Realfoodology - Bloating, Gas + Better Digestive Health | Dr. Mary Pardee

Episode Date: September 7, 2023

162: Join us as we uncover the truth about common stomach issues such as bloating, IBS, and constipation with Dr. Mary Pardee, a functional medicine practitioner and naturopathic medical doctor. Discover the viral TikTok trend of hot girls with IBS, its possible contributing factors, and how to identify the right type of doctor when dealing with such issues. Topics Discussed: 0:07:34 - IBS and Eating Disorders Factors 0:14:34 - Visceral Hypersensitivity and FODMAPs in IBS 0:25:21 - Understanding and Treating Bloating 0:36:17 - Overtraining Syndrome, Hormonal Imbalance, and Bloating 0:43:36 - Gas, Microbiome, and Constipation 0:50:30 - Understanding and Treating Constipation 0:53:08 - Time, Miscommunication in Medical Diagnoses 0:59:41 - Find a Specialist for Gastrointestinal Health Check Out Mary: Instagram Modrn Med Sponsored By: Ancestral Nutrition (Organ Capsules) www.ancestralnutrition.us 15% off using the code REALFOODOLOGY Cured Nutrition www.curednutrition.com/realfoodology REALFOODOLOGY gets you 20% off BiOptimizers: Magnesium Breakthrough www.magbreakthrough.com/realfoodology Code REALFOODOLOGY gets you 10% off any order. Organifi www.organifi.com/realfoodology Code REALFOODOLOGY gets you 20% Off Better Help Get 10% off Your First Month of Therapy by visiting: www.betterhelp.com/realfoodology Check Out Courtney: Courtney's Instagram: @realfoodology www.realfoodology.com My Immune Supplement by 2x4 Air Dr Air Purifier AquaTru Water Filter EWG Tap Water Database

On today's episode of The Real Foodology Podcast. When we talk about causes of bloating, there's so many. And so you have to get a diagnosis of what your cause is. And that requires testing. So if you come into our practice, we are going to run full blood work, maybe a stool test, depending on what your symptoms are. So it's really important to figure out what is the cause of your bloating and then go from there because the treatment is going to be very dependent on the actual cause. Hi friends, welcome back. You're listening to the Real Foodology Podcast and I'm your host, Courtney Swan. Today's episode is a fun one because we're talking all about poop and bloating and all sorts of stomach issues,

constipation, you name it. Let's go. Why do all the hot girls have IBS these days? If you guys have seen the trend on TikTok, there's this trend of girls claiming that all hot girls have IBS or all hot girls have stomach issues. So we dive into that. We talk about what is maybe contributing to all of these issues with our stomachs. We talk about gas, bloating,

what kind of testing you should be doing, and also what kind of doctor to look for. And I brought on the perfect doctor for this conversation. Her name is Dr. Mary Pardee. She's actually a good friend of mine, and she's a functional medicine practitioner and a naturopathic medical doctor who specializes in fecal microbiota transplantation. Try saying that three times. Otherwise known as FMT. She also specializes in integrative gastroenterology, gut brain health, men's hormones, and thyroid optimization. And she just also happens to be a really awesome human who's a really good friend of mine and one of my hiking buddies here in LA. So I really enjoyed the

conversation. We got really into the details of the stuff. So let's get into the episode. Also, as always, if you guys are loving the podcast, if you could just take a moment to rate and review it, it not only means so much to me, but it really helps the show. So I really appreciate your support. Love you guys. With rising rates of infertility, hormonal imbalance, nutritional deficiencies, also the alarming rise of chronic disease in this country has caused a lot of people to stop and really start to question what we're eating. More and more people seem to be noticing that our ancestors ate quite differently to us. Their diet was more nose to tail and eating organs wasn't abnormal. In fact, for many of our ancestors, the organ meats were the prized possession

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is a mineral that plays a crucial role in the production of thyroid hormones. It also has antioxidant properties, which can protect the thyroid gland from damage. I talk about this often, thanks to a failing food system and declining soil health. Our food does not have the vitamins and minerals that it once did.

They are in much lower levels now. And so it is more important than ever that we look for higher sources of these imperative crucial vitamins and minerals. that it once did. They are in much lower levels now. And so it is more important than ever that we look for higher sources of these imperative crucial vitamins and minerals. And supplementing with organ meats is one of the best ways to do that. I love this brand, Ancestral Nutrition, and they actually gave me a code to share with you guys. So if you guys go to ancestralnutrition.us and you use code REALFOOD realfoodology, you're going to get 15% off all of their organ complexes. They have a women's one. They also have just a grass-fed beef liver

supplement. They also have one that is grass-fed beef organs that has all the organs mixed in there. So again, you guys are going to get 15% off with code realfoodology when you go to ancestrallnutrition.us. And of course, these are really good, high quality grass fed beef organs. It is so incredibly imperative that when you consume organ meats or these complexes, they come from a really good, high quality source. Sleep is absolutely imperative to our overall health. It controls hunger and weight loss hormones. It boosts energy levels. It's also the key to our body's rejuvenation and repair process, and it impacts countless other vital functions. So a good night's sleep will improve your well-being more than anything else. I would say for my health journey, sleep has really been my

main focus the last couple of years more than anything else. And one of the ways that I started doing that was taking magnesium breakthrough from Bioptimizers. It contains all seven forms of magnesium. A lot of people are deficient in magnesium and magnesium really helps to calm down the nervous system, get your body ready for bed. I recently had the founder of Bioptimizers on my podcast actually, and we did an entire sleep hygiene episode. So if you want to go back and listen to that, we talk very extensively into why sleep is so important, how to get better sleep, what supplements really help. And one of the things that we talked about was magnesium breakthrough. And I can tell you guys, I've been taking this for

about a year now. I travel with it and it helps so much. I wear an Oura ring at night to track my sleep and I've seen my REM and my deep sleep go up. So this magnesium breakthrough is a total game changer. If you guys want to get Bioptimizer's magnesium breakthrough today, make sure that you go to magbreakthrough.com slash realfoodology. That's M-A-G breakthrough.com slash realfoodology and intercode realfoodology and you're going to get 10% off. Mary, I'm so excited to have you on the podcast today. I'm so excited to be here. Thank you for having me. We've chatted a lot, but not professionally, I guess. I know. This is fun. So I wanted this to be kind of an all-comprehensive

podcast, just helping people when it comes to stomach issues, because this seems to be a huge problem that a lot of people are dealing with right now, like gas and bloating, IBS, constipation, all this stuff. So, okay. First and foremost, I want to dive into IBS because I know... So you and I have talked about this before. There's this trend on TikTok where everyone says, hot girls have IBS. And I want to know one, why you think this is trending right now? Like, why are so many people having IBS and what is IBS? Yeah. Yeah. It's interesting trend. Very interesting. But I mean, the reason it's trending likely is because it's really common. So I think people are just starting to talk about it. So women especially are twice as likely to

have IBS compared to men. So it's much more common in females than males. So I think that's a big thing. We don't really know. It could be a hormonal component. Also, like one of the predisposing factors for irritable bowel syndrome is a neurotic personality type or people that worry more frequently. And I think that we see that more often in females. And that's just me going

based off of clinical experience. It doesn't mean that men don't worry. Of course, a lot of them do whether they talk about it or not is a little bit different. But also in general, people that are more likely to come to the doctor are also females. So there's a few different factors there. I wonder too, if there, I could be totally wrong, but I think there tends to be more women that struggle with eating disorders than men. And I think that's probably a part of it too, like under eating and binge eating, and that probably plays a role as well. Yeah. So if you have a past history of an eating disorder, whether it's anorexia, bulimia, disordered eating, body dysmorphia, you have a much higher likelihood of having a functional

bowel disorder, including IBS, but also functional bloating, dyspepsia, things like that. Very, very common. Yeah. So when I was in school, we learned that IBS is more of like a blanket term. If you get that diagnosis, I was told at least that it's kind of your doctor being like, okay, we're acknowledging you have stomach issues. We don't really know what's up. So what is that? And also if someone was diagnosed with IBS, well, one, maybe what are some of the common things that you think that it could be?

