Imagine this scenario – you’ve been getting symptoms such as vulval itching and redness so you treat it with an over-the-counter thrush cream. The symptoms go. Must have been thrush, right?

It happens again later, but this time the treatment doesn’t work. So you try something else – maybe a pessary or an oral antifungal. Still getting symptoms…

Eventually, you get a swab from your GP, but the results don’t show anything definitive.

So you do a bit of research and decide to go on a strict anti-Candida diet and take several strong natural products that wipe everything out.

But now your gut’s feeling off, you’re anxious about everything you’re eating, and somehow you’re no closer to answers.

You go back to your doctor, and this time you’re given an antidepressant.

How did you end up here!?

Now take this story, and swap out thrush for recurrent UTIs, or BV, or interstitial cystitis. It’s a common journey for so many people, and it can be incredibly frustrating when symptoms keep recurring and you’re left without clear answers. Sometimes things do get picked up early and treatment is straightforward – but often I hear variations of this story, where people don’t fully know what’s causing their symptoms, or they’re led to believe it’s just something they have to live with. Others are placed on long-term medications they don’t feel comfortable with or are never told there may be an underlying imbalance.

A different approach –

When looking into vaginal microbiome health it’s important to have a good idea what you’re working with.
Most people are familiar with the classic symptoms of Candida/thrush – itching, redness, discharge. But sometimes it can present in less typical ways – for example, with only skin irritation or splitting, and no discharge at all. And importantly, Candida is just one type of imbalance. There are many microbes that can disrupt vaginal health – including bacteria linked to BV or chronic UTIs, and others that can trigger inflammation or discomfort without a clear “infection.”

So how do you find out what the cause is?

First and foremost we look at signs and symptoms. The colour, texture, sensations and odour of vaginal discharge can be very informative. Then we can narrow down whether the environment is too acid or alkaline, something that has a big impact on determining what sort of microbes can grow.

After examining symptoms, we can look at vaginal pH – an easy thing you can do at home to monitor the fluctuates from day to day. Vaginal pH is a good indicator of whether the condition is bacterial or fungal, and can show changes before symptoms appear.

A typical swab performed by the GP can also provide a lot of insight. Things like the presence of clue cells, leucocytes, what can be cultured, and whether bacteria appears to be there regardless of whether we know what type it is or not. However, Candida and other microbes don’t always show up on the day of testing, especially in cases of RVVC (recurrent vulvovaginal candidiasis), which can wax and wane.

This can often be enough. But if we need to dig deeper a more in depth vaginal microbiome test can be helpful.

There are several versions of vaginal microbiome testing available, currently my preference is through Nutripath which I discuss in the below video.

What is a microbiome?

A community of microorganisms that exist within an area of our body contributing to that spaces function and wellbeing. In female reproductive health we commonly refer to the vaginal microbiome – that microbiome that exists within the vagina and also affects the vulval tissues, as well as the endometrial microbiome (impacting the uterus and surrounding fluids) which may be different depending on cervical competency, and the peritoneal fluid microbiome. In the case of RVVC and chronic BV the vaginal microbiome is the most relevant.

Unlike the gut microbiome, the vaginal microbiome is meant to be relatively low in diversity. In most people, it’s dominated by Lactobacillus species, which help keep the environment slightly acidic and defend against invaders. There are variations in the vaginal microbiome based on hormonal stage (e.g. puberty, pregnancy, menopause) and even across the menstrual cycle. The type of lactobacillus that is dominant may vary based on your genetics, referred to community subtype (CST).

Signs of vaginal microbiome imbalance

• Itching in the vulval or vaginal tissues
• Redness or irritation
• Discomfort or soreness of the vulva or vagina that’s not related to
• Discharge that does not fit the typical ovulation discharge pattern
• Discharge that has a fishy, yeast, acidic, or “rotten/off” smell
• Recurrent UTIs
• Splitting in the creases
• Gushing or watery discharge (a clue depending on the microbe involved)
• Symptoms that flare or change during different phases of your menstrual cycle

Underlying Drivers of Vaginal Microbiome Imbalance

There’s no single cause for microbial imbalance. Often, several systems in the body interact and contribute. Here’s a breakdown:

• Gut health: Our gut is integral in almost all facets of our health and wellbeing. The impact of gut health on vaginal health may be different to what you may think. While older theories linked gut Candida to vaginal thrush, newer research shows this is unlikely due to the gut’s low-oxygen environment. RVVC is not typically caused by reinfection from the gut. Our gut health has an impact because of it’s influence on things like our immune system, hormonal balance, nutritional status and inflammation levels such as histamine tolerance. While gut candida is uncommon, and if present does not typically cause RVVC it is still important that we support gut microbiome in chronic dysbiotic cases.

• Oral health: Poor gum and oral health can drive systemic inflammation, which in turn can affect microbial balance elsewhere in the body.

• Immune health: An immune system that’s either overactive or suppressed can make it harder for the vaginal microbiome to stay balanced. Histamine excess can perpetuate chronic vaginal/vulval symptoms and can cause a heightened reaction when candida is present. There is a relationship between hormonal imbalance and mast cell activation issues that can feed RVVC.

• Hormonal balance: Both high and low oestrogen can create imbalances. In cycling women, this may lead to fluctuating symptoms throughout the month. In menopause, reduced oestrogen means less glycogen in vaginal tissues – a critical food source for Lactobacilli – leading to lower populations of these protective microbes. PCOS can be associated with a unique discharge pattern, and hormonal contraceptives like the OCP can alter both microbiome composition and typical discharge characteristics. Supporting hormonal balance is often a key goal in treating vaginal dysbiosis.

• Stress and nervous system regulation: Chronic stress can shift immune function, disrupt hormonal signalling, and create conditions in which opportunistic microbes thrive.

• Medication use: Antibiotics, antihistamines, and even some hormonal treatments can alter microbial environments by reducing protective species.

• Diet and lifestyle: High sugar and low-fibre diets, synthetic underwear, scented products, improper use of soaps or douching and certain sexual practices can disrupt pH or microbial stability.

The Complexity of Candida and RVVC

Recurrent vulvovaginal candidiasis is notoriously difficult to manage. One major challenge is timing – it may not show up on a swab done at your GP’s office if you’re between flares. But days later, symptoms can spike again.

And while low Lactobacilli is often linked to chronic Candida, this isn’t always the case. Some women have recurring Candida issues despite normal pH and healthy levels of Lactobacilli. In these cases, the key lies in addressing deeper factors – not just treating the yeast, but looking at immune regulation, inflammation, and systemic triggers.

The Broader Impact on Fertility and Reproductive Health

A disrupted vaginal microbiome can affect far more than just comfort. Studies link dysbiosis with higher miscarriage rates, IVF failure, and unexplained infertility. It may also fuel systemic inflammation via LPS production, worsening conditions like endometriosis and adenomyosis.

Both male and female reproductive microbiomes play a role in conception. The quality of the vaginal environment can influence sperm survival and how the sperm and egg interact.

What Can Be Done About It?

Effective treatment requires more than just “killing off” whatever shows up in a test. This is where working with a practitioner can make all the difference.

I’ve completed extensive training in vaginal microbiome care and offer tailored support – including custom pessaries and individualised treatment plans that target your unique underlying drivers.

