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Ready to go deeper? Learn more about the 3 Week Inflammation Detox and the 12 Week Whole Health Solution at www.andrearobertson.health

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Dr Andrea Robertson is an Osteopath, Naturopath, and Nutritionist. The information shared in this podcast is for educational purposes only and does not constitute medical advice. Always consult your healthcare provider before making changes to your health regimen.

Show Notes

Episode Transcript

Episode 6

Andrea: I want to ask you something. Have you ever had a week where everything felt off? Your digestion was sluggish, you were bloated by lunchtime, your energy was flat, your mood was lower than it should've been, and your skin was breaking out, and you couldn't quite put your finger on why, especially when you had not done anything differently.

Same food, same sleep, same life,

And yet something in your body clearly wasn't working the way it should What if I told you that almost every single thing I just described had one thing in common? And that thing is your tummy, your gut. I'm Dr. Andrea Robertson, osteopath, naturopath, and nutritionist. Here we nourish because food is medicine, and what you eat changes everything. We heal because the body has an extraordinary capacity to self-repair when [00:03:00] we remove what's blocking it. And we rise because feeling well isn't the destination, it's the foundation for living the life you truly desire.

This is Nourish, Heal, and Rise.

 Before we begin, a quick and important note. Everything I share on this podcast is for educational purposes only. It's not personal medical advice, and it can't be, because in the context of this podcast, I don't know your health history, your medications, and what else is happening in your body. What I want this podcast to do is give you the knowledge to ask better questions, understand your body more deeply, and make more informed decisions in partnerships with the practitioners who do know you.

If something resonates and you wanna take action, please work with a qualified healthcare provider who knows your full picture

Welcome back to Nourish, Heal, and [00:04:00] Rise. We are now up to episode six in our inflammation series, and today we're going somewhere that I think many of you have been waiting for us to go. If you have been listening to this series from the beginning, you will have noticed something. The gut has come up in every single episode.

The gut-brain axis in the brain fog episode, the connection between gut health and insulin resistance in the weight loss resistance episode, the role of gut dysbiosis in driving joint inflammation, the gut's protection of 90% of the body's serotonin. The gut keeps appearing because it keeps being relevant, and today the gut gets its own episode, solo episode on gut, because the gut has earned it, and because the gut, more than any other organ system in the body, is the foundation on which everything else is built

So today we are on sign number five of chronic inflammation, gut issues. Bloating, particularly after meals, irregular bowel movements, food sensitivities that seem to be multiplying no matter [00:05:00] how carefully you eat. That uncomfortable distended feeling

That makes you feel like you're carrying something around your middle that should not be there. Digestion that feels sluggish and incomplete. These symptoms are so common in the women I work with that many of them have simply stopped calling them symptoms.

They've become background noise, normal, just part of being a woman in midlife. I wanna challenge that today because these symptoms are not normal. They're common, but they are not normal, and they're signals, and the gut dysfunction producing them is affecting every other system in your body simultaneously.

I wanna map out what we are covering today so you know exactly what is coming. We are going to start with the science, of course. What is actually happening in your gut when it is inflamed and dysfunctional? What does the microbiome actually do? What is leaky gut, and is it real? And what is SIBO? And

What is the estrogen-gut connection that so many women in perimenopause have no idea about? Because once [00:06:00] you understand the machinery of the gut, everything else clicks into place. And buckle in, because we're gonna talk about something I am very comfortable talking about,

And do so nearly every single day. But you may not feel quite so comfortable talking about this because we are talking about poo.

Then after going through the science, we will move on to nourish. So food as medicine for your gut. The foods that actively damage your gut ecosystem and the foods that rebuild it. The 30 plant-based foods target that has completely changed how I think about eating. And I will also share a personal story here about the long-term stress in my 30s and early 40s of running a big allied health clinic that had a really negative effect on my own gut health.

Then we go to heal, the naturopathic tools, gut lining repair, targeted supplementation, the role of stomach acid, and what a comprehensive digestive stool test can tell you that standard testing almost never picks up. This is where the clinical details live. [00:07:00] And finally, we will move on to rise, the lifestyle piece, because healing your gut is not just about what you eat.

It's about how you live. The gut-brain axis runs in both directions, and stress, sleep, and your nervous system state directly determine the health of your gut. So let's get into it

Let me describe the most common presentations I see of what gut inflammation actually looks and feels like. Because gut symptoms have a way of becoming invisible through sheer familiarity, and I wanna name them clearly so you understand. Okay, bloating, particularly after meals. This is the one I hear about most frequently.

That uncomfortable distended feeling that arrives during or after eating. Sometimes regardless of what was eating, sometimes triggered by specific foods, sometimes it makes absolutely no sense whatsoever.