And maybe how would someone go about getting any sort of treatment for that? Yeah. And I've heard this a lot too. And I actually have been told that by mentors and people in the past as well. It's not entirely true. So the idea that IBS is a diagnosis of exclusion, meaning like we don't know what it is or an idiopathic condition isn't actually that true. So when we actually look at what it requires to diagnose IBS, there's really specific criteria that people have to meet. And that's why I think likely it's overdiagnosed or it's a misdiagnosis where they actually don't have IBS, they have functional bloating disorder, or they have something else.

So the things that you need to make sure are there, the number one thing is recurrent abdominal pain. And so you have to have pain, abdominal pain, at least once a week to be able to be diagnosed with IBS. And this has to have been going on for the last three months with onset of symptoms six months ago. So this can't be like I have abdominal pain for the last three weeks. That would not qualify as irritable bowel syndrome. It has to be a chronic condition that's there. But you also have to have two or more of the following, which is going to be, it's related to defecation, meaning that having a bowel movement either makes symptoms worse or better, or you have symptoms around having that bowel

movement, or it's associated with the changes in either frequency or the consistency of the stool. So meaning that you're having really hard stools, which is IBSC, constipation predominant, or really soft stools, or you're not going very much at all, or you're going a lot. So it's a pretty clear diagnosis when you look at those criteria as to what qualifies for IBS and what doesn't qualify. So I often see people that are coming to me and they're like, yep, I was diagnosed with IBS. And when I really look at those, they're not, they're diagnosed, the diagnosis should be chronic constipation, or it should be functional bloating disorder. So it's really important to know your actual diagnosis.

And some people will say, why? It's just a label. Like I want to know the root cause. And of course, we're going to dive deeper into that, but there's almost, there's so much literature and medical research around conditions that you want to have the benefit of knowing what you're dealing with, because then you can go in and look at all those studies and see what's going to be best for you. And so there's a lot of different causes when it comes to how did IBS develop? I think that was your question is it's like, I just don't have this thing. Why is it going on? That's what people really want to understand. And I follow the biopsychosocial model of IBS, which is pretty well understood at this point

in terms of it includes components that are biological or physiological, like things that are actually going on in your body, but it also includes components that are psychosocial. So things that have to do with your mood or stress or your social support, your community. And so we know that IBS is comprised of these different buckets. And so when we look at, you know, what are the main causes, part of it's genetic. So we see that people that have a family history of IBS are more likely to have it themselves. And I really question that one too. I think that there's likely environmental components, whether it's actually genetic meaning from your genes or due to the fact that you were raised in a household that was stressful and mom had IBS because she was stressed, right? Those are two different

things there. And you're also eating the same foods. So that could also be a factor. Exactly. Like there's so many components to that layer. And like I said, there's that personality type, the neurotic personality type, people that worry, you know, you're more likely to have a parent that worried, right? But that is also a component that increases your risk of developing IBS. And then there's things like having ineffective coping strategies that I know predisposes somebody to IBS. And that's a really important one because we want

to talk about, you know, what do you do when you're stressed? People with IBS will feel stress in the gut. So symptoms will likely get worse when they're stressed. And so we want to have alternative coping strategies for those people, especially. And then we have the physiological or biological components, which is changes in motility, which is the movement of the GI tract. And then one of the most important ones that I talk about with all my patients is something called visceral hypersensitive in people with irritable bowel syndrome. So the sensations that they're feeling in the gut shouldn't be as magnified as they are in the brain. So an example of that would be if I exert so much pressure on somebody's intestines, say they have like this much gas in the intestines. For somebody with IBS, they would feel like there was, you know, four times the amount

of gas in the intestines and they would send pain signals to the brain. The brain would say, we're uncomfortable, we're uncomfortable, we're uncomfortable. Whereas if you look at somebody without IBS, they could have the same amount of gas in the intestines and not view it as uncomfortable. And there's been a lot of research studies done on this where they're actually infusing amounts of gas into the intestines of people with IBS and people without IBS. And the people with IBS are much more uncomfortable than the people without IBS. And that's this visceral hypersensitivity phenomenon that happens. And that's an area that you can actually target and treat, which is really empowering.

That's so fascinating. I've never heard of that before. Wow. It's really fascinating. And it's so important to understand because a lot of the times people get frustrated and rightfully so that they're not feeling better. Why am I still feeling like I'm bloated or gassy? And understanding that you actually might not be bloated. There might not actually be you actually might not be bloated. Like there might not actually be an excess of gas in the intestines. It may be that those nerve endings are on fire and we need to calm down the central

nervous system and reestablish a healthy connection between the gut and the brain. And so when I work with patients, like that is one of our biggest things is to reestablish a healthy connection with the gut and the brain. And there's several ways that we can do that. But without identifying that, people go down the route of, is it this food? Is it this food? Is it, you know, did I do this? Or it's because I, you know, you name it, I've heard it in terms of what people will try to associate with one thing or the other. But we really know that there isn't even a huge dietary component to IBS with one exception, which is FODMAPs and food. But there's been a lot of studies trying to figure out, is it foods that are causing this? And what we know is really the

visceral hypersensitivity is a very real thing. And if we can heal that connection between the gut and the brain, we get better outcomes with IBS patients. The FODMAP foods, which are fermentable, oligo, mono, polyols, those can increase symptoms in people with IBS, but I usually don't start there, especially with people with a history of eating disorder or restrictive eating, because taking out more foods from somebody's diet who is already over-restricting is not a healthy choice. Yeah. And mentally, it's just going to be even harder on them. So for people that have never heard of FODMAP or like a low FODMAP diet, can you explain that? Yeah, sure. So a low FODMAP diet basically takes out high FODMAP foods. And FODMAPs are not

intuitive. So I tell people, you can't learn this. You're really going by... I have people download like the Monash app, which is Monash University is one of the leading institutions for researching IBS and FODMAPs. But that way, if you download that app, then you can just go based on exactly what it says. Is it high FODMAP? Is it low FODMAP? An example of some high FODMAP foods are going to be things like avocado, garlic, onions. And sometimes it's amount dependent. So you can have, you know, let's say a cup of a food, but not two cups of a food. And so you want to look at those specifics because there's no way to learn it. Like me having studied it for so many years, I still would use the app myself if I wanted to do something like that. But these are things

that are fermentable in the intestines. So fermentation is normal process in our intestines. We have our gut microbiome. One of its biggest assets to us is the fermentation of fibers that we ourselves can't digest. And so these little bugs go in after, you know, the pancreas has secreted its digestive enzymes and it goes into the small intestines and it is starting to break down those residual fibers that we can't break down ourselves. And in order to do that, it uses different products, but the result of that is going to be digested fiber and its products, but it's also going to be gas. And that's totally normal. Our bacteria will produce things like carbon dioxide, hydrogen, methane, hydrogen sulfide, and other gases. And those gases have to go somewhere. And some of them are absorbed back over the intestinal wall. And we actually will expire

