“All disease starts in the gut”…
…said some guy 2500 years ago.
Yup – that includes anxiety too!
In today’s article we are going to look at how to improve your gut health (…and lower anxiety levels).
- How Your Gut Influences Your Mind
- How The Gut-Brain Axis Can Explain Anxiety
- The Problem With Increased Intestinal Permeability (Leaky Gut)
- What Actually Causes Gut Inflammation And Leaky Gut?
- How to Improve Your Gut Health And Reduce Anxiety?
- Step 1: Eliminate Problematic Foods And Reduce Gut Inflammation
- Step 2: De-Stress
- Step 3: Strengthen Your Digestion
- Step 4: Improve Gut Motility
- BONUS: More Gut Healing Stuff
- Conclusion – Make Gut Health a #1 Priority
How Your Gut Influences Your Mind
This is probably not news to you:
Your gut, or gastrointestinal tract, is a long winding tube that runs from your mouth all the way to the other end.
Its main job it to break down and absorb nutrition from food and also to expel waste (poop).
Here’s the kicker:
Your gut even has its own autonomous nervous system known as the enteric nervous system (ENS).
In other words, gut and brain health are intimately linked.
Poor Gut Health → Anxiety
Poor gut health tends to go hand in hand with anxiety and depression.
Here are just a few studies on this subject:
- Research shows that anxiety and depression is more common in patients with irritable bowel syndrome (IBS) vs healthy people.
- Increased gut permeability a.k.a ‘leaky gut’ is found in over 40% of people with depression!
- Constipated people tend to be more depressed and anxious.
Which means that having a healthy gut (and eating healthy foods) is super important if you want to feel good and not deal with anxious.
How The Gut-Brain Axis Can Explain Anxiety
The link between gut and mind is what is known as the gut-brain axis…
This ‘gut-brain’ axis or ‘gut-microbiome-brain’ axis is a two-way street:
Your brain influences what goes on in your gut – and vice versa – your gut (and gut microbiome) influences your mind, mood and cognition!
In other words:
Poor gut health can make you feel anxious and depressed…
…and being stressed out can impair the digestion of foods.
It goes both ways!
(Often in a nasty vicious circle).
So, we know that the gut and mind are always chatting with each other via the gut-brain axis.
In my estimation, A LOT of anxious, moody or depressed feelings can directly be traced back to gut issues; poor gut health tends to really wreak havoc on your mood and stress resilience.
- Eating pro-inflammatory or allergenic foods, e.g gluten
- Eating something that doesn’t digest well
- Excessive gas and bloating and walking around with a ballon belly 24/7
And these stress hormones will make you feel anxious, moody and unwell!
It may also help to think of gut inflammation as a form of stress, and stress is really the main driver of anxiety (as explained in this article).
Gut problems can also manifest itself in other ways, e.g., trapped gas in the colon can cause really bad chest pain by stretching the intestinal walls (bruxism, teeth grinding, is typically a symptom of some kind of gut problem).
More Fascinating Stuff On The Gut-Brain-Microbiota Axis
The main communication line between your gut and brain is the vagus nerve… but immune pathways, the hypothalamic-pituitary-adrenal (HPA) axis, and metabolites produces by the gut microbiome (e.g neurotransmitters such as GABA, acetylcholine, adrenaline) also play a role in shaping the gut-brain axis.
“What exactly is the gut microbiome?”
The gut microbiome is the 10-100 trillions of different bactera, yeast, protozoa, viruses, and other creatures that reside in the intestinal tract (mostly in the colon or large intestine).
“So why are there so many creatures inside my gut?” you then ask.
Well, simply put, it’s because they eat the leftovers!
Any undigested food particles, e.g fibre and polyphenols, acts as prebiotic food for the bacteria residing in your gut. Fibre is a bit of a double-edged sword as dietary fibre can feed both bad bacteria and good bacteria.
The Problem With Increased Intestinal Permeability (Leaky Gut)
One way that poor gut health causes anxiety is through intestinal barrier dysfunction, also known as ‘leaky gut’, where all sorts of nasty stuff start leaking into the blood.
