Episode 77: Hypothalamic Amenorrhea: The Factors That Stall Healing

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Thanks for joining us for episode 77 of The Ancestral RD 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 the following question from a listener:

“I’m a 37 year old woman with a long history of disordered eating and over-exercising. I have a 3 year old son and have been hoping to have another child for the past year and half. However, this is sort of hard to do when you’re not ovulating. I never got my period back after the birth of my son.

I breastfed for 18 months. At that time, I also took on a more Paleo-esqe lifestyle. Then I became underweight at about 96 pounds at 5’3 and my pre-pregnancy weight was 110 pounds. My reproductive hormone levels were very low. I had hypothyroidism and was diagnosed with hypothalamic amenorrhea.

I also have significant gut issues, severe bloating. And I’m now 120 pounds and I’m eating more and more drastically reducing my exercise and have been for several months. Still no period.”

Are you taking steps to heal from hypothalamic amenorrhea? Whether you are at the beginning of your healing journey or you feel like all your effort hasn’t been helping, don’t miss today’s podcast!

It’s important to remember healing can be multi faceted process. There can often be seemingly unrelated factors that are actually much more integral to the body’s ability to fully heal than realized.

Join us today as we discuss the significant role gut dysbiosis, stress, and emotions have on the process of healing hypothalamic amenorrhea. We talk about what should be treated first and share ways to address these additional factors to allow your body to fully heal.

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

  • How chronic bloating is usually a red flag for a gut infection such as SIBO
  • Why treatment for gut infections should precede treatment for hypothalamic amenorrhea
  • Ways in which gut dysbiosis is a potent stressor for the body
  • The connection between gut dysbiosis and HPA axis dysregulation
  • The importance of stress management on the healing process
  • The effect of stress on the microbiome
  • How a negative mindset can be an unrecognized hindrance to the healing process
  • How the “Paleo Rehab” program helps participants addresses emotional aspects related to healing

Links Discussed:


Kelsey: Hi everyone. Welcome to episode 77 of The Ancestral RDs. I’m Kelsey Kinney and with me as always is Laura Schoenfeld.

Laura: Hello, Kelsey.

Kelsey: Hey. Alright, Laura, we are both a little wiped out today. I’m in the final throes of wedding planning. We have our big reception party thing on Sunday this week, so all these last minutes details. And you’re starting your journey into wedding planning. I know exactly how distracting that can be.

Laura: Yeah.

Kelsey: We’re a little bit off our game today, but hopefully this will still be a good show.

Laura: We’ll do our best.

Kelsey: Yes. The other big thing that we’re working on now is gearing up for “Paleo Rehab” to launch. Our class is going to start on October 31st and the day that this podcast releases will be a few days out from that final deadline to sign up “Paleo Rehab.” You can sign up until the first day of class which is the 31st. You’ve got about, let’s see…

Laura: A few days.

Kelsey: A few days, yeah. If you haven’t checked out the previous episode where we talk about “Paleo Rehab” in a little bit more detail at the end of the episode, go back and check on that. There’s a lot of really great stuff in the program. We’re very excited about it. And you can also just check out MyPaleoRehab.com if you just want to see everything written out for you very easily. You can check out what’s in the program and see if it makes sense for you to take.

But we’ve gotten a lot of really, really great results with our students in the past and everybody’s really enjoyed the program and it’s something we’re super proud of. If you’ve been thinking about joining “Paleo Rehab,” now is definitely the time to do it because as of right now we don’t know when our next launch date will be. If you’re thinking that you need to do it anytime within the next 6 months, I’d say signing up for this round would make the most sense since we’re not sure when we’re going to do it again.

Laura: Yeah, we tend to do it twice a year, but all of that’s tentative.

Kelsey: Right.

Laura: Even though we may potentially run a program in the spring, there’s no guarantee for that. I’d even say if you’re thinking you would want to be doing this class in the next year, this would be the time to join it.  We’re not saying we wouldn’t launch it again next year, but we don’t have any guarantee plans. Obviously this takes a lot of work for Kelsey and I to do the launch, so depending what’s going on, even though I feel like right now is maybe a really busy time for us, there is somewhat of a commitment that we have to have our schedule open enough to be able to do the launch. That’s why we don’t commit to specific times.

We do like to have it twice a year because we do think that about every 6 months there’s another group of people that are ready to join. But again, we don’t know when that’s going to be. If you are thinking of joining, if you read our e-book, if you have followed us for a while and you’ve been listening to our discussions on HPA axis deregulation or if you’ve read any of our writings on the topic and you think that this is something that could help you, you should definitely join us this round.

