Like many of my patients, 33-year-old Dawn didn’t initially make the connection between irritable bowel syndrome (IBS), depression, and overall gut health. While we discussed her digestive problems during our initial consultation, she casually mentioned her primary care physician wanted to wean her off selective serotonin reuptake inhibitors (SSRIs). These antidepressant medications change your brain chemistry but also wreak havoc on your gut and impair nutrient digestion.
Along with about 30 other neurotransmitters, your gut manufactures about 95 percent of serotonin, the feel-good neurotransmitter that SSRIs keep circulating. (Worth noting: SSRIs prolong the time serotonin stays stimulating the neurons. These drugs don’t actually make serotonin. They falsely elevate the serotonin that is already there, leading to greater depletions down the road.)
"Want to feel happier, get off SSRIs? You have to mind your gut," I told Dawn before explaining the often-overlooked gut-brain connection. It isn’t just depression that gut health affects but headaches, migraines, allergies, autoimmunity, weight gain, acne, skin rashes, yeast infections, hormonal imbalances, fatigue, immune challenges, and even the way you sense pain can be linked to your gut health. So as a medical doctor who specializes in gut health, when I say things start in your gut—I really mean it!
Your gut comes in continuous contact with important nutrients your body needs, but also toxins, food additives, microbes, and drugs that regularly pass through your digestive tract. Your gut has a huge task to not only serve as a porous filter for the building blocks of life but also to keep out all the detrimental substances you may be exposed to. Beyond being a gatekeeper, your gut digests food and absorbs nutrients, maintains an immune barrier, and helps you detoxify, all while maintaining the correct balance of healthy flora or probiotic (from the Greek pro = "for"; biota = "life") bacteria.
The biggest threats to your gut health:
Those are lofty jobs, and ,unfortunately, things like diet and lifestyle factors can impede your gut from functioning optimally. Among the culprits that sabotage gut health, these are the five big offenders:
If you want to get to the root causes of what goes on inside your gut, look at what you’re putting at the end of your fork. If you consume a milkshake, hamburger, and French fries, you turn on genes that promote inflammation in your gut and your body. On the other hand, if you eat 2 cups of steamed broccoli, you will turn on anticancer and anti-inflammatory gene pathways. The foods you eat control your state of health, and the gut is the gateway to the rest of the body. Identifying and eliminating foods that rob your body of energy becomes a central focus in my program. Gluten, eggs, dairy, soy, most legumes, corn, and sugar (and, for some of you, nightshades) are inflammatory and make you and your gut sick. When my patients eliminate these problem foods for at least 28 days, they feel better, lose weight, and heal their gut.
The stress response can alter the natural balance of healthy bacteria in your gut, causing the gut ecology to shift in favor of a more hostile group of bacteria. When patients with gut issues visit me, I ask what they do to relieve and manage their stress, and often they say, "nothing." Many people are majorly lacking in the self-care department. They believe they don’t have the time or that stress management is a luxury, but incorporating meditation and a few yoga stretches as part of a daily routine can take as little as 10 minutes. Those few minutes will pay off with big rewards for your gut and general sense of well-being.
Bad sleep creates a vicious cycle that damages your gut. Insufficient or poor-quality sleep also makes you crave something sweet or starchy because your body is tired and demands quick energy to keep it going. By the next morning, your digestive system is out of sync, and eating can actually make you feel sick to your stomach. With a few exceptions like shift workers and new moms, the choice to have regular sleep times is yours. Regular sleep patterns and at least seven hours of uninterrupted nightly sleep are crucial for gut and overall health.
Antibiotics are simply overprescribed. Most of the time, rest and immune support are enough to resolve infections for which doctors often prescribe antibiotics. Antibiotic overuse is leading to more antibiotic-resistant bugs that are difficult to treat and can claim lives. Each time you take antibiotics, you also alter your gut flora. If you don’t eat the right foods, including cultured or fermented foods, you’ll inevitably suffer from dysbiosis—an imbalance between favorable and unfavorable microorganisms in the gut.
Everything from the air you breathe to the food and water you consume to the pharmaceutical drugs you use create toxicity in the body. Preservatives, pesticides, and environmental toxins are among the culprits that can damage your gut lining, creating leaky gut and other issues.
Between antibiotics, eating the wrong foods, getting bad sleep, stressing out, and exposing yourself to toxins, you can begin to understand how dysbiosis or gut imbalances occur, creating chronic inflammation and leading to problems like leaky gut.
And when you get leaky gut, food and other particles slip through the gut lining into your bloodstream. Your immune system does not recognize these, so it attacks, leading to food sensitivities and more inflammation. You might not even be aware of these sensitivities that take months or years to develop and can manifest as hives, allergies, chronic sinus inflammation, and migraines. They often become triggers for autoimmune disease or, for patients like Dawn, depression. This is why maintaining good gut health becomes crucial, and why havoc occurs throughout your body when your gut goes bad.