And sometimes it builds gradually through the day so that the woman who woke up relatively comfortable is loosening her waistband and the belt by lunchtime, And looks [00:08:00] and feels really distended by the evening. Women describe it as feeling and looking pregnant as their clothes fitting differently by the end of the day than when they did at the start, and as a feeling of tightness and pressure that is genuinely uncomfortable, that has become so constant they stop mentioning it.

Bloating is not just a digestive inconvenience. It is a sign that fermentation is occurring in the wrong places, that undigested food is being fermented by bacteria in regions of the gut where that fermentation should not be happening, or that the gas produced by fermentation is not being properly cleared.

Both are signs of dysbiosis, an imbalance in the gut microbiome or of impaired digestive function. Then irregular bowel movements. A healthy gut moves things through predictably and comfortably, typically once or twice a day, with stools that are well-formed, easy to pass, and that do not require significant effort or urgency.

Constipation, which is infrequent, [00:09:00] difficult, or incomplete bowel movements, and then the loose stools are both signs that the gut is not functioning properly. And then also swinging between the two, constipation and diarrhea, which is the hallmark of irritable bowel syndrome and is a sign of very big gut dysfunction and dysbiosis.

Next, we often see food sensitivities that keep multiplying. This is one of the most clinically telling signs of gut inflammation, and one of the most frequently misunderstood. When women come to me with a growing list of foods that seem to be causing problems for them, their almost universal instinct is for them to keep removing the foods, to find the safe list and stay on it, to restrict further.

But here is what I always say. If your food sensitivities are multiplying, if the list keeps getting longer no matter how carefully you eat, the problem's not the food. The problem is your gut. And removing more foods without addressing the gut is like turning up the heating in a house with the windows open.

You feel like you're doing something useful, but you're not solving the underlying root cause problem. [00:10:00] Okay, so what is actually happening in your gut? Let me build you a picture of the gut that I hope will fundamentally change the way you think about it, because the gut is not just a tube that processes food.

And once you understand what it actually does, you understand why gut health is the foundation of everything else.

Okay, let's talk about the gut as an immune organ. Approximately 70% of your entire immune system lives in and around your gut. Stop and think about that for a moment. How cool is that? The majority of your body's immune defenses are concentrated in your digestive tract. And this makes complete sense because the gut is the, the main, the primary interface between the outside world and the inside of your body.

Everything you eat, drink, and swallow passes through your gut, and the gut has to make a pretty important decision about every single thing that passes through it. Is this friend or foe? Nutrient Or threat. Let it through [00:11:00] or mount an immune response against it. There is something called gut-associated lymphoid tissue known as GALT.

This is the name for the extensive immune network lining the gut wall. Think of GALT as the most sophisticated, like, customs and border control system imaginable, inspecting everything that attempts to cross from the gut into the body and responding appropriately to genuine threats while allowing nutrients to pass freely.

When the gut is healthy, this system works beautifully. When the gut is inflamed and compromised, the custom system becomes overloaded, dysregulated, and reactive. And the systemic immune activation that results is one of the primary drivers of the chronic inflammation we've been discussing across this entire series. Your gut contains approximately thirty-eight trillion microorganisms, so bacteria, fungi, viruses, and other microscopic life form that collectively make up your gut microbiome.

[00:12:00] Think of your gut microbiome as a living ecosystem, as complex and as interconnected as a rainforest. And like a rainforest, it thrives on diversity. The more diverse the species in your gut, the more resilient and functional the ecosystem. Your gut microbiome does extraordinary things. It produces neurotransmitters, including ninety percent of your serotonin, like your happy hormone.

It produces short-chain fatty acids. Think of those as powerful anti-inflammatory compounds produced when gut bacteria ferment fiber from your foods. The most significant of these short-chain fatty acids is called butyrate. It's a fuel source for the cells lining your colon. It directly supports gut lining integrity, and it has potent anti-inflammatory effects throughout the whole body.

Your microbiome regulates your immune system, training it to distinguish between genuine threats and harmless substances. It [00:13:00] also metabolizes hormones, particularly estrogen, and it's responsible for a significant portion of estrogen's clearance from the body.

It influences your metabolic rates and insulin sensitivity, and it affects your mood, your sleep quality, your pain sensitivity, and your cognitive function. When the microbiome is diverse and balanced, it is one of your most powerful anti-inflammatory assets.

When it is dysbiotic, when the balance between the beneficial and not so beneficial species is disrupted, it becomes one of your most significant inflammatory drivers. So we talked about the gut as like a rainforest, all the different species. So then let's think about dysbiosis as the gut microbiome equivalent of a degraded rainforest, where diversity has collapsed, where certain species have taken over at the expense of others. It is extraordinarily common in the modern life and in the modern woman, and it is driven by some very common factors.[00:14:00] 

We have antibiotics which kill bacteria indiscriminately, wiping out beneficial species alongside the targeted pathogens that the antibiotics were aiming at. And a diet high in refined sugar and ultra-processed foods which feed pro-inflammatory bacterial species, while often starving the beneficial ones.

