Hormones, the Gut and Autoimmunity

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome.

This is your host, Lindsey Parsons, and today I'll be speaking with Kiran Dunstan, MD, OB-GYN, host of the Hormone Prescription podcast and pioneer of female hormonal justice. After discovering the hidden cause of midlife weight gain and fatigue in women, Kiran lost a life-changing 100 pounds and fixed her adrenal issues. She is fellowship trained in anti-aging, metabolic, and functional medicine and has practiced this exclusively for over a decade. She's also the founder of The Hormone Club, an end-to-end all-inclusive membership providing women access to state-of-the-art natural hormone therapy treatment throughout the US, and the Midlife Metabolism Institute, providing educational and coaching programs for women at midlife to fix their hormones, their metabolism, and their health. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, pop over to my website, High Desert Health and sign up for my newsletter. You'll also get my free ebook, Find Your Root Cause Through Stool and Organic Acids Testing when you sign up. And if you haven't yet done my quiz on which stool test would help you get to your root cause, you can find a link in the show notes and take that. Now onto the show.

Welcome to the podcast, Karen.

Thank you, Lindsey. I'm so excited to be here with you today.

Yeah, well, it was so awesome being on your podcast and had such a good time and really just, uh, I was impressed at how much background you had done on me and how much knowledge and enthusiasm you brought to it. So I really wanted to invite you to my show and have you share your knowledge too.

Yeah, hopefully I bring something that will help your audience and it should be fun. I love talking about hormones.

Good. Well, of course, as a host of a show on hormones, I wanted to start with a general overview of the various hormone systems in the body and how they interact with the gut microbiome. And then we can dig deeper into some of them?

Sure. So I would say there are 7 main metabolic driving hormones. There are actually hundreds of hormones. Hormone just means chemical messenger. And so you've got many, many of them throughout the body and they're brothers and sisters to neurotransmitters, right? So they're a part of your nervous system. Most people don't realize that. And they originate in your brain, the majority of them. It's just that they travel a long distance through the blood in order to get their message across, whereas neurotransmitters travel a short distance across a neuronal synapse to get their message across. But they're part of your nervous system. And I like to tell people that because, A, most people don't know that, and B, it really puts them into perspective because even Though I went through OB/GYN training and we're supposed to be the experts on women's hormones, we were always kind of taught and hormones were treated as if they were this accessory pack. Like, "Women's hormones, that's a little accessory pack you women have that confers reproductive capacity on you," right? Kind of like that black bag you take down from the back of your closet when you have to go to the black-tie dinner once a year at Christmas, right? And what I discovered is nothing could be further from the truth. They're really fundamentally, foundationally a part of who we are as women, and that's because they're a part of our nervous system. And I, I like to emphasize that because otherwise I find that men and women alike relegate hormones to that other category. That's that other thing you have to deal with. No, it's like you have to deal with your brain cells in your brain. You have to deal with your neurons. So anyway, the 7 main The metabolic driving hormones, I always say, are insulin, thyroid, cortisol, DHEA, estrogen, progesterone, and testosterone. They really set the tone for the level of your metabolic rate, how you process the calories, macronutrients that you eat, and what you do with them. Do you store them as fat? Do you burn them as fuel? And your basic biologic processes, your sleep-wake cycle, your energy level, your weight is a basic biologic process. Most people just think of it as, "I don't like how I look in the mirror. It's unwanted fat." But when you think about what is excess fat, it's excess fuel storage, right? Your body has fuel. It has to operate and your main fuel source is glucose or sugar. And you use that up usually within a few and then you dip into your stores, which is fat. So when you have a weight problem, you have a fuel storage problem. Most people don't think about it like that. And that's a basic biologic process. And if you can't burn your fuel, then you can't make energy. And the currency of energy in our body is ATP. So you're tired. And a lot of times sleep disorders are coupled with that. So these are the things that drive it. Now, how does it interact with the microbiome, which is your thing?

