Episode 12: Why Your Hormones are Messing With Your Gut
Why does your gut seem to rebel before your period? Why does stress leave you bloated for days? And what do hormones like cortisol, thyroid hormone, insulin, estrogen, and progesterone actually have to do with digestion?
In this episode of Team Gut Girls, Dr. Whitney Baxter, ND, Dr. Dominique Vanier, ND and Dr. Christina Carew, ND break down the powerful connection between hormones and gut health. From bloating, constipation, and diarrhea to stress-related digestive issues, they explain how hormone fluctuations can influence gut motility, stomach acid production, nutrient absorption, inflammation, and even the gut microbiome.
You’ll learn why period bloating isn’t just water retention, how chronic stress impacts digestion through the cortisol response, why thyroid dysfunction can cause constipation or diarrhea, and how insulin resistance may contribute to digestive symptoms long before blood sugar levels become abnormal.
The team also explores digestive hormones like gastrin, secretin, CCK, ghrelin, leptin, GLP-1, and motilin, plus the emerging role of the estrobolome, the collection of gut microbes involved in estrogen metabolism.
Most importantly, you’ll walk away with practical tools to better understand your body, including symptom tracking, cycle awareness, stress management strategies, and questions to ask your healthcare provider.
In this episode, you’ll learn:
• How hormones influence bloating, constipation, diarrhea, and gut motility
• Why stress and cortisol can disrupt digestion and increase gut permeability
• The connection between thyroid health and digestive symptoms
• How insulin resistance may affect gut function and metabolism
• What the estrobolome is and why it matters for hormone health
• Why period bloating is more than just water retention
• The role of GLP-1 medications in digestion and fullness signals
• Which lab tests may help uncover hormone-related digestive issues
• How to track gut symptoms alongside your menstrual cycle
• Foundational habits that support both hormone balance and gut health
If you’ve ever wondered whether your hormones are contributing to your digestive symptoms, this episode will help connect the dots and give you practical next steps.
Because Better Gut Health Changes Everything.
00:00 Why Your Hormones Are Messing With Your Gut
01:01 Hormones Meet the Gut
02:13 Myths and Cycle Clues
04:25 How Hormones Signal
06:39 Digestion Hormones 101
08:36 GLP Meds and Testing
11:07 Insulin and Motility
14:20 Thyroid and Bile Links
20:30 Vitamin D as Hormone
22:31 Cortisol Stress and Gut
31:27 Hormone Balancing Debate
39:23 Estrobolome and Period Bloat
44:39 Practical Tracking and Foundations
49:12 Talking to Your Doctor
51:10 Key Takeaways and Wrap
12 Why Your Hormones Are Messing With Your Gut
Hormones Meet the Gut
Dr. Whitney Baxter, ND: Welcome back to Team Gut Girls, the podcast where we simplify health so you can ask better questions, find answers, and feel empowered.
Dr. Dominque Vanier, ND: Today we’re diving into another important topic that’s relevant for everyone, which is how do hormones impact the gut? So from estrogen to thyroid hormone, these chemical messengers play significant roles in how our digestive systems function.
Dr. Whitney Baxter, ND: I am Dr. Whitney Baxter, joined by Dr. Dominique Vanier and Dr. Christina Carew. And when we talk about hormones, we’re not just talking about estrogen and progesterone. Those are the ones you often think about when we say hormones. But we have at least 50 different hormones working throughout our body right now.
These are the chemical messengers that work on things like reproduction, metabolism and energy balance, growth, our sleep-wake cycles, and the immune system. Have you ever [00:02:00] wondered why your digestive issues seem to flare up with hormonal changes? Or do you have Hashimoto’s and experience constipation and bloating?
Today, we’d like to uncover these connections
Myths and Cycle Clues
Dr. Christina Carew, ND: So Whitney, there’s lots of myths around hormones and bloating. So maybe we could start with the most common one, hormones have no impact on your gut health. This is probably what most people have heard when they’ve been in their primary care office.
Dr. Whitney Baxter, ND: And I think anyone with a period knows that’s just not true.
Of course, throughout our cycle even, there’s shifts. There’s looser stools, there’s constipation, there’s bloating. There’s lots of research, and more recently I think, showing these hormonal changes and fluctuations in our gut health. Even IBS or irritable bowel syndrome is more prevalent in women, so researchers started to look at sex [00:03:00] hormone influences on IBS.
Dr. Dominque Vanier, ND: An interesting point. So okay, so why do you think some people will still downplay this connection, Whitney?
Dr. Whitney Baxter, ND: Hormones influence multiple bodily symptoms, and the gut is often overlooked despite it being a major hub. It’s a major communication hub in our body. It has its own brain. It’s connected to the rest of our whole body systems
Dr. Christina Carew, ND: Awesome.
you said we were gonna talk about lots of different hormones today and what their roles are in the body. where do you wanna start?
Dr. Whitney Baxter, ND: So I think it helps to first review the hormones involved in digestion, ’cause there’s a lot, and we can see that other hormones, like estrogen and progesterone, can play into this as well.
So we’d like to connect the dots to explain bloating that isn’t caused by food or digestion itself, so this [00:04:00] podcast has a lot of episodes on these things. Wow. period-related bloating and nervous bowel movements or the ne- nervous poops, why we always talk about slow, mindful eating and how this improves digestion, how chronic stress or burnout disrupts digestion.