them in our breath if it's carbon dioxide. But some of them will hang out there. And so if we have an increase in the gas production that happens, of them will hang out there. And so if we have an increase in the gas production that happens, it can cause some bloating. And people with IBS are more sensitive to that bloating because we talked about the visceral hypersensitivity. And so sometimes doing a low FODMAP diet can be really helpful with people with IBS. I do not recommend a low FODMAP diet long term. So I would put somebody on it for a few weeks and then we would start to reintroduce the foods because it's very likely that you're not sensitive to all the FODMAPs, but it may just be one or two. And so you want to identify those so you can have the

most diverse diet possible and also have your symptoms under control. Okay. Yeah, that's awesome. That was a great description of that. Okay. I want to talk about this because I'm actually really shocked to hear this. So IBS is generally not really food related. There's not a huge food component except when it comes to FODMAP. So FODMAP is like, yeah, we have good research there. We know that a big percentage of people will benefit from a low FODMAP diet and they should do it with a dietician or somebody knows how to eliminate and then reintroduce. So many people come to me and they've been like, I've been strict low FODMAP for five years. And I'm like, no, because we also have good research that being on a strict low FODMAP diet can reduce the diversity of your gut

microbiome, which we don't want. We want a diverse gut microbiome, tons of different bugs that are there for other health effects too. But otherwise there's not a huge correlation with foods and IBS and some slash all of my patients will hear this. And usually the first response is like, I can, I can even like see them in their mind. They're like, Dr. Mary doesn't know anything. Like I'm leaving this office kind of thing. And then i go through the research with them and i really explain the bio so biopsychosocial model and how ibs actually develops and we go through how stress induces ibs and there's a stress cycle with ibs that most people get into and once people start to hear it and say like oh okay, okay, that actually makes

sense. Then when we get the buy-in, that's when people usually start to feel better too. And then I'll always ask people like, you've done everything with your diet. You've taken out gluten, you've taken out dairy, you've done this and that, and you're still in my office. So something's not working. Right. And they'll say, but I always have more symptoms after eating, explain that. And then I'll say, but I always have more symptoms after eating. Explain that. And then I'll say, great, let's talk about it. And that's because of something called the gastrocolonic reflex. So the gastrocolonic reflex is something that happens inside your body. When there's food in the stomach, it triggers the colon to move. And so if people that have IBSD are more

likely to have diarrhea after eating, it's because of the gastrocolonic reflex. It's not because of the food that you put in the stomach. It's because there was anything in the stomach that triggered that reflex to happen. So the associations with having symptoms around food is really due to that and not due to the fact that you put the wrong food in there. So I'm always trying to empower people. You're not going to choose the right food because you have this going on. We have to target this more from the other factors that we know for sure are contributing to your IBS. And that's really when we see people improve. Wow. That's fascinating. I'm sure too, that there's also an anxiety component there when people have decided that they have all

these different foods that they have to avoid. If maybe like have a bite of it and they're super anxious about it then they're going to have like even more of a flare-up probably so i don't know right there's that connection with the vagus nerve with the gut and the brain so i'm sure that plays a big role too yeah yeah so if some people have put in their list of foods that i don't eat things that you know exacerbate their ibs and it's not FODMAPs, then I'm really challenging. But I'm telling them you actually may have symptoms from this food because you're scared of it because you've told yourself that this is not something that you should eat. And so if that is increasing stress in the body, just like we can get worsening IBS symptoms

when we travel because it's stressful or when we have an exam to take. But if we have a food that we are going to eat that we've told ourselves is bad for us, it can cause the same effects, but it's not because the food is bad. It's because we've told ourselves the food is bad. So it's a really good point. Yeah, it's so interesting. So do you think we're seeing more incidences of it now or do you think we're seeing more incidences of it now? Or do you think we're finally just starting to diagnose it? I think likely is the fact that people are talking about it more. And I think stress is probably continuing to rise. So I think there's probably two components to it.

But I think both of those are valid. Yeah, for sure. I mean, I have to think that some of this has to do with the fact that, I mean, we're living more stressful lives. We're not spending a ton of time outside, probably like pollutants in the air, just like overall our bodies are inflamed and not working as well as they should. So I would assume that some of just like the modern factors of living are probably having an effect on that as well. Yeah. And there's things that we don't know, of course. And those are the things that we just don't know. And so we do believe now that

inflammation may be a piece of IBS. And so that wasn't always thought to be the case. But now research has kind of shown that there may be certain inflammatory markers that are elevated. They're not your typical ones though. So if you run a CRP and a SED rate on a patient, as well as calprotectin, which are all inflammatory markers, if somebody has IBS, those won't be elevated, but in somebody with ulcerative colitis or Crohn's disease, they will be elevated. So it's a much lower level of inflammation that we're only really seeing in the research setting when they're looking at things in a much finer lens and have other markers that they can

actually look at. So that's a possibility that's there too. And when we keep researching, we'll keep learning and we'll have that. But when I tell people, I'm like, we have to go with what we know right now, because the guessing actually can make symptoms worse because it's increasing the unknown. And it's making us go on this like search of like, well, what if it's this and what if it's that? And we've proven that if we have that mentality with IBS, it increases stress and that's going to increase your symptoms, not reduce your symptoms. So it's very unlikely that you're going to be the one to like figure out this like one thing with IBS that nobody else has when there's researchers working on this day in and day out. Not to disempower by

any means, but to say like you can get great results in the research that we do have in terms of feeling better. Awesome. So I want to talk about like testing options and stuff, but let's maybe first of all, talk about a couple different of maybe the most common stomach issues that you see. And then we can talk about that after you mentioned Crohn's. Yeah. What are some other of the stomach issues that you're seeing? Yeah. So after IBS, probably the most common ones that we see are constipation and bloating. So we can start with either of those, but those are definitely going to be like the biggest ones that are coming into the office. Yeah. Let's talk about bloating. Because actually that's another one that I've been seeing so many trends on TikTok and reels of people. I want to put this lightly and be

sensitive to it, but like I've tried to normalize bloating and just saying, oh, it's totally normal. I bloat up to be nine months pregnant after every meal. And they're like, just trying to normalize it. And it really frustrates me because I want to tell all these people like, look, it's totally fine that that's happening to you right now. It doesn't mean anything's like bad or wrong with you, but it doesn't mean your body's trying to tell you something. Like it's not just like normal to be bloating up like that every day. Yeah. Yeah. So let's start there then. Like what is normal and what's abnormal? So there is a level of normal bloating. Let's say, let's first talk about like, what is bloating too? Because this is not the same for everybody. So what I consider bloating, let's say, let's first talk about like, what is bloating too? Because this is not the same for everybody. So what I consider bloating is from a gastrointestinal standpoint.

