Episode Summary 

Today, I am joined by Christa Biegler, functional medicine nutritionist and podcast host of The Less Stressed Life, to talk about bloating! Bloating can be very frustrating for Hashi ladies because we think it starts with eating habits when it actually starts in the brain. Tune in to hear all the factors involved in what could be your belly bloat.

Key Takeaways 

Bloating is different for everyone. For some, it can take place within the two hours after eating, for others it may feel like a rock in the gut. Depending on the symptoms of the bloating, practitioners can narrow down where the problem sits in the gut, whether in the small intestine or the large intestine. The answer isn’t always a food sensitivity but rather a bacterial infection, stress levels, or parasitic infection.

About Christa Biegler 

Christa Biegler is a functional medicine nutritionist and podcast host of The Less Stressed Life. She helps health-conscious women reduce inflammation and symptoms to live a less stressed life.

The Prevalence of H. Pylori and its Connection in Digestion

A common Hashimoto’s infection is called H. Pylori, found as a bacterial growth in the small intestine. It is very prevalent as it is easily exchanged in saliva, sharing cups and spoons, etc. With the bacterial infection, the digestive system is unable to properly digest proteins leading to other deficiencies in the gut needing to function as normal. Christa discusses how to treat H. Pylori during infection and after a relapse.

Bloating and its Root Causes

Bloating can look different for everyone, and your symptoms can tell practitioners more about the potential root causes of the bloating. Usually, our first plan of attack is to start on a restrictive diet, but Christa recommends treating the adrenal glands first. Targeting stress and becoming aware of unrealized stress, then go to the gut to discover where in the gut to target next.

In This Episode 

What does bloating look like? [2:03]

H. Pylori in relation to Hashimoto’s thyroiditis [6:39]

The prevalence of H. Pylori [9:07]

The connection between H. Pylori and protein [9:57]

What to do after you relapse with H. Pylori [12:17]

Unrealized stress and what to do about it [14:13]

Low stomach acid and unrealized stress [15:57]

Reactionary versus proactive when it comes to stress [19:02]

Hierarchy of treatment for bloating [23:54]

Food sensitivity and bloating [30:22]

Bloating 0-2 hours after eating [34:53]

Bloating and digestion [37:39]

Quotes

“So bloating in different parts of the abdomen can direct a practitioner to different possible root causes of the bloating.” [5:04]

“If you're not digesting food, regardless of what you see coming out the other end, it will ferment and cause gas and bloating overall.” [6:11]

“Sometimes we have to get real, raw, and honest.” [17:03]

“Be more supportive than aggravating.” [34:14]

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Listen to the episode on Apple Podcasts, Spotify, Stitcher, or on your favorite podcast platform. 

Topics Covered:

• Practical approaches to solve the belly bloat
• What different types of bloating mean
• The reasons why you could be bloated
• H. Pylori and digesting protein
• Four things to treat in bloating

Resources Mentioned:

Gut Healing Guide: the step by step process & testing I use to help my 1:1 clients efficiently improve gut, skin and energy symptoms at Less Stressed Life Nutrition! 

https://www.christabiegler.com/gutguide

Guest Info: 

Connect with Christa Biegler on Facebook, Instagram, her website, and podcast.

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And that may be related to if you have gotten balances. It impedes your body's ability to make its own enzymes as well. So that's really important because if you don't digest or make your own enzymes, well, you don't digest things. And then essentially that sends a cascade of signals in your body that look like food sensitivities

What's up lovely ladies Dr. Emily Kiberd. Here with thyroid strong podcast, I am a chiropractor, a mama to Elvis and Brooklyn and I have Hashimotos what is currently in remission. On this podcast, I share simple actionable steps with a little bit of tough love on how to lose that stubborn weight, get your energy and your life back and finally learn how to work out without burning out living with Hashimotos Christa Biegler, welcome to thyroid strong podcast I'm super excited to have you on because a lot of women write in email me asking questions around bloating and their gut health and you are the person to go to?

Well, you know, it's funny you say that, because we were just talking about podcasting. I moved my podcast host, I don't know, maybe a couple of years ago. And so I think there's a variable from the old host versus the new host. But the point being that one of my most popular episodes is about practical approaches to bloating, which tells me I don't know what the percentage is of people. And I think there's a lot of angles in which to look at this. But it affects a lot of people for a lot of reasons. And I know we're looking at it with the lens of Hashimotos. But as people become more aware, they understand that gut health is a key component of overall health is like the holistic insight. It's like the the core of the body, right? But our perception of bloating can be really significantly different overall, but you're right gut health is massively implicated in Hashimotos. And what are some potential root causes of it?

What does bloating look like? So when I first saw my first functional medicine doctor, I lay down, he's like, do you feel like you're bloated? I was like, man, like I didn't even know. And he palpated my tummy, my abdomen. He's like, Yeah, you're bloated. I was like, hey, yeah, how could bloating show up? Like, what does it feel like? What does it look like? Because I think sometimes we're so disconnected from our body, when we're going through nearly finding out that we have an autoimmune condition, I

