The health of the gut determines the health of the body.  This is a well-known fact.  There are roughly 100 trillion cells inside our bodies, yet the there about 10x as many cells of bacteria living on our bodies.  This mass of bacteria lives in harmony with us (most of the time) and helps make sure our immune system is functioning and we are able to digest our food.   Without these bacteria in our gut and on our skin, we wouldn’t survive long.

That is all good news but what happens when these bacteria become imbalanced?  What are the implications to our health when we have an overgrowth of bacteria in the gut?  As we will see, when the small intestine is overwhelmed with bacteria (diagnosed as Small Intestine Bacterial Overgrowth – SIBO) it can have major impacts on our methylation cycle…it can make methylation problems much worse!

As a quick reminder, those of us with MTHFR, PEMT, MTR, MTRR, etc. have defects in how well we recycle homocysteine and how well we convert folic acid into folate.  Many of you are aware of Dr. Lynch and his concept that folic acid is a toxin for those with MTHFR.  While there is still some debate about this issue, Dr. Lynch is right on when he points out that having too much folic acid can impair the methylation cycle.  Here is how it works:

1) Folic acid comes from fortified food AND from gut bacteria.  Yes, you heard that right…folic acid is a NATURAL by product of the metabolism of bacteria that live in our intestines, mainly the colon.  Every person on earth gets some folic acid into their bodies from the action of our gut bacteria.

We get in trouble when the bacteria in our colon grows and moves into the small intestine.  Normally only a small amount of bacteria is found in the small intestine, but when the digestive system becomes imbalanced the population of bacteria in the small intestine can increase, creating a condition of SIBO.

2) Folic acid and folate both enter the cell through the same receptor.  If there is an excess of folic acid, it is harder for the folate to get into the cell.  The more folic acid you have inside your blood stream, the less often folate will get to the receptor.  In other words, there is competition between folic acid and folate, and when folic acid is elevated, it wins the competition to enter the cell.

3) In a person WITHOUT MTHFR issues, this poses zero problems since folic acid is rapidly converted to folate in their methylation cycle.  For the rest of us however excess folic acid makes it harder for us to create methyl donors.  Since MTHFR is often slowed down along with MTR, MTRR, BHMT and other SNPs, having high doses of folic acid may slow down the methylation cycle.  This is why folic acid in high amounts can be a problem.

There is new research that shows that the bacteria involved with SIBO actually poop out large amounts of folic acid (yes the dreaded folic acid!) and we absorb that folic acid into our bodies.  Many individuals with MTHFR C677T/A1298C, MTR, BHMT, etc. may have symptoms of under- or overmethylation due solely to the excess folic acid from improper gut bacteria and digestion.  An imbalance of the gut bacteria, namely in the small intestine, is a major reason WHY an individual has elevated unmetatoblized folic acid.  If we are going to balance methylation pathways, we need to control how much folic acid gets into the system. – we have to control the gut!

In other words, until the gut infection is properly taken care of, the methylation cycle is at the mercy of what is happening in the gut.  The same is true of important vitamins like choline, B12, vitamin D, protein, etc…the gut imbalance makes it very difficult to absorb these vitamins.  Side effects from vitamins are most commonly due to an untreated gut problem.

When someone has SIBO, or an overgrowth of “non-pathogenic” (aka normal species of gut flora) bacteria in the small intestine, the bacterial infection can produce EXCESS AMOUNTS OF FOLIC ACID!  Too many bacteria in your gut, can lead to way too much folic acid being released and absorbed.  This can lead to high blood levels of folic acid, which as Dr. Lynch and other researchers have shown, can impair the methylation cycle in people with MTHFR and other genes.  What I have just discovered is that one important and often-overlooked source of this increased, UNMETABOLIZED Folic Acid is a raging Gut Infection!

This gut infection, aka SIBO, is an infection made up of non-infectious bacteria.  Meaning, its not an infection in the traditional sense, its an overgrowth of something that should normally be there, only exists in way too high of a quantity.  This is a problem since the bacteria down there can produce folic acid while at the same time causing all kinds of other digestive issues.