A treatment strategy will typically involve:

• Supporting and regulating hormone balance

• Calming inflammation

• Addressing metabolic health and blood sugar regulation

• Modifying lifestyle and sexual practices as needed

• Supporting local vaginal tissue repair and resilience

• Enhancing immune function

• Restoring nervous system regulation and reducing chronic stress load

• Optimising diet, nutrient intake, and specific nutritional markers

• Identifying and targeting key pathogens where necessary

• Using timing strategies to prevent symptoms before they begin

• Balancing vaginal pH

• Supplying prebiotic fuels to feed beneficial microbes

• Using specific probiotics

References

Bradfield Strydom, M., Nelson, T.M., Khan, S. et al. The impact of fluconazole use on the fungal and bacterial microbiomes in recurrent Vulvovaginal Candidiasis (RVVC): a pilot study of vaginal and gastrointestinal site interplay. Eur J Clin Microbiol Infect Dis 44, 285–301 (2025). https://doi.org/10.1007/s10096-024-04999-1

Ono, Y., Kobayashi, Y., Shimada, S., Fukushi, Y., Yoshino, O., Wada, S., & Yamada, H. (2024). Uterine Endometrium Microbiome in Women with Repeated Implantation Failure Complicated by Endometriosis. Journal of clinical medicine, 13(16), 4605. https://doi.org/10.3390/jcm13164605

The post What to do when Thrush and BV don’t go away appeared first on Alison Mitchell Naturopath.

Endometriosis is a multifaceted gynaecological condition that affects many people with uteruses from as early as the first menstrual cycle, and possibly well into menopause. It is believed to be associated with a complex interplay of genetic, hormonal, and immune system factors that drive inflammation. A lesser known player that influences endometriosis is our microbes, in particular the bugs of our vaginal and digestive microbiome.

The vaginal microbiome is a complex ecosystem of bacteria, fungi, and other microorganisms that plays a crucial role in maintaining the health and function of the female reproductive system. In recent years, there has been growing evidence to suggest that changes in the microbiome of the vaginal and peritoneal fluid (the fluid which are reproductive organs exist within) may be associated with endometriosis.

Typically people without endometriosis are not shown to have many microbes within the peritoneal fluid, whereas those with endometriosis have been found to have dysbiosis of this area.

Photo by Alexander Krivitskiy on Unsplash

The vaginal microbiome can be imbalanced at many stages of life, however a long term imbalance such as in chronic candida can contribute towards inflammation and perpetual irritation of the nerves, aggravating the pain associated with endometriosis.

Dysbiosis within the digestive system can also aggravate endometriosis due to the increased production of lipo-polysaccharides (LPS) from dysbiotic bacteria, which contributes towards growth of endometrial lesions, increased inflammation and pain. Our gut bacteria play a large role in the balance of our immune system, and imbalances within our gut bacteria can disrupt this, worsening the inflammation of endometriosis which is driven by altered immune function.

If only correcting our microbiome was the sole answer, but it is part of the jigsaw puzzle.

You may be interested in these articles:

Endometriosis – Natural Management Options

Updates on Endometriosis

Thrush

10 Ways to Ease Period Pain

Endometriosis – an overview

The complexity of endometriosis makes it an overwhelming condition to tackle by yourself. Please don’t hesitate to get in touch if you would like to work together to improve this condition.

The post Endometriosis and the Microbiome appeared first on Alison Mitchell Naturopath.

I find that more and more people are aware of the importance of a balanced gut microbiome these days. The good bugs in your gut influence things like your immune system, hormone detoxification, metabolism, nutrient absorption, mood, skin health, levels of inflammation, reaction to food, oxidative stress, and more.

But did you know that antibiotics aren’t the only medication that can affect the bacteria in your gut, and in fact aren’t the biggest culprit for upsetting the balance.

I have gone knees deep in a research paper to find for you what medications will influence your very important microbiome. There are several commonly used medications which will potentially have a negative impact.

The main ones that were found to have an impact are:

• Proton pump inhibitors (PPIs) were one of the most notable drugs that influenced the bacteria, influencing multiple pathways, especially increasing the Streptococcus parasanguinis bacteria and affecting many pathways of bacteria’s ability to help our digestion of carbohydrates and fat
• Metformin seems to correlate with an increase of Escherichia coli, but also appeared to show an increase in the metabolic function of the microbiome, which may contribute to its effect.
• Antibiotics decreased overall Bifidobacterium levels
• Laxatives also affected multiple bacteria but were correlated with higher levels of  Alistipes and Bacteroides bacteria groups and a decrease in bacteria that digest starches

And to a lesser degree:

• SSRI antidepressants
• Oral steroids increased Methanobrevibacter smithii in those with inflammatory bowel disease. This is a bacteria which influences metabolism which could potentially explain the weight gain frequently observed in oral steroid users.
• Anti-androgen oral contraceptives
• Vitamin D and calcium supplements
• Levothyroxine use was associated with an increase of Actinomyces group

The analysis explored a multiple of different papers which examined the different microbiome associated with different medication use and found these patterns. In many instances it was thought that the microbiome changes are a result of the medications, however it is possible that when certain over growth or undergrowth of certain bacteria was present that this could be responsible for the condition that prompted that medications prescription in the first place. Given the majority of the conditions included things like constipation, reflux, inflammation and mood disorders, it makes sense as these conditions can be affected by an imbalance in your gut bacteria.

Overview of the number of associated microbial features.

Reducing the damage

While some of these correlations may not be the fault of the medication but just a reflection of the nature of the disease, it is still notable that many medications to disrupt our microbiome. In some instances, there are important reasons for taking medications, in which case you need to take steps to ensure you’re supporting your gut microbiome.

Feeding your good bacteria is one of the most important steps, and this is achieved by eating foods rich in prebiotics. Plant foods are the most notable source of this, and the bigger variety you can have, the better.

Including fermented food such as saurkraut, kimchi, kefir and kombucha and yoghurts can introduce some bacteria, but it isn’t always guaranteed that they will bring the type of bacteria you need to replace. If you tolerate these foods (people with histamine intolerance or SIBO may find them problematic) then it’s certainly beneficial to include them.

Probiotic supplementation can be very valuable, however the important thing to remember is that you need to choose a strain of probiotics that meets your aims.

Nutrients that support gut health lining include glutamine, n-acetyl-glucosamine, lysine, glycine and proline.

In some cases, it may be worthwhile discussing with your health practitioner whether there are alternatives to these medications. While natural medicines will not be as powerful as conventional medicines, in some conditions they can provide a very satisfying effect, reducing the need for medications.

Photo by Adam Nieścioruk on Unsplash

Herbs for the Gut

Herbal medicines can soothe the digestive system beautifully, and for conditions such as GORD (reflux) they can reduce the requirements for these medications.

For reflux: consider herbs such as Marshmallow root, Ribwort, Meadowsweet, Licorice (avoid if you have high blood pressure) and Dandelion root.

For reducing inflammation in the gut: A tablet containing herbs such as Boswellia and Turmeric can be particularly beneficial.

For sluggish bowels: a regular brew of Dandelion root, Ginger, Licorice, Yellow Dock and Cinnamon can help to get things moving.

References

Vich Vila A, Collij V, Sanna S, Sinha T, Imhann F, Bourgonje AR, Mujagic Z, Jonkers DMAE, Masclee AAM, Fu J, Kurilshikov A, Wijmenga C, Zhernakova A, Weersma RK. Impact of commonly used drugs on the composition and metabolic function of the gut microbiota. Nat Commun. 2020 Jan 17;11(1):362. doi: 10.1038/s41467-019-14177-z. PMID: 31953381

The post Medications and your Microbes appeared first on Alison Mitchell Naturopath.

Guts & Girl Bits – Episode 45 with Kirsten Greene

I’m so excited to share this episode with you all because SIBO is a condition I have been seeing a lot in clinic, and so I am thrilled to share this deep dive into SIBO with you.

