Woman eating dinner

4 Crucial Steps for Mealtime that can make-or-break your digestion

When it comes to healing digestive issues, it’s certainly true that we need to test to identify and then treat any infections or dysbiosis that may be contributing.

But just as importantly, we need to optimize the environment of the gut.  In order to develop infections or overgrowths, the environment has to be right. Otherwise, our healthy gut terrain is inhospitable to the “bad guys”, and nurturing to the “good guys”.  

This mainly involves things like optimal digestive secretions (like stomach acid and pancreatic digestive enzymes) that set the pH and fully digest our food. This ensures that we both assimilate the nutrients contained in what we eat, but also prevents other organisms, like bacteria and yeast, from eating it instead.  

Other secretions, like bile from our liver/gall bladder, are also super essential.  Bile digests fat, but also is a powerful antimicrobial, and regulates the motility of our intestines.

Of all the digestive secretions, Stomach Acid might be the most important when it comes to resilience against infections.  Stomach acid (called Hydrochloric Acid, or HCL) is like your first line of defense.

You may know that stomach acid’s main role is to break down the proteins we eat, so that we can absorb the smaller amino acid building blocks to use as nutrition.

But stomach acid is also antibacterial to undesirable strains because of the low pH environment that it creates.

Keeping food in the stomach long enough is critical for the action of stomach acid to control the populations infused into lower regions with each pulsatile release of chyme. This is because food needs to be exposed to stomach acid (HCL) long enough to kill bad bacteria, preventing them from proceeding on into the small intestine.

So, if you have super-rapid motility (this is common in people who have chronic diarrhea), your food may pass too quickly through the stomach and into the intestines, and not have enough exposure to HCL. This equals increased risk of infections, in addition to not enough nutrient digestion.

Due to…

  • Stress
  • Nutrient deficiencies
  • Modern diet and lifestyle
  • And even just natural aging!

it’s unfortunately very common for people to produce less than optimal amounts of stomach acid to meet the demands of food intake.

And…..we need enough HCL present to keep the stomach pH below 4 for the entire time the food we are digesting in the stomach. If this doesn’t happen…pathogenic microbes pass unharmed into the intestines where they can take residence! (hello SIBO and parasites!)

Here’s the most important thing I want you to learn today:

HOW we eat our meals is one of the most important factors in optimizing gut environment.

Just becoming aware of HOW we eat, is one of the biggest things you can do to change what is happening with your digestive secretions, and therefore, with your microbiome.

Chewing: Why is chewing your food so important in regards to this?

Yes, chewing breaks your food down into smaller pieces, increasing the surface area, so that digestive secretions in the stomach and small intestines (like pancreatic enzymes, bile, and stomach acid) can further break them down.

But….there are other not so obvious reasons!

Chewing exposes foods to enzymes in the saliva that break down the cell walls of gram positive bacteria, causing them to die.

This means that chewing adequately is really our first weapon against pathogens that might be entering with our food!

Being relaxed while eating: Stress is a big factor that leaves us more prone to getting opportunistic gut infections, because stress shuts down our digestive secretions.   

When our brain thinks we need to run from the proverbial tiger, it focuses our body’s energy and attention on surviving NOW, and diverts it from activities that are about long term survival, like digesting our nutrients.   

Stress also spikes our cortisol, and this suppresses our gut’s immune system big-time--for much the same reason. And the hormone that our brain uses to signal the adrenal glands to make more cortisol, CRH,  can promote leaky gut.

Healthy Meal Hygiene for Healthy Gut Environment:

1) Focus on creating a state of overall calm before, during and after eating to encourage stomach acid and digestive enzyme secretion.

2) Chew adequately—more than you think….keep chewing!-- to reduce particle size and mix enzymes in the saliva.

3) Include balanced fats, carbohydrates and proteins in each meal to encourage food to stay in the stomach long enough.

4) Planning enough time for meals—not eating on the run—is critical, to help allow for parasympathetic (rest-and-digest) nervous system activity. This allows for proper secretion of digestive fluids. Otherwise, if our body thinks we are running from the hypothetical tiger, there’s no digestion being emphasized, and no secretions being made—“Ain’t nobody got time for that”!

