Your Gut Already Knows How To Do This
Three questions about bathroom trips, MTHFR, and a GLP-1 that stopped working. Underneath all three is a body that can do the job, if you give it what it runs on.
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 who all think they need to add something. One is in the bathroom constantly and wondering what to take. One has MTHFR and can't tolerate the supplements that are supposed to help. One has been on Tirzepatide for almost a year and hasn't lost a pound in months.
Here's the thread tying them together. Your gut already makes GLP-1s. Your liver already runs methylation. Your digestive tract already knows how to repair itself. None of that works on processed sugar, four hours of sleep, and a missing set of nutrients. 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!
Knowing what to eat is harder than knowing what to take.
The answer below gives you a food list and a supplement list. What it can't do in a few paragraphs is give you the order. Which foods come back first, what to do in month three when something that was fine stops being fine, and how a missing gallbladder changes the plan.
That's the Digestion course. Self-paced, and you keep it.
Ten dollars. That's the whole price.
Q: Nurse Doza, what can help with the constant bathroom trips? I know I am trying to eat better, and I am taking some medications but I don't know if it's helping. Is there something I need to be doing, eating or taking that could help?
A: Nurse Doza: Yes, there is plenty that can be done. Good poops come from a diet, lifestyle and supplements that help support the gut, liver and gallbladder (even more important if you don't have a gallbladder anymore).
How to support your gut, liver and gallbladder:
Eat more healthy fats like salmon, eggs and avocados. Healthy fats are needed and can be eaten by someone with a fatty liver and gallbladder issues. In fact, you can still eat healthy fats after a gallbladder removal (if you can't, that's often a sign your liver needs support).
Eat starchy and non-starchy vegetables like sweet potatoes, carrots, beets, plantains, squash and seaweed.
Add fermented foods like sauerkraut, kimchi and even refrigerated pickles, as they help support the gut microbiome.
Cut out processed sugar, processed grains and processed dairy from your diet.
Add supplements to help support the repair of the digestive tract. The liver and gut need nutrients in order to function and most people do not know which ones to take. NAC, Milk Thistle, Alpha-Lipoic Acid, Turmeric and Green Tea are my favorites for the liver, as each one has been studied for its role in supporting liver health. L-Glutamine and Berberine are two of my favorites for the gut, as glutamine has been studied in gut barrier conditions like leaky gut, Crohn's and colitis. Berberine helps glucose digest in the gut microbiome, and it supports healthy blood sugar and cholesterol metabolism. L-Glutamine and Berberine can also support your gut microbiome's own GLP-1 production, which plays a role in weight and appetite.
I know this is a lot but it will help. Understand it could take up to a year or two to finally repair the digestive tract. Don't give up and don't stray from the diet.
Extra credit: the supplements I mentioned are found in our GOOD POOPS protocol that is designed for liver, gut and gallbladder support (even if you are missing a gallbladder). Follow the instructions and clean up the diet.
Extra extra credit: watch our DIGESTION course that provides the guidance to help you work on your gut problems.
Most of your methylation happens in your liver. Almost nobody supports both.
The answer above is about the gut. The one below is about a gene. They meet in the same organ, because the MTHFR pathway runs through the liver's detox machinery, and folate is the first ingredient on the Liver Boost label for a reason.
The MTHFR Stack is the three products Nurse Doza sequences for this: Bliss (sublingual SAMe with the TMG that helps it work), Boost (methylated B12 and folate with the minerals and amino acids the pathway needs), and Liver Boost (phase I and phase II support, folate first).
$269 for all three through September 30. It goes to $299 on October 1. Bought separately they're $340, so that's $71 off. No code needed.
Q: Hi Nurse Doza. I have a MTHFR issue and I was looking at your supplements for some help. I have been taking methyl B12 and Folate but they both make me feel anxious. I have tried SAMe before but that did the same thing. I take Zoloft already and I don't know if that has anything to do with it. Any advice or guidance would be helpful. Thanks.
A: Nurse Doza: I understand exactly what you are going through as I have addressed MTHFR issues for the last decade in my clinic. I myself have the worst variant and found out that MTHFR people like me and you need a very special type of supplement to address this issue.
(Before anything else: you're on Zoloft, and SAMe has already made you feel anxious. That combination is one to make a decision on with your prescriber, not on your own. Bring this email to them.)
Folate (5MTHF) and Methylcobalamin help but are sometimes not enough. You already know that inferior forms of vitamins like folic acid and cyanocobalamin are not going to process well in our bodies with our MTHFR issues, because B vitamins need to be methylated. Poor methylation and poor MTHFR genes can make it harder for the body to use B vitamins for hormones, neurotransmitters, detox, energy production and even DNA repair.
How to support MTHFR and methylation:
Start with our BLISS, which has the universal methyl donor SAMe (S-adenosyl-L-methionine), but it also has Trimethylglycine (Betaine), which is the missing piece of the MTHFR puzzle. The Trimethylglycine is needed to help the SAMe work better. Taken together, they're built to support methylation pathways in a way B vitamins or SAMe alone may not. Because BLISS is a sublingual, it absorbs quickly. A lot of people tell me they notice a shift in mood or energy, which I think is tied to MTHFR's role in helping the body make Serotonin and Dopamine. It's our most unique supplement and one I never go a week without. Methyl donors like SAMe and Trimethylglycine support your body's own neurotransmitter production. That's a different job than what a medication like Zoloft does, and it's another reason to have this conversation with your prescriber. My view is that a lot of people with mood issues have MTHFR issues and aren't making enough Serotonin and Dopamine genetically. Imagine finding this out when you are an adult.