Kirsten Greene (previously Swales) is a Naturopath who loves working with all this digestion, especially SIBO. She shares helpful tips of how to work through SIBO and also her own journey with this condition.

SIBO, also known as Small Intestinal Bacterial Overgrowth is a condition that can contribute to a wide variety of symptoms, but some of the classic signs that this may be something to consider include:

• Bloating, especially soon after eating
• Diarrhoea, or Constipation
• Wind (Farting, Burping)
• Stomach pain
• Food sensitivities – especially the fodmap group
• other inflammatory conditions that you can’t pinpoint the cause

In this episode Kirsten shares information about:

• What is SIBO
• Her personal journey with SIBO
• How to test for SIBO
• How to treat SIBO, and how to target treatment based on whether you have a dominance of methane or hydrogen bacteria
• How to support digestive health while healing from SIBO
• What is hydrogen sulphide SIBO?
• Other forms of microbial imbalance: LIBO, and SIFO
• Strep infections and SIBO, and how your dental health can impact SIBO
• Biofilms and SIBO
• What are some common mistakes that people make when trying to treat themselves from SIBO?

The Podcast

Have a listen here or on the embedded player below:

iPhone   Stitcher   Youtube   Soundcloud  Spotify 

Get in touch with Kirsten

Kirsten Greene (previously Swales) has been a practicing Naturopath, Nutritionist and Western Medical Herbalist for the past seven years, and specialises in working with clients who have SIBO (Small Intestinal Bacterial Overgrowth).

Kirsten has worked in Australia, South Africa and Europe and consults with clients worldwide online.
Originally from South Africa, trained and qualified in Australia, Kirsten is a practicing member of Naturopaths and Herbalists Association of Australia and now calls Bali, Indonesia home.

Kirsten has worked in Australia, South Africa and Europe and consults with clients worldwide online.
Originally from South Africa, trained and qualified in Australia, Kirsten is a practising member of Naturopaths and Herbalists Association of Australia and now calls Bali, Indonesia home.

Her primary focus is helping women heal their digestive issues so they can enjoy a loving relationship with their body and food, and for some, so that they may feel “normal”, sometimes for the first time in their lives.

Having been through SIBO and suffering digestion issues herself for years, Kirsten is super passionate in this area and can relate to what her clients are going through.
SIBO free to this day, Kirsten has gone from living with an extreme fear of food due to bloating, weight gain and discomfort, to having a healthy, functioning digestive system and sound relationship with all food.
This is what she wants this for all other SIBO sufferers too.

Connect with Kirsten:
www.kirstenswales.com/

Instagram: www.instagram.com/kirsten.greene.nd/
Facebook: www.facebook.com/kirstenswalesnaturopath/
Youtube: www.youtube.com/channel/UCjgjfDxqujHARmLtuf3Dpug

Kirsten’s Online Course: www.kirstenswales.com/online-course/

Podcast Transcript

Alison Mitchell 0:08
Hi everyone, you’re listening to Guts and Girl Bits. I’m Alison Mitchell, a practicing Naturopath. I hope to share with you all sorts of information about women’s health and digestive health to educate and empower you to make informed choices about your own health. Please remember that all information is general and does not replace consulting with the practitioner.

Hi, everyone. Welcome to guts and girl bits. Today, I’ll be talking with a fellow naturopath. All About SIBO! SIBO, also known as small intestinal bacterial overgrowth is something that is affecting so many people and causing all sorts of tummy troubles. So I love working with people with digestive stuff, hence the name of this podcast, guts and girl bits and I’m really excited to share this information because Something that I’ve been talking about to a lot of my patients about SIBO and finding there’s heaps of people out there that are like ‘What? What is SIBO?’

So this podcast is awesome because my guest is extremely, extremely knowledgeable about SIBO. She has been through the process of healing herself, of SIBO and has helped countless people in their own journeys with the SIBO as well. We talk about what is SIBO? How does it come about? What are some of the testing options? What can we do to treat it, including different options with medicines from doctors like certain anti biotics as well as different herbal options, and we talk about, you know, do we use probiotics? And if you do, what sort do we use? We talked about the different diet options because there’s so much information out there. And what are the common mistakes that people make when trying to treat themselves for SIBO? And how long should we wait expect to get better.

So my guest is the amazing Kirsten Swales (Greene). She has been a practicing naturopath, nutritionist and Western medical herbalist for the past seven years. And she specializes in working with clients who have SIBO. She’s worked in Australia in South Africa and Europe and she consults with clients worldwide online. She’s originally from South Africa, but she’s trained and qualified here in Australia. And she now calls Bali Indonesia home. So her primary focus is helping women to heal their digestive issues so that they can enjoy a loving relationship with their body and food emphasizes that they might feel normal sometimes for the first time in their lives. Having been through SIBO and suffering digestion issues herself for years because it’s super passionate in this area, and can relate to what her clients are going through. Having been SIBO free to this day. Kirsten has gone from living with an extreme fee of food due to bloating rates. pain and discomfort to having a healthy functioning digestive system and a sound relationship with food. And that is what she wants for all other SIBO sufferers to have as well. Kirsten is so generous with her knowledge. And she has shared so much amazing content in this podcast. I was like wow Kirsten you are giving gold. So I’m really excited for you to listen to anyone that has been diagnosed with SIBO or suspects that they have SIBO or even if they just have some health issues that they haven’t quite been able to get to the bottom of have a listen to this episode because as we talked about SIBO is linked to so many other things in the body and it’s actually not a forever Doom diagnosis you can get better. So thank you for listening. I hope you enjoy!

Hi, Kirsten, thank you so much for joining me today.

Kirsten Greene 4:03
Thanks, Alison. Thanks for having me.

Alison Mitchell 4:06
Yay. So I’m so excited to have you here to talk about all things SIBO, because this is just a topic that I’m seeing so much more of, I think is becoming so much more common as well. And many people don’t know much about it, but it’s one of those hidden issues, isn’t it? Like, you know, if in doubt, look for SIBO in terms of gut health do you think that’s right?

Kirsten Greene 4:32
Definitely. And it’s just it’s been around I’ve found references in the studies from like the 1800s. But only recently has it been getting that awareness and it’s so so so common, and it’s something that is fixable, so I get really excited about it.

Alison Mitchell 4:47
Yeah, I love that you start with that it’s fixable because it is isn’t there then so many people like ‘oh no have I got this forever?

Kirsten Greene 4:56
Yeah, where sometimes people get tell they just have IBS, and it’s given what’s causing your IBS, and then this is something that causes it and you can get to the bottom. Mm

Alison Mitchell 5:05
hmm. You know, that’s so common, isn’t it? IBS? Oh, I’ve got IBS. That’s the answer. So I have to eat this particular diet or take this drug for the rest of my life. And it’s like, no. Oh, you don’t? So I’m really fascinated to know, how did you get into this career path?