I’m cer- I’m sure you’ve heard this a lot
Dr. Christina Carew, ND: And so you mentioned a lot about hormones.
How Hormones Signal
Dr. Christina Carew, ND: How do they impact our gut health directly?
Dr. Whitney Baxter, ND: So hormones are our body’s little messengers. They help with long-range communication networks versus the nervous system, which is really quick. It’s immediate. They’re are released from glands throughout the body and travel through our b- bloodstream to act at specific sites.
And then when they get to that site, so s- say along the gut, they use a specific key and lock mechanism, which is called the receptors. So there are a lot of different receptors for various hormones throughout the gut. So our [00:05:00] stress response is a good example. So adrenaline, so say you, you get an email you’ve been anticipating and it’s not a good one, and you, feel that rush of heart rate starting to beat, your vision starts to go.
So that’s norepinephrine. That’s that immediate response that’s happening. But then cortisol, our stress hormone that I’m sure you’ve heard about, that’s also released, but this is through- through the blood, so it’s a little bit slower, and it has to go through a series of checkpoints, as our hormones do.
But its response and its purpose is to keep us being able to run from that threat or react to that email and cope for longer. And cortisol has receptor sites along the gut. So during the stress response, for example, it’s gonna ask the liver to release more glucose for energy into the bloodstream. It’s also gonna ask the gut, “Hey, please stop digesting that meal.
We have [00:06:00] to keep running. We have to keep reacting.”
Dr. Christina Carew, ND: I hope you’re gonna talk about cortisol belly, ’cause we get asked that all the time in clinic.
Dr. Dominque Vanier, ND: So now since the whole digest- digestive tract is so complex with, there’s many different jobs that we talked about and there’s a lot of messages that are going back and forth, so these messages that we, are full, and there’s messages that we are full and to stop the release of hunger hormones.
It needs to be able to sense chemicals and nutrients to know what is safe to absorb.
Dr. Whitney Baxter, ND: And these chemical messengers, these are the hormones.
Digestion Hormones 101
Dr. Whitney Baxter, ND: So let’s just do a rapid review of these digestion-specific hormones. You’ll probably recognize a lot of these things. We’ve talked about before how to set your digestive tract up for success.
So eating without distracti- distraction, sitting, being mindful about your meal, smelling that food as you [00:07:00] prepare it, eating and chewing slowly and mindfully. So this is just setting the gut up for success so you can fully digest that meal and not get bloated or, indigestion.
Dr. Dominque Vanier, ND: okay, so point one, let’s talk about this a little bit further. As food… As soon as food hits the stomach, gastrin is signaled to release hydrochloric acid, also known as stomach acid more broadly, to break it all down. Point number two is once this acidic mix enters the small intestine, secretin is gonna stimulate the pancreas to release bicarb or bicarbonate into the small intestine, and this will neutralize stomach acid and helps aid digestion.
And then point three, or the third in this whole sequence, is we have another hormone that senses the presence of fats and proteins in the small intestine and triggers the release of digestive enzymes from the pancreas and bile from the gallbladder to help break these down. So we’ve got something called, [00:08:00] CCK, which it goes for, in short form, or cholecystokinin is what it’s known for in the medical terms.
Dr. Christina Carew, ND: And there’s still others. Yeah. So there’s ghrelin, which senses that our stomach is empty. There’s leptin, that is the signal that helps the brain to reduce appetite, so sometimes you’ll hear people get their leptin tested. and when leptin is released, it increases fat stores in the adipose tissue. So our levels rise after eating to tell us to slow down our motility and not need to eat as much.
GLP Meds and Testing
Dr. Christina Carew, ND: and then there’s the GLPs, which we know way more about now, or maybe less about than ever before. and so they’re the signal that tells us that our brain is full. That’s how the GLP medications are working, is to try to halt, the motility in the intestinal tract so the I’m full. I don’t need to eat more,” and hence cutting out things like [00:09:00] snacking, which is why some GLP medication users find that it’s really helpful, in lowering, the food noise or being able to help them with less snacking.
but if you’re not a snacker and you don’t have food noise, then this may actually be one of the reasons why it’s not working for you. And the side effects of the delayed gastric emptying, that’s one of the things that happens with the GLP is it stops the stomach from emptying its contents out so you feel full longer, actually can make you feel very bloated and nauseous.
and so that fullness is actually similar to what we talked about in the gastro paresis, we- podcast, which is a cou- a couple, before this. And so that’s how this therapy is currently working. and then there are variations of this that include other, other peptides that are also, working on different [00:10:00] receptors, so back to that lock and key.
Dr. Whitney Baxter, ND: we could test most hormones, but can you test leptin or have you seen people do this in practice, Christina?
Dr. Christina Carew, ND: Yeah, I have seen, a, an, a nurse practitioner that I work with, I’ve seen it come on labs. I’m not sure that it… it seems like hormones, as we know, when we test them, they’re, like, very up and down.
It’s like one of the challenges of testing hormones in females is, it changes based on the timing of the cycle, the timing of the day, if they’re using medications. There’s all these other components, right? And so it’s not that we… And, all of our blood changes all the time. It’s, a reflection of that moment in time on that day and that blood draw.
and so these types of things give us some insight or information, but they’re not like, it’s not like a perfect slam dunk. It’s not like an X-ray of a broken bone where we’re like, “That bone is clearly broken. It will still be broken, in 12 hours [00:11:00] from now.” hormones are very fluctuating, so it becomes really challenging.