This leads to systemic inflammation, HPA-axis dysregulation (high cortisol), low dopamine and low motivation…
…and anxiety and depression, too!
Here’s a useful analogy for how the gut works.
Again, you can think of the digestive tract as a long tube that runs straight through the body, from your mouth all the way to the opposite end where the poop leaves.
So in a way, the inside of your gut is technically still outside of the body... if that makes any sense.
Your gut has two main responsibilities.
It is faced with the difficult task of both:
1. Absorbing nutrients in food needed to maintain your health.
2. Keeping out all the nasty stuff that you DON’T want to absorb.
Normally this is no problem – your gut is able to break down food and assimilate all the good nutrition WHILE keeping out any bacteria or bacterial toxins or other unwanted bad stuff.
A healthy intestinal barrier safeguards the gut-blood axis and prevents “bad stuff” from entering into the circulation.
Gut inflammation throws a monkey wrench into the whole system.
Gut inflammation leads to loss of the tight junction proteins that help seal your gut lining → increased intestinal permeability (a.k.a leaky gut) → which allows harmful bacteria, toxins, and undigested food particles to pass right through into your blood!
Basically, when the long tube running through your body becomes inflamed and leaky, well, you run into all sorts of issues.
Bacteria and their toxic by-products are now free to enter the bloodstream and can travel to other body parts (including the brain!) and wreak havoc.
If you have a lot of “bad” bacteria leaking toxins into the body, this can lead to the development of a wide variety of diseases through a chronic or acute inflammatory response.
All of these toxins can make you feel quite unwell and anxious:
- Bacteria and bacterial toxins such as lipopolysaccharides (LPS) and peptidoglycans
- Alcohols and aldehydes
- D-lactate – elevated in patients with chronic fatigue syndrome and cognitive dysfunction, also a possible link between high lactate and schizophrenia.
- Toxic gases such as hydrogen sulfide (H2S) and ammonia (NH3) produced by bacteria.
- Antigens/allergenic proteins from undigested food
“Stealthy” Gut Issues?
The sneaky thing about all of this is that you might be suffering in silence from gut issues without even realising it!
I find that it’s not all that uncommon for people to become used to having poor digestion and feeling miserable. What I mean is that if you are bloated, constipated and miserable all the time then that is going to become “normal” for you, and you’ve sort of forgotten what it feels like to have a normal, healthy gut.
And I should also point out that poor gut health doesn’t necessarily mean you have to experience noticeable symptoms like IBS, indigestion, gas, bloating or pain, and so on.
Just eating something slightly allergenic can put you in a bad mood. And if you were to cut out all offending foods from your diet you wouldn’t believe how much better you’d feel!
So sometimes it can be somewhat difficult to tell if you’re dealing with some type of gut issue.
Here are a few things that could indicate poor gut health though:
- Do you feel like you lack enthusiasm or have no ‘zest for life’?
- Do you feel anxious and overwhelmed by negative emotions for ‘seemingly no reason’?
- Struggle to kick back and relax and enjoy the present moment?
- Get bothered and stressed out by small things? Feel frustrated and irritable?
- Poor cognition and “brain fog”?
I really can’t overstate the importance of keeping your gut healthy and happy – I know personally that when my gut is not in good shape I notice I feel WAY more anxious and irritable.
How Lipopolysaccharides (LPS) Ruin Your Mood and Well-Being
I mentioned lipopolysaccharide (LPS) above.
These structures are found in the membranes of Gram-negative bacteria that live inside your gut. And when the bacteria die they release their LPS into their environment.
To make a long story short:
LPS is seriously inflammatory.
If you have a gut dysbiosis or “leaky gut”, endotoxin can leak into your blood and mess with your mental health:
- Giving LPS intravenously to people makes them anxious, moody and depressed!
- LPS administration also leads to an increase in the stress hormones cortisol and noradrenaline.
LPS itself can destroy the intestinal barrier and cause leaky gut, allowing more LPS to enter systemic circulation and cause even more inflammation.