Health tips for better digestion and optimal gut health:
While I take an individualized approach to digestion and optimizing gut health based on each patient’s conditions, medical history, preferences, and other factors, I’ve found these seven principles make a solid foundation for almost everyone. I talk about them in more detail in my free Quick Start Guide to a Happy Gut:
1. Eat a gut-supporting diet.
Focus on clean ingredients with foods that are easy to digest, low in fructose and other sugars, and devoid of substances hard on your gut like gluten, dairy, soy, and corn. I emphasize foods that are organic, pesticide-free, non-genetically modified (GMO), full of healthy fats, locally grown, and sustainably farmed. Those include healthy fats, nuts and seeds, high-fiber and low-glycemic carbs, nonstarchy veggies, and clean proteins like wild-caught cold-water fish.
If you want more specific instructions, when you fill your plate with food, imagine that it's divided into quarters. Fill one-quarter of your plate with protein and healthy, omega-3-rich fats (like wild-caught fatty fish, grass-fed meats, humanely raised and antibiotic-free chicken, and avocado), and fill the other three-quarters with raw, baked, or steamed greens and veggies. This simple rule will ensure that you get the right balance of proteins, fats, and carbs without the stress of having to weigh your food or count calories. Now you can simply enjoy the act of eating.
2. Focus on fiber.
Dietary fiber comes in two "flavors," and they each play a different role in gut health. Soluble fiber attracts water and forms a gel-like substance during digestion, helping you feel full longer and slowing the rate at which sugar from food enters your bloodstream. Soluble fiber also doubles as a prebiotic to feed your good gut flora (more on that in a minute). Good soluble fiber sources include apples, beans, blueberries, and freshly ground flaxseed. Insoluble fiber, on the other hand, is found in vegetables and whole grains and provides bulk to your stool and prevents constipation. Because it doesn’t dissolve in water, insoluble fiber passes through your gut relatively intact, promoting the passage of food and waste. Most foods contain a blend of soluble and insoluble fiber. If you also supplement, look for a powder that contains a blend of soluble and insoluble fibers that mimic what you get in food.
3. Support the good guys.
The trillions of bacteria in your gut play many roles including encouraging proper intestinal permeability (keeping things within your gut that shouldn’t slip out) and keeping out unfavorable bacteria, yeast, and parasites. You’ll always have some bad guys, but you want to keep your gut predominantly filled with good bacteria. To do that, eat plenty of fermented food like unpasteurized sauerkraut, kimchi, and no-sugar-added coconut yogurt. You might also want to supplement with a professional-quality probiotic. Look for dairy-free probiotics that contain at least 15 billion CFUs each of Lactobacillus and Bifidobacterium (a total of 30 billion CFUs) guaranteed by the manufacturer through the expiration date. Take on an empty stomach once or twice a day for at least three months, and keep probiotics refrigerated after opening to maintain their freshness and potency. If you have a leaky gut or inflammatory bowel disease (such as Crohn’s or ulcerative colitis), you may need to take up to a total of 200 billion CFUs daily. For those and other conditions that require very high-dose probiotics, I recommend working with a gut-health specialist.
4. Feed your gut flora.
Your probiotic flora feed on nondigestible fibers called prebiotics that promote the growth of beneficial flora. The best way to get your prebiotics is to eat them. Incorporate more prebiotic-rich foods like raw chicory root, raw Jerusalem artichoke, and blanched dandelion greens. You may also take a prebiotics supplement, but so slowly. Going too fast increasing prebiotic foods or supplements can make you gassy.
5. Dial down inflammation.
Chronic inflammation contributes to nearly every disease imaginable, and it doesn’t do your gut any favors. Studies connect inflammation with everything from leaky gut to weight gain. Those are among the many reasons to add cold-water fish and other omega-3-rich foods to your diet. The two primary omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are important anti-inflammatory promoters in the body often deficient in the American diet. Along with these foods, take one to four 1,000-milligram softgels daily with meals to enhance their absorption.
6. Consider digestive enzymes.
If you struggle with post-meal gas, bloating, and other problems, your body might not be making sufficient digestive enzymes. Gut imbalances, stress, and age are among the factors that inhibit the digestive process. For many patients, supplements that replenish digestive enzymes can reduce or eliminate those problems, especially while you’re healing your gut.
7. Be mindful when you eat.
How you eat is just as important as what you eat. Your eating philosophy not only factors into your food choices but also into how your body digests and assimilates foods. Slow down when you eat, really taste your food, chew thoroughly, breathe deeply, and be present with your company. Many people have a no-technology rule during family meals. A good rule of thumb is if you need to have a drink to help you swallow your food, you’re probably eating too fast, swallowing air, and not chewing enough.