You’re eating right, you found a diet that works best to help manage your Crohn’s and colitis, you take gut healing supplements and medications when you need them.
You’ve even found the best mindfulness practices to help reduce your stress and anxiety around your illness.
You’re doing everything right.
Why aren’t you feeling better? Today on the podcast, we discuss the three hidden conditions that may be holding you back from full IBD remission.
We’re talking about:
And so much more!
After the episode, you’ll have the knowledge you need to take to your doctor to get proper testing and treatment for these hidden conditions that might just be keeping you from reaching full IBD remission.
Episode at a Glance:
Mentioned in This Episode:
Additional Resources from the Episode:
INTRO: You are listening to The Cheeky Podcast for Moms with IBD, a safe space for moms with Crohn’s and colitis, connect, explore powerful tools for healing and transform our lives to thrive in motherhood and in life. I’m your host, Karyn Haley, IBD health coach, integrative wellness enthusiast, and mom to three outstanding kids. After having Crohn’s disease for 30 years and working as a health advocate exclusively with IBD clients for the last 10 years, I know it’s time to bring the types of candid conversations I have with my clients out into the open. It’s our time to go on an IBD healing journey and do it like only a mom can. Let’s do this.[music]
[00:52] You’re eating right, you found a diet that works best to help manage your Crohn’s and colitis, you take gut healing supplements and medications when you need them, you’ve even found the best mindfulness practices to help reduce your stress and anxiety around your illness. You’re doing everything right. Why aren’t you feeling better?
Unfortunately for IBDers, this experience is all too common. It’s so frustrating when you know you’re doing everything right, but you’re still not getting any better. It’s such a head scratcher because there’s no one to turn to figure out why this might be happening to you.
I’ve literally sat across from dozens of clients who are part crying, and part pulling their hair out because they just don’t know what to do. What do you do when you’ve tried everything, when you’ve done everything right and you still don’t feel better? What is the magic secret that it seems so many people have and why don’t you have it too?
I really get this because not only have I seen it with fellow IBD mom friends and clients, but this has happened to me as well. For me, it happened when everything was going along swimmingly, in remission, everything seemed great one moment. And the next moment, without warning for any reason, it seemed like everything went to Crohn’s hell. Excessive bloating, gas, diarrhea, abdominal pain… and it took me a moment to figure out what was going wrong.
Now listen, there are so many reasons why things might not be going your way with your IBD, even when you are doing everything right. There’s way too many factors to go into or even fathom for this podcast. When this happens to you, I want you to go see your doctor. I want you to turn over every rock and devour all the information you can gather to help yourself.
But I also have this episode of The Cheeky Podcast to also offer to help you on your journey figuring out what might be going wrong. When I work with clients, there’s often three reasons why they’re doing everything right but they are still not in complete remission.
3 CONDITIONS THAT MIGHT BE KEEPING YOU FROM 100% IBD HEALING
So here we go with my 3 hidden conditions that might be keeping your IBD and your total health down. These are little known conditions that for the most part, are not being talked about in mainstream medicine. And that’s why you may not know that you have fallen prey to them. This is one of those action packed, step by step episodes where you’ll want to have a pen and paper handy. So if you don’t have one, quickly pause and come right back with something to write with.
Let’s start with Hidden Condition #1- Small Intestinal Bacterial Overgrowth or SIBO
What is Small Intestinal Bacterial Overgrowth (SIBO)?
[04:40] Small intestinal bacterial overgrowth is exactly what it sounds like, an overgrowth of bacteria in the small intestine. Most of our microbial bacteria actually resides in our colon. There are small amounts of bacteria in the small intestine but too much there, is not a good thing. It makes digestion and absorption of our food challenging and it damages the lining of the small intestine.
Why don’t I know I have SIBO?
Two reasons really. #1: traditional gastroenterologists and doctors aren’t taught about small intestinal bacterial overgrowth. It’s very unusual to find a G.I. doc that talks about it as a possibility when you go for an office visit. And #2: we don’t know that we have SIBO because it’s symptoms are so similar to IBD.