A.k.a a double whammy!
People suffering from irritable bowel syndrome (IBS) have higher serum level of LPS compared to controls. This same study also found a correlation between antibodies against another bacterial component called flagellin and anxiety in IBS patients.
Are You Suffering From LPS Poisoning?
The best way I can describe a high endotoxin state is that it feels like you’re about to come down with something; a sort of malaise, anxiety, poor mood, feeling “off”, creaky joints, stiff back, runny nose.
Like a low-grade inflammatory response.
Implementing strategies to lower your systemic LPS load can massively improve your sense of well-being and stress resilience…
…it will help balance your hormones, increase energy, increase dopamine and alleviate depression, lower stress hormones such as serotonin, cortisol, adrenaline, and estrogen.
Activation of the innate immune system with endotoxin leads to a constellation of behaviors similar to depression in humans: anhedonia, decreases in novelty-induced and social behaviors, reduced food intake, and sleep disturbance (Larson et al. 2001).
Simple “hack” to reduce LPS
Take 1-2 tsp of activated charcoal every morning or evening in 8 oz of water. Activated charcoal is an excellent adsorbent (it binds to things) and it can help eliminate endotoxin from your gut. A.k.a an anti-endotoxin agent.
What Actually Causes Gut Inflammation And Leaky Gut?
This gets a little complex as the cause of poor gut health is most certainly multifactorial.
Leaky gut is often the result of an overall poor lifestyle, poor diet, not enough sleep (i.e disrupted circadian rhythms), too many medications, too much stress, and so on and so forth.
If I had to guess I’d say emotional stress is one of the major culprits.
Cause I mean, who is not stressed living in modern society?!
Here are just a few things that can make your gut very unhappy and inflamed and leaky:
- SIBO – small intestinal bacterial overgrowth. Ideally your small intestine should be close to sterile, whereas your large intestine (colon) is more suited for fermentation and contains a lot more bacteria. What happens during SIBO is that the bacteria migrate upwards to the small intestine where they shouldn’t really be and cause unpleasant symptoms. Common symptoms are bloating, loss of appetite, indigestion, feeling overly full after meals, GERD and reflux, malabsorption.
- Gut dysbiosis – i.e an imbalance of the microbial community in your small and/or large intestine. Usually there is a lack of the beneficial gut bacteria (e.g Bifidobacteria and Akkermansia) which help to maintain a healthy mucus layer together with a presence of more pathogenic bacteria and fungus.
- Gastrointestinal infections – caused by viruses, bacteria, fungus, parasites (e.g H. pylori)
- Emotional stress which increases gut permeability and negatively impacts the gut microbiome.
- Drinking alcohol.
- Nutrient deficiencies.
- Bacterial toxins (lipopolysaccharides).
- Secondary bile acids.
- Eating foods that irritate your gut, for instance gluten or A1 dairy.
- Medications/chemicals/environmental toxins/pesticides that harm the gut. For example NSAIDS.
- Past history of using antibiotics.
How to Improve Your Gut Health And Reduce Anxiety?
Good gut health is key for the gut-brain communication to work smoothly!
When you make gut health a #1 priority you will notice that you feel A LOT calmer and more relaxed, have much better stress resilience, and improved mood and zest for life!
Here’s my 4-step approach for improving overall gut health:
- Eliminate problematic foods & eat beneficial foods.
- Strengthen digestion.
- Improve gut motility.
Improving gut health and digestion, and shifting the gut microbiome to a healthier place, often involves a lot of trial and error…
And it takes time!
It’s best to have realistic expectations — you are probably not going to heal your gut and anxiety in 1 or 2 weeks.
(Though I will say that sometimes just eliminating an irritating food or supplement can result in pretty much instantaneous relief from anxiety and mood issues.)
And just to emphasise an extremely important point:
Diet should be the #1 focus and any supplements should be just that, supplements. You will always get the most bang for your buck by eating easy to digest, nutritious foods and avoiding irritating foods and supplements.