We do have a 14 day, no questions asked, money back guarantee. That means if you join the program and you realize it’s not a good fit for you or if it’s just not the right time for you to be doing this kind of work, you can ask us for a refund within that 14 day period, so that would take you to November 13th or something, I think, maybe. That way you can test it out, see if it’s something that would helpful because we did have some people last year that didn’t realize the kind of format it would be and we try to be super clear about the format as far as it being an online format where there’re going to be presentations, and transcripts, and handouts, and all this stuff. But some people just don’t fit super well with that online class format and they might need something more like a one on one consult.

Kelsey: Mm hmm.

Laura: But if you’re not sure if that’s something that would be good for you, then certainly feel free to try it out. And like we said, no questions asked about that 14 day money back guarantee if you did try it out and you thought it wasn’t what you needed at the time or what was your best way of learning. Because we totally understand it’s not designed for everybody and some people really do need that one on one help where they can ask the person questions or ask for specific details that apply to them.

We did create the program to help as many people as possible, and like Kelsey said, we’ve had a lot of really good results. We’re actually going to be hopefully talking to one of our participants. I don’t know if it’ll be before this episode comes out or around the same time.

Kelsey: Yeah, I think it’ll be before.

Laura: Hopefully this will happen. We haven’t necessarily locked it in, but we’re hoping to get her on some kind of call to talk about her experience because she had a really awesome experience and got some great results from the program. Definitely check out our website MyPaleoRehab.com if you want to get more information.

If you haven’t ever heard of this stuff and you want to check it out, then we do have a free 28 page e-book that you can download that’ll give you some more information about the health condition and what kind of different recommendations we have for getting started on fixing it. No need to rush into this if you are hearing about this for the first time, but you can definitely check out that e-book as a way to get started for free.

Kelsey: Yeah.

Laura: Anyway, we hope you’ll join us for that if you‘re thinking about it. Again, the first week of class starts on October 31st. If you decide to buy the program on October 31st, you’re not missing anything. We’re not doing anything live on that day. Don’t worry if you’re running a little behind and you decide to join us on the 31st. We’ll hopefully see you there.

Kelsey: Alright, cool. We’ll jump into our question for the day which relates to the topic of adrenal fatigue and all that kind of stuff. But first, let’s hear a word from our sponsor:

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Kelsey: Okay. The question for today is:

“I’m a 37 year old woman with a long history of disordered eating and over-exercising. I have a 3 year old son and have been hoping to have another child for the past year and half. However, this is sort of hard to do when you’re not ovulating. I never got my period back after the birth of my son. I breastfed for 18 months. At that time, I also took on a more Paleo-esqe lifestyle. Then I became underweight at about 96 pounds at 5’3, and my pre-pregnancy weight was 110 pounds. My reproductive hormone levels were very low. I had hypothyroidism and was diagnosed with hypothalamic amenorrhea. I also have significant gut issues, severe bloating. And I’m now 120 pounds and I’m eating more and more drastically reducing my exercise and have been for several months. Still no period.”

Laura: One things she does mention in the question, so she says, “when addressing hypothalamic amenorrhea in the setting of gut dysbiosis, what is an optimal approach to healing the body to re-establish ovulation?” As far as gut dysbiosis is concerned, she did say severe bloating is her significant gut issue. If I hear that somebody has severe bloating even if it doesn’t go along with any sort of other IBS type symptoms like diarrhea, or constipation, or anything like that, I would say I would definitely want this person to get tested for SIBO. What about you, Kelsey?

Kelsey: Yeah, absolutely. Anytime I hear bloating, I’m like okay, SIBO probably. I think you mentioned a couple episodes ago that pretty much every time you test somebody for SIBO, they come back being positive for SIBO. I have the same experience. Granted, I want to hear more from her about the bloating and everything, but even just anyone saying severe bloating, I’m like okay, SIBO.

Laura: Yeah.

Kelsey: Let’s at least test for it.

Laura: Yeah, I mean sometimes it’s not. If somebody has bloating and I look at their diet and their eating habits and I see that they’re eating just tons of vegetables or something that could be contributing to bloating just in a normal person without SIBO, then yeah, it’s not necessarily SIBO. I don’t want people to think oh I’m bloated sometimes, it must mean I have SIBO. But severe chronic bloating, bloating every single day, bloating no matter what you eat definitely points to something like a gut infection, SIBO being one of the most common ones.

Kelsey: Yeah.