What are the symptoms of SIBO?
Let’s talk symptoms so you can see just how similar SIBO and Crohn’s and colitis really are. Common symptoms of SIBO include gas, bloating, abdominal pain, diarrhea or constipation, sometimes going back-and-forth between diarrhea and constipation. Of course, if you have IBD, you already have an in balance in your digestive system which puts you at greater risk for getting SIBO in the first place.
SIBO symptoms can also include non-gut challenges like fatigue, joint pain, headaches, moodiness, skin rashes and respiratory symptoms.
There are several conditions besides IBD that have been linked to being at increased risk for SIBO and they include IBS, GERD, leaky gut, Hashimoto’s, Lyme Disease… and the list goes on and on. And even though some of these conditions seem to have nothing to do with your digestive system, this really makes sense because all roads lead back to the gut. Hippocrates and his wisdom, all disease begins in the gut.
Many people with IBD have no idea that they also have SIBO because the symptoms are just so similar. It’s hard to distinguish between the two. So how do you know? How do you know if you have SIBO?
How do we test for SIBO?
It is of the utmost importance that you get a proper SIBO test. I mentioned earlier that many doctors don’t recognize SIBO as a condition at all. Many G.I. doctors who are familiar with this condition are still not doing proper testing. So, you may be left taking a test, getting negative results. When in reality you just didn’t get proper testing.
According to Dr. Allison Siebecker, SIBO expert extraordinaire, the gold standard in SIBO testing is a 3-hour lactulose breath test. Or, and this just came out very recently, a new test that seems to be even better than a traditional 3-hour breath test, and this is the lactulose 3-gas test. The 3-hour lactulose breath test that I mentioned first, tests for two gases present in the gastrointestinal tract when SIBO is high and those are hydrogen and methane levels. These levels are tested after drinking lactulose, which is a synthetic sugar, sometimes used to treat constipation, but in this test, your body will react to it by increasing these gas levels if you have SIBO. This new test that came out recently looks even better as it looks at hydrogen, methane, as well as hydrogen sulfide in the gastrointestinal tract. This test gives even more information to help with a proper SIBO diagnosis.
Depending on the results of your SIBO test, and which gases are present, this gives your doctor a good indication of which SIBO treatment protocol will work best for you. Methane dominate SIBO has a different protocol than hydrogen dominant.
A SIBO Case Study
[09:15] Let me make this really tangible for you with this case of my client Ginger. She was doing everything right. Ginger had Crohn’s and had started the Specific Carbohydrate Diet, she was on a strong gut healing supplement regime, she was still on 6MP (a medication to help her IBD). Ginger practiced yoga, she walked in nature daily. She had a strong support group of friends to lean on, she was active in her church community… Ginger was doing everything right, but Ginger was still having gut problems. She was feeling gassy and bloated after her meals. She couldn’t find consistency in her poops. She’d have diarrhea for a few days and then constipation for a few, back and forth the cycle went. Ginger was feeling very discouraged when she came to see me. If the SCD and everything she was doing wasn’t working, what could she do? Her doctor was pushing biologics. Should she give up?
In coaching Ginger through her next steps, we talked about some reasons why even though on paper, it looks like she’s doing everything right, there still might be some deeper lingering issues going on. Ones that aren’t often tested for. Of course, SIBO was one of the things we considered. I encouraged Ginger to talk to her doctor about getting proper SIBO testing. Ginger ended up with seriously off the chart hydrogen gas levels from her breath test.
And with this powerful information we realized that there were several foods on Ginger’s SCD diet that were not working for her. Super healthy foods like avocados, ripe bananas, apples, onions, and garlic that are SCD legal, but they just weren’t working for Ginger in this moment due to her SIBO challenges. These are just a few of the food changes I helped Ginger make. When Ginger tweaked her diet, and moved a diet called the SIBO Specific Diet, similar to SCD, but with modifications for those with SIBO, everything turned around for her.
