Case Study: Bloating, Constipation, Unpredictable Periods
You've tried elimination diets, seed cycling, 'balancing your hormones'—but your cycles are still unpredictable and bloating won't quit. Sometimes the answer isn't another supplement or restrictive protocol; it's getting back to basics.
As a holistic nutritionist, my focus is always on identifying the root cause behind a client’s patterns and experiences. The diet, lifestyle, and supplement changes that I recommend are not band aid fixes or hacks; they’re ones that have foundational influence on a person’s health. Oftentimes this actually means starting with the basics, because—as annoying as it may seem at first—that is where the most progress is made.
When you start to focus on well-balanced nutrition, managing and mitigating the stressors of life, improving the quality of your rest, or maybe sitting down in the sunshine for a meal instead of wolfing it down while you’re driving: those are some of the changes that I’m talking about.
I want to share with you the experience of one woman in our work together so you too can understand how the basics can be so influential and some tools I use to get to the root cause.
Background
Consider this background information on this client:
30 year old female
High-paced corporate job; often traveling 2-3 times per month via plane
Considered herself to be a “healthy eater,” incorporating organic produce when able; went out to eat 3-6 meals per week on average
Exercise consisted mostly of walks with occasional group fitness classes, 1-2 times per week
Menstrual cycles of 40+ days for approximately one year; this change coincided with when she started a new role that was higher stress and involved more travel
Bloating and discomfort occurred most days and usually towards the end of the day for at least 6 months
Constipation coincided with her travel schedule but would usually return to daily bowel movements upon return home
She had tried multiple elimination diets over the last six months and eliminated gluten, though didn’t notice any change to her bloating nor to her cycle lengths. Seed cycling was part of her routine for about eight months; she noted that she wasn’t sure when to switch to the second phase of seeds given that her cycles were so long.
Foundation Building
With all of my clients, we being by completing a Nutritional Assessment Questionnaire (NAQ), initial intake form, and completing a 5-day food & mood journal (F&MJ)—this helps us start to get clarity on what habits, history, and/or functions of the body may be playing a role in the client’s hormones and digestive imbalances.
Two prominent trends that we noted were surrounding her stress and nutrition. Here’s how these two foundations can impact hormone and digestive function:
Your stress hormone, cortisol, plays many roles in the body and it can inhibit digestive function, specifically the release and production of stomach acid. We want adequate stomach acid production because that’s what’s, well, digesting your food! By lowering stress (especially around mealtime), your digestive system has the chance to operate as designed.
When cortisol is elevated, it can cloud communication for other hormones including estrogen. If the world is crazy and stressful (which is what your body interprets when cortisol is high), why would it want to risk procreation? That takes a lot of energy! Ultimately, this could signal to your body that ovulation should be delayed. When ovulation is delayed, unpredictable periods and cycle lengths result.
Through proper nutrition, your body has the chance to get all of the little building blocks (vitamins, minerals, and more) needed to create hormones, perform all of the functions of a cell, repair damaged tissues, and a zillion other things. (Yes, one zillion is the precise number of things.) As I also see with many clients: she was minimizing fats in her diet, usually eating just two meals per day, and had a low variety of plants in her diet. By improving these areas of her diet, she can offer her body the nutrients it needs to make hormones, manage stress, restore consistent bowel movements, and more.
Given all of this context, we built a plan for her to begin implementing, focusing on supporting her stress and nutrition. While this can look different for everyone, this is what she incorporated:
Eat a savory breakfast within 1 hour of waking. This was the meal she skipped most often yet sending your body signals of safety (through nourishing food) can support your cortisol and blood sugar levels throughout the day. To support her stress, her goal was to eat this on her patio in the sunshine and she committed to not scrolling on her phone while dining.
Eat at least 15 different plants per week. This included whole, unprocessed plants of all varieties including seeds, nuts, vegetables, fruits, herbs, and spices. This goal would grow each month (to 20+, then 30+ plants per week) but we started at a manageable goal in order to get a variety of nutrients for her body and her gut microbiome.
Do a zinc taste test. This is a one-time fiesta where one uses aqueous zinc to determine what their own levels of zinc may be in their body; the strength of the zinc taste (or lackthereof) indicates whether your body may be deficient. For her, she decided to start taking a zinc supplement which is a key component of stomach acid.
Restructure the agenda. She set aside time each Sunday to look at the week ahead and cancel or reschedule anything needed in order to avoid overloading herself. Daily exercise was something that she wanted to incorporate regularly in part because she knew it was so great for her stress and anxiety levels, so she would use that time each week to coordinate with friends to walk or go to a class together.
These are only four starting points, and they may or may not resonate with you. And that’s okay.
Incorporating Testing
By the second month, we received her GI-MAP test results. The GI-MAP is a comprehensive gut panel which details markers regarding inflammation, fat digestion, gluten sensitivity, microbe populations, and the gut immune system to name a few. We decided to order this panel because her bloating was so disruptive to her daily life and confidence, and it was the main motivator that made her want to reach out and get one-on-one support.
Her GI-MAP results suggested:
An overgrowth of several inflammatory bacteria
Poor breakdown of dietary fats
Mild inflammation
Let’s tie this back to her experiences and other context that we have:
Inflammatory bacteria can contribute to bloating and constipation. They also can lead to higher levels of cortisol, which can play a part in delayed ovulation and longer-than-normal menstrual cycles.
