Hello to the most incredible community!
I hope you're taking care of yourself this week — and if you're not quite there yet, that's okay. That's what this newsletter is for.
This week's questions come from three people in very different spots: one bloated every day and staring down a course of antibiotics for SIBO, one watching a kid come home sick in the first week of school, and one who just wants to know which labs actually show a fatty liver.
Here's the thread tying them together — your gut, your immune system, and your liver are not three separate departments. They share a bloodstream, they share inputs, and when one of them is running on processed sugar and four hours of sleep, the other two feel it. Let's get into it.
Here's what we're covering in today's questions:
(Click to skip ahead)
Thank you for being here. Now on to the questions!
You can't digest well in fight or flight.
The answer below is about what you put into your gut. This is about the state your body is in when it gets there. Digestion runs on the calm side of your nervous system — rest and digest. Spend your days on the other side instead and digestion gets deprioritized, which is part of why the same meal can sit fine one week and bloat you the next.
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Q: Nurse Doza, I see you talk about the liver all the time but I have serious gut issues! What can I do for my SIBO? I am so bloated all the time and I have no idea what to eat. All my doctor wants to do is give me antibiotics. Is there anything I should be taking for this? What would help? Thank you for your help!
A: Nurse Doza: Yes, there is plenty that can help you and your gut issues. No matter if it's SIBO, colitis, Crohn's, or even a leaky gut, it's possible to support the repair of a damaged gut and gut microbiome, which is what you are dealing with.
SIBO (small intestinal bacterial overgrowth) can be caused by a previous infection. Your gut microbiome contains trillions of microbes like bacteria, viruses, parasites and even fungi. Not all these germs are bad, and in fact, most of these trillions of bugs are actually great for your health. But SIBO is an overgrowth of bad bacteria leading to gut dysbiosis or an unhealthy ratio of bad bacteria to good bacteria. Taking antibiotics won't help regrow healthy bacteria. This is where lifestyle, diet and supplements come in. (That's a decision to make with your own provider — what follows is what I'd add alongside whatever you two decide.)
How to repair a damaged gut and gut microbiome:
Stop eating processed carbs, processed grains and processed sugar. Bad bacteria found in SIBO "crave" bad sugar as glucose (sugar) feeds our gut. Substituting healthy fats such as avocados and flaxseeds will not only help with the cravings and the daily blood sugar drops, but avocados and flaxseeds have healthy nutrients that provide prebiotics to the gut microbiome to help you develop healthy probiotics in the gut microbiome.
Fermented foods such as sauerkraut, kimchi and refrigerated pickles contain probiotics. You will have to go out of your way for these foods but you might notice less bloating after meals.
The supplements I would focus on for gut support are L-glutamine and Berberine. L-glutamine is our body's most abundant amino acid and the gut lining is made of glutamine. Leaky gut or gut dysfunction could be a disruption in this glutamine lining. Taking our glutamine powder called GUT has helped a lot of our clients have good poops on a daily basis. It's even kid friendly and glutamine has also been shown to help support a healthy immune system (we give it to our kids every day during the school year). Berberine can help digest food in the gut microbiome, supporting healthy blood sugar and cholesterol metabolism and your own natural GLP-1 production. (L-glutamine has also been shown to help GLP-1 production that comes from your gut microbiome, so these two supplements would also be worth a look if weight and appetite are part of the picture.) Btw, check the site for what's on this month! Pick up both! (Throw in some LIVER BOOST too, as gut issues are closely linked to fatty liver and roughly 1 in 3 adults have some degree of fatty liver. The inability to digest those healthy fats, especially after gallbladder removal, can be a sign your liver needs support too!)
Extra credit: These tips are meant to be the start of repairing your gut. If you want more info and guidance, please take our Digestion course.
You can start rebuilding a gut in a week. Knowing what to eat for the next year is the harder part.
The protocol above will get you moving. What it can't do in three bullet points is answer the question the reader actually asked — I have no idea what to eat. That takes a food list, a reintroduction order, and knowing what a bad week means versus a real setback.
That's the whole Digestion course: what to eat and in what order while the gut lining is healing, how a missing gallbladder changes the plan, and how to tell dysbiosis from a food you simply don't tolerate. Self-paced, and you keep it.
Ten dollars. That's the whole price.
Q: Nurse Doza, school just started and one of my kids is already sick. They get sick all the time and I am worried I will get sick too. I can't afford to get sick! Is there anything we should be doing or taking to help keep us healthy? Thank you for all you do!