There were other herbals and supplements that Ginger’s doctor added too. But it was game changing for Ginger. Back when she first came to see me, she was ready to throw in the towel. She was down on herself, frustrated, and angry because she was doing everything right. See how just a small tweak can make all the difference in your world?
SIBO. One of those hidden conditions that might be holding you back from those last 40 yards of healing.
What can you do if you suspect SIBO might be holding you back?
[13:35] Start by going to Dr. Siebecker’s website. There, you’ll get up to date, researched back information on SIBO. If you think SIBO might be a culprit for you and you want to know more about it, SIBO symptoms, testing, treatment, etc… that’s the place to start.
Next, talk to the doctor you currently have an ask them to order a SIBO test for you. If your doctor is not open or recommends just a 2-hour test or doesn’t know what you’re talking about, find a nutritionist or functional medicine provider who knows about SIBO and proper testing. I’ll leave a link in the show notes for a functional medicine provider database to find a doctor around the globe. And if all else fails, there are a couple direct to consumer companies you can order a test kit from. One is Direct Labs. I’ve seen people order and test successfully with this company. Reading the test is in an important step and one that all practitioners seem to have their own way for interpreting the results, so it really is your best option to find a provider that can help you with this.
OK, so that’s how come your IBD’s not getting better with hidden condition #1. Let’s talk about hidden condition #2. And that’s Candida. Candida is another digestive ailment that can plague those with IBD, but it’s not talked about in traditional medical circles. Your doctor is not testing for it, and it may be hindering your recovery, even if you’re doing everything right.
What is Candida?[16:01] Candida is a condition where there’s too much yeast in your digestive tract. This is different from SIBO where it’s a case of too much bacteria in the small intestine. Symptom differences might be subtle in these two conditions, but treatment options are different so it’s important to distinguish between the two before your doctor decides what to do about it.
Candida is short for candida albicans fungus. It’s the most common yeast found in the digestive tract. The yeast can grow out of control, especially when there isn’t enough good bacteria in the G.I. tract. The yeast grows and creates dysbiosis (or an imbalance) in the intestine.
Many people can be at risk for Candida. People who overuse of antibiotics, people with diabetes, people with autoimmune conditions (especially gastrointestinal like Crohn’s or colitis), people who are on a high sugar or high carbohydrate diet, and people with chronic high stress.
Any of this sounding like you? Candida is much more common than we realize. And it may be the underlying condition that’s keeping you from IBD remission even though you’re doing everything right.
What are the symptoms of Candida?
There are several signs that you may have candida, or an overgrowth of yeast, in your digestive system. I’ll tell you about the ones that I see most often for those with Crohn’s and colitis: Oral thrush or a white spotted coating on your tongue, those with recurrent yeast infections might have Candida, people who experience strong sugar cravings, brain fog, digestive challenges like bloating, diarrhea or constipation, those with fungal infections on their nails or their toenails might have Candida, as well as people who have excessive anxiety or panic attacks. Of course, just because you have anxiety doesn’t mean you have Candida. It’s when we put the whole picture together that the anxiety may be a part of the puzzle.
Why don’t I know I have Candida?
And of course, you don’t know you have it because of the same reasons you don’t know you have a SIBO. They are just way too similar to our Crohn’s and colitis symptoms. Doctors are just not looking for it And if we are following a path of proper eating, proper supplementation and taking our medication’s, and following mindfulness practices that work to reduce our stress and help with the demands on our life and we’re still not getting any better, it can leave us feeling very defeated and uncertain about our future. This is why I’m so passionate about making sure you know about these conditions. Knowledge is key here.
How do we test for Candida?
Practitioners who test for candida will often start with symptoms. When a combination of symptoms like I’ve mentioned comes up to a knowledgeable Candida practitioner, they might decide to dive deeper with testing. The gold standard of candida testing is a 2 to 3 day stool test that looks at the DNA of the pathogens in your poop.
