The Single Molecule Driving Both Your SIBO and Your MCAS (And Why Nothing Has Worked) — The cell at the center of it all

To understand what succinate is doing, you have to understand the cells that make it: the colonocytes &#8212; the cells lining your colon. They are not glamorous. Most people, including most doctors, never think about them. But they are doing something extraordinary that almost no other cell in your body does. A normal cell burns glucose for energy. Your colonocytes don&#8217;t. They burn butyrate &#8212; a fatty acid produced by your gut bacteria when they ferment fiber. Burning butyrate consumes around seventy percent of all the oxygen your colonocytes use. They are, metabolically speaking, the most demanding cells in your gut, and they are running their mitochondria at near-maximum capacity all day long. This isn&#8217;t a detail. This is everything. When colonocytes burn butyrate properly, three things happen at once. First, they make energy for themselves and the rest of the gut wall. Second, by consuming so much oxygen, they keep the lining of the colon at very low oxygen levels &#8212; a state called epithelial hypoxia . This low-oxygen state is what your healthy gut bacteria are adapted to. The good bugs &#8212; the ones that make more butyrate, the ones that produce the indoles your immune system needs, the ones that make secondary bile acids that protect you from C. difficile &#8212; cannot survive in oxygen . The colonocyte&#8217;s metabolic appetite is what creates