Dr. Whitney Baxter, ND: Yeah. Great point.
Insulin and Motility
Dr. Whitney Baxter, ND: and similar, insulin, is a hormone release, but that too, there’s so many different ways of testing it. There’s fasting insulin. There’s a two-hour glucose tolerance test. If you’ve had a baby, that’s what you’re doing, and- it’s the worst. Or sometimes medical doctors will just test blood sugar with the, what this, insulin is involved with.
So yeah, it’s hard to capture these fluctuating little chemical messengers. So yeah, one that you’ve heard a lot about and tests, we test often to see how your body’s managing glucose balance and even how it’s coping during chronic stress. So we talked about how stress triggers glucose to be sent into the bloodstream.
So insulin, its job is to sense blood glucose rise after eating. So we eat, the food [00:12:00] gets into our bloodstream, that rises the sugar, and then, its job is to bring that into our cells to influence metabolism and digestion.
Dr. Dominque Vanier, ND: I test fasting insulin pretty often because I do, like on the topic of this podcast, is I do a lot of digestive health and hormone health.
And we can see insulin start to rise well before somebody’s glucose or their A1C will start to go up, right? So you wanna think almost like insulin, yes, it has, plays a tremendous role in dig- digestive health, but it also acts more as like a primary indicator, and then we can see glucose and A1C start to rise as lagging indicators.
So I find it a really helpful test.
Dr. Christina Carew, ND: Also, when, people’s triglycerides are high, this means like your body is storing fat in, in a way generally less desired. So we’re thinking about things like fatty liver or belly fat. Yeah. And so insulin can also help to uncover like why the body is in this m- more of a storage than a burning mode.[00:13:00]
which definitely d- affects digestion and what foods we decide to eat.
Dr. Dominque Vanier, ND: Absolutely. And so another hormone, as it relates to the digestive tract is something called motilin, and its function is to stimulate gastric and intestinal motility. So motility, again, is the speed at which things move through the digestive tract, especially during fasting, and this helps to promote regular digestion.
And so the trigger for the release of motilin is going to be somebody who is in a fasting state. So let’s say that, they’ve been fasting overnight, for example, for 12 hours. stomach distension. Those are the two main, things that will trigger its release
Dr. Whitney Baxter, ND: So again, it’s this whole hormonal cascade as you eat. It’s constantly your body’s re- there’s a feedback mechanism. So okay, the brain it hits this section, and it goes back and tells the brain to release this hormone, and it’s this, [00:14:00] yeah, complicated process and we love the names, motilin, gastrin. I remember being in university and laughing, saying, “Really?
We got really creative here.” Okay, so let’s get into some other hormones that have receptors and actions on the gut.
Thyroid and Bile Links
Dr. Whitney Baxter, ND: So one that we introduced earlier is our thyroid. So what are some clues that thyroid imbalance is acting on the gut?
Dr. Christina Carew, ND: Yeah, so we can have a fast thyroid, so a hyperthyroid, and we can have a slow thyroid, a hypothyroid.
And so think of the thyroid like a thermostat. And so when things are slow or low, things are low and slow. So we’re more cold, we gain weight, we might have more constipation, we might have more dryness or muscle aches or swelling in the body. certainly bloating in this case might be as a [00:15:00] cause of constipation.
we also know that the thyroid is responsible for lots of our LDL recycling, and so we might see like cholesterol starting to go up, which can then be part of this like sort of fatty liver picture, which might be another reason why we’re getting some like abdominal changes. and so that’s like the slow thyroid.
And then we can also see, maybe not related to bloating as much, but a fast thyroid actually can make people feel more, I would say often confused with like menopausal type symptoms. They feel more hot. They feel more agitated. they may have some heart racing, sometimes more diarrhea. It’s the other way.
Things are going too fast or, insatiable hunger. And the thyroid really does regulate this sort of continuum of what’s going on in the body, and even a little fluctuation can actually show up as a large amount of symptoms. So you don’t have to be, fully in a state of hypothyroid [00:16:00] where you are needing medication, but you may actually be somewhere on the continuum and still be getting constipation.
So it’s not always a only once you cross this line and you get these symptoms, you’re gonna get maybe some of these symptoms along the way. And so we can definitely, test, things around the thyroid. often traditional medical system tests, a marker called TSH. It’s the signal from your brain to your thyroid gland, and I always think about this as the last piece to break.
And so generally, if the TSH is going wild, then this has been a problem for a long time. It’s not like yesterday my thyroid stopped working very well. we can actually do a full thyroid panel, which includes things like, free T4 and free T3, and even thyroid antibodies, which are similar to what Dr.
Vanier mentioned as, this sorta, insulin is a precursor to diabetes. we can think of some of these [00:17:00] thyroid issues as being indicators of, a future thyroid problem to come, and as a place where we can actually make a lot of change and, reverse things that are maybe no longer our destiny by just knowing that they’re there
Dr. Whitney Baxter, ND: That’s a great point.
You can really get a full picture. Sometimes you do have to pay out of pocket if TSH is normal. it doesn’t… I meant yeah, the health system won’t cover the active thyroid hormones because that’s
Dr. Christina Carew, ND: just the- Depends on where you live.
