Dr. Max Dula, Digestive Functional Medicine, San Diego, CA (2026)

06/11/2026

Link in the Bio to work with us 💪

SIBO (small intestinal bacterial overgrowth) is usually treated like an infection. Just kill the bugs. But for a lot of people, the bacteria aren’t the root problem. The motility is.

Here’s the mechanism most people never hear:
Your small intestine is meant to stay relatively clean. The vast majority of your gut bacteria belong downstream, in the colon. Keeping things that way depends on movement, a steady coordinated wave that sweeps food and bacteria through the small intestine instead of letting them pool.

That movement is cued, in part, by your stomach. When food empties from the stomach into the small intestine, it signals the gut, through the nervous system, to keep contents moving along from the small intestine into the large intestine.

Now slow the stomach down. Delayed gastric emptying is extremely common in SIBO.
The signal weakens. The wave stalls. Food lingers where it shouldn’t. And bacteria do exactly what bacteria do when handed stagnant food in the wrong place. They multiply, ferment, and produce the gas behind the bloating, distension, and that “six months pregnant” feeling.

This is why antimicrobials alone so often disappoint. You can lower the bacterial count, but if the motility that caused the stasis is still broken, the overgrowth grows right back.

Address the movement, and you stop feeding the problem at its source.

Disclaimer: This content is for educational purposes only and is not intended as medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making changes to your health regimen. Individual results vary.

06/08/2026

If you’re exhausted searching for answers about your IBS, schedule a free 15-minute call with us through the link in my bio. Let’s figure out what’s actually driving your symptoms.

I see this pattern constantly: IBS patients who’ve tried elimination diets, probiotics, fiber supplements, even antidepressants and still can’t get consistent relief.

What almost nobody is investigating is histamine.

In practice, when I look at gut microbiome data in IBS patients, I frequently find bacteria capable of producing excess histamine.

Combined with mast cell activation and impaired histamine clearance, this creates a gut environment that’s constantly hypersensitized to normal stimuli.

Pain that shouldn’t be pain. Bloating from foods that should be tolerated. Urgency that comes out of nowhere.

When we address the histamine load, identify which bacteria are driving production, and calm the inflammatory response sensitizing pain receptors, IBS symptoms improve in ways that fiber and stress management alone never achieved.

This isn’t experimental. The research is published in Gastroenterology and replicated across multiple patient cohorts. It’s just not being applied clinically.

Link in bio to work with us.

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

06/02/2026

Comment “PREQUEL” if you’ve treated SIBO multiple times and it keeps coming back.

I see this constantly: patients who’ve done multiple rounds of antimicrobials or antibiotics, followed protocols to the letter—sometimes protocols that worked for someone else—and still can’t get well long-term.

The SIBO clears. Then it comes back. Because nobody investigated what created the environment for overgrowth in the first place.

Was motility already compromised before SIBO developed? Was stomach acid chronically low? Was there an underlying nervous system dysregulation slowing gut function? Were opportunistic organisms already present that antibiotics made worse?

These aren’t afterthoughts. They’re the prequel. And if the prequel never changes, the sequel looks a lot like the original movie.

This is why I don’t use cookie-cutter protocols. I don’t care what worked for your friend. I care about YOUR terrain, YOUR history, YOUR prequel. Because that’s the only way to create a lasting outcome instead of a temporary one.

If you’re tired of treating SIBO without actually resolving it, link in bio to schedule a free 15-minute call with us.

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

05/26/2026

Depression isn’t a Prozac deficiency 💊

I know that’s controversial, but hear me out.

SSRIs work for some people. But for many, they don’t—or they work temporarily and then stop. And you’re left feeling stuck.

Here’s what I see clinically: depression is rarely just a serotonin problem. It’s often driven by inflammation 🔥, nutrient deficiencies, gut dysfunction, hormone imbalances, or chronic stress dysregulating your entire system.

So before jumping straight to pharmaceuticals (or if you’ve tried them and they didn’t work), these are research-backed options worth exploring:

SAM-e & L-methylfolate → support methylation and neurotransmitter production. If you have MTHFR gene variants, you might not process regular folate well.