Basically, we're donuts. We have a big hole inside of us, and that is our gastrointestinal tract from top to bottom, and the surface area is as large as 2 doubles tennis courts. And we're taking the external environment food, and we are putting it inside of us, seemingly inside our bodies, but really that tube is outside of us even though it's inside of us. Hopefully that makes sense, kind of like a donut. So our biggest interface is with the external environment, and one of our body's main jobs is security, right? And everybody knows how important security is. If you've tried to log on to any program on the internet lately, or your bank account, you know how two-factor authentication has become a thing because security can be easily breached on the internet. Well, it's the same with your gut. Because most of your gut lining is only 2 cell layers thick and you're taking the external environment and putting it inside this tube in your body and it's contacting all the surface area, security has to be very high. And it is the highest, at the highest level in your body, all along your gastrointestinal tract. There's something called GALT, gut-associated lymphoid tissue, which is little patches of lymphocytes all along. And your immune system is mostly clustered in your abdominal cavity around the gut because it is security. It is your body's military system designed to protect you against foreign invasion. So what does this have to do with your hormones, Karen? Well, it has everything to do with your hormones because your hormones' number one job is also security and survival, right? If your body can't survive, you're done, right? And so, Any animal organism, any living thing has at it as its number one priority, survival and security. And you as a human is no different. So you've got your security system, which is part of your survival system in your gastrointestinal tract. And then you've got your adrenal glands right there in the mix on top of your kidneys that produce cortisol, which is your survival hormone. Right there, and it works hand in hand with the immune system to balance your hormones. And if you ever hear a woman say, oh, I was stressed out and I missed a period, right? Because your body will sacrifice periods. Your body really does consider reproduction an accessory function, although the hormones that it uses to create that reproductive cycle are not accessories. They're vital for many processes, since number one I'll mention is brain function, but it will sacrifice a period and a reproductive cycle for survival and immune system function, and that has to do with gut health. So the microbiome, which I'm sure your audience knows very well, represents trillion of bacteria that live in the gastrointestinal tract and are essential for our survival. Well, we're back to that security and survival. We cannot live without these bugs in our gut. And those bugs directly speak to our immune system and directly speak to our cortisol stress hormone. So they're really having this three-way conversation and it's, it's much bigger than three ways because other hormones are involved in other systems in the body. And you've got to have the right members in the council, in the bug council, in the gastrointestinal tract to send the right messages, to have the right conversation. Because if you have abnormal bugs that shouldn't be there, or there are too many of certain good types, or if you've got parasites or fungi or other unwanted visitors that are having a very negative conversation, it's kind of like, you know, the UN. There are certain countries, and I am not a government expert, but there are certain countries that aren't part of United Nations. And if they show up and they start speaking in a language no one's understand and they don't really know how the UN operates, it's going to be a not nice conversation. It's the same in your gastrointestinal tract. So you have to have enough of the right ones and you don't want the wrong ones to have the right conversation. And this directly works with your cortisol. And cortisol, I call her Queen cortisol. She is the queen hormone. She will be served at all costs because you cannot live without her. And your body will take down all the other systems— reproduction number one, and many others— in order to preserve your survival. So your gut health, your microbiome, is key for that, is directly and intimately involved through your hormones. Very much through your cortisol, but also we could talk about estrogen, which I think we're going to get into. And I don't want to go on too long if you wanted to interrupt me and ask something else.

Yeah.

Yeah.

Let me, let me interject with a question. So I've actually seen a number of clients who, following, obviously following a period of high stress, but also following medications, steroid medications like prednisone, had really big gut problems. And I'm, I'm wondering if you've seen the same or if you, if you understand the mechanism where that's, or can, or can explain the mechanism how that happens.

Oh yeah. So when we as physicians give people exogenous from the outside corticosteroids, that's what cortisol is. And it falls under that category of hormone. It's because your own cortisol isn't working properly. So we do that for conditions. That are usually inflammatory. So things like asthma exacerbations. I had an injection in my knee once for bursitis, or when I used to have back problems, I would get— they would inject steroids. Maybe some people have had that, or I've had that. If you get a bad bronchitis, they might— yeah, they might give you steroids. So they're very common. And in fact, I like to say in mainstream medicine, the two drugs of choice are antibiotics and steroids, right? When in doubt, antibiotics and steroids. Steroids. But that's a key indicator that your own queen cortisol is off the job. She's not doing a good job. And usually the first places you should look is gut dysfunction and immune system dysfunction, cuz they're gonna be a part of that. So when you give a human steroids, cortisol or prednisone or whatever it is, You basically give them a high dose of cortisol, higher than their body usually makes. And that serves a few functions. One, it's anti-inflammatory and it works to shut down the inflammatory response in the body. So bronchitis that's chronic, right? If you have all that inflammation, mucus going on, you give the steroid and it cuts down the inflammation because it tells the immune system, go have a seat, I've got this. But then it also temporarily shuts down your own cortisol production. And so, you were saying that they have problems after this. And so, what's the mechanism? So, because cortisol is your stress hormone, it has beneficial aspects and it has deleterious aspects. So, you can't get one without the other. So, anyone who's ever taken steroids knows, yes, it's going to cut down inflammation. I remember when I first moved down to the South, I had never heard of fire ants. I was from the North, and a patient came in one day with her ankle swollen. I said, what happened? She said, I got stepped on a bed of fire ants. And I'm thinking, what in the world is a fire ant? So I had to get an education in what fire ants were and then learn that the treatment of choice is steroids. So everybody knows steroids cut down inflammation and pain. So it does that, but you also get the deleterious side effects. So what are they? Number one, it's going to jack up up your blood sugar.

Right.