see this swinging really strongly in both directions. So there are times where Bloating is not wildly abnormal. I mean, generally, it's not a good symptom. But there are people who any little hint of it throughout the month. And I will tell you that with disordered eating history, there is a like think it's like 90% of people with disordered eating history have gut issues later in life. And so there is a combination of body dysmorphia, or how we're viewing our body and kind of working with it's like working against it versus working with it, I would say it would be a simple way to say it, there are times of the month like around ovulation and around your cycle, it's actually really normal to have some bloating, and some gut changes the week before your cycle because of prostaglandins and different things. Technically normal things you can potentially do about it, depending on what you think. But that's really about awareness around Hey, my hormones ebb and flow. And there are different changes that affect bloating that week, you know, so having that awareness. First of all, it's very nice, because sometimes we can become a little obsessive about it. So bloating can look like if you're bloated, like it can feel like you have pressure or just extension distension on the upper part of your belly, or the lower part of your belly was isn't super precise. But if you have any bloating, zero to two hours after a meal, we can talk about what that means. But that is essentially the transit time in the small intestine. And then food goes into the large intestine. So there's a lot to say about how you digest how well you digest it, what impacts that overall. But I've had people swing on the pendulum the total other way, where they've had at certain times of the month, what looks like they you describe a basketball or volleyball, or like massive pregnancy belly, and I would say, that's totally not normal. That's not what you want. And that can help us come up with some different root causes like deep, deep gut infections and what's going on in the trenches. Now. To that end, it made me think about diastasis recti die, and of course, diastasis recti. Being those core muscles that are challenged, you would probably be able to speak more to diastasis recti than I would, but that can obviously change your ability or the cores ability to hold everything in there and you can have what may look like distension or you may like struggle a little bit more with that. In general, real Bloating is kind of a source of discomfort. It feels like you might have to unbutton your pants. It feels like more pressure in the abdomen, and it might be paired with gas or gurgling or something like that. Overall, that would be kind of how I would look at it like massive swings to either side, and then kind of like what's most significant through the middle. So bloating and different parts of the abdomen can kind of direct a practitioner to different possible root causes. Maybe Maybe, I think if we're thinking about what's going on in the gut, I think it's more important to think of like, overall digestion. And I will say that conventionally, we are now accepting SIBO, or small intestinal bacterial overgrowth, as more commonplace because it's been around for over 15 years, which is how long it takes for things to get from research into practice. So we're accepting that more, but what happens is people go in, sometimes have trouble even getting this, what is actually not a very expensive test through a regular primary care provider. And maybe just because I see the people feeling out of this, you know, so I might have a bit of a skewed perception around it. But people will get treated with a drug that is supposed to target the small intestine, I often call di faccin, or Rifaximin. That's the most common standard of care for SIBO small intestinal bacterial overgrowth. And I mentioned that the transit time in small intestine was zero to two hours, but people have relapsed. And I think there's so much more to it than that what's going on upstream, and then downstream, and how is our stress involved in the overall digestion, etc. Because point blank, if you're not digesting food, well, just regardless of what you see coming out the other end, you're not digesting well, it will ferment and cause gas and bloating overall, interesting. So there's lots of options, but we can boil it down to simplicity, with small intestinal bacterial overgrowth. What they're looking at with testing is just to bacteria. I think that is so short sighted. And I think there's so much more bacteria and other infections that can be happening in the larger test time. And then also above, and we should actually this is a perfect segue into talking about infection that really is related to Hashimotos thyroiditis, which is H. Pylori. So if you don't mind, I'd love to talk about that for a quick moment, because this is like one of I'd love for you to talk about it, because it just came up on my GI map. Okay, great. So thanks for even giving me that segue. So I was going to do a little bit more literature review. So anecdotally, in practice, I see this all the time. But in the literature, it's there too. For example, I pulled up one study from 2016 about and it was a small study under 100 women and they looked at the prevalence of H. Pylori with and I wonder what diagnostic tools they use, because we need to talk about that. Next. They looked at the prevalence of H. Pylori in those with Hashimoto thyroiditis, and it was almost 50% of those women had H. Pylori. So I find that that's 100% going on with people with H. Pylori. But what's more important is I have to remember that we're not all on the same page when we're talking about this. So it's just talking about SIBO testing, hit like your primary care providers office. And I find that like, depending on where you are in the US, your provider, all those things, you may have a different experience on on what's most progressive, but this takes me back to my years working in conventional medicine, and seeing clients that were like had these severe H. Pylori symptoms of indigestion, nausea, etc. Like when it gets really severe. It looks like massive indigestion, nausea, maybe even trouble holding weight that was like very severe and this guy would test positive take a bunch of antibiotics test negative, but never really looked different. And now we're in retrospect, our testing conventionally is just so there is a huge gap in sensitivity. So things have to be a real hot mess or really acute in that moment or horrific for it to typically show up on conventional testing. That is for parasitic pathogens. That's for H. Pylori. That's just been my experience. So there are options out there. I will say the GI map is probably the better functional medicine stool test out there. And I can't tell you the exact stats, but they are able to tell you how sensitive it is looking at h pylori. Now, I will say that this can be a bit of a piece of contention in our field because it's thought that 50% of the world has h pylori, is it actually commensal or normal bacteria. And it's found in research that 30% of Americans have H Pylori. Here's how I interpret this. If I see it on a test, I take care of it symptoms improve the ENT and I counseled people on not continue to pass it around. Why is it so prevalent? We share it with saliva, and we're sharing cups and spoons, etc. It's an upper GI bacteria or pathogen more so and so that's how we typically share it but it may be presented on a lower GI so when you're describing a GI map, it is a stool test and that is the lower GI or the large intestine. So if it's showing up there, it may not exacerbate in the upper GI through nausea through vomit news, real extreme. Probably not going to say anyone most people are not dealing with that. Honestly, nausea, indigestion, burping, etc. It's typically upper GI even though you're seeing it low range, obviously, it's all connected. It doesn't matter. And we've already pushed record you were talking about protein. And I also want to tell you about how this influences that and why it's so important and what it actually feels like to you as a person if I may. Yeah, please do. So if you've got some h pylori going on here. Then you know your stomach acid or your ability to specifically digest protein is going to be an issue. Even though protein is amazing and we need it and we need all the amino acid what is protein because when we when we digest it is amino acids. Amino acids are key for mood, detoxification, phase two detoxification, tissue regeneration, all kinds of things. It's like massively important, massively important, but if you are definitely dealing with low stomach acid, gut imbalance, etc. And there's other reasons stomach acid can be suppressed. Chronic stress suppresses stomach acid, digestive enzymes, bile function, etc. But if you got h pylori, that's another reason you can have low stomach acid, if that is suppressed, you will eat protein of real a common red flag is that eating a large amount of protein just kind of sits or maybe feels like a rock in the gut, or doesn't really feel like it goes anywhere, right. So that's one thing to think about there. And one other thing, animal proteins are our only source of vitamin B 12, which is a nutrient related to energy very simply, and you can pretty easily get your doctor to check for that that's pretty commonplace. I will say that the reference for each has changed over the years I've been in practice. If it's under 500, I think it's worthwhile to consider improving it. But what I want to say is always ask questions, if you're being told as low grade, you're probably going to feel better putting beats while back, it's gonna maybe possibly help with energy. And if it's low, there's a history of some gut things going on and you're not digest, it's just another outward sign that you're not digesting those animal proteins. So you're not absorbing those nutrients. So we've got like, there's quite a cascade, it feels complex, but it's all like the same thing that the road, right, like the same track, right? It's an infection or imbalance. And then also, like there's a stress component potentially, as well, that can cause all kinds of things. So it's like a couple different root causes. But if you look at the big umbrella, just simplify it. So like there's imbalances that have to be corrected. This particular imbalance causes low stomach acid, poor protein digestion, which causes then a cascade of other things. So sometimes people feel like they have to do so much like it's just like overwhelming, but I encourage you to think about, it's really just so connected. So when you hit the right Domino, it just makes all the other dominoes kind of come into place.

