Thanks for joining us for episode 111 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering following question from a listener:

“I’m looking for some guidance with a gut issue I’ve been experiencing. I already know from listening to your show that I need to stop treating the symptoms and get to the root of the issue. I’m just wondering what specific tests I should ask my doctor to order and what the names are. Every month I get inflammation in my intestines. It’s tender when I press on my lower belly. I can tell things aren’t digesting correctly from my stool and I eat low FODMAP when this comes up and it clears eventually and then we’re back to the same issue. My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Digestive problems are hard enough to deal with, but even harder can be figuring out the cause. Often an imbalance of gut bacteria is the culprit, but how do you know if that’s at the root of your digestive distress?

Today’s podcast is all about the ins and outs of testing for unbalanced gut bacteria to uncover the root cause of your symptoms. We’ll walk you through which laboratories and specific tests we recommend for both SIBO and large intestine dysbiosis to take the guesswork out of the process. We even cover the gut and hormonal health connection as well as other health conditions related to unbalanced gut bacteria to help you further in the process of determining the root cause.

Here’s what Laura and Kelsey will be discussing in this episode:

• The two gut bacterial imbalance tests to have done if you have any digestive problems
• How gynecological issues can cause digestive symptoms
• The connection between gut health and hormonal health
• Guidelines for choosing a lab and testing method for a SIBO test
• Why working with a practitioner to interpret SIBO test results is recommended
• How to approach your doctor on the subject of SIBO testing
• Recommended stool tests to check for large intestine dysbiosis
• The benefits of doing a functional medicine stool test over a conventional one
• Health conditions other than digestive that are related to gut dysbiosis or SIBO
• The reasons to get tested before beginning treatment with antibiotics or antimicrobials
• How the Build Your Biome program can help walk you through the process of testing

Download

Links Discussed:

• This episode is sponsored by Paleo Rehab
• Kelsey’s Build Your Biome program
• Kelsey’s article “How Do You Know If You Have Bad Gut Bacteria?”
• Dr. Pimentel’s “Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus”
• GI-MAP stool test

TRANSCRIPT:

Kelsey: Hi everyone! Welcome to episode 111 of The Ancestral RDs podcast. I’m Kelsey Kinney and with me as always is my cohost Laura Schoenfeld.

Laura: Hey everybody!

Kelsey: We’re Registered Dietitians with a passion for ancestral health, real food nutrition, and sharing evidence-based guidance that combines science with common sense. You can find me at KelseyKinney.com, and Laura at LauraSchoenfeldRD.com.

Over the next 30 to 45 minutes we’ll be answering your questions about health and nutrition, and providing our insights into solving your health challenges with practical tips and real food. Make sure you stick around until the end of the show when we’ll be sharing exciting updates about our personal lives.

Laura: If you’re enjoying the show, subscribe on iTunes so that way you never miss an episode. While you’re in iTunes, leave us a positive review so that others can discover the show as well! And remember, we want to answer your questions, so head over to TheAncestralRDs.com to submit a health-related question that we can answer on an upcoming show.

Kelsey: Today on the show we’ll discuss how to assess your gut health to determine if you have any pathogenic or unhealthy bacteria. But before we get into that, here’s a quick word from our sponsor:

This episode is brought to you by Paleo Rehab, a five week online program designed to help you recover from HPA axis dysfunction, also known as adrenal fatigue. Is your perfect Paleo diet and lifestyle leaving you exhausted? Now is the time to start feeling the health and wellness you know you deserve. If you’re sick and tired of feeling sick and tired, and are ready to take back your health, then head over to MyPaleoRehab.com to get your free 28 page e-book on the 3 step plan for healing from adrenal fatigue. That’s www.MyPaleoRehab.com

Kelsey:Welcome back everybody! Here’s our question for today’s show:

“I’m looking for some guidance with a gut issue I’ve been experiencing. I already know from listening to your show that I need to stop treating the symptoms and get to the root of the issue. I’m just wondering what specific tests I should ask my doctor to order and what the names are. Every month I get inflammation in my intestines. It’s tender when I press on my lower belly. I can tell things aren’t digesting correctly from my stool and I eat low FODMAP when this comes up and it clears eventually and then we’re back to the same issue. My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Kelsey:Really good questions in here. I’m going to be talking about a lot of different things that I discussed in an article that I recently wrote. If you want all of this information in an easy to digest format that you can just check off and make sure you’re testing for everything with the names of the tests all written out for you, you can just check out that blog post. I’ll link to that in the show notes just so you guys can get to that really easily. This person obviously has a little bit more specific questions in here too, so I’ll touch on those as well.

The first thing that I think about when somebody comes to me with any sort of digestive problems is like this person mentioned, getting to the root of the issue. I mean digestive issues can be caused by many different kinds of infections. Sometimes you may not even have an infection. You might have some sort of autoimmune type disease that is causing digestive problems and it doesn’t really have a whole lot to do with the digestive system.

But I like to rule out the more obvious answers first of course. That would include things like SIBO, which is small intestine bacterial overgrowth, and dysbiosis of the large intestine. That can be something that I like to call insufficiency dysbiosis which essentially just means that you don’t have enough good bacteria, or it can be a combination of not having enough good bacteria and having too much bad or commensal bacteria. Those are the two things that I test for a lot in my practice. Honestly they are the two things that I would recommend that you get tested for right off the bat if you have any sort of digestive issues.

This person’s problem sounds like it’s fairly cyclical and one thing you want to think about if that tends to be the case for you, like you’re not necessarily noticing your digestive problems all the time, I’ve had quite a few people at this point that they don’t end up having any sort of infection, or overgrowth, or anything like that. I don’t know if this person is a woman, but it actually ends up being some sort of ovarian issue like they have cysts or something going on gynecologically so that’s causing bloating and can cause digestive problems as well.

I definitely think it’s still a good idea to rule out the digestive problems. You can have both too. I mean you can have bacterial imbalance in your gut that causes digestive problems along with some gynecological issues that can cause problems as well. Laura, do you see that at all in your clients where they have any sort of gynecological issues that are causing digestive issues?

Laura:Yeah, I think it’s kind of a weird chicken or the egg scenario because I have some clients that I think they’re gut dysbiosis is actually contributing to hormonal imbalances. For example, there are certain types of bacteria that produce toxins or LPS toxins basically can affect estrogen elimination.

Kelsey:Yep.

Laura:Whether or not the person is overproducing estrogen or if they’re not clearing it out well enough because of a gut infection, that’s definitely something that I see a lot. The combination of gut issues and hormonal issues, even amenorrhea is pretty common with a lot of my clients. And then there’s always the shifts that happen around the menstrual cycle with digestive function that may not be related to gut bacteria specifically.

Kelsey:Right.

