I get a lot of questions about the use of honey with SIBO. Many of my muffin, smoothie, and treat recipes call for honey. So, why do I use honey if it is not Low FODMAP?
The Use of Honey For SIBO
For a long time, honey was thought to be Low FODMAP because it is easy to digest and has been used for decades for those with gut health issues.
However, about two years ago honey was tested and proven to be high FODMAP, even clover honey. At the time honey was shown to be high FODMAP, SIBO began picking up steam in main stream medicine and general practitioners began using the Low FODMAP Diet for gut related issues including SIBO. In the years before the Low FODMAP diet, the GAPS Diet and Specific Carbohydrate Diet were the main diets used to lower SIBO symptoms. Because honey was used in both the main diets to help with SIBO and honey (especially clover honey) was thought to be Low FODMAP, there wasn’t any fear surrounding its use. After all, many SIBO patients used honey in their diets successfully. It wasn’t until SIBO began to hit main stream medicine and honey was shown to be high FODMAP that the use of honey became a concern. But is the concern legitimate or helpful? And how exactly does the body digest honey?
While the Low FODMAP diet was designed to help with digestive issues, it was NOT designed specifically for SIBO. The only two diets designed for SIBO are the SIBO Specific Food Guide by Dr. Siebecker and the SIBO Bi-Phasic Diet by Dr. Jacobi. While the Low FODMAP diet does not include honey, both of the diets designed to target SIBO specifically do allow honey. This is because many SIBO patients actually tolerate small amounts of honey well.
Honey is easily broken down by the body very high up in the digestive tract. As a result honey has been used successfully for decades for those with digestive issues and SIBO. For most SIBO patients honey can be digested and absorbed before it reaches any SIBO bacteria thus feeding the body well without feeding the SIBO. Honey is used in the homemade elemental diet formula to treat SIBO because most SIBO patients can break it down and absorb it in the upper part of the small intestine. It can be a fast energy source and help make SIBO-safe recipes more palatable.
When Honey Is Not Good For SIBO
For those with SIBO located as high up in the digestive system as the stomach honey may not be helpful but for those who fall into this category most carbohydrates (even Low FODMAPs) are going to be difficult to digest before the bacteria can eat it and cause symptoms. For those who have SIFO (Small Intestinal Fungal Overgrowth) or Candida, honey can also cause problems because yeasts can feed on the sweet syrup. In this case Stevia is recommended as the replacement sweetener.
Some doctors do not allow the use of honey in diets used to lower SIBO symptoms. If your doctor has told you not to use honey then you should follow your doctor’s guidelines.
Many doctors will encourage patients to avoid any fruits or sugars in the first phase of a SIBO diet protocol. This is also in line with most intro diets which begin with proteins, low FODMAP vegetables, and bone broth. The idea behind this is to lower symptoms faster, especially if SIFO may be involved, or if taking pharmaceutical antibiotics. Pharmaceutical antibiotics only target bacteria and are not anti-fungals. When antibiotics are taken fungal overgrowths occur very easily, as the bacterial void allows room for yeast and other microbes to grow. Herbal treatments are generally broad spectrum antimicrobials so bacteria and yeasts are killed at the same time.
Clover, Clear, and Runny Honey
When using honey for Small Intestine Bacterial Overgrowth the words “clear” and “runny” and sometimes even “clover” are used.
“Clear” is probably the worst word to describe honey that is safe for SIBO. I have no idea why “clear” was picked.
What clear really means is filtered honey with a light, golden-color that is still in liquid form. Unfiltered honey contains pollens, wax pieces, propolis, and other tiny things that can be difficult to digest (even if they are healthy for you).
The test I use is to hold a jar of honey up in the sunshine and if it glows and you do not see a lot or any suspended particles that is “clear” honey and is what you are looking for. So most of the light, golden-colored honeys in the store will work. Also, when you drizzle the honey it will look pretty clear as it streams down from a spoon or squeeze bottle.
Stay away from whipped honey, solid honey, and dark, coffee-colored honey.
Clover honey is often recommended because it was thought to be low FODMAP even when other honeys were proven otherwise and it is easily found in stores. Clover honey has been recommended for SIBO patients for a long time with proven helpful benefits like its use in the Elemental diet and in recipes to help SIBO patients gain weight. This track record of success is part of the reason why the word “clover” is used to describe honey for SIBO.
Why I use honey on Journey Through SIBO
Honey is used on the diet designed specifically for SIBO so it is a food item I use on this blog. I also happen to be one of those people who tolerate honey well. It helped me gain and maintain weight when I needed it the most.
My body does not tolerate Stevia and it tends to trigger migraines for my husband so it is not something I bring into my home to cook and bake with which is why you will not find recipes with Stevia on Journey Through SIBO.