Kirsten Greene 5:28
So I think like most naturopaths it comes from a desire to fix ourselves. I had issues most of my life, and I got a bit of a joke that I probably popped out the womb on a digestive back foot. my mom said I was a very colicky baby. And then I was always just aware that digestion was not so much digestion. I was always just aware that food was a bit of an issue for me. So I was often hungrier than I seemed. compared to most of my friends. I struggled with gaining weight really quickly, except now that I know that I want to know It wasn’t that I was getting fat, I was just getting bloated. So I just came to believe that it was normal that every time I put food into my stomach that it would puff out. That’s actually not normal. That’s not meant to happen. So i was constantly trying all these different things to just feel better than I did for any new diet that came along. I would try to eat one thing diet, I would try eat cabbage diet, I would try the Atkins diet just so I could feel better. And I maybe did feel better in the moment, but it would always just rebound. And I often feel a bit worse than when I first started. So that was always a thing for me. And when I travel quite a lot in my early 20s and then run by the age of 24. I decided I was going to study something and it just happened to be a trade remedial massage because I like people I like working with people and this was an area that fascinated me. So it always been into natural stuff and how this can help us without hurting ourselves and then didn’t even know what a naturopath was but the college that I was studying at in Australia had a naturopathy course, a nutrition course, had a homeopathy course. And then we go home and with my friend, we had that prospectus in our hand, and we were googling these names meant because we didn’t even know. But just before the course started, there was a lecturer giving a talk on introduction to naturopathy and I thought. Oh, my goodness, this is it. So walked out of that room into the registers to my course and haven’t looked back since. So I’m so so grateful for all the issues that I’ve had myself, even though they were so horrible, but it led me to where I am. And if I had to do it all over again, I totally would, I’m so grateful.

Alison Mitchell 7:37
Yeah, I guess that has given you that real empathy that so many people really need from their carer as well. Mm hmm.

Kirsten Greene 7:45
Yeah. I can totally understand because I probably had all the symptoms that they’ve had themselves. Yeah.

Alison Mitchell 7:53
Hence the passion for digestion. Right. So is that what people mostly come to see for for digestion, Or are people coming to see you for other things as well?

Kirsten Greene 8:04
Definitely digestion. And so now I focus. I specialize in SIBO specifically. So I myself had SIBO back in 2016. And since then that’s really, really been my focus. So I know inside out and I get so much joy from helping other people with it. So they come to me with SIBO. Sometimes it turns out that it’s not SIBO, even if they’ve been told that it’s SIBO. So, I don’t specifically exclude anybody else that doesn’t have SIBO so all digestive stuff I help with. So often the method of healing up the digestive system is the same the specifics in terms of treatment might be different. But there’s so many different guidelines that apply with all digestive health. So it could be “just IBS” or it could be crohns, or it could be coeliac or it could be food intolerances. So all these things are my favorite topics. And when people come to me for.

Alison Mitchell 8:53
yeah, okay. And SIBO in particular is something that as we were talking about, you know, it’s becoming more more well known people are getting more awareness around it. But it’s been around for a long, long time. But So how long have you been treating that specifically? Has that been something that you know, you’ve just jumped you started your practice really passionate about it? Or was there a moment where it’s like, oh, this is the thing.

Kirsten Greene 9:19
I kind of evolved from my own journey. So when I graduated as a naturopath I knew that I wanted to specialize in digestive health because that had been my journey. And then when I got see by myself four years ago, then it became my sole practice because I know it. I know it so well, because I’d been through it myself and I’ve all the hundreds of you are treated since then. I’ve just know it so well and what to look out for how to get better in the quickest and most enjoyable way because it doesn’t have to be awful SIBO treatment doesn’t have to be awful. You just need to know what you’re doing. And I really enjoy that the past four years and then just have health for the past almost decade, I guess. Yeah.

Alison Mitchell 9:56
Now I think there might be some people listening that don’t actually know what SIBO is. So can we just, you know, backtrack a little bit and say what actually is a SIBO?

Kirsten Greene 10:09
Sure thing so it’s S I B O, and that’s acronym for small intestinal bacterial overgrowth. So it doesn’t necessarily mean that there’s bad bacteria in your digestive system, it just means that it’s in the wrong spot. So ideally, we want this one to find to be relatively sterile in terms of bacteria. And then we want most of our bacteria to be in the large intestine. And there’s different kinds of SIBO as well. So there’s two main ones and then there’s a third one that’s getting more attention recently. So you have your methane dominant SIBO, where your methane gasses at highest produced by the methanogens, and then you get your hydrogen dominance SIBO, and then the third one that’s come out recently, more more focus on recently is the hydrogen sulfide to see by three different kinds there.

Alison Mitchell 10:56
Ah, and the hydrogen sulfide one is not somthing thing that I’ve heard or is that something that you can pick up, particularly with the testing, which we’ll talk more about the testing later.

Kirsten Greene 11:07
So there’s no specific test just yet that you can get Park Pimental from Cedar Sinai is working on it. But so it’s more of a process of elimination from the other tests, and then also taking a really good case history, and then they can find out more about this. There’s certain kinds of bacteria that released the sulphate gas, like Desulfovibrionales and Bilophilia wadsworthia they are the most common ones, but it’s that stinky guess is that rotten egg smelling gas may produce that.

Alison Mitchell 11:34
Interesting. So, let’s talk about some of the symptoms of SIBO what are some things that people should be looking out for that might go ‘hmm Maybe that’s related to me.’

Kirsten Greene 11:47
There’s so many, so the most common one for sure is the bloating especially and the timing of the bloating is important as well. So if it’s one to three hours after eating, then you can suspect at this moment of time, if it’s actually to three hours, then you might think of the large intestine. So definitely, definitely, definitely the most common symptom, but you don’t have to have bloating to have super. I’ve had clients before that, no issues with bloating but still have SIBO. Then also there are issues with your number twos. So it could either be diarrhea, it could be constipation, or could be an alternating of the two. Then you also get your food intolerances. So lactose intolerance is definitely a common one. And then also an issue with foods like the fodmaps, which are your fermentable carbohydrates and certain foods, and even garlic would be a biggest triggers for sure. There’s often an issue with digesting and breaking down the fibers in the foods and then the fiber is the indigestible part of a plant food so in your carbohydrates, so that’ll be the biggest one in there. But then you can also experience pain, gas. cramping, brain fog is really really common, joint pain, stiffness, skin issues, so many things associated with SIBO.

Alison Mitchell 13:01
Okay. So sometimes it could be something that you wouldn’t even think is related to your digestive system, but then turns out it actually is.

Kirsten Greene 13:13
I know, it’s all so connected.

Alison Mitchell 13:16
Yeah, the gut’s just connected to so many things. Okay. So why are people actually getting SIBO in the first place?

Kirsten Greene 13:28
Someone asked me on my Instagram a little while ago what I think the common cause of SIBO is, and I say stress. And that could be physical stress. It could be mental stress, or it could be emotional stress. So SIBO is a condition and SIBO is an underlying cause of things like IBS, but then what went wrong to allow SIBO to get there in the first place? Because our bodies are so amazing. It’s an amazing organism. It is so well adapted at keeping everything in check and functioning by itself. But for SIBO to have got there, there’s got to been a breakdown in a protective mechanism somewhere along the way that allowed it to get there. A really common cause is food poisoning. So a lot of people can pinpointed on that holiday to Mexico where they had a funny mohito. And now they’ve got digestive issues. So food poisoning can do things with a digestive system and then somehow the bacteria is allowed to migrate up into this momentous time. And once it’s in this momentous sign, you have to take steps to get it out. So that could be we’ll come to this later, I’m sure but the antimicrobials or pharmaceuticals or the elemental diet. So that’s a physical stress that can cause the SIBO but really underestimated is the emotional stress as well. So if we are constantly under pressure, and no one likes to think that they stress they really don’t, but if you could take a little minute and just look at yourself and how you respond to the stressors in your life. So say you say someone scratched your car and he didn’t even really care that might be pretty low on the scale. Say you went to the shop to buy an avocado and they were out of stock and he burst into tears, it would probably that your stress response is a bit on high alert And if you’re having panic attacks, and you might get a 10 out of 10. And I just wanted to bring that up is because when we’re in the stress mode, we tend to be in what we call our sympathetic nervous system, which is also called our fight and flight. And then when we’re in our sympathetic nervous system, our parasympathetic nervous system, which is our rest and digest gets shut down. So what that means is that sometimes our stomach acid doesn’t get produced at the right amount, or our stomach is constantly contracted like this, if you get a fright, you can notice that you gasps and your stomach will be contracted. So the peristalsis couldn’t happen. So things don’t move through as effectively. So that would be really common. But in terms of the physical thing for sure, there’s food poisoning, and then a history of antibiotic use. It could be back from when you were two years old, unfortunately, and things like this probably out of your control. So it’s always lovely to find your underlying Cause for getting SIBO in the first place. But also knowing that sometimes there might not be one specific thing. So for myself, I probably can’t relate it to one specific thing, more like a accumulation of things going wrong from birth, pretty much. So then it’s looking after your whole digestive system to get everything. And there’s protective mechanisms back in place, and then you can keep it away.