Then low plant food diversity, which reduces the fiber variety that sustains microbiome diversity, and also chronic stress, which directly affects the composition of the gut microbiome through the gut-brain axis. And let's not forget alcohol, which significantly disrupts microbiome balance, and hormonal contraceptives, which alter the bacterial populations that metabolize estrogen.

A dysbiotic gut produces significantly less of the anti-inflammatory short-chain fatty acids that support the gut lining and that modulate systemic inflammation. It produces more of the pro-inflammatory compounds, particularly something called [00:15:00] lipopolysaccharides. These are toxins released from the outside of certain bacteria that drive immune activation throughout the whole body.

And it also impairs the serotonin production, hormone metabolism, and immune regulation that a healthy microbiome supports Okay. Now I wanna talk about leaky gut. And the ladies who work with me in my program, they are very used to this. I talk about leaky gut about 10 times through the videos they have in their 12-week program.

It's such an important thing. It has a formal name of increased intestinal hyperpermeability syndrome. Try saying that fast five times in a row. Increased intestinal hyperpermeability syndrome. Did you know, okay, the gut wall is lined with only one single layer of cells, I find that amazing, called enterocytes, and these are held together by tight junction proteins.

So think of the gut wall like a, a brick wall. The enterocytes are the bricks, and the tight junction proteins between them are the mortar. When healthy, this [00:16:00] wall is only selectively permeable. It allows nutrients through the cells, comes through little tiny hair-like structures called microvilli, then through little finger-like structures called villi on the edge of every cell, then through the cells into the bloodstream, while keeping larger particles, bacteria, and toxins staying in the gut where they belong.

When the gut is inflamed and dysbiotic, the tight junction proteins become compromised, so the mortar loosens and gaps open between the bricks, and particles that shouldn't be able to go through the cells, that should be staying in the gut, like undigested food proteins, bacterial fragments, those lipopolysaccharides, again, that are toxic, well, they start leaking through and start crossing into the bloodstream

Think of this like a water filter with holes in it. The filter is supposed to keep contaminants out while allowing clean water through. When the filter is damaged, contaminants get through, and those contaminants in the gut's case, undigested food particles and bacterial products, trigger immune [00:17:00] responses wherever they end up, in the joints, in the brain, in the skin, in the liver, throughout the whole body.

This is why I never see gut symptoms in isolation. In 26 years of clinical practice, I have not had a woman come to me with significant gut issues who did not also have fatigue or brain fog or joint pain or hormonal disruption or skin conditions. The gut is not isolated from the rest of the body. It is connected to everything, and when the gut wall is compromised, unfortunately the rest of the body pays the price.

Now I want to share about a couple of other relatively common gut issues that I see in practice. Have you heard of something called SIBO? That stands for small intestinal bacterial overgrowth. Think of this as bacteria setting up camp in a part of the gut where they do not belong.

SIBO is a condition in which bacteria that should live mainly in the large intestine, they migrate and multiply in the small intestine, where food is first being [00:18:00] digested and absorbed. And the small intestine is supposed to be relatively low in bacteria. Like there is meant to be some there, but much lower in amounts.

And when bacteria overgrow there, they begin fermenting foods before the food can be properly digested and absorbed, and that produces gas and inflammatory compounds in the wrong location. The result is bloating, the distension, that discomfort that occurs during or shortly after eating, often within kind of half an hour window.

Because the bacterial fermentation is happening right where the food arrives rather than further down in the colon where it should be happening. SIBO is very common, and it is very much underdiagnosed. It requires a specific breath test for diagnosis, and it requires specific treatment, often including herbal antimicrobials alongside gut lining repair and microbiome building.

If you have significant bloating that arrives very quickly after eating, within thirty to sixty minutes of a meal, SIBO is worth investigating with a functional medicine practitioner.

[00:19:00] I had a moment in my health journey where I was getting really bloated as well, and I couldn't quite put my finger on why. Like I was having... I was dealing with a lot of stress running my busy business, which I'm gonna talk about later. But this particular time, I had a big bowl of broccoli soup, which is super healthy, like broccoli, some almond meal, and some stock.

That was literally all that was in it, and I was bloated like I was six months pregnant afterwards. I was so annoyed with my body, I can't tell you. I was super, super, super annoyed with it. However, I took an objective look and I said, "If I was one of my patients, what would I do?"

And I ordered a SIBO test. It came back positive. I followed the very similar protocol to what I do with my patients, and which is always very targeted, of course. It's not a straight protocol for everybody. And it took me about three months, but then I was really back on track again, and my gut's just been getting better and better from there.