Step 1: Eliminate Problematic Foods And Reduce Gut Inflammation
Improving your gut health doesn’t have to be all that complicated.
Often it’s just a matter of a. eliminating problematic foods and b. focusing on eating beneficial foods.
I like this quote from Ray Peat:
“I think people shouldn’t eat things that damage them, and should eat things that taste good and that provide the essential nutrients, while making them feel good and function well; is that a diet?”Ray Peat, PhD.
Using antibiotics to reduce endotoxin load is fraught with risks as it can kill off helpful bacteria and instead promote more pathogenic strains to take hold.
In my experience, the focus has to be on a diet consisting of gut-friendly foods that support a healthy gut microbiome!
In a nutshell:
Any foods or supplements or medications that cause gut inflammation can worsen your anxiety/OCD/depression/etc.
Often you don’t notice the negative effects of an offending food until you cut it out!
I believe this is why individuals on the carnivore diet report getting relief from their lifelong depression or bipolar disorder or anxiety; likely the explanation is that they stopped consuming a gut-irritating food such as gluten.
I’m not a fan of eating a 100% meat diet, there’s really no need to restrict your diet to that extent.
You just have to get rid of the gut-irritating foods!
*Blood sugar regulation also tends to improve when avoiding inflammatory foods which helps to stabilize your mood.
a. Eliminating Offending Foods
As a rule you tend to get better results by removing something harmful than adding in something beneficial.
Figuring this stuff out is very much individual/contextual.
You need to listen to your body and see which foods cause symptoms and which ones don’t. Sometimes going an elimination type of diet – for example eating only unprocessed meat, white rice and well-cooked vegetables – can be immensely helpful for finding out what is causing issues for you.
I will say though that I am, generally speaking, not a huge fan of the standard high grains, fruits and vegetables approach.
So having a healthy gut microbiome is not necessarily about what foods you eat, but also the foods you are not eating.
Here are a few foods that can trigger gut inflammation and/or cause dysbiosis:
- Refined seed oils high in PUFA/omega-6 (soybean, canola, cottonseed etc)
- Excessive amounts of fiber from whole grains, beans, nuts, seeds
- Gluten (store-bought bread, pasta)
- Iron-fortified grains
- A1 dairy
- Processed junk food with emulsifiers, preservatives, fillers etc.
- Most supplements and medications (containing excipients such as titanium dioxide and talc)
Again I’m not saying you shouldn’t eat any of these foods ever again.
With some foods the dose makes the poison, meaning you might be able to tolerate a small amount of an offending food occasionally, but perhaps not 3-4x daily as a staple food.
…Okay one exception is that you really want to avoid ALL refined seed oils (they are highly toxic).
b. Focus on Digestible & Nutrient-Dense Foods
Same concept applies here…
When it comes to diet there is no such thing as a cookie-cutter approach that works for everyone!
Your needs are different from my needs, and your needs may also change over time!
You will have to experiment and see what works for you.
Here’s a list of easily digestible, nutritious foods that work well for many people.
As your gut health improves you may find that you tolerate more foods and can expand your diet.
- Meat – beef, goat, lamb, deer, lean pork, lean turkey, lean chicken
- Seafood – oysters, shrimp, cod, salmon
- Dairy – milk, cheese, yogurt (some tolerate raw/A2/goat dairy better)
- Ripe fruits – whole, dried, frozen, 100% juice are all okay
- White rice (poor nutrition but doesn’t have irritating fiber/antinutrients)
- Potatoes and tubers
- Quality sourdough bread
- Well-cooked vegetables (certain fibers can protect against endotoxemia)
- Healthy fats like butter and olive oil
- Honey, maple syrup
Step 2: De-Stress
Remember, the gut-brain axis is a two-way street:
What goes on in your head affects your gut!
Sympathetic activation, a.k.a a fight-or-flight response, redirects blood flow away from your gastrointestinal tract to your skeletal muscles.
Meaning you are not going to digest your food properly if you are stressed out!
Psychological stress is also known to cause intestinal barrier dysfunction, resulting in increased absorption of toxins from the gut lumen (like LPS).