As I will show in the next video, SIBO can be caused by antibiotics, proton-pump inhibitor drugs, chronic leaky gut, ileocecal valve dysfunction, and chronic stress.  All of these triggers make it easier for the bacteria that normally lives in the colon, to make its way up into the small intestine where it doesn’t belong.  In fact, those individuals who have been on long-term antibiotics and/or proton-pump inhibitors often have the most challenging methylation issues.  The reason is that those drugs – antibiotics and acid reflux medication – make is much more likely to get a Small Intestine Bacterial Overgrowth.  And with SIBO comes excess folic acid, low b12 and a host other malnutrition/methylation issues.

Common health issues associated with SIBO include:

  • Low B12
  • High Folic Acid
  • Low Iron
  • Low Vitamin A, D, E, and K
  • Low Omega 3’s and other fatty acids
  • Difficulty gaining weight / failure to thrive
  • Gas
  • Diarrhea
  • Bloating
  • Abdominal Pain
  • Food in stool
  • Fat in stool
  • GB disease
  • Acid reflux
  • Malabsorption
  • Difficuly losing weight / obesity
  • and much more…

Many patients with methylation issues are dealing with the symptoms I’ve just listed above.  The take away point is to realize that in order to heal the methylation cycle, you have to heal the gut.  Every supplement you take, every food, every beverage interacts with the bacteria in your gut.  If the gut is imbalanced and you have too much bacteria in the small intestine, you are likely going to have luke warm results until you treat the gut problem.  If someone is suffering from a digestive problem like SIBO with symptoms like the ones I’ve listed, it is going to be very difficult to fix the methylation issues until the gut is working better.

Because the bacteria in the small intestine have the ability to produce folic acid, many patients are suffering because their body is full of folic acid and they don’t have enough folate.  Dr. Lynch demonstrates that because folic acid can starve the cell of needed folate (L 5-methyltetrahydrofolate) it can weaken the methylation cycle.  And since the SIBO infection continously produces folic acid, I’m not sure taking more folate is the answer.

In our office we have learned to treat the gut first, making sure to clear out the gut infection before embarking on supporting methylation.  Through trial and error we have learned that until the gut bacteria is working properly, there cannot be methylation balance.  The research discussed in the videos above also supports this idea as well.  We all know having too much folic acid can create an imbalance.  I believe the many patients with digestive symptoms like bloating, reflux, gas, and abdominal pain of a chronic nature are suffering from some form of SIBO.  I also believe that unmetabolized folic acid is a SIDE EFFECT of a gut infection.  Even if someone avoids fortified foods and high doses of folic acid, just having SIBO means they can still be absorbing folic acid directly from the gut itself.

If you or someone you know is dealing with digestive issues and is concerned about methylation problems, then please contact my office.  We have developed effective, safe, and natural approaches to clear the gut infection quickly to make way for the more long-term healing methylation support.  Once the gut has been restored and is working properly, the body will be able to heal much more effectively and the methylation cycle can then be addressed.

Yours In Health,

Dr. Rostenberg

By studying the current peer-reviewed research, Dr. Rostenberg has discovered powerful, natural strategies to restore your gut and heal your body.  He can help you uncover the genetic or root causes of your health problem and find a natural solution!  If you would like help with your methylation genetics to improve your gut function and reduce/eliminate your symptoms, please contact Dr. Rostenberg at Red Mountain Natural Medicine today. Phone 208-322-7755. Email Website


  • September 12, 2014 Reply

    Paula Eisenberger

    How do you normally treat SIBO? I currently am suffering from SIBO and have had little luck eradicating it. It came on suddenly after eating spoiled chicken.