Omega-3s (EPA specifically) → reduce brain inflammation. Depression is increasingly being understood as an inflammatory condition.

St. John’s Wort & Saffron → both have clinical trials showing they work as well as SSRIs for mild-moderate depression. Saffron especially is underrated.

5-HTP → direct serotonin precursor. Helps if you’re actually low in serotonin.

Vitamin D & Magnesium → deficiencies in both are strongly linked to depression. Most people are low in both.

Rhodiola → adaptogen that helps with stress-induced depression and fatigue.

Low-dose naltrexone (LDN) → modulates the immune system and reduces inflammation. Game-changer for some people.

The point isn’t to DIY this.

The point is to work with someone who understands that depression is multifactorial and tests for what’s actually driving your symptoms—not just throws an SSRI at you and hopes it works.

If you’re interested in exploring root causes of depression and want to see if we can help, link in bio to work with us 🌱

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

05/24/2026

Here’s what most doctors miss: when estrogen drops in perimenopause, histamine accumulates.

High histamine causes the same symptoms everyone blames on low hormones—flushing, sleep disruption, anxiety, brain fog.

Add in gut bacteria producing excess histamine and chronic inflammation, and you’re in constant histamine overload.

HRT addresses hormones. But if histamine and gut dysfunction aren’t addressed, you’ll never feel optimal.

This is why we take a comprehensive approach to perimenopause—not just hormone replacement, but addressing gut health, histamine regulation, and inflammation.

LINK IN THE BIO TO WORK WITH US 💪

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

04/26/2026

If you’re reacting to nearly everything you eat, the problem isn’t food sensitivities, it’s digestive dysfunction.

Low stomach acid, insufficient enzymes, poor bile flow, slow motility, microbiome imbalances, and more.

When your digestive system can’t break down food properly, everything becomes a trigger.

When we restore digestive capacity, food sensitivities disappear. Not from elimination but from fixing what’s broken.

Message me TERRAIN if you’re reacting to nearly everything you eat and want to see if we can help.

04/20/2026

If you’ve been told you have SIBO but know there’s more to it—schedule a free 15-minute call with me. Link in bio.

The issue isn’t that the treatment didn’t work. The issue is you’re treating a symptom, not the cause.

Most practitioners run a breath test, see positive results, prescribe antimicrobials or antibiotics, and send you on your way.

But they never ask: why is bacteria overgrowing in the first place? What’s upstream? When we run comprehensive testing and address all the layers, SIBO doesn’t come back.

04/04/2026

Real-time update from a SIBO and MCAS patient.

This is what happens when you address root causes—not just manage symptoms with restrictive diets and antihistamines forever.

SIBO and MCAS are connected. Gut dysbiosis drives mast cell activation. When you heal the gut barrier, support motility, and reduce microbial overgrowth, mast cells calm down.

This patient is getting their life back. Not from avoiding everything. From fixing what was broken.

Link in bio to work with us.

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

03/05/2026

DM me “HASHIMOTOS FIX” if you’re tired of being told your labs are “fine” while you feel terrible.

This is the approach your endocrinologist isn’t using. When you treat Hashimoto’s as an immune problem instead of just a hormone problem, everything changes.

I work with patients who’ve been on thyroid medication for years and still don’t feel right.

We identify what’s driving the autoimmune attack, address the root causes, and watch antibodies stabilize while symptoms resolve.

Link in bio to work with me.

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

03/05/2026

DM me “HASHIMOTOS FIX” if you’re tired of being told your labs are “fine” while you feel terrible.

This is the approach your endocrinologist isn’t using. When you treat Hashimoto’s as an immune problem instead of just a hormone problem, everything changes.

I work with patients who’ve been on thyroid medication for years and still don’t feel right.

We identify what’s driving the autoimmune attack, address the root causes, and watch antibodies stabilize while symptoms resolve.

Link in bio to work with me.

This content is for educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Always consult with your healthcare provider before starting any new treatment protocol.

Dr. Max Dula, Digestive Functional Medicine

06/11/2026

06/08/2026

06/02/2026

05/26/2026

05/24/2026

04/26/2026

04/20/2026

04/04/2026

03/05/2026

03/05/2026

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