So when women are diagnosed with an h pylori infection, and they treat it, but then it comes back or they feel like they're frequently treating an h pylori infection. Maybe they should start looking somewhere else.

Yeah. So there's a couple things to think about there. Anytime I see it pop up on a test, I want to just talk to you about the people in your life because we share microbiota with the people that we live with, regardless if we are in romantic involvement or not, which is interesting. So I always want to ask about significant other symptoms, does your significant other have any burping, indigestion, nausea, heartburn, for some reason, those are all different. They all mean something different to different people. So I like to ask about that first. Because otherwise, that's a vector point where you continue to be reinfected. Now, let's not leave out animals, because I've had these conversations with that before and they're like, oh, yeah, dogs have H Pylori all the time. And they're like vomiting, or whatever. And people get licked in the face by their dogs a lot. So just another thing to think about from a vector point, like, where are you getting exposed to this, I'm so much more careful than I used to be. Now I'm like some weird, I don't live my life way. But just do not share things with people or drinks with people in the way I once did. There are also things that relax the lower esophageal sphincter and allow some reflux to come up. So it can be H. Pylori, and it's like you're continuing testing over and over and over. So one, how was the first protocol to the next thing, which was a, your question is, could there be another cause? It's almost always some form of stress. And like, no one wants to hear that. But stress chemistry, what it does is it suppresses stomach acid, which allows bacteria to overgrow stomach acid is meant to be a gate. It's why I always love this is my favorite analogy for this. It's like, why, when you're in college, and you leave a pizza out all night, you can go eat it the next day and not get really sick of stomach acid is but that pizza is baked in with all that crap growing on it. So if you have suppressed stomach acid from stress, or from bacterial pathogens, like H Pylori, one or the other, it is going to allow crap to come in and set up shop, it's a gate. So it's that gate is wide open. Now you allow things to come in and go downstream and continue to cause havoc. And unfortunately, our greatest challenge is unrealized stress or the thought that we don't have it or that we're actually fine. Just because we're doing some meditation or all these different things. It is a bit of an ongoing process of like, really stopping. So I use a few data points to help me understand what stress looks like because in in transparency, even last year, I thought my stress was pretty good. And I got my mineral test results. And it was like, Yeah, your stress actually sucks historically. And I was like, this looks real bad. I am going to look at this differently from now on, and I can tell you a little bit about that. But and so what I want to say is that minerals are dumped under stress, and that's kind of the area I look at are one nutrient deficiency. perspective. And there are minerals involved in how you make stomach acid. And when your cortisol is elevated, which is the Darlene stress hormone secreted by the adrenal glands. When your cortisol is elevated, you dump out potassium, you dump magnesium, etc. So for me things that I don't I don't think were stressful, like talking fast. He's getting excited being interviewed on a podcast, I have to really watch the rate of my speaking and watch my heart right now. Because even though I didn't think of it as a negative stress, it was my cortisol was pumping and I was dumping nutrients. And I was continually having not reflux exactly but burping like recurrent burping because of poor stomach acid, which was really a downstream effect from stress. Interesting. The sad deal, low stomach

acid, very common in the Hashi women. Stress is a factor, gut infection is a factor. Is there any other like why the Hashi ladies with low stomach acid?