Laura:But I do think there’s a lot of connections between gut health and hormonal health in general. Like I said, it’s kind of a chicken or the egg scenario where it’s like okay, did the hormones change first and then that affected the gut health or vice versa? It’s just interesting to see how certain symptoms of like let’s say their hormonal issues will be affected by treating SIBO or dysbiosis.

Kelsey:Yeah, absolutely. That’s something I see a lot. Because you’re right, especially I find that estrogen clearance can be highly, highly affected by somebody having dysbiosis or SIBO. You just have a lot of problems getting rid of estrogen. It gets reabsorbed and you get estrogen dominance which can cause a lot of symptoms as well.

I just wanted to mention that because if this person is a woman, it’s something to think about. If you haven’t had a GYN appointment in a while, I would definitely at least go to that, get everything checked out, make sure it’s all functioning appropriately. Because like I said, I’ve seen a few people having cysts or other issues gynecologically that can lead to dealing with digestive symptoms like bloating where if you feel like you’ve tried everything and you cannot figure out what the heck is causing your bloating or your digestive problems, that is something that I’ve seen happen with quite a few clients. Just make sure you’re thinking about that as well.

Laura:I’m actually doing just like a little on-air Google search. I’m pretty sure that endometriosis can cause bloating.

Kelsey:Yeah.

Laura:I believe that would be potentially cyclical as well. I would definitely rule out endometriosis as part of this process. I feel like gut health is related to everything.

Kelsey:Yeah.

Laura:As far as this whole treatment of bacterial issues is concerned, and I know you’re going to talk about this, but I don’t know if that’s something great to do without doing some testing first because I would hate for this person to get a ton of antibiotics if their issue is endometriosis.

Kelsey:Yeah, absolutely. Now that I’ve seen that happen quite a few times with my digestive clients, and honestly it was something that just occurred to me through being in clinical practice for a while and having some female clients that we just could not for the life of us figure out what was going on with their digestion. They would have all these problems and then they had no bacterial imbalances, or we cleared them and everything was looking good digestively, but still these symptoms remain. For the first person, it just happened randomly that they got diagnosed with some gynecological issues. And then from there on out, I was like okay, I’ve got to make sure everybody is getting checked out for this if it could just be something like that and it has almost nothing to do with digestive system itself.

Absolutely, if you’re a woman listening and you’re got digestive problems especially if they’re not consistent, though I will say you can absolutely have consistent digestive problems that are gynecologically related, but definitely if they’re cyclical, please do get checked out to make sure that there’s nothing else going that could be causing your digestive problems that really has nothing to do with the digestive system.

I just want to drive that point home because for me that was something that like I said I learned through clinical practice. It was not something that I even really considered until I saw it happen a couple times and then a little light bulb went off in my head and I was like okay, make sure everybody gets checked out for this stuff.

Other than that, or if you’re a man, you know that’s not part of the issue here, of course you definitely want to be testing for some bacterial imbalances. The two that I am typically doing in my own practice and what I recommend in my Build Your Biome program as well are like I said SIBO and a stool test which is going to test for the bacteria in your large intestine.

It sounds like this person has not had any tests I think. It sounds like they’re also working with a doctor to potentially get these tests. The ones that I am using right now and I’m not incredibly partial to these I’ll say. There are a lot of good tests out there, but these are just the ones that I am tending to use these days. For SIBO testing I use BioHealth Labs, but there’s tons of SIBO tests out there now since it’s becoming more and more of a popular topic. But I just use BioHealth. The only thing you want to make sure depending on what lab you order from is that it’s a three hour test because you want all of that information. I’ve seen some other SIBO tests, I saw one actually that was like an hour and that to me didn’t really make a whole lot of sense.

The reason you want it to be so long is because we want to see what happens as it gets into the large intestine as well to kind of help you to determine if something is truly a positive test because what you’ll tend to see for that is a double peak where your gasses will increases before the 120 minute mark which is when for most people the solution that you’re drinking will head into the large intestine. The large intestine of course is where our micro biome is. It has tons of bacteria and so they are absolutely going to ferment that solution and they’re going to produce a lot of gas as a result.

If something is really positive, then you’ll see the first peak at some point before the 120 minute mark and then you’ll see another even larger peak after the 120 minute mark because that’s again when it’s heading into the large intestine. You want a longer test so that you can see when it gets into the large intestine and that will help you to determine if your test is truly positive.

Because the thing with SIBO testing as is is that there’s no real gold standard for SIBO testing. These breath tests are the best thing we have and they’re not perfect by any means. That’s just something to think about. It’s sometimes why doctors will say they don’t want to do SIBO testing or they think it’s unproven or something because there’s just again not gold standard in the testing and these tests aren’t perfect. But to me that’s a little silly I think just for me because I’ve seen so many people benefit so much from clearing SIBO and this is really the best way we have right now to determine if somebody has it. It seems crazy to me to not use what we have right now even though it’s not perfect.

Now there’s two different types of solution that you might drink or substrate for a breath test. Actually I mean there’s other ones too, but the two main ones are glucose and lactulose. I prefer the lactulose test for the most part at least for a screening test for the first test that you do because it tends to pick up on more people that have SIBO. You might get some false positives in there, but I’d rather make sure that somebody who does have SIBO gets it picked up by the test rather than have somebody who doesn’t have SIBO get a false positive. I do like that as definitely as the first test. And then if you want to retest, that’s when I might use a glucose test just because it is a little bit more accurate. It will tend to have less false positives, but you might miss a couple people who actually do have SIBO because they might get a false negative.

That’s something to think about wen you’re deciding or talking with your doctor about which kind of test you want to get. If you’ve never had a SIBO test, I do recommend getting a lactulose test and then from there you can do the glucose test as a retest or as you retest you can still do the lactulose. There’s no issue with doing that as your retest. But definitely for your first test, at least from my opinion and what I’ve done in practice, that seems to make the most sense is to the lactulose.  Laura, do you do SIBO testing?

Laura:Yeah, I’ve started to order those now in the last maybe six months or something because at first I was just finding doctors to get it for my patients, but after we had a couple of patients that couldn’t find a doctor to do it, I jumped on the testing myself bandwagon. Because I’m like alright, I’m not going to spend all this time trying to hunt down a GI doctor for this person when I can just order that for them myself. Definitely have started doing that lately. I do the lactulose hydrogen and methane test, the same one that you do I think, the BioHealth.

Kelsey:Yeah, and BioHealth now has started to offer the glucose test as well. I think they didn’t offer it before and now you can do either lactulose or glucose, or you an even do both them together.

Laura:A combination.

Kelsey:Yeah, not at the same time, but you can order two different tests for each one if you want to be super thorough about it. BioHealth you can only really get that through a practitioner or a healthcare provider, so just be aware of that.

