Unfortunately, a recent USDA investigation revealed that 50% of wild salmon sold in the U.S. is fraudulent and is actually farm-raised. Farm-raised salmon is fed grains and has little omega-3 in the meat. Stick with supplemental fish oil from the approved brands.
The essential omega-3 fatty acid for brain recovery is DHA and that is found only in the highest concentration in fish. Flax or flax oil do not contain DHA, they contain a different omega-3 called ALA. ALA does not have the same beneficial effect of DHA. Try adding the fish oil to orange juice or lemonade to see if that helps mask the flavor. Alternatively you could try switching to the fish oil capsules or fish oil gummies.
It is allowable to add fish oil to any food, cold or hot.
Fish contain many different molecules other than omega-3 fatty acids that can cause allergies. Remember, our own cells are made up from the identical omega-3 fatty acids found in fish. Using highly purified fish oils such as Nordic Naturals will often allow those who are sensitive to fish tolerate the omega-3 supplementation. Alternatively, using an algae-based omega-3 supplement would avoid the fish reaction.
Sometimes the amount of fish oil or olive oil in the protocol can contribute to loose stool. I recommend my patients stop the oils for a week or so to see if the remaining diarrhea resolves. If so, I restart the oils but split the dosing into 2 portions. If the diarrhea does not stop, then I recommend discussing the situation with the child’s pediatrician.
Pre-existing diarrhea often improves within a few days to weeks after starting inulin or rifaximin. nIf diarrhea does not improve, I suggest having your child evaluated by a pediatrician.
Chronic diarrhea that does not greatly improve or resolve with rifaximin needs to be evaluated by your physician.
If the diarrhea started with the protocol, it may be from the fish and olive oils. Try splitting up the oils so he gets it in smaller doses throughout the day. If the diarrhea was present before starting the protocol and it does not improve with either inulin or rifaximin and you are seeing gains, I suggest having your child evaluated by a pediatrician.
If the child is experiencing abdominal cramping or blood or mucous in stool, I recommend the parents stop the use of any probiotics, digestive enzymes, or supplements. If these additional supplements are not being used, I recommend stopping the inulin and oils for a week and then try restarting if the symptoms stop. If the symptoms still do not stop or are also accompanied with blood, I recommend evaluation by a pediatrician.
There is no evidence to suggest low digestive enzymes could trigger SIBO.