To give an example, public speaking makes your gut more leaky.
Perceived stress can also change the gut microbiome for the worse (e.g reduced beneficial Bifidobacteria) and this “stressed out microbiome” can negatively impact mood and keep you in an anxious and depressed state.
There’s even such a thing as a depression microbiome.
Researchers have shown that taking the gut flora from individuals with major depressive disorder (MDD) and “transplanting” it onto germ-free mice resulted in depressive-like behaviours in these mice, compared to colonization with a ‘healthy microbiome’ from healthy controls.
What To Do About Stress?
Sure, a good diet is important for fixing your gut, but it’s equally important to also work on your emotional and spiritual health/de-stressing.
Being stuck in a stress response and constantly worrying about things is not going to help your gut.
It is important to enjoy your meals in a relaxed state.
You are not going to digest your food is you are eating whilst running around multi-tasking and being stressed out.
For advice on how to de-stress, I would do things that you enjoy doing and that you find relaxing.
You could take walks in the forest, exercise, play guitar, read books, be out in the sun and ground yourself, meditate, hang out with fun people.
You want to spend as much time as possible being present here and now, and spend as little time as possible wrestling with the “monkey mind”.
Step 3: Strengthen Your Digestion
Good gut health starts with good digestion.
Digestion is the process whereby large food particles gets broken down into smaller pieces that can be absorbed by the GI tract.
Here are 2 reasons why robust digestion is so crucial:
- It allows you to absorb the vital nutrients found in food that your body needs for optimal functioning.
- It reduces the risk of undigested food particles feeding pathogenic bacteria or fungus in the small intestine (where bacteria and fungus are not supposed to hang out). Meaning there’s a lower risk of developing SIBO/SIFO, IBS and acid reflux, and other digestive issues
So, we really want to make sure we are properly digesting the foods we eat!
And one of the most important factors for healthy digestion is proper stomach acid (HCL) production.
Why Stomach Acid Is SO Important
Stomach acid creates a highly acidic environment (1-2 pH) that aids your digestion in tearing apart complex proteins and facilitates absorption of minerals…
…and the low pH also helps kills off any pathogens!
Thanks, stomach acid!
Low stomach acid is a problem with lots of downstream consequences.
Symptoms such as bloating, pain, GERD, heartburn and belching could all be due to a lack of stomach acid.
Sufficient stomach acid output is a #1 priority for keeping the gut clean and prevent any bacterial or fungal overgrowth!
Moreover stomach acid helps stimulate the gallbladder to release bile (which helps with fat digestion and works as an antimicrobial in the small intestine to prevent infections) and the release of pancreatic enzymes that help break down food – leaving less food for bacteria!
How to Support Stomach Acid Production?
Here are some things that can support healthy HCL production:
- Zinc – a super important mineral for HCL secretion. It’s a kind of catch 22 situation as you need sufficient stomach acid to absorb minerals such as zinc and iron. Red meat is a good source of zinc. A sign of possible zinc deficiency (and/or low stomach acid) is ridges or white spots on your nails.
- SALT (!)
- Thiamine (vitamin B1)
- Niacinamide (vitamin B3)
- Eating warm food and drinking hot liquids (avoid cold drinks/meals)
If you eat a nutrient-dense diet with meat, tubers, dairy, eggs etc you should be getting plenty of these nutrients from your foods, but sometimes higher doses from supplements can be very helpful!
I’m not a huge fan of digestive enzymes. I think it’s a much better idea to address underlying issues (e.g nutrient deficiencies or thyroid function) and restore stomach acid secretion that way.
Still some people do report benefits from taking digestive aids such as betaine HCL, ox bile or pancreatic enzymes with their meals.
Step 4: Improve Gut Motility
Another pillar of good gut health is having regular bowel movements.
Not pooping 1-2 x (or more) per day?
You gotta get that fixed.
Slow gut motility is no bueno!
As mentioned earlier, constipated people tend to be more depressed.
