02Feb
23 Nutrition TherapyHealth Conditions, Stress

The Real Root Cause of Your Hormone Imbalance Brain Fog, Adrenal Fatigue, and Digestive Symptoms: Part 1

You’ve just left your doctor’s office with as many questions about your symptoms as when you walked in. During your consultation, you felt rushed, and your symptoms were minimized to a general diagnosis. Next, your clinical lab results came back, and everything was “normal.” However, YOU know there is something wrong. The real question is what is conventional medicine offering you?

In conventional medicine, doctors are trained to treat symptoms. This approach disregards the root cause of disease and how chronic illnesses develop. Functional medicine addresses the three foundational body systems — the neuroendocrine system, the digestive system, and the liver detoxification system. Addressing these 3 body systems will help you correct metabolic imbalances related to adrenal fatigue, anxiety, sleep disturbances, digestive issues, leaky gut, and brain fog.

If you’re at a dead-end and sick of the band-aid approach, dive into this 3 part blog series to understand what’s at the root of your symptoms.

Foundational Wellness
The Gut-Hormone-Detox System

The gut, brain, and liver work together to keep the body in a state of homeostasis aka balance. When an organ is not functioning optimally, imbalances of biological systems occur within the gut-hormone-detox system (neuroendocrine system, digestive system, and liver detoxification system). The neuroendocrine system, mainly controlled by the brain, regulates neurotransmitters and stress hormones, which affect sex hormones, thyroid hormones, and mitochondrial energy metabolism.

The large intestine includes the gut microbiome, which is home to many beneficial bacteria. It is essential to have a healthy gut mucosal lining because it serves as a protective barrier, keeping pathogens from entering the body and causing leaky gut. A leaky gut may put you at a higher risk of developing GI disorders – Small Intestinal Bacterial Overgrowth (SIBO) and Irritable Bowel Syndrome (IBS). 

Detoxification takes place in the lungs, digestive system, kidneys, and skin. However, the majority of detoxification occurs in the liver. There are gene variants that influence enzymes, antioxidants, and nutrient cofactors. Toxins are filtered by enzymes, and keep the body free from harm. 

What happens when one of these three foundational body systems is out of balance? In part one of this blog series, we’ll be diving into the neuroendocrine system and its connection to the root causes of your health concerns. 

The Neuroendocrine System

The neuroendocrine system guides the production of hormones (stress, sex, and thyroid) and neurotransmitters (catecholamines, dopamine, and serotonin) and can be tested through nutrigenomic testing. The production and processes of these hormones/neurotransmitters are largely dependent on lifestyle, diet, and nutritional genetics. This is called Neuro Nutrition. 

Mitochondrial Markers and Neurotransmitters on the Individual Optimal Nutrition Test ION

These two tests are used by functional medicine dietitian, Gayatri at 23 Nutrition Therapy to measure neurotransmitter metabolites: the Organix Organic Acid Test (OAT) or the Genova ION Test. Despite the OAT providing an Organix comprehensive profile,  the ION test is more comprehensive than the OAT and involves a urine sample and a blood draw. You can also review the sample report for the ION test here.  

There are over 150 biomarkers in the ION Test, with two critical mitochondrial energy markers: adipate and suberate. These organic acids are necessary to convert fatty acids to energy, using the help of an amino acid, L-carnitine. When these markers are high, it is possible that there is an L-carnitine deficiency, which means your body does not have the ability to break down stored fatty acids and convert them into energy thus leading to fatigue and difficulty with weight loss. These markers also help us understand if there is an energy deficit leading to a mitochondrial deficiency which can cause thyroid function impairment. 

Hormones of the Neuroendocrine System

Hormones are the body’s chemical messengers that travel through the bloodstream to various organs and tissues. Hormones are responsible for development, metabolism, growth, reproductive function, and mood. High amounts of stress hormones tax the adrenal glands, which are part of the neuroendocrine system. High levels of stress hormones may stem from external stressors that come with life’s unpredictable events, but there are internal stressors such as infections, gut pathogens, molds, and exposure to heavy metals. 

Internal and external stressors can impact the production of the hormones cortisol and DHEA, which are released by the adrenal glands. Cortisol is a catabolic hormone, meaning it breaks down components in the body, often during times of stress or “fight-or-flight”. Dehydroepiandrosterone, or DHEA, is an anabolic hormone that repairs damaged cells in the body during times of growth. When the body is presented with high levels of long-term chronic stress, the production of cortisol and DHEA is impacted thus more cells are being broken down and less damaged cells are being repaired. Both of these hormones are released from the adrenal glands and play a crucial role in maintaining homeostasis (balance). 

