Why Butyrate Supplementation Makes Chronic Gut Dysfunction Worse: The Data They Don't Show You — Why Conventional Medicine Recommends Butyrate (Despite the Data)

This is where I need to be direct: There is no strong mechanistic data on butyrate supplementation in chronic SIBO or severe dysbiosis. The trials cited typically involve: Healthy volunteers Mild, self-limited diarrhea Dietary interventions (prebiotic intake) rather than direct supplementation Short duration (weeks, not months) No measurement of butyrate oxidation capacity When practitioners recommend butyrate supplements, they&#8217;re applying a model that works in healthy people to patients whose fundamental problem is loss of the capacity to metabolize it. This is not evidence-based practice. This is model-transfer without validation. And it can be catastrophic. I&#8217;ve seen patients whose SIBO and dysbiosis worsened significantly after butyrate supplementation. Some took months to recover. Others developed secondary histamine intolerance or mast cell activation that persisted long after the supplement was discontinued. The conventional recommendation&#8212;&#8221;butyrate is anti-inflammatory, so more is better&#8221;&#8212;is based on a model that ignores colonocyte bioenergetics entirely. It&#8217;s a gap in reasoning so fundamental that recommending it without measuring oxidation capacity is, frankly, reckless.