Laura: For this person, she’s asking about how to address hypothalamic amenorrhea in the setting of gut dysbiosis. Which ironically I just had a client and I might have been talking about…I can’t remember if I was talking about it on the podcast or just with somebody else about her experience, but she actually developed gut dysbiosis from going Paleo which I thought was a total bummer when she told me about her story because she didn’t have any health problem at all when she started Paleo. She was just doing a Paleo challenge at her Cross Fit gym.

Kelsey: Yeah.

Laura: She developed these really severe gut issues, lots of bloating and pain. It ended up leading her GI doctor to remove her gallbladder.

Kelsey: Wow.

Laura: Which didn’t even do anything which I felt so bad when she told me about that because it’s like wow, so they just took an organ out and it didn’t even help.

Kelsey: Wow, yeah.

Laura: She was one of my examples of a client where I suggested that she get tested for SIBO and it came back positive. She started the antibiotic treatment because she did use the antibiotic combo of Rifaximin and Neomycin and she’s almost back to normal with her gut issues.

Kelsey: Mm hmm.

Laura: I just can’t even believe, like it really frustrates me that she got told to get surgery when she didn’t even have any pathology with her gallbladder.

Kelsey: Yeah.

Laura: But I think that’s a really good example. Oh, and the reason why I bring her up is because she also had hypothalamic amenorrhea, or I guess she still technically does. And the reason I’m bringing her up is because I think this is a good example where the gut issues are going to precede the hypothalamic amenorrhea treatment.

Kelsey: Mm hmm.

Laura: And the reason for that is because first of all, when somebody is experiencing severe bloating and gut pain and they can’t really eat without being uncomfortable, it’s very hard for them to be able to eat in a way that’s going to support the recovery of the menstrual cycle.

Kelsey: Yeah.

Laura: There’s a certain amount of calories that we recommend and I know that this person says that they’re eating more and reducing their exercise, but that doesn’t necessarily mean their body is either getting enough in general or absorbing enough of that nutrition to really solve the hypothalamic amenorrhea.

On top of that, when someone has something like SIBO, or another gut infection, or gut dysbiosis, or bloating in general, I think can really cause the body a lot of stress. For those of us who have experienced bloating either in the short term or long term, like I know when I’ve dealt with lactose intolerance type symptoms in the past, that pain that you experience is really stressful for the body.

Kelsey: Yeah.

Laura: Having that level of distention and discomfort, and like I said actual pain when it’s in your gut where you have so many nerve endings and you are so sensitive in that area, that is going to be causing lots and lots of stress to your body. If you’re having chronic severe bloating every single day, that in itself is a stressor to your body even if you are getting enough calories.

Kelsey: Mm hmm.

Laura: Like I said, the reason I brought my client up is because she had almost this exact situation where she had severe gut issues and hypothalamic amenorrhea which literally was caused by a turn to a Paleo diet while doing Cross Fit. I use this as an example because even though we’re generally promoters of Paleo, and high intensity exercise, and that kind of thing in moderation, it is kind of crazy to see someone come to me and say I was perfectly healthy until I went on a low carb Paleo diet with Cross Fit and now I’m experiencing all these crazy health issues. I feel like she is in a very similar situation to this woman asking this question.

Kelsey, do you agree with the thought that this…I almost want to just want to operate under the assumption that this person has SIBO based on her severe bloating, but do you agree that SIBO would be the first thing to work on before really diving deep into the hypothalamic amenorrhea? Or would you take a different approach?

Kelsey: I definitely would take the same approach because like you said, any sort of gut issues is a stressor on the body whether or not there’s pain or discomfort really. Some people have bloating and it doesn’t really bother them from a physical sensation. I get a lot of women that are coming to me saying I just look six months pregnant and it doesn’t bother me in a physical sensation, it’s just this can’t be normal. Whether or not there’s any sort of discomfort or pain that goes along with the bloating, it’s not normal to be that bloated.

Having some sort of dysbiosis in the gut where your gut bacteria is just imbalanced or you have this overgrowth of bacteria in the small intestine, that really is a stressful thing for the body to deal with because essentially it’s dealing consistently with an infection. It’s trying to get rid of an infection all the time. You can imagine that it’s kind of putting other things off to the side, or putting things on the back burner that it probably should be dealing with on a regular basis but can’t because it’s trying to get rid of this infection that you have.

It’s important to remember that any kind of infection that your body is dealing with is a huge, huge stressor. Getting rid of that as the first priority really makes a lot of sense to me because your body is just not going to be able to focus on healing in any way until you can get rid of this giant stressor that’s standing in the way of that.