Have you ever heard the saying, “You can’t control life’s stressors, but you can control your response?” Let’s break this down.

Our bodies have a built-in mechanism to help us respond to stressful situations, using hormone signaling between the hypothalamus in the brain, the pituitary glands, and the adrenal cortex. Under long-term chronic stress, the hormone signaling communication network between organs and glands starts to malfunction, this is called hypothalamic-pituitary-adrenal (HPA) axis dysfunction and is often mistakenly referred to as adrenal fatigue. 

Though the adrenals are not fatigued, HPA-axis dysfunction can be compared to losing cell phone signal reception in a basement. This loss of communication impairs your body’s ability to respond to stress and adapt, initiating a catabolic effect on other body systems that ultimately leads to breaking down other cells and tissues and damaging the gut lining.  

HPA-Axis Dysfunction or “Adrenal Fatigue”

HPA-axis dysfunction is commonly mistaken as “adrenal fatigue,”. Symptoms of adrenal fatigue/HPA axis dysfunction symptoms include:

  • Insomnia
  • Weight gain
  • Immune dysfunction
  • Depression
  • Gastrointestinal symptoms
  • Chronic pain
  • Chronic fatigue

Despite the adrenals not actually being fatigued, HPA-axis dysfunction is often mislabeled as adrenal fatigue since the symptoms are similar. Oftentimes, however, it is actually your body’s stress response that is initiating these symptoms, especially in a state of chronic long-term stress.

Physical, emotional, and biochemical stressors influence cortisol and DHEA levels. Potential stressors include working overtime, blood sugar dysregulation from a Standard American Diet (SAD), undereating protein, a sedentary lifestyle, poor digestion, compromised immune function, gut infections, and toxin exposures, combined with a poor ability to detoxify. These all can add up to underperforming HPA-axis signaling and low DHEA levels. 

One of the first steps in assessing your body’s stress response is to test your adrenal hormones through the Adrenal Stress Profile test. The Adrenal Stress Profile is a salivary lab test to assess HPA-axis dysfunction. 

The cortisol awakening response (CAR) marker on the Adrenal Stress Profile, tests for cortisol levels that are present upon waking up. This cortisol level is known as the baseline. Under normal conditions, cortisol elevates to a peak in the morning, about 30 minutes after waking. Elevated cortisol levels give the body energy to transition from a sleep state to an awakened state. Once cortisol levels peak, cortisol returns to baseline about 30 minutes later. 

Another way to assess HPA-axis dysfunction is to monitor DHEA on the Adrenal Stress Profile test.  Low levels of DHEA stem from aging and chronic stress. Diminished DHEA or a low cortisol awakening response, along with disrupted cortisol rhythm throughout the day, tells us how well our HPA axis is functioning.

The Adrenal Stress Profile will assess six points of salivary cortisol samples throughout the day.  This test involves sending saliva samples to the laboratory, this is called salivary hormone testing. Your functional medicine dietitian will look for high and low cortisol patterns, determine if you have HPA-axis dysfunction and what stage it is at, and recommend further treatment protocols.

Three Stages of HPA-axis Dysfunction 

HPA-axis dysfunction is not a linear situation, it develops in stages. After completing an Adrenal Stress Profile, your functional medicine dietitian can begin to stage your HPA-axis dysfunction to personalize your treatment regimen further.

Treatment for stage 1, 2, & 3 HPA-axis dysfunction includes dietary adjustments, emphasizing blood sugar balance, and insulin response. Lifestyle factors, including stress management, exercise modifications, and pain management paired with a personalized therapeutic supplement program prescribed by a functional medicine dietitian will restabilize the HPA-axis.

It is important to note that sleep and circadian rhythms play a huge role in cortisol balance thus for those with sleep disorders/imbalances, those who work night shift, etc.., it is crucial to complete an Adrenal Stress Profile to see if that is the cause of your chronic fatigue. 

What is the Gut-Brain Axis? Gut Neuroendocrine System

The gut-brain axis (GBA) is the communication pathway between the central and the enteric nervous system, which connects the emotional and cognitive centers of the brain with intestinal function. More research is emerging on the importance of gut microbiota in influencing these interactions. One explanation is through the vagus nerve which originates in the brain and ends in the large intestine. 