And so what happens when your blood sugar gets increased artificially? Well, sugar is inflammatory and sticky. So you get the decrease in the short-term inflammatory response, but in the long term, you're driving up sugar. If people are on chronic steroids, oftentimes they become diabetic. I— a lot of people have had dogs. I had a dog that had that. Had to be on chronic steroids and she became diabetic. Well, that can damage all the cells in your body because sugar in the body that's too abundant— well, sugar is sticky anyway, right? Think sticky bun. Why is it sticky? Because it has sugar that's been heated. Well, sugar that's in your bloodstream and in your body is no different. It's heated to body temperature, so it's warm and it's sticky. And it's inflammatory, so it sticks to all your cells. So it can stick to the cells in your kidneys. It will stick to cells in your blood vessels. So there could be long-term damage, but in the short term, why does it mess up the microbiome? A lot of these bacteria in the gut, especially the unsavory ones that you don't want, consume sugar. So when sugar is higher and plentiful they will proliferate and propagate. So if you've got a lot of sugar, you're feeding your unsavory bugs. You get a dysbiotic picture, and especially if there's Candida or fungi, they love sugar, right? If anyone's ever made bread, what do you need? Warm water, sugar, and yeast, and you put it in the dark, which is dark and moist already in your gut and it's warm and you add sugar, you get that nice yeasty concoction you make bread out of. Well, that can happen in your gut. And it's not, do we have Candida? We all have Candida. It's around, it's in us, it's everywhere. It's when the conditions are right and there's too much sugar, then you're gonna have too much. So you, it fosters a dysbiotic picture.

Okay. Well, that's an awesome and thorough answer that helps me understand and explain to clients. So I personally reversed my Hashimoto's thyroiditis by both changing my diet and by eliminating gluten and dairy and most added sugar and just by healing my dysbiotic and leaky gut. And so I imagine you must see a lot of patients with Hashimoto's. So in your experience, is there a best order of operations for reversing this type of condition? And have you seen patients who've been on thyroid meds like Synthroid who've been able to come off of them?

Great question. So Hashimoto's, and we can lump even some other autoimmune conditions in there because they're all caused by the same thing. And I know some people are thinking, what are you talking about, Kiran? Most people don't realize that all autoimmune conditions have the same root cause, and most physicians don't understand that either. But what does autoimmunity mean? It means auto, yourself, immunity. Your own immune system is attacking you. What causes that, right? And so in mainstream medicine, we're up in the leaves and the branches of the health that is our tree. We're trimming this leaf and over in another branch, right? In one branch, we're over at the neurologist getting those lesions in our brain looked at in an MRI because we we suspect we have MS. And then for our urinary leakage, we have, we're over at the urogynecologist on another branch, right? Nothing's related in mainstream medicine. The truth is if you go down the trunk of the tree into the roots and the soil, all disease has the same root causes and autoimmune disease in particular has, every disease has a driver and every disease should have a break that is not present, and that's why it's happening, because your body naturally will heal itself. Anyone who's ever cut themselves knows that, you know. Do you need to do anything to— when you cut your hand, say you're cooking in the kitchen and you cut your hand and it bleeds, all you need to do is put something over it to protect it and your body naturally heals. Well, your body will do that for everything. It naturally has innate healing mechanism. So every disease has to have something that's the foot on the accelerator, accelerating dysfunction. And every disease has a lack of a brake because you should have a brake in your body on disease. So with autoimmune disease, what's the accelerator? The accelerator is inflammation, most of which comes from the gastrointestinal tract. So like you said, Lindsey, You remove gluten and dairy, heals your gut. So that's A number 1 with Hashimoto's or any autoimmune disease. You go immediately to the gut. I love the gut. And unfortunately, she is the source of most of the inflammation. Why? Because we treat her like a trash can, not, not the temple that she is. And if you treat her like a trash can, guess what you're going to get back? Trash. So autoimmune has foot on the accelerator, gut, and no brake. What is the brake on autoimmune disease should be? Your cortisol stress hormone. We just talked about how when your own steroids or cortisol fail, you go to the doctor, they give you shots of prednisone or whatever steroid they give you, or they give you pills, and then that becomes the brake. But you only need that brake when your own brake isn't working and your own brake is your body's natural cortisol. So every autoimmune disease has gut dysfunction and cortisol problems at its root cause. And so when you fix those, you can reverse autoimmune disease. So because gut is part of that, fixing the microbiome, removing food sensitivities, which may not be allergies, right? I'm not talking about— if you go to any board-certified allergist, they're going to tell you there's no such thing as food sensitivity. And that's not true, right? So science knows way more than you're going to find at your mainstream doctor's office. So go take a visit to somebody who can help you. Your allergist doesn't believe in that as if it weren't science. It's science. It's not religion. So you can be sensitive. You're Immune system has many different branches, just like our military. So your immune system is your military. So we've got Army, Navy, Coast Guard, we've got SEALs, we've got— I don't even know all the branches of the military.