    • September 15, 2014 Reply


      SIBO is treated through a combination of powerful, safe, and effective nutrients and supplements. Drugs are not necessary and actually do more harm than good (this topic will be addressed in the second video). I would suggest that your spoiled chicken did the following: The bacteria growing on the chicken entered your stomach but your stomach acid wasn’t strong enough to kill all the bacteria in the food. Normally the stomach acid protects us from this issue when it is working properly. Then the spoiled meat entered your small intestine and the bacteria stayed in that area and began to grow. As you eat food, the food goes into the small intestine and if there is bacteria there the bugs will eat the food first. Over time this give the bacteria first access to the fertilizer (food) you are eating, and so naturally the bacteria continue to grow. This is why it is hard to eradicate…every time you eat a meal or take a vitamin there is a chance it will cause the bad bacteria to grow. I understand how this problem works and I can help you fix it naturally. Please reach out to my office 208-322-7755 or if you would like my assistance in treating your SIBO. In Health – Dr. Rostenberg

  • September 12, 2014 Reply

    Julie Martin

    Excellent Dr. Rostenberg. Thank you for sharing the “Ah Ha” moment the Gut is producing Folic Acid and that is how increased exposure is happening even when a person does not eat “enriched” foods! Super helpful! Also hoping that Robert and Linda Hendricks take advantage of your wonderful health talks and health care. THey live in Boise too!

    In Gratitude,
    Julie A. Martin, DC

    • September 15, 2014 Reply


      Thank you Dr. Julie…I appreciate your positive feedback!

      In Health,
      Dr. Rostenberg

  • September 13, 2014 Reply

    Mary Anne Prost

    I enjoyed the video very much, plan to share it with others, and look forward to seeing part 2. I found that I wasn’t able to make out the particular SNPs shown in the graphics under Methylation and IgA. Even with my glasses and a magnifying glass, I couldn’t make them all out, especially the GADs. If you feel it’s important to know if we have SNPs in the genes shown in the graphics, would you please share them in a larger format.

    Thanks much.
    Mary Anne Prost

    • September 15, 2014 Reply


      Hello Mary Anne,

      Thank you for your comment. You ask a good question about which SNPs are in the video. The video shows MTHFR, MTRR, MTR, ACE, GAD, COMT, MAO-A in those slides. There are other SNPs that combine with these as also. The take away message from the relationship b/t methylation and gut problems is that SIBO is very common and produces elevated levels of folic acid into the body. Many patients are suffering from symptoms of overmethylation – they take “good” supplements but actually feel worse. Now how is that possible? It is only possible if the gut bacteria are eating the vitamins FIRST, then pooping out something that the body doesn’t need. In the case of MTHFR and SIBO we are talking about how imbalanced gut bacteria leads to a toxic level of vitamin B9. This causes overmethylation, disturbs people with MTHFR and other genes…generally wreaks havok on our biochemistry. If you would like more help dealing with your unique issues, then please reach out! 208-322-7755 or – Dr. Rostenberg

  • October 19, 2014 Reply


    Thanks for a very informative video Dr Rostenberg. Just a small question about the ‘leaky valve at the exit of the small intestine. Is that cured as part of your natural treatment or is there need for surgery.

    • October 20, 2014 Reply


      Hi Corona, the leaky valve is a muscle, and like other muscles, when it is correctly massaged and taken care of, it works properly and prevents the leaky gut issues. Any skilled chiropractor trained in Applied Kinesiology can help fix this problem, without drugs or surgery, and usually in a very short time. Hope that helps. – Dr. Rostenberg

  • December 14, 2014 Reply


    Thank you for your informative videos. I have been devouring them and think the answer is definitely my gut.
    Over methylation due to being treated for homozygous C677T has made my body go CRAZY in response. Pain, neuropathy, hair falling out, bowel incontinence and debilitating hay fever. I am frightened and cry a lot (not intentionally). Don’t want my depression to return. I am homozygous for MTHFR, MAO, MTHRR, MTHFD1L, DAO, FOLR1 & 2, GAD, NOS, TCN2 and VDR and heterozygous for PEMT, MTRR, MTHFS, FUT2, CBS, BHMT and ACT.
    I have since made an appointment with a clinic in Australia, but can’t get in till March 2015. Is there anything I can do till then to help stop the downward slide. I have been eating Paleo since October, including nothing processed, making my own bone broth, drinking kefir, lots of leafy greens and am stumped as to what next.
    Thank you so much if you reply, as I realize the pressure on your time. Liz

    • December 18, 2014 Reply


      Hello Liz,

      Thank you for reaching out and sending me a message. Your history is a perfect example of what happens when you throw high amounts of fertilizer (methylfolate) into a body that isn’t ready or willing to accept that much stimulus. In other words, taking the B-vitamins and other nutrients without dealing with the gut (when there is a gut issue) leads to symptoms such as yours. The bacteria we harbor in our bodies are necessary for life, but they often become imbalanced, excessive in growth and aggressive. This leads to the bacteria releasing all kinds of chemicals when you eat good healthy food and take good healthy vitamins. The reason your body is reacting this way is that you are reacting to what the bacteria are releasing into your system, rather than benefiting from the vitamins themselves. I can help you unravel this problem and find a natural solution. I work with Aussies via Skype and we can connect live in person if you wish for my help. In Health, Dr. Rostenberg.

