Part 9: Sleep and gut health
Sleep:
During sleep, damaged and destructed cells and toxins are removed from your body, which plays a crucial role in combating and reducing inflammation. Ever woken up with more pain and inflammation that dissipates later during the day? This can be due to lack of deep or REM sleep, due to your “clean up crew” not getting to complete their jobs. Lack of sleep can negatively affect your hunger levels by increasing ghrelin hormone levels and increasing fatigue. This can lead to increased cravings, lack of control with food, as well as decreased satiety with meals. It can also increase your risk of developing chronic diseases such as high blood pressure, cardiovascular disease, diabetes, and obesity. Lack of sleep or poor quality of sleep can also increase inflammation, decrease recovery, inhibit optimal thyroid and hormone production, and decrease your immunity. According to the National Sleep Foundation, the key determinants of quality sleep include (1) sleeping at least 85 percent of the total time while in bed; (2) falling asleep in 30 minutes or fewer; (3) waking up no more than once per night; and (4) being awake for 20 minutes or less after initially falling asleep.
What Can Go Wrong to Screw With Your Sleep?
-Hormone imbalances
-Thyroid disorders
-Gut infections
-Nutrient deficiencies
-Adrenal imbalances
-Poor nutrition
-Blood sugar imbalances
-Mold toxicity
-Under-eating
-Poor liver health
More on Gut Health:
Your gut controls key functions of your health, including the production and conversion of hormones, neurotransmitters, and micronutrients (yes, you produce micronutrients in your gut too). Your gut is also your most important immune system barrier, as 80% of your immune system resides in your gut.
Here are some signs that your gut is out of whack:
-Abdominal pain
-Bloating
-Reflux
-Diarrhea/loose stool
-Steatorrhea (fat in stool)
-Constipation
-Weight loss
-Muscle wasting
-Micronutrient deficiencies
-Hair loss
-Dry, brittle hair
-Dry, flaky skin
-Brittle nails
-Fluid retention
-Anemia
-Acne
Mechanical Digestion: Mechanical digestion begins in your mouth when your teeth help to break down the foods that you eat. This is such an underrated and forgotten part of the digestion process, and many people sometimes forget to optimize the first and one of the most helpful parts of digestion. Chewing your food sets the stage for what is to follow. The process of chewing sends signals to your stomach to start producing gastric juices. Basically, it says, “Get ready! Food’s coming!” If you are “inhaling” your food and not taking time to properly chew it, your stomach isn’t getting that time to prepare. Your salivary amylase is also not produced to the same extent, which can impact the beginning of your carbohydrate digestion. By chewing your food thoroughly (about 20-30 times per bite), you are helping all later digestion phases to work more efficiently.
What Influences a “Healthy Microbiome”? Many factors influence the health of your microbiome, including: Exercise and sleep habits, Diversity of plants in the diet- including fiber and prebiotics, Amount of digestive enzyme secretion (including stomach acid, pancreatic juices, and bile), Environmental toxins and pollutants (including mold, endocrine disruptors, and heavy metals), Geographic location, Stress levels (which can damage the gut lining and heighten your risk of infection and intestinal permeability), Antibiotic usage, Artificial sweeteners and food additives, Intake of fermented foods and probiotics, Diet quality- mostly plant based vs animal based and highly processed vs whole food based, Birth and infancy- the way you were born (natural vs C-section), bottle-fed vs breastfed, how your mom ate during pregnancy and her environmental exposures.
“Heal Your Gut Starter Pack”- 4R Approach: Please work with a professional to do this. Don’t blindly drive your “car.” You could crash it.