So we're talking about gas in the intestines or a feeling of distension, which would mean that the abdominal girth is actually larger. So you're seeing an outpouching of the stomach. And that's different from edema or water retention, and it's different from fat accumulation. So sometimes people will call bloating all of those things. And really, we just want to focus on the gastrointestinal piece today. Um, cause there's very many, I mean, fat is fat accumulation and water retention is a totally different mechanism. So with bloating that's in the intestines, there's a normal amount

that does happen after you eat. And this is because if you consume, you know, one cup of food, let's say, that cup has to go somewhere. And so you will, you know, quote unquote, bloat a cup worth plus more because of the fermentation process that will happen. So you have to displace the volume of the food plus a little bit more because you are fermentation process that will happen. So you have to displace the volume of the food plus a little bit more because you are going to produce things like carbon dioxide, hydrogen, hydrogen sulfide from the normal digestion of the food, as well as the fermentation from the bacteria. We have a couple areas there and that's normal. So what that would feel like is, okay, I ate breakfast and I feel

just like a little fuller. My stomach pushes out a little bit more and then it gets better after an hour and I feel fine. Then lunch, same thing happens. And then maybe I overeat dinner and I like stuff myself and you're going to feel really descended and not that great. But again, it'll get better in an hour or two. What's abnormal on the other hand is when bloating gets worse and worse and worse as the day goes on. So you wake up with a flat stomach, then you eat breakfast and you feel bloated. It doesn't go down. You eat lunch, you feel even more bloated, doesn't go down. You eat dinner. And then finally before bed, you feel like you need to unbutton your pants. You feel nine months pregnant. It's like tender, like you just feel like, oh, and that's abnormal.

So that's like really the type of bloating that we want to look into. And usually the key question is, is it affecting your quality of life? So if the answer is no, then we may not treat it. And it really just depends on the person, of course. But usually in the second scenario, the answer is going to be yes. Like I don't go out with friends. I feel like I can't eat anything. I skip meals. You know, I've restricted my diet to figure out what food it is, this and that and the other. So that's really the one that we want to focus on. So when we talk about causes of bloating, there's so many. And so you have to get a diagnosis of what your cause is.

And that requires testing. So if you come into our practice, we are going to run full blood work, maybe a stool test, depending on what your symptoms are. And that's because the causes are going to be pretty diverse. So small intestinal bacterial overgrowth is a huge cause of bloating. And that's an overgrowth of normal bacteria in the small intestines. And it's because of what we talked about earlier. Those bacteria produce gas, hydrogen, hydrogen sulfide, methane. And if there's more bacteria, they're going to produce more gas and you're going to feel bloated. So we're always looking to rule out

SIBO or intestinal methanogen overgrowth. We'll also do pancreatic markers for people because chronic pancreatitis can cause low-grade bloating as well. And then we'll look for malabsorption. So one cause for bloating is lactose intolerance. So taking dairy out of the diet may be a trial that we do. And if that resolves symptoms, then you have your answer, but super common. We're ruling out celiac disease, which is a condition that can cause bloating as well. And that's reaction to gluten. We're looking at thyroid numbers. So if you have low thyroid function, hypothyroidism, that can result in bloating. And we're also

looking at inflammatory markers. We want to make sure we're not missing Crohn's or colitis, which can cause both bloating, but usually will cause diarrhea, but not all of the times. We want to make sure we know the answer. If you come back and everything is normal, it's not that it's in your head. It's that you have something called functional bloating. So functional bloating is one of the functional GI issues. And we want to go in and treat it a little bit differently, but there's still treatment options for functional bloating. And so that's where it's really important to figure out like what is the cause of your bloating and then go from there because the treatment is

going to be very dependent on the actual cause. Do you struggle with anxiety like I do? I have been pretty open about my journey and my struggles with anxiety throughout the years. And therapy is one of the things that has really helped me out a lot. EMDR therapy specifically has helped me through a lot of my traumas that I went through. But another thing that has really helped me throughout the years with my anxiety journey, if you will, is CBD. I really like Cured Nutrition's CBD. I love that you can go to their website and you can actually see their third-party testing that they do from their lab. So you can actually go to the website, see how much CBD is in all of their products and they update it all the time. You can hear more about this in depth in my episode that I had with the founder of Cured Nutrition. And my favorite ones, I would say,

I really like the CBN night caps. And then I also like the Zen CBD caps as well. They also have a calm oil, which is really great and a topical. So if you're dealing with any sort of injuries or maybe muscle soreness, they have a topical that you can put on. They also came out more recently with some Serenity gummies, which is like low THC relaxation gummies, which are really great. And if you follow me on Instagram, you know that my dog Turkey loves their CBD dog treats. He like freaks out every single time I open the pantry, he follows me in, he immediately goes for the bag and he starts begging for them. And they're great. They're really high quality ingredients, all organic, have really high quality CBD. My boyfriend just got a golden retriever puppy more recently, and we have been giving the dog treats to both of our dogs when we go for road

trips. And it's been really helpful. And the dogs love them. They taste really great. So if you want to try any of the products that I talked about today or anything on the Cured Nutrition website, make sure that you go to curednutrition.com slash realfoodology. That's C-U-R-E-D nutrition.com slash realfoodology. And you can also use code realfoodology and it's going to save you 20%. I want to take a second to talk about some of my favorite Organifi products and why I love them. When I first started getting into health, I was an avid juicer. I was buying fresh veggies every couple days and wearing out my juicer and also wearing out myself by trying to constantly juice vegetable juices because I wanted to flood my body with all of the nutrients, the phytonutrients that you get from green juices. But after a while, I was like, I cannot

keep doing this every day and also maintain my job, maintain my social life and everything else. But I really wanted to make sure that I had a good high quality green juice that was organic. And I knew that I could trust came from a good source. So when I discovered Organifi, I was so happy. They not only have a green juice, but they also have a red juice. And I really like to mix them together because it really helps with the flavor profile. And you're not only have a green juice, but they also have a red juice. And I really like to mix them together because it really helps with the flavor profile. And you're not only getting all of the green phytonutrients from the green juice, but you're also getting all the antioxidants from the red juice. So it's like a win-win situation.

I also really love their chocolate gold. It's their low sugar hot chocolate mix. And it's loaded with ingredients like lemon balm, turkey tail, magnesium chloride, and reishi. Oh, there's also turmeric in there as well. So it really helps to calm down your nervous system before bed. And it really makes me sleepy. It also helps the digestion because you have the turmeric in there, you have cinnamon, you have ginger, black pepper. So it's helping with digestion and inflammation. I'm a really big fan of this. You can also put it in your coffee in the morning and it kind of helps to balance out the jitters that you might get from your morning coffee. And then another product that I'm really

loving and taking every single day is their liver reset. Modern living is incredibly taxing on our liver. Like just existing is hard on our liver because we are constantly being inundated with pesticides, heavy metals, environmental toxins, not to mention if we drink alcohol, that's also going to put a strain on our liver. So I think it's incredibly important that we take something every single day to support our liver health. This product has triphala in it. It also has dandelion, milk thistle, and artichoke extract, which all have been scientifically backed and proven to provide protection for the liver. And then of course, the most important part about Organifi products is that they are all organic and they go a step further by guaranteeing that they are glyphosate residue free. Glyphosate is a known herbicide that is sprayed on a lot of

our crops these days. It's also sneaking into organic foods and it is a known carcinogen. So it's incredibly important to make sure that we limit our exposure as much as possible to glyphosate. If you guys want to try any of the Organifi products and get 20% off, go to Organifi.com slash Real Foodology. You're going to see all of my favorite products in that store. And you're also going to get 20% off. That's O-R-G-A-N-I-F-I.com slash Real Foodology. Yeah, it's really interesting. I just want to share my personal journey with bloating because I think some women can relate to this. I went through a phase where I was bloating a ton and it was because I was working out too much and I was creating a ton of cortisol and I was super stressed out. My body was really, really stressed out. And it was so interesting because at the time

I thought I was doing really well for myself. I was like, I'm going. And it was so interesting because at the time, I thought I was doing really well for myself. I was like, I'm going really hard. I'm working out like six to seven days a week. I was sometimes doing two SoulCycle classes a day, which is crazy. And a girlfriend of mine actually pointed this out. She was like, I don't think we're supposed to be stressing ourselves out that much and creating that many endorphins because endorphins are also hormones. And it turns out I just had a major hormonal imbalance and I had way too much cortisol. And the second that I stopped doing those crazy workouts and I just started doing more low impact, I started walking every day. I mean, the bloating went down like that. It was wild.