Alison Mitchell 16:26
Beautiful, thank you. I think that’s really interesting. linking it to that sort of relative stresses of that and how some people would say, I don’t have that much stress, everything’s right, but it really comes down to how they feel about it, how they react.

Kirsten Greene 16:42
yeah, if you’re waking up at 3am definite sign that your adrenals are a little bit fried. So I would you know, glands help us with our stress hormones, so adrenalin and cortisol, which is really important because if someone is pointing a gun at you, you need to make it so the cortisol will help us make those really quick decisions about which way to go. What do we do? So we need this one. But when it goes into prolonged stress, that’s when it becomes a problem. If you ever seen a zebra getting chased by a lion in the wild, while they’re getting chased, they in full on sympathetic nervous system fight or flight. But if they managed to get away from a lion and see the lion eating a difference zebra, they switch back very easily into their parasympathetic so they get back into the rest and digest. So you’ll see them eating grass happily and no problem. And then the biggest stressors, they say, studies have even backed this up. The biggest stressors that we have these days is deadlines, the deadlines at work, and bills that we receive a bill and then also even low batteries on our smartphones. So we know… laughs it’s so funny. So we intellectually know that these things won’t kill us. But our body will go into the same protective mechanisms as if it would. So it goes into your sympathetic nervous system, so digestion shuts down. Huge Cause.

Alison Mitchell 17:58
you know, I mean, for me I’ve got a really good life and things stress me out. And it’s the stupidest things. It’s things like my son way to put his socks on in time. You know, they’re such little things and yet maybe my adrenal glands need a bit of nourishing, who knows. But it’s all relative, it’s how you feel about the situation.

Kirsten Greene 18:24
And then also in our digestive system, we’ve got the enteric nervous system. So enteric relates to your intestines, and there are more nerve endings in your enteric nervous system than they are in the spinal cord. So if you’ve got digestive issues, and you’re constantly being triggered by an enteric, nervous system, say with food intolerances, that’s going to over stimulate the rest of your nervous system as well.

Alison Mitchell 18:46
For sure, so I think that people don’t often think about that do they but I’m so glad you’re talking about it because you’ve got to work on the gut to treat the nervous system, and you’ve got to treat the nervous system to treat the gut.

Kirsten Greene 18:59
No and it’s so wonderful when it all comes back into balance and it’s kind of I see my clients go through the process and then when I’m doing my last consult with them and then when they’re better we go through the intake form and compare with how far they’ve come and they often it’s so wonderful to see that they forget how stressed they used to be or they forget how scared of who they used to be. And that’s when you know that… God love it. I love it. I love it so much.

Alison Mitchell 19:25
That would be so nice, for both of you I would imagine. So that’s so that’s really interesting. So the SIBO has this massive connection with our mental health because of enteric nervous system and we’ve got all these neurotransmitters being made in gut like our serotonin and dopamine and our GABA, they’re all needing a health gut. We need that for our healthy neurotransmitters. But what about other sorts of conditions? Are there other sorts of health conditions or other seemingly unrelated symptoms that we can link to SIBO?

Kirsten Greene 20:04
I could probably tie almost every condition back to the gut. The main ones I’d say, because SIBO can lead to a lot of inflammation in the guts. And so SIBO can mess around with our digestion and absorption. So if you imagine that you are making food in the kitchen, and you just leave it lying around, so if you leave it laying around long enough, you’ll start to get the ants, leave it lying around even longer, and then you’ll start to get the mice and then you’ll start to get a whole bunch of stuff. So it gets a really big, festy mess. So that’s happening in your digestive tract. Just imagine the kind of bacteria that you are attracting and the pathogens that you are attracting, and it crowds out good stuff, which usually controls them. So then that can lead to a lot of inflammation in the digestive system. And then inflammation in that digestive system, if it goes on too long, can lead to inflammation, body wide. So most conditions have to do with inflammation. So almost anything that ends in ‘-ITIS’ so like arthritis, dermatitis, the itis relates to even hepatitis relates to inflammation of – all those conditions for sure. Then acne is a big one. I used to have horrendous skin, it was so bad. And then back when I was in college, it was okay. And then learning what we know, I came off the contraceptive pill, my skin just exploded. And then I was managing it a little bit with different herbs. And then I went vegetarian for a period of six months, because it was heralded as the most healthy diet. It’s like, Okay, this is gonna make me feel amazing. I’m going for it. So I went full vegetarian for six months. But I felt so so so awful, because at that stage, I didn’t have the digestive system strong enough to handle it. Whereas nowadays, my diet is mostly vegetarian, because I’ve spent so much time working on it and I can actually digest the food that I’m eating.

Alison Mitchell 21:52
A lot of plant fibres there.

Kirsten Greene 21:53
I know, and it’s so good for us. We just need to make sure that we can digest them and break them down. I had really, really bad acne when I was going through the vegetarian stuff. Now I don’t. So now that I healed my gut that’s gone away. Definitely joint pain for sure. And then also anxiety and depression often are connected to the digestive system as well. Not saying always, but definitely a lot of the time. If there is a group of bacteria called the gram negative bacteria, and these are the not so good bacteria, and then when our digestive system is out of balance, they can override a lot of good bacteria. Just I love to compare it like a garden it’s so similar to a garden. So if you have this garden, the grass and the plants and all the things and if the weeds start to take over, and they knock that balance, then they can just grow and grow and grow and more and more and more our good plants would kind of suffer there’s no space for them. So these Gram negative bacteria, they, in their shells, they have something called lipo- polysaccharides. So lipopolysaccharides are classed as an in endotoxin: endo means within and a toxin is a toxin. So these lipopolysaccharides are so inflammatory. And then if there’s a case of leaky gut, which is when the tight junctions of the gut separate and things can get into the bloodstream, they aren’t meant to. So if these lipopolysaccharides get into the bloodstream, and then just like the gut barrier, we have a blood brain barrier, which can also end up leaky, so leaky brain some people call it, and then if that gets into the brain, it can inflame the brain and cause feelings of depression. And this is even how they test the pharmaceutical antidepressants. Like they inject the poor mice with lipopolysaccharides and then test their pharmaceutical antidepressant to see if it’s effective. So that’s hugely connected.

Alison Mitchell 22:41
That doesn’t get spoken about much does it?

Kirsten Greene 23:43
Noo, and people don’t realize and they think that it’s a nervous system condition, when actually it’s coming from the gut. And if you can fix your gut, you don’t need to be on antidepressants you don’t need to be on even if it’s herbal Nervous System support, if it’s coming from your digestive system. There’s a lady called Dr. Allison Siebecker. She’s probably one of the pioneers in terms of theSIBO world. I love her. And she’s got a website called siboinfo.com, and she’s got a whole page dedicated to associated conditions. Also, because she’s a research scientist, she’s got the research studies backing up all the different things. If you wanted to see more, what’s involved in you can go to siboinfo.com. I forget the exact page, but it’ll be there somewhere.