The vagus nerve stimulates the intestines influencing how food is digested and eliminated. This is known as the migrating motor complex. The vagus nerve also signals the release of digestive enzymes, further promoting food migration through the digestive tract. This function is essential in preventing constipation and increasing nutrient absorption. The vagus nerve can also stimulate the production of stomach acid, which breaks down food in the stomach. If the vagus nerve is compromised, consequences such as indigestion, constipation, and bloating may occur. 

How can you tone your vagus nerve? This includes eating nutrient-dense foods, including a diet high in whole grains and fiber, consuming probiotics, staying hydrated, and limiting the consumption of caffeine. Pointing to the importance of maintaining a healthy gut microbiota, gut dysbiosis has also been linked to compromised immune function.  

Where Do I Go From Here? 

As we continue to see, the systems of the body are all interconnected and highlight the importance of finding the root cause of your symptoms. Working with a skilled Kalish Method Practitioner, gut-hormone-detox specialist, and functional medicine dietitian is essential in developing an individualized plan for long-lasting success! The very first step before beginning the initial “Comprehensive Root Cause Analysis” program is to schedule a free 15-minute nutrition strategy call to discuss the best approach for you!

Stay tuned for part 2 of this blog series where we will continue to discuss the gut-hormone detox system diving into the gut microbiome, digestion, and detoxification![/vc_column_text][/vc_column][/vc_row]

12Oct
23 Nutrition Therapy TeamDigestion

Restore Gut Health Using the 5 R Protocol

There are so many different problems we can face when it comes to gut health. Constipation, diarrhea, cramping, gas, acid reflux… These uncomfortable symptoms are annoying, but they are also usually signs of a much larger problem! So how do we restore gut health?

Many of us tend to reach for short-term solutions that alleviate symptoms but do nothing to restore gut health! Addressing the root cause is the only way to guarantee better health outcomes in the long-term, but this is something that often requires a bit of guidance.

Currently, one of the best approaches to restore gut health outcomes is to utilize the 5R Protocol guided by your functional medicine dietitian.

This involves correcting the problems in the order that they occur, beginning with the neuroendocrine system (stress), to the gastrointestinal system, and then finally repairing the liver detoxification system. 

Working on the 5R Protocol for a full year is the best practice in order to see ideal results.

This means utilizing adrenal testing for stress hormone levels, organic acid testing for intestinal health, neurotransmitter activity, and detoxification demands, and additional testing, such as micronutrients, SIBO, or food sensitivity testing as needed.

These types of tests help your dietitian obtain enough information to identify the root cause of your symptoms, making them able to restore gut health.

What is the 5R Protocol?

The Institute for Functional Medicine established The 5R Protocol as a comprehensive method to address a variety of gastrointestinal (GI) issues.

This approach is effective because it addresses all aspects of gut health, improving symptoms while also tackling the root causes of dysfunction! This protocol is also individualized. It directly targets your issue based on your symptoms and your distinct needs.

Digestive health is the key to your overall health! Digestion keeps our cells healthy and functional by absorbing nutrients. Your GI tract is also home to many immune cells, so it makes sense that any disorder in the digestive tract can lead to bigger problems if the root cause isn’t sorted out.

Treating symptoms is only the tip of the iceberg. Improving gut health requires a multilayered approach to ensure outcomes that actually last.

So, what are the 5 R’s and what does each step involve?

Step One to Restore Gut Health: Remove

The first step of the 5R protocol is to Remove. Remove any stressors, irritants, or excess bacteria that could be causing issues in the gut.

Gut irritation can be caused by:

  • Certain foods
  • Medications
  • Infections
  • Bacterial overgrowth (like SIBO)
  • Emotional stress

This step might involve eliminating triggering foods. This could include food sensitivity testing to determine what kind of foods are causing your issues, temporarily removing a couple foods (or food groups), or following  a therapeutic elemental diet protocol. You could also take a comprehensive stool test to determine whether your issues are the result of an infection or a microbiome imbalance.

Once you determine the irritants, you will eliminate those foods from your diet altogether. If there is an infection (bacterial, parasitic, or viral), a referral to your doctor may be necessary to receive the appropriate medication. You may also be asked to follow a supplement protocol.