Now, let's go on to chronic gut infection from parasites or even other pathogens. This is the one that surprises many women. The idea that [00:20:00] they might have a gut parasite living in Australia without having traveled overseas seems kind of unlikely. But in my clinical experience, parasitic gut infections are far more common than most people realize.

You hear of them with people who have traveled overseas, especially to third world countries. However, I have tested and gotten back positive results in women who have never traveled to such countries. Gut parasites, including Blastocystis hominis, Dientamoeba fragilis, and Giardia can be contracted through contaminated water, food handling, or contact with infected animals, including beloved pets, unfortunately.

And they can sit in the gut for years, sometimes decades, producing a chronic low-level immune response, driving dysbiosis and intestinal permeability, and staining a systemic inflammation picture that does not fully resolve with dietary and lifestyle changes alone

Now, about 10 years ago, if you had presented to your GP with Blastocystis or Dientamoeba, you would've been put on some very strong antibiotics, and they would've tried to wipe it all out.

Now, because it's [00:21:00] so common in Australia, these two especially, we're starting to think that maybe they are part of the normal gut microbiome in some people. However, if there are symptoms and they are present and they are overgrowing, we definitely need to pull the amount of them down in the gut, but we don't need to think about we must wipe them out, especially if we can pull them down and get rid of all symptoms So if you have done everything right, cleaned up your diet, worked on your gut, reduced your stress, addressed your sleep, and the gut symptoms and inflammatory picture are still not fully resolving, a comprehensive digestive stool analysis is one of the most important clinical investigations available.

 I will talk about this more in the heal section

Okay, now the estrogen-gut connection. Your gut microbiome is directly responsible for metabolizing and clearing estrogen from the body through a collection of bacterial species collectively

called the estrobolome. Think of the estrobolome as the oestrogen's management team within your gut microbiome. When this team is functioning well, used oestrogen is efficiently processed and excreted with the [00:22:00] stools. When the microbiome is dysbiotic and the estrobolome is compromised, used oestrogen gets reactivated and reabsorbed back into the bloodstream, increasing the overall oestrogen load and deriving oestrogen dominance.

This is one of the mechanisms through which gut health directly drives hormonal imbalance. It's the reason why many women with significant gut dysbiosis so commonly experience worsening PMS, heavier periods, hormonal weight gain, and a big amplification of perimenopause and menopause symptoms.

The gut and the hormonal symptoms are in constant conversation, and when the gut is dysbiotic, that conversation goes wrong.

[00:23:00] That's the science that I wanted to talk about today. Let's now move to the [00:24:00] nourish section of this episode, and this is where I wanna share something personal with you because I cannot talk about gut health without talking and telling you about my own personal experience.

During my burnout in my early 30s when I was seeing 80 patients a week, a bit ridiculous, and dancing at night as well, still dancing professionally, there was this moment where my vision blacked out and my body went into spasm and I ended up in hospital. I talked about that a bit more in episode one.

But I found out later my gut had essentially stopped working properly. I was constipated, I was bloated all the time, I had no energy, my body felt like it was really running on empty. At the time, I had no framework for understanding what was happening in my gut, but I just knew it was wrong. So when the beautiful Amanda, my naturopath who helped me turn my health around back in my early 30s, when she looked at me, one of the first things that she said was that my elimination systems had stopped working, that my gut was one of the primary pathways through which my body should have been clearing its inflammatory load, and it was not, [00:25:00] that we could not address the inflammation without first getting the gut working again.

So I went on a completely gluten-free, dairy-free, processed sugar-free approach, and I was super strict for the first three years without exceptions, and within the first week, I had this 10 kilograms of fluid that I had gained. Well, it all went. I lost it all. I sat on the toilet and I peed it out, 10 kilograms.

And that bloating that I had been living with that I accepted as just how I felt, it was gone pretty quickly too. My gut, once supported, began to do what it was designed to do. It has been a long journey though. Like, I really do believe that once there's been some kind of gut imbalance, you've really gotta work with it for a long time. So just managing it so you can have your best health all the way along. And that experience is the foundation of how I practice today, and it's the foundation of my three-week inflammation detox diet, which begins always with the gut.

So let me walk you through three things we can do with food as medicine and what that looks like for gut health, starting with what to [00:26:00] remove, because you cannot build a healthy gut on a daily foundation of gut-disrupting foods. So number one, remove the primary gut disruptors. No amount of probiotic supplements or fermented food consumption will restore the gut if these disruptors remain in place.

No supplement will out-supplement a poor diet. Think of trying to fill a bath with the plug out. You can keep filling, but you'll never hold water until you put the plug in first. So the primary gut disruptors to remove are refined sugar. Every gram of refined sugar you consumed is preferential nutrition for the dysbiotic bacterial species that you do not want thriving in your gut.