Alison Mitchell 24:25
I’ll pop the link for that in the show notes. (Here it is: https://www.siboinfo.com/associated-diseases.html).

…more transcript to come!

The post A Naturopath’s Guide to SIBO appeared first on Alison Mitchell Naturopath.

Insights from the Endometriosis Symposium

I recently attended the ATMS Endometriosis Symposium, and boy did I nerd out. I have always had an interest in women’s health and period pain, having dealt with my own personal issues in this area but also because I have seen countless women who were dismissed, told to ‘put up’ with their pain, or given medication that the woman didn’t feel comfortable with.

During the seminar I went from feelings of excitement about the emerging research and treatment possibilities, to frustration that there is still so much we don’t know, to sadness about the extent to which this condition can affect a woman’s life, and anger at the issues women face in seeking effective diagnosis and treatment. A key statement during this Symposium was that women with endometriosis were frequently ‘missed and dismissed’.

What is Endometriosis?

For those that have never heard of endometriosis before, it is a condition that is currently considered to be an inflammatory disease where women can experience extremely painful periods, and 1 in 3 women with endometriosis have fertility difficulty. It is diagnosed when the tissue that is normally present in the lining of the uterus is present elsewhere, such as within the pelvis however it can possibly travel elsewhere in the body.  The only way to definitively diagnose endometriosis with via a laparoscopy, a surgical procedure, however for many women the diagnosis of endometriosis is suggested without having a laparoscopy, particularly is the risks associated with the surgery outweigh the benefits of the diagnosis.

I have written about endometriosis before here, however I would like to expand on some of the points made previously and discuss some of the newer information I received from this seminar.

A key point to remember is that endometriosis is a complex condition that we still don’t 100% understand or know the best treatment for, however we do know that holistically addressing the condition by working on it like a jigsaw puzzle provides better results.

The importance of a good laparoscopic surgeon, and excision vs. ablation.

One of the key speakers, Professor Jason Abbott who is one of the leaders of surgical treatments for Endometriosis in Australia imparted the importance of seeking an advanced laparoscopic surgeon if choosing to undergo a laparoscopy, and discussed his preference for excision (cutting) rather than abalation (lasering off of tissues), something that will hopefully become more commonplace as research supports this as well.

Neither pregnancy nor hysterectomy will cure endometriosis

If you’ve got endometriosis, chances are you’ll be told to get pregnant to cure the condition. Or maybe to have a hysterectomy.

Well unless either of these options are just what you want to do, don’t rush into it! It seems that neither option really provides long lasting relief, as the underlying causes of the condition will not be addressed and symptoms can come back, or still exist.

In the case of pregnancy, many women will find that not having a period for 9+ months is a welcome relief, and the hormonal and immunological shifts that occur during pregnancy also allow many endometriosis symptoms to ease. But the condition can come back, especially if the condition is driven from an imbalance in your immune system or pelvic muscles.

A hysterectomy should theoretically address endometriosis, but unfortunately many women with endometriosis experience problems that aren’t directly related to their period and so these issues can remain. Bowel problems, muscular problems and hormonal imbalances can still persist.

Nerve or Muscular issues in the pelvis can drive endometriosis

Having worked alongside osteopaths my entire naturopathic career I am well versed in the impact that tight muscles or structural imbalances can have on internal health. Seeing the ways that pelvic muscle tightness and nerve signalling issues can contribute to endometriosis was a lightbulb moment, as for many of my patients I have felt there was something ‘missing’ in my understanding of their complete picture, and I think this was it.

A physiotherapist who specialises in women’s health can assess the internal muscles of the pelvis to assist with conditions such as vulvodynia (pain in the vulva), dyspareunia (pain during intercourse) and dyschezia (pain with bowel motion), but it can also be extremely helpful for those with endometriosis. In my clinical experience I have also found that chronic vaginal and bladder infections may benefit from a women’s physio, as tight pelvic floor muscles can cause ongoing inflammation and tension which affects the bladder from eliminating properly.

think about what a muscle cramp in your foot or your calf feels like, then imagine this feeling as happening inside your pelvis or the vagina. The normal contraction and relaxation of a muscle allows blood to flow through, but if the muscle does not effectively contract and then relax it can cause hypoxia (reduced blood flow) which is itself very painful, and it also makes the pH of the muscle more acidic. In itself this can cause pain, but the lightbulb moment for me was realising the way this sort of issue can feed, and be fed by the inflammatory nature of endometriosis.

The constant pain in the pelvis that occurs in something like endometriosis can sensitise the nerves, so that even things which aren’t normally pain can become unbearable. The sensitised nerves can make you more likely to get pelvic pain, period pain and bladder pain, and there is actually an increase of inflammatory chemicals being produced, which worsens endometriosis, an inflammatory based condition.

On a side note, vulvodynia and dyspareunia, like endometriosis is an issue that many women feel ‘missed and dismissed’ about. These problems can have big impacts on a relationship. There may be an issue with the skin such as in chronic candida or lichen sclerosis  or there may be nerve sensitisation worsening the muscle spasms and pain signalling. If you experience these issues, or if your pelvic pain occurs at times other than ovulation and menstruation, consider that there may be a muscular component. If you experience pain when your bladder is full, then again when you have finished weeing, or pain during intercourse, a women’s physio may be able to help you.

Women with Endometriosis have a different type of immune system

There are many different types of cells with different responsibilities within our immune system, and the interplay between all of these can determine whether someone can fight off infections well, or if they are more prone to inflammatory type reactions. For women with endometriosis there have been an increase of some types of immune cells and inflammatory chemicals observed, and less activities of some immune cells which are responsible for ‘keeping things in check’. Interestingly, there is also communication between the hormones progesterone and oestrogen and our immune cells, and as women with endometriosis tend to experience progesterone resistance, the type of immune cells that these hormones normally work on are not able to be reined in.

Bacteria may affect endometriosis

The balance of bacteria within our digestive system has a dramatic effect on our immune system. Normally it can affect things such as how well we can fight off infections or whether we are likely to experience an allergic reaction, however for women with endometriosis there is also a reaction that occurs that worsens their inflammation.

On the coating of some bacteria there are substances which can break off, and the immune system reacts to this by releasing a lot of inflammatory chemicals. This substance is known as endotoxins, or lipopolysaccharides (LPS) and has been shown to be present in higher quantities in women with endometriosis, and the LPS works hand in hand with the higher levels of oestradiol  to then increase certain inflammatory chemicals.

The link between the gut bacteria and hormonal actions and subsequent severity of endometriosis is interesting. If there is an imbalance of good and bad bacteria (dysbiosis) which is very likely for those with endometriosis, it appears to be a key player that needs to be addressed for a holistic approach to endometriosis.

One of the papers referenced suggested that “there may be a direct link between pathological changes of the gut microbiota and the onset and progression of endometriosis”.

Addressing the gut bacteria can improve the severity of endometriosis, as this reduces inflammation and improves immune regulation. Specifically, using herbs that are antimicrobial to gram negative bacteria (such as those containing berberine) and using herbs and nutrients to support digestive lining health and motility, as well as promoting the presence of good bacteria are helpful treatment aims.

The role of histamine

Histamine is a chemical that works in a lot of different areas in the body. It acts a neurotransmitter affecting mood, and it is involved in immune and inflammatory responses. It’s well known for it’s role in allergic responses, causing dilation of blood vessels and stimulating white blood cell activity.