Dr. Whitney Baxter, ND: Depends on where you live. But, here it’s about $25 for each one, so it’s worth it sometimes just to get a full picture of what’s, what we’re looking at.
but yeah, so thank you. That was a great description about our thyroid. So let’s talk about insulin resistance. What are some clues that insulin resistance is at play?
Dr. Dominque Vanier, ND: So we talked a [00:18:00] little bit about this before, but insulin regulates blood sugar levels, and you wanna think of it like, insulin and your glucose are best friends.
So in order for glucose to get in the cell, we need the presence of insulin. one of the caveats is that you actually don’t necessarily need this when you’re exercising, which is why exercise is so amazing for getting glucose into- the cell out of the blood. But interestingly, insulin also has implications for gut health, like we started to go over before, and we do know that elevated insulin can promote inflammation and influence gut permeability.
I think it’s a bit of a chicken or egg here, right? ‘Cause we are often seeing, yeah, elevated insulin with more like a metabolic picture, and truly with like metabolic issues such as, the crossover of cholesterol, glucose, fatty liver, PMOS, which was formerly known as PCOS. They’re more likely to have inflammation, and so it can be a little bit like, point A to point B, back to point A.
but all of this is, going to [00:19:00] influence gut permeability, so we can see issues with digestion show up in that picture. And I think it’s important to talk about bile a little bit more. so Whitney, talk, talk to us a bit more about what the role of bile is.
Dr. Whitney Baxter, ND: So it’s not a hormone, but it’s definitely involved in this whole cascade of things, and we need the hormones to release the bile to be able to di- digest the fats.
So if we’re not getting that release, we’re not getting that absorb- absorption of fats, which can lead to something called bile acid diarrhea or bile acid malabsorption. So that’s always something we’re considering too if you’re presenting with looser stools. but it’s crucial for this digestion and absorption.
It also supports our gut microbiome, so there is a ni- there’s a really interesting link there. And disruptions in bile acid [00:20:00] productions can, again, flare up our gut, so even irritable bowel syndrome,
Dr. Christina Carew, ND: Yeah, if we think of the gut like a conveyor belt, bile is the thing that turns on the conveyor belt.
And so if we’re missing it, then everything gets halted, which is why we get more bloating and more fermentation. So lots of gas, burping, things like that.
Dr. Whitney Baxter, ND: And a lot of people are told they have sluggish gallbladders or, yeah.
Vitamin D as Hormone
Dr. Whitney Baxter, ND: And lastly, vitamin D. It’s called a vitamin, but we’re also learning a lot more about it, that it works like a hormone.
There’s vitamin D receptors all over the body, which is really fascinating. It plays a role in immune function, inflammation along the gut. Low vitamin D levels have been linked with gut diseases, dysbiosis, which is really exciting. So it’s another one you have to pay out of pocket for if you don’t have a osteoporosis [00:21:00] diagnosis.
I guess, again, depends on where you live. But it’s worth it to understand what your levels are so you can take higher than the recommended 2,000 IU per day.
Dr. Christina Carew, ND: I would also say that if you’ve been taking a larger amount, it’s definitely worth making sure that your vitamin D is tested, because more often than not, people can be actually really high, and that can actually cause you a lot of symptoms.
I have had some patients that listen to podcasts, not this one, who were taking very high doses of vitamin D, and their symptoms were actually from high vitamin D. But every time they had declined getting it tested, so they didn’t actually know their levels. super important. and then the other side could be you could be taking a ton of vitamin D and not absorbing it.
And so that can also still show as low even though you’re taking it and you think you’re doing the right thing, it may not actually [00:22:00] be absorbing. So-
spending the couple of dollars to get the number even once a year can be really helpful.
Dr. Dominque Vanier, ND: And I will say, at least in Ontario, so again, it depends on where you are, there are other reasons to get it OHIP covered.
So malabsorption syndromes- will typically allow for OHIP coverage of vitamin D. but a lot of the time patients need to pay out of pocket first in order to identify that they’re low and there’s other stuff going on. So it’s, they usually have to pay for it first.
Cortisol Stress and Gut
Dr. Dominque Vanier, ND: I wanna talk a bit more about cortisol, ’cause we know that plays a role with stress, and then further can affect our gut.
Whitney, let’s talk a little bit more about that.
Dr. Whitney Baxter, ND: We’ll talk about testing cortisol too, you brought that up earlier, and whether we do that or how we do that. I think that was something that is good to talk about. but yes, we’ve all experienced this. High stress can significantly [00:23:00] impact our gut, hormonal digestion cascade.
When you’re stressed, you may have bloating, looser stools. Some people have no appetite at all, and maybe they’re really constipated or uncomfortable, so it really depends. So the stress response, you may have heard of this, the hypothala- hypothalamic pituitary adrenal axis, or HPA axis. So our hypothalamus is in our brain.
That sends a message to the pituitary, which is also in our brain, which then travels down to the adrenals and then releases the cortisol and mineral cortic- corticoids, just to basically help our body deal with the stress. so it’s, the… j- its job is to get you running. Its job is not to get you digesting.
So this is why your mama told you not to jump into the pool after you’ve eaten, because your body cannot exercise and [00:24:00] digest at the same time. You will cramp. I have… Yes, we don’t. I’ve had too much of a meal before going out for a run, and it’s just the worst. So over time, chronic stress contributes to gut hyperpermeability, so tune into the episode on leaky gut or gut hyperpermeability.
