Interesting! I had Giardia as a kid, it was absolutely terrible. I wonder if it's true that it can remain dormant in your system for a long time.

1. No, we can't and we need not assume that the study was sponsored by those companies. This would be divulged at the end of the paper, and no conflicts of interest were reported. Johns Hopkins University doesn't work like that; in fact, funding to research universities, to their programs including their medical programs, works quite differently. I know because my work has involved such things. Not to mention that supplement companies don't have the kind of money to fund such studies. They are not multi-billion dollar companies like pharma. Moreover, even if the study was supported by the companies, which it was not, how would that be relevant? Are you insinuating that this corrupted the data, that the authors doctored the results? That's one serious accusation, which would then have to be proven, again not assumed.

2. The length of time of the studies and hence use of the supplements are not arbitrarily set. They are not testing long term, random usage of said supplements, but a one-month course of these herbal antibiotics, which is the norm for herbal antibiotic use in SIBO. This is the standard in pretty much all studies. Just like a pharmaceutical course of antibiotics tends to be 14 days for SIBO. There are standards depending on the condition and so it's not really a criticism of the study that they didn't go against protocol and standards.

So I don't know how it's relevant to the study that they may or may not be safe long term. They are effective and safe for the purpose of the study and condition under study. I also don't see how you draw the following inference: "we dont know these products are really safe apart from hear say knowledge". The study is not "hear say", it's a leading study by a leading research university.

3. Regarding the second study, just because a study involves a smaller number of participants, it doesn't follow that it has no "credibility at all".

And as I said very clearly, there are many other studies, not just two. I've read dozens myself. You can look for them. I'm not going to bother posting them here, because you seem dead set against the potential that herbal antibiotics can be and are both safe and effective, even in the face of quality studies. I'm sorry to hear you had a bad experience with "herbal medicines", but personal experience is no reason to mis-characterize people's quality work and evidence based on much larger sample sizes and better controls than a single person's negative experience. The evidence speaks for itself, and as a researcher and a patient I value quality research.

I don't have anything against herbal products per se, but generally I think mainstream medicines are more effective, safer, and better tested short and long term.

I take your point regarding the university study, I wasn't saying their research was bias, perhaps it seemed like I was implying it which wasn't my intention. However, I do think these small study papers have poor statistics, any conclusions based on 10-15 people are weak even for a pilot study. I think any scientifically minded person would agree. For example, there is a clinical trial for a drug to replace lyrica which has 1000 patients in it at the moment. I hope it works out for them.

A lot of mainstream medicines are derived from plants so it would be foolish to deny the value the plants in medicine. However I am a big believer in science and medicines that have been properly tested, just having one paper on a small group of people taking a herb or any medicine doesn't justify its safety or efficiency. It takes many years of hard work to know a medicine is safe, and even then, it will cause problems for some people. Thanks for an interesting discussion.

"I think mainstream medicines are more effective, safer, and better tested short and long term."

There just aren't enough studies, not nearly enough, to settle the issue either way on effectiveness, and on a number of issues, including SIBO, studies are showing the opposite, namely, that herbals are more effective. Regarding safety, I'm surprised you say this, given the horrendous list of side effects that come with many pharmaceuticals. Regarding studies, you're certainly right, but we know why that's the case. But sure, it is definitely the case.

In an ideal world where there would be more funding for researching the wealth of natural substances at our disposal, we would have more studies and on larger scales. But we take what we have, and there are hundreds of smaller scale studies being conducted yearly for herb based medicines for various conditions. And honestly, if I can help it, I would rather take my chances with garlic and neem, or onion and grape seed extract, than with toxic chemicals manufactured by pharma, say so called safe statins or the like.

Many people are here due to side effects from so called well studied pharmaceuticals. Most studies don't study long term effects, because it's not cost effective, and the medication under study gets approval after a couple of years. But then we have people who after a decade of using some med end up with PN or some other chronic illness and have to suffer the rest of their lives. The funding you're worried about is in the pharmaceutical industry and does impact results and length of studies, and there have been some infamous cases, so I think there are some difficult issue here that need to be considered. And even with the most thorough studies, yes, as you note, there can be those who fall outside of the safety zone, so to speak, and so suffer.

On a personal note, so far I've only had benefit from everything natural, immense benefit and healing in fact, but much of my problems, perhaps even the SFN, was either made worse or perhaps partially caused by the so called least harmful OTC meds. I'm glad that natural herbs and supplements are getting more traction and studies are being done, even if on a much smaller scale than with pharmaceuticals. I'm not against meds when needed, but they always come with some serious side effects and support a terribly corrupt industry, so I will continue to seek natural methods of healing to the extent that I can. When/if I fail, I'll turn to big pharma. But I hope that never comes.

I do appreciate a good discussion, especially when it's about an important issue.

I have tried many pharma drugs and herbs by now unfortunately. On the whole the mainstream drugs were more effective by a long way. Side effects about even. That's just my personal experience.

There is a fine line between what you call natural and non natural, I mean codeine comes from poppies. I think purity and strength being a problem with drugs is often over sold by natural product enthusiasts, I mean it is nice to know what exactly your taking instead of just a mixture of many non rigorously tested compounds, it also makes it more potent. Yes side effects will often be stronger too than just eating poppy seeds, but life is always a balance.

I've my best results from lyrica, which improves sleep a lot, and pain a little, despite reading horror stories online about the side effects, for me at least they are mild. That's just me anyway, clearly you've got a different way of doing things and all the best to you.

I'm glad you've found something that works for you and gets you some good zzz. Sleep is essential. I use magnesium and avoid carbs and get very good sleep most nights. If I'm up, it's usually due to vitamin D jacking me up too much. But it also gives me plenty of energy to get through the day, so it's a trade off.