Air Force, Marines, Marines, right?

Well, your body is the same. We've got IgG, IgM, IgA, we've got cell-mediated immunity, we have mast cells, we have different types of lymphocytes, all with numbers. We've got like CD4, CD8, cluster design— we got like so many branches in our immune system, it probably outships the military. Well, when your immune system's attacking itself, it's not doing it for no reason, it's because it's been triggered into that. It's like if America started bombing ourselves, Right? Well, everyone would say that's insane. What caused that? Right? It's the same in the body. Your immune system is throwing bombs on you.

Why?

What caused it? So, let's see. I got a little off track. So, we're back to the gut health. Oh, we're talking about food sensitivities. So, you— you have many different ways you can be sensitive to a food. Mainstream medicine pretty much only recognizes that if they inject you in your arm and you get an IgE sensitivity, like you get a wheel, that's an allergy, right? But that's not true. It can be so many other things. So you gotta get maybe tested for food sensitivities. I love a test. Test, don't guess. You can energetically test. There's so many ways you can figure out what foods you're sensitive to. But gluten and dairy have to go for Hashimoto's, and I think for all autoimmune conditions. So you've got to fix that, and then you got to work on the cortisol. Why aren't the adrenals functioning properly? And you've got to support and nurture and love them and give them what they need. And I have had plenty of patients, you know, if you ask most doctors, do people ever get rid of autoimmune disease, they're going to say no, it's progressive and you'll have it forever. And that's just not true. I see people all the time who have Hashimoto's antibody, whether it's thyroid peroxidase, antithyroglobulin, or both, and then they don't have any, Lindsey.

Right. That's, that's my situation. Excuse this brief interruption, but I wanted to remind you that if you've been struggling with IBS, IBD, reflux, gastritis, SIBO, dysbiosis, Candida, diarrhea, constipation, and all that gut health stuff, that's my specialty. So I work with clients not just here in Tucson, Arizona, where I live, but also virtually on video chat. And I offer single appointments as well as a 5-session gut health program for people with tougher gut health issues or mental health or autoimmune challenges that go along with that, who likely require testing and longer-term follow-up, as well as 12-week programs for weight loss. If you think that a 5-session or longer course of health coaching might help you meet your health goals, you can set up a free 30-minute breakthrough session with me to talk about what you've been going through, and I'll listen and hear if it sounds like I have something in my toolkit that you haven't already tried and let you know if I think that health coaching would be appropriate for you. You can find a link for that in the show notes and I hope to hear from you. Right.

And so it happens regularly.

Yeah.

Now, your other question, do they get off thyroid medicine? Let's take that one. So the problem with Hashimoto's is that these antibodies are destroying thyroid tissue. If you catch it early enough, and I'm a big proponent of checking auto thyroid antibodies early and often on everyone, um, because they're so common in women. Because I've seen plenty of people with an optimized TSH, an optimized T3, T4, reverse T3, who actually had autoantibodies. And if you can catch someone who's in that stage before, like, preclinical Guess what? You can fix their gut and fix their cortisol and they don't ever have to get Hashimoto's.

Right.

Right? And their antibodies can go away. And so I love it when I find someone like that. That's before there's anatomic damage to the thyroid. Now, once you've had these antibodies long enough, they're in there destroying your thyroid and causing anatomic damage. And once you have an anatomic problem, it's much harder to reverse. So there's a spectrum of how health disorders occur. They don't just— you don't just wake up one day and have no cartilage in your knee, right? It doesn't happen that way. Everybody knows that. You had great cartilage and it got eaten away by inflammation and pressure, and it got degraded, degraded, degraded, so you didn't have any anymore. Well, all disorders happen that way. You just can't— don't know it or see it. So they happen on a spectrum and they start on a functional disorder spectrum. So that's why we say we practice functional medicine. We're working on the function before you see any anatomic problem. And it'll start as a small functional problem. That's why I'm a proponent of checking autoantibodies in peop— women early because if you can catch it, it's just functional. Then there's no anatomic damage. You can fix it.

Let me stop you for a second on that.

Yeah.

So when you're checking the autoantibodies, is— are you doing this by default with like every person you see, or is this something that you do when you see, say, gut issues or something that would— or some— something that would indicate to you that they might have something going on?

Well, I only work with people, women with health problems. So all of my people get it.

Okay.

Got it. But I don't do just regular screening care. I don't do physical exams, pap smears, all that. I only see women who have problems. And they— if you're a woman and/or a man and you have health problems, in my opinion, the thyroid is so vastly affected in I mean, millions of us. And I forget what the specific numbers are on thyroid disorders and Hashimoto's that I— all women need that check.

Okay.

If they're having—

and just to specify, you're saying thyroid is a part of that? Women need it in particular because the majority of Hashimoto's occurs in women?