We talk a lot about this. But chronic cortisol elevation can disrupt the tight junctions, those proteins in the intestinal epithelium, increasing this intestinal permeability, so this disorganized, good barrier system that should be there. So this can allow bacterial components, like the more inflammatory lipopolysaccharides to translocate into our circulation, just triggering our immune system.
So there’s more inflammation. This is d- going to disrupt the good movement or motility of our gut, so that can slow things down or [00:25:00] that can speed things up, leading to bloating and discomfort. So chronically elevated cortisol is going to impact the hormones of digestion we went over before, so impacting sufficient stomach acid release, enzyme production, optimal gut motility, nutrient absorption, so which we can either slow gut movements, send the whole food particles into the microbiome, causing fermentation, bloating, or just trapped gas
Dr. Christina Carew, ND: So the rest and digest.
Yeah. Fight and flight.
Dr. Dominque Vanier, ND: maybe this is a good switch into cortisol testing, right? And it… And I think it’s quite similar to what we talked about before, which cortisol is just fluctuating pretty, constantly, right? And so somebody does have the option of testing it at 8:00 AM or at a different time, and it’s supposed to be highest at 8:00 AM, and then there’s another peak around midday, and it’s supposed to taper off.
But [00:26:00] even if somebody’s cortisol is normal, which most of the time it will be at 8:00 AM, it doesn’t mean that they’re not experiencing stress. and if somebody was to test their cortisol the next day and the next day and the next day, we would see different numbers come back. So often when it comes to cortisol testing, we’re really looking at, like for example, is there like an adrenal tumor, right?
Like something that is, is releasing such significant amount of cortisol where we’re gonna see it a bump above the elevated range, or are we looking at something like in the autoimmune range where somebody’s cortisol is really low? but for our purposes is peop- people are most likely to have normal cortisol when they’re going through like high levels of stress.
Dr. Christina Carew, ND: Yeah, I think it also depends on what you’re looking for. So the range, at least, where some of us are, is like pretty large. So it’s like 150 to 500. And typically if we’re thinking about this is your amount for the day, and it’s earlier in the [00:27:00] day, we would hope that you’re towards the top end of the range and not the bottom end of the range.
And back to the idea of there’s dysfunction, and then there’s disease. And so we may see, one of the things that I will sometimes do is run this test, and I see people are, a little bit on the low side or chronically high. I have had people that have been chronically high, like so 500 being the top of the range, I’ve had someone, she was eight- 18, and she was 900.
and so then we’re like, “Okay, is this normal?” Is this a dysfunction, or is this, also I didn’t wanna get my blood tested, I was irritated by going there, all the other things that happen. and so there are some other ways, like a salivary test where someone can do it at home, so we can see, are they historically low.
It was actually what drove me to become a naturopath in the first place. My, salivary cortisol was actually a straight line. Should be like a mountain. And, the naturopath I seen, saw at the time was like, “How are [00:28:00] you existing?” And so it actually opened the door for me to understand so much more about what was going on in my body.
And so it’s not similar to the others, not a perfect test, right? We’re not looking, often not looking for disease, but we’re looking for clues to tell us like how your body’s running, not just how you’re feeling. Sometimes it’s nice to have a piece of paper that says something’s not right.
Dr. Whitney Baxter, ND: Wow, that’s, fascinating. Good thing that you caught that. And like you said, sometimes with the symptoms, plus you do these tests, it’s gonna give us more information, right? Because you can’t always capture that hormone exactly where it needs to be f- to give you that information. But if it is lining up with your symptoms and how everything else looks, then it can be an answer to that, and it can give us some more options to support you
Dr. Dominque Vanier, ND: And so on the topic of stress and cortisol, again, we wanna talk a little bit more about insulin. We know that higher stress levels over time, may lead [00:29:00] to some sort of insulin type of resistance picture. elevated cortisol levels will increase blood sugar levels, prompting the pancreas to release more insulin.
So there is definitely a relationship there. And then this can disrupt the delicate balance of insulin and glucose regulation, leading to cravings for things like high sugar foods, and potentially cause weight gain
Dr. Christina Carew, ND: And we see that in, ghrelin and leptin too, is, some people when they are stressed are eaters, right?
They just want to just fill the void, and some people when they’re stressed don’t eat at all, and so they’ll have periods of time where they have rapid weight loss. And some of that is regulated by the hormones, some of it is regulated by our traumas and our past experiences. some people, food is a control piece for them, and so that may also dictate how they affect things regardless of how the hormones are speaking.
[00:30:00] But just to be conscious of that, stress actually can play a big role in bloating because some of that actually might be, putting more food in, and a lot of these hormones have told us that the adrenaline will stop the motility, so we’re putting more in and it’s not moving, and so that may cause more of the bloating that some people experience.
Dr. Whitney Baxter, ND: I eat when I’m stressed. Ugh, wish I didn’t, but just love it. Okay, our microbiome takes a hit, too. So lots of sustained high cortisol, can impact beneficial bacteria species, so Bifidobacterium, Akkermansia. That’s one of those keystone species that supports our healthy gut lining and all the other good species.
high cortisol can shift our microbiome composition to more of a pro-inflammatory s- state and suppress short chain fatty [00:31:00] acid production. So again, we’ve talked about the microbiome before. This is not a forever ecosystem change. It’s, it can be very dynamic. But if you are constantly having that stress HPA axis, system being turned on, and it started…
It’s just constantly signaling, signaling, then we’re gonna wanna do some, kinda repopulation work.