Yeah. And so you could have been dealing with something called overtraining syndrome, which is not uncommon. So even i work with some professional athletes and it's pretty common in the professional athlete space that and they'll usually know it too because their coaches are well informed on it but ots or overtraining syndrome is when you do exactly what you said you over train your body there's such thing as too much exercise and if you go there what you're first usually going to notice is a decrease in performance of the exercise. But if you're not tracking things, if you're not a professional athlete, you may not notice that. But usually that's one of the first signs.

Also fatigue after exercise. So not feeling energized, but feeling more fatigued after. And then, like you said, GI issues are a really common symptom of overtraining syndrome, which may be bloating and maybe diarrhea for some people may actually be constipation. And then the other thing is sleep quality. So sleep quality usually declines pretty drastically with OTS where people are just not sleeping well, they're restless, they have insomnia, they're not waking, feeling energized. And then there's a few other symptoms, you know, in terms of just like feeling achy, we'll actually see liver enzymes go up, cortisol go up. You'll see testosterone reduce as well. Some women will start stop cycling, having their cycle,

not all women though. But that's a really common one that we will see, especially in the health world. So people come in, they're like eating perfectly, they're exercising and we're like, wow, everything's great. But how many classes are you doing a week? And they'll be like, yeah, I'm doing five classes a week. And then I also lift and then I also cold plunge and I also sauna. I'm like, oh wow. Okay. Let's dial it back. Yeah. Yeah. I mean, sometimes you can do too much of a good thing too, you know? So it's important to watch yourselves in that. I was also going to bring up with bloating and our periods too. So I know, so I've had a couple of period experts come on and they've talked to me about how like PMS symptoms, over bloating, all this stuff can actually be a sign

of hormonal imbalance. Like we're being told that PMS is totally normal and you're supposed to have cramps and all this stuff, but actually it's common, but it may not be normal. So what is that connection there with bloating in our periods? And when do we know when it's like actually something, maybe we should go get like a hormone panel done? Yeah. Yeah. So to understand bloating in the period, you need to know about the cycle a little bit. So how the menstrual cycle works is day one is where we label the first day of bleeding. So that's the first day of your period is day one. And then you ovulate, let's just take a 28 day cycle to be really simple. Some women will be a little longer, a little shorter, but for 28 day cycle, you're going to ovulate around day 14.

And so right then you're going to see a surge in LH and you're going to see estrogen go up. And then afterwards, we're looking at the luteal phase. So the luteal phase is preparing the endometrium for implantation, assuming pregnancy. And so most of the months we're not going to be pregnant. And so if it is one of those months that we're not pregnant, then what you will see is progesterone reached its highest around day 19 to 21. And then that's the body being like, oh, we're not pregnant. We don't need this anymore. So we're going to drop progesterone and then we're going to shed the lining and we're going to start all over again. If you are pregnant, then that doesn't happen.

Progesterone stays high and you're pregnant. But usually PMS symptoms are going to be around the time when that progesterone starts to decline. So it's like seven days before your period, most women will experience symptoms and some of the symptoms are normal. So you're not going to feel completely the same throughout your cycle because we have fluctuating hormones. And so, but the degree to which they're abnormal is really what drives treatment options. So if it is affecting your quality of life, then you want to seek treatment. And that's really common for a lot of women where they'll be really irritable. It's affecting their relationships or they have to miss work because of cramps. So all of these things are things to talk to your doctor about.

But what's interesting is we actually believe that it is the change in the hormones themselves versus abnormal hormone levels. And then it's going to be different for different women. So some women, and we don't know why yet, but some women are more susceptible to the changes and they are more likely to report PMS symptoms. But there was a research study that was done that looked at a group of women that report PMS and a group of women that don't report PMS. They measured hormones in the luteal phase and they were not statistically different. So it wasn't that the hormones were different. It was that there was a group of women that are more susceptible to those changes, those drop-off of the hormones in that late luteal phase. But that being said, progesterone being high in the luteal phase slows down the gut.

So progesterone slows down the gastrointestinal tract. It's one of its mechanisms, which is why constipation during pregnancy is really common, but also is why constipation in the late luteal phase is really common because progesterone's at its highest. It's also why when you get your period, you may have diarrhea because progesterone really drops and you'll see that decline and then intestinal motility can increase at that point. So there's some level of bloating that is normal just because of high progesterone and you don't want to lower progesterone to fix it. You want nice high progesterone levels in the luteal phase.

So what I tell women is if you're noticing constipation or a little bit more bloating in that luteal phase, then increase your magnesium and make sure that you're still having one full bowel movement every day. And that should really help the level of bloating that's there. Also, make sure you're hydrating well, because you can cause water retention if you're actually more dehydrated. And so there's a few things that you can do with that. And then definitely talk to your doctor about treatment. So we still treat women, despite there may not be normal hormone levels, you can still give women progesterone in the luteal phase most of the time. And that can really improve symptom outcome, especially

irritability and mood changes. Okay. That's awesome. That was really interesting about how women seem to all have the same around like hormonal levels, but they're being affected differently. It's really interesting. I wonder why that is. It'll be fascinating to see as more stuff comes out, we learn more about that and see if we can make a connection with it. Because I mean, I have a ton of friends, girlfriends that get really, really affected by PMS, you know, like really like crazy cramps and bloating and yeah. So it's hard. I'm one of them too. I started taking progesterone myself in my luteal phase and it made a huge change for me. Really? Like night and day. And I have normal progesterone levels too. So there wasn't anything at lab work wise, but just adding that in made a big difference. You can ask my partner and see if he agrees, but I think he would.

I think he's a fan for sure. He's like, yes, we love the progesterone. That's awesome. Okay. So well then let's talk about, okay. So gas and bloating kind of go hand in hand. Let's talk about gas. I know this is, I love following you on Instagram. I feel like you always end up talking about like poop and gas and I'm like, let's go. Cause not many people talk about it, you know, and we need to like normalize it. Cause you know, we all have it and we all have issues with it. So as far as gas goes, I mean, what, okay, well, first of all, what's like a normal level and then what, where is it where it's like concerning? Yeah, yeah. And there's actually information in medical textbooks about this, which is funny.

I love that. But there's an actual normal amount of gas and an abnormal amount of gas. And so what I tell people is up to 20 times per day of passing gas is normal. I forget, there's a milliliter amount and I'm gonna butcher it if I say it, but there's an actual milliliter.

But I'm like, how are you measuring? Maybe in a research setting, that's applicable. But at no point do I ever recommend a patient go to try to capture their farts and measure it. That's not on my list of things to test. Please don't. But also if you do, please report back. Yeah, but let us know Yeah. But let us know.