This is not about cutting sugar forever, but if gut healing is a current priority, Sugar needs to go, at least for the healing phase. Then alcohol. You may not like me for this, but just listen in. Alcohol dramatically increases leaky gut, so intestinal permeability, within hours [00:27:00] of consumption.

Like, when I read the study on that, I was floored. It was a couple of years ago I learnt that, and I haven't had alcohol since. Even moderate alcohol intake really opens those tight junctions of the gut wall, the mortar between the bricks, remember that? And it allows inflammatory compounds to cross into the bloodstream.

If gut healing is where you are right now, alcohol needs to go, or at least be significantly reduced or eliminated during this phase. And then industrial seed oils, so canola, sunflower, vegetable oil, soybean oil. These are directly damaging to the gut lining and disrupt the microbiome composition, so replace them with extra virgin olive oil, coconut oil, and avocado oil.

And of course, you must remove ultra-processed foods. Most ultra-processed foods contain emulsifiers, carrageenan, polysorbate 80, and carbomethylcellulose. These are added to improve texture and shelf life. But the research in the last decade has shown consistently that they [00:28:00] disrupt gut microbiome and increase intestinal permeability.

The label reading rule that I use with all my clients, in Australia anyway, is no numbers. And then internationally with my clients, we talk about no chemical-sounding names. So if you need a chemistry degree to understand the ingredients list, that food is not going into your gut. And then number two in healing the gut is to rebuild microbiome diversity through plant food variety.

Now, here is the most important and most underrated nutritional intervention for gut health, and it is not a supplement. It is dietary plant food diversity. Different plant foods contain different types of fiber, and different types of fiber feed different bacterial species.

Think of the different plant foods in your diet as different food stalls at a market, at your local farmers market, each one attracting and feeding a different group of customers. The more diverse the stalls, the more diverse the crowd. The more diverse your plant food intake, [00:29:00] the more diverse your microbiome.

So the target is 30 different plant foods per week. Now, I know that sounds like a lot, especially if you're the typical Australian evening meal of meat and three veg, broccoli, carrots, and potatoes. So I know 30 sounds like a lot, but it becomes very achievable when you count herbs, spices, nuts, seeds, legumes alongside vegetable and fruits. A little sprinkle of mixed seeds on your breakfast, three different fresh herbs chopped up into your cooking, a mixed salad leaf salad instead of a single green.

Every different plant food is a vote for microbiome diversity, and every vote counts. Some of my favorite things to do is to make a turkey mince scramble or a pork mince scramble for breakfast, and I add every single vegetable in I can from the fridge. It gives me that diversity, and I know I'm supporting my gut every time I eat it

Plus I'm getting my protein in, which is so important. That's one of my favorite breakfasts, and often I'll have it for lunch on the same day as well. Specific [00:30:00] prebiotic foods deserve a special mention here, too. These are foods that directly feed the beneficial bacterial species in your gut, and that's garlic, onion, leek, asparagus, Jerusalem artichoke,

Though I am not good at cooking that. Chicory, slightly underripe green bananas, and then cooked and cooled potatoes and rice, which develop resistant starch as they cool. Think of resistant starch as the premium gut bacteria food. It passes through the small intestine undigested and arrives in the large intestine as nutrition for your most beneficial bacterial species

And number three in gut healing, add fermented foods, but carefully. Fermented foods introduce live probiotic bacterial species into the gut and support microbiome diversity. Sauerkraut, kimchi, coconut yogurt, water kefir, kombucha, and if dairy is tolerated, kefir and natural yogurt with live cultures.

The caveat here though, [00:31:00] there's always a caveat with nutrition, and I need to name this clearly because it applies to many of you. The caveat is histamine intolerance. Fermented foods are high in histamine, and for women with histamine sensitivity, which is very common in perimenopause as estrogen fluctuates, it wobbles, and then also drives mast cell reactivity, introducing fermented foods can actually worsen symptoms.

It can cause bloating, headaches, skin flushing, joint pains, heart palpitations. I personally follow a low histamine dietary approach myself because I started getting migraines in my 40s, and as long as I stay off the histamines or at least reduce the load, I don't get any symptoms, and that means I'm very careful with fermented foods.

So for you, if this sounds like you, start with a very small amount, like just a teaspoon of sauerkraut or a small glass of kombucha, and pay close attention to how your body responds. Even without histamine concerns, start slowly. When the microbiome is significantly dysbiotic, the introduction of new bacterial species can cause a temporary worsening of symptoms

as the microbiome shifts. This is [00:32:00] sometimes called a die-off reaction, and it's a sign that things are changing, not that the fermented foods are actually wrong for you. So reduce the amount, maintain consistency, and slowly build over time. The nourish section is about feeding your gut well and removing what damages it.