The smooth muscles in your intestine work to contract and move food forward through the GI tract (a.k.a peristalsis or gut motility).
When gut motility slows down, it means that bacteria, yeast, etc, and microbial toxins aren’t transported out and instead get backed up in intestine; a risk factor for developing SIBO/SIFO and gut inflammation.
Or to put it another way…
A fast gut transit time is key for keeping the intestine nice and clean and preventing dysbiosis.
Taking antimicrobials or antibiotics or probiotics won’t work unless gut motility has been optimized!
When you eat something it shouldn’t really take more than ~24 hours for it to come out the other end – I’ve discovered that you can check transit time by eating coloured foods such as blueberries or beets and checking when they show up in the toilet.
How To Increase Gut Motility?
If you suspect that you have a slow transit time, certain foods and supplements can help speed things up:
- The smooth muscles in the intestine need energy (ATP) to contract and propel food forward. Thyroid and vitamin B1 can restore ATP production and increase gut motility.
- Drinking hot water and tea between meals
- Magnesium bicarbonate
- Cascara sagrada
- Insoluble fibre found in vegetables like raw carrots and well cooked mushrooms (also good for binding toxins and eliminating them via poop)
BONUS: More Gut Healing Stuff
95% of gut healing comes down to de-stressing, cutting out inflammatory foods and eating a nutrient-dense diet of easy to digest foods. Often just doing that alone, and being consistent with your diet for a couple of weeks, will solve a lot of gut issues.
However you can help the process along by taking some gut healing herbs and nutrients:
- Drinking hot water and tea between meals – this is seriously awesome and will help strengthen your digestion, stomach acid, bile flow, etc. IMPORTANT, do not drink water with your meals as it will dilute precious stomach acid!
- Eating fruits high in vitamin C such as kiwi, melons and oranges. Vitamin C can improve gut barrier function and reduce the absorption of endotoxin (LPS), and has been shown to prevent exercise-induced endotoxemia.
- Niacinamide (vitamin B3) – this vitamin can restore NAD levels in your intestinal cells which helps with ATP production. In one study done on mice, vitamin B3 reduced endotoxemia by strengthening the gut barrier.
- Triphala – an ayurvedic herb blend. In mice, triphala has been shown to repair the intestinal villi of the brush border (the intestinal villi are responsible for absorbing nutrients) and reduced markers of inflammation.
Help! Now I’m Even More Confused on How To Fix My Gut
Sorry about that.
I know that was a lot of information to take in all at once – I’m not sure if I even understand all of it!
If you feel confused on what to do, here are a few actionable steps you can take today to improve your gut health:
- Experiment to find a diet that works for your body. Don’t know where to start? Try eating a super basic, non-allergenic diet of just unprocessed meat, white rice, potatoes and whole fruits. From there you can tweak things and see how you feel by adding in or taking out specific foods.
- Sit down and relax during meals!
- Drink hot water or tea between meals, and eat warm cooked meals, to stoke your digestive fire!
- Avoid snacking and leave about 3-4 hours between meals. This engages the migrating motor complex which helps to clean out your stomach and small intestine.
- Do some brisk walking every day.
- Get some insoluble fiber daily from, for example, raw carrots. Or take 1 tsp activated charcoal on an empty stomach in the morning.
- Spend time out in the sun and get your daily dose of vitamin D.
- Minimize alcohol intake.
- Sleep 8 hours every night.
- If you have symptoms of SIBO like burping after meals, bloating, distention – try a course of Oregano oil.
Conclusion – Make Gut Health a #1 Priority
For all the reasons discussed, you absolutely want to make gut health a #1 priority.
I’ve seen so many people get relief from life-long anxiety just by changing their diet, and personally I’ve experienced some profound changes in mood from optimizing nutrition and cutting out offending foods.
For me the worst offender is specific fermentable fibers– when I go too crazy with potatoes, whole grains, legumes and vegetables my OCD gets worse and mood suffers. Gluten in large amounts also makes me feel sub-optimal.
So with that said… I hope some of this was useful to you!
Let me know if you have any questions.