Have any questions or comments on this?

Pop on over to my facebook page and ask me anything!  

Woman sitting on swing over valley

Why Your Gut Health and Microbiome Make-or-Break Your Hormone Balance

Acne worse than puberty, ten pounds that won’t budge, a period-induced mood swing that turns you into a totally different person-- these are sure signs your hormones are out of whack. The solution to hormone problems like these seems obvious: Fix your hormones.

But what if I told you that the first step to balanced, happy hormones (and clear skin, easy, regular periods, a healthy weight, and even-keeled moods) isn’t about estrogen, progesterone, or testosterone?

I’m going to let you in on a big secret about female hormones: They never break in isolation.

What does that mean? Simply that if something is not right with your hormones, it’s a sure sign that something ELSE is not working right in your body that is causing the hormone problems. If you’re having symptoms caused by imbalanced hormones, we have to do more than just treat the symptoms - and we even have to do more than just treat the hormone imbalance. (Prescribing artificial hormones is NOT the answer).

We have to go back even further and find out: What caused the hormone imbalance in the first place?

Finding and addressing the root cause of your hormone imbalance is the MOST important step to achieving hormone balance for life.

And 9 times out of 10, when we do the careful detective work to find the real root cause behind hormone imbalance, it’s actually related to gut health.

I know it sounds a little odd at first - but the health of our gut is actually closely tied to our hormone health. In this post, I’m going to explain the link between our gut and hormone health, and what you can do to optimize both.

The Gut-Hormone Dream Team

The gut and our hormones are meant to be in communication. They support each other and work together to make our body run smoothly. In fact, our intestinal cells have special receptors for hormones that allow them to detect hormonal shifts.

It’s intuitive that our hormone and gut interact, too - even women with symptom-free periods will report noticing slight changes in their bowel patterns before and during their menstrual cycle.

Both estrogen and progesterone impact gut motility & peristalsis - the rhythmic movement of the intestines that moves food from your stomach down through your intestines and eventually out of your body. Estrogen and progesterone play opposing roles in motility. Progesterone slows down motility in the gut by relaxing smooth muscle and slowing transit time (the time it takes for food to move out of your body). Even women without IBS or other digestive issues are more likely to feel mildly constipated, or just more “full” during the week prior to the period, when progesterone levels peak.

Estrogen, on the other hand, increases contractions of the smooth muscle in the intestines. When estrogen levels are just right, this helps keeps things moving. Estrogen also increases the diversity of your microbiome, which is a good thing for immune health. Estrogen levels drop off suddenly, twice, during a normal menstrual cycle: once right before ovulation, and again just prior to your period starting. This can cause spasm and fast motility in the digestive tract, which can cause diarrhea at these times (even in healthy women). For the same reason (sudden, dramatic drops in estrogen levels), this can also happen during perimenopause and menopause, too.

Pregnant women experience an increase in progesterone in early pregnancy and then again in the third trimester - this is responsible for the constipation so many women experience during pregnancy. The excess progesterone can also cause the sphincter in the upper GI tract to loosen, leading to heartburn and reflux.

When estrogen and progesterone are in balance, you’ll tend to have normal motility most of the time - neither constipation or diarrhea. (Unless you also have some gut infections like SIBO, Candida, or parasites….then you could still have constipation.)

The Estrobolome

Our gut and hormones do more than just “talk”-- your gut microbiome also regulates estrogen. The estrogen-regulating function of specific bacteria in the microbiome is called the “estrobolome.”

The estrobolome is really important to keeping healthy estrogen levels in the body -- but to understand why, you need to know how the estrogen cycle works. Here’s how it happens in a healthy system:

  1. Estrogen is produced in the ovaries (but also in the adrenal glands and adipose tissue to a lesser extent)
  2. Estrogens circulate in the blood, making their way to tissues in the breasts, brain, bones, uterus and elsewhere
  3. Eventually, the estrogens travel to the liver, where they are broken down and deactivated
  4. Detoxified estrogens are deposited in bile which is secreted into the intestines, and exits the body with the stool.  


Path of estrogen

So, where does the gut come in? The gut - or more specifically, the estrobolome - regulates the amount of estrogens circulating in the bloodstream through the creation of β-glucuronidase, an enzyme which breaks down estrogen into to its “free”, or biologically active form.  

