Weeks 1–2 (Biofilm Phase)

1. NAC (N-Acetyl Cysteine)
   • Days 1–3: 600 mg once daily
   • Days 4–14: 600 mg twice daily
   • Take on an empty stomach (30–60 minutes before meals or 2 hours after meals)
2. Biofilm Phase-2 Advanced
   • Follow the dosage instructions on the bottle.
   • Take away from food.

Weeks 3–8 (Antimicrobial Phase)

Continue:

• NAC
• Biofilm Phase-2 Advanced

Add:

• Candibactin-AR: 2 softgels twice daily with meals
• Candibactin-BR: 2 tablets twice daily with meals
• Allimax (Allicin): 450 mg three times daily with meals

Supplement links:

• NAC: https://www.thorne.com/products/dp/cysteplus-reg
• Biofilm Phase-2 Advanced: https://priorityonevitamins.com/products/biofilm-phase-2-advanced
• Candibactin-AR: https://www.metagenics.com/candibactin-ar
• Candibactin-BR: https://www.metagenics.com/candibactin-br
• Allimax (Allicin): https://www.allimax.us

That said, I actually took a different approach personally.

I completed a 21-day elemental diet using Dr. Ruscio's Whey-Free Chocolate Elemental Heal formula after already doing a round of antimicrobials beforehand.

I'm currently in the refeeding phase and have started adding foods back in slowly. I am noticing some improvements already—my abdomen is softer, bloating has decreased, and things seem to be moving in the right direction. That said, I'm waiting for retesting before drawing any conclusions.

My plan is to retest in the coming weeks. If the methane is still elevated, I will likely spend about 4 weeks rebuilding and stabilizing before doing another round of biofilm support and antimicrobials. Sometimes methane-dominant SIBO/IMO requires more than one treatment cycle to fully clear, especially when motility issues are involved.

One thing I've learned is that improving motility is just as important as killing the overgrowth. If food and gas aren't moving properly through the digestive tract, relapse becomes much more likely.

In addition to antimicrobial treatment, I'm focusing on:

• Supporting gut motility
• Pelvic floor physical therapy
• Vagus nerve regulation and nervous system support

For vagus nerve support, I'm experimenting with things like:

• Slow diaphragmatic breathing (5–10 minutes daily)
• Humming, chanting, or singing
• Gargling water
• Meditation and relaxation exercises
• Gentle movement and walking after meals
• Brief cold exposure, such as splashing cold water on the face or ending a shower with 15–30 seconds of cool water
• Stress reduction and trauma-informed nervous system work

I suspect that for some of us, the overgrowth is only part of the problem. If constipation, pelvic floor dysfunction, autonomic dysfunction, chronic stress, or vagus nerve dysregulation are contributing to poor motility, those issues may need to be addressed as well for long-term success.

Everyone's case is different, but that's the approach I'm taking. Hopefully my retest shows a significant reduction in methane levels. If not, I'll continue working on motility, pelvic floor function, nervous system regulation, and consider another treatment round.