Majority of thyroid disorders occur in women. It's like 80-20, 80% in women, 20% in men. The majority of Hashimoto's, the majority of thyroid disorders. And thyroid is so fundamental to our health. I mean, it's our thermostat. So it determines the rate at which we burn calories, which means it determines the rate at which we make energy, which means it determines the rate at which we do anything. Because if you don't make ATP for energy, you can't fix anything in your body. So if there's ever a health health problem, as a part of that health problem, at its cause, is an energy production problem because you don't have the energy to fix it because we already talked about the body naturally wants to fix itself. Why doesn't it? Something's preventing it. One of the things that usually is preventing it is your body isn't making the ATP to fund that activity. And why isn't it?

It—

the thyroid is Ties into everything. So, I mean, if you've got liver dysfunction, which is huge in women who have hormonal problems, well, thyroid is converted into the active form partly in the liver. Well, you're going to have thyroid problems. Everything is— has its hand in the thyroid, and thyroid has its hand in everything. So it's just so fundamental to me. It's like You should get weighed, you should get your blood pressure, respiratory rate, and you should get your thyroid checked.

Okay. And then let me also dig in a little further. You mentioned food sensitivity testing, and in my experience, anybody with a leaky gut, which is pretty much anybody with a gut infection, just kind of has every single thing they eat come up positive on those food sensitivity tests. So I've written them off as terribly useful, at least. I mean, maybe I would think like after we've done some work and after we feel like we've sealed up the gut and we've healed gut infections that the food sensitivity testing might be useful at that point. But, but beforehand, it just seems like everything. And then that's what happened with me, by the way. I did a, I did an IgG test and pretty much every food that I ate came up positive.

Right, right. And, and if you have leaky gut, which most people with autoimmune do, everything you've been eating is gonna come up. So let me say this, there is no perfect food sensitivity test, or we have yet to find it because there's so many different branches of the military immune system. You can react in so many different ways and most people are creatures of habit and eat the same stuff over and over and over again. So their immune system is so over it. It's like, "Oh my gosh, not again." Right? You're not eating, drinking milk again. So there is no perfect test. Now having said that, I find that a lot of people are in denial about what they're actually eating. With themselves. And they also are very resistant to give up what they love. And they're also addicted to the things that they eat all the time is why they eat them all the time. In fact, if you are sensitive to a food, you are highly likely to be addicted to it. What do I mean by that? You're gonna— it's gonna make you feel really good when you eat it because part of what happens when your immune system is deployed against the food you're sensitive to is your endorphin system is deployed and that makes you feel really good. So maybe people listening can relate to like that euphoria you get after you eat pizza made with cheese and gluten at some point in your life. That's because cheese produces something called casiomorphin after you eat it. That is a morphine-like substance that makes you feel really good. And gluten produces gluteomorphin, which is a substance like morphine that makes you feel really good. This is why people so love bread and cheese. It's, it's because they're addicted to it. They're getting a morphine hit every time they eat it. So back to the food sensitivities, I find if you just tell someone, okay, stop eating all the foods that you regularly eat and eat all these things you never eat in parenthesis because you don't like them, end parenthesis, and do it on a 4-day rotational basis. Most people are going to A, doubt me, and B, they're not going to do it. So I like a food sensitivity test sometimes just to be able to show them in black and white, look at all the things you are sensitive to, and they go, oh my God, it's all the things I eat all the time. Exactly. Stop.

And so for that reason, tell me about the 4-day rotation. How would— how does that work?