  • April 29, 2015 Reply

    Suzanne Young

    Thanks so much for sharing all this wonderful information. Does resident starch like potatoes starch feed the bad guys as well as the good bacteria? Thanks

    • May 2, 2015 Reply

      Dr. Rostenberg

      Hi Suzanne,

      Thanks for your comment. If a patient is extremely sensitive to bacterial overgrowth and/or has a candida or blood sugar problem, then even potatoes can make them worse. Potatoes are a member of the nightshade family and certain people with chronic health challenges do better by avoiding nightshades as well. That being said, potatoes are not FODMAP foods and so they typically are tolerated by people with SIBO. I would encourage you to experiment by using small amounts to see how your body tolerates them.

      In Health,

      Dr. Rostenberg

  • May 12, 2015 Reply

    Rebecca Corvello

    I would be less skeptical if you posted copies/links to these “scientific journal” articles. I want to read these for myself and then decide if you are correct.

    • May 12, 2015 Reply

      Dr. Rostenberg

      All the scientific references are clearly marked and highlighted in the video. I’ve spent thousands of hours reading and sifting through the research, and the articles and blogs on my website are the result of that effort. Luckily, all you have to do is push pause on the youtube video, write down the PMID number and put that into google. That will bring straight to the peer-reviewed journal articles I used to back up all the claims made on the videos and articles.

      Dr. Rostenberg

      • October 7, 2016 Reply


        You mean folate is synthesized by bacteria, not folic acid. Folic acid is man made and doesn’t occur in nature. Folate though is produced by bacteria and plants in abundance,

        • October 10, 2016 Reply


          Hi Carolyn,

          Thanks for your comment. I can assure you what I wrote and said is 100% scientifically correct. Folic acid is made by man, but it is also made by nature. Why would our bodies have the capability to convert folic acid into folate if the first time we ever came into contact with it was 1946? The answer to your question, which I have provided several peer-reviewed references in my videos, is that folic acid is produced by bacteria AS WELL AS by mankind. Its just the way it is. So if someone has too much bacteria like a SIBO problem, they often have high levels of FOLIC ACID even though they didn’t ever supplement with any; even if they are gluten free and don’t eat processed food they can still have sky high levels of FOLIC ACID. The reason is that bacteria can poop out either folate or folic acid, because these are almost identical and simply have two hydrogen atoms rearranged. Again, thanks for your comment but I have to disagree with you. Bacteria in fact capable of pooping out chemically identical FOLIC ACID just like man figured out how to synthesize way back in the 1940’s.

          In Health,

          Dr. Rostenberg

          • December 1, 2016


            Hi Dr Rostenburg,

            I am a PhD student studying the impact of folic acid on gut bacteria and host health. I like your general message here, that we must consider our gut microbiota when taking vitamins and supplements, however I disagree wholly with your insistence that folic acid is natural. Folic acid is a synthetic supplement. It has an oxidized pteridine ring. I have checked your references and these papers show no evidence for bacterial synthesis of folic acid. Infact, the paper you reference on the slide which talks about folic acid is infact a review and does not mention the words ‘folic acid’ in the paper. It is decieving (and baffling) to tell your listeners that when the literature says ‘folate’ they infact mean ‘folic acid.’ This is simply not the case. I can only assume this is to boost sales of your folic acid alternatives?

            Please could you send me the reference of the paper which has found the bacterial enzyme which is able to oxidize the pteridine ring of tetrahydrofolate.

            Awaiting your reply and willing to answer your questions.