Step 1- Remove: Identify and eliminate factors that may be contributing to your symptoms, including allergens, intolerances, infections, overgrowths, and parasites. The removal agents that you use will depend on your situation and needs. For example: Anti-fungals (such as caprylic acid) may help eradicate yeast overgrowths such as Candida, Antiparasitics (such as black walnut, goldenseal, wormwood, and oil of oregano) may help to clear out parasites, Antimicrobials (such as allium from garlic, berberine-containing herbs, neem, and oil of oregano) may help to diminish SIBO and aid in dysbiosis – may be used in single products or combination products, Products such as activated charcoal and modified citrus pectin may be helpful in removed mold or heavy metals.
Step 2- Replace: Replacement includes HCl, pancreatic enzymes, and bile acids based on your specific needs. Be careful, more is not better. Too much HCl can cause stomach burning and lead to ulcerations if H pylori is present. The replace phase also includes replacing and ensuring adequate sleep, stress reduction, and switching from a low quality, processed food diet to a whole food based diet.
Step 3- Reinoculate: Repopulate your microbiome with good bacteria by taking a targeted probiotic supplement and eating fermented foods. You can also repopulate your gut by consuming prebiotics that will serve as additional fertilizer for your gut bugs. My favorite reinoculation products include: PHGG (partially hydrolyzed guar gum) or “Sun Fiber”- acts as a prebiotic to stimulate the growth of healthy gut bacteria. It is slow to ferment, reducing the risk of gas and bloating that other prebiotic fibers can cause, and may help to reduce symptoms of both diarrhea and constipation dominant IBS. S. Boulardii probiotic- this is a yeast-based probiotic that can help to reduce inflammation, eradicate infections, and aid in healing a weak intestinal lining. Megaspore- this product is spore-based, broad spectrum probiotic, meaning that it was formulated to survive through the digestion tract to ensure short-term colonization within the GI tract. Megaspore may help to increase microbial diversity, reduce metabolic endotoxemia (aka “leaky gut”), strengthen the immune system, and reduce symptoms associated with “IBS”.
Step 4- Repair: Help seal the gut lining through diet, lifestyle, and supplementation. You should always be repairing in every one of these steps. A quick note- repairing can’t truly happen if an infection is present, or if mold and heavy metals continue to circulate their toxicities throughout your body. You have to find the root source to prevent your health issue from coming back and flourishing. Products for repairing the gut include: Glutamine: serves as a fuel source for your intestinal cells, helps in the maintenance of your intestinal lining, and stimulates gut mucosal cell proliferation, Zinc carnosine: may help aid in the repair of the gut lining and reducing inflammation, Bovine colostrum/immunoglobulins: colostrum comes from the first milk produced after an animal gives birth, reduces inflammation, and stimulates the immune system, Deglycyrrhized licorice: helps to soothe the gut lining, lower inflammation, and promote healing of the mucosal lining, Saccharomyces boulardii: a beneficial yeast probiotic that can help to preserve and restore gut barrier infection, increase secretory IGA levels, and combat conditions such as H pylori, SIBO, and food poisoning, Full spectrum CBD oil: lowers inflammation and pain levels- may enhance the healing of the gut lining.
During these four phases, remember that diversity of plants in your diet is one of the biggest contributors to a healthy gut. Fiber is your friend. Prebiotics and fiber ferment to produce SCFAs (short-chain fatty acids) that serve as fuel sources to help maintain your gut lining health, reduce inflammation, combat pathogens, lower cholesterol levels, as well as influence your immune, cardiovascular, and nervous system. They also help to enhance the diversity of your gut microbiome, which is what you want in order to have a healthy, not rebellious, gut.
Dysbiosis:
The presence of dysbiosis or an overgrowth of bacteria in your gut can spell a recipe for disaster to your thyroid, hormones, metabolism, and your overall health. Not only can digestive symptoms occur, but so can nutrient deficiencies, autoimmune attack, low immunity, hormonal imbalances, and poor thyroid conversion.