So yeah, like 20 times per day, and this is an estimate you're going to have days where, you know, maybe you binge on beans and broccoli and Brussels sprouts. I would expect it to be more that day. That was me in Mexico. Yeah. Too many beans. So you're looking at like 20 times per day, way more than that abnormal. If you're farting all day long, every day, abnormal, it's affecting your quality of life. And then again, that's a big one that we want to look at. And again, in the functional bloating, we'll also see the visceral hypersensitivity. So some people reporting bloating, when you do a CT scan on that group of people that reports abdominal distension and bloating and the people that don't report it, they don't see a difference in groups of people like that sometimes. So we're actually not super sure if it's actual gas increases in functional bloating that are

causing the issue or if there is this visceral hypersensitivity that's also at play there. And so we want to examine that and make sure that we just take into consideration that it may not be the amount, it may just be the sensation. And then obviously when people are actually passing it, you know that there's something going on there. And the microbiome is a huge effect there with what things we talked about in the past as well. Yeah. I mean, I think I already know the answer, but I want to hear it from you. I'm assuming that our microbiome and our gut flora and the balance of the good and bad bacteria probably have something to do with a gas as well. Yeah? Yeah, for sure. And we're at the point that we don't

know enough about the microbiome to be making huge claims. And that's always a red flag for me. So if you hear a company that's come out with this test and they are claiming to sequence your whole microbiome and tell you exactly what to eat, we don't know enough about it. So they are going off of information that we have not validated. We don't know enough about. So be really wary of that. We will get there. I'm pretty sure that we'll have a lot more information to be able to say like how much D. Sulfuribio bacteria should we have in the intestines? Right now, we don't know the answer to that. So we can't be making claims based on that.

But for sure, it's different for every person too. Sorry. Yeah, very, very likely. When they sequence people's microbiome, they're really unique. So like they're as unique as your fingerprint. So not every human has the same microbiome and we don't know what the optimal microbiome is, you know, in FMT research, which is fecal microbiota transplantation. They actually think that they're super donors, like people that have like this amazing stool. And those people,

when they donate to people that have C. diff or ulcerative colitis, get better outcomes versus somebody else who's totally healthy, has nothing wrong with them. When they donate, they don't get as good of outcomes. So there's so much we don't know yet, but it's definitely an area that we're keeping exploring and there will be more information that comes out there for sure. Okay. That's interesting. As far as gas goes, I've always wondered this and I've never looked it up or asked anyone. Sometimes when you get gas, it's like your stomach hurts so bad, but you can't even pass it. And you're just in hell for God knows how, 30 minutes to an hour. What is that? What's happening? Yeah. Gas pains can be painful.

So gas pains can actually have people go to the ER. It's not uncommon. If you ask ER docs, they will 100% have seen people that come in with acute abdominal pain, swearing that it's acute pancreatitis or something. And it's just gas. It's like you just got a rip. Yeah. But it doesn't mean that it's not that painful. It can be so painful. And so, yeah, it's usually, you know, sometimes we have these things called colonic flexures. So, there's a hepatic flexure on your right side, which is where the liver is. It's right where the ascending colon that goes up means the transverse colon. So, you have this little corner almost in your colon and gas can get stuck there and it's really uncomfortable when it does. And so, you know, sometimes I'll tell people, try to do some yoga positions because our bodies aren't much different than machines. If you have a pocket of gas that's stuck in a tube, how would you move it? You would kind of shift the tube and

the gas would start to move. The issue is, is that it's not all liquid in our intestines. There's stool that's starting to form. And so it's not as easy sometimes for the gas to pass through that tube, but doing things like downward dog or what's the one where you've got like your forearms on the ground, but your butt in the air, it's like dolphin or something. Yeah. That one's a great one to like move gas. Also moving from your right and left side to try to move it. Or doing an abdominal massage where you're kind of moving from your ascending colon massaging in a circular motion up across your transverse and then down your descending colon, which you can just Google which sides those are on and everything. But that can be helpful too. And then just

drinking a lot of water, promoting motility, ginger or peppermint tea are amazing. Peppermint is an antispasmodic, so it helps to relieve any cramping in the intestines, which is why we use it for IBS patients a lot, but for bloating as well can be really helpful. And if you're constipated, treat the constipation and it will likely get better as well. And this is a perfect segue into constipation because I wanted to bring that up as well, because I know a lot of people struggle with that. I actually, I have a girlfriend who has had chronic constipation basically her whole life and I told her to get a thyroid panel. Would that be? Yeah, you're right on. You should definitely rule out hypothyroidism. So low thyroid function can

cause constipation. And that's because thyroid hormone actually causes and helps with movement of the intestinal tract. So if you don't have enough, you're going to experience slow movement. Constipation is really common. Again, it's like the second most common thing that we treat. It's really common in young women, especially. And then there's that hormonal component. So in the luteal phase, progesterone slows down the gut too. But usually with constipation, you're either going to experience hard stools. I call them like rabbit pellets, you know, like those like hard little lumpy stools or just not going to the bathroom as frequently. So three times or less, or I should say less than three bowel movements per

week is considered constipation. In my practice, I treat people that say they go to the bathroom every other day because they usually don't feel well. So I base it on quality of life. If they're like, you know, I go to the bathroom four times a week, I'm not going to be like, oh, you don't meet the criteria. Like you're fine. I just don't understand that. So, so yeah, it's either frequency or it's the consistency of the stool or some people go every single day, but they complain of incomplete bowel movements where it's just like, it feels like there's more in there. I feel like I still have to go. And so again, I know people get sick of me saying this, but you got to figure out the cause because there's many causes of constipation. IBS is the most common

cause of constipation. So like 70% of people with constipation will fall under that IBS diagnosis criteria. And then the next one is something called a dysinergic defecation, which is less talked about, but it's issues with the anorectal pubic muscles and their contractions. So not being able to actually have a bowel movement. And then you actually have like your intestines is moving slow. So we call that slow transit constipation, but understanding the reason that you're constipated is going to drive your treatment recommendations. So you really want to go through the testing and figure it out and go from there. And then there's things, obviously, when somebody comes in, I'll start them off with some basics, which we could talk about too. Yeah. I want to know kind of what the basics are and then let's

start going into testing options, how to find a doctor. Because we talked about this yesterday, but I see this a lot and I get DMs about this all the time, but I'll use my friend as an example. I have a girlfriend right now who's dealing with really horrible stomach issues. I actually told her to go see you. And she doesn't really know where to go, who to talk to. I mean, she went to a gastro and he basically did a stool test and he goes, everything looks fine. I don't know. Maybe I have IBS. Just take some antibiotics and send her home. And she was like, I'm literally dying. She was like, every meal I eat, I'm in so much pain. I've been having so many issues.

And I feel like he didn't help me at all. And I feel like people hear that a lot. Yeah. And my question for you would be like, do you feel like she felt unheard? Or like not fully seen? Oh, 100%. Yeah. Well, because in a way he kind of, and again, I feel like this happens a lot with people and I'm not putting this on the doctor. I think the doctors have a lot on their plates and they're seeing how many patients a day and they have like 15 minutes and there's only so much they can do. So I'm not trying to vilify them. But I think often what happens is they're kind of like, I don't really know, maybe it's anxiety. Here's some drugs and send you home. And she's over here being like, I'm in so much pain and there has to be more to this.

