Posted on: May 31, 2016 at 1:54 pm
Last updated: September 14, 2017 at 4:35 pm

This great guest post was written by Dr. Serena Goldstein, a naturopathic doctor specializing in natural hormone balance! I encourage you to go check out her website!


Research is endless about the amount of gut dysbiosis that occurs throughout our 20 plus feet of intestines that sometimes it’s hard to decipher exactly what is occurring, especially when the risks, etiologies, and symptoms tend to be similar.

Some common conditions tend to be an umbrella term for more specific diagnoses that are usually determined clinically or through stool testing.


Gut Imbalance

When our 4 pounds of gut bacteria become imbalanced, gastrointestinal related symptoms occur. These symptoms can be: gas, bloating, and diarrhea, as well as joint pain, weight gain, weight loss, headaches, rashes, memory concerns, painful periods, fatigue, and poor sleep, to name a few.

The gut is literally central to medicine and health, and its optimized health can improve a multitude of concerns.


The Gut as a Second Brain

“The gut as a second brain” is a common and popular phrase uttered in medicine, as research expands to understand the full impact of the microbiome. About 95% of serotonin, our happy hormone, is made in our gut, which can get converted into melatonin (our sleep hormone).

In addition, nearly 50% of dopamine (our reward hormone) is formed in the gut, as well as over 90% of our immune system. A brain disease like Parkinson’s, characterized by a decreased in dopamine and treated with therapies to increase dopamine, can benefit from well-balanced gut flora as research is continuously finding that it may relieve non motor symptoms and improve quality of life (Felice, Quigley, Sullivan, O’Keeffe, O’Mahony, 2016).

It would only behoove clinicians to optimize gut health as it’s the origin for about half of all dopamine production.

Furthermore, such linkages can determine skin health and development of children as research has linked an increase of Bifidobacterium, Staphylococcus, Escherichia coli and Clostridium difficile to higher risks of developing a skin rash called atopic dermatitis (Bornigen, et al., 2013).

However, disrupted gut flora tends to unravel in more than one condition, and can generally not be treated the same despite similar risk factors.


Dysbiosis is a general term that refers to an imbalance of gut flora that can trigger leaky gut, as well as lead to candida, and parasitic infection. Contributing factors include antibiotics, stress, illness, aging, and certain dietary components (Myers, 2004).

One of the risks with dysbiosis is elevated estrogen levels, which can manifest as weight gain, decreased libido painful periods, and mood swings, due an increase in beta-glucaronidase, an enzyme that cleaves estrogen off a bound molecule to recirculate, where it should have been excreted.

Leaky Gut

Leaky gut, a form of dysbiosis, has similar risk factors but the pathophysiology refers to tight junctions, which are structures that open and close intermittently to allow fluids, nutrients, and some microorganisms to cross from the lumen into the lamina propria of the intestine (Hollander, 1999).

Gluten, dairy, sugar, and high alcohol consumption can all compromise the integrity of tight junctions, and that can create larger spaces for foreign substances to ‘fall through the cracks’.

When too much goes through, or the body doesn’t recognize them (e.g. whole food particles), our immune system goes to fight invaders. Development of autoimmune diseases (e.g. Celiac, Hashimoto’s) is thought to be partly due to an overactive immune system in which leaky gut is a contributing factor.

Additionally, people with autoimmune may have deregulated zonulin pathways, a physiologic modulator of intercellular tight junctions, an important mechanism in gut integrity, and further denotes importance of a healthful diet and lifestyle (Fasano, 2012).

Low stomach acid may be due to genetics or as we age, as the amount of stomach acid decreases with age. We need stomach acid to help digest our food, and the mucosa within our stomach helps protect the acid from eroding surrounding tissues. Common contributors are similar to those of dysbiosis and leaky gut, but its physiology is based on ‘production of’, a role for the thyroid (responsible for metabolism).

Therefore, an underactive thyroid, or contributing factors that inhibit optimal thyroid function such as chronic stress, poor food and lifestyle choices, increased alcohol consumption (most of active thyroid conversion takes place in the liver), can all decrease production and potentially lead to more specific conditions such as Candida or H.pylori.

Parasitic infection is typically due to poor digestion due to food poisoning, or from poor quality water, undercooked meats, lakes or ponds, and also seen commonly in tropical and subtropical countries where many bugs are present in abundance.

An infection can shift the gut flora both in the short and long term, and has also been linked to conditions such as Inflammatory Bowel Disease (IBD), which encompasses both Crohn’s Disease and Ulcerative Colitis (Walk, Blum, Ewing, Weinstock, & Young, 2010).

Optimize Your Gut Health

Optimizing gut health continuously proves to be a permanent strategy when considering a wide array of health conditions, as the complexity of the microbiome and strains of bacteria have been linked to certain conditions of all ages. Fortunately, many of the risk factors are similar, so at the minimum focusing on a healthful diet and active lifestyle can decrease the chance of developing any of these conditions.


Bornigen, D., et al. (2013). Functional profiling of the gut microbiome in disease-associated inflammation. Genome Medicine. 5(65).*~hmac=494529f6572b804f4818b811129d39bab6a8f6b4ca5c3490f1863cf66caf39dd

Fasano, A. (2012). Leaky gut and autoimmune diseases. Clinical reviews in allergy & immunology, 42(1): 71-78.

Felice, V.D., Quigley, E.M., Sullivan, A.M., O’Keeffe, G.W., & O’Mahony, S.M. (2016). Microbiota-gut-brain signaling in Parkinson’s disease: implications for non-motor symptoms. Parkinsonism & Related Disorders.

Hollander, D. (1999). Intestinal permeability, leaky gut, and intestinal disorders. Current Gastroenterology Reports. 1(5):410-416.

Myers, S. P. (2004). The causes of intestinal dysbiosis: a review. Altern Med Rev, 9(2), 180-197.

Walk, S. T., Blum, A. M., Ewing, S. A. S., Weinstock, J. V., & Young, V. B. (2010). Alteration of the murine gut microbiota during infection with the parasitic helminth Heligmosomoides polygyrus. Inflammatory bowel diseases, 16(11), 1841-18

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Dr. Serena Goldstein
Naturopathic Doctor
Dr. Serena Goldstein is a Naturopathic Doctor in NYC who helps people lose weight and keep it off when diets, cleanses, and supplements don't seem like enough, or take too much mental energy and time. Dr. Serena also has a special focus on hormone health, a main hurdle to weight loss efforts, as she tailors her plans around mindset, nutrition, lifestyle, and appropriate natural therapies in an integrative approach to addressing the mind-body connection. Learn top tips to feel lighter & more balanced here!

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