But that isn’t all the gut does - it can also create its own estrogen, too!

Bacteria can manufacture estrogen-like compounds from foods that we eat. For example, lignans, found in plants like flax seeds, are converted into estrogen-like compounds when acted on by bacteria in the gut. On their own, they don’t have any hormonal properties, but once converted the can either promote uptake of our own more potent estrogens into receptor sites, or can compete for the same receptor sites,.   

Newer research also suggests that the microbiome (and also specific types of probiotics) can produce its own estrogen and also signal glands around the body to produce it. We don’t yet fully understand exactly which strains of bacteria are responsible for all of these hormone modulating roles, but we do know that we want good overall proliferation, and greater species diversity.

When Things Go Wrong

The gut and your hormones are closely linked. You can see that both the gut and the hormone systems depend of each other to work properly - and when something goes wrong with either one, it spells trouble for the other.

Problems in the gut-hormone relationship usually start with the gut - but once the delicate balance is thrown off, it’s hard to know where to pin the blame. Imbalanced hormones cause gut problems, and gut problems cause imbalanced hormones.

Here are just some of the ways gut problems can lead to hormone imbalance:

Leaky Gut Syndrome: Leaky Gut Syndrome (aka Increased Intestinal Permeability) occurs when the tight junctions between cells in the intestine become “leaky” and allow toxins called LPS (which are fragments of dead bacterial cell walls) to pass from the intestine, into the bloodstream, and circulate through the body. It sounds crazy, but it’s actually common and causes a wide range of symptoms.

If you have leaky gut syndrome (with or without symptoms), you are more vulnerable to developing hormonal imbalances. Why? Because leaky gut causes widespread inflammation throughout the body. LPS is known to cause inflammation in any tissue that it comes into contact with, and in the ovaries, the result is suppressed progesterone production. (Women with higher levels of LPS in the blood had elevated markers of inflammation in fluid inside the ovary (follicular IL-6), and correspondingly low progesterone production.)

Studies show that infections, allergic reactions, being born by cesarean section, and even chronic stress can all cause inflammation in the gut, as well. And inflammatory conditions like obesity and inflammatory bowel disease are associated with disrupted menstrual cycles and infertility.

If you’re not having digestive symptoms like bloating, diarrhea, or constipation, you may think you don’t have leaky gut syndrome - but leaky gut may not show up as digestive symptoms, depending on the person. Even without digestive symptoms, the “silent” inflammation caused by leaky gut affects nearly every other aspect of health - especially our hormones.

Gut Dysbiosis: Your intestines are filled with trillions of bacteria, fungi, and even some viruses, that are all collaborating to keep your system running smooth and healthy. These bacterial cells and their genes are called your microbiome, and they live not just inside the intestines, but on every surface of your body, from your skin, to your eyes, your lungs, vaginal walls, and bladder. When the microbiome gets disturbed and the type or number of bacteria is damaged, we call it gut dysbiosis.

Along with your brain, your microbiome regulates the expression of your hormones, and can restrict or promote hormone production elsewhere in the body. The bacteria in your microbiome are like air-traffic control for hormones. In addition to signalling other glands in the body to dial up or down the volume on hormone production, your gut flora regulate hormone metabolism post-production, by either helping (or hindering) detoxification of already-used hormones, when they are being cleared from your system to make way for new fresh hormones.

To work properly, your microbiome needs the right bacteria, in the right amount. When the type or number of bacteria gets messed up (from something like poor diet & stress, an infection or parasite, or even just a course of antibiotics) your gut can no longer perform it’s hormone-regulating functions properly.

Increasing reactions to food, bloating, skin outbreaks, constipation, stubborn weight that won’t budge despite your best efforts, and even heavy periods— can all be signs that your microbiome is compromised and you’re unable to properly metabolize hormones like estrogen in the gut. Ultimately, this causes a build up of hormones in your system, which shows up as worsening of your PMS, period symptoms, or menopausal symptoms, and leaves you bloated and moody.