Commonwealth Labs was the other one that you could order yourself as a patient, but they actually just closed rather suddenly. They were a big lab doing lots and lots of SIBO tests. I don’t know the full details about their closure, but I do know that you can’t order form them anymore. Or if you have a SIBO test from them that you haven’t submitted yet, don’t because I don’t think they’re even processing anymore SIBO tests that have been sent out. You’re probably going to want to think about a different lab to work with.

Do you know of any other tests that people can get on their own because I always just order the BioHealth and I assume you do to, so I actually don’t really know of any that can do just online themselves.

Laura:I’m not sure. They might have it on Direct Labs.

Kelsey:Oh yeah, that’s true. I think they do.

Laura:I haven’t really looked into that. The thing about the substrate is that glucose is not a controlled substance so I think that one would be the one you could order on your own.

Kelsey:Yeah.

Laura:As far as the lactulose is concerned, you do have to have a doctor. It looks like on Direct Labs they have a couple of different, oh yeah, they have the BioHealth kits available. They usually tend to be more expensive.

Kelsey:Right.

Laura:Yeah, BioHealth charges $60 more than I charge for the test for my patients. It’s a little bit more expensive. But to be fair, then you have to pay for somebody to order it for you and give you the results. That’s the only other thing just thinking about that with tests, I feel like interpreting a SIBO test is kind of an art.

Kelsey:Yes.

Laura:Ordering it on your own and not having somebody look over it with you is not a good idea. Maybe you might get a very clearly positive test, but I know I’ve had a lot of tests recently that had a lot of nuance to them and I’ve had tests that they say that they’re positive and they might be, but they’re not definitely positive. To go into a full on SIBO protocol from that result I would say is maybe not the best idea. I feel like you have to work with somebody who can interpret them correctly because they can be a little bit confusing.

Kelsey:Yeah, and this is why I say these tests aren’t perfect because there’s not even a consensus necessarily on how to interpret these tests at this point. We’re getting closer to that. I think it was Dr. Pimentel who came out with an article this year actually that aimed to do that, to come up with a consensus for how to interpret SIBO testing. I’ll see if I can find that and link to it as well because it’s pretty interesting and it actually changes a little bit of what we had previously thought to be positive.

Just as an example, when you had high methane gas, Dr. Pimentel specifically at that point in time was saying that anything over 3 parts per million was positive. I believe in this latest article they’ve changed that to 10 parts per million. That’s again looking through all the data available. I don’t know if that’s his personal opinion at this point, but certainly from all the research that we have available to us, it does seem to suggest that anything over 10 parts per million…I think it’s 10, we can double check…but anything over 10 parts per million for methane, it should be considered positive. That changes things a little bit than what they were before if you were following Dr. Pimentel’s interpretation advice. All that to say that, yes, Laura is absolutely right, SIBO interpretation is a little bit tricky, definitely is a bit of an art for sure. I do really suggest working with somebody once you have that.

The reason why somebody would go order that themselves I find is typically that their doctor for whatever reason, like I was saying before, they don’t want to do the SIBO test or they don’t even know what SIBO is necessarily so brining that up to them and asking for a test can feel like a big hurdle. Some people just choose to order the test themselves and then bring it into a doctor because then they’ve got some proof in their hand coming in and the next step is how to deal with that, not can I even be tested for that, will you test me for that. That’s something to consider.

Now I do want to mention though that SIBO testing through a doctor is becoming more and more common. Depending on where you live and the kind of doctors that are around you, you may be able to get a SIBO test done by your doctor and get it covered by insurance. That is definitely an option to think about especially if you’re on a budget and you really just want to make sure it’s covered by your insurance.

If that’s you, if you’ve got an open minded primary care, they can definitely order the test for you. Even if they’re not super familiar with SIBO, if you feel comfortable having a good conversation with them about it and saying, look, these are my digestive symptoms, I’ve done a bit of research…I know doctors always hate to hear that when patients have done their own research. But as long as you come in from a place of respecting their degree, respecting how much time they’ve spent to get that, and all the research they’ve done, and all the hard work they’ve put into it, I find that patients actually have a really good success rate with getting the SIBO test done. Even if they have to refer you to a gastroenterologist in the area who maybe does the SIBO testing in office, that’s an option as well.

I like to just make sure that people go into that conversation not coming from this perspective of I read all about this online, you’re an idiot for not knowing what SIBO is, blah, blah, blah, blah. I think you can kind hit a hard wall if you come in with that attitude. Just really come at it from a place of respect and open mindedness, listen to what they have to say.

But at the end of the day, I find that most doctors, they struggle I think with digestive health clients a lot of the time because it can be difficult to get somebody results, get somebody feeling better from digestive problems when they’re not looking at these bacterial infections. They often come to a point where they are like I really don’t know what to do next, and if my patient is coming in asking for this test, I’m not opposed to it. That’s often the attitude from doctors that I’ve heard about from my patients who have gone to ask them for testing. Just go into it with a good attitude and you probably will have decent luck.

That’s SIBO. I think that’s everything I want to mention about SIBO. Like I said, BioHealth, that’s what Laura and I both use as a lab, but there are plenty of other ones out there. If you’re ordering it on your own, you can order it through DirectLabs.com depending on what state you live in. New York and New Jersey I think are the only two that you may not be able to order them through Direct Labs. I can order a test for somebody in New York and they just have to basically check off a box that says I didn’t collect this specimen in New York and then BioHealth will be able to run the sample. But that’s the only thing to think about.

Laura:Direct Labs says that services are not available in Maryland, New Jersey, New York, and Rhode Island.

Kelsey:Okay, so there we go. If you’re in one of those states, you’re probably going to have to work with a practitioner and you will need to go to another state to actually take the sample. But again you just have to check off that box saying I didn’t take the sample in New York or any of these other states and BioHealth will be able to run it.

You can do lactulose or glucose testing. We recommend lactulose for at least that first test. There’s lots of labs out there, BioHealth is just the one that we tend to use. But you can definitely check out others as long as they are three hour tests, they’re looking at both methane gas and hydrogen gas because whether you’re hydrogen positive or methane positive is going to affect the way that you clear that bacteria out of your small intestine. We need to know if you have too much methane or too much hydrogen, or both. If you’re only getting a hydrogen breath test and it’s not looking at methane, you’re missing out on a really big piece of the picture there. Anything else you’d add about SIBO testing, Laura?

Laura:I don’t think so. I guess that the question about the sugar that you’re using is interesting because I know I think it was this week I was asking you about a client of mine that had a dextrose SIBO test from a GI doctor and I was looking at it and there was literally no hydrogen gas production at all. It said it was a negative test. I was just like I don’t know if that is legitimate. We’re running a new one with the lactulose.