Well, it's not that we're just picking on them. It's actually like a, I feel like it's everyone. And again, I look at it from the lens of like all kinds of people with got stuff backing up. I've never seen an autoimmune case that didn't have like a stress straw that broke the camel's back situation. Just never seen it. So there's some kind of stressful history that changes stress chemistry and allows like a cascade it basically suppresses the immune system suppresses stomach acid suppresses digestive enzyme function, which remember, if we aren't making enzymes digesting things, we're going to have bloating, which I know is our main topic suppresses bile, which also helps digest fat, fatty foods or like any fats, which are essential, essential, by the way, so all of those things are gonna get suppressed. So when we're talking about low stomach acid, it's actually not about Hashimotos. As much as it's about stress, when we all have stress. So it's just a matter of, how are we processing it? How do we feel when we have it, we like to shove things under the rug. And we are strong, powerful women like successful women, right? So we'd like to pretend it's not an issue or that we're managing it fine. Sometimes we have to get real, raw and honest and be like, Oh, that person that wasn't very nice to me for a very long time, made me feel uncomfortable every time I walked by them. And that was a stressor. Oh, starting meetings, 15 minutes after my kids walked out the door. And I didn't have time to like prep fully for the day. That was a stressor, going from back to back to back meetings. And then back to back to back. Other things is a stressor. It's stuff we don't really think about because we're like, well, it's just life. But depending on how a short temper yelling at our spouse, or our children, or our friends or someone we love, right, it's we have to take it out on someone we love. Those are all that's like unrealized stress, right? And so for me, I just like pay so much attention to like, oh, is my heart beating very quickly? Or is it a little bit slowly? And I'm, like, pay a lot of attention to that now. So anyway, to answer your question, it's not just talking about us, ladies, it's not like, Oh, it's just you, it's actually because we're surrounded by stress. And we don't fully always recognize it, or we haven't changed how we are personally processing it. So I have to stop myself a lot and just say, that's okay, I can slow down to talk a little slower. Because it's a bit of a stressor to which I've been like that my entire life. So it's part it's not instant, it's going to be a bit of a journey to shift. What is your current normal to your new normal?

How do you differentiate a stressor that is pushing under the rug that's chronic versus maybe a stressor that's motivating, right? Because stress, cortisol is also motivating it up and going does I think sometimes the narrative is de stress, don't stress and stress but using stress to our advantage and leveraging it is also a powerful tool.

Yeah, I think I would ask you, which parts of cortisol are motivating? Yes. When I see something on my schedule at x time, it's motivating him to get things done at a certain time. So it's not, this is a journey for everyone. There's not like one quick, easy fix. It's simply a, Hey, am I reactionary? Or am I proactive to it? Like, if my week is jacked, full? Am I actually nourishing throughout that, because what happens when we get busy as we sometimes like everything kind of goes downhill, like we don't ever want to show up to the day. And so we forget to like even put food in our mouths, right? That's a common problem. And like the whole 2017 2018 event, and now fasting was a big thing. So when we don't nourish, we are creating more stress in our body as well, whether we realize it or not, because the body's like, I'm trying to balance my blood sugar over here, and I got nothing to work with. I have to increase your cortisol to balance your blood sugar, just like coffee in the morning without any food. It's like, all right, cortisol showing up popping. There are ways to show up and be motivated by cortisol but also it's a matter of how are we processing it internally and the nervous system? Can we switch from yep, I can go to go go meetings and Can I sit at my desk? Or not sit at my desk more importantly, like eating at my desk? Because it's not the banter is not like, Let's dress approach to eating. But Can I switch from the fight or flight side of my nervous system to the rest and digest? And that's really what it boils down to is like, how neuroplastic am I? Meaning how quickly can I switch from one to the other? If I was doing biometric data on this? What would this look like? Can I get my heart rate to slow down? Can I do like around have a little bit of breath work? Like for like a minute, before I eat, Can I acknowledge whether certain meetings or people that I encountered through the day are bigger stressors, and I need to take a second, and like, exhale that and do what I can to try to mitigate that instead of pretending that we are like super women. It's not supposed to be disempowering. It's just allowing us to like see it a little bit differently. Because I think right now we're like, Well, I'm not I'm fine. I'm not stressed, I get good sleep, I do this, I do this. But it's the little thing. It's like not nourishing, not like running from thing to thing to thing without paying attention to the kind of what your heart rates doing all. So I don't know if that really answers your question. Yeah, at all. Because it's like, I think people say often they say, exercise is my antidote to stress. And I think that that can be fine, it's totally fine. But if your exercise is always cardio only, you know, that hits your stress or your heart rate a little bit differently, then switching that up with weights, etc. And if we have some kind of weight on our shoulders, I was actually doing some, I'm constantly a work in progress as well. So I was paying attention to the way I was taking a quiz the other day, and was talking about your behaviors around exercise. And it got me thinking about when I first got into exercise, and how I had to show up and do this very specific thing every day. And I know this is a bit of a cliche term and listening to your body. But I'm in a little different place now than I was at that time where it was like I have to show up have to do it this way, I have to have to have to. Now I look at it as I'd like to move my body, I enjoy it, I get to get to right. And so that might be one way I would differentiate that or it's like, you know, yeah, you know, your alarm goes off, and you're reacting. But what if your whole circadian rhythm What if you, like, woke up a little bit more gently, you know, and got to whatever you wanted to do for the day. So I always like tried to break it down from reaction to proactive. And I know I got a little off tangent there. But it's hard to talk about stress, because it can be something that we can't touch very well. I am not an expert on like the all of the things happening in the brain Exactly. I'm more looking at what are the downstream effects, what happens with nutrient deficiencies, what happens in the gut, etc. But what I can tell you is that people have relapse, and they don't get as better as fast as they could. When stress is really significant. I told a client recently, she was you know, asking about where she was in timeline. And I just said to her, I've never seen you sit down in any of our calls. Every week for 10 weeks. I've never seen you sitting you're always on a treadmill, running around doing all the things like I've never seen you sit which is just interesting. It was just like pointed out to her she hadn't realized it. She didn't realize that she was the only person moving around that our calls. It's not right or wrong. I mean, if you are on the phone and you want to get some movement, fantastic. But there is a you know, we have patterning right now don't even realize our pattern. And sometimes it's unrealized stress that this issue