Laura: Mm hmm.

Kelsey: Yeah, I would definitely start there. But along with that, anytime we’re talking about hypothalamic amenorrhea, adrenal fatigue is always coming to mind too. The two pretty much go hand and hand almost always, and the same thing goes with any sort of gut issues too. I really do think about adrenal fatigue or HPA axis dysfunction whenever I think of any sort of gut dysbiois because again, if you have a huge stressor like that and depending on how long you’ve been dealing with the stressor like that, your HPA axis can begin to dysfunction.

At that point, I would say that yes, you want to deal with the gut issues for sure and that would be the first thing that I’m testing for and treating. But at the same time, I would also start thinking about okay, what are the ways that we can really reduce other stressors in this person’s life?

Laura: Mm hmm.

Kelsey: This person is eating more, she’s reducing her exercise, so she’s already well on that road to reducing other stressors. But like you said, anytime you’ve got major bloating like that, it really tends to be hard to eat enough even if you feel like you’re eating more than you normally would. Sometimes even that amount isn’t enough to actually heal from hypothalamic amenorrhea or adrenal fatigue, or things like that. That’s just simply because when you’re bloated, you tend to get full really easily so it’s hard to know that you need to eat more food without counting calories and making sure that you’re eating enough for what your goals are. I’d say, yeah, definitely get rid of the SIBO if it’s there, but also reduce the other stressors, so reducing exercise, eating some more. Eating even more will come after getting rid of the SIBO if that reduces the bloating.

But then also thinking about things like okay, what perceived stressors in my life can I deal with? If your work life is super stressful, is there any way that you can reduce some of the stress that goes along with that? Are you fighting with your spouse a lot? Anyway you can reduce some of the stress surrounding that? Can you go to a counselor? Can you incorporate some sort of mind/body activity on a daily basis to help manage some of the stress that you’re dealing with if it can’t go away or be perceived a little bit differently? Can you start journaling so that you can work though some of the feelings that you’re having surrounding the health issues you’re having or other stressors in your life? Anything that you can do to do either reduce the amount of perceived stressors that you have, or manage the stressors that you can’t do anything about necessarily is a really, really good idea because like I said, it just goes hand and hand with hypothalamic amenorrhea and gut dysbiosis.

Dealing with both at the same time actually makes a lot of sense because especially when we’re talking about the gut, let’s say you don’t get rid of SIBO, you’re working on getting rid of SIBO. So let’s say you’re taking antimicrobials or antibiotics, you have a much better chance of actually clearing the SIBO if you’re also focusing on stress reduction or stress management. Because the gut and the brain are really intimately connected, and if you are stressed out all the time, your gut isn’t functioning properly, so you’re not moving things through the gut at a normal pace usually if you’re stressed out and it just has an effect on the bacteria itself. It actually changes what your microbiome looks like when you’re always stressed out.

As much as you can do to reduce the amount of stress in your life or manage the amount of stress in your life, that’s really going to actually help you clear the SIBO more effectively so that you maybe won’t have to go through multiple rounds of antimicrobials or antibiotics because at least in my experience, that’s pretty common. I’ve had a lot of people that have to go through multiple rounds of antibiotics or try different antimicrobials because the first one or two don’t really do it for them. But I think if you really focus on the stress management aspect, I think you have a lot better chance of it actually working for you.

Laura: Yeah, I mean just looking at this question where the person says that they have a long history of disordered eating, I wonder if there’s any extra stress coming from the eating more and exercising less. She mentions that she weighs 120 pounds now and she used to weigh 110 before she got pregnant. Now, at 5’3” I’m not saying that 120 is…like I’m not worried about that weight, I don’t think there’s anything wrong with that weight.

Kelsey: Yeah.

Laura: It’s a perfectly healthy weight, but I can see that potentially as being something that was stressing her out. Again, I’m making a lot of assumptions. I don’t know this person, I don’t know her history other than the fact that she admits to a long history of disordered eating. But from my experience with clients, somebody who has that history and is eating a lot, exercising less, and has gained weight above what theyir maybe ideal or their original weight was that they felt good about, that could be something causing stress.

It can be really hard to really overcome those disordered eating tendencies even if you are doing the physical piece, like just the eating more and exercising less piece. Yes, that’s less stress on your body if you’re going from disordered eating with inadequate food intake, over exercising, that kind of thing. But I find that a lot of my clients at least in the beginning of our work together, even if they’re eating more and exercising less, they still have these really intense negative thoughts that they’re experiencing about their body, about what they’re eating, about not exercising, and there’s a lot of self-critical thoughts that go through their brain about their body weight, about the fat that they might have gained during that time, the amount of exercise they’re doing. I have a lot of clients who proclaim themselves to feel lazy because they’re not exercising the way they used to. Even if maybe she’s reduced her exercise, she may be exercising a normal amount now if she has a history of over-exercise.