So your body was made to eat rotationally on a seasonal basis, like in back in the Stone Age, and that's part of what keeps our microbiome healthy. Our microbiome doesn't want to eat the same thing every day any more than our immune system does. It's our human We love— we don't like change. We like security, we like sameness, we like safety. We're like, what do you eat for breakfast? I have 2 scrambled eggs and I have a piece of toast and 1 slice of bacon and I have coffee with 2 scoops of sugar and a drop of milk. Like, we are such creatures of habit, but the only reason we have that luxury is because we are, like, particularly in America, we're relatively wealthy and we can have whatever we want whenever we want how we want it over and over and over again. Back in the Stone Age, how nature made us is we could only eat seasonally and locally. We could only get blueberries at blueberry season. And until we came up with canning methods, we could only eat blueberries at blueberry season. We could only get a deer when we could kill a deer, which wasn't every single day, right? Maybe a couple of times a year. We could get a deer, so we would have deer. And that kept our microbiome healthy and it kept us healthy and our immune system didn't go freak out because we were eating the same thing all the time. So we already talked about how our gastrointestinal tract is our biggest interface with the external environment. So it is the main central for our immune security system. So your immune system gives a bypass to food. So it has to allow certain things, like it has to, it has to back off when a woman becomes pregnant, otherwise it would be attacking the baby because the baby is not genetically the same as the mom. So it knows, and your body has systems set up to tell it, okay, calm down, that's not foreign. And it has the same type of thing when it comes to food. So your immune system rings your mouth. You have your adenoid glands and all kinds of lymphoid tissue that circle your throat. Why are they there? Not to make kids have to get a tonsillectomy and adenoidectomy, but because they are monitoring everything that comes in your mouth, friend or foe, friend or foe, friend or foe. And your immune system gives food a bypass. If it only sees blueberries at blueberry season, it's like, yeah, I know you're good. You only come once a year at blueberry season. If you're eating blueberries every day, it starts to freak out. It's just like the example I use is if you go out of your house and you you see a stranger standing in the road by your house, you see them one day, you might just look around and go, I don't know them, what are they doing here? You're not going to worry about it. You come home the next day, they're standing outside your house, you might ask your neighbor, so do you know who that is? Like, I don't know who that is, why are they standing outside our houses in the street? If you come home every day for a week or a month and you see this stranger standing outside your house You are going to call the police and say, "Come, something's wrong. They're doing something wrong," right? It's the same with your immune system. When it starts seeing blueberries every day, maybe not even every day for a week or every day for a month, but when you eat blueberries every day, and I know there's some of you listening who eat certain things every single day, your body sees something that's wheat or gluten or something that comes out of a cow. Right? You— your immune system does not like that and it goes, "There is a problem here," and it starts reacting. Not to mention that if you're eating these same things that are highly inflammatory, gluten is inherently inflammatory, particularly the GMO strains in the US that has such a high gliadin content or cow's milk dairy. We are not baby cows. We're not made to digest cow's milk. Then they're inherently inflammatory. You're gonna have inflammation from that that's gonna affect the gut. It's gonna be just destroying your microbiome and you're gonna start to get your tight junctions are gonna start to separate in your gut and you're gonna start to get a leaky gut. Well, then it's a chain reaction. You don't break down and digest your food properly. So then you have this ginormous particles of broccoli coming through because they still look like broccoli in the small intestine when they're not supposed to. They're just supposed to look like magnesium and some carbs and amino acids, and they don't look like that. If they look like broccoli, well, then they can get through these tight junctions and your immune system really freaks out about that. So you need to eat on a rotational basis, right? So in the Stone Age, we ate seasonally, locally, We don't, we don't live in that, that way now. We can have whatever we want whenever we want it. So a way we can emulate that is do a 4-day rotational diet. So any food you eat on a Monday, you will not pass your lips until 4 days later. Tuesday, Wednesday, Thursday, Friday. So not till Friday. So if I eat olive oil on a Monday, I won't eat olive oil or anything containing olive until Friday because it's the particular antigen of the food. So you could have olive oil, olives, olive tamponade, right? So that all falls in the same category. If I have arugula on Monday, I'm not going to have it again till Friday, but I can have spring mix on Tuesday because that is a different antigen than arugula.

This is just within the things that come up positive on the test, or is this a way that you eat normally?

I recommend for people in a gut healing protocol period to eat all foods on a rotational basis.

Okay.

Once you get your gut healed, then I say everyone has to find their own edge of what your body can tolerate and what it can't tolerate. Like gluten for me, I'm not celiac. I do have the DQ2 and 8 genes, heterozygous. So I have a genetic predisposition to a gluten sensitivity, and my— that was a big part of my leaky gut when— before I got healthy. So I eliminated— so it came up, gluten came up sensitive on my first food sensitivity test. And like I said, I loved seeing in black and white, oh yeah, those are all the things I eat. So I got rid of it and I got rid of it for 6 months. And then I always say 3 strikes, you're out. So the first strike was on the first test and the second test. No, I didn't test. Then I tried adding it back. So after I kind of got my gut straight and I was feeling a lot better, I tried to add it back and I, of course, one food at a time, no more than one every 4 days, and I reacted to it. So that's the second strike. I took it out for another 6 months. And then 6 months later, I tried again and I reacted to it. So that was the third strike. But what I've learned— this was 12 years ago— is that I can eat— so I love Indian food, probably a lot of other people do too, and I particularly love naan bread. And it's— I have had a hard time finding gluten-free naan bread, and I've tried to make it, and a laugh, I can't make it like they make it. And so I have found that I can have one piece of naan bread about once every 3 months and I am okay. So, you know, you have to find your own edge with this food situation. I really don't recommend that people go back to eating the same things over and over every single day once they've healed their gut because I think it's just asking for a problem because it's trying to go against our biology. It's not how we're wired. And, and try as we might, we want to be able to watch blue lights till 1 AM and then immediately fall asleep because that's just how we want to be. We want to be able to thrive on 5 hours of sleep because I, I know people who say sleep when I'm dead, it's a waste of time, right? No matter how we want to do that, then we come up with Oh, I'm gonna power nap, or I'm gonna do this theta brainwave meditation to make up for the sleep I'm missing. Your body doesn't care. The body will have the final say, right?