Poor fat breakdown could be because of low stomach acid production which we know is influenced by zinc levels. She reported oftentimes eating meals and snacks during meetings and while on the go which could also inhibit release of stomach acid and then the enzymes that break down dietary fats.
This takes us to the second phase of her protocol during which time she continued with the good habits of phase one, while also incorporating targeted supplements to restore balance to her gut microbiome. This included eradication agents, hydrochloric acid, digestive enzymes, a binder, a formula to support repair of her gut lining, and a quality probiotic. In most cases, my protocols are 12-week protocols, so this regimen maintained through the end of month four.
Noticed that I’m being a little vague on supplements, did you? Good eye, and you’re right. What’s right for one person may not be a suitable fit for someone else even if you have identical symptoms. Getting clear on exactly what’s happening in your gut is the best way to make sure you’re spending your hard earned money on the right supplements to take you to your goals. I will mention this though: I do not recommend buying supplements from Amazon. You don’t know exactly what you’re going to get and some scammy people make their Amazon stores look surprisingly legit. My clients always buy supplements through my Fullscript dispensary because we know the quality is excellent.
Progressions Towards Her Goals
Month 1: the focus was on mitigating stress, improving mealtime habits, and getting a larger variety of plants in the diet. During this period, my client noted:
Fewer cravings, especially in the mid-to-late afternoon. This was a huge win because she used to rely on a coffee and sweet treat to get her through the day.
Feeling stronger. Getting back into her workout routine and prioritizing social time with her friends had her feeling physically stronger and more confident as well as strengthened her friendships.
Less overwhelm. Once she realized that she could cancel or reschedule plans and—wait for it—everything would be fine… that was a huge breakthrough for her. She runs her work day instead of her work day running her.
Consistent daily BMs. She did a great job of upping her fiber by eating more non-starchy veggies and noticed the good consequence of that each day. This was important to establish regularity in before she started any type of protocol to remove bacterial overgrowth, so she was all ready for the next phase.
Month 2: she incorporated the supplement protocol, focused on getting 20+ different plants in her diet each week, and implemented her dream bedtime/wind down routine. This month she noted:
Less bloating. She credited this to no longer multitasking while she ate and overall stress reduction. After starting the supplement protocol, she experienced a temporary increase of bloating again but overall was happy with her comfort levels.
Better sleep. Her wind down routine was something she looked forward to daily. Avoiding blue light, minimizing scrolling on social media, and drinking sleepy time tea were three staples of her evening.
Toned waistline. Because she was prioritizing whole foods and avoiding overly processed foods, that meant she opted out of high sugar desserts she had before. The combination of this dietary shift, her exercise, and the improvement in her digestion had her feeling like herself again.
Month 3: the focus shifted towards assessing endocrine disrupting chemicals in her environment while she continued with the habits she had already put in place. This month she noted:
Consistent energy throughout the day. She never felt fatigued throughout her day and reflected that she had the energy she wanted to do everything on her agenda.
Less bloating. This trend continued as she remained consistent with her supplement protocol and in avoiding inflammatory foods.
A shorter menstrual cycle. She had her first 30-something day menstrual cycle (specifically, 36 days) in over a year! This isn’t yet in the ideal range but it’s getting closer to where we would like to see it.
Month 4 & 5: by this point, we shifted from having bi-weekly sessions to meeting every third week as she had a strong handle on her routine and implementing all of the shifts we’d discussed. During these two months she noted:
Continued regularity with BMs, energy levels, and quality sleep.
Clear skin. This wasn’t an acute challenge for her initially, but she noticed that she hadn’t had any acne develop since starting her supplement protocol.
Healthier cycles. Her menstrual cycles continued to shorten in length to between 30-34 days each, indicating that ovulation was not being delayed as much as it had been before our work started.
Final Results
We did a re-test of her GI-MAP to “check our work,” in a sense—and we saw dramatic changes from her initial results, reflecting the work that she’d done to support optimal digestion and rebalance her gut microbiome. Using this data, we put together a framework for her to implement as she went forward without one-on-one support, focusing on nutrition, lifestyle, and supplementation.
This client’s last cycle with me was 29 days long and she felt confident that she had the tools to continue supporting healthy ovulation, now understanding what influenced it and what signs of ovulation to look for. She no longer faced bloating daily and she understood how to support her digestion, even while traveling, to avoid it from occurring; similarly, she no longer dealt with constipation while traveling.
What Moves the Needle
I want to reiterate that not all changes are made equal. And that’s a good thing! There are some adjustments you can make that will have a large impact and will make the other shifts you elect just that much more effective. When you examine the basics—like nutrition, blood sugar regulation, hydration, sleep, and stress—and commit to making those new habits stick? That’s when you’re ready to bring in the right tools like supplementation, adding or removing specific foods, or maybe checking out that new red light sauna down the road from your place.
It all comes back to understanding the root cause behind what’s causing your experience. Recognizing how something like stress can have a ripple effect on your health. And committing to making healthy lifestyle shifts that are sustainable. If that sounds the solution that you’re ready to invest your time and energy into, pick a time for your free discovery call to see if we’re a fit to work together.