Estrobolome Dysfunction: Remember, the estrobolome are the specific bacteria in the microbiome responsible for regulating estrogen in the body through the production of the enzyme β-glucuronidase. Disruption of the estrobolome are really a type of dysbiosis. The estrobolome can be damaged in the same way the rest of the microbiome gets hurt: common triggers are stress, poor diet, and especially antibiotic use.

If the estrobolome bacteria become overgrown, the result is too much beta-glucuronidase being made. This causes already-detoxified estrogen to be reabsorbed and recirculated, in really high levels. This leads to a state of estrogen dominance. And estrogen dominance creates all kinds of chaos - PMS, cramps, fibroids and cysts, endometriosis, PCOS, heavy bleeding, infertility, a zapped sex drive, and weight gain. And of course, it can increase the risk of certain types of breast and uterine cancers.

And while it’s clear that we don’t want gut bacteria producing too much  beta-glucuronidase enzyme, we actually don’t want them under-producing it either! When women have extremely low microbial diversity or even just extremely low levels of bacteria in the gut (think: excessive antibiotic use), the decrease in beta-glucuronidase causes a reduction in circulating free estrogens. Excess estrogen isn’t a good thing, but insufficient estrogen levels, especially in post-menopausal women, isn’t good for our health either! Estrogen is critical for maintaining healthy brain cognition, bone density, gut health, and cardiovascular health.

It isn’t just these gut problems that could be causing your hormone issues. The gut-hormone connection is a two-way street: here are some of the ways imbalanced hormones can wreak havoc on your gut health:

  • Gallstones - women get gallstones twice as often as men! Estradiol (one of the types of estrogen) increases cholesterol levels in bile produced in the liver. (Cholesterol is the building block of our reproductive hormones, so when they are detoxified and broken down, cholesterol is released.) This increased saturation slows bile flow, which can lead to more stone formation.
  • Leaky Gut - While inflammation caused by leaky gut can lead to hormone imbalances, low estrogen levels can also contribute to leaky gut. The epithelial layer of the intestinal wall needs estrogen to and keep it healthy and elastic. Leaky gut has been associated  development of food sensitivities, autoimmune diseases, weight gain, acne, depression and anxiety, as well as almost every chronic illness you can think of.
  • IBS - researchers know that estrogen and progesterone levels have an impact on the development of IBS (Irritable Bowel Syndrome). Symptoms of IBS include diarrhea, constipation, bloating, pain, and food intolerances.

Here’s the bottom line: if you want healthy hormones, you have to fix your gut!

Healthy Gut, Healthy Hormones

We know that we need a healthy gut to get healthy hormones - but what messed up your gut in the first place?

It’s a fair question, and not always easy to unravel. These are the most common causes for gut problems I see in my clinic - but there are many more (and most people have more than one contributing!)

Antibiotics: A single dose of the antibiotic Augmentin can kill off up to 90% of your gut flora - and most people are prescribed a 5-day course! Gut flora will regrow, (although it can take up to a year) but what types take hold and flourish impacts every aspect of our health. Generally we lose lactic-acid-producing species (like L. Acidophilus) first. This causes pH to go up in the intestines. Good colonic bacteria flourish in a more acidic environment, so in a less acidic environment, unfavorable strains can grow.  

Toxins: Pesticides, herbicides, glyphosate from GMO corn and other foods, environmental chemicals, infections, and even stress can negatively shift the microbiome.

Diet: Eating a diet low in fermentable fibers and resistant starches (found in veggies, fruits, nuts, seeds, legumes, and grains) will also decrease bacterial diversity. Dairy, sugar, and gluten are major culprits in promoting bacterial imbalances.

The Pill: Contraceptive pills damage your microbiome as much as antibiotics do! The pill is known to promote candida overgrowth and SIBO (small intestine bacterial overgrowth) as well. Recent research has linked oral contraceptive use to development of inflammatory bowel diseases such as Crohn's Disease and Ulcerative Colitis, too.  

The good news is there is a lot we can do to support better gut health - leading to better hormone health.

The best ways to support a healthy microbiome for healthy hormones, is through a diverse whole food diet, optimizing digestion, and taking steps to lower inflammation.