Help. I don't know what to do. I'm so in the dark. And so I think there's this mismatch happening right now. Yeah. No. And it's not uncommon. And like you said, I think it has a lot to do with our system and they just don't have

enough time. I spent an hour on the first consult with somebody and that's already after I've spent probably like 30 to 40 minutes on my own reviewing the paperwork that they submitted before their consult. So I'm already like an hour and a half to two hours in of learning about who they are after that first consult. And then I'm seeing them for like 30 minutes to an hour each follow-up. So you're really gathering a lot more information in that way. And I'm so thankful that I'm able to do that because a lot

of times when people come see me the first time, I'm like, huh, like this doesn't all make sense. And sometimes it takes more than the initial intake for me to get the full picture. And that's likely to do that some people, you know, don't want to divulge that they have a history of anorexia, you know, there's some shame around that, or they don't know that they're under eating. And so it's hard for me to know that unless, you know, I'm really digging in and asking the exact right questions. So there's a lot of components to it, but anorexia is a huge cause of constipation. And I would say it's not just anorexia, it's just under eating. So even people that don't meet the criteria for anorexia, if you're not eating enough food, not a lot's going to come out. And that's really how it works. Not much in, not much out.

It's just science. It's science. And it's not just a volume thing either it's that if you don't have enough calories then your body's going to start to shut down systems and the digestive system is one of the first ones along with reproductive um function that that will go so you'll stop having your period maybe or maybe it'll be that you're constipated first um and then there's things like pregnancy normal cause for constipation first. And then there's things like pregnancy, normal cause for constipation. We talked about thyroid medications can cause constipation, which is pretty common. So things like calcium channel blockers that treat high blood pressure, antihistamines really common,

right, to take for allergies can cause constipation as well. And then things like iron. So if you're taking iron pills for anemia, those can cause constipation too. So we want to look at everything and see, you know, what are the causes. And then when I'm starting to treat somebody for constipation, some of my go-tos are going to be magnesium. Magnesium is a natural osmotic laxative, which means it pulls water into the intestines to hydrate the stool so that you're having more regular hydrated bowel movements, especially for people that have those rabbit pellet kind of stools. That's like a no brainer. And which form of magnesium is best for constipation? Because there's different ones.

For sure. And great question. So your go-tos for constipation are going to be, there's two big ones. Magnesium oxide is great for constipation magnesium citrate as well is really good for constipation those are going to be your less absorbable forms of magnesium which means they're not going to be really going into the bloodstream to affect all of your organ systems they're going to stay in the intestinal tract and pull in the water there which is what you want them to do when you're constipated. So those are kind of the two that I'll start with, but then, you know, patients will be listening to this and be like, why did she give me glycinate then? Like, did she make a mistake? I always like people will

come to me and they're like, you said this on the podcast. I don't know why it's an old woman voice either, but, and the reason, yeah. So with clinical experience, you get to know that like not everything's textbook and this is so frustrating because it would be so easy if every time you had constipation, you gave magnesium oxide, but there's those patients that don't respond to magnesium oxide or citrate, and they actually respond better to magnesium glycinate or another form. And that's really just like experience and me being able to say like, okay, we're still not going to give up on it. We're going to try this one for you. Glycinate is also really calming to the nervous system. So if anxiety is involved,

sometimes that's better. So it usually requires a couple of tries to find the right magnesium for you. And we do it to bowel tolerance, which means that maybe a hundred milligrams of magnesium is not enough for you. But if we go up to 200 or 400, sometimes 500, then you get results with it. And so I teach people kind of how to do that on their own. But it doesn't work for everybody because some people come in and they don't have hard stools. Their stools are really well hydrated and they're just not going to the bathroom. And so that's where we want to do the testing and figure out what the actual cause is. Yeah. Interesting. Okay. So let's say someone listening is dealing with some sort of stomach issue and they want to get to the root cause. Maybe let's talk about what kind of doctor they

should look out for, because I think this is also a really important key piece of this, because you want to find a doctor that knows what tests to get and how to read the tests. There's a couple of things here. I really believe that gastroenterologists are super intelligent, specialized doctors. So even sometimes people come to see me, I'm referring them to a gastroenterologist. And there's a really good reason for that is they are able to do colonoscopies and endoscopies. And those are scopes of the upper and lower digestive tract. And especially with things like constipation and bloating, you can have obstructions, things that are malignant, you know, cancerous that are causing the issue. And we do not want to miss those. So especially if there's red flags, if it's an 80

year old woman coming to me with first onset constipation, she's going to go get a colonoscopy. So you want to make sure you've ruled out all of the big things and gastroenterologists are amazing at doing that. So I think it's a really great idea to do a consult with a gastroenterologist, make sure that, you know, you've ruled out the big things. And then if they, you know, say, we don't have anything else for you to do, you want to find a doctor that has other options. So you never want to find a doctor who eventually says, I don't know anymore. There's always options. You may not like the options, but that's different than not having options for you. So a lot of people that are going to be doing this is going to be people in the functional

medicine space, but you really want somebody who's actually specialized in gastrointestinal health. I see it all too often that like I have colleagues and they say, yeah, I specialize in gut health, but they also specialize in everything else. And that's literally impossible. It's too much information. That's why we have specialists out there. So it's really important that you understand how all the organ systems interact, but you want somebody who really knows constipation, if that's what you're dealing with, or really knows bloating or really knows inflammatory bowel disease. So have a conversation with them, how many, what percent of their patients actually have the condition that you have, you know, if you're seeing somebody with

IBD is not that common. And so you want to have a doctor that deals with it every single week and has a bunch of options for you. So that's how I would go about it. I know it's not straightforward, but some of the places you can go to look for those people are going to be Institute of Functional Medicine and then CNDA or the naturopathic, what's the national one for naturopathic doctors, but there's naturopathic doctors search engines as well. And they'll usually have alternative things. And then there's a lot of gastros that have specialized in integrative treatments too. So some of it is just finding somebody that you feel like you have rapport with.

Yeah. Yeah. No, that's actually a really good point. I'm glad you brought up the going to see the gastro, ruling out anything really serious because that is a big concern too. I would recommend if someone can find someone that does it integratively, like you said, I think that's really a great option because then they're also going to look at the body as a whole and probably make more connections than one that isn't. Yeah. But seeing a couple of doctors isn't always a bad thing where you'll see a gastroenterologist, maybe you do have to get a colonoscopy and then you know that there's no obstruction there.

You know that you don't have an atypical form of IBD that's not super common. And then you can go into advanced testing and really dial it down. The gastros are also really good at diagnosis. So they may be able to tell you, yeah, you have IBS or yeah, you have chronic idiopathic constipation. And then what you do with that information is really up to you. If you then seek the help of somebody who has more integrated, greater treatments. I'm a huge component advocate of that, of course, because that's exactly what I do. There's so much you can do, dietary, exercise, lifestyle for all of these GI complaints that you'd really be a mess to not do those things. What is the type of testing look like

that you guys normally do? I'm assuming you do like a stool test. You probably do some blood work. What's kind of typical testing? Yeah. So when somebody comes in very dependent on their symptoms, we don't give everybody the same set of tests. But if it's GI complaints, then we're doing full blood work. So we're looking at thyroid, we're looking at inflammatory markers, we're looking at nutrients. And the reason for that is we're looking for malabsorption. So we want to see is B12 low, is vitamin D low, is folate low. So we'll do micronutrient testing as well. We're also going to look at, sometimes we're going to look at insulin resistance. So we're looking at insulin and blood sugar regulation. That's because diabetes can

