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How Stress Can Mess With Your Gut & 4 Things You Can Do About It

Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator
By Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator
Ali Miller R.D., L.D., CDE is a Registered Dietitian and Certified Diabetes Educator with a naturopathic background.
Image by Sergey Filimonov / Stocksy

In times of stress, many people experience muscle tension, racing thoughts, tightness in the chest, and some may deal with digestive shifts. (Think butterflies in your belly or nerves hitting your stomach.) The fact is, the brain and the gut communicate directly. Emotions and cognitive function affect the intestines and vice versa. Stress can wreak havoc on your stomach—and your gut health can affect stress levels.

Which came first, the stress or the gut issues? 

The connection between stress and the gut runs deep. High stress can trigger the immune system1 to send out signals to break down the gut lining and an imbalanced or damaged gut may drive a chronic stress response, perpetuating more gut damage.

This can be compounded if you already have leaky gut issues. When the gut barrier is compromised, it allows large compounds into the bloodstream (hence: leaky), creating an overactive inflammatory response. If your body is in a low-grade state of inflammation from leaky gut, it is essentially perceiving a constant threat. Your neurological system stays on edge with a survival response of adrenaline, which you may feel as distress or unease.

The health of your microbiome also matters. The gut produces over 90% of the body's serotonin, as well as GABA, a mellowing neurotransmitter, dopamine, norepinephrine, epinephrine, and acetylcholine. Based on the balance of gut bacteria2, the gut will either produce more "mellow" or more "stress" neurotransmitters.

How stress drives leaky gut.

To further understand the stress-gut relationship, let's look at two important markers that your doctor may test for: secretory IgA and lipopolysaccharide (LPS).

When these markers are elevated, it typically means you have an infection or a state of gut dysbiosis. The immune system is activated, and in the case of LPS, gut permeability3 is increased in an attempt to "deal" with this imbalance that the gut itself can't resolve.

However, IgA and LPS can also be elevated by a state of mental and emotional stress1. Studies have demonstrated social anxiousness alone can cause elevations in both secretory IgA and LPS, which means chronic stress causes gut permeability and mucosal membrane damage over time.

What's more, when the body is in a stressed state, it tends to burn through the glutamine at a more rapid rate. This amino acid is used to produce GABA, but it is also a fuel source and a building block for gut cells. This means the depletion of glutamine to fight stress further drives gut damage.

How to heal your stress-induced gut issues.

So where do you begin? When looking at ways to heal your gut and balance your stress, it's important to reduce inflammation in the diet, support gut health and repair leaky gut, provide rich sources of gut-supporting nutrients, and foster microbiome balance.


Remove inflammatory foods.

Begin with an anti-inflammatory diet that removes the most common allergens: corn, soy, gluten, dairy, and sugar. If after removing these for a period of time, you are still dealing with symptoms of digestive stress or inflammatory response, consider an elimination diet or advanced blood testing.


Integrate more stress-reducing habits into your life, such as a mantra practice.

Work with mantra and mind state. Focus on being present and releasing what "is not" what "should be" or what "might be." Even beginning with, "I am safe" or "I am" while practicing breath can send a signal to the vagus nerve to support gut health and microbiome balance.

Next time you realize you are stressed, pause and consider that maybe you can "handle" it but your body may be affected. Find ways to cut down on commitments to maintain a present state in your life and nourish your body to be more resilient to your daily stressors.

Exercising regularly, meditating, reducing caffeine and sugar intakes, and getting the right nutrients from diet or supplementation are also great ways to help promote a healthy stress response.*


Rest your gut.

When you are in a state of stress, your body functions in the fight-or-flight response rather than rest-and-digest. This can mean fewer digestive enzymes are produced, leaving the gut prone to damage. After an acute bout of stress like a big life change or major event, consider resting your gut by doing a one day reset of just bone broth with optional cooked protein added.


Incorporate more therapeutic foods.

Focus on healing your gut lining by adding therapeutic foods to support absorption of nutrients and reduce inflammatory reactions.

  • Bone broth: Sip on your broth in a mug, or use it as a cooking liquid, the base of a soup, or even an elixir; I love to blend bone broth with fresh lime, dried turmeric, salt, and cilantro.
  • Gelatin: This is a great summer option when bone broth becomes less appealing. Kids love it as gummies or in fruited flavors. I also add gelatin to many puddings or panna cotta desserts and use it as a thickener in stir-fries and sauces.
  • Collagen: Perhaps the most versatile of these options, collagen has the least flavor and least influence on texture. Collagen can be used in hot or cold beverages and can be added to any liquid with a quick stir. It is so easy to use, I often travel with single packs on the go to boost an unsweetened iced green tea or cold brew.
  • Fermented foods: Probiotic-rich food can support microbiome health and optimize neurotransmitter production; cultured vegetables, kombucha, kimchi, and sauerkraut are all great choices

The bottom line.

Many of us are overwhelmed or overextended and this chronic stress may be interfering with our gut health, our microbiome, and ultimately our mood. Taking the steps to interrupt these vicious cycles with food as medicine will support your digestive function while reducing inflammation and balancing neurotransmitter output.

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Ali Miller, R.D., L.D., CDE author page.
Ali Miller, R.D., L.D., CDE
Registered Dietitian & Certified Diabetes Educator

Ali Miller R.D., L.D., CDE is a Registered Dietitian with a naturopathic background and a contagious passion for using nutrients and food as the foundation of treatment protocols and programs. She received her bachelor's in nutrition and dietetics from Bastyr University. She is the author of the cookbook Naturally Nourished: Food-as-Medicine for Optimal Health, The Anti-Anxiety Diet, and The Anti-Anxiety Cookbook.

Her Food-As-Medicine philosophy is supported by up-to-date scientific research for a functional integrative approach to healing the body. Ali is a certified diabetes educator (CDE) and renowned expert in the ketogenic diet with over a decade of clinical results using a unique whole foods approach tailored to support thyroid, adrenal and hormonal balance.

Ali’s message has influenced millions through the medical community and media with television, print, and her award winning podcast, Naturally Nourished. Ali’s expertise can be accessed through her website: offering her blog, podcast, virtual learning, and access to her practice and supplement line Naturally Nourished.