A: Nurse Doza: Kids are supposed to acquire germs in order to build up their immune system. There's no better place to do that than getting those bugs from school. But a compromised immune system could lead to your kids getting sick throughout the year (think repeated strep infections) or you getting sick as well (think missed time from work).
There is a daily routine that can help boost you and your family's immune system. Our family has followed this routine, especially over the last few years with COVID going around, and it has helped keep us strong and healthy, even when we visit their schools and have kids coughing and sneezing all around us.
How to boost you and your family's immune system:
Morning sunlight. It helps support your own vitamin D production, as vitamin D receptors are found on essentially every immune cell in our bodies. I know in some places, and with the time change in the fall, this can be difficult, so make sure you give your kids vitamin D3 every day. We give our kids a liquid droplet of Vitamin D3 & K2 every morning before school. My wife and I take our vitamin D called THE D, which has 5000 units (anything less for adults is too little). Vitamin D deficiency has been associated with repeated infections and, over time, with autoimmune disorders (we talk about this in our upcoming School of Doza podcast episode where we talk about PANDAS, where repeated strep infections can lead to an autoimmune neurological disorder — please subscribe to hear this episode when it comes out). This is an article talking about how kids taking vitamin D was associated with fewer ear infections and higher vitamin D levels (>30) in their labs.
I would also give your kids L-glutamine. L-glutamine helps support your immune system. This is a study where 30 grams of oral L-glutamine was given to ICU patients in the hospital with COVID. None of the patients got worse and their hospital stay was shortened. (That's a hospital dose in a hospital setting — not what I'd give a child.)
I would also cut out processed dairy, as it has been tied to increased mucus production everywhere in the body including the sinuses, the gut microbiome and even our private parts (yes, you have a microbiome down there too — think repeated UTIs).
And of course, make sleep a priority. Sleep is our time to recover and regenerate. Poor or disrupted sleep = a person who gets sick all the time.
Extra credit: Watch our "what to do if you are always getting sick" podcast. And make sure to subscribe to our YouTube channel, as new episodes come out every week and you definitely want to watch our upcoming PANDAS episode.
You can do everything right for your immune system and still lose it at 2am.
Notice which item on that list has no supplement attached to it. Sleep is the one input Nurse Doza never negotiates on during the school year — it's when the immune system does its actual repair work — and it's also the one most people quietly give up on, usually because the surface they're sleeping on stopped working years ago.
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Q: Nurse Doza, how do I know if I have a fatty liver? What are the labs I need to order to see if I have this? Thank you!
A: Nurse Doza: One of the first signs someone has a fatty liver or is starting to develop a fatty liver is… you feel sluggish. The liver helps detoxify the body, and with our lifestyle nowadays, our liver needs to detox a lot. Feeling sluggish can mean your liver isn't detoxifying the body as efficiently as it could be.
The next step to determine if you have fatty liver is to get labs done. There are several labs that can check this but unfortunately most doctors don't order the right labs.
These are the labs:
AST
ALT
GGT
hsCRP
Homocysteine
Fasting Insulin
The great thing is that you can get these labs through Superpower labs (use code NURSE20OFF) without the need to see your own doctor (my guess is that they wouldn't even know how to interpret them or what to do about them anyway). I use Superpower labs myself as they order everything I want to order for our clients in the clinic (like hormones, nutritional markers and even comprehensive heart & brain health markers). It's easy to find a local lab draw station and once you get your results, book a $99 lab review consult with me so we can go over the fatty liver markers, as well as your hormone, brain and heart labs to help you get healthier and start feeling great.
Extra credit: Fatty liver and insulin travel together. If you want the mechanism behind why, take our $10 Insulin course.
Six labs are only useful if somebody reads them with you.
You now have the list. What you'll get back is a PDF with six numbers on it, each marked "normal" against a reference range built from a population that is largely not healthy. Normal and optimal are not the same thing, and the gap between them is where fatty liver hides for years.
A Read Your Labs session is me, your results, and a plan. We go through the liver markers, then keep going into hormones, brain, and heart — because those six numbers rarely go sideways alone.
$99, and you bring whatever labs you already have.
Your body isn't broken. It's asking for better inputs.
Your gut doesn't need to be sterilized. It needs to be fed.
Your immune system isn't weak. It's under-supplied — light, sleep, and fewer processed inputs.
Your liver isn't quiet. It's been asking for a lab draw.
Start with one change. Do it daily. Repeat.
To your health,
Nurse Doza
