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With host Dr Nirala Jacobi BHSc ND, Chief Medical Officer,

Nov 8, 2017

 In this episode, Dr Nirala Jacobi is in conversation with SIBO and diabetes expert, Dr. Mona Morstein.

Dr. Mona Morstein has been a naturopathic physician for 29 years. Her private practice, Arizona Integrative Medical Solutions Clinic, is in Tempe, AZ, USA. Her practice has always had a focus on treating gastrointestinal conditions and she was Gastroenterology professor at Southwest College of Naturopathic Medicine for 11 years. 

Dr. Morstein has been working seriously with SIBO patients for 5 years and is now considered to be an expert.   She has authored the recently published resource ‘Master your Diabetes’, which is the number 1 best selling book on type 2 diabetes on Amazon.  Dr Morstein was a speaker on the First and Second SIBO SOS Summit, and is now on the Medical Advisory Board of Quintron Instrument Company, Inc.  Dr. Morstein’s innovative and comprehensive Step by Step treatment of SIBO has earned her patients around the world. She has just created a high quality line of SIBO supplements through Priority One Supplements.


Topics discussed in this episode include

  • How did Dr Morstein get into SIBO and why did she want to specialise in this topic?
  • What is the association between SIBO and Diabetes?
  • Insight into A1C
    • 7 is considered well controlled, although damage to the human body is cited in the science as when the A1C goes over 5.5.
  • What are the four places in the body that cannot produce insulin resistance, and so express the effects of high sugar in the serum? How does this reflect the health of the rest of the body?
  • Diabetic neuropathy to the Autonomic Nervous System (ANS), particularly in the gastrointestinal tract (GIT) and how this relates to hypomotility and SIBO.
  • How do you specialise treatment to diabetes induced nerve tissue damage in the GIT as compared to other SIBO triggers, such as post-infectious SIBO?
  • What to use to treat autonomic diabetic neuropathy in SIBO?
    • Acetyl L-carnitine
    • Lion’s mane
    • Alpha Lipoic acid
  • Is diabetic neuropathy reversible?
  • Autoimmune vinculin damage to the migrating motor complex (MMC) in the small intestine.
  • Lion’s mane - powerful nerve regeneration capacity
    • Is there a role for it for regenerating nerves in the small intestine in light of Anti-Vinculin, and Anti-cytolethal Distending Toxin B (CdtB) antibodies?
    • The form of Lion’s Mane required - it must be water extracted.
    • Dose: 1 capsule bd.
    • Using Lion’s mane in conjunction with a prokinetic.
  • Patients with a strong history of post-infectious IBS or SIBO get more attention paid to prokinetics than those who may have adhesions causing the restrictions and outflow problems, rather than nerve based causation.
  • Diet, diabetes, and SIBO - where to start?
    • Low FODMAP
    • Bi-Phasic Diet
    • Specific carbohydrate diet (SCD) Diet
    • Fibre - what fibre, and how to integrate.
  • Why to have diabetic patients avoid grains.
  • The importance of short chain fatty acid (SCFA) butyrate for colonic cell health, and how to navigate this for diabetic patients in light of no grains.
    • Fibre powders.
  • Types of fibres for SIBO patients
    • Quinoa
    • Millet
    • Hydrolysed guar gum
  • Types of fibres for diabetic patients
  • Microbiome restoration in the large intestine
  • Dr Morstein’s specific SIBO protocols for diabetic patients - 8 Essentials
    • Diet
    • Exercise
    • Sleep
    • Stress management
    • Healing the gut
    • Addressing the microbiome
    • Environmental detoxification
    • Supplementation
      • Multivitamin
      • Fish Oil
      • Diamend - specialty diabetes product
    • All about the contents of Dr Morstein’s specialty diabetes product - Diamend (which contains benfotiamine)
    • What is Benfotiamine?
      • Fat soluble thiamin with positive benefits in neuropathy.
      • How does it interfere with glycosylation?
      • Maximum dose 450mg/day
      • Prevents damage in high glucose areas - protective to those who do not even have neuropathy.
    • Dysglycemia not just in diabetic patients
    • Tips to manage hypoglycemia in patients who do not have diabetes.
      • The role of the adrenals in reactive hypoglycemia
      • How to nourish the adrenals and the liver to rectify reactive hypoglycemia
      • Other triggers that can drive reactive hypoglycemia?
      • Products used for SIBO and Diabetes
        • How is berberine beneficial for clients with metabolic syndrome?
          • Turns off protein kinase-C
          • Reduces insulin resistance, promotes energy use, anti-inflammatory, supports the liver and bile function, reduces cholesterol and triglycerides.
          • Present in Diamend
          • A caution for berberine use for those with anxiety - impact on monoamine oxidase (MAO) for people with single nucleotide polymorphisms (SNP) in that area.
        • What role does the microbiome play in the development of diabetes?
          • Could we prevent the development of type 1 diabetes?
          • The type 2 diabetes microbiome and the impacts of inflammation, nutrient absorption, production of tumour necrosis factor (TNF), intestinal endotoxins and insulin resistance.
        • Dr Morstein’s products developed for SIBO via Priority One Supplements
        • Zanthoxylum (Prickly Ash)
          • Used for dry mouth syndrome
          • Motility agent
        • Dr Morstein’s top clinical tips for SIBO and Diabetes treatment



Dr Mona Morstein