actually cause constipation. So we want to get a real overview of somebody's health. And so in addition to the blood work, we may do a stool test, like you say. So depending on if there's bloating or diarrhea, we're going to look for parasites or things like bacteria or protozoa that can cause bloating and constipations. Giardia, for instance, is actually really common, especially if you're a hiker or camper, and that can cause just bloating in some people or in some people it'll cause bloating and diarrhea and then we'll do the lactulose breath test a lot of the times if the symptoms warrant it for small intestinal bacterial overgrowth and then there's advanced testing and imaging so

sometimes people will need an ultrasound of their abdomen or a CT. Sometimes we'll be doing something called anorectal manometry testing to see how the muscles of the anus, the rectum and the pubic muscles react to going to the bathroom. And I know I'm missing things, of course, but it's much more comprehensive than your conventional gastro would do. And we get a lot more information from it so that we can give you what you should do to treat it then. Because we want to have an answer of like, okay, we're treating IBS or we are treating slow transit constipation. And that's the mechanism we're going to go off of. Yeah. No, that was really helpful. And I think it's important for people to hear this because someone maybe that is just now getting into all this and really struggling and has no

idea where to start. I think even just hearing kind of like what doctor to look for, maybe a certain test to ask their doctor if they think it's a good idea. So I think it's a good start for people. So is there anything else before we go that you feel like people really need to know? Um, yeah, that we haven't talked about. One is I will say that I'm creating a course about this. So, cause it's not super straightforward. So what I want to do is be able to arm people with the education around it. That like you said, they could go to their gastroenterologist and be like, Hey, these are the symptoms I have.

Should we do this test? Because a lot of these, anybody can order. So that's a big thing that I think will be really amazing is if you don't have somebody that does integrative, you know, gastro focused practice, then you can go to your doctor and talk about them ordering the test for you to get more answers. That's a big one. Just be your own advocate. So make sure that if it's affecting your quality of life, you're seeking somebody that can actually help you. Yeah. Yeah. I think it's a really, really important thing for everyone to understand just going into our healthcare system. We need to

be our own advocates. Okay. So I ask all my guests this question before we go, what are your personal health non-negotiables? So these are things either that you do daily, maybe weekly that are just your non-negotiables to take care of your health. Oh, I love this question. I want to know your answer. Am I allowed to ask you back? Oh yeah. Cool. Um, mine, my number one is exercise. So that's like a hundred percent non-negotiable for me. There's so much research behind it, weight training and aerobic exercise. Um, both of those, the other one is sleep is definitely a non-negotiable. If you ask my partner, he will

agree. Like I'm in bed by like nine 30, 10 o'clock and get eight hours of sleep pretty much no matter what meditation I would put there, although I will admit I don't do it seven days a week. It's probably closer to six, but that's pretty high on the non-negotiable list for me as well. And then what my partner would definitely say is I need to eat regularly or else I get hangry. So eating enough protein specifically on a regular basis is helpful for not just me, but my loved ones as well. What are yours? So funny. I've been dealing with that lately with my boyfriend. He's like, good God, are you hungry? I'm like, oh, I actually am. Yeah. I think they're better at figuring that out than we are. Cause sometimes I'll be like, no, I'm not. Cause sometimes I

don't feel like I'm hungry. I'm just angry or irritable, which is the same thing for me. So funny. Yeah, no, he's learning. It's great. I would say, okay, my health non-negotiables are exercise, but also getting outside. So I would say hiking at least a couple times a week. I want that one. Yeah. We're hiking buddies. We got to go on a week. I want that one. Yeah. You're, you know, we're hiking buddies. I love, we got to go on a hike when I get home, but because I haven't really been doing many lately and I, I really do notice a difference because for me it's meditative. It's connecting with nature.

I always bring my dog. So I feel like it's almost, you know, kind of a bonding thing for me and my dog. I'm getting sunlight, obviously moving my body. Like there's so many different components to it for me that it just, it really, it feels like therapy almost. It's really, so I would say that's one of my non-negotiables. Also just getting sunlight every day. Well, weather dependent, but if I can get outside, get sunlight. Filtered water is a really big one for me. And just making sure that I'm eating real food. Because when I'm not eating healthy and eating real food, I really feel it. I was just in Mexico for two weeks. I was messaging about this the other day. The food is amazing. I don't think

I had a bad meal, but also I'm pretty careful about not eating raw food when I'm in Mexico because of the water and they wash everything. By the end of it, I was dying for a salad. I was like, I just feel like... Because I haven't really eaten anything green. I felt like I had tortillas for literally every meal for basically two weeks. And I just felt like a big tortilla coming back. I was like, I really need real food right now. Yeah. So I would say those are probably my top ones. There's only so many tacos you can eat. Oh, I know. I'm like, I can't have tacos for at least a couple of weeks. Yeah. But they're also so good. Yeah. I'm stealing all of yours. Nature is definitely on my list of non-negotiables. Some good ones.

Yeah. Yeah. Well, please tell everyone where they can find you also where they can get your course. Yes. So my website is modernmed.com. There's no E in modern. So it's M-O-D-R-N-M-E-D.com. And then I share a lot of information on Instagram, which is at dr.maryparty and then at modernMed as well. And I just joined Threads, so you can follow me on that. I don't even know if I'm threading right, honestly. I'm like, is there a right way to do this? I'm like, I'm probably doing it wrong, but I give some sort of information there too. And then I have a gut health course that's hosted by One Commune right now. And it's a really general overview of a bunch of different GI conditions. And so that's a great place to start. It's One Commune. And then my other future courses are going to be coming out on my own website. So just follow me and you'll hear about them when they're ready. Awesome. I'm so excited about your new courses. And yeah,

thank you so much, Mary. This was such a great episode. I loved it. Thank you. I appreciate it, Court. Thank you so much for listening to this week's episode of The Real Foodology Podcast. If you liked the episode,

please leave a review in your podcast app to let me know. This is a Resonant Media production produced by Drake Peterson and edited by Mike Fry. The theme song is called Heaven by the amazing singer Georgie. Georgie is spelled with a J. For more amazing podcasts produced by my team, go to resonantmediagroup.com.

I love you guys so much. See you next week. The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and doesn't constitute a provider patientpatient relationship. I am a nutritionist, but I am not your nutritionist. As always, talk to your doctor or your health team first. Do you suffer from IBS or other digestive issues? Are you looking for a new podcast to listen to? From the producer of the Real Foodology podcast comes the all-new health and nutrition podcast, Digest This, hosted by Bethany Ugarte. You may know Bethany as the face of the popular Instagram page, Lil Sipper, or you may have even read her book. Now you can find her

wherever you get your podcasts. On Digest This, Bethany examines topics such as gut health, nutrition, the food industry, and highlights specific ingredients that can be beneficial or harmful to your gut health. She also explores non-toxic options in beauty, home, and cooking essentials. If it has to do with your health, Digest This is talking about it. Each episode features an interview with health experts, doctors, and wellness advocates and delivers you information that is, well, easy to digest. Bethany also delivers a weekly segment every episode called Bite of Knowledge, where she highlights an ingredient commonly used in food, skincare, household cleaning, you name it, and gives you the lowdown on the benefits or dangers that ingredient might have in your

everyday life. From Botox, potassium, olive oil, and magnesium, all the way to those ingredients you can barely pronounce on the back of your cereal boxes, Bethany has you covered. There's a reason why it debuted at number two on Apple Podcast Nutrition Charts. Check out Digest This on your favorite podcast app. New episodes every Monday and Wednesday. Produced by Drake Peterson and Resonant Media.