Kelsey: Right.

Laura: I find that, like what you were just saying about stress management, for people who have this disordered eating and maybe exercise addiction type history, the process of healing from hypothalamic amenorrhea…and if she has hypothyroidism, we can like you said assume that she’s got some HPA axis dysregluation too just because of the way the hypothalamus affects both the ovaries, and the thyroid, and the adrenals.

Kelsey: Mm hmm.

Laura: I wouldn’t be surprised if there was still some stress coming from the thoughts surrounding the healing approach that she’s taking.

Kelsey: Yeah.

Laura: Again, like I said, I have no idea, she could be totally on board mentally with this approach. But more times than not, the people that I work with even if they’re doing what we suggest that they should do in this situation, they don’t necessarily feel great about it.

Kelsey: Yeah.

Laura: Have you experienced that, too?

Kelsey: Absolutely. I think that’s one of the hardest things for people with a history of eating disorder struggle with. Even if they feel like they’re for the most part recovered from an eating disorder, those thoughts and I guess just that thought process tends to remain. That’s really hard because someone feels like they’re recovered and then they’re uncovering all these deep seated emotions about gaining weight or the healing process when they have to eat more and reduce exercise that maybe thought they had really dealt with most of the time a long time ago. I do think that that can be a really difficult thing though. And that’s why for someone with a history of an eating disorder, it can make more sense to work directly one on one with someone because sometimes the person themselves doesn’t realize that those feelings are playing a role.

Laura: Mm hmm.

Kelsey: I’ve definitely had to have those conversations with some of my clients and they’re like, no, no, no, I’ve recovered, I don’t think that’s playing any part. And the more we dig deeper into it, the more they realize that wow, yeah, these thoughts are still there to some degree and they’re still making me feel bad about this way of healing.

Laura: Yeah, it’s really crazy just generally with mindset stuff how you can think that you’re over something and that it’s not affecting you anymore, and then if somebody else gets you talking about it, it’s like all of a sudden you’re emotional about it.

Kelsey: Yeah.

Laura: Whenever that happens, like when I’m working with a client and that comes up that they start to get upset when we’re diving into a topic, or even in my own life there’s definitely things that I have worked through either from a health or mindset perspective that you kind of think, oh I’m over this, it’s not a thing anymore, and I’ve kind of moved on, and it doesn’t bother me anymore. Then somebody will say something that triggers like an emotional reaction about it and you’re just like, wow, I had no idea I was still feeling this way.

Kelsey: Right.

Laura: This is something with disordered eating or body image issues, I mean I think women are a lot more prone to it, but I’m not saying that men can’t have disordered body image and eating disorders, that kind of thing. But I do work with a lot of women who they don’t think that it’s impacting their health with the way that they think about their body and the way that they have these almost repressed emotions about the whole situation.

Kelsey: Yeah.

Laura: Especially when someone’s trying to recover from hypothalamic related issue like hypothalamic amenorrhea, hypothyroidism, HPA axis deregulation, if they’re not addressing some of that stuff that’s still deep in there, I really think that that can impact their progress. It’s not going to necessarily totally prevent them from making progress because at the end of the day, this woman eating more and exercising less is reducing physical stress on her body. But if there’s just this chronic underlying negative feeling about her body, about her health, maybe the stress of not being able to get pregnant and she’s 37 and I’m sure that’s on her mind that as she’s getting older maybe a lot of women in that mid to late 30’s start to feel like the clock starts ticking with having a baby, and so that could be something that’s causing her a lot stress, anxiety, and negative emotions, and sadness, that kind of thing.

I don’t want to get crazy heavy on this podcast, but it is something that I see happen a lot with a lot of my clients and it’s actually one of the reasons that I’ve kind of moved more into a coaching type of practice as opposed to a functional medicine practice which we talked about recently. It’s just because all of these emotional and mindset pieces that people just don’t even think to look at do have such an impact on their ability to heal fully. It’s tough work, I mean it’s hard when you’re talking to somebody about something and they just like start crying on the phone.

Kelsey: Right.

