For the past few years, I've had gut issues with a very unclear root cause. I was definitely under an insane amount of chronic stress due to the pandemic and isolation when the issues started, but after isolation ended and my life should have been less stressful the issues persisted. Some doctors seemed to take this gut-brain connection thing to mean that it was all in my head since they couldn't find anything medically wrong with me. That was incredibly frustrating because I was experiencing real physical issues like weight loss, hair loss, bloating, indigestion, etc. But all of the tests and biopsies they did came back normal. With functional medicine and a lot of trial and error with diet and lifestyle changes I've gotten to a point where I feel pretty much recovered, though still with a very sensitive gut. I never discovered the root cause of my problems. My leading theories are long-covid, non-celiac gluten sensitivity, or chronic stress. Possibly a combo of those things.
All of that being context, the thing I wonder about this is, if chronic stress does indeed inflame the gut, what does the process of reversing that inflammation look like? It doesn't seem like you can simply remove environmental stressors to undo the inflammation. It seems that there are feedback loops and damage that occur that can take awhile to undo. When someone has a stressful life, it can be difficult just to reduce the amount of stress, much less completely redesign their life to be less stressful. And gut inflammation makes it even harder. Even if they manage to do so, say perhaps by taking a year long sabbatical if they can afford to do so, removing the stress may not be an instant solution.
I hope more research is done in the area of healing from gut inflammation triggered by chronic stress.
To pull an HN evergreen and reply to the overly specific instead of your main point: My wife developed "histamine intolerance" after a time of heavy stress, in a story that's scary similar to yours. It took her years to figure it out, from chance result on a super broad blood test. To confirm this, she changed her diet to be only low-histamine foods and it made all the difference. She went from "a single chocolate chip cookie makes me sick for 3 days" to "mostly leading a normal life, just watch what you eat" in half a year or so. Over time it helped her gut recover to the point that she now generally does not need to watch out much anymore, except in some periods when some old symptoms pop back up and she reverts to low-histamine diet for a while.
Statistically speaking this is probably not it and you considered/tried it already, but just wanted to bring it up in the off chance that you hadn't heard of this before. I mean doctors just said "irritable bowel syndrome! theres no cure sorry bye". She's been writing a low-histamine foodblog for some years, which includes a good starting point for what to eat and avoid: https://histaminefriendlykitchen.com/histamine-friendly-food...
For years I had the same gut issues described by others here, seemingly caused by a combination of factors. I'll share what helped me solve the problem.
The most effective thing for me seemed to be hitting the gym hard, lifting heavy and sweating a lot.
Alongside that, I went through a lot of trial and error with the foods my body would tolerate. I started with a low histamine/low FODMAP approach, various fasting methods, bone broths (collagen), probiotics (sauerkraut, kefir), etc., and slowly introduced various foods on top of that while noting what made me feel good or bad and basing my diet around that. Everyone is different so what worked for me diet-wise may not work for you.
Lastly, for my particular case, I think liver-boosting supplements like milk thistle and NAC helped significantly (and probably some others for any vitamin/mineral deficiencies, especially D3+K2). I suspect the root cause of my problems was toxic mold plus stress/trauma.
Thanks for sharing this, and pass on my thanks to Tania too.
It's just uncanny to see a whole lot of the "random" foods that make me feel bad on a single list, and that number next to the anchovies explains the post-homemade pizza feeling too...
Meditation, mindfulness, reframing, emotional self-care, movement, exercise. The usual things.
Not trying to be smug.
But I noticed on a three week vacation, where I was walking 15K steps a day, I lost weight and had zero gut issues while eating freely in restaurants for the duration. Got home, day one the old issues came back. I definitely had a stressful association with my day job and the attendant life. I let a lot of things slip because I allowed that my situation required me to reward myself with lethargy and vices. When I’m above the baseline on self care, I don’t turn to the vices as much and my physical systems generally work better.
I got back into my “me first” routine and my gut issues subsided. For me it was like a switch.
I'm glad it was so easy for you. For me, I've been living like a self-care saint for over a year. Meditation, mindfulness, gym three times a week, active recovery, sufficient sleep, 15k steps a day, perfect diet, low-stress job, fulfilling sex life, morning sunlight, ice baths, saunas. I'm not OCD or up tight about it, but I'm very consistent. I get constant comments about how I take such good care of myself. A lot of people say they have never met someone who take such good care of themselves. But recovery has only happened very very slowly over the course of many many months.
But my experience is similar - I quit drinking in 2020-2021, eliminated grain from my diet, and eat probably 80% of my calories in vegetables now. Overall my body is in much better shape than it was then, but something is still wrong with my gut-brain axis. I think what the article misses is the microbiome factor. Any active microbiome is going to produce metabolites, and some of those metabolites can be destabilizing and disabling to the enteric nervous system, even if they’re not producing something as acutely toxic as a bacteria like C. Diff.