  • Eat fermented foods - Sauerkraut, yogurt, kefir, kombucha, etc.
  • Eat prebiotics/fiber - Found in root vegetables, flax seed, psyllium, beans, seeds, nuts, fruits and veggies. Women who eat more fibers from plants clear greater levels of estrogen in their stool.
  • Take probiotics - In particular, Lactobacillus Acidophilus helps lower beta-glucuronidase!
  • Optimize the environment of your digestive tract so good bacteria flourish there - This is similar to prepping the soil in your garden beds. Digestive secretions like pancreatic enzymes, stomach acid, and bile help optimize the conditions in the gut to promote the desirable bacteria. Taking these supplementally if you are deficient can help prime the gut for healthy colonization.

Get Your Gut & Hormones Humming

Every woman’s health is unique - but if a woman is having hormone symptoms, it almost always comes back to gut health! Heavy periods, adult acne, and PMS may not seem like they are related to your gut, but they so often are! That’s why I always test and treat the gut alongside hormone balance problems in my clinic.

Remember, our hormones don’t break in isolation! It’s almost always a sign of a problem somewhere else in the body. If you are struggling with your hormones, don’t forget to consider your gut health!

I hope this article and my suggestions for optimizing gut health help you. Need more help unraveling the root cause of your hormone issues? Want to run the right testing, so that you can really know for certain, what’s going on with your hormones and gut? I love to help women like you get back to radiant health so they can live big!  If you’re interested in learning more about how I do this, you can book a free 20-minute prospective patient call here.

can a uti cause bloating and constipation

Acid Reflux and Chronic Urinary Tract Infection; Totally 'Unrelated' Symptoms With the Same Root Cause?

One of the principles of Functional Medicine is finding and treating the “root cause.”

But sometimes, it isn’t as simple as finding one root cause and getting rid of it. Most of my clients have multiple health concerns - and multiple causes behind them. Helping them is about peeling back the layers and addressing each one as we go.

For my client Jane, peeling back the layers was exactly what we needed to do! She came in because she was experiencing tightness in her chest caused by acid reflux - and we wound up working through multiple gut infections, addressing vaginal dryness,  and putting interstitial cystitis (a condition that causes chronic bladder pain like a urinary tract infection) into remission.

Every time we treated another “layer” Jane felt better than before.

Today, Jane wants to share her story in her own words. If you’re considering pursuing help with a Functional Medicine Practitioner like me, I hope this story helps you better understand the process of working with a practitioner.

Jane’s Story

About three years ago, I started dealing with some bloating. Then, I’d occasionally have constipation - not all the time, but enough that I noticed it. I had a colonoscopy and the results came back normal. I started taking a probiotic. The bloating and constipation just became kind of a general annoyance I was living with.

But then I started feeling tightness and pain in my chest. That was really scary. I went to the doctor right away, but the tightness and pain weren’t heart-related. That’s when I realized they were actually a digestive issue. I decided to go see a physician at my regular clinic, and they told me it was acid reflux, prescribed Prilosec, and referred me to a GI doctor.

Luckily I had read enough about Prilosec to know I didn’t want to take a proton-pump inhibitor. Instead, I decided to get a second opinion from a Functional Medicine Practitioner - that was Brie.


Working With Brie

From the start, Brie was very thorough. She took a really detailed history that helped me connect some dots about what had started all my digestive symptoms in the first place. The past summer, I’d had a urinary tract infection and taken a course of antibiotics. Then in the fall, I went traveled out of the country and had to take a course of the antibiotic Cipro for traveler’s diarrhea. That's when the bloating and constipation became worse and the other acid reflux symptoms started.

But she wasn’t just interested in the acid reflux - Brie asked questions about my overall health. When I told her I was experiencing vaginal dryness, urinary pain, and low libidio, she took me seriously. My doctor had diagnosed my with interstitial cystitis - basically pain in my reproductive organs for no reason.

Brie explained to me how the antibiotics had killed the good bacteria in my gut as well as the bad. She recommended stool testing and a breath test for Small Intestine Bacterial Overgrowth (SIBO), as well as hormone testing. She also recommended I cut out dairy and gluten temporarily to give my system a break, since those foods are common gut irritants. She also recommended some supplement that would soothe my gut and help with symptoms until we got the test results back. All this happened at our very first meeting!