Chronic stress is an overarching cause of many bodily ailments. Our bodies release stress hormones (like cortisol) to help combat threatening situations. In modern society, we tend to utilize our stress response far too often.

This results in digestive issues and inflammation, among other issues such as HPA axis dysfunction (adrenal dysfunction and adrenal fatigue). Consequently, reducing your daily stress and improving your ability to remain in a calm state are vital to restore gut health.

Adrenal stress hormone testing, stool analysis, and food sensitivity testing are all extremely helpful for Step 1. 

Step Two to Restore Gut Health: Replace

Eliminating certain foods and food groups from your diet can lead to other issues, so it is meant to be only temporary.

After removing the triggers to your digestive issues, the next step involves replacing anything you are personally missing in your gut that is critical for proper digestive function. 

Depending on your condition, you may need to add digestive enzymes, support stomach acid (important for protein digestion) and bile flow (important for fat digestion), or tackle any nutrient deficiencies. 

Stool testing and microbiome analysis are helpful in Step 2. 

Step Three to Restore Gut Health: Repopulate

The next step of the 5R protocol is to reinoculate your microbiome by reintroducing and supporting beneficial bacteria through consuming probiotics and prebiotics.

Probiotics are live, beneficial microbes that we ingest through certain drinks, foods, and supplements.

While taking a probiotic supplement is convenient, there are also benefits to consuming fermented, probiotic-rich foods and drinks. These include things like kombucha, pickles, yogurt, kefir, sauerkraut, kimchi, tempeh and miso.

Prebiotics are non-digestible fibers that feed your beneficial gut bacteria, helping them to repopulate your GI tract in healthy levels.

Some foods rich in prebiotics include garlic, asparagus, onions, leafy greens, whole grains (quinoa, oats), apples, flaxseed, lentils, jicama, and chicory root. Partially hydrolyzed guar gum (PHGG) is a great option for a supplemental prebiotic fiber.

Microbiome analysis is helpful in Step 3. 

Step Four to Restore Gut Health: Repair

Now, the intestinal wall needs to be restored so you can optimize digestive function.

Leaky gut is a condition where your intestinal wall is unstable, leaking toxins, bacteria, and other large particles into your bloodstream. This can cause systemic inflammation and lead to other chronic illnesses.

Repairing the gut lining reduces this permeability and prevents harmful substances from traveling outside the digestive system. This allows for their elimination when we use the bathroom!

Consuming essential key nutrients such as zinc, glutamine, and vitamins A/C/D/E can help restore the linings of the digestive tract and promote absorption. Many of these nutrients cannot be properly utilized when your gut is out of whack.

Micronutrient testing is helpful with Step 4.

Step Five to Restore Gut Health: Rebalance

Now that you’ve set the stage for proper digestive function by improving the environment of your microbiome, the final step of the 5R protocol is to adjust your overall lifestyle.

Rebalancing your lifestyle is crucial for continued maintenance of your restored, healthy gut. Things like sleep, exercise, diet, emotional states, and stress all impact digestive function. 

So what kind of things can be done to improve these segments of your lifestyle?

Focus on improving the quality of your sleep by reducing blue light exposure after the sun has set. Possibly attempt a new workout regimen to ensure you get your muscles moving regularly. Eat a nutritious diet that continues to support your healthy gut.

Tune into your emotional states and practice relaxation methods.

Maybe try to practice mindfulness, yoga, and add gratitude exercises to your list of daily tasks. Be sure to reduce stress where possible and nurture your stress response to improve your stress resilience. Practice vagus nerve activation to keep your body in a parasympathetic, tranquil state instead of falling into unhealthy stress response patterns.

Summary of the 5 R Protocol

First, we must determine and eliminate the root cause of your symptoms. Then, any missing components of digestion are supplied and then fortified. Next, nourishing your gut microbiome and your gut lining should set the stage for efficient digestive function. And finally, we fine-tune our lifestyles to maintain the improvements we accomplished in the previous steps.

By now, you should understand the importance of a full lifestyle overhaul to combat your gut issues and restore gut health.

Treating the symptoms alone is usually not enough to cut it, because symptoms are the result of a larger problem.

We use the 5R Protocol to assure that your individual problems are contended with. The 5R Protocol lays the foundation for maintaining gut health by supporting your overall wellbeing.

Why not get started today to restore gut health? Schedule your appointment now to get started on your own individualized 5R Protocol!