going back to bloating, like how do you start to create a hierarchy of treatment? Right? So stressor is kind of one tip of the triangle. I've heard some practitioners talk about like since H. Pylori is high up in the GI system that that should get treated first and then to work your way down. How do you start to I mean, obviously, you have to uncover the root causes, but how do you start to prioritize treatment? Right? So you don't want to treat everything at once and overload someone with you know, 100 supplements. But you know, you're ruling things out you're really not SIBO h pylori, maybe a parasitic infection.

How do you approach it? Yeah, first, before I kind of jump in prioritizing, that's a great question. If we're going with the theory that you start from the top to the bottom, the brains at the top, technically, right? So when I'm assessing a case I'm looking at, if I'm being a bit I always tell them, like the boring approach is I'm going to support four things, the gut, the liver, the thyroid and the adrenals. And they just need to figure out what is the priority overall. And if your adrenals have been so to speak, burned out, like stress has been up for a long time, and you now are not producing cortisol because your adrenal function literally cells have been killed and so your mitochondria and producing hormone the same way they were and let me give you some red flags for that dizziness from sitting to standing and lane to sitting up craving salts, feeling worse after cardio versus other types of exercise or more tired or more exhausted a little longer and just feeling kind of like exhausted, which can be a lot of things right but just like overall exhausted, can't really get moving during the day can't really function without coffee, potentially or stimulants. Those are like big, big red flags for the adrenals just not showing up to work, if that's going on, that needs to be supported for like a month or so probably before you get into got work. The problem is, is that everything probably needs support. It's just a matter of what do you start with, and I agree with you, I start with one and then I kind of my efficiency as a core value. And so then I kind of move on to the next one. So I'm like, Okay, I'm hearing the adrenals are in rough shape, or like late late sleeping is another adrenal one. So I want to give you some mitochondrial support, and some minerals, and some other just gentle things that support what's going on in the adrenals. And by the way, if your adrenals are in rough shape, you tend to be more sensitive to everything. As a side note, you're just very sensitive. And this is very much on the table, because any kind of autoimmune stuff. It's just related, like there, it's very common for us to be kind of burned out, honestly. And we need to take a beat. So supporting that for at least maybe a few weeks to a month before layering in those gut recommendations may allow you to get ahead farther, and sustain your results, longer healing and correcting and supporting and loving on and nourishing. Those glands and organs that are really struggling, they're atrophied is about a 369 12 month process, depending on what kind of inputs you put in. But it doesn't mean you have to stop and do only that. So I would just say, if your adrenals look like they're on the struggle bus, if you start there, give that a little attention, you may actually give your gut a very positive downstream effect, to be perfectly honest. Because if you're paying attention to what your stress and cortisol and adrenals and nourishing that you're stopping and being a little more intentional in other areas, hopefully. And so that is going to influence how your body makes digestive enzymes on its own. And so at least if you start adrenal stuff, or stressed stuff, three, four or five weeks in advance of like layering in gut stuff, and gut stuff just depends on I mean, I like to do gut testing on pretty much everyone who walks in my door, but they know what they're asking for when they walk in the door when I advertise that stuff, right? So I like to see what's going on under the hood, what's going on in that large intestine, it gives me and then use questioning for what's going on upstream. Personally, I do like to address a lot of things in the gut as streamlined and as efficiently as possible. So h pylori is a big deal. But sometimes your symptoms, unfortunately, a lot of these tests don't bring up whether parasites are potentially an issue. So sometimes you have to listen for symptoms. So like the gal that had the volleyball or the basketball in her gut, around the full moon, those are super parasitical symptoms. And those are significant bugs, you know, they're a problem. And they're not just going to go away because you reduce stress, they're just not. And so I mean, that's my opinion, but addressing each of those pathogens, in a way, that's not a zillion supplements, you're right. There are people like sometimes this is not done in a way that is cognizant, or aware or considerate of the client, and what they can handle or what is reasonable. I always like to say like what is like a rational person want to do. So adrenal stuff, adding then gut stuff, some of those even start with like, the bigger ones, the thing is, is like everything is important. So there's a ways to like just step them all in so you're not overwhelmed. And then always, I think, be an advocate for yourself, if you see a practitioner, and they feel a bit overwhelming, because I've also seen some people recently, more and more and more, I see people who are coming from other practices, and like, Well, why are you here from this other practice what's going on? So we review the case, which, you know, takes a bit more time. And sometimes people have done a zillion tests, and there aren't a zillion things. I'm like, this is just too much. It's a disaster. You know, it's just overwhelming and too much. And I think it's okay to just step back and say, I'm going to implement one piece of this information at a time, and to ask for more help, or to say, Hey, this is a lot of stuff could we prioritize a little bit differently, just being a really good advocate for yourself is really, really important as well. And sometimes, you want to, like pull out before things get too deep. If it's just, we all learn lessons, and sometimes the practitioner is not the right fit for us, depending on where we're at. So priority wise, if your adrenals are fried, start there. If not, then potentially start with the gut, it kind of depends on the symptom, but we're talking about you motos. And I would say like, if I broke that in half, it's got stuff and stress chemistry, what's going on the brain nervous system and the downstream effects of the deficiencies and then from there, filling in nutrient gaps, rebalancing things, etc, trying to make it simple, streamlined, etc, overall, but sometimes develop other symptoms that you know, throat where something gets kind of to the front of the line type thing. So skin stuff is an issue, depending on how that skin stuff was presenting would change sometimes that priority so a little different for everyone, but hopefully that was useful and helping someone kind of self identify like where they are because if you just go like after guts off, got stuff got stuff and you don't pay attention to the nervous system. Very often you will not make the progress you would like to make unfortunately, we'll just kind of keep coming back.