Laura: It’s not like I get excited about making people cry when I talk to them, but on the other hand, a lot of times more often than not after that experience, by the end of the phone call they’re like oh my gosh, I feel like a weight has been lifted off my shoulders. It’s not fun to be upset about something in the short term. I’ve definitely had this experience even recently talking with friends or my fiancé about certain issues that I thought were things that didn’t bother me anymore. Getting emotional about it and being like, why am I crying about this? This is so stupid, I thought I was over this. Then afterwards feeling like wow, I feel so much better that I talked about it and got it off my chest and really acknowledged that that was something that was bothering me. It’s kind of crazy, the amount of times that I’ve had clients have that experience where we were talking about their health and then somehow we got onto the topic of their marriage, or their children, or their body image, or just anything that could be bothering them. Actually it’s been kind of crazy how many of those conversations go into relationship discussions.

Kelsey: Yeah.

Laura: Which is always fun when you’re planning for a wedding and you’re like oh wow, there are so many relationships out there that are not good. It’s like, let me make sure to step mine up in a good way. But it’s just crazy just the amount of impact that those negative emotions on a chronic basis can have on people’s recovery.

Kelsey: Yeah.

Laura: Again, I’ll say it again because I want this person to feel like we are respecting the fact that we don’t know her and that we don’t know what she’s going through, or what’s she dealing with, or what kind of experience she’s having with this process. But I think most people in this kind of situation, and I’ve worked with a lot of clients that, obviously this woman is unique, but very similar situations where there’s disordered eating, stress about family, or having children, or whatever kind of things would be stressing her out and then dealing with a gut issue, or hypothyroidism, or HPA axis dysregulation, or hypothalamic amenorrhea. And just I don’t know if I’ve ever worked with a woman in that situation that didn’t have some kind of emotional issue that was exacerbating everything.

Kelsey: Yeah. I completely agree. Like I was saying before, I just think even if they know that that’s been a problem in the past and they feel like they’ve gotten over it, at least in my experience, and again, I really don’t want to put this onto this woman because again we don’t know her, but more often than not, those feelings, those emotions, those thought processes are still there. They may be at a different level than they were at some point in her life, but those things are still there and they still tend to cause some of these issues or at least be a part of the reason some of these things are going on.

Laura: Mm hmm.

Kelsey: They are probably the most difficult thing to deal with. You can find out you have SIBO and you can take antimicrobials and most of the time it’s just gone. But when you find out or discover that you have some of these feelings or some of these emotions that are really holding your healing process back, those things are really difficult to work through. It tends to take a lot more time. It tends to take a lot more effort too. It’s not like you just pop an antibiotic or pop some antimicrobials and six weeks later you’re fine. This stuff takes a lot of work, it takes a lot of introspective thinking, it takes talking about hard stuff. And that’s really, really difficult for a lot of people, but it’s really worth it. I’ve seen the same thing, Laura, that once these things are worked through or even just talked about, it doesn’t even have to be solved ever.

Laura: Right.

Kelsey: It’s just a matter of talking through it with someone. It could even be a friend or it could be your coach, or a counselor, a therapist, anybody who really truly listens to you and helps you work through an issue. Even like I said, if it’s not solved by the end of a conversation, you feel like that has lifted off of you and at least you released some of that emotion that you’re holding at that point in time. Those thoughts can come back over time of course, but the more you talk about them and the more you work through them, the less power I feel like they have over you. I’ve seen that a lot with clients where they kind of talk to me about certain things. It’s funny you mention the relationship thing because I feel like I have a lot of that same experience with my clients where you hear about unsupportive partners when someone’s trying to heal and that has a huge negative impact on the healing process.

Laura: It’s awful.

Kelsey: Yeah. That stuff is really hard to deal with. I think a lot of clients who are just dealing with the health stuff on its own feel like that’s a really difficult process and a totally is.  But when you add in emotional issues or relationship issues to the mix, it just makes it that much harder. When those things are talked about or worked through in a session, or again, even if it’s just on their own with their own friends or with a counselor, I think that really, really helps the healing process.

Laura: Definitely, or at least it stops hindering it.

Kelsey: Right, exactly.

Laura: It’s funny because I’ll have clients that by the end of the phone call are like apologizing to me for the fact that they talked about all this stuff that had nothing to do with nutrition, or exercise, or anything like that. I’m like no, this is awesome. I really love getting deep into that kind of stuff because at the end of the day, I want to work on what is really causing the root issues.