Now we go on to the heal section of this podcast, and this is where we go deeper

With three more things you can do for your gut coming from my naturopathic perspective. The first thing to do, support gut lining repair, like healing the gut lining, restoring the integrity of those tight junctions between the gut cells. This is the most important structural intervention for leaky gut, and there are five specific nutrients I want to address that directly support this process.

Remember though, please talk to any health practitioner you're working with that knows your case before introducing any of these supplements. The first is L-glutamine. This is the primary fuel source for the cells lining the gut wall. Think of L-glutamine as the energy supply that keeps the gut wall bricklayers working.[00:33:00] 

Without adequate L-glutamine, the gut wall cells cannot maintain and repair themselves effectively. A therapeutic dose is five grams per day in water, ideally on an empty stomach, and it's available as a powder that is tasteless and dissolves easily. Then zinc. This is essential for the production and function of tight junction proteins, that mortar again between the gut wall bricks.

Zinc deficiency directly increases intestinal permeability. Found in quality meat, shellfish, and oysters are the richest food source of zinc, if you can eat them. I cannot. Cannot stand oysters.

But then there's also pumpkin seeds and nuts. Supplementing with zinc bisglycinate or zinc citrate at fifteen to twenty-five milligrams per day is usually well-tolerated and highly bioavailable. Vitamin A is also essential for the health and renewal of the cells line in the gut wall.

Think of vitamin A as the quality controller for your gut wall cell production. Without it, the gut wall cells are not produced to the standard needed to [00:34:00] maintain that barrier integrity. Vitamin A is found in liver, eggs, and the orange and yellow vegetables that contain beta carotene, which is the plant precursor to vitamin A.

Two more of my favorites are slippery elm and deglycyrrhizinated licorice, DGL. These are two herbal medicines with a long tradition of use for gut lining support and a growing evidence base. Slippery elm. Now think of this as the soothing coating for the gut lining. It forms a gel-like substance in the gut that protects and soothes the gut wall. DGL, the deglycyrrhizinated licorice, supports mucus production in the gut, and

The protective mucus layer that sits between the gut contents and the gut cell walls. Both of these are available as supplements and are generally really well-tolerated. And I wanna add in both collagen and bone broth too. These provide the amino acids glycine and proline that are the building blocks of the connective tissue supporting the gut wall.

A cup of quality bone broth daily is a beautiful therapeutic food for gut lining repair. The next step we need to address is stomach acid [00:35:00] adequacy. This is one of the most underappreciated aspects of gut health, and one that runs directly counter to a great deal of conventional medicine practice around gut symptoms.

So adequate stomach acid, hydrochloric acid, is essential for proper digestion. Think of stomach acid as the first line of defense in your digestive system. It breaks down protein, it kills pathogenic bacteria and parasites swallowed with food, and it triggers the cascade of digestive signals that activate pancreatic enzyme release, your digestive enzymes and bile flow into the small intestines. When stomach acid is low, a condition called hypochlorhydria, protein is not properly broken down. Little pathogenic microorganisms survive passing through the stomach and establish themselves in the gut, and the entire digestive cascade downstream is impaired.

Paradoxically, many gut symptoms that are attributed to excess stomach acid like heartburn, reflux, bloating, are actually caused by insufficient [00:36:00] stomach acid. Food sits in the stomach fermenting because it has not been adequately broken down, producing gas that pushes upwards against the esophageal sphincter and causes the symptoms that feel like excess acid.

The most commonly prescribed conventional treatment for reflux is protein pump inhibitors like Nexium. These suppress stomach acid production, and it can actually worsen this picture over time by further reducing the stomach acid that is needed for proper digestion I do work with my patients to get off PPIs, protein pump inhibitors, if they've been on them a long time.

They should really only be used for a couple of weeks for treatment, if at all, and they shouldn't be there as a long-term support for any stomach acid. It does take me a long time to get my patients off PPIs only because they're such a good drug for the pharmaceutical companies essentially, because once you're on them, it's very hard to get off them.

So we take a very slow approach, usually over about nine months to get people off, but we most usually have success. Supporting stomach acid production, particularly [00:37:00] before heavy protein meals, can be done through apple cider vinegar diluted in water before meals, a teaspoon or so of that in a glass, which gently stimulates stomach acid production.

And also bitter foods, rocket, radicchio lettuce, dandelion greens. These stimulate digestive secretions through the bitter taste reflex. And a comprehensive digestive enzyme supplement containing lipase for fats, amylase for carbohydrates, and protease for proteins, your digestive enzymes.