But it was just really odd because I didn’t even know they had a dextrose test. The funny thing about dextrose is that’s one of the sugars I know Dr. Siebecker I think is her name, she recommends dextrose a sweetener because it doesn’t feed the bacteria. I’m like I don’t know why that would be a SIBO test using dextrose.

Kelsey:Interesting.

Laura:But honestly, I have no idea. I just was very surprised to see that from a GI doctor, like an actual MD. If you are getting a SIBO test done through your MD or any practitioner I should say, ask them exactly what they’re testing, what the sugar solution is especially if you’re paying for it out of pocket because you don’t want to spend a couple hundred dollars on a test that’s totally useless.

Kelsey:Exactly. Just to talk about that no gas production thing. I’ve had that happen, not nothing, yours was literally zero which was really weird.

Laura:Yeah, it was like flat lined and the doctor was like well, it’s negative.

Kelsey:I don’t know about that.

Laura:I’m like I don’t think you’re supposed to have nothing. I think you’re supposed to at least see some gas at the end.

Kelsey:Yeah. I’ve had a couple patients that at this point I think it’s literally been two patients where they had really oddly low gas results for both methane and hydrogen, no spike at the end or anything. I actually, like when that happened with BioHealth, I called in and I was like this makes no sense. They were like, yeah, this makes no sense, we should retest. If you get a really weird test result like that, definitely consider retesting. But that’s something of course that you can work on with your healthcare practitioner as well if they think it looks really weird.

Laura:Did you have to pay for the retest, or did they just send you one?

Kelsey:No, they sent me one.

Laura:That’s nice.

Kelsey:Yeah, it was really nice.

Laura:Good to know.

Kelsey:I think they were like perplexed by it as well because it just made no sense whatsoever. I think that’s it about SIBO testing. Honestly, that’s the first one that I usually test for unless somebody wants to do both SIBO testing and stool testing together to just get everything out of the way. For both of these tests you want to be off of probiotics, prebiotics, any sort of antimicrobials or antibiotics for two week prior. Because of that prep time, a lot of times people just want to get it all done in one shot.

Next it would be stool testing. If you just started with SIBO testing, let’s say that comes back negative. Next step would be stool test. If it comes back positive, you’d of course want to deal with SIBO first, retest for SIBO. If you still have SIBO after retesting, you’re going to have to work with somebody to go through more treatment for that, get rid of it, retest again, make sure it’s gone. Once you then get a negative test for SIBO and let’s say you’re still having symptoms, that’s when I would move onto a stool test.

For stool testing you’ve got a lot of different options. I used to recommend the Doctor’s Data test or I’ve had a lot of patients come to me with Genova testing for stool tests just because I think for many people that is a least partially covered by insurance. If they’re going to an Integrative MD, their doctor’s ordering that test for them at least getting partially covered. All of these tests I think are all really pretty good.

The one though that I have been using lately is called the GI-MAP test. I’ll link to that. It’s from Diagnostic Solutions Laboratory. The interesting thing about this test is it’s all PCR technology meaning that they’re looking at the DNA of bacteria to see if it’s present in your stool. Doctor’s Data for example, they do some PCR and then they do sections that are cultured as well. For some things they do both the PCR and a culture. That’s a good way to look at things. You can see both. But for a lot of people the Doctor’s Data test is really, really expensive. Depending on where you’re ordering that from, I believe you can do, I’m positive actually that you can do Doctor’s Data through Direct Labs. But again, pretty expensive. I think it’s in the mid to high 300s depending on how many stool samples you’re sending in.

The GI-MAP test is one stool sample. Like I said it’s all PCR so it’s only looking at the DNA which is a very accurate way of looking at it. You don’t necessarily need as many stool samples for something like Doctors Data to pick up things on cultures. I’ve been using that lately. I really like it. But like I said, I’m not hugely partial to any one lab. The GI-MAP is just the one that I’m tending to use these days. It’s what I recommend in my Build Your Biome class, but I give you options for getting the Doctor’s Data test, or a BioHealth test, or Genova you can also order I believe through Direct Labs as well.

The thing about these stool tests because if you’re somebody with digestive problems, you probably most of you have probably been to a gastroenterologist and they have possibly recommended a stool test for you. That’s like the typical conventional stool test. It’s really looking mostly for parasites, which of course is a good thing and it definitely can diagnosis some of those parasites. I think most of these tests even now are not PCR so they’re only looking at cultures, which like I was saying before is just a little bit less accurate than looking at the DNA. It’s just much easier to find bacteria when you’re looking for the DNA rather than trying to make everything grow in a petri dish.

You can miss a lot of things I think with those conventional tests and they’re not testing for as much information that you would get from some of the more functional medicine, integrative medicine stool tests. They’re not looking at your good bacteria to see how much good bacteria you have. They’re not necessarily looking at your commensal bacteria which is just bacteria that in a certain lower amount is fine, but if they start to take over, if they start to overgrow a little bit because maybe you don’t have enough good bacteria, then they can become pathogenic and cause you symptoms. This is not to say that you shouldn’t do a conventional stool test, I just think that you can miss a lot with that and it’s worth doing a integrative or functional medicine type stool test, something like the GI-MAP test, the Doctor’s Data, BioHealth, Genova, any of those brands are going to just give you a lot more information.

If you’ve done SIBO tests, that ends up being negative eventually, you do a stool test, what that can show like I was mentioning at the beginning here is that you could have too low amounts of good bacteria, you can have high amounts of commensal bacteria which can potentially be pathogenic, you can have parasites, you can have yeasts so things like Candida can show up on these tests. It really looks at quite a lot. Once you find something on that test, you can do antimicrobials, you can take prebiotics to help bring up good counts of bacteria. It gives you a lot information that you really can do something about.

I like both of these tests. I like doing SIBO and stool. Like I said, some people choose to do them both together, but others I like to just do SIBO first. If they’re on a budget, they don’t have the money to do both at the same time, I’ll start with SIBO and then move on to the stool test. Laura, do you do stool testing at all, or are you just doing SIBO at this point?

Laura:I’ve been using the BioHealth GI Screen right now. It tends to be kind of easier to do the SIBO and the stool test through them at the same time and get everything sent. That’s what I’ve been doing. I kind of do the same thing where depending on the person’s symptoms, we might do one or the other or do both at the same time. What I like about doing both at the same time is it kind of speeds up the process of identifying the problem.

Kelsey:Yeah.

Laura:I’ve had some people that we did the SIBO test which came back negative and then we were like alright, well let’s do the stool test now. That just adds time to the treatment. If somebody can afford to do both, I like to do both because then you know this is covering kind of everything as far as what could be going on in your gut. Obviously you can get false negatives and the BioHealth stool test isn’t going to cover all the different things that could be an issue, but I think it’s a really good place to start and it’s not crazy expensive to do it.

