The Gut-Brain Connection - A BIG Piece of the Puzzle

A few questions for you first - Is bloating your most prominent digestive symptom? Do your IBS symptoms worsen during periods of stress? Do you feel bloated with a certain food one day, but not another day? Do you get bloated even from water? Yes is a common answer I hear but it does not typically indicate any serious damage to the gut, or that you most definitively have SIBO. It could actually be a misfiring of signals from your gut to your brain and back…aka a gut-brain connection issue (or a disorder of gut-brain interaction - DGBI).

Bloating & Distension are Different:

Abdominal bloating and distension are 2 of the most commonly reported GI symptoms. For some they can be chronic and very uncomfortable, but for other it may be infrequent.

But there is a difference between bloating and distension! They can occur together or independently. To get technical, abdominal bloating is the subjective sensation of excess intestinal gas, but without obvious visible abdominal distension. People with bloating may feel a sense of fullness or discomfort. Abdominal distension is the objective physical manifestation of an increase in abdominal girth (aka “looking 6 months pregnant” for some). Unfortunately, because of how the health care system categorizes IBS, the differentiation is not regarded, but it can be very helpful to determine the cause of your IBS.

If you have bloating and/or distension but regular bowel movements, or if you have explored celiac testing, the lowFODMAP diet or SIBO testing and you still have bloating, it would be helpful to explore the idea of a disorder of gut-brain interaction (DGBI).

It's Not "Just in Your Head":

It’s important to understand that a DGBI is not "just in your head." While the brain and gut communicate closely, the symptoms are real and need proper management - these are gut conditions that can be affected by stress and mental health. But they are not just stress and mental health.

Think of your gut as a house and a DGBI as a highly sensitive fire alarm system. Normally, the fire alarm only goes off when there is an actual fire, alerting you to real danger. However, in DGBI, this fire alarm system is malfunctioning. It’s hypersensitive and can be triggered by everyday activities like cooking or lighting a candle, causing unnecessary panic and stress. Just as you would need to fix a malfunctioning fire alarm, DGBI requires a tailored approach to manage the symptoms and improve your quality of life.

What can help?

There are several things we need to explore in order to calm this hypersensitivity and correct a DGBI. Everyone in unique of course so unraveling the trigger and make the correction does need an individual approach. Do we need to start with correcting any imbalance of gut bacteria? Or does daily stress and anxiety have a bigger impact on your gut symptoms. These are things I love to explore with people.

My Go-To Immune System Supports

For some reason the change of season has hit many of us hard this year bringing on bad colds/upper respiratory infections, including my family. I am relying heavily on my go-to immune system supports right now, as well as rest (when I can) and lots of healthy food and fluids. I wanted to share what I find works for our family and what I often suggest for patients.

• Vitamin C - Vitamin C in powder or capsule form is a great support for both the immune system and adrenal/stress system. When we are burnt out our immune system is not as effective. Taking 2000-3000IU daily of vitamin C down regulates the stress response and at least 1000IU daily supports the immune system.

• Vitamin D - Keeping up your vitamin D level is to key to helping prevent colds/flus (as well as improve mood). 1000-2000IU daily is a recommended dose for most people to maintain levels. Make sure to take it with food or in drop form as it is fat soluble.

• Immune Matrix (by Cytomatrix) - This is a great blend of herbs and vitamins indicated for reducing the duration and severity of symptoms of upper respiratory infections, including the common cold. It can also be effective as a preventative measure at a lower dose. It includes echinacea, reishi, andrographis, vitamin c and zinc. I always have this on hand! You can find many variations of this at health food stores.

• Probiotics! - There is good research showing that taking probiotics daily decreases colds and flus for both children and parents. A 2014 meta-analysis looking at the impact probiotics have on children's immunity showed that parent and child pairs that took probiotics had fewer colds and flus, shorter duration of colds and less sick days. My 3 year old daughter loves the Flora Matrix Kids (by Cytomatrix), and I sometimes bump it up with an elderberry supplement like this if needed. Another great option is Fit for school (by Genestra) - both with probiotics, vitamin D, C and A.

