The relatively new herbal supplement Atrantil claims to attack the root cause of IBS-C at its source. But what are the ingredients exactly, and what do the studies say? I recently tried the supplement, and have got all the info for you!
Though it's been a bumpy road, I've made massive improvements in my gut issues, which largely started after a bout of food poisoning and diagnosis of "SIBO" about two years ago. For my entire story, and to find out what ended up being key in largely resolving things rather quickly, check out my post, Breaking Free From SIBO: MY IBS Story And "Cure" (Things get real!) That said, I'm not 100% (are we ever?), and am always looking to achieve the ideal gut state which my rose-colored glasses (likely erroneously) view in my past. I now do this by pursuing gut health with a mindset of restoration rather than eradication. In other words: what can I gain from this supplement, food, or protocol, rather than what can I "get rid of."
ATRANTIL: AN INTRODUCTION
During my panic-driven SIBO #attackmode days of old, I slammed my system with anything and everything I could find which would possibly kill the critters residing in my innards. We're talking things like oregano, allicin, SCRAM, interphase, grapeseed oil extract, etc. etc. The herbal supplement Atrantil was one such supplemental flirtation. Given the context, I'm not so sure I could distinguish Atrantil's effects from the vast swarm of other potential remedies. I remember taking a few pills of Atrantil during this time, feeling a bit of bloaty reaction, and giving up.
I recently, however, listened to an interview with Atrantil's creator, gastroenterologist Ken Brown, on Robb Wolf's Paleo Solution podcast. I appreciated Dr. Brown's thorough knowledge of SIBO and IBS-C, as well as his explanation of Atrantil's mechanism of action (more on that in a just a bit!) While I suppose Atrantil qualifies as an "attack" supplement, Dr. Brown maintains the supplement supports gut health in general, so it satisfies my new criteria of restorative supplementation. After doing some of my own additional research on the Atrantil's active ingredients, I as well see promise in it.
So I gave Atrantil another go. I'll relay my experience in a moment, but let's first look at Atrantil's ingredients and proposed mechanism of action, as well as the clinical studies on the subject.
THE METHANE CONSTIPATION CONNECTION
SIBO stands for small intestinal bacterial overgrowth and (surprise!) involves too much bacteria in the small intestine, a portion of the GI tract which should be relatively sterile compared to the large intestine (also known as colon.) This dysbiosis of the gut microbiome can lead to digestive troubles, such as bloating, diarrhea (IBS-D) or constipation (IBS-C). While a multitude of factors (neurotransmitters, the vagus nerve, food intolerances, etc.) and different compositions of bacteria can affect these effects, the presence of hydrogen and methane gases in the intestines, which the bacteria produce as a byproduct of fermenting our food (particularly fiber and carbohydrate), can help indicate the type of overgrowth. If you often get bloating after a meal, it's quite possible you have some SIBO-y stuff going on.
People who experience predominantly excess hydrogen gas often have an overgrowth of bacteria resulting in diarrhea (IBS-D.) On the other hand, people with an abundance of methane gas may harbor an overgrowth of archaebacteria, which aren't actually bacteria, but rather slightly more resilient single-celled microogranisms. These archaebacteria actually "eat" the hydrogen produced by the other bacteria as a fuel source, and then output methane gas. And guess what! Methane functions as a sort of neurotransmitter in the gut which actually slows motility. See the very major problem here? The archaebacteria create methane gas which creates bloating, which slows down motility, which further encourages constipation and more archaebacteria and more bloating. Oh hey downward spiral! (Sidenote: this is also why things like antidepressants have been used to treat gut issues - due to their neurotransmitter modulating effect. But that's a discussion for another day!)
Atrantil contains 3 key herbal ingredients which may work synergistically to attack and discourage the growth of the methane-producing archaebacteria. According to the studies, the supplement contains the highest commercially-available concentrations of these compounds which do not promote toxicity.