Kelsey:Yeah, I agree. I think it’s a good option. Actually a lot of practitioners will recommend that you do two different tests from different labs. They’ll often combine the Doctor’s Data test with the BioHealth test just to have first of all two different samples going to two different labs because not every lab necessarily is going to pick up on potential pathogens or parasites and things.

So it doesn’t hurt to have two, but for me at least with the clients I’m working with, at that point it becomes a lot of money that you’re spending on tests. To be honest, I am usually just going one stool test if we even get to that point of needing a stool test. But yeah, I think BioHealth is a really good option and if you have the money to do it, doing two different tests from two different labs is not a bad idea either.

Laura:I think that’s what they do at The Kresser Institute. They do I think it’s the Doctor’s Data, maybe the Bio Health.

Kelsey:I think it is.

Laura:I don’t remember which two. That’s just to kind of increase the likelihood of finding what’s going on.

Kelsey:Exactly.

Laura:Obviously every test has a risk of missing something.

Kelsey:Yeah, absolutely. Just one thing to mention about digestive issues in general is that you don’t necessarily have to have digestive problems to have issues with your gut health. In the article that I’ll link you guys to that I wrote recently about this topic, I do go through a lot of different conditions that are associated with either SIBO or dysbiosis that for many people they don’t get any digestive symptoms along with those conditions yet they are definitely more likely to have unbalanced bacteria. Just keep that in mind.

Potentially if you don’t have digestive problems, you may not be listening to this episode anyway. But just in case you are and you never tested your gut health but you have some other kind of health condition going on, it really does not hurt to test your gut health because like Laura said before, your gut health affects pretty much other body system that you have. If you’ve got some other health condition or other symptoms that seemingly do not relate at all to your digestive system, so you’re not getting bloating, you’re not having diarrhea or constipation, anything like that, like your digestive system seems to be working perfectly, it doesn’t necessarily mean that your bacterial balance is on point. Definitely consider doing some of these tests that we’ve talked about today even if you don’t have digestive problems.

Laura:I thought one of the interesting ones you had on that list was restless leg syndrome. I’m actually working with someone right now and we’re getting her SIBO tested that had RLS. Her doctor just put her on medication which is not an unusual treatment. She’s got other symptoms that sound like SIBO. It’s just interesting. It’s not that she doesn’t even have gut symptoms, that’s the crazy part. She does have gut symptoms and it’s almost like why wasn’t that tested? But I guess like you said earlier, it’s not a super common thing that the average doctor would be doing at this point.

Kelsey:Yeah, it’s really funny because I was just walking my stepmom through this process because got really bad food poisoning back in November and she’s been having digestive issues ever since. She had some digestive problems prior to that, but nothing really severe. After the food poisoning incident, things just were taken to another level let’s just say.

That’s first of all something that’s been highly, highly associated with SIBO infection is having food poisoning at some point especially if that seems to trigger ongoing digestive issues. I was shocked that she went to her gastroenterologist and she was like I’m having all these problems, I had food poisoning back in November. She actually was given antibiotics for her food poisoning and she had it again after November as well. Just lots of indicators that SIBO is what was going on. They do SIBO testing in house and they did not recommend that she do SIBO testing.

I was like, what! I just did not understand. I had to tell her you need to ask for SIBO testing. You have many, many indicators that that’s what’s going on. She asked them and they were like, oh yeah, sure, we do that right in house. I was like are you kidding me? How is that possible that you wouldn’t immediately recommend her to be tested for that?

Laura:I know. I always think it’s funny when it’s like the patient asks for it and the doctor is like okay, sure. It’s just like why did they have to ask? It’s just that’s an example of where being informed is important and going in and assuming your doctor is going to say no is not always the case. Because again, it’s pretty common for them to be like, alright, let’s try it because they’re kind of willing to do whatever it takes to find out what’s wrong, but they just may not have thought about it.

Kelsey:Absolutely. Push for testing that you feel like you should do. Again, come into it with a good attitude. But it’s your health, nobody cares more about it than you do. If you feel like you need to maybe find a new doctor or push harder with your current doctor to get the testing that you think you might need, I’m all for being a patient who is very informed and can have open and honest conversations with their doctor.

I want to touch on this last question that this person had briefly here which was they said, “My doctor mentioned an antibiotic blast as a treatment. Is this a smart thing to try? Blasting my gut with antibiotics sounds intrusive and I worry about the good bacteria being destroyed.”

Definitely a valid concern here. Yeah, I would be a little wary of that as well especially given that it sounds like the doctor decided that no testing is necessary before doing that. Now of course, listen to your doctor, have conversations with your own doctor. I’m just a Dietitian so I can’t really comment that much on prescriptions or any sort of pharmaceutical treatment here. But I will say that you should definitely consider some other options.

To me it seems logical to do some testing before just jumping into, especially an antibiotic blast. I will say that sometimes if somebody can’t afford testing or anything like that and they just have a lot of digestive symptoms, sometimes I will try an antimicrobial protocol with them. But I feel a bit more comfortable with antimicrobials than somebody just jumping into antibiotics which of course can have quite a damaging effect on your large intestine microbiome.

But if your doctor was talking about an antibiotic like Rifaximin for example that only stays in the gut, it doesn’t go out outside the gut really, it doesn’t go into the bloodstream to affect other parts of the body, Rifaximin is actually quite interesting in that it’s considered a you-biotic because it actually increases counts of good bacteria in the large intestine which is really unusual for an antibiotic. It’ll kill bacteria in the small intestine while increasing counts of good bacteria in the large intestine. If it was that, I’d feel more comfortable with it.

This is just speaking from my own personal opinion. If I was the patient I think I would feel more comfortable doing that than going on any other kind of antibiotic that is going to have a much larger effect on other areas of my body. But again, for me personally I would definitely want some testing first if I was going to jump into pretty much any antibiotic treatment, but if you can’t afford it for whatever reason or it’s just not an option, I’ve sometimes had people in other countries where they can’t get SIBO testing.

Laura:Actually, did you know that BioHealth can send SIBO testing internationally?

Kelsey:I did, yes.

Laura:Oh, okay.

Kelsey:Sometimes I’ve had people though in really faraway places that the shipping is just so exorbitant that they can’t. That’s more so specifically for like the stool testing tends to be for whatever reason more expensive. I think BioHealth, from what I remember, I believe they have a flat rate international shipping fee which is great.

If somebody just can’t get testing for whatever reason, whether that’s finances or anything else, that’s when you would maybe want to consider just jumping into an antimicrobial protocol or potentially antibiotics. Again, I feel way less comfortable with that. But for the most part, I mean for anybody who can do testing, I would definitely recommend doing it first.