I think when a lot of women experience bloating, the very first thought is okay, what is it in my food? What is it that I need to cut out? And a lot of women are like, Oh, I have a food allergy or sensitivity or this food intolerance. And I know there's a lot of different tests out there, none of them are really great. Or maybe the gold standard for picking up those specifically sensitivities, less of like a anaphylactic reaction to food. What do you tell women when they are thinking, maybe it's what I'm eating, maybe just start cutting a bunch of stuff out or start to look down that route?

Yeah, I mean, this like, is a deep question for me, because this is actually kind of my practice started, I think I started doing some of this work in like 2015 2016. And as a dietitian by trade, of course, I looked at Food First, and I got a lot of success. And I was doing food sensitivity testing, I was doing a very specific one doing a very specific protocol. And that worked for a while, and then it didn't. And maybe God just gives you what you can handle in that moment, I think sometimes, and now it's like a 360, where people come in, they've got sensitivities to food, and my and I've always like, can we eliminate those sensitivities by not restricting further? So that's just like one way of how I wanted to set the stage. And like, that's how I think about it now. And then. So that's kind of how I'm gonna answer that question a little bit, I want to challenge someone, because if you are not digesting, well, those undigested bacteria will create, essentially messages in the system. And the system will say, I'm confused by this food, and I'm, I'm gonna I'm gonna fire a reaction at it, where inherently the food is not bad. But it's the digestion of the processing of the food that looks wonky to the body, because there's things kind of out of balance overall. So backing up, your question is, hey, what if I remove things, so it's so gratifying when we like change our diet, and we see some changes, and I will tell you, once you cross the line for autoimmune conditions, sometimes changing your diet can give you quite a bit more, I'll ROI. What I see commonly walked through my door is someone who's already tried things, I always think it's like, good, there's different ways to think about food. Am I restricting without an end in sight? Am I doing an experiment for a couple of weeks, maybe maximum four weeks? Or am I to have like, restriction disorder, which is really that first one, it's like, there is restricting without any exit plan, or reintroduction plan, or life is busy, and I just like felt good. And then then all of a sudden, I woke up and it was six months later, and now I hate it. Or am I going to be really intentional? And I'll tell you what, the first time you change your diet, you hate it. Typically, often, often people do. And so actually, most people come to me they've already done some diet changes. My question is, are you in a place of too much restriction? Or did you do a short term experiment for a couple of weeks? And what can you tell me about that time, because I don't think we need to over restrict if something is not necessary. So I'm not a fan of like unnecessary restriction overall. Now, can there be food stuff going on with with Hashimotos, or any autoimmune thing? Totally. So I use the integrative process, also as a lens. So the first step of the integrative process to to remove barriers, those barriers might be gut imbalances, toxic burden from the liver stress. So all things we've talked about today. And sometimes food stuff fits in there, right, but it just needs to have an exit plan. Second step is replacing enzymes, nutrients, etc. The next step is repairing or populate. So that's kind of where that fits. But the main takeaway is that people get stuck and remove. And so if I get some with Hashimotos, and we want to know, the tricky thing about Hashimotos is sometimes there's not an outward signal, or sign or symptom, without gluten, or something like that could be an issue. And so for people, I just kind of like match the client, if someone has been restricting, and they'd like to see if it's actually making a difference, and they don't see symptoms from re adding it, we will kind of make a game plan around checking those antibodies, and seeing if it's making those antibodies flare overall. And if so, then we just go back to like doing rebalancing, correcting, correcting, correcting, and potentially trying again later and see where we land because where you're at in your healing journey today, will hopefully be different than it is in three months from now, six months from now, nine months from now. And I used to eat gluten and get hurt keratosis pilaris on the back of my arms or chicken skin for a long time, probably like a year or two. Now I don't Saatva you just continue to heal and you've reintroduced it. Yeah, reintroduced it. I think food quality can be an issue, right? Food quality can be an issue. But one mantra that I use a lot is just be more supportive than aggravating, like I went to the state fair this weekend. And I enjoyed it. And that was great. And maybe like five years ago, I couldn't have done that with where my health was, at that time without some negative reactions. And so you can try things. If it doesn't work, chalk that up to say, I'm not quite there yet. It's fine. I'm just going to keep healing in this non rigid way, and listen to my body and just pay attention to the signals that it's giving me.