Hormone Balancing Debate
Dr. Whitney Baxter, ND: Okay, next I wanna go back to some more myths. I hear this one all the time. Some naturopathic doctors hate this word. Other people use it all the time. So I’m curious what you two think.
What about hormone balancing? Let’s talk about hormone balancing I’m gonna ask you both. Tell me more …
Dr. Dominque Vanier, ND: not my favourite phrase. I think it’s also flashy. It’s “Oh, my hormones are [00:32:00] imbalanced, so I need to balance them,” right? But I think it, it also is a little bit vague. what, hormones are out of balance?
And you can have one hormone that’s, potentially not optimal or… So like for example, fasting insulin can be not high but not optimal, and we can see symptoms, but that can cross over a lot of other symptoms that we see with other hormonal issues. So yeah, definitely not my favourite, reference to hormones.
What about you, Christina?
Dr. Christina Carew, ND: I say I’m guilty of saying this, definitely. because I think about it, so maybe I, maybe, and I think I have a different brain, so, so- This is what I was looking for. Hear me out. This is why I think about it this way. So especially when I think about women, who are cycling regularly, that there is, having run, couple hundred, hormones, I could say, in general, women are [00:33:00] generally this much estrogen, this much progesterone.
And so it’s a bit of a ratio for me. And so if someone is much higher in estrogen and lower in progesterone, I start seeing it as a bit of a teeter-totter. And so I would consider that imbalance, like where we’re, like, seeing a lot of one and not as much of the other. It doesn’t mean … It may mean that we need to do some work to either, lower one or raise the other.
but it’s, n- it’s, just a part of the clue gathering to say, are some of the things that I’m experiencing related to my hormones that maybe one is functioning more than the other? So especially in stress, back to the cortisol piece, we’ll often see that women have lower amounts of progesterone, and I always think of this as, progesterone steals.
my body is hey, it’s not a good time to have a baby. I’m gonna recycle this progesterone over here to deal with this stress, and so that may make my hormones seem like they’re imbalanced. It doesn’t necessarily mean they’re not being made [00:34:00] at the similar rate. It’s, being redirected or re- reused.
and so sometimes women do feel better if we can improve some of that imbalance in their body. And I don’t know if balance is the right word, but it’s like visually for people I think that they can be like, oh yeah, I’m getting more of this symptom and less of this maybe counterbalance.
I always think of it a little bit like a scale or a teeter-totter
Dr. Whitney Baxter, ND: Yeah, and it’s, what our hormones, it’s what the hormone system’s job is to keep us in what’s called homeostasis. like some will fluctuate up and some will fluctuate down. There’s different cycles. So there’s of course our sleep/wake cycle, so cortisol should wake us up. So we should have cortisol, but it should spike in the morning and then gradually drop so melatonin can rise.
We have monthly cycles, estrogen and progesterone, and yeah. So it, is a bit flashy, it is a bit [00:35:00] oversimplified, but that is the endocrine system’s job in a way, is to keep it balanced. So instead, or in addition, we can look at supporting our hormones at doing this job in a couple of ways. So in general, we can support their production, their function, and then we can ask to measure them.
So to support their production, remember they are built from the food that we eat, so our macronutrients, like our proteins, amino acids. some pro- p- hormones are built from a cholesterol backbone, so our sex hormones are, so eating enough healthy fats. this can include mitochondrial support. Our mitochondr- mitochondria are the powerhouses of our cells, and they help h- to make our hormones as well, so supporting that mitochondria, that system too.
And their function, [00:36:00] so back to basics. Sleep. How is your sleep quality? How is your nervous system? Are you running on fumes? Do you say you’re okay, but you’re actually not? So just kinda diving deeper into those, and then can we measure the hormones, and not just a couple? Maybe we look at all of them.
Maybe we do a thyroid panel, we look at your estrogen, progesterone at certain phases of your cycle, your vitamin D, your fasting insulin, just to kinda get a whole picture of how your body’s functioning. A
Dr. Christina Carew, ND: good way to think about this is if we think about athletes, so I always think about gymnasts or skaters or young athletes.
Like the more stress their sport and their exercise and maybe even the hours they do their sport causes, the less their body makes the sex hormones. And so we’ll see lots of women that lose their menstrual cycle when they’re in their athletic prime, and part of that’s [00:37:00] back to W- Whitney’s comment about cholesterol.
if you don’t have the cholesterol to make the hormones ’cause you’re using it other places, then that’s one of the things that we’re seeing. And running a cholesterol panel on a young person can actually be beneficial because if they’re not making enough cholesterol, it’s like one of the reasons why they might not be menstrual bleeding.
Dr. Whitney Baxter, ND: Yeah. Yeah, that’s a good point.