Laura:Yeah. It’s one of those things doing some antimicrobial herbs may not cause a huge problem, but I would prefer not to do it if we don’t have testing. That’s kind of my approach too. I’ve had a couple clients that I did some just mild antimicrobials just to test to see if that helped because they couldn’t afford the test or because it just wasn’t feasible. I’ve seen recommendations to go on these hardcore SIBO antimicrobial protocols without testing and I’m just like I don’t know if that’s the best idea.

I mean it’s certainly an option and it’s up to the person if they want to do that, but it’s getting testing first I think is a really good idea. Especially because like we were saying earlier in the episode, it could be completely unrelated to your gut bacteria and then you’d be doing all this antimicrobial treatment for no reason and that could potentially affect your beneficial flora. Testing is always going to be recommended in my opinion. I don’t like to do things just making assumptions.

Kelsey:Yeah, I agree. And especially for SIBO in particular like I mentioned before, if you have methane positive SIBO versus hydrogen positive SIBO, how do you deal with those different types becomes different especially with antibiotic treatment. Now with antimicrobials there’s less of a difference, but there’s certainly some particular supplements that you can add for methane positive that you wouldn’t necessary need for hydrogen. It does change how you would deal with it and so having that testing makes a big difference.

The other thing I want to mention about that too is that for SIBO and stool testing, you just get so much information that you kind of need that. Because if you are just going to give somebody Rifaximin for example, because like I said that only really affects small intestine, it’s only clearing out bacteria in the small intestine and not the large intestine for the most part. If your problem is dysbiosis in the large intestine or a parasite in the large intestine, it’s not really going to have much of an effect there. It’s only going to be affecting your small intestine.

That’s why I feel less comfortable with that antibiotic blast approach. Whereas with antimicrobials, they’re going to have more of an effect in both areas, so both in the small intestine and in the large intestine. That makes a little more sense if you don’t know that’s going on necessarily. But yeah, I agree, testing is really important if you can afford it, if you’re able to get it if at all possible, you really should do that before jumping into any of this stuff.

I think that’s all I have to say. This is a huge topic obviously. Honestly, if somebody sat here and asked me questions, I could talk about it for days. But I’ll leave it here for now. I’ll link you guys to that article that I wrote if you want everything written down in terms of the tests that you want to ask for and all that.

But if you need further help on this, you guys probably know by now that I have an online program called Build Your Biome. You can work with me personally on this stuff too, but I put a ton of time into that Build Your Biome program. It’s really comprehensive. If all of this stuff is pretty new to you and you just want someone to walk you through the whole process of doing all these sort of tests, and talking to your doctor if you need to do what, or working through it on your own, my program does go through all of that. I’ll put a link in the show notes for the program as well.

Laura:Sounds good. I like online program option because obviously a lot of people are not going to be able to afford to work with us one on one. Anytime I have somebody that contacts me that has a gut issue that their budget is in that kind of couple hundred dollars range, I’m like alright, I’m just going to send them to Kelsey’s gut health program because I feel like you do a really good job of covering all those topics in your program.

Kelsey:Well thank you!

Laura:It makes me jealous, I need to get my own group program started at some point.

Kelsey:Yeah, it’s really nice to be able to refer people to that because it’s like okay, here’s all of my thoughts on this topic in one place. It’ very nice to just be able to point people to that because dealing with gut issues too is generally a pretty long process. People who are working with me one on one, I mean that’s a three month minimum usually for working with me on it because it just tends to take a long time to deal with. But yeah, you can obviously get that at a way lower price and all that information just in an online program so it’s great to be able to have that option for people.

Laura:Awesome.

Kelsey:Cool.

Laura:As promised, we do have some personal life updates that we wanted to share at the end of the episode. If you are totally bored by that stuff, now is your opportunity to turn off the podcast. But for those of you who like this kind of thing, we’ve had some feedback that some people like it at the end, other people miss it at the beginning. I think for now we’re going to keep it at the end because I think we both like the fact that people can just stop listening when this comes up.

We understand that some people are not listening to hear about our personal lives, which I totally understand. We’re not that excited of people. But those of you that do like hearing about our business and our personal stuff going on, hopefully you guys are willing to hang around to the end to listen to it. Today’s update, I’m just laughing because oh my God, I can’t wait until we can stop talking about this. I think this is going to be the last wedding update ever.

Kelsey:Pre wedding. You have to do a post wedding recap.

Laura:I’ll just be like, it was great! I don’t want to talk about it! But we are just getting into June now so it’s my official wedding month, and Kelsey, it’s just about your one year anniversary of your wedding.

Kelsey:Yeah!

Laura:We just wanted to update about that. I’m just laughing because seriously I’m at the point where I’m like this just needs to happen already because I feel like I just had my entire life in the last six to nine months be completely wedding focused. I shouldn’t say completely wedding focused because obviously I have a business that I run and everything, but it’s almost like I feel like this has become my new normal to always have this stuff hanging over my head needing to be dealt with.

Kelsey:You’ll feel so free and like oh my gosh, I have so much brain capacity!

Laura:Well hopefully it’s not permanently damaged. I’m just going to not know what I’m supposed to do with myself. Maybe I’ll have an online program creation because I’m not planning a ridiculously complicated wedding. When I was first starting the planning process last year, I was like oh I’m going to be such a chill bride, it’s going to be so laid back and stuff. Now I was just showing Kelsey my day of timeline.

Kelsey:I about had a heart attack looking at it.

Laura:I am developing my inner type A person. It’s been an amazing process of learning how to be stupidly, creepily organized and OCD. But it’s one of those things that, I don’t know, just when you’re spending this much money and it’s like your one and only wedding, which I fully intend this to be my one and only wedding, even God forbid something ever happened to Josh, if I ever got married again I’m like nah, that’s not happening again.

Kelsey:Yeah. I can only do this once.

Laura:I’m like part of me is like wishing I hadn’t done all the different things that I committed to because I feel like when you’re in the beginning planning stages, it’s like it’ll be cool to do this and it’ll be cool to do that.

Kelsey:Yeah.

Laura:And then in the last couple weeks you’re just like…

Kelsey:Why did I do this?

Laura: Now I have to figure out how all of these little pieces of the puzzle are actually going to fit together and they don’t always look like they’re going to fit together. It’s just like this is ridiculous, why did I sign myself up for this?

There’s just been a lot going on. Luckily I have a day of coordinator who’s been really helpful. I don’t know how I would have done it without having one just because she helped me create the timeline and there was so many things that I wouldn’t have thought of. It was nice to have someone who kind of knows what questions to ask, that kind of thing. Even with her help, there was still things we had to work around. I have two bridesmaids with infants. Well, what is an infant, technically?