You mentioned in the beginning that if you had bloating within like the first hour or two after eating, that that was a potential sign of something small intestinal bacterial overgrowth, potentially, okay. Yeah,

but what and thanks for asking this and clarifying it, because I don't want people to run up and be like, Man, I gotta do this. zillion testing things, I think that you can learn so much from just questioning your symptoms and pulling it together. Honestly, I'm like working on a whole spreadsheet of symptom checking, because I just think symptoms tell you so much, if not more, sometimes in testing does for cheaper. But if you have bloating, zero to two hours after eating, you have some small intestinal imbalances probably like that's a transit time. Some people still motility anyway, by the way, but what I do in that situation is I address large bowel imbalances, because if you have small bowel imbalances, we're usually only looking at our standard of care and I was looking at two bacteria. And I again, I just think that's very short sighted, it doesn't attribute for H. Pylori doesn't attribute for larger bacteria, Prevotella, Staph strep and all the things that are going on down there. So I would just chalk it up as there are imbalances and there is an issue with enzyme production. And that may be related to if you have gotten balances, it impedes your body's ability to make its own enzymes as well. So that's really important. Because if you don't digest or make your own enzymes, well, you don't digest things. And then essentially, that sends a cascade of signals in your body that look like food sensitivities. If you've got bloating, zero to two hours after eating, there's a couple things to consider. Could I have some downstream stuff, let me look at my symptoms a little bit more, let me Google up multiple symptom questionnaire on the old Googler. And fill that in and see if there's any other symptoms that are coming up. Because the gut can be kind of far reaching on other symptoms as well. And also, so let me look at what's going on downstream. And also, let me look at how I'm eating. So another structural intervention is, how am I eating? Do I inhale something that is not a very big badge of honor. It's in college, my classmates used to say, somehow, she can talk the most and still be done eating first. That's a terrible, terrible prize to win. Because your stomach doesn't have any dang teeth. So you got to chew that up. And so if you are kind of like just gulping down food between things which granted, just stop, like we've all done that my charge for you today or tomorrow is like, make yourself a little alarm on your phone, like around the time you're going to eat and say, Can I chew each bite 15 to 20 times that does not feel normal, but it does slow you down. And whether we like it or not, sometimes we'd have to slow down for a minute in order to like, see what things look like. So if you're have imploding, pay attention to how you eat, as well as I think we're often like, what am I eating? That's okay. But pay attention also how you eat and then pay attention. It might be what you eat, but it also might be downstream and how the body's processing now. Yeah. For people who don't know what, undigested food in your stool, like you should not have undigested food in your belly that annoying corn does not digest for anybody. Yes, just be real, neither to whole flax seeds. There are some things that you do come out on the other side, let's be honest. Now the tricky part is, is that I don't think that that's the only or best way to assess for it. I think in general, if you've got bloating, things are not digesting optimally, then. So if Bloating is happening, you're probably not digesting optimally, what are the potential causes of you're not digesting for enzyme function either related to gut imbalances or stress chemistry? Simplifying again and reiterating or how you ate which is also related to often like behavior behaviors overall, like so how am I eating? How am I digesting, like, you brought this up? Like, hey, I should start at the top, the small intestine actually start in the brain, and then in the mouth, and then in the small intestine, right at the stomach, then the small intestine like go like consider down the stream. You could also think about it going from backwards up to and it's not totally wrong, to be perfectly honest. Like, however you want to think about it, there's multiple areas want you to know, like, there's multiple ways to arrive at the same conclusion. Yeah, it's just like, what is the best fit for you? And we learn that somewhat by failing, or not liking what we experience? Like, probably you too, I practice the way I practice because people that failed me, you know, and like things I did that were hard. And I didn't want other people to have to deal with that. Like I've taken a zillion supplements without an endurance I just having a closet full of them. I don't really care for that. That sucks. Like, I did stuff like that for a couple of years, or for a few years when I first met my husband and yeah, I don't really care for it anymore. There's a level of understanding what I've got and having things for times of need. And then there's just having a bunch of crap. I don't know what I'm gonna do with like, but you know, you live in your learn with every piece of it. And if we aren't catching our lessons, then we continue to have to learn the same one. So that's been a new thing for me this year is like, Oh, if I didn't learn from that lesson, I have to just continue to learn the same one. That's fun. Well, good. Lessons are rich this year. Yeah. Unrelated to nutrition. You talk about autoimmune disease not being an organ dysfunction, but an auto immune system dysfunction. Well, autoimmune disease, at the most basic level is the body kind of attacking itself. When I think about Hashimotos. It's trending in the more sluggish thyroid realm. So it's like thyroid stuff, which by the way, I think all of us need to love on our thyroid, but then it's turned into a, the body got some mixed up messaging, where it's kind of like attacking. So there's 100%, a brain component and like what happened? But also what are the other potential implications? I would say, with all autoimmune issues, addressing what's going on in the gut, the liver, the adrenals, it's all it has overlap. So you have things in common with other people that are dealing with it as well. There's just some nuances like potentially up to 50% of people with Hashimotos have some H. Pylori. Now, how you're gonna diagnose it or find it can vary. And I would say a GI map is a good way, asking your doctor, it's probably going to be negative, usually, because I have to be really, really, you'd have to really, really, really severe symptoms, but symptom wise with a breath test,

does that how conventional medicine or how do they do it?