Of all the things I’ve tried, I’ve never felt as stress-free or clearheaded as I have near the end of a fast.
Out of curiousity, have you tried activated charcoal? It's not good to take frequently because it blocks nutrient absorbtion, but if I'm feeling really awful or just need to feel clear for a day so I can focus on something important, charcoal seems to mop up some of the toxic metabolites and give me a short break.
Yes, same – but taking too much or taking it for too long (basically taking more than 2g) seems to be abrasive to my GI system in a way that isn't helpful.
I had a food intolerance test. I replaced every item in my kitchen (new coffee maker [after ditching coffee for a while], new pots and pans, new cooking utensils). I did multiple elimination diets. I went to doctors (one doctor, when I said I had no issues in Europe and lots of issues immediately upon returning responded, with no mocking at all, I should consider moving to Europe) most of whom simply told me to go Whole 30 or Mediterranean diet (been there, done that).
I hoped a lot of it would subside when I eliminated the relationship in my life, too (alas, maybe.. not sure).
When I did the elimination diet the doctors said it could be a combination of things, it could be things that will take longer than a cycle of elimination to identify, etc.
They didn't know.
I guess there's always: therapy.
Wish I had a better answer, and not having answers is stressful enough. I did a lot of "letting go" and "eating freely" hoping a more carefree attitude would help. It always seemed like something else though.
My doctor friend says if he simply instructed all his patients to eliminate gluten from their diets he would still succeed with 80%+ of his patients having problems...
I'm quite a bit better, but given that my parents are European immigrants, I do think.. ultimately.. I'm better off back there in their food system.
I went through it for many years. It got to the point where certain foods made me feel unwell. I had brain fog. Felt tired, exhausted. I changed my diet, cut out a lot of processsed foods and got by as best as I could.
In the end I realised stress was a major factor. Diet would have an impact but stress was the triggering agent that would make certain foods much more inflammatory.
I broadened my diet, ate much healthier. Made more effort to do exercise on a regular basis.
Slept regularly, slept earlier. Took time to go hiking or running long distances. Stopped thinking about work after hours. Made an effort to stop worrying about things outside of my control.
It took a few years and I reversed almost all the symptoms.
The main problem is with stress + gut issues, it's a downward spiraling feedback loop. Stress causes gut irritation, gut irritation makes you more stressed.
I suggest going to a gastroenterolog, that knows about gut flora restoration. Basically you'll get a Low-FODMAP diet for a month, then RENEW diet for ~1 year, but you will also get a bunch of special probiotics, mostly based on Bacillus Subtilis.
During this time the negative feedback loop is being broken, the gut will have a chance to recover and the symptoms should improve/disappear.
I am slowly finishing this diet and I have to say that apart from a few ups and downs, it helped me tremendously. I have much more energy during the day, less oily skin and hair, smoother skin on my face, and consistent stool.
I recommend an Organic Acid Test (OAT). I've been struggling with gut problems similar to yours for years but then it got so much worse during the lockdowns. At the time I survived it by embracing fasting and keto diets but that wasn't much fun.
More recently my OAT discovered fungal activity and an enormous vitamin C deficit. Potentially this has been going on for more a decade and it would explain why I'm so tired all the time. Treatment through supplementation is in the early stages but I'm already feeling noticeably better.
If you want to go a bit off the traditional path, you can look into BPC-157 which is a peptide that was designed to help heal the gut. Nowadays it's mostly used by athletes and anti-aging people to help heal soft tissue damage, but the original purpose was to heal your gut.
If you're in the US, you can probably find an anti-aging clinic with a doctor that you could ask about it.
I went way off the beaten path and got into peptides by way of kambo. It's an indigenous medicine that's very controversial with very little controlled scientific research, but it actually made a dramatic difference for me. Might look for into peptide injections, though it's harder to find them in my home country (Hungary).
The change in my gut health has been astounding. There was a period about 1.5 months after I started taking it when things definitely felt worse (which I guess is about the time the bacterial colonization was underway) but since then I've felt so much better it's incredible. About 1.5 years now with it as my standard and improvement is consistent.
Now for me this was a big improvement, but it works better (for me anyway) when paired with Questran Lite[2] which is prescription (at least in Australia) but has become the darling of GI doctors because it seems to have good results in improving gut health. I was on it before I started the L. Reuteri, but things only improved once I added the probiotic in.
So - in order: try L. Reuteri supplements for about 6 months (because it's OTC). If the gut inflammation is an issue there's evidence that they will in fact help reverse it. If things are still somewhat not great, get a Questran Lite prescription (though there's actually a global shortage going on now).