Kelsey: I don’t even know.

Laura: My sister has seven month old and then one of my bridesmaids literally just gave birth like three days ago, two days ago.

Kelsey:I think those are babies, definitely.

Laura:Well, the two days ago, that’s an infant. That’s newborn status that she has. Just trying to create a timeline that allows for them to do what they need to do to take care of their babies, and then coordinating with Josh and his groomsmen. I’m just like oh my gosh, this is getting crazy.

I think it’ll be cool when it’s happening because I kind of will have done everything I needed to do to prep for it and I can’t change anything at that point. I’m just going to outsource any crazies to my day of coordinator and just be like, I don’t even want to know, don’t even tell me unless it’s like absolutely 100% essential that I know. I feel like I want to designate one of my bridesmaids as the second in command that gets told first and decides if I need to hear about it.

Kelsey:That’s a good idea.

Laura:I’m like I really just don’t even want to know. It’s just kind of funny because I feel like I’m generally a pretty laid back person. My fiancé is the most laid back person. To be fair, none of this is his fault. This is all my fault. But it’s like just the level of complexity that this whole thing, just I don’t know, it evolved into this monster that I just I feel like I don’t have any control over it anymore.

It’s just funny because we have just all these little things that need to be dealt with, like I have a vegan and a kosher aunt and uncle that we had to get them special meals. I had to figure out getting gluten free, vegan cupcakes as dessert option since we have a normal cake.

Kelsey:Wow!

Laura:One of my fiancé’s uncles requested that we have Mountain Dew as one of the drinks. I’m just like alright, whatever, we’ll just to the grocery store and get a six pack or something because they don’t have Mountain Dew at the bar. It’s just like all these little things like that. One of my bridesmaid’s skirts came in the wrong color.

Kelsey:Oh no!

Laura:And it just happens to be the one that just had her baby so it’s like she’s already got a bunch of complications with finding a dress to fit into post pregnancy.

Kelsey:Right.

Laura:The fact that the skirt was like bubblegum pink when the color is supposed to be a muted blush basically.

Kelsey:Oh gosh!

Laura:That was fun because she texted me the photo and was like I don’t know what to do! I’m like panicking texting my fiancé because I’m like I don’t want to bother her because she’s literally a day away from having a baby, but this obviously can’t be the dress that she wears.

Kelsey:Everybody’s all muted, she’s like the hot pink.

Laura:I know! It was like a tulle skirt so it looked like a bubblegum pink ballerina basically. I felt so bad because I knew that she didn’t mean to do that at all and she had ordered the skirt on Etsy and it just totally came in the wrong color. It’s just like one thing after the next and then trying to get my house ready for my fiancé to get down here tomorrow. It’s amazing how many different pieces of the puzzle have been all needing to be put together in the last couple weeks. I feel like it’s getting there.

Kelsey:But you’re almost there.

Laura:I know, I know. Nine days.

Kelsey:Almost there, which is super exciting. This is particularly the worst time I feel like because you’re like, like I was saying before it’s like oh my gosh, why did I do this? My wedding, it doesn’t like it was anywhere near as complex as what you’re working on and even I at that point was like maybe we should have just had our small family which we did in June rather than doing both that and then having a huge reception in October. I understand the feeling.

Laura:I feel like on the day of and after everything’s said and done, I’ll feel happy that I did all this. I hope that’s what’s going to happen.

Kelsey: Question mark?

Laura: It’s funny because I’m like I’m 100% confident about the marriage choice. My fiancé and I have a great relationship, I’m not worried about that whatsoever. So I guess I should be thankful that that’s not what’s making me in panic mode. It’s just all the different moving pieces that, again, totally my fault for deciding that I wanted all this complexity. Which honestly the funny part is I don’t really feel like the actual final product is going to look that complex.

I don’t know how some people have these super complicated, really over the top decorated weddings because I am barely doing any DIY stuff. We have a DIY ceremony arch that Josh is making from some trees from his backyard and we have a couple of little DIY things. We have some picture frames that are going to be going up on the mantle inside. But other than that everything is being done by other people.

It’s just like coordinating everything is crazy.I just am like I can’t even believe how many different timelines I have to put together for different people. I literally have on my timeline I need to be finished eating lunch at this point and brush my teeth at this time so I can start my makeup. It’s just like oh my gosh, I’m not the kind of person that is this scheduled.

Kelsey:That’s so funny.

Laura:It’s just funny because I put my reception table arrangement together and sent all that to my caterer who’s coordinating the rentals, and I have my weather game plan because we’re trying to have the ceremony outside, but if it’s too hot or raining we have to have it inside. I have some backup rentals for that. It’s funny because my caterer was like oh you’re so organized, this is great. I’m like I feel like you need to tell my mom this because if she ever heard someone call me organized, she’d be like are you joking? I feel like it’s just kind of amazing to see the kind of skills that you can whip out when something’s that important. I think for me it’s more of an interest and priorities issues if I’m not organized because I just don’t care. But if I care I can be the most organized person on the face of the earth apparently.

Kelsey:Right, you can pull it together when it’s necessary.

Laura:I think it’ll be good though. I’m just glad my fiancé is coming down tomorrow finally. I’m like it’s been almost like 3 weeks since I saw him.

Kelsey:I know, that’s super exciting!

Laura:Yeah, I think it’s just going to kind of take a lot of the panic out of me.

Kelsey:I’m sure.

Laura:That nonstop knot in my stomach that’s been going on through the whole week this week because it kind of feels like I’m doing it all by myself. I know my fiancé is doing his best to help me, but again, it’s I made all these decisions and I kind of have to like deal with them.

Kelsey: Follow through.

Laura:Yeah. But there’s all these little decisions that I didn’t even know we had to make. I was telling you before we got on the call that now we’re trying figure out what song we want to play after the ceremony. We know what song were going to go down the aisle to, but what are we going to play coming back from the ceremony, back down the aisle? I’m just like I don’t even care! It doesn’t matter!

Kelsey:Who cares! Just play something!

Laura:I know. I’m in hardcore decision fatigue at this point and I’m just like I don’t know. But then when I try to outsource the decision, like I was trying to have my fiancé pick the song and he’s sending me the options and I’m like, no, no.

Kelsey:No, I’m sorry, I need to make this decision myself I think.

Laura:Yeah, It’s my own fault. Like I said, I think when all is said and done it’ll be beautiful and fun, and we’ll have these great pictures, and we’ll have some video. Then I’ll be in Mexico for a week in a coma just dead.