Contributors to Dysbiosis include: Dietary factors (low fiber, high processed foods, high intake of artificial sweeteners, added sugars/sugary foods, food additives or preservatives), Environmental toxins (mold, heavy metals, etc), Impaired digestion, Nutrient deficiencies, Medications such as birth control, proton pump inhibitors (PPIs), antibiotics, NSAIDs, Diabetes, Viral, bacterial, or parasitic infections, Poor oral health, Low stomach acid, pancreatic enzymes, or bile acids, Intestinal adhesions, Chronic stress (physical or emotional), Undereating, Food poisoning, and Ileocecal valve malfunction (lies between your colon and small intestine).
There are 3 main patterns of dysbiosis:
-Low Beneficial Bacteria: causes include chronic stress & inflammation, chronic antibiotic use, undereating, low-fiber diet, poor digestion, chronic antimicrobials, environmental exposures
-High Pathogenic Bacteria: causes include poor digestion, lack of enzymes, low stomach acid, chronic stress, heightened intestinal permeability, parasites, yeast overgrowth, slow motility, chronic inflammation, food poisoning , poor oral health
-Loss of Overall Microbial Diversity: causes include chronic stress & inflammation, chronic antibiotic use, undereating, low-fiber diet, poor digestion, chronic antimicrobials, medications, environmental exposures
SIBO:
Symptoms of a small and/or large intestine overgrowth include: chronic bloating (especially present upon waking without having eaten food), belching, reflux, brain fog, chronic fatigue, chronic diarrhea and/or constipation, acne, eczema, hair loss, depression, joint pain, weight loss (or weight gain), hormonal imbalances, iron or B12 deficiency, heartburn/reflux, and hypothyroidism. If you say these things, consider SIBO to be the culprit: “I feel pregnant all day long!” “Sugar and carbohydrates seem to make things worse” “I just can’t eat anything without symptoms” “I’ve tried probiotics they make me feel worse” “I just can’t seem to get rid of my acne” “I am tired, irritable, and anxious. Nothing seems to help” “I can’t poop no matter what” or “I have diarrhea despite any change in my diet”. Causes of SIBO include: Medications (ex. birth control, proton pump inhibitors, antibiotics), Low stomach acid, Pancreatic enzyme deficiencies or bile acid deficiencies, Mold toxicity, Ileocecal valve malfunction, Immunosuppression, Traumatic brain injury, Poor MMC- Migrating Motor Complex, Chronic stress, Chronic undereating or eating disorders, Abdominal surgery, Intestinal adhesions, Slowed motility (ex. Gastroparesis), Nerve dysfunction, and Food poisoning Co-infections (H pylori, Candida).
Candida:
Candida, aka Candida albicans, is an opportunist yeast that is naturally present in your intestines. However, when it becomes overgrown, it can compromise your immune system, deplete your good bacteria, and increase your risk of nutrient deficiencies. Symptoms of Candida include: Skin, hair, or nail fungal infection, Brain fog or poor mental clarity, White tongue, “Drunk” or tipsy feeling without drinking alcohol, Digestive distress such as gas, bloating, or constipation/diarrhea, Recurring UTIs or yeast infections, Skin issues such as acne, rosacea, hives, or psoriasis, Mood swings, Worsening anxiety or depression, Sugar or refined carbohydrate cravings, Vaginal or rectal itching, Chronic fatigue, Sinus infections of worsening allergies
H. Pylori:
H pylori is another normal bacterial inhabitant that when overgrown, causes total health chaos. Symptoms include: Burping/belching, Difficulty digesting protein, Bad breath, Heartburn or reflux, Upper abdominal pain (esp right after meals), Acne, Bloating & gas, Constipation, Headaches, Nausea, Undigested food in the stool. H pylori overgrowth can lead to: SIBO, Candida, Anemia, Nutrient deficiencies, Hormonal imbalances, Hypothyroidism, Stomach ulcers, gastritis, or gastric cancer, Intestinal permeability
Intestinal Permeability:
Intestinal Permeability, or “leaky gut” as it is commonly called, is not a specific disease, but an explanation of how well your gut barrier is intact. When you have increased intestinal permeability, the lining of your intestinal tract and intestinal wall tight junctions become loose, allowing for undigested food particles, toxins, and microbes to escape your gut and enter your bloodstream. Having increased intestinal permeability simply indicates that your gut lining and gut barrier are not fully intact. Symptoms and Diagnoses associated with heightened intestinal permeability include: Anxiety, Depression, Asthma, Allergies, Brain fog, Chronic fatigue or pain, Indigestion, Diarrhea or constipation, Bloating, Recurring illness or infections, Multiple chemical sensitivities, Exercise intolerance, Acne or skin rashes/ eczema, Arthritis, Autoimmune disease (ex. Crohn’s disease, Type 1 Diabetes, Hashimoto’s, Lupus, multiple sclerosis, Sjogren’s syndrome), Celiac disease, Ulcerative colitis, Gluten intolerance, Irritable Bowel Syndrome. What causes “leaky gut” or increased intestinal permeability? Chronic inflammation (can be from undereating and over-exercising all the way to low or high cortisol), Infection or dysbiosis, Medications (such as NSAIDs, hormonal birth control, steroids, and antibiotics), Food poisoning, Impaired digestion (i.e., low stomach acid, pancreatic enzymes, bile acids), Nutrient deficiencies, Infections or viruses, Stress and trauma, Alcohol, Environmental toxins, Poor diet with low fiber and prebiotic intake, Food sensitivities such as gluten (which can weaken tight junctions in susceptible people).
Bloating:
The Common Causes of Bloating: Sugar alcohols or artificial sweeteners, Food additives and preservatives (especially thickeners like xanthan gum), Too much fiber or raw vegetables, Eating too quickly, Not chewing food properly, Drinking too much liquid with meals, Dehydration, Low stomach acid, Low pancreatic enzymes, Food Intolerances, Constipation, Hormonal or thyroid disorder, Gut infection or overgrowth, Stress, PMS, Dysbiosis. Remember this- it’s normal to have mild bloat from food and water after eating, especially if you had a higher volume meal. Big salads are going to be harder to digest as the plant cell walls are harder for your body to break down. Higher fat meals take a longer time to digest in your GI tract. If you consume a lot of gas-producing foods such as cruciferous vegetables and beans, or eat too much fiber, you are also welcoming a bloat. However, if you struggle with consistent, constant bloating that creates pain or takes away from your day-to-day life- it’s time to address it. That isn’t normal.
Constipation:
If your poop life isn’t happy and consistent- neither are your hormones or metabolism. Pooping is one of the most important steps of natural detoxification. Can’t poop? You can’t get out any toxins or excess estrogen either. Weekly bowel movements may look different for everyone, but you should be pooping daily. Chronic constipation is not only extremely uncomfortable, but it can lead to estrogen dominance, gut dysbiosis, SIBO, and the development of pelvic floor disorders. It also may worsen thyroid disorders, burden your liver, and cause nutrient deficiencies. How can you fix it? Always look to fix the root cause. This should be redundant to you by now. In many cases, constipation can be relieved by: Increasing water intake - dehydration causes constipation. Drink 1 gallon a day, minimum. Low electrolyte intake can also cause constipation. Try using Nuun tablets, Ultima replenisher powder, or adding Himalayan salt to your foods. Increase your activity - movement helps increase peristalsis of the large intestine, helping with gut motility. Walking after meals can help with digestion. Get outside after meals and go on a 5-10-minute walk. Note- over-exercising will not be helpful as it blunts digestion via the stress and cortisol connection. We want parasympathetic dominance- aka rest and digest mode. Try to increase your fiber intake - 25-40 g is a good range, however everyone has a different “fiber sweet spot.” Remember the different types of fiber here. Insoluble fiber helps move your digestion along and increases stool bulk, while