Yeah.

If you're not getting 7 or 8 hours of sleep, you will pay for it. You will die sooner. You will have more health problems. Your sleep will be disrupted if you look at blue lights till right before you go to bed. And the eating patterns are are just like that. Now, having said that, I do know some people who have healed their guts now, but I will say they don't go back to eating bread and cheese every single day.

Yeah.

And I find that those who do really struggle. So I don't— I think that people have to learn their own edge of what their body will and will not tolerate, and then they have to live that edge.

Yeah.

And it's a, it's a living edge. Edge. It's not a hard edge, right? It's not like the wall in your bedroom. So it can change. If you are under a lot of stress at work, your body's not going to be able to tolerate certain foods with a certain frequency that maybe it can other times.

And of course, the irony is that's exactly when people eat those bad foods.

Exactly. So everybody's got to individually figure it out.

Yeah. Okay. Getting back to the hormones, Although that was certainly tangentially related. One relatively common complaint I have for some of my female clients is PMS-type symptoms like migraines, bloating, et cetera, prior to their period. Do you think this is gut related?

So first off, let me say that PMS, bloating, PMDD, premenstrual symptoms, or menstrual symptoms like dysmenorrhea, pain on your periods, Heavy periods, painful periods, passing clots. None of this is normal. Mm-hmm. Let me say this. I just want everyone to hear that. We have normalized menstrual dysfunction in our modern society and it is not okay. So is it microbiome related? I definitely think that could be part of it and usually is part of it. So what all those things generally mean is you've got too much estrogen or estrogen dominance and not enough progesterone. And we really do live in a culture that fosters our lifestyle, our diet fosters estrogen dominance, lack of estrogen detoxification. So we accumulate too much estrogen. We take in a lot of pseudoestrogens like phytoestrogens from plants. Or xenoestrogens from our environment, like in plastics. I heard it estimated that we eat a credit card of plastic on average every month. I was appalled by that. But plastics act like estrogens in the body, you know, parabens and phthalates and all these additives in our cosmetics, our cleaning products, act as estrogens in the body and endocrine disruptors. So most of us have too much estrogen. And if you've got any of the symptoms you mentioned you generally have too much estrogen and not enough progesterone. Why don't we have enough progesterone? Because we're all stressed out. And we already talked about how Queen Cortisol, she will be taken care of and served at all costs. And there's something called pregnenolone steal that happens in your body and the adrenal glands. So all of these— a lot of these hormones are made from the grandmother hormone, which is pregnenolone, and they all are made from cholesterol, which comes from animal proteins, that's turned into pregnenolone. She's the grandmother. And then the grandmother goes— she can be made into estrogen, testosterone, progesterone, aldosterone, which regulates your kidney water and electrolyte balance, and cortisol and DHEA, and a bunch of other minor hormones on the pathway. We already said cortisol will be served at all costs at the expense of progesterone. This is why when you're stressed out, you might miss a period. And this is why when you're worried about missing a period, you might miss a period, because your body— you're worried, you're stressed, cortisol goes up and stops— your body stops making progesterone. Progesterone is the antidote to estrogen. Estrogen is the builder and progesterone is the developer. So think of estrogen makes would make a tree grow tall. Progesterone makes that tree grow wide with a lot of bat branches and a wide trunk. You need both for balance. You don't want a tree 200 feet tall that's a little toothpick because it's going to fall over in the wind. It's not sturdy. And you don't want a 1-inch stub of a tree with a million branches so that it it just looks like a hairy monster. You want a healthy height tree, right? Whatever that is, 20, 50 feet. And you want good branching architecture so that it gets good sunlight exposure and it can have photosynthesis. So it's the same with estrogen in your body. Your breasts, your uterus, and all your tissues respond to estrogen and progesterone. You want good growth and development. So if you have too much estrogen, you're growing and not enough progesterone, you're going to have symptoms like PMS, PMDD, bloating, and then painful periods, clot—