Dr. Christina Carew, ND: Okay, so maybe we’ll talk a little bit, we’ll give you a preview about, hormones that are more related to the female cycle and its relationship to bloating, ’cause we definitely have an episode coming up on that. but there’s lots of talk about, can IBS and perimenopause be actually linked in any way?
and certainly, my belief is that, the hormones’ fluctuations definitely affect our digestive tract, and similar to what I mentioned around the estrogen and progesterone, we definitely know, [00:38:00] during phases of time when our cycle was maybe more predictable or regular, that you would have periods of time where you’re constipated or periods of time where you have more looser stools, and those might be related in some way to the hormones that were being more exhibited.
but if we think about the mast cell stuff that we had talked about a couple episodes ago, we know that progesterone’s link is actually in mitigating some of the histamine balance, and so we have lower progesterone, we have higher histamine, so another reason why we- the hormones may be starting to affect the bloating.
and then we also know that sometimes women will have higher amounts of estrogen, which may feel like bloating, but actually could even be estrogen buildup. And so it’s like why someone will be like, “Oh, second half of my cycle, my pants don’t fit,” or, “I, I don’t feel good, and then once I have this bleeding, then all of a sudden things seems to change.”
And so we certainly know [00:39:00] that, some of that is impacted from, our awareness of our gut, what’s the contents, how are, we feeling about it, and then is there even some physical reasons why things are altered, including our motility and how food moves through our digestive tract.
So lots that we can dig into.
Dr. Whitney Baxter, ND: Stay tuned.
Estrobolome and Period Bloat
Dr. Whitney Baxter, ND: And do you talk about the estrobolome at all in- Yeah … the podcast? You do? Okay.
Dr. Christina Carew, ND: Yeah. I think we can talk- That’s exciting … definitely talk about the estrobolome. So estrobolome is this collection of gut microbial genes that are more effective at, breaking down and, metabolizing estrogen.
So sometimes if people have, those, fancy stool tests or maybe you’ve done, one of the at-home stool tests, they’ll sometimes test something called beta-glucuronidase. It’s, one of our enzymes that breaks down estrogen [00:40:00] and allows it, for reabsorption and circulation. And so sometimes people will see, blockages or, highness in this.
And if we think about symptoms, if our body’s recycling things that are destined for the trash, then we- … have symptoms of, an overload, right? And this actually even happens with medication. We’ll see people that are taking medications and, they were on the same dose forever and ever and then all of a sudden their, labs are starting to change.
And we’re like, “Oh, did you change your dose? Did you change the time of day that you were taking it? what happened?” And it might be that they got constipated, and when they got constipated, then everything started to reabsorb more. And so then now we’re seeing, a change based on a functional change in the body.
The medication wasn’t meant to be there that long, and it’s now reabsorbing back in. There is some belief that maybe this is part of where we’re getting, a lot of the hot flashes and, s- heat [00:41:00] symptoms from in women that are in perimenopause ’cause the estrogen, instead of leaving the body, is, recycling back in.
And so now you’re getting this overload of this one hormone, maybe not ’cause you’re building so much, but you’re actually not getting it. and so who knows? There’s lots of reasons why our bodies operate in the way that we do, and it’s so not straightforward, which is why we ask 1,000 questions and, why hopefully you’re listening so you can see how some of these things might connect.
Dr. Whitney Baxter, ND: Yeah. Direct connection of the gut and hormones. Love it. Thank you. Okay, here’s another myth. Dom, why don’t you take us through period bloating is just water retention. It has nothing to do with your gut
Dr. Dominque Vanier, ND: it’s, yeah, period… I call it the period bloat and period poops, right? And there’s, an overlap of hormones and lots of stuff going on. So the truth is that while water retention, [00:42:00] plays a role, hormonal changes slow gut motility and can cause gas buildup and constipation. when I’m talking to patients, I’m asking, “Do you st- are you more likely to have constipation right before your period?”
‘Cause any time, as we know, when we are more constipated, we’re more likely to have bloating. When things are slowing down, we’re more likely to de- distend and bloat. But we also have prostaglandins that play a role at this time too. So prostaglandins released during your period can also trigger diarrhea and cramping in the digestive tract.
And then estrogen is primarily known for its role in the female reproductive system, like we’ve talked about, but it also protects the gut lining. And so there was a randomized control trial, which indicated that estrogen can enhance gut barrier function by supporting the integrity of tight junctions.
and we know that the tight junctions are critical for preventing permeability. So there’s a really important role there too [00:43:00]
Dr. Christina Carew, ND: Some more leaky gut as your hormones decline, just from your hormones
Dr. Whitney Baxter, ND: Just keep showing
Dr. Christina Carew, ND: up Like a whole nother episode.
Dr. Whitney Baxter, ND: It’s like a whole other episode. and patients ask me this all the time, I’m sure they ask you too, but birth control pills, and they’ve been told they don’t impact their gut.
I looked into this more, and the data was mixed. There wasn’t really anything, signi- statistically significant. they were looking at micro- the microbiome, so I don’t know if that was the best place to look, but there was nothing that was found after a six-month study. the vaginal microbiome h- saw some things.
There were some benefits with oral contraceptive use, actually. A two-year longitudinal cohort study found that oral contraceptive users had more stable vaginal microbiomes [00:44:00] and less, bacterial vaginosis. So that’s positive, but in other studies, it showed that it may increase the risk of candidiasis. So basically, if you’re starting or stopping a pill, and you notice some, vaginal changes or indigestion, just talk to your doctor ’cause there could be a link here Okay, so let’s go through some practical takeaways to support optimal digestion and understand how your role- your hormones can be at play.