soluble fiber slows things down and draws water into your intestines. Psyllium husk and citrus pectin are two fiber supplements that may be helpful, however try increasing your overall food fiber first. Great first addition could be 2 tbs chia or flax seeds. Stress less - If you are constantly in fight-or-flight mode, your body doesn’t want to digest. You need to do more parasympathetic work and relaxing (or slothing) to help get those digestive movements going. Get sleep. Make sure to aim for 7-8 hours of sleep per night. Lack of sleep slows down intestinal motility and increases inflammation. Make sure you aren’t undereating. It can be common to get constipated if you aren’t eating enough. It’s also common to be mildly constipated when you are dieting, as your thyroid hormones naturally decline. Lower thyroid hormones can lead to slow gut motility. That doesn’t make being constipated normal while dieting. It just means that if you are dieting, be aware that your poop motility may change. Try adding a natural prokinetic such as ginger, triphala, or tryptophan or digestive bitters, which help to stimulate digestive juices, as well as can help relieve heartburn, support the liver, support blood sugar, and stimulate peristalsis. Digestive bitters include ginger, myrrh, orange peel, fennel, dandelion root, rhubarb, wormwood, and cinnamon. If the previous tips don’t help, coffee or tea may help move things along. Caffeine can increase motility and so can the use of natural prokinetics like magnesium citrate. I would be cautious and avoid using supplements to enforce movements, as for some, they can become dependent and addicted to them. For example, senna (found in many “bowel movement regulator” supplements) is habit forming and the body becomes accustomed to it. Meaning that as you continue to take it, it will work less and less. The same may happen for magnesium citrate. Luckily, I have not seen dependency with caffeine, but that doesn’t mean that it won’t happen. Look at lifestyle factors first to find what may be preventing you from happy daily bowel movements, then look at: Possible food intolerances, Overgrowths (methane-dominant SIBO is a major cause), Lack of pancreatic enzymes or bile flow, Cortisol dysregulation, Hypothyroidism, Intestinal adhesions, Gut nerve damage, and Colonic muscle weakness.
Low Stomach Acid:
Do these symptoms sound familiar? Bloating or belching immediately following a meal, A sense of fullness after eating, Itching around rectum, Chronic candida infections, Peeling or cracked fingernails, Mineral deficiencies, Acne, Chronic parasite infection, GERD (gastrointestinal reflux disease), Post-adolescent acne, Undigested food in stool, Morning diarrhea or diarrhea after big meals, Iron, B12, or zinc deficiency, Nausea, Lack of desire to eat protein or meat, Bloating, and Multiple food allergies or intolerances. The best way to find out if you have low stomach acid is to perform a baking soda test. How to perform a baking soda test: Drink a mix of 1/4 tsp in 4 oz water on empty stomach See if burping occurs within 5 minutes. If it does, it is likely you have adequate stomach acid. If you burp right away, you may have high stomach acid. Low stomach acid can be caused by: hypothyroidism, infection or illness, autoimmune disease, stress, fasting, post-surgery, medications (such as proton pump inhibitors, antihistamines, antacids), gastroparesis, hiatal hernias, pyloric sphincter malfunction, and/or increased age. If you suffer from low stomach acid or GERD, there are some specific changes that may help with your symptoms. Foods to avoid: high fatty/fried/greasy foods, chocolate, coffee, mints, high sugar, alcohol, onions, garlic, citrus fruits, tomato-based foods, spicy foods, and carbonation. Lifestyle changes to make: eat smaller meals, minimize liquids with meals, go on walks after meals, wear looser fitting clothing, don’t lie down after meals, limit food intake before sleeping, prioritize stress reduction, try chiropractic adjustments which may improve blood flow to the stomach to improve HCl production.