The L. Reuteri theoretically you don't need to keep taking, and I did try going off them for about 6 months recently, and was mostly fine but eventually started seeing some regression so started taking them again.
I tried L. Reuteri. Probably heard about it on HN too haha. But for me that one didn't seem to make much difference. I had really good luck with BB536 though.
You might want to read 'The Lady's Handbook for Her Mysterious Illness: A Memoir' by Sarah Ramey (Known also from her band Wolf Larsen). She goes back and forth between providing an overview of this 'mysterious illness' from different angles, and her gutwrenching absolute trainwreck of a personal experience of it. It seems you already found your way the same way she eventually did, though.
As the title says, the book is womens body specific - but also a guy i still found it very insightful to read.
Another book to suggest, "The Comfort Crisis" by Michael Easter. In it he does a solid and helpful flyover on how humans evolved vs how we actually live now, and how the disconnect is impacting (negatively) our physical and mental health.
While there are few individual ah-ha moments, seeing everything laid out end to end to end aggregates into a realization that The First World lifestyle is extremely unhealthy and often (premature death) deadly.
Fwiw, in some ways The Comfort Crisis was like physical (and mental) health version of The Coddling of the American Mind, but without the PC-ish type baggage. Note: this comparison - for me - is a compliment as both books look to challenge mainstream narratives and normalizations.
Also, have a healthy and easy to digest diet, and don't try to eat too much (don't push too much undigested food through your gut, which will cause further issues by feeding the bad bacteria). Pre and pro biotic food may also help.
Like sibling posts say, inflamed gut leaks histamine, inflames it more and leaks more. Try low histamine and in general low processed and spicy food diet for a while to reset this feedback cycle. Good start: https://www.mastzellaktivierung.info/downloads/foodlist/21_F...
I tried a low histamine diet for a few months. Including DAO enzymes and histamine lowering probiotics. Didn't seem to make a difference for me. Eventually I found out that spicy food actually helps me a lot: it's anti-inflammatory and prokinetic.
After 6 months of testing different diets to try to solve my migraines, I eventually discovered an ultra-low histamine diet resulted in a ~90% decrease in my headaches. Then I began trying different DAO products before eating foods with histamine, but the headaches returned. I eventually discovered NaturDAO (available via Amazon) and its much higher 1,000,000 HDU per pill. Taking two of these before any meal or coffee finally worked to stop the food-induced migraines for me. Hope this helps.
I've been in biotech long enough to see that the beaten path (traditional drugs) does not have robust answers due to patentability.
Post-stress inflammation can persist due to latent infections of various kinds. To accelerated recovery, I would recommend a course of plant-based anti-pathogen treatments. (Not going to shill a specific one.)
My non-verbal son has autism and gastrointestinal issues. Unfortunately, all the pediatricians would test for is C-diff. After years of problems expressed in the most challenging behavioral ways(!), we finally had an MD (trained as a naturopath) prescribe a battery of pathogen tests (https://www.gdx.net/gut-health) that identified an obscure protozoa. Nearly, overnight difference upon treatment (a drug). The remaining GI issues were addressed with plant-based treatment. I've also suffered from GI issues that improved substantially with anti-fungal focused supplements (e.g., French Tarragon leaf).
I would recommend eating a diverse range of fermented food too (yogurt, real sauerkraut, etc), since they compete with pathogens for resources.
Sorry, I was trying not to advocate for any particular brand in this space. There are quite a few on the market and I don't have direct experience with more than a handful. They are all plant parts, dried, crushed to a powder, and put in a capsule. I have used Biotics Research (Dysbiocide and FC Cidal) and my son was prescribed a 90 day course from a different brand (don't remember off-hand). I'd suggest consulting with a naturopath, if you can find a reputable one.
Inflammation is an immunological reaction. It can be triggered a few different ways. Chronic inflammation is either because of a chronic infection or some sort of immune disorder. Chronic immune disorders don't just stop. They have a trigger and then keep going for the rest of the suffers life at some level. They can be controlled, but they can't be cured. This is because of the way the adaptive immune system works, which produces antibodies. Antibodies do a lot of different things, but one of the things they do is trigger inflammation in the presence of a specific protein. Your body has the capability of producing antibodies for basically any conceivable protein. Once an antibody is triggered, by having cell damage while the antibody is "activated." Your body replicates the B-cell that makes that specific antibody and the antibodies stick around in your blood stream. This is why you become "immune" after getting a vaccine, your body is able to "remember" the antibodies it needs to use in case you catch the real disease. When there is cell damage and the presence of another protein, your body could "remember" the wrong antibody. If it's environmental, this is an allergy. If it's from your own body, making the antibody attack some component of its own body, it's an autoimmune disorder. Once triggered, there's no known way to reverse that negative association. Immune disorders are also incredibly difficult to diagnose.