Atrantil's first key ingredient is 150 mg of quebracho extract, a flavonoid which provides a concentrated dose of tannins. You may be familiar with tannins from wine. (And we do love our wine around here!) The word "tannin" hearkens back to the tanning process, in which tannins "tan" hides - drying them out into leather. Tannins in wine (both from the grape and also any aging in oak barrels) create a characteristic astringency and bitter nuance in the beverage. They actually have this drying effect because they serve as a natural defense mechanism in plants, by attaching to the proteins of potential fungi and bacteria. When you taste tannins, they attach to your saliva, which serves to deactivate them so they don't attach to your digestive enzymes later down the road. Isn't it crazy how your body has totally got your back?
While that may have seemed like a meaningless tangent on wine and weird body interactions, hopefully it helps makes sense why tannins can be antimicrobial and antioxidative in our own body. When it comes to Atrantil, the tannins in quebracho serve two primary functions:
- The quebracho tannins can soak up hydrogen so the archaebacteria can't use it for fuel. (In fact, tannin food supplements are used in the farming industry to effectively reduce methane production in cattle, since too much gas in these animals can affect their milk and meat.)
- The quebracho tannins can attack and destroy the cell walls of the archaebacteria overgrowths themselves. (The clinical trials on Atrantil also note that tannins can bind to fiber, discouraging its fermentation.)
Conker tree: Saponins
Atrantil's second key ingredient is 470 mg of conker tree extract (likely akin to an herbal supplement more popularly known as "horse chestnut.") The conker tree extract in Atrantil features 20% saponins: plant compounds with soapy like characteristics, which are antimicrobial in nature like tannins. Studies have also shown saponins may encourage motility in the intestines and discourage methane production, again possibly by eradicating excess hydrogen.
M. balsamea Willd: Peppermint
You may be familiar with Atrantil's third key ingredient, .2 mL of Mentha balsamea Willd, which is better known as good ol' peppermint oil. Peppermint oil can sooth digestive discomfort, and also function as an antispasmodic. (It's also great for alertness and a wicked breath freshener, though I suppose that isn't really applicable here.)
While this isn't discussed specifically in the clinical trials, Dr. Brown provides a synergistic timeline for the mechanism of action of Atrantil's 3 ingredients. The M. balsamea Willd peppermint first functions to temporarily slow intestinal movement, allowing the tannins from the quebracho and saponins from the conker tree extract to adequately absorb the gasses and attack the archaebacteria. While you'd think you wouldn't want to slow motility if you're struggling with constipation, I suppose the temporary pause could be worthwhile, if it does indeed allow for more effective absorption and attack (though I would like to see a more clinical discussion of the concept.)
Furthermore, while both the tannins and the saponins in Atrantil seemingly do similar anti-bad guy things (reducing hydrogen and attacking the archaebacteria), Dr. Brown explains that the tannins specifically attack the cell wall of the archaebacteria, allowing the saponins to then enter and do further interior damage, discouraging future methane production.
THE CLINICAL TRIALS
There have only been two published clinical trials of Atrantil, with small sample sizes. That said, they were well controlled and overwhelmingly positive. Let's look at them, shall we?
Atrantil Trial #1 (2015)
Efficacy of a Quebracho, Conker Tree, and M. balsamea Willd blended extract in patients with irritable bowel syndrome with constipation.
Published in 2015, Atrantil's first trial lasted for 2 weeks, and was a double-blind placebo-controlled study. This is pretty good. It means the participants didn't know if they were receiving Atrantil or a fake pill, and neither did the researchers.
In the study, 16 people (13 females and 3 males, aged 23-57) who had been struggling for years with IBS-C, and who had similar levels of bloating and constipation, were randomized into 2 groups. 8 received Atrantil, while 8 received a placebo.
After 2 weeks, those unknowingly taking Atrantil experienced a pretty significant and convincing improvement of symptoms. Those unknowingly taking the placebo experienced essentially no improvement. The graph of the results is pretty convincing, and I strongly encourage you check it out here.
Neither group experienced side effects.