Histamine also has a role in endometriosis and period pain, as high levels of histamine stimulation oestrogen, and also feed the growth of dysbiosis. Oestrogen feeds back into this cycle by reducing the DAO enzyme, which is responsible for clearing histamine, and stabilising mast cells, one of the main white blood cells involved in the histamine response. There is also a stimulation of a chemical called VEGF (vascular endothelial growth factor) which causes the endometrial cysts to grow faster, and attracts more inflammation.

Methylation, involved yet again

Once again, methylation rears its head and as player. I have spoken about methylation before here and here, and while I consider it important to understand the role it has when not working properly, I firmly believe that addressing methylation by itself won’t solve everything.

Problems with methylation can worsen inflammation pathways, and dysbiosis can worsen methylation. Methylation problems can also affect oestrogen levels, histamine processing, and sensitivity to chemicals and toxins (such as mould, viral infections and parasites), all of which affect dysbiosis, immune balance and the inflammation levels.

Where to go from here?

It may seem confusing and overwhelming, realising how much is going on that needs to be addressed. That is completely understandable, but if you are able to find a naturopath or other health care practitioner that can help you, they will be able to guide you in your health journey. Ideally, having a team of practitioners such as a GP, a naturopath, a women’s physio, an acupuncturist and a gynaecologist and/or advanced laparascopic surgeon will mean that you are getting all your bases covered.

The first thing that should be address is pain. After the level of pain is scaled down to a bearable amount, then looking at the drivers of the condition such as gut health, diet, immune imbalance, infections, methylation, stress etc can be done.

Not everyone may want to or be able to afford the testing that can be done to get a clearer picture of the underlying imbalances and that’s okay. Your practitioner should be able to get a lot of information and ideas as to what needs addressing from a thorough case history.

The decision of what form of treatment to use is also very individual, and entirely up to you as the patient. I have not gone into detail about the forms of treatment, but there are many different options in terms of natural medicine, a variety in conventional medicine as well. Natural medicine can potentially be used alongside conventional medicine, or on its own. This is always something that is best discussed with your health care practitioner.

Resources:

Endometriosis Australia

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Health & Wellbeing Podcast #2

This is my second podcast and this time it’s all me. Today I’m talking about reasons for fatigue. Energy problems can be caused by a huge range of issues, so I wanted to discuss some of the most common ones. While it’s not a 100% conclusive list, I hope that this gives people a good place to start when they’re trying to work out why they’re so tired.

Want to subscribe to get podcasts automatically? You can do that here: https://itunes.apple.com/au/podcast/health-wellbeing-podcast/id1006574743

Podcast breakdown:

2:30 Mitochondria – The powerhouse of your cells, where energy is made. The health and quantity of our mitochrondria determine our ability to make energy, and they can they are susceptible to oxidative damage, and can be depleted by certain nutritional deficiencies.

5:22 Inflammation, particularly chronic inflammation can affect energy and cause other imbalance.

7:40 Andropause, also known as male menopause

8:16 Some tips on reducing chronic inflammation

9:14 Stress is a major cause of fatigue, usually presenting in the form of adrenal exhaustion of HPA Axis dysfunction.

11:28 Thyroid problems are another major cause of fatigue, especially hypothyroidism.

13:36 Nutritional deficiencies that can cause fatigue, Iron, B vitamins, magnesium, zinc

16:12 Certain medications can affect energy levels

16:46 Inadequate exercise can cause fatigue, but this isn’t always straightforward

18:27 The wrong diet – not enough food, too much food, or the wrong type of food for you.

20:39 Sleep. Most of us aren’t getting enough, or it can be an issue with the quality of sleep. I discuss some tips on sleep hygiene.

23:00 Sleep apnoea

23:40 Shift work

26:30 Obesity and fatigue

28:57 The importance of gut health; gut problems can cause fatigue as well.

30:00 Toxicity affects the mitochrondria- what is toxicity, where does it come from, how can you identify if you’re toxic?

31:13 What do you do if you’ve been tired for a long time and you don’t know why? Start by working out a timeline. If you can’t do this because the fatigue has been going on for such a long time then testing may be helpful. There are several different types of testing available, but you may not need to do all of them.

33:00 Some tips for reducing inflammation and improving energy through diet

34:30 Depression is a common cause of fatigue.

35:29 My favourite herbs for energy

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You probably all know by know that I love to bang on about the importance of gut health. Well the good people at casadekarma.com.au let me do just that on their beautiful new website.

In my article I talk about good and bad gut bacteria, how the gut affects the immune system and your mood. I also share some tips on how to improve your gut health by feeding your good bugs and keeping stress at bay.

Want to dive in? You can check it out here: http://casadekarma.com.au/why-gut-health-is-critical-to-your-wellbeing-and-theres-more-than-1-reason/

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When your gut controls your mood: the gut-brain axis

From as early as the 1930’s, scientists were beginning to understand that the health of our digestive system could influence our mood.  The state of our intestinal lining and the balance of bacteria within our digestive system have a major role to play in the production of our neurotransmitters: chemical transmitters that tell our brain whether we should be feeling such ways as happy, sad, agitated, or calm.  But even though the research in this area sky-rocketed in the last decade and continues to grow every day, the concept of our gut-brain connection isn’t very well known.

The gut is linked to the brain

Did you know – When you were just starting to grow in your Mumma’s womb, your brain and your digestive system developed from the same lump of tissue.  During this process of dividing up cells (embryogenesis) this lump of tissue divides and forms our central nervous system and our enteric nervous system (this is the nervous system of our gut – sometimes called the second brain).  These two are connected by an important ‘wire’ – our vagus nerve.  This development can help us understand why there are so many similar chemicals and receptors in both our brain and our digestive system, for instance serotonin.

Gut bugs and your mood

As soon as you’re born, bacterial colonies start to develop in your digestive system.  Within the first few days, the bacteria starts sending messages to the nervous system and can actually determine our nervous system ‘set point’ long term (1).

When the balance of our gut bacteria (collectively referred to as the microbiome) is affected, this can affect your mood.  Studies have found that the microbiome can have a major impact on stress levels and anxiety (2).  In fact, by treating imbalances in our microbiota, it is possible to support a wide range of mental health disorders (3), (4), (5), (6), (7).

The second brain

The nerves in your digestive system are constantly speaking to your central nervous system.  If your gut is irritated for some reason – say you’ve eaten something that you’re intolerant to (like gluten, for example), you’ve generally got a bad diet, there’s an imbalance in your microbiome (that’s your collective gut bacteria, remember) or you’ve got an infection – this can create an inflammatory reaction and will certainly make you irritated as well.  We know that depression is both associated with, and worsened by inflammation.  This inflammation in the brain can be driven by inflammation in the gut, which can be caused by intestinal permeability (leaky gut) and bacterial imbalances (dysbiosis).  Treating leaky gut can help reduce the severity of depression (4), (8), (9), (10), (11).

Neurotransmitters in our gut

Serotonin is produced in large amounts in our digestive system.  In people with Irritable Bowel Syndrome (IBS) there is too much serotonin in their digestive system.  This is why antidepressants known as SSRI (selective serotonin reuptake inhibitors) can improve the symptoms of IBS: these act by reducing the amount of serotonin taken into cells in the rest of our body which allows more to get into the brain.  However anti-depressants can affect the gut negatively as well, because if you weren’t making enough serotonin in the gut in the first place, you’d end up with even lower levels in the digestive tract and so it can become irritated, affectively you’ll get a depressed gut (12), (13).

