Rifaximin for SIBO — Can It Increase My Tinnitus?

Hey guys! Does anyone here suffer from SIBO or IBS and take Rifaximin? If so, did it affect your tinnitus?

I'm having the usual anxiety we all have when trying a new medication. Any feedback would be appreciated.

 

Well my question got answered only a few hours after I took it. My tinnitus spiked from 4/10 to 8/10 with major crackling and fullness in the ears. Sadly I really need to take this medication and I hope to god my tinnitus goes back to baseline when I'm done. I've only taken one pill out of 28 and this stuff cost a fortune. Would you continue to take the med?

 

I'd say yes. I'm under the impression that any protein synthesis inhibitor antibiotic can spike tinnitus. Rifamycin/rifamixin is a protein synthesis inhibitor, so not only are aminoglycosides the bad guy.

 

Yup I found out very quick that it will. I am not taking it anymore and I hope this spike subsides.

Now I have a serious dilemma. How to cure the SIBO without Rifaximin?

 

Are you taking any probiotics? They certainly could be beneficial, and definitely tinnitus safe.

 

Rifaximin is very poorly absorbed. It isn't supposed to really leave the GI tract. Unlikely to spike tinnitus, but I guess it could still happen.

 

Probiotics are not recommended when suffering with SIBO.

 

This is exactly what my doctor and pharmacist told me yet my tinnitus went through the roof. I am going to try it again in a few days.

 

This is an old thread but I always like to reply when I have relevant info, just in case someone in the future wants to know more.

I took Rifaximin for one day (3 pills), with the plan of taking for two weeks. After taking the second pill, my tinnitus clearly was louder. But I had slightly tweaked my neck earlier in the day (really just a minor kink caused by being in an awkward position sitting for about 30 minutes), so I took a hot bath, and figured maybe it wasn't the pill. But I was more suspicious of the pill because my tinnitus spiked about 45 minutes after taking the second pill. I took a hot bath at night, and my very slight neck pain went away. My tinnitus was still slightly higher but I thought maybe the lingering effects of whatever from my neck still might be the cause. (Incidentally, the reason I thought (hoped) it wasn't the Rifamaxin was because I read a meta analysis medical study saying that in blood / urine tests, only .4 of this antibiotic leaves your gut and gets into your bloodstream or urine. But we who suffer from tinnitus know that even a little of something bad can potentially spike tinnitus, for reasons no one will probably ever understand.) So I decided to take the third pill at bedtime, and my tinnitus spiked throughout the night. It was still higher this morning although lower than overnight.

Obviously I am praying that this spike will calm down soon. (Also, by the way, my neck felt fine overnight and this morning so I no longer think that had anything to do with it -- it was this medication.)

I was conflicted about whether to continue, and pray that the tinnitus spike would calm down after finishing the medication, which is what has always happened for me (although the last terrible spike from Flagyl didn't calm down for a few months).

Often if a medication spikes my tinnitus, the spike will lower within a day or a few days, but that's usually short-term use, like Advil or Ambien (which I very very rarely take). I've taken a few other drugs that only spiked my tinnitus briefly and stopped when I stopped the medication. But I'm always very quick to stop anything that I think is spiking my tinnitus. (I'm not sure if it matters but I also eat about 90% whole plants and exercise 6 days a week -- sometimes I think those things help calm any inflammation faster but who knows.)

Anyway, this morning I was conflicted about whether to continue the Rifamaxin. So I decided to search this forum. After reading about others' experiences, I'm definitely going to stop.

My particular problem is that I have IBS (mild) from taking harsh antibiotics about 4 or 5 months ago. The most upsetting symptom is bloating. That might get better over the next year or so, or it might not. But it's definitely NOT worth worsening my tinnitus to solve that problem (even though I am very upset about that problem -- it doesn't interfere with my serenity every minute, of every day).

If you are considering Rifamaxin, I wouldn't do it unless whatever ailment you are experiencing is WORSE than worsening tinnitus.

 

I've been prescribed Rifaximin, and while it seems that tinnitus is a low incidence with this drug, it seems, anecdotally, people with pre-existing tinnitus get a spike? I've taken my first this AM but going to stop if it spikes. Has your spike gone down yet?

Elemental diet would be my next step if this doesn't work. Pimentel has some great resources on SIBO in general.

 

I've read his book, and another SIBO book, tons of online resources, medical studies, etc. I've also consulted with 3 gastroenterologists, with another planned later this month. And two naturopaths, with another planned later this month. Before the last two years, I never went to doctors. Ear infection + cat bite and resulting antibiotics, which led to chronic gastro issues, have really screwed over a formerly very healthy person.