            Best wishes,

            Claire Maynard

          • December 26, 2016


            Hi Claire,

            Thanks for your comment. You are a good researcher to be asking such a detailed question. The issue with your question is that the scientific literature for a long time used the words “folate” and “folic acid” interchangeably. Now that generally has been tossed aside in favor of the word folate denoting the natural sources of B9 and folic acid denoting the artificial form. What caught my attention was research that said in plain English that bacteria synthesize folic acid. Now I will admit we might be letting the nomenclature confuse us here, as the researchers could mean folic acid to represent natural folates as well.

            Folic acid received its name in 1941 when it was isolated from spinach 2folium ˆ
            leaf 2Lat.)] and was shown to be a growth factor for Streptococcus lactis R2 S. faecalis) 2Mitchell et al, 1941). A large number of other names were given 2Table I). The compound was subsequently synthesized in pure crystalline form in 1943 by Bob Stokstad working at Lederle Laboratories 2American Cyanid Company) in Pearl River, New York, and by Angier et al 21945). This proved that folic acid was composed of a pteridine ring, paraminobenzoic acid and glutamic acid, and was called `pteroylglutamic acid’ 2PGA) 2Fig 3). Soon after its synthesis, it became apparent that natural folates usually differed from pteroylglutamic acid in three respects: 21) additional glutamate residues 2`polyglutamates’), 22) reduction to di- or tetra-hydroforms, and 23) additional single carbon units, e.g. methyl 2±CH3), formyl-CHO, methylene CH2, methenyl CH4 attached to the N5 or N10
            nitrogen atoms 2Fig 3). Folic acid (pteroylglutamic acid) is now used to denote the fully oxidized chemical compound, not present in natural foods.

              The term `folate’ is used to denote the large group of compounds possessing the same vitamin activity and includes natural folates and folic acid.

            Br J Haematol. 2001 Jun;113(3):579-89. PMID: 11380441


            The potential of the folic acid biosynthesis pathway as a target for the development of antibiotics has been acknowledged for many years and validated by the clinical use of several drugs. Recently, the crystal structures of all but one of the enzymes in the pathway from GTP to dihydrofolate have been determined. Given that structure-based drug design strategies are now widely employed, these recent developments have prompted a re-evaluation of the potential of each of the enzymes in the pathway as a target for development of specific inhibitors.

              Here, we review the current knowledge of the structure and mechanism of each enzyme in the bacterial folic acid biosynthesis pathway from GTP to dihydrofolate and draw conclusions regarding the potential of each enzyme as a target for therapeutic intervention.

            – Bioessays. 2002 Jul;24(7):637-48. PMID: 12111724

            Lets not let the nomenclature distract us from the message – your gut bacteria produce vitamins and that can be a good and a bad thing, depending on the situation. I will leave it up to hard-working PhD’s like yourself to determine if folic acid or folate is the better word choice. But just look at the two references I provided…even published authors are throwing the folic acid concept around when talking about gut bacteria.

            Yours in Health,

            Dr. Rostenberg

  • July 14, 2015 Reply

    Mike Pfirrman

    I liked this article. I’m a bit of a professional researcher too but not a medical professional. My wife was diagnosed with fibromyalgia in January and felt like death. Within 6 months, she’s 90% better from saying she would rather die than go on living like that (back at the beginning of the year).

    I found out about methylation (and had it confirmed with 23andme) before really looking at SIBO as a potential cause. I wish I had known about this in advance and the Folic Acid load on her system. We are now addressing the SIBO along with diet, exercise and methylation therapy and she’s doing tremendously well. We also found (after looking long and hard) a Holistic MD that specializes in fibromyalgia that doesn’t think it’s all in her head (and doesn’t just throw Lyrica at her).

    From all the research I’ve done, you’re on the right track Dr Rostenberg. Nice article.