A vicious cycle

When your gut is upset, you feel upset.  But stress can affect your digestive system just as much as it affects your mood.  It can impair the secretion of digestive acids, slow down the motility of the gut, allows the unfriendly bacteria to grow, reduces your friendly bacteria and exacerbates intestinal permeability (leaky gut) (14), (8).  This is a recipe for an unhappy digestive system, and as you know this can then go on to send more messages to your brain: so you can see how the cycle continues.

People with gut problems are more likely to experience anxiety and depression.  Some studies have found a high proportion of anxiety in those with gut conditions such as Irritable Bowel Syndrome(IBS), Crohn’s disease and coeliac disease (15), (16), (17).

Helping the gut-brain axis.

By treating digestive problems, sealing leaky gut and balancing your microbiome it is possible to help with conditions such as anxiety and depression, and there’s even research showing the benefits of treating the gut in conditions like chronic fatigue syndrome, schizophrenia and autism (10), (18), (11).  Probiotics are one of your major tools when it comes to treating the gut, but it’s a good idea to consult with a health practitioner to make sure you’re getting the right type, and also to get a good gut healing treatment program to go along with it ⁽¹⁹⁾, (4), (9).

Related articles:

• Probiotic stress busters: http://www.naturopathnsw.com.au/probiotic-stress-busters
• Depression starts in the gut?:  http://www.naturopathnsw.com.au/depression-begins-in-the-gut
• What is Dysbiosis: http://www.naturopathnsw.com.au/what-is-dysbiosis
• Fermented foods (foods to stop bloating and farting): http://www.naturopathnsw.com.au/foods-to-stop-bloating-and-farting-fermented-foods
• Enhance your health with probiotics: http://www.naturopathnsw.com.au/enhance-your-health-with-probiotics
• The benefits of soaking and sprouting: http://www.naturopathnsw.com.au/the-benefits-of-soaking-and-sprouting-plus-a-sprouted-chickpea-hummus-recipe

Works Cited

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Losing weight can be a long and frustrating process.  Some people can change their diet slightly or do a small amount of exercise and their weight just drops off.  However, some people find that no matter how much they exercise they cannot lose weight at the rate they want.

If you are struggling to lose weight with the normal methods, it may be that you have an internal barrier to weight loss.  There are several hormonal and chemical issues that can stop you from losing weight more effectively.

In the last newsletter I discussed different hormonal imbalances that can affect your ability to lose weight.  If you missed it, click here to read it: Are hormone imbalances affecting your ability to lose weight?  In this edition I will be covering some other factors that can impede your efforts as well.

Aciditiy

If the pH (acid-akaline balance) of the body is too acidic, then this can cause problems with weight loss.  Ideally our internal pH should be around 6.5 for healthy functioning.  pH can be lowered (made acidic) by drinking soft drink or eating acidic foods such as too many grains or meats, or by stress.  Your pH can be measured by a simple urine pH test.

Food intolerances

If you have an intolerance to a food and you continue to eat it, this can cause all sorts of problems in the body, due to the way it upsets the immune system, causes stress on the nervous system and increases inflammation.

Most often food intolerances cause digestive problems such as irritable bowel syndrome, diarrhea, constipation, reflux, or bloating.  However food intolerances don’t always express the same way in everyone – some people may get mood swings, headaches, skin problems, immune problems, hormone imbalances, fluid retention or aches and pains as a result of eating it.

Food intolerances can be difficult to identify because they can cause symptoms up to 48 hours after eating a food, and because the problems they cause aren’t always obviously food related.

Food intolerances are usually caused by the immune system developing an antibody or immune memory to a food, when the protein of the food slips through an enlarged pore in the digestive system and is then taken up by the immune system.  The next time you eat that food, the immune system recognizes it as being something foreign, so launches an immune attack.

Eating foods which you are intolerant to will affect normal functioning in the body and can interfere with weight loss.  It can also cause bloating and fluid retention, making your feel larger than you are as well.  Most people who cut out food intolerances lose some fat mass after a few weeks.

These can be identified by an in clinic test called Food Detective via a finger prick, with the Hair500 test, by a blood test in external laboratories, or with an elimination/challenge diet.

Gut & Liver Toxicity

There are many toxins present in our environment, and some people can have difficulty detoxifying them normally.  When we are presented with more toxins than we can process and eliminate, our body will still them in our fat cells.  This presents a problem: our body has put these toxins away for a reason – it cannot cope with them, and therefore it will block weight loss until it can effectively detoxify through the gut and liver.

People with gut and liver toxicity may carry weight in a band around the bottom of their rib cage (Naturopaths refer to this as a ‘liver roll’) and they may also experience symptoms such as headaches, fatigue, bad breath, stomach upsets and a foggy mind.

Not only will toxicity cause us to store away fat, but if we have problems with our digestive processes than it makes our weight loss efforts all the more futile.  If there isn’t enough stomach acid and enzymes being produced to break down your food for easy absorption, then all the fuel we’re putting into build our muscles doesn’t get used properly.    There more muscle you have, the better your metabolism, so if you can’t make enough muscle than it makes fat burning very difficult.

 There are many factors which can contribute to this, such as stress, bacterial imbalances, medications, food intolerances and more.  The good news is that when this problem is remedied, weight loss happens much more quickly and smoothly.

The degree of digestive toxicity can be tested by a urine test known as Urinary Indicans (first morning sample only) which is performed by your naturopath.  A VLA/bio-impedance analysis can also indicate if there may be toxicity present This test is no longer available.

A good detoxification program that supports gut, kidney and liver function will allow your body to release these toxins safely.  Most people will lose a few kilos just from detoxifying, and find that weight loss can occur much more easily after the detox is finished as well.

MTHFR

If a person has a particular gene known as MTHFR, they cannot convert folate to its active form in the body folinic acid.  This causes an increase in an inflammatory chemical, homocysteine, which can cause several problems such as weight gain that is very difficult to shift, depression, heart disease, clotting problems, and blood sugar levels imbalances.

A cheek swab or blood test can be done to identify if you have this gene present.  A blood test to assess for elevated levels of homocysteine could also be done to assess the inflammatory impact of this.

Leptin

Our fat cells produce the hormone leptin which regulates our metabolism and determines how much fat will be stored. Altered levels of leptin can cause problems with food cravings, over eating, hunger and difficulty losing weight.  This can be tested by a blood test.

Poor sleep

Is a known risk factor for weight gain, can increase appetite and blood sugar metabolism problems.

Nutritional Deficiencies

Certain nutritional deficiencies can cause a reduction in metabolism and reduce your ability to burn fat, in particular Vitamin D.

Vitamin D deficiency can be identified by a blood test.  Your Naturopath may be able to tell you if you are showing signs of mineral or vitamin deficiencies by asking symptoms and with some simple in clinic testing.

Inflammation

People suffering from chronic or systemic inflammation may find it hard to lose weight. This is because the inflammatory process diverts energy into fat cells, causing them to thrive and grow. This can make it very difficult to lose weight! The inflammation might come from an existing health complaint, such as an injury, digestion problem, arthritis, allergies etc, or it may be related to current dietary and lifestyle sources.  There are some markers that can be measured by a blood test to assess for inflammation.  A VLA/bio-impedance analysis can also indicate if there may be inflammation present.

If you feel like you have one or more of the above issues that is affecting your ability to lose weight, make an appointment to see how we can help you. We will go through your case history and can suggest which factors may be relevant for you, and can discuss your testing options with you. Once we have identified what is happening we can create a treatment plan to naturally and safely address your internal barriers to weight loss.

The post Internal Barriers to Weight Loss – Part 2 appeared first on Alison Mitchell Naturopath.