Add the LIVER BOOST next (the first ingredient is Folate), as that also supports MTHFR in the liver. Yes, there's a lot of MTHFR and methylation happening in the liver. The MTHFR gene is part of the liver's detox pathways and its ability to make antioxidants like Glutathione. Imagine better detox and less inflammation in the body.
Then add our BOOST, our methylated B vitamin complex mixed with the minerals, electrolytes and amino acids also needed to support the MTHFR gene. Heads up that BOOST does contain caffeine, so if you're sensitive right now, start with a half packet or take it early in the day.
Try the BLISS daily for the next month, as it comes in a box of 30 packets. Right now we have a special on all three MTHFR supplements, so try them all out and please tell me what you notice with your energy, mood, detox and even poops.
Extra credit: watch our YouTube podcast "The MTHFR gene" to learn more and geek out.
Extra extra credit: attend our live MTHFR & LIVER class on Tuesday, October 6 at 5:30pm, where you can ask me any question live after the lecture.
You shouldn't have to guess whether a supplement is the problem.
The reader above is stacking methyl donors on top of a prescription and going by how she feels that day. That's a hard way to make a decision, and it's the same position most people are in.
A Read Your Labs session is a 15-minute telehealth call where Nurse Doza has already gone through your results before you get on. Thyroid, inflammation, hormones, gut, nutrients, lipids, plus whatever else you've had run. You get a plain-language read and a next step.
$99, down from $199. Bring whatever labs you already have.
Q: Nurse Doza, what are your thoughts on GLP-1s? I have been taking Tirzepatide now for almost a year and it's not working as well as before. Is there another one I should try? Is there anything else I could take instead? I haven't lost any weight for months and I am really frustrated.
A: Nurse Doza: I don't know if the Tirzepatide is the problem. It's a diabetic medication designed to lower blood sugar and appetite. The reason it works for weight loss is that high insulin, high blood sugar and high appetite can all be linked to diabetes, prediabetes and weight gain. I talk to a lot of doctors in different fields of practice and they are all prescribing it, from dermatologists to bariatric surgeons. I know oncologists and neurologists have been talking about early research looking at GLP-1s and the risk of dementia and certain cancers. I see GLP-1s becoming a first line medication for most metabolic issues over the next few years.
What has your diet looked like since starting Tirzepatide? Have you changed it? What are you eating more of now? What are you eating less of now? How many meals are you eating every day? Have they changed in size? Do you eat late at night? Have you exercised more or less since starting Tirzepatide? What does the health of your digestive tract look like before and after Tirzepatide? Do you have fatty liver? Are you missing a gallbladder? Do you have daily constipation? Are you bloated after a lot of meals? How is your sleep? How are you managing stress levels?
I want you to think about the lifestyle changes that are needed to support your health goals, even weight loss. During any health journey, it is possible to see a plateau at one point. Out of the questions I asked, which have you done so far and which have worked? Which didn't work and why? I have personally prescribed GLP-1s with the idea that diet, exercise, lifestyle and even supplements will be involved. My approach is one of getting to the root cause of what caused us to be in this position to begin with. That's why when it comes to weight loss, insulin or blood sugar issues, I always address the digestive tract, emotional eating and stress management. Those are factors that can influence a person's health journey, especially if that main goal is weight loss.
Here are the next steps I would take:
Understand that our gut makes its own GLP-1s naturally. You're not deficient in Tirzepatide. The question is whether your gut is making its own GLP-1s the way it should.
Address the gut and liver, which usually started long before the medication did.
Change or update the diet: Mediterranean, Paleo, Whole 30, Low FODMAP. You still need to modify any of these to your own needs, ideally with someone watching.
Exercise. It's not an option, it's a requirement for your overall health.
Take supplements for your gut, liver and insulin/blood sugar. My favorite is our BERBERINE PLUS, which supports healthy blood sugar and cholesterol metabolism. Plus Berberine supports natural GLP-1 production in the gut.
Order your labs. This can take the guesswork out of what's going on. Check all your hormones, your liver, your heart, your nutrition and even your metabolism. This is the lab we use in the clinic and the one I personally use myself.
Track your progress at home. You can measure your body fat percentage, your muscle mass percentage, your weight and even your visceral fat, all from one device at home. This is the HUME pod (code nursedoza) which I use for myself and our weight loss/GLP-1s clients in the clinic. Most people just focus on the weight, but when you see positive shifts in your body fat and visceral fat, you can see the changes going on underneath the surface. That can be the motivation some people need to keep going.
If you want to keep this simple, book a weight loss consult with me to discuss a more customized approach for your own health journey. I've worked with thousands of people on weight and metabolic health, with or without GLP-1s.
Extra credit: a plateau on a GLP-1 is usually an insulin story. If you want the mechanism, take our $10 Insulin course.
The scale is the least useful number in the room.
Step 7 above is the one people skip, and it's the one that keeps them going. Months of "no progress" on the bathroom scale can be months where visceral fat dropped and muscle went up. You just had no way to see it.
The Hume pod measures body fat, muscle mass, visceral fat and weight at home, on the same device Nurse Doza uses with GLP-1 clients in the clinic. Free app, ten-year warranty.
20% off with code NURSEDOZA.
Your body isn't broken. It's asking for better inputs.
Your gut isn't failing. It's been fed the wrong things for a long time, and it takes a while to come back.
Your genes aren't a sentence. They're instructions, and instructions need raw materials.
Your GLP-1s aren't missing. You make them. The gut that makes them is the thing to work on.
Start with one change. Do it daily. Repeat.
To your health,
Nurse Doza