But anyway. I'm pretty obsessed with gastro health at the moment because my bloating and what I considered mild constipation led to upper airway reflux (LPR), in about 6 months. By the way, I also consulted a reflux expert -- literally the doctor who coined the phrase LPR -- she says this is much more common than most people think, and often has effects before people realize -- thus "silent reflux."

Anyway, the reflux can permanently damage hearing because it can get into the Eustachian tubes. I've had a few things lately that I think caused spikes (dental drilling and acupuncture). But I started thinking the reflux was the main problem because my tinnitus has been finally calming down until I ate breakfast one day this weekend, laid down immediately for a nap, then my tinnitus was raging soon after I woke up -- lying down too soon after eating worsens reflux so there was a clear connection.

The reason I mention all of this is most gastro doctors do not believe SIBO should be treated in the way that Pimentel and many naturopaths propose. The last gastro doctor told me that my bloating *might* be chronic constipation caused by antibiotics screwing up my microbiome and therefore my gut motility (she thought this even though I have bowel movements a few times a day-- the issue is whether there is "complete" evacuation). She says resolving the constipation could resolve the SIBO, if I don't actually have IBS.

She also said I don't need antibiotics.

I'm currently trying bowel cleansing supplements (Magnesium Oxide). This is a special brand. Anyway that might have caused a slight spike in my tinnitus but I'm pretty sure that will go back down. She wanted me to do a high dose cleanse, then maintenance doses of Magnesium Oxide "might be all you need." I'm just hoping the lower maintenance dose doesn't spike tinnitus. And that this works for bloating and constipation. She said if those go away, the reflux will eventually resolve on its own. (There were some differences because her opinion and the reflux doctor... I'm just trying to put them together to get a solution.)

As far as the Rifaximin, yes, that spike went down after a day or two. But I only took two pills. My guess is that any spike would go down -- but maybe take longer if you took more.

I consulted with a gastro doctor at "Planted Forward," if you wanted to hear another opinion.

I'm reserving judgment for whether SIBO is really something to treat. She said that I probably have SIBO but the root cause might be constipation -- which would remedy if I can fix that.

She was definitely pretty opposed to antibiotics for my symptoms. She said it's mainly naturopaths diagnosing SIBO, and Pimentel, who she said is smart but very controversial among mainstream gastro doctors.

But IF I were going to treat SIBO, I would do the elemental diet, *especially* if you have constipation because most supposed SIBO with constipation requires both Rifaximin and Neomycin, the second of which is known to definitely be ototoxic. But even Rifaximin, as important as these symptoms are to me, I would not take again. The elemental diet has equal success in treating it.

 

Ah yes LPR, I actually got that after stopping Mirtazapine. And histamine intolerance as well, which I am hoping clears up. The LPR has improved a fair amount, so doesn't bother me every day. But I know too well how gastro stuff sucks.

I have had IBS-D for two years, and I got worse GI symptoms after taking probiotics for two weeks (and some acid reducers for part of that as well) in December. Bloating, cramps, gas, fun stuff.

Either way I am two days into Rifaximin and no spike yet, but of course you are always a little more aware as it's tempting to monitor it. The Rifaximin also seems to have given me 95% relief from not only my symptoms I picked up in December, but my IBS as well, almost like I don't have it anymore. I'm kinda shocked (so used to nothing going right). I know that it usually doesn't last, but if I can support my motility after and be careful I am hoping to hold onto a good chunk of this progress.

 

How are you doing these days?

 

I would love an update too.

I got tinnitus from the Neomycin + Rifaximin 8 months ago. Still dealing with it. =/

Still dealing with what I believe to be SIBO as well... brain fog, anxiety, poor gut motility...

Trying to manage symptoms doing zero carb at the moment. Slow progress, but seems to be subtly successful so far, after 2+ months in.

 

This video seems like a game changer for SIBO:

How I Cured My SIBO "IBS"...

I’m currently the sickest I’ve ever been in my life from what I think is likely Hydrogen Sulfide SIBO with d-lactate acidosis. I’ve lost 25 pounds this month because everything I eat makes me delirious and poisoned from the neurotoxins traveling into my brain.

It seems like Rifaximin is the gold standard antibiotic for killing off the invading bacteria, so it’s par for the course in my life that there’s a thread here saying it can worsen existing tinnitus.

Now I have to choose between potential brain damage and torture from catastrophic tinnitus. Unreal.

Anyways, the above video argues that simply repairing the MMC (Migrating Motor Complex) will cure SIBO. And the guy says that taking ginger extract and artichoke extract, while spacing meals out for 3-5 hours and fasting between dinner and breakfast will get rid of it.

I’m obviously skeptical but I use ginger a lot for my hyperacusis so what the hell...