These supplements can support the full digestive cascade when stomach acid and downstream enzyme productions are compromised. Now something else to consider if you have gut issues is to get a comprehensive digestive stool test done. If you have implemented significant dietary and lifestyle changes for eight to 12 weeks and gut symptoms persist, or if you have significant unexplained fatigue, joint pain, skin conditions, or hormonal disruption alongside your gut symptoms, a comprehensive stool analysis is one of the most [00:38:00] clinically valuable investigations available.

Usually when I do these on my patients, I can see exactly what is going on, and we can really target a treatment approach to it So a comprehensive digestive stool test is different from the standard stool test ordered in conventional medicine if you go see your GP. Those ones look primarily for blood or obvious pathogens, while the more comprehensive ones provide a really detailed look at the gut microbiome composition.

It identifies the balance between beneficial and dysbiotic bacterial species. It looks at parasites, including the ones that standard testing of- often misses, including Blastocystis, Dientamoeba, Giardia. And it also measures zonulin, which is a protein that regulates those tight junctions of the gut wall, and it's a direct marker of intestinal permeability of leaky gut

These tests also measure pancreatic elastase alongside many other things. But the pancreatic elastase, it indicates how well your pancreas is producing digestive enzymes, and it also measures other markers of gut inflammation really directly. [00:39:00] So think of this test as a comprehensive audit of your inner ecosystem.

They do require a functional medicine practitioner to order them for you and prescribe them and then interpret it. But the clinical information provided is often the missing piece in a complex gut picture that has not responded to the standard interventions. As I said before, I've run this test for hundreds of women over my career, and a number of times it has revealed a chronic parasite infection in a woman who has never even left Australia, who's been eating well for years, who has done everything right.

It continues to surprise me how commonly that comes up. Blastocystis hominis in particular, is extraordinarily common and extraordinarily persistent. It will not resolve with dietary changes alone. It does require a targeted herbal antimicrobial treatment. Once it's treated and once the chronic immune stimulus is removed, the inflammatory picture often moves really quickly and dramatically.

People feel so much better so quickly. Now we're gonna go on to the rise section of this episode, the lifestyle pieces for [00:40:00] gut healing

The gut does not live in isolation from how you live. This is where I find many women get stuck. They do the nutritional work, they add the supplements, and they still wonder why the gut is not fully resolving. The lifestyle piece is not optional. It is non-negotiable, and I have three main things I want to share here

The first is to manage stress for gut health. Now, the gut-brain axis runs in both directions. We have talked in previous episodes about how gut health affects brain function, but the reverse is equally important and equally powerful. Chronic stress directly damages the gut. Chronic stress through its elevation of cortisol reduces blood flow to the gut, impairs digestive enzyme production, alters gut motility, disrupts the microbiome composition, and increases leaky gut intestinal permeability.

Think of the gut as a luxury organ. When the body is in a stressed state, blood flow and [00:41:00] resources are directed away from digestion towards the muscles and brain that need to respond to the perceived threat. Digestion is not a priority when the body believes it's in danger.

This is why so many women notice that their gut symptoms worsen dramatically during periods of stress, even when the diet has not changed at all. The stress itself is directly affecting gut function through the gut-brain axis. The practical implications of this are significant, and they go beyond taking magnesium at night or doing ten minutes of yoga.

So some tips for how you can lower your stress response to support the gut. First of all, you're going to eat in a calm, unhurried state wherever possible, not eating at your desk or in the car or while scrolling on your phone or in the middle of a stressful conversation.

Then try taking three to five slow, deep breaths just before you eat. When you sit down, food's in front of you, a couple of deep breaths. This activates the parasympathetic nervous system, the [00:42:00] rest, relax, and digest state, and it really prepares your gut for optimal digestive function

And really work well on managing the chronic stress load at its root, not just supplementing around it. No amount of gut-healing nutrition will fully overcome the effects of a nervous system that is chronically in that fight or flight mode. The gut and nervous system are in conversation all day, every day, and the nervous system has a pretty loud voice, so we need to support that.

Now, sleep is also a non-negotiable part of gut health and gut healing

And sleep is another area where the conversation goes in both directions. Poor gut health disrupts sleep through serotonin dysregulation, through the impact of inflammatory cytokines on sleep quality, and through the discomfort of gut symptoms themselves. And poor sleep also disrupts gut health through its effect on the gut microbiome composition, on intestinal permeability, and on the regulation of appetite hormones like ghrelin and leptin.

Research published in [00:43:00] the last decade has shown that even short-term sleep deprivation really can alter the gut microbiome, reducing the diversity of bacterial species even after just two nights of insufficient sleep. Think of sleep as the gut's repair window. The gut lining is constantly renewing itself.

The entire gut wall cells are actually replaced approximately every five days, and the vast majority of that renewal work happens during your sleep. When sleep is insufficient or disrupted, the renewal process is compromised. The gut lining becomes less robust.