> When there is cell damage and the presence of another protein, your body could "remember" the wrong antibody.
I'm skeptical of this part. Aren't there always a huge number of proteins present in the body when cell damage occurs? For example, if I get a cold, and I eat chicken soup to prevent it, according to your explanation, I could develop antibodies for chicken soup. This doesn't seem to happen significantly often.
There are a lot of processes I skipped over. One of those is how the body removes B-Cells that react to benign or helpful proteins before they mature. But yes, if you had a B-Cell that produces antibodies against some antigen in Chicken soup, your scenario could lead to an allergy. The key is the body tries to select B-Cells that aren't going to produce antibodies that will be harmful to you. Sometimes it misses one and those are the ones that will cause an allergy or autoimmune disorder.
Tablespoon of apple cider vinegar during meals (mentioned this in the GERD thread, also helps with my gut and brain fog issues too).
There are a ton of rabbit holes you can go down for SIBO, leaky gut, gastroparesis, MMC, etc. All of them revolve around how fast and how well food transits your gut. Longer food stays inside you, the more problems you have.
I went off the beaten path of things proven by clinical research. So none of this stuff is more than anecdotes, but some of the things that helped for me: digestive enzymes, oregano oil, gluten-free diet, probiotics (BB536, and kefir), mastiha tears, kambo, vitamin B, organ meats. I'm currently refining my daily supplement stack.
Things that don't kill you make you weaker. The other saying only applies to mental hurt, not physical.
From my experience, there's nothing you can really do to fix this beyond 'live a normal healthy life, and let it heal itself, slowly, and not fully.'
I worked at a hospital (in IT) during covid, had to be onsite a couple of days a week. lots of people dying all around, n95 all day, etc. not a problem. As I settled in, I realized my manager, and the director, were absolutely toxic people on a powertrip. they didn't care if you said "this is likely to bring down random hospital applications, we need to do it this other way." 2 stars on glassdoor, cowboy hats all around, staff morale not present. they'd come up with technical ideas on how to do something, despite being barely technical people. telling them how to do, say a data migration online, because you're an SME who's been doing it for almost 30 years is a personal challenge, and you get crapped on, overruled, and put in your place. Lots of downtime, lots of patients affected, yet they report literal fake status reports up the chain and generalize-away every issue to the point that the generic statement hides the issue.
I started getting heartburn during the day. Then I started getting hearburn in the morning as my alarm rang. Then I started waking up 5min before the alarm rang, with heartburn, and teenager zits on my face at mid-life. Morning was now a cup of baking soda water instead of coffee. ion pump blockers. more baking soda.
after 6 months, the manager ordered me to execute a migration plan that would shave off 2 days from a year-long plan. I made a nice writeup stating we need to monitor sockets on the array a few days to make sure people aren't actively using the data she want's to trash. Last time she had me do this, she asked over email, and it brought down a whole clinic that was using a share she thought was unused. This time, I was asked not over email, but with a call from her cell phone, to my cell phone.
I said no problem, send me an email or type it in chat, and I'll do it despite the high risk. I was of course fired 5 days later, but already had a new fully remote job, which I started 5 days earlier (lol).
The point of the story is - the stomach issue didn't go away. 3 years later, it's still there. It's much less, but that last/final bit, where a couple of times a year I need ion blockers for 2 weeks, and maybe one day a week I still need to start w/ baking soda water - that's probably there to stay. I eat very healty, lots of fiber, I'm fit. That 6 months of acidic people did damage that a middle-aged body can't heal all the way.
I am about five years out from a similar situation, so let me give you a glimmer of hope: I did get better, very slowly. I wish I could say why, I’ve obviously tried all sorts of things and also a lot of life has happened between then and now, but _don’t give up hope_
And best of luck, I suspect you really helped some patients at your former job relative to someone who would have been less conscientious. Maybe even me, we’ll never know!
All of that being context, the thing I wonder about this is, if chronic stress does indeed inflame the gut, what does the process of reversing that inflammation look like? It doesn't seem like you can simply remove environmental stressors to undo the inflammation. It seems that there are feedback loops and damage that occur that can take awhile to undo. When someone has a stressful life, it can be difficult just to reduce the amount of stress, much less completely redesign their life to be less stressful. And gut inflammation makes it even harder. Even if they manage to do so, say perhaps by taking a year long sabbatical if they can afford to do so, removing the stress may not be an instant solution.
I hope more research is done in the area of healing from gut inflammation triggered by chronic stress.