    • July 15, 2015 Reply

      Dr. Rostenberg

      Thanks for your comment Mike! – Dr. Rostenberg

  • December 15, 2015 Reply


    Hi Dr. Rostenberg,

    It seems you have done a lot of own research – could you please tell me what do you think about the idea that SIBO is autoimmune disease caused by the body attacking small intestine nerves – at least this is what dr Pimentel claims. I have no doubt that this is true for some people – the question is what percent of SIBO patients have SIBO as a result of this autoimmunity

    • December 21, 2015 Reply


      Hi Pet,

      I haven’t heard about the autoimmune connection to SIBO. If you search for that in pubmed, you don’t find a lot of research. It is possible to have an autoimmune response to ANY tissue in the body – it is possible what Dr. Pimentel is saying. The immune system is capable of attacking any tissue we have, be it brain, gut, skin, muscle, blood vessel, eye, thyroid, etc. So the physiology exists for an autoimmune response to the small intestine to cause SIBO. The evidence points in a different direction however as I have covered in my MTHFR and SIBO blog posts and videos.

      In Health,

      Dr. Rostenberg

  • May 24, 2016 Reply


    Hi Dr Rostenberg,

    In a TFT stooltest they discovered I had
    1+ candida albicans
    1+ candida parapsilosis
    3+ alpha hemolytic strep
    3+ gamma hemolytic strep
    4+ citrobacter freundii complex
    3+ enterobacter cloacae complex
    3+ klebsiella oxytoca

    No growth bifidobacterium
    No growth enterococcuss spp
    No growth Escherichia coli
    4+ bacteroides fragilis group
    1+ lactobacillus spp

    Would the gut protocol help here? If so I I’m confused with the 4 week follow through period.
    Is it 10 days the recommend supplement protocol & Monomeals
    Then 30 days the recommend supplement protocol (& no monomeals)
    Then 30 days the reduced supplement protocol from the bottom of the page
    Then nothing anymore?

    • June 2, 2016 Reply


      Hi Kris,

      Thanks for your comment. Yes, the 10-day gut protocol would help in a case like this. For 10 days just following the directions exactly. After that for a period of 30 days, reduce the dosage of products as it lists on the Protocol page. After the first 10 days is over you stop eating monomeals and just combine food always eating organic and low glycemic as much as possible. IF needed, the second 30 day phase can be extended for an additional 60 days for a total of 90+10 days. Hope that helps!

      In Health,

      Dr. Rostenberg

  • May 29, 2016 Reply


    Would you be able to help someone in IL without them coming there?

    • June 2, 2016 Reply


      Hi Val,

      Thanks for your comment. Yes, we work with people all over the world – Ireland, South Africa, Poland, etc. – as well as right here in the USA. Distance doesn’t mean we can’t help you, and while an office visit is best, we work with patients every day over phone or Skype. Let my staff know you would like to schedule a consultation by calling 208-322-7755 or emailing us at

      Yours in Health,

      Dr. Rostenberg

  • June 15, 2016 Reply


    Thank you for this information. Do you have any links to the research you mention above? I’m really interested to read more about this and share it with others.

    “There is new research that shows that the bacteria involved with SIBO actually poop out large amounts of folic acid”

    • June 20, 2016 Reply


      Hi Yvette,

      The links to the science in are in the video. Simply pause the youtube video and then write down the PMID# and search for the research. Go to and search “folic acid bacteria”. You will find the data there. Hope that helps!

      In Health,

      Dr. Rostenberg

  • July 11, 2016 Reply



    I have mfthr c677, apparently. Sibo, pots, adrenal fatigue, borderline low thyroid…im taking supplements for Sino hoping mfthr supplements will help. I can’t do no carbs no milk I do no gluten little rice meat and some veg..can’t eat potatoes, yeast. Sugar, fruit etc…been going on ten years I’m now so dizzy…I have a toddler and struggling to function..

    What’s the best treatment for Sino if got mfthr? I’m worried about antibiotics ..

    I have right side of facve, neck, arm leg muscular spasm flaccid..makes me look like have a wonky face. Worse after seeing or toilet, low bp, massive belly when eat foods, constipation, headaches, breathless, bad fatigue, sudden mood drops, hair loss, thinned skin, mood swings, excema, no libido, sudden drops in temperature, tinitus, alcohol intolerance black out, can’t handle stress I’m ill, exceeds intolerant, depressed, sudden can’t think confusion, yeast infections, mouth ulcers, can’t tolerate stress, heart pounding, feeling like I’m going to fade out…. loads of symptoms…

