In the past 20 years, a gastro-intestinal complex has emerged that has been tentatively linked to Small Intestinal Bacterial Overgrowth (SIBO). The symptoms of constipation or diarrhea, bloating and distress, even to the level of cachexia have been presumed to be from bacterial overgrowth of methane producing Achaea bacteria including Methanobacteriales oralis and Methanobacteriales smithii. However, the SIBO symptom complex that was initially reported to be responsive to rifaximin and neomycin antibiotic therapy has subsequently become more and resistant leaving both patients and treating physicians in a quandary. The author was asked to consult on 18 patients whom had disruptive gastrointestinal symptoms, positive SIBO breathe test and repeated failure to respond to courses of primarily rifaximin therapy. These patients were overwhelming female and fell into the newly described field of Gender Specific Medicine (GSM). The biomarker for decreased bioavailable testosterone is the Free Androgen Index (FAI) in both sexes. Serum dysregulation included the gambit of hormonal assays: hypothyroidism, Hashimoto’s thyroiditis, menopause, male hypogonadism, adrenal fatigue and low levels of vitamin D3 (Cholecalciferol). These patients had an unexpected high incidence of gastrointestinal autoimmunity including pernicious anemia, hyperchlorhydria per the Heidelberg test and autoimmune gastritis. Treatment was naturopathic, non-gonadal hormonal and when all else failed, in systemic anabolic hormone replacement, patient improvement did not reach the 75 percent threshold required in the study. Therefore, the protocol of mixed anabolic steroid replacement was initiated subsequently.