PM—

post, uh, premenopausal dysphoric disorder. It's more severe than PMS. Okay, so what does it have to do with the microbiome? Like we mentioned estrogen earlier, estrogen metabolism is regulated not only by what your body makes in terms of estrogen or takes in, but what it discards or doesn't discard. And a key step in estrogen detoxification occurs in the gut. And there are certain bacteria that are dysbiotic that you can have that can cleave off the tag that your liver put on the estrogen to tag it to go in the trash, which is your poop, which goes in the toilet. And so this beta-glucuronidase, it can cleave off the tag. So your liver tags the estrogen to go in the trash, and then these bacteria cleave it off, and then you reabsorb it. And so not only are we getting all these exogenous estrogens from the outside, but we're not pooping our estrogen that we need to detox out. And constipation is epidemic in our country, like Nature made you to poop every time you eat. You have something called the gastrocolic reflex. Your stomach feels gastrocolic, colon. Your colon should empty. Eat, poop, eat, poop. If you're not doing that, your doctor's not going to call it constipation because based on the Rome criteria, it doesn't meet criteria, which is some insane thing like you don't poop regularly more than once every 4 to 7 days, which is insane because basically if you're not pooping when you eat I consider it— that's not normal. I don't care what you call it, constipation or not. So, and that's epidemic. I can't tell you— I'm sure you do too, and you talk to people who are like, oh, I poop once every 7 days. So if you're not pooping, you're not taking out the trash, and you're not getting your estrogen detox, and you're just— your body's just sucking it back up along with everything else it's taking and making. And this is why we are a nation of estrogen dominant people.

Yeah.

Yeah.

No, I had that problem. So can you supplement it? Obviously you wanna fix the gut and you wanna fix the root cause issues, but can you supplement progesterone by itself or do you just try and detox the estrogen? What do you do to fix that?

I mean, I'm a proponent of root cause resolution, like fix the cause of the problem, don't mask it. Particularly in younger women, you know, if you take— start taking exogenous progesterone from the outside, you can really— it can help you in the short term, but long term you can wonky your cycle worse. You got to detoxify the estrogen, right? So stop using cosmetics and cleaning products that have xenoestrogens. Stop eating cow's milk. Stop eating hormone-laden animal protein. And then get your liver tuned up so you can take supplements to help your liver detox. Get your poop tuned up. You can do coffee enemas to get your liver getting rid of that stuff and just get your gut, which is the sanitation department, is supposed to be getting this stuff out. And you can do supplements and diet and activities to get the poop moving and get the estrogen moving out. That's usually best place for everyone to start. And then there are things you can do if you're not making progesterone. The number one reason is 'cause you've got a cortisol problem. So you gotta work on your cortisol. We all have cortisol problems. I've only ever seen one person who didn't, and that was a woman who already took impeccable care of herself and brought her daughter to me 'cause her daughter was having problems. And she said, I want you to do my cortisol salivary test just to see. And it was perfect, right? I've never seen another perfect one. So it's to fix your cortisol. And there are supplements you can take, but really, like, I'm at a yoga retreat right now, Lindsey Parsons, and I've been here 3 weeks. And sometimes it is so painful for me to sit in the classes and see how slow they go because they're all about mindfulness. Mindfulness and that deep belly breathing, which I love and helps your cortisol. But I even think that in my day-to-day life, I do way less than many people. And I don't watch the news. I don't own a TV. I barely go on social media. I just don't do— I don't want to attend to the news. I don't have these distractions. And I think that I'm doing it slow. And then I come to a place like this and I find out just how not slow I am. And, and really like the stress level in our lives, we have normalized it. We really have normalized a very unhealthy level of stress. Now, some of it we can't get rid of it, but a lot of it we can. And the intention with which we approach the activities that we do undertake and the rapidity with which, like I notice how I speak really fast. And I noticed that that's stressful, but it's just a habit, but I can choose to do it differently. So anyway, back to the progesterone. The number one thing we need to do to fix our progesterone is cut our stress. Now, I, I think you should do those things first, address the root causes. Having said that, at a certain point when a woman— sometimes if women are trying to get pregnant, they do need to supplement with progesterone.

Yeah.

Sometimes at a certain age, women just do need progesterone and that can start as young as 30, 35. And by the time you're 40 or 45, it's almost guaranteed to feel like a normal— your normal self. Most women are going to have a hard time. I will say there are some supplements you can take to help the ovaries to function better when— if they have enough reserve, like chaste berry.

Chaste berry?

Can help with that. Mm-hmm. Chaste berry. And so that can help if you have enough reserve. Once you get over 40, you know, your number of eggs in your ovaries is going down and your reserve is going down for most women. You might get some benefit with that, but you have to see, and then you might just need to go to progesterone. And progesterone is pretty easy to get. It's over the counter. You don't need a prescription and it's pretty easy to use and it's pretty forgiving. So it certainly is something people can do.

Are we talking about creams or over-the-counter pills?

Oh yeah, cream. Cream.

Yeah, I have used, I have used those. Okay. Well, unfortunately we are out of time and this has been such an interesting conversation. I really enjoyed talking to you about this stuff.

Yes, I've enjoyed it too. It was super fun. Thank you so much for having me.

Yeah, it's my pleasure. I loved her metaphors for everything. I think that's very useful for making hard to understand scientific concepts very accessible. So links are gonna be in the show notes to where you can find Kiran and her hormone programs. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my gut healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as Twitter, Instagram, and Pinterest.

Links for all those are in the show notes.

Thanks for joining me today, and here's wishing you all the perfect stool.