The Test Results Came In

The test results came back a few weeks later - they showed low cortisol, low estrogen, H. pylori, low beneficial flora, and a few overgrown bacteria (citrobacter, pseudomonas). Plus, I had both methane and hydrogen type SIBO and was under-producing pancreatic enzymes.

It was a lot to take in and I was so glad I had Brie to help me understand what the results meant. She saw how everything was connected.

Brie explained that the H. pylori infection was likely causing the acid reflux, and that the SIBO was probably the cause of the constipation and the uti bloating. My hormone problems were tied in to all of it and causing the vaginal dryness, urinary pain, and low sex drive.

It was a relief to know there was a reason I was feeling the way I was feeling  - especially because my symptoms had gone into a flare as we waited for the test results. I remember going to visit a friend for a few days and having to come home early because I was just so uncomfortable.  

Brie started my on a supplement protocol for 6-8 weeks for both the H. pylori and the SIBO. I kept avoiding gluten & dairy, too.

After I finished the first supplement protocol, we re-tested. The H. pylori was gone! The SIBO levels had come down, but it wasn’t completely gone. On the second stool test, I also had positive results for some other common gut infections and parasites, including candida overgrowth. Brie explained that all of this was normal - the first protocol of supplements had helped destroy the “biofilm” - the protective cover the bad bacteria use to protect themselves and hide. With the biofilm gone now, we could see other parasites and better treat the SIBO, too.

By, then my acid reflux was totally gone and I was feeling pretty good gut-wise. But I was still struggling with the vaginal dryness and hormone symptoms.  And, what I initially thought was a bladder infection turned out to be Interstitial Cystitis. The “UTI” pain didn’t respond to normal treatments, and the pain turned chronic. Can a UTI cause bloating and constipation?


Putting Interstitial Cystitis Into Remission

My hormone symptoms were slowly improving as my gut healed - but Brie also suggested using a plant-based bioidentical estrogen replacement. She also had me use vaginal DHEA, a vaginal probiotic, and some herbs. Those helped me feel better right away.

Brie also explained that two of the bad bacteria that the tests had shown were overgrown in my gut - proteus and citrobacter - were related to the Interstitial Cystitis, too. As we treated those, my symptoms disappeared completely.

Brie suggested I work with a pelvic floor therapist, too. That helped me relax some overly tight muscles that were contributing to the pain.


Changing My Diet

Brie suggested I follow a gluten and dairy-free, low-FODMAP diet. It helped me a lot in the beginning, but I was anxious to reintroduce more foods as soon as I could.

After a few months, I was able to reintroduce beans and some other legumes, which I hadn’t been able to tolerate for years, and I really missed. I am now back to eating all fruits and veggies, and I can even add in a little gluten here and there. That makes me feel good!


Where I Am Now

After working with Brie, I feel great for the first time in years.

I came to see her because of the acid reflux - but she opened my eyes to a lot of problems I had been writing off as “normal” or just “part of getting older.”

Gut-wise, I am feeling so much better now! After having given up gluten and dairy for years, I’m finally able to experiment with adding them back into my diet again now.  

The interstitial cystitis pain is gone now, too. I didn’t realize how much the pain held me back from enjoying life - I even cancelled an overseas trip because of it!

I’m so happy to be where I am now with my health. I’m following a maintenance protocol now and continuing to meet with Brie occasionally to make sure I’m doing the right things moving forward.

Working with Brie has made a huge difference for me, and I wish more people could have access to it! I hope my story helps to spread the word.


Do You Need Help, Too?

Jane had amazing success - she cleared multiple gut parasites, fixed her digestion, reversed interstitial cystitis, and was even able to reintroduce foods she hadn’t eaten in years.  

Why was she so successful? Because she dedicated herself to working through the process of Functional Medicine. She didn’t give up even when it got complicated - and neither did I!

I hope reading Jane’s story has helped you understand better understand the process of working with a Functional Medicine Practitioner like me.  

If you’re inspired and ready to start your own journey, you can book a free, no-obligation Prospective Patient Interview with my team. During this 20-minute appointment, we’ll learn about you and discover if you’re a good fit for working with us.