I think there's a couple ways. I'm kind of actually like not remembering this right now. If they use a breath test, and or if sometimes they look with endoscopy, don't quote me not to provide an added diagnostic clinician. So I cannot remember at the moment, so in a jam app is a stool test. So again, slightly unconventional, but what about just looking at symptoms? If you're burping, indigestion, heartburn, etc. Like those are big H Pylori symptoms when you put those together. And then the last thing I want to touch on is you talked about the trifecta approach, right? So stress is kind of one corner of the trifecta. What are the other two corners? Yeah, I always think you can go through like any symptom or issue, looking through it through this one lens. And like you said, stress or emotional is one angle, structural is another angle, and nutritional is another angle. Let me give you a couple of examples of this. Since our conversation started with bloating, let's just run bloating through that trifecta that triad. So from an emotional perspective, if our were more in fight or flight and rest and digest, literally, the body is not going to process or be in a place where it can make enzymes and do the digestive processes that need to happen for up to four hours after meals. Right? So if it's in that fight, or flight, state versus rest and digest, so there's one emotional angle, structurally, we talked about mastication, or chewing food, you know, from uploading perspective. Nutritionally, this feels confusing, because I'm going to talk about gut dysbiosis as well, because I feel like gut dysbiosis is part of you could decide is that more of a structural issue or whatever. But gut imbalances, impact nutrient deficiencies, for sure. So we talked about B 12 earlier, which is going to then affect your energy levels. And then another thing is that having like poor mineral status, or poor nutrient status also can affect stomach acid production, and then therefore digestion and therefore bloating overall. So there's little overlap. So let's use another one. Let's say someone has a headache. For example, if you run it through that having stress can make someone like gritting their teeth and cause like tension. Or I believe your chiropractor by trade, right? So there's a lot of like subluxations, right subluxations or do not like that's really not my tongue very well, that can be involved in like a headache. So that's a structural like, often refer people to either PT or DC, often for a structural intervention for a headache. Nutritionally, sometimes there can be things, a means which build up in like aged food or histamines, etc. Sometimes this can be triggering two different mechanisms around a headache. And then Emotionally, I started to, but then kind of jumped around emotionally, if someone's kind of like grinding their teeth or something like that it's part structural, but it started in the brain where someone's kind of like solving problems in their sleep and kind of clenching their teeth and creating a bit of a structural issue, but also causing kind of a tension headache. So you could run that through multiples, like if someone comes to me with an emotional distress, they're usually going to go to like the therapist or the counselor first to the emotional piece, then they may actually go to the chiropractor next, because they seen that be involved in new stuff. And then they might finally make it over to the nutritional corner, and look at how what's going on nutrition from a food, digestive etc. Experience and a mentor that I really like. I don't know if you know what the T's kharrazian Think he's also a chiropractor by trade. But something I've paid a lot of attention to him about recently is that there's more about gluten sensitivity and neurology research coming out. And so only 1/3 of gluten sensitivity presents in a GI capacity. And most of it's like a brain capacity. And it's like well, which was started the situation. But in general, that sensitivity is causing potentially some mood stuff. So figuring out what that looks like. And also can you like calm down the brain from like, essentially these messengers in the body from kind of freaking out, that's what often is happening with sensitivity stuff is like, there's some messengers freaking out, they're like, this is not going right. I'm gonna have a problem. And so you need to quell that and calm it down. So just a few examples on how you can look at kind of any symptom or condition through that, try it and that can help you. Oh, so often we get in a state of overwhelm. I think once we were already starting overwhelm, and we just add more to the plate. We pile it up and we're like, No, I'm more overwhelmed. And instead of that, I'm like, How can We just like split this into sections and say, You can do a little bit of something in every section, but you might prioritize one over the others for a while.

I think that's a great triad trifecta, I think it's for someone who feels kind of paralysis by analysis, in their diagnosis can feel empowered, which I love. And they can, you know, I

think women can start to use for themselves. I like to oversimplify everything, because we just don't, there is a lot of pieces. But if you just put it under umbrellas, it's all like, under a few umbrellas overall. And then, like people say, like, I tried so much. And it's like, from like a toxic Bird said, but they're like, change my laundry soap. And I did this and I'm like, oh, cool, you did some environmental or essentially, the structural angle. Great. Now it's time to do the other two angles, you know, and that's fine. You did do a lot of things in that area. And that's fantastic. But I'm saying, there's a lot of opportunity. If it feels like you've exhausted options, I bet there's a lot of opportunity or options left. You don't have to do all of them all the time. If you failed forward and not had success yet. I just want you to know there's options if you're willing encounter them, which can feel like creating freedom. Yeah, like it's an option to have overwhelm or for you to say, I have options. I'm not stuck here where I am. You know, it's that's a nervous system shift as well. I love it. Where can people find you funny enough, my podcast is called the less stress life, which was an accident in 2017, I was actually looking for a synonym for inflammation. And then it's become a beautiful umbrella, so to speak at different times to talk about so I'm over at the less stress life and at Crystal bigler.com.

Love it. Thank you so much. I feel like I've learned so much. I've now no longer living at the top of my GI system but going to be in your brain. Yay, brain. And then my mouth is MIT. Yeah, so many opportunities. Yeah. Thank you so much. Thank you. If you enjoyed this episode, or even learned just one new piece of information to help you on your Hashimotos journey. Would you do me a huge favor, rate and review thyroid strong podcast on iTunes, Spotify or whatever platform you used to listen in to this podcast and share what you liked. maybe learn something new. And if you didn't like it, well shoot me a DM on Instagram Dr. Emily hybird. I read and respond to every single DM I truly believe all feedback is good feedback. Even the ugly comments if you're interested in joining the thyroid strong course a home workout program using kettlebells and weights where I teach you how to work out without the burnout. Go to Dr. Emily chi bird.com forward slash T s waitlist you'll get all the most up to date information on when the course launches and goes live special deals and early access bonuses for myself and my functional medicine doctor friends again Dr. Emily khyber.com forward slash T. S witless hope to see you on the inside ladies.