Atrantil Trial #2 (2016)
Response of irritable bowel syndrome with constipation patients administered a combined quebracho/conker tree/M. balsamea Willd extract
Atrantil's second trial was published in 2016, and included 24 patients (2 men and 22 women, aged 18-58.) This study also lasted 2 weeks, but contained no placebo. Instead the participants, who had seen no improvements with previous IBS treatments (including applicable drugs, the FODMAPS diet, and probiotics), all knowingly tried Atrantil to aid their IBS-C symptoms.
After two weeks, 21 of the 24 patients reported improvements in bloating (5.1 fold), constipation (2.7 fold), abdominal pain (3.2 fold), and quality of life, yielding an 88% success rate. As in the previous study, no side effects were experienced.
I again encourage you to check out the graph, which makes the improvements pretty clear.
MY ATRANTIL EXPERIENCE
I strictly followed Atrantil's recommended initial protocol: 2 capsules, 3 times a day. They do suggest taking Atrantil with food to minimize any discomfort, but since I practice intermittent fasting every day (eating only at night), that was out of the picture.
I found pretty consistent results and reactions throughout the whole first bottle, especially once I got into the "groove," as it were. The initial morning dose would have a remarkable effect of clearing any lingering feelings of "pockety air" that I seem to get in my intestines. I now imagine this is due to the "soaking up" effect of the tannins and saponins. The afternoon dose would actually create a slight bubble feeling which would dissipate (perhaps from attacking the archaebacteria?) I'd also usually sweat a little bit. The night dose wouldn't create any physical feeling, but would, interestingly, kill my appetite. This dose would also occasionally result in a slight but passing nausea.
Though I was a bit uncertain while going through the bottle, I now feel that, overall, Atrantil helped with soaking up gasses, and perhaps encouraging migration of the archaebacteria to the large intestine. Now that I've been off the supplement for awhile, I do feel like some of the bloating is creeping back.
I notably didn't know about the hydrogen/methane soaking ability of Atrantil's tannins and saponins while taking it, but now that I've done the research, it all does make a lot of sense in retrospect. I know for me in general, that as long as I can keep fermentation "down," then motility seems to be pretty good. It's only when things start a-brewin' that I can enter downward spiral land (which Candyland would totally create, by the way.)
While I would like to try another round of Atrantil, I'm not thrilled with the magnesium stearate and silicon dioxide additives. Additionally, the supplement is a smidge expensive for this struggling actress/writer 🙂 So I've decided to try using the knowledge I've gained from my experience and research, and concocting my own version!
The studies, which have me pretty convinced of the hydrogen/methane soaking potential of tannins and saponins, do (thankfully) provide the dosage and concentrations of Atrantil's ingredients (unlike the bottle, which is more vague, in a "proprietary blend" type way.) I'm having difficulty finding a good source of quebracho to order, but since its mechanism of action is due to its high tannin effect, I'm going to try substituting white oak bark powder, which is known for its tannin concentration. I am able to order the conker tree extract, in the exact 20% standardized saponin content mentioned in the study. Yey! As for the peppermint, I already use a pure peppermint oil for a breath spray, but I think I might pass on this 3rd ingredient for now, at least for my initial experimentation. I'll be encapsulating the compound in gelatin capsules, which I prefer to cellulose.
I shall report back about how my experimentation goes! Hopefully I will be able to create an affordable, additive-free home alternative to Atrantil which supports the gut. Worst case scenario, white oak bark and conker tree extract are used as supplements anyways for an array of health benefits, so I figure I can't do much harm.
I definitely thank Dr. Brown for his developing research and attention to the SIBO/IBS-C problem, in regards to these obnoxious methane-producers. We definitely need more certified GIs conducting thorough clinical reasearch of holistic, herb-based approaches for managing (and hopefully eradicating) gut dysbiosis.
And as final note, doing this research has also made me realize why red wine potentially always seems to calm my gut 🙂 Oh hey tannins!
What about you? Have you tried Atrantil? I'd love to hear your thoughts in the comments below!