If somebody has a really stressful relationship like they’re married and their marriage is really not going well, listen, I think that marriage is something that can be awesome if it’s in a good state. I don’t think a marriage that’s struggling needs to necessarily be ended, but something needs to change obviously because I think marriage relationships, I’ve seen this happen where that can really be like the catalyst for people developing health issues if they’re in a bad marriage. Again, like I said, that doesn’t mean the marriage needs to end, it just needs some kind of change to either get counseling or talk to each other in a way that you can solve whatever problem you’re dealing. But it’s just amazing to me.

I’m not only saying married people, obviously people that are dating or whatever can be in that same situation. Also I work with young single girls they have lots of negative thoughts about themselves because they’re single.

Kelsey: Right.

Laura: It’s not like being single protects you against having a bad relationship or that being in a marriage is guaranteed you to make you happy all the time and have a supportive partner in your health issues. But I think here’s a lot of that kind of that kind of stuff going on in a lot of people’s lives that affects their health and maybe even caused the health issue in the first place. And if it’s not dealt with, then it needs to be a high priority and it may be something that they do need to talk to them about because it is making such a big difference.

Kelsey: Yeah.

Laura: It’s funny because with our “Paleo Rehab” program that again is launching this week, so if you want to join us if you’re dealing with some of this stuff, it would be a really good fit. I actually feel like this person asking the question probably would be a great fit for the program.

Kelsey: Yeah.

Laura: We do have an entire module in the program all about disordered relationships with food and emotional healing. The reason why we  put that in there is so many of our clients that have HPA axis dysfunction and the different associated conditions like hypothyroidism, hypothalamic amenorrhea, that kind of stuff, I would say more often than not do have some kind of emotional issue that’s exacerbating or causing a problem.

We wanted to give people some basic assistance and guidelines for how to deal with these issues and how to heal from emotional…I didn’t come up with this term, but we call them emotional injuries in the program based on the work of a psychologist, and I’m blanking on the name right now, but basically these emotional issues that do actually impact your physical health. We talk about trauma, we talk about disordered eating, we talk about poor body image.

That’s actually my favorite module of the whole thing because I feel like it’s rare for a program that covers diet, exercise, supplements, testing, and all that to really go into that detail on the emotional side of healing. The one downside about it is honestly I think people really do need to talk to somebody to really get through the healing process.

Kelsey: Mm hmm.

Laura: However, one thing that’s cool about the program is we do have a private community group for the program where people can share things if they feel comfortable, or they want some feedback, or even just a sounding board to share something that they’re struggling with. It’s private, we can’t guarantee that nobody will see it because it is the internet, but it is about as private as Facebook is going to get where you can share stuff that shouldn’t be seen by other people.

Kelsey: Mm hmm.

Laura: If you have something that you want to just get off your chest or share and see if anyone’s got any advice, it is a great forum for that. Or if you just feel like you want to make some friends on there and then go have a private conversation or a phone call even to talk to somebody that can kind of just be there to listen, we’ve had some participants that really started building friendships and more I guess one on one relationships in the group itself.

Kelsey: Yeah.

Laura: Then they were able to talk to each other about stuff that they were dealing with. Even though we strongly recommend working with somebody that can help you deal with these emotional issues and the stress, and all that, we do give a lot of really great resources in our program for healing either a disordered eating or bad relationship with food, healing from traumatic experiences that might be lingering in terms of emotional health, just anything that could be contributing to the issue which we kind of hammered home in this answer here. But honestly just from the different things that this woman is sharing, it’s a very common picture that we see and it is something that does require emotional healing at the same time.

Kelsey: Yeah, I think with that module too, it helps people to recognize some of these issues because I think a lot of people are like okay, I kind of see what you guys are talking about, like emotional injuries, emotional issues. Yeah, I maybe have something going on with that. But they can’t pinpoint what kind of issues they’re dealing with necessarily. I think that module really helps people to get specific about what kind of stuff might be bothering them. And then you can take that information and when you go see a counselor or when you go talk to a friend, you have a much better idea of what kinds of things you need to work on to get through those issues that you’re dealing with.

When things are very unspecific, of course like a counselor is meant to help you work through that and figure out what’s going on, but I think people feel like oh, since I don’t know what it is, why would I even go to a counselor? They kind of feel like it’s pointless because they’re not even sure they’re dealing with anything. But I feel like this module really helps people to pinpoint a little bit further what might be going on exactly.

I think that’s what we’ve heard from participants in the past is like wow, I didn’t even realize that I had an issue with this until I went through this module and all of a sudden my eyes were opened to the fact that this is definitely an issue for me.

Laura: Right. That doesn’t necessarily mean the program fully 100% solved that issue.

Kelsey: Oh for sure, yeah.

