center. SIBO (small intestinal bacterial overgrowth) and hashimotos (autoimmune thyroiditis).
This article is going to go along with the corresponding video [linked HERE].
To step back, let’s talk through SIBO a bit more. The small intestine is a long organ. And you can see below, the baseline is the bottom through line to number nine. This is giving you a good idea of the entire small intestine and the lines in the chart gas production.

RELATED: What Actually IS Small Intestine Bacterial Overgrowth
When bacteria grows on the inside of your small intestine–they attach themselves to the intestinal wall and these bugs will eat the food that you are eating and ferment that into a gas. That gas can be hydrogen, methane or hydrogen sulfide gasses. And then those gases are created. It’s important to know which gases are created and where they are located in your small intestine as it can change treatment timeline, herbs and/or antibiotics that are used and the types of symptoms you may be having.
Breaking down the breath test
This test measures how much of that gas you have inside and where the biggest colonies are located. In the case of this patient, the largest colonies of bacteria are at the end of her small intestine, closer to the large intestine, which gives a little bit of information about root cause and where this came from. But that’s for a different article.
RELATED: Here’s How We Treat SIBO in Two Phases
The small intestine is a porous organ. It is where all of your nutrients–think magnesium, zinc, carbs, fats, protein is absorbed from this organ. If you have bugs that are physically lining the pores of your small intestine, there is going to be malabsorption. You can think about those pores as little windows for your immune system.
Your immune system also gets this window into the small intestine and we can actually see the bugs that are in there and respond to them–what that’s going to do is both call more of your immune system to come over and take care of it and if the infection is there long enough, it can cause your immune system to need to create new soldiers. These new soldiers are immature and new and more prone to being ‘distracted’ by other organ cells – like your thyroid.
Enter hashimotos to the discussion
As you get this immune system stimulation, the protein cells have this rapid turnover, especially if SIBO been there long term, you can get this attraction and inflammation of other autoimmune diseases–such as Hashimoto’s.
Not only do those pores allow your immune system to see in, but remember when we said the bacteria attach to the lining of your GI? Well the bacteria can also send metabolites and toxins of their own into your system creating your immune system to be upregulated (and a whole host of other issues).
If you already have Hashimotos and then find out you have SIBO as well, this immune activation can really aggravate Hashimoto’s thyroiditis. Our strategy for hashimotos is to not only treat the thyroid (important but if you only stay there–you’re missing a HUGE component for treatment) but to treat the immune system as well. And, that leads to the question of what things can aggravate the immune system.
If you can get rid of the SIBO, you can decrease the immune system stimulation in the gut and get your overall immune system to calm down a bit. And if SIBO isn’t the only thing triggering your immune system, getting rid of it can highlight other symptoms that are lingering and allow you to see what else may be there–think: heavy metals, environmental toxins, mold, food allergies, to name a few.
One of the ways that we will treat Hashimoto’s specifically is by looking both at the gut and IN the gut. Our goal here is to rid you of this abnormal bacteria to stop this immune system stimulation and make our thyroid gland work a little better.
Dr. Cassie Wilder is a registered Naturopathic Medical Doctor (NMD) and founder of MIMC. Her passion is empowering her patients through education, understanding, and support through their healing journey. After graduating from Iowa State University with a Bachelors of Science in Kinesiology and Health, Dr. Wilder earned her Doctorate of Naturopathic Medicine from Southwest College of Naturopathic Medicine & Health Sciences, a fully accredited and nationally recognized institution in Phoenix, AZ. During her clinical training, she received extensive hands-on training with many leading experts in the field of functional medicine and developed a passion for treating hormonal imbalances, thyroid disorders, cardiovascular concerns, and adrenal fatigue.
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