• My immune smoothie - I crave this when I am sick. It is full of fruits packed with vitamin C. I make a variation for my girls as well. See the recipe here.

• Some other supplement brands with great immune support blends you can easily find are A.Vogel (Throat spray, Echinaforce) and St. Francis (lung tinctures, Deep Immune).

There are many other immune supportive vitamins and herbs, and others I pull out if my family is sick with a fever or specific upper respiratory infection, but these are what I tend to gravitate towards first.

Low Energy? What blood work an ND may want to see.

If I was to ask you to rate your energy on a scale of 1-10 (10 being great) what would you say? If you said lower than 5/10, even after a good nights sleep, it is something that should be addressed.

I like to review blood work first when fatigue is a concern, as a few common nutrient and hormone deficiencies can be the culprit. The reference ranges I refer to may be slightly different than your MD for a few reasons.

1. I want to optimize your levels to sustain better energy.

2. I am referring to the newest reference range recommendations that will hopefully be reflected in blood work soon.

3. I see results when patients levels reach a certain level.

So what blood work do I like to see and what levels should they be at? This may vary slightly depending on someone’s health history.

• Vitamin B12 - This should be above 200 pmol/L, ideally above 450 pmol/L.

• Ferritin - You have iron deficiency anemia if your ferritin level is below 30 ug/L. Unfortunately, this is becoming more and more common in today’s society. A full iron panel is not often needed.

• TSH - Your thyroid stimulating hormone should be between 0.8-2.5 mIU/L. This can fluctuate during times of stress or hormone changes. Medication is not often needed until the level gets much higher, however supporting adrenals (stress hormones) and the thyroid gland if out of this range can help.

• Morning Cortisol - Between 7-9am your level should ideally be between 450-550 nmol/L. Cortisol is an essential hormone that plays many important roles, including regulating your body's stress response. If it is low you are most likely suffering from burnout!

There are several reasons why someone may be deficient in any of these and it is important to address the cause as well as supplement for the deficiency.

Take a look at your most recent blood work. What are your levels like? I’m happy to help improve them and ultimately your energy!

For the Love of Fibre!

Chances are that someone has told you at one point in your life that you need to eat more fibre.

Maybe you tried to do so and you got constipated or you ended up farting a lot! Or maybe you tried decided to give up because it was too hard.

Well whatever the reason, here are a few fibre tips that can help make increasing fibre a little easier on the digestive system!

#1 - Soak your beans!

• Beans aren’t called the magical fruit for nothing! Beans, which can be a great source of fibre, contain a carb called raffinose. Raffinose can be a bit harder to break down in our digestive systems, which means that our gut bacteria get a lovely meal! When our gut bacteria snack on things they produce gas! Now we do need to show them love, but it can be uncomfortable when you get a bout of wind at Sunday dinner over baked beans!

• In order to help reduce the raffinose load a dose of baked beans or bean salad provides us, we need to soak the beans first! They can be soaked for a few hours or overnight. This will help hydrate them and reduce the gas producing raffinose snack without impacting the overall nutrition of the beans!

#2 - Fruits contain fibre too!

• Whole fruits can have more sugar in them than their vegetable counterparts, but wapping in some fruit for dessert or part of snack time can add in some more fibre to your day!

• Notably high fibre fruits include: pears, citrus (eating the whole inside not just the juice), berries, apples, avocado, kiwis, bananas

#3 - Baked goods and ground meat!

• Shredded vegetables like zucchini, mushrooms and carrot can be added to baked goods and ground meat dishes without altering the flavour too much!

• So making meatballs or cooking ground meat for tacos? try shredding in some zucchini or dicing mushrooms to add some extra fibre in!

• Making muffins? try added zucchini or carrot to give not only extra flavour but also extra moisture!

There are tons of ways to make fibre fun! What do you like to do to add more fibre? I would love to know!

Dr Paige