Practical Tracking and Foundations
Dr. Whitney Baxter, ND: So simple things we’ve talked about before. Track your digestive sys- symptoms, but do it with your cycle. So a lot of these free apps like Clue will have gut symptoms in there, so bloating, constipation, diarrhea, which is great. Or you could do it in your iPhone calendar, somewhere where you can take a step [00:45:00] back and look at the month and try to see if there was any correlations with different phases of your cycle.
So when you feel bloated, changes in bowel movements, energy dips or cravings, where you are in your cycle, so this can all have some, some patterns. So maybe some more, bloating in the luteal phase or pain or discomfort where estrogen is spiking right before you ovulate. So this is always data for us when you bring us more information.
In fact, we’ll often give you this as homework if you haven’t done it before. But it’s really, helpful to start to see when you’re noticing these symptoms.
Dr. Christina Carew, ND: And a lot of the apps also have, a, area where you can add your own information in, and so it might be useful to say, “This was a very stressful period of time,” or, “I wasn’t sleeping very well,” so we can start to think about some of those other reasons why we see hormonal imbalances [00:46:00] having more impact.
Or, “I was extremely hungry,” or, “I didn’t eat at all.” because all of that information can be really helpful, and in the moment when we’re experiencing it, we’re like, “Oh yeah, I’ll totally remember that,” but we don’t remember. I don’t remember. I’m pretty sure someone else doesn’t remember, and I’m clued into remembering.
and so I think that helps us to be more of our own detective work in our body and definitely helps the practitioners, to get more information. And I, always think that the information that someone else said was, like, useless or not helpful was actually usually the most helpful information.
And so don’t disregard it even if someone says, “Oh, that’s not helpful.” just bring it up to a different doctor. So how long would you recommend, tracking, Whitney, before you would, want someone to come to see you with that information?
Dr. Whitney Baxter, ND: I usually say at least three cycles so it’s not a one-off.
That’s … You have to consider [00:47:00] if you’re regular too, if you have a regular cycle versus irregular cycle. So try to capture three cycles at least. even one is helpful, if nothing.
All right, what if someone’s cycles are irregular or they’re in perimenopause, or even if you don’t know you’re in perimenopause, we still say track. So these symptoms are true to you, so something is going on in your body, and you might notice some kind of pattern. Maybe it’s related to sleep or s- foods that you ate that month.
Maybe something else is going on. So it start to, capture some kind of pattern. It’s not perfect. Hormones are all over the place, as we’ve learned. yeah. So next, let’s just talk about some foundations. So focusing on foundations is key before restriction. So before you [00:48:00] start to cut out the foods or start on an expensive supplement protocol, let’s remind you to eat in a calm state.
So really optimize the gut’s job at digesting something effectively. S- taking some deep breaths before you eat, especially if you are someone who is undergoing a lot of stress right now, or you’ve been… You’re in a high-stress phase of your life. deep breathing before your meal can make a huge difference if, just to support the digestive process.
Chew thoroughly. I read that 40 chews was the most optimal. I think that’s crazy. So 20. Start with 20. and putting your fork down between bites can really help prevent rushing through a meal. So this is gonna support the release of gastrin, that CCK, and [00:49:00] other digestive hormones we talked about. And then building your meals to help support your hormones too.
So getting all those essential proteins and fats, and even the minerals and vitamins.
Talking to Your Doctor
Dr. Whitney Baxter, ND: Your body needs those amino acids and cholesterol to build the hormones So let’s finish up with how to talk to your practitioner. A lot of people feel dismissed when they bring up their gut symptoms, especially if it’s, coinciding with hormones.
So here are some things that you can say at your next appointment. “So I’m noticing a correlation between my cycle and digestive issues. Could we explore a potential hormonal connection? I want to understand how my stress levels might be affecting my gut health.”
Dr. Dominque Vanier, ND: And maybe I would add, “What lifestyle changes should I consider to manage my [00:50:00] symptoms?”
Dr. Christina Carew, ND: another piece that we might look at is, asking for more comprehensive blood work. Sometimes this is met with, “What is that gonna tell you?” or, “How will that help?” it can be helpful depending on the practitioner that you have, and you may find it, also frustrating if you ask a practitioner who’s not used to being, to running those tests so that they know, what the tests even mean.
But some of the ones we mentioned were, like, the full thyroid panel, so including, free T3 and free T4. if we would also have things like checking fasting insulin or vitamin D levels or even estrogen and progesterone at specific points in the cycle. And if your, first ask is met with a, negative response, just ask someone else.
There will be someone that can help you to get this information
Dr. Whitney Baxter, ND: Yeah, and you’re, asking questions. You’re not diagnosing yourself. Most practitioners appreciate [00:51:00] when our patients come and are engaged, and they’ve looked into it, and we were just gathering information.
Key Takeaways and Wrap
Dr. Whitney Baxter, ND: Okay, so today we explored a lot. We went through how thyroid hormone, cortisol, insulin, estrogen, and progesterone, and other hormones of digestion impact gut function but also could be the underlying cause or contribution to your bloating.
Some hormones slow down the motility of the gut or movement of food and gases through and out, so that could lead to bloating. Some hormones trigger an immune response or hyperpermeability of the gut lining, which could also lead to bloating. So we hope that you learned some things to talk to your doctor about, how to track your symptoms, and feel more powered, empowered with your gut health.
As always, thank you for listening to Team Gut Girls because better health, gut health changes everything
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