    I’m seeing a professor for Sabo. Next month, nutritionist for mfthr who also says I need sex hormones and cortisol tested… but specialist endocrine said he thinks Sino malabsorbing affecting hormones and everything….nhs don’t do mfthr testing I’m single mum on my own trying to oay for nutritionist… feel like a loosing battle any advice would be really appreciated as ruined last ten years of my life and got worse since having baby…

    Thank you Amanda 😢

  • October 4, 2016 Reply


    Thank you so much for making this all a little less confusing. I seem never to be the norm. I tested in the extremely high range for SIBO, off the charts. My folic acid levels are low,not high. Several others (A, B12, B1) are borderline. Does this make any sense at all? Could there be some reason I am not showing low levels of some nutrients even with the SIBO?

    Since the test for SIBO I have found I am COMT +/+ V158M. My gut feeling (no pun intended) is that I need to fix my digestion issues before I am able to help any methylation problems. So many of my pathways seem to be going into the wrong direction.

    Thank you so much,

    • October 7, 2016 Reply


      Hi Sherrill,

      Thanks for your comment. Yes, the gut must be fixed first just like the foundation of a house must be square before you go and spend money remodelling the other rooms, etc. The gut is just the first step, cannot be skipped. Sounds like you need a custom protocol to kill gut bugs and help restore normal peristalsis and motility. SIBO can be very well treated naturally, although it takes a few months for most people and requires a diligent diet and plan. My office can help you get this sorted out and on the path to recovery. Please reach out and contact us directly at 208-322-7755 and You can and will be better!

      In Health,

      Dr. Rostenberg

  • October 31, 2016 Reply


    Hi Dr Rostenberg,

    I sent an email but also thought it might be easier to leave a comment here. I have SIBO (Streptococcus overgrowth). My doctor wants to start working on it with herbs (Oil of Oregano) and probiotics. I also have the methylation defects, and she wants me to start off with a low dose of Methylfolate (200mcg) in conjunction with the herbs etc.

    I tried B12 early into my CFS, but it overwhelmed my system.

    1. Is it okay to start the folate while simultaneously working on the gut?

    2. Is it okay to start the methylfolate without B12? My B12 levels were in range, but a little on the low side. I have read Folate without B12 can lead to methyltrapping. I thought I might try B12 again down-the-line, eventually ..

    • October 31, 2016 Reply


      Hi David,

      Thanks for your comment. In my experience it is unwise to use methylation support at all until you have made progress with healing the SIBO issue. SIBO will create its own set of methylation problems, so taking methylated B-vitamins on top of that problem usually produces bad reactions, insomnia, pain, anxiety, etc. I say avoid until you know your SIBO is much more under control.

      In Health,

      Dr. Rostenberg

      • November 1, 2016 Reply


        Thank you Dr Rostenberg. Do you believe that Oil of Oregano is a suitable treatment for SIBO? I have read it can kill off good flora as well, so was a little concerned.

  • June 8, 2017 Reply


    Hi Dr. thank you for the above article it was fascinating. I wanted to know have there been any studies that you know of to prove this relationship with the folic acid competing with the folate absorption? My daughter is 14 yo and has autism and left lower extremity osteosarcoma for which she had chemo and above knee amputation. I am strong believer in cerebral folate deficiency and am having her testing for MTHFR gene mutations and FRA. Please guide me to any studies that I could look over.


    • June 12, 2017 Reply

      Dr. Rostenberg

      Hi Asma,

      There are studies if you search…the most important one I believe is this one:

      “Increased consumption of folic acid is prevalent, leading to concerns about negative consequences. The effects of folic acid on the liver, the primary organ for folate metabolism, are largely unknown… We suggest that high folic acid consumption reduces MTHFR protein and activity levels, creating a pseudo-MTHFR deficiency. This deficiency results in hepatocyte degeneration, suggesting a 2-hit mechanism whereby mutant hepatocytes cannot accommodate the lipid disturbances and altered membrane integrity arising from changes in phospholipid/lipid metabolism. ” – Am J Clin Nutr. 2015 Mar; 101(3): 646–658. PMCID: PMC4340065

      Hope that helps!

      Dr. Rostenberg

Leave a Comment

Error: Please check your entries!