Low Pancreatic Enzymes:
Common symptoms of low pancreatic enzymes include: Watery diarrhea, Undigested food in stool, Undesired weight loss or muscle wasting, Chronic fatigue, Chronic bloating, Malnutrition or nutrition deficiencies, Edema, Indigestion/fullness 2-4 hours after meal, Chronic bloating, and Slow digestive transit time. You can naturally support enzyme function by: Focusing on rest and digest: mindful and slow eating, ensuring proper mastication (aka chewing of your food), and prioritizing stress management, Being cautious of your food choices: limit high fatty and processed foods, consume cooked vs raw vegetables, Add in herbal therapies and digestive bitters that help stimulate digestion such as ginger, fennel, mint, and natural proteolytic enzymes such as bromelain (from pineapple) or papain (from papaya).
Low Bile Acids:
Bile acids help to emulsify fats from your food. Remember, bile is what helps to digest and absorb dietary fat and fat-soluble vitamins. It also plays a crucial role in helping to remove excess cholesterol, environmental toxins, and hormones from your body. Think of bile like pac man- gobbling up toxins to remove and sweeping up to help vitamin absorption. If you say “yes” to the following symptoms- you may have issues with creating bile acids. Symptoms: Fatty stools (bulky, pale/gray, oily stools), Floating stools, Diarrhea, Unintentional weight loss, Constant feeling of fullness, Nausea or pain after a high fat meal, High cholesterol levels, and Malnutrition or nutrient deficiencies (especially of fat-soluble vitamins).
Histamine Intolerance:
Histamine is a natural compound produced by mast cells (immune cells) that is naturally found within foods and aids in regulating your immune and allergy responses. It triggers the beginning of an inflammatory response by helping to increase blood flow and marks as a red flag to your body that some “attacker” is present. It also helps to increase stomach acid and acts as a neurotransmitter in your brain. Symptoms of histamine intolerance include: Rashes or eczema, Increased allergies, Dry throat, Sinus congestion, Runny nose, water eyes, Stomach aches and cramps, Low blood pressure, Flushing Headache, Heartburn, Diarrhea, Rapid heart beat, and Insomnia. Treatment for histamine intolerance includes rebalancing the gut and restoring the immune system. Symptoms can be managed by removing high histamine foods such as fermented foods, alcohol, wine, aged cheeses, eggs, citrus fruits, seafood, spinach, processed meats, ripe bananas/avocados, tomato based products, vinegars, and even leftovers (in which histamine is produced with microbial fermentation and maturation). Histamine intolerance occurs when you have too much histamine in your body than it is able to break down. Histamine intolerance can be caused by: Lack of DAO or HNMT enzymes that help to degrade histamine, overgrowth of bacteria that produce histamine, and/or supplements and medications that black DAO production.
Testing Bowel Transit Time:
“Transit time” can be defined as the time it takes for you to eat, digest, and eliminate (aka poop) out the food that you eat. Testing your bowel transit time can tell you about a possible potential problem digesting your food. If you can’t digest your food, you can’t absorb your nutrients. An optimal transit time is between 12-24 hours. Less than 12 hours may indicate malabsorption or infection, while greater than 72 hours may indicate slow motility, which can predispose you to overgrowths due to increased colonic fermentation, as well as increase the reabsorption of toxins back into your bloodstream. The Test: Calculate the number of hours it took from eating three to four beets and when your stool turns a dark red color. The best way to increase your bowel transit time? Increase your water intake, consume 30-40g fiber per day, exercise at least 30 minutes per day, and prioritize stress reduction.
Foods to Limit In Your Diet:
(limit does not mean 100% avoid) (obviously including any specific food intolerance or allergy you may have yourself) Highly processed vegetable oils (canola, soybean, sunflower, corn, safflower, margarine), Alcohol, Hydrogenated oils and trans fat (avoid), Food additives and preservatives including: carrageenan, nitrates, nitrates, gums, sulfites, artificial food dyes, BHA, BHT, polysorbates, sulfites, sodium benzoate, potassium bromate, EDTA, Processed meats, Canned fish unless low mercury (for example, Safe Catch), Sugary beverages or condiments, and Artificial sweeteners.