Kelsey:Yeah, you’ll get to chill out there. That’s a good idea. We did a little bit of a crazy thing. We weren’t even planning on doing anything after our wedding because we had actually gone to Japan earlier in the year. We kind of counted that as our honeymoon. But then we ended up going to Budapest after because the timing just worked out well, which was a little crazy. I probably, I don’t know, I’ve talked about this before on the podcast. I’m a trip person, not a vacation person. I think while it would have been awesome to lay on the beach somewhere, I don’t know if I could have actually physically done it without wanting to get up and run around the whole place and check everything out while I was there. But I think that’s going to be great for you guys after all these decisions and after all the stress. Like oh man, just sitting on a beach in Mexico sounds perfect.

Laura:Yeah, we have a pool on our balcony so I don’t even have to leave the room.

Kelsey:What! That’s amazing!

Laura:I don’t know if I’m going to get bored. I feel like I’m so exhausted that I’ll be too tired to get bored. But we’ll see.

Kelsey:It’ll be impossible.

Laura:It’s an all-inclusive and I’ve never done all inclusive before so there’s just like unlimited food and drinks and they literally have a full bar in our bedroom that’s being stocked. I’m just like I don’t know what we need with five bottles in our liquor in our bedroom, but okay.

Kelsey:Sounds good! That’s awesome! I have to say being one year out of marriage, definitely you’re like brining me back to all of that when you’re talking about how stressful and decision fatigued you are. I can remember that all too well. But being a year out, I’m like, man, I’m so happy I don’t have to do that again. Now the decision is what are we doing for our anniversary? We’re going to go to DC this weekend and we’re going to stay in a fancy hotel and just like explore the area. And we’ve actually planned a vacation to the Azores in Portugal for September which is kind of I guess…

Laura:Your second anniversary.

Kelsey:Yeah, my second anniversary, which is actually technically in October, but whatever, close enough. But that’s more of like the most I guess relaxing vacation I could agree to which is because it’s this archipelago off of Portugal. So we’re on an island, but it’s apparently like supposed to be Hawaii of the east so it’s tons of hiking and volcanoes, and just really cools views. You basically drive around the island, check out all the cool stuff. We’re staying in really nice hotels there for a week. I’m really looking forward to that. It’s like a very different kind of vacation than I normally do, but I think it’ll be really awesome.

Laura:Very cool. I feel like I like a half and half vacation, like some lounging and beaching it and then some activity. When I went to Costa Rica and Nicaragua, there was like beach time and then also hiking, and surfing, and all that active stuff. I don’t know if we’re going to do anything active on the honeymoon. I feel like honestly right now all I want to do is get in bed and not get out for like a week, so that might happen. But I think they do have some activity options if we got bored.

Kelsey:I doubt you will. It’s going to be great to just like lounge.

Laura:I honestly can’t even think that far in advance because it’s like the wedding stuff is so imminent that I’m like alright, we’re just going to get to Mexico and we’ll decide from there what we’re going to do because obviously the weather is going to be a little unpredictable so we might just have to decide the day of what we’re going to do.

Kelsey:Yeah.

Laura:I’m just like oh my gosh, like not having an alarm set, not having to be on an computer at all, not having to make any decisions about anything except what do I want to have to drink or what do I want to eat? That’s all I have to decide about. That’ll be nice.

Kelsey:It’s all right in front of you. It’s like oh, what restaurant do we go to? It’s like everything is here. I barely have any choices.

Laura:Apparently I can just walk to my closet and be like what liquor do I want to get trashed on? No, I’m just kidding. I don’t drink. I mean I guess I drink like that sometimes, but I don’t drink in excess. I might have a nice whisky neat or on the rocks or something at a bar, but I’m not going to get trashed in my hotel room.

Kelsey:That’s doesn’t sound like you, Laura.

Laura:I feel like that’s a little too far in the laziness category if you can’t even leave your room for a drink. But we’ll see. They have swim up bars which I’ve never done before.

Kelsey:What! That’s awesome!

Laura:Noelle Tarr and her husband Ken hooked us up with this, so shout out to them for getting us the hookup with all of the different honeymoon related things. This package, they got us a discount on it and we have a butler, we have a dinner on the beach scheduled.

Kelsey:Wow!

Laura:We have couple’s massage, like full on honeymoon setup.

Kelsey:That’s awesome!

Laura:Definitely appreciate Noelle and Ken getting us that. Apparently their baby is due the week we’re there. So I’ll have to be at least on Instagram a little bit to see if there’s any announcement there. We’re very excited.

Kelsey:That’s awesome! That sounds like you’re going to live it up in honeymoon world, which is great.

Laura:Honeymoon world. That’s sounds nice. I’m like maybe we’ll just skip the wedding.

Kelsey:Yes, like Disney World but honeymoon.

Laura:Yeah, I’m excited. I think next time we record, gosh, I’ll be a month long married person at that point I think.

Kelsey:Yeah.

Laura:Maybe not a month, maybe just a couple weeks. But next time we talk for one of these updates, I will tell everybody all the fun stuff that we did or all the hotel room drinking that we did if the weather is awful.

Kelsey:I’m very much looking forward to your recap of not only your wedding, but also this epic honeymoon.

Laura:Yes. Maybe I’ll do a blog post with some photos or something. But I’m just like I can’t wait until all of this is happening so I can just stop thinking about it.

Kelsey:Probably talking about our weddings on this podcast, we’re like convincing half of the world’s population to never plan a wedding.

Laura:Maybe, but then if the recap thing is like oh my gosh, it was amazing! I loved all of it! It was the best thing ever! That might turn the tables saying no you should go through this totally stressful process to have an amazing wedding. I’m hoping that’ll be the case.

Kelsey:I can say it’s worth it.

Laura:I know.

Kelsey:A year out I’m very happy I did it.  I will say that.

Laura:That’s what I’m hoping is it’s not like oh I was right, I shouldn’t have done that. I doubt that’ll be the case.

Kelsey:I doubt it too.

Laura:Anyway, like I said, I’ll give everyone the lowdown on all the stuff that we did and maybe have some photos available online to show people. But it’s coming! We’re almost there!

Kelsey:Whoo-hoo! An early congrats from me and we’ll obviously hear from you after that.

Laura:Thank you. Hopefully I’m still alive and functioning brain at that point. It’s really getting close to brain damage at this point.

Kelsey:Wedding equals brain damage.

Laura:Anyway, thanks everyone for joining us and if you’re still on I hope you’re enjoying these updates. Like I said, if you have any opinion about how these updates should go, I think we’re sticking with the end of it. But if you have a strong opinion let us know because it’s obviously your interesting in our updates we want to make sure that you get the opportunity to hear from us. But if you have a question for us to answer on the podcast, you can always go to TheAncestralRDs.com to submit that as well. But we will be here next time. I think we have an interview on our next show. But either way, we’ll look forward to having you here next week.

Kelsey:Alright. Take care, Laura.

Laura:You too, Kelsey.