Overgrowth, dysbiosis & antimicrobials

One of 5 mechanistic pathways to 🦠 Gut health & digestion · 21 options

SIBO, SIFO and H. pylori all involve organisms in the wrong place or in the wrong numbers. This is the pathway where prebiotics make things worse and where the sequence — kill, then clear biofilm, then re-establish motility — determines whether it comes back.

🩸 Is this pathway actually your problem?

SIBO's signature is a HIGH folate with a low B12 — the overgrown bacteria produce folate and consume B12. That combination on a standard panel is a genuine clue and almost nobody reads it.

Complete Blood Count (CBC) with Differentialhs-CRP (High-Sensitivity C-Reactive Protein)Vitamin B12Folate, SerumComprehensive Metabolic Panel (CMP)

🌱 Gut Health & Absorption covers these in one panel →

What engages this pathway

Ordered by how directly each one acts on the mechanism above — never by how much trial evidence exists. Each links to its full breakdown with dosing, half-life and vendor.

🧬 Oregano Oil

Carvacrol has broad antimicrobial activity, and one trial found herbal antimicrobials non-inferior to rifaximin in SIBO. Non-selective, so it hits commensals too.

✅ Clinically validated

🧬 Berberine

Antimicrobial as well as metabolic — a component of most herbal SIBO protocols.

✅ Clinically validated

🧬 Allicin

Stabilised allicin has particular activity against methane-producing archaea, which is the hardest SIBO subtype to treat.

✅ Clinically validated

🧬 Neem

Traditional antimicrobial used in the same protocols.

🧪 Theoretical / mechanistic

🧬 Caprylic Acid

Disrupts fungal cell membranes; used for Candida overgrowth.

🧪 Theoretical / mechanistic

🧬 Undecylenic Acid

Antifungal fatty acid with better mucosal persistence than caprylic acid.

✅ Clinically validated

🧬 Monolaurin

Disrupts lipid-enveloped organisms — viruses and some bacteria.

🧪 Theoretical / mechanistic

🧬 Wormwood

Traditional antiparasitic; thujone content means duration limits matter.

🧪 Theoretical / mechanistic⚠ Safety flag

🧬 Black Walnut Hull

Traditional antiparasitic, usually combined with wormwood and clove.

🧪 Theoretical / mechanistic

🧬 Grapefruit Seed Extract

Broad claims, and a long documented history of products being adulterated with synthetic preservatives that were doing the actual antimicrobial work.

🧪 Theoretical / mechanistic⚠ Safety flag

🧬 Mastic Gum

Direct anti-H.-pylori activity in controlled trials, plus symptomatic improvement in dyspepsia.

✅ Clinically validated

🧬 Olive Leaf Extract

Oleuropein with broad antimicrobial activity in vitro.

🧪 Theoretical / mechanistic

💉 LL-37

An endogenous antimicrobial peptide that also disrupts biofilm — the reason resistant overgrowth persists through antibiotics.

🧪 Theoretical / mechanistic

🧬 Saccharomyces boulardii

Competitively excludes pathogens and is unaffected by antibacterials, so it can run throughout.

✅ Clinically validated

🧬 Bismuth Subsalicylate

Biofilm disruption and antimicrobial activity; a standard component of H. pylori regimens.

✅ Clinically validated

🧬 Serrapeptase

Proposed biofilm disruptor. The rationale is better than the evidence.

🧪 Theoretical / mechanistic

🧬 D-Mannose

Binds E. coli fimbriae so bacteria are flushed rather than killed — genuinely elegant, and it has trial evidence for recurrent UTI without driving resistance.

✅ Clinically validated

🧬 Cranberry (PACs)

Proanthocyanidins prevent E. coli adhesion to the urothelium. Meta-analysis supports prevention of recurrent UTI — prevention specifically, not treatment of an active one.

✅ Clinically validated

🧬 Pau d'Arco

Lapachol and naphthoquinones with antifungal and antibacterial activity in vitro. Traditional use is long; human trials are absent and high doses are toxic.

🧪 Theoretical / mechanistic⚠ Safety flag

🧬 GI Relief

A formulated blend for acute gut irritation — demulcents plus anti-inflammatories.

🧪 Theoretical / mechanistic

🧬 Diatomaceous Earth

Food-grade amorphous silica marketed as a parasite treatment on a mechanical-abrasion theory that has no human evidence behind it. Inhalation of the powder is a genuine lung hazard.

🧪 Theoretical / mechanistic⚠ Safety flag
Nothing here is ranked by evidence tier. A lot of what works in this space has never had the trial run, and sorting by trial count would bury exactly the compounds you came looking for. The tier is a label. The mechanism is the map.

The other 4 routes to gut health & digestion

Pick the pathway that matches where you are actually stuck. An appetite drug does nothing for someone who already undereats.

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← Open this pathway in the interactive Vault

Frequently asked questions

What is the overgrowth, dysbiosis & antimicrobials pathway for gut health & digestion?

SIBO, SIFO and H. pylori all involve organisms in the wrong place or in the wrong numbers. This is the pathway where prebiotics make things worse and where the sequence — kill, then clear biofilm, then re-establish motility — determines whether it comes back.

What compounds and supplements work through overgrowth, dysbiosis & antimicrobials?

21 options are mapped to this pathway in the Vault, including Oregano Oil, Berberine, Allicin, Neem. They are grouped by the mechanism they act through rather than ranked by how much trial evidence exists — 9 carry clinical validation and 12 are mechanistic predictions.

How do I know if overgrowth, dysbiosis & antimicrobials is actually my problem?

SIBO's signature is a HIGH folate with a low B12 — the overgrown bacteria produce folate and consume B12. That combination on a standard panel is a genuine clue and almost nobody reads it. The markers worth checking are Complete Blood Count (CBC) with Differential, hs-CRP (High-Sensitivity C-Reactive Protein), Vitamin B12, Folate, Serum.

Are the 12 theoretical options for overgrowth, dysbiosis & antimicrobials worth considering?

Unproven is not the same as ineffective. Of the 21 options on this pathway, 9 have clinical validation and 12 are graded theoretical — meaning the mechanism is sound but the specific human trial has not been run, which is true of a great deal of what works in this space. Nothing on this page is ordered by evidence tier, because sorting by trial count would bury the compounds you came looking for.

Educational and research reference only — not medical advice, and not a recommendation for human use. Mechanistic predictions are exactly that: what the biology suggests should happen, which is not the same as what has been shown to happen.