Laura: But I feel like just knowing that it’s something that’s causing a problem is so valuable to people because then they actually have a place to really invest their time and energy to solving the problem. The program is not designed to help people heal from childhood trauma, or abuse, or a serious issue with their marriage, or anything like that. But once they realize that that’s something that’s contributing to the problem, then they can go and get help for that.

Kelsey: Right.

Laura: Like see a counselor or go to a therapist that can really dive deeper into that issue that is contributing to the overall picture of their health but really does need a lot more focus than even something like their diet or their supplements.

Kelsey: Yeah, I know. This person like you said, I actually think would be a great fit for the program. I hope that this answer has really given this woman at least some stuff to think about and start with. Certainty definitely get the gut stuff checked out preferably by somebody who’s experienced with functional medicine, or I don’t even really like the term alternative medicine, but a lot of mainstream doctors don’t necessarily know about SIBO at this point. Like Laura was just saying, one of her clients had to get her gallbladder out before even realizing that there was SIBO going on because her doctor didn’t even think to check for something like that.

Laura: What’s crazy is I was spending some time with a friend of mine who’s an RD the other day and she said one of her patients went to four different GI doctors to try to get a SIBO test and I think three out of the four either said that they didn’t believe in SIBO…

Kelsey: What?

Laura: …or that they didn’t know enough about it to want to test it.

Kelsey: Yeah.

Laura: The comment that they don’t believe in it, it’s not like its Santa Claus or something.

Kelsey: I know.

Laura: It’s not a question of like I believe that it exists. It’s just crazy. But yeah, so it’s kind of amazing how many people I’ve worked with that either SIBO wasn’t even something that was presented to them as an issue, or if they asked about it they were told that no, I don’t do that, or no, that’s not real, or whatever.

Kelsey: Yeah, it’s definitely real guys. Laura and I have seen it time and time again. We’re literally treating that to solve someone’s gut issues like 100%. It definitely worth testing for, it’s definitely worth treating for if you do have it. And like we said, anytime we hear bloating from somebody, that’s like the first thing that comes to mind. Definitely check that out as a possibility because you’re going to have a hard time healing fully without dealing with that issue first, or at least at the beginning of your healing process.

Laura: Right.

Kelsey: As you’re working on getting rid of SIBO if that is what’s going on the gut, work on reducing stress in any way that you can whether that’s figuring out some of these emotional injuries that might be there and working with a counselor through those or just talking to somebody you trust about those things. And then a lot of times the other stuff starts to fall into place after that because you’ve then taken off so many stressors from your body that it can start to heal from something like hypothalamic amenorrhea, and it can start to heal a little bit from hypothyroidism, or you may not have to take as much thyroid hormone because your adrenals aren’t so freaked out and the HPA axis isn’t so dysregulated that it’s causing problems with your thyroid.

A lot of these other things once you get HPA axis dysregulation back into its normal rhythm, it’s normal functioning, and you get your gut to work again, all these other things start to get better on their own. I’m not saying that’s going to heal it 100%. You probably are still going to have to do some other stuff to deal with those things, but it helps to at least get that healing process started for the other things.

Laura: Whew, these cases!

Kelsey: I know.

Laura: But honestly like this person describing herself, I’m like that’s kind of like who I work with.

Kelsey: Yeah.

Laura: It’s just crazy because it’s like there’s so many different factors that are involved in a case like this where it’s like the physical treatment of the gut issues, and then adjusting the diet to support the hormone production, and then reducing stress levels, and diving into emotional issues. It’s just like it’s amazing how many different facets of treatment that you can really hammer into and actually see improvements in this kind of situation.

Kelsey: Exactly.

Laura: It gets complicated, and this situation like we said, this person probably would be a good fit for our program. I thinks she’d be a great fit for one on one counseling.

Kelsey: Mm hmm.

Laura: But regardless of what her approach is, I do think that this is going to require a multi-pronged approach.

Kelsey: Yeah.

Laura: Really dealing with a  couple of different things at once, but also realizing that certain things like the gut is probably going to precede the hormonal improvements when it comes to just timing of the improvements that we’re looking for.

Kelsey: Yeah. Well, I hope this was helpful. And just as a final reminder about “Paleo Rehab,” if you are interested in joining us, you’ve got a couple of more days to sign up and we hope that you will join us and that we’ll see you in Facebook group. We will talk to you next week.

Laura: Alright. You have a good week, Kelsey.

Kelsey: Take care, Laura.

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I'm a women's health expert and a registered dietitian (RD) with a passion for helping goal-oriented people fuel their purpose.

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