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lovely post! i had honey yesterday, woke up this morning and thought omg, what happened? your explanation is so much clearer than other articles i’ve read who never mention the location of the overgrowth and its potential impact on our ability to digest certain “allowable” foods that are otherwise fine. this was super helpful. i’ve passed it along to others also experiencing confusing. thank-you!
Absolutely!! Never knew SIBO could reach the upper level of the GI tract! Explains SO much! But I tolerate honey well after a period of strict Eskimo Diet and symptoms usually only occur when I allow other carbs to creap back into my diet. Coeliac diet 100 yrs ago was in essence, Eskimo, I.e. ZERO carbs. It really works on all G I symptoms, though weight soon crashes 🙁
Thank you so much for the clarification. As someone recently diagnosed with SIBO, I had anxiety around the idea of honey, so this information is extremely useful.
Thank you so much for your blog AND this article. My 9 yr old was just diagnosed with SIBO, so we are figuring things out. Your blog has been the most helpful resource I’ve found so far!
I would LOVE to use honey in recipes and after reading your article, I feel hopeful about doing so. Could you share some of your resources for your post? For me to add honey into my daughters diet I need to do my due diligence and be confident that the breakdown does indeed occur in the upper part of the small intestine.
Again, thanks so much for the time and energy you put into helping the rest of us!
Hey Sarah,
For the most up to date SIBO diet information I recommend watching/attending one of the SIBO conferences where you can hear from the leading experts and researchers. The Integrative SIBO Conference is available for purchase online. The SIBO Symposium is a great conference to attend. As well as the SIBO Diet Masterclass with Dr. Siebecker through SIBO SOS (available online). Look for experts like Dr. Allison Siebecker, Dr. Steven Sandberg-Lewis, Heidi Turner, Lisa Shaver, Dr. Mark Pimentel.
That was an excellent article. I was researching the “clear” honey aspect of my Bi-Phasic protocol, and this article saved me a lot of time and effort. Thank you so much for sharing it and explaining it so very well!
Hi,
Why not maple syrup or sugar instead if they are considered low FODMAP? And any insight to if you do not have SIBO but LIBO? Thanks
Hi Sarah,
The Low FODMAP diet was not made for or intended to treat SIBO. The SIBO diets incorporate low FODMAP foods and properties to help heal SIBO but they are more complex diets. Even SIBO experts say a straight Low FODMAP diet is not successful for those with SIBO. However, to get a scientific answer to your question you’d need to pose it to Dr. Siebecker or Dr. Jacobi. What I can tell you is that people with SIBO who eat sugar don’t get better. For LIBO, you’d just have to give it a try. I haven’t heard any of the experts speak on honey and LIBO directly.
Elena
Hi! Thank you for this very interesting article. I recently stumbled upon a potential SIBO diagnosis after I added probiotics to my diet and had a bad flareup of some recurrent digestive issues. SIBO alongside low stomach acid seems to explain a lot of the symptoms I’ve dealt with over the years. Interestingly, I was previously taking manuka honey daily for another issue and found that my stomach issues went away. Health is such a personal and complicated thing!
This is a great article. Thanks so much for writing it. I’ve done SIBO SOS, and I have just relapsed after 3 months treatment with Rifaximin and Neomycin. 2 months free and whammo. It’s right back full force… maybe I’ll stop sweet things all together after reading this (again).
How do I know if I tolerate honey? Does the bloating increase after eating it? Is there a telltale sign I don’t tolerate it well? I NEVER had many carbs or honey (only maple syrup occasionally) before this SIBO and was experimenting with a new ‘diet’ (way of eating to heal adrenal fatigue) that brought in more fruit and carbs (1/4 – 1 cup per meal) but resulted in SIBO. I am enjoying eating clover honey (when I can find it – do you have a source?). But I am wondering how to tell if I have bacteria higher up as you mention. Do I actually bloat above the belly button?
Thanks, looking forward to your reply.
Hi Holly!
To determine if you tolerate eating honey you will need to try eating some honey, either alone or alongside foods you know you tolerate, and wait to see if you develop your normal SIBO symptoms. There isn’t a telltale sign as everyone is SO different in how they report symptoms. A good way to determine where your SIBO is located is to note the time when you develop symptoms, the faster you develop them the higher up your SIBO is in your intestines. But the very best way to determine where your SIBO is located is to look at your SIBO test and see where your bacteria spikes along the time graph. Your doctor should have discussed this with you prior to starting treatment, as it can affect treatment. Do you feel bloating, stomach pain, or indigestion as soon as you eat? This could be a sign your SIBO is higher up. But again, look at your SIBO test- the earlier your methane and/or hydrogen go up, the higher up or closer the SIBO is to your stomach.
Also, did you discuss why you got SIBO with your doctor? While relapse is common it is less common when the source is treated alongside the SIBO.
Elena