The tight junction proteins are less well-maintained, and the leaky gut, the intestinal permeability increases. So seven to nine hours for most women are non-negotiable for a healthy gut. Now let's talk about movement, what helps and what to watch for. Movement supports gut health in several ways. It stimulates gut motility, which is the way the gut moves [00:44:00] everything down.

It supports the diversity of the gut microbiome. It reduces systemic inflammation and regulates the cortisol response that directly affects gut function. Regular moderate exercise is consistently associated with greater microbiome diversity in the research. Now, the caveat, and I will say this as someone who trains with progressive overload programming and plays paddle five or more times a week and does barre, that an extreme or prolonged exercise routine can actually increase intestinal permeability.

So very high intensity, high volume training drives up cortisol, reduces blood flow to the gut, and can transiently increase gut permeability. This is sometimes called exercise-induced leaky gut, and it's one of the reasons that adequate protein, adequate anti-inflammatory nutrition, and adequate recovery and rest are so important for women who train hard.

Note to self, Andrea, remember that too. I'm very good at dishing out that information, not always as good at taking it myself. The movement sweet spot for gut [00:45:00] health is regular, moderate to vigorous exercise, resistance training, brisk walking, swimming, cycling, paddle barre, whatever you love, but with appropriate recovery and without the chronic cortisol elevation that comes from doing overtraining Let me bring all of this together before we close.

I shared a number of things that I feel are important for gut health and to heal a compromised gut. One, remove the primary gut disruptors, refined sugar, alcohol, industrial seed oils, and ultra-processed foods with emulsifiers. Do it this week. Get rid of it. Then number two, rebuild microbiome diversity through plant food variety.

Set yourself a challenge this week. Aim for 30 different plant foods per week this week. Every new plant food is a vote for your microbiome. And three, add fermented foods carefully, but start small. Watch for histamine reactions. Build it carefully. Four is to support your gut lining repair. L-glutamine, zinc, vitamin A, bone [00:46:00] broth, slippery elm, and DGL.

But work with a qualified practitioner who knows your body and your case with this. And then address stomach acid. Apple cider vinegar before meals, bitter foods, and maybe talk to your practitioner or me and my team about a comprehensive digestive enzyme where needed. Number six, consider a comprehensive stool test if you're not getting the results you expect from dietary and lifestyle changes alone. Now my team and I can help with that if you need, if you haven't already got your own practitioner. And seven, manage stress and prioritize sleep.

The gut-brain axis is real. Your nervous system state determines your gut function. Rest is medicine. Your gut is not just your digestive system. It's the foundation of your immune health, your hormonal health, your brain health, your skin health, your energy, your mood, your pain experience. It's the organ through which you interface with the food you eat, the environment you live in, and the inflammatory picture you carry.[00:47:00] 

When your gut is not well, nothing else can be truly well. And when your gut heals, when the microbiome diversity is restored, the gut lining is repaired, and the inflammatory drivers are addressed, the ripple effect through every other system in the body is just beautiful.

Women describe it as everything clicking, everything falling into place, as the fog lifting, as finally feeling like their digestion is working the way it should, and noticing, often with genuine surprise, how many other things improve alongside it. Energy gets better, skin is clearer, moods are more stable, joints are less achy, sleep is deeper.

Because the gut, when healthy, it lifts everything My three-week inflammation detox and my 12-week whole health solution both begin with the gut, because in 26 years of clinical practice, I have found that the gut is always the right place to start. Everything you need is at andrearobertson.health. Start with step one today, this week.[00:48:00] 

Remove the primary gut disruptors, refined sugar, alcohol, industrial seed oils, ultra-processed foods. These are the things actively working against your gut every single day, and removing them even for a certain period gives your gut the space that it's been waiting for. Next week, we're onto sign number six of inflammation and chronic inflammation in the body, which is skin conditions.

Why your skin is always a reflection of what is happening on the inside , and what to do to clear it from the root cause. You'll see some similarities to this episode, as gut health is so involved in skin health. So please hit subscribe or follow the show on whatever platform you're listening on right now, because you do not wanna miss a single episode.

And if someone in your life needs to hear this, please share it with them too, because the more women who have access to this kind of information, the better. Just a little note, all of my free resources, my three-week inflammation detox and my 12-week whole health solution can be found at andrearobertson.health.

Everything you need is right there waiting for [00:49:00] you. If you loved today's episode, please take 30 seconds to leave a review on Apple Podcasts, Spotify, or wherever you listen to your podcast. It really helps more women find the show so they can nourish, heal, and rise too. Until next week, nourish your body, keep healing, and never stop rising.

I'm Dr. Andrea Robertson, and this has been Nourish, Heal, and Rise.

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