And although I know it’s controversial and this is clearly anecdotal and doesn’t have scientific evidence behind it, I’ve seen people start with a simple at home spit test. The spit test involves spitting into a cup of water first thing in the morning. Often times, people start here because they don’t have a provider that they can go to who knows about candida. So, although I don’t have the research to back up the validity of the spit test, I have seen clients try this first with the spit test coming up positive and then later have stool testing that also comes up positive for Candida. It’s about putting all of the pieces together when it comes to Candida. Looking at your symptoms, getting a stool test if possible, and talking to a doctor who is knowledgeable about the condition is key.
What can you do if you suspect Candida is holding you back?
The best place to start is always by talking to your doctor. You never know unless you bring it up whether they’re willing to talk about Candida and these other conditions we’re talking about today. If you don’t find satisfaction there, remember that there are nutritionists and functional medicine providers who do know about Candida. Don’t stop your search just because the first place you go doesn’t give you satisfaction. Continue searching for someone who can help you. When you do get proper testing for Candida, you may also want to get tested for SIBO at the same time since both of these conditions present so similarly.
Now I know I have Candida. What do I do?
Every provider’s approach to treating Candida is different. But I can give you some general guidelines and what I see most practitioners doing. There are several supplements that can be helpful to get rid of the extra yeast. Antifungals like oil of oregano, caprylic acid, and allicin (from garlic). There are combination antifungal supplements that might be a part of your healing regime. Some people with Crohn’s and colitis tend to be sensitive to multi-strain antifungals so be careful there. Probiotics are also used for Candida after some healing has taken place, but none of these supplements are helpful unless they are combined with diet change. If you’re in the category of doing everything right for your IBD, you’ve probably already changed your diet, but your diet may need some tweaking to make sure it’s tailored to getting rid of your Candida. The low FODMAP diet is really good for this condition. I’ll link to my favorite low FODMAP website in the show notes.
Generally speaking though, a diet that’s low in sugar, low in carbohydrates and that doesn’t include gluten or dairy is preferred when Candida is present. And bone broth or as you know if you listen to this podcast, meat stock is my preference, can be really helpful. As well as including high-quality fats in your diet, especially coconut oil which has that caprylic acid that I mentioned earlier as a supplement, because it helps with Candida overgrowth. Other oils that are good fats and also helpful with candida are extra-virgin olive oil, walnut oil, and avocado oil. Drinking herbal tea like ginger, peppermint and pau d’ arco tea are also helpful as well as drinking black tea because the tannins in the tea help control the Candida overgrowth.
[25:49] When it comes to candida and diet, I just want to mention one last thing about sugar. We want to limit sugar, but we don’t want to get rid of it completely because getting rid of sugar completely can exacerbate Candida. It’s important to focus on small amounts of natural sugars when Candida is present like honey or maple syrup.
Ok, that’s Candida, hidden condition #2 and hopefully some information to get the wheels turning for you to think about and get you moving down the right path if you are doing everything right, and still not feeling better.
Let’s move on and talk about our last hidden condition, condition #3 and that’s thyroid issues. Challenges with your thyroid often times get misdiagnosed, and definitely underdiagnosed. We may be moving along on our IBD healing journey and not feeling as good as we know we should. Thyroid challenges could be at the heart of keeping you from where you deserve to be with your health. Let’s dive into this problem a little deeper.
What are thyroid issues?
Let’s start by talking about what your thyroid is and what can go wrong with it. Your thyroid is a gland, it’s butterfly shaped, and it’s located at the base of your throat. It produces several hormones that have an impact on your total health. Your thyroid gland regulates your body temperature, slows or speeds up your heartbeat, and most importantly for us with IBD, it controls the rate that we digest our food. Unfortunately, this gland malfunctions and sometimes causes thyroid challenges like hypothyroidism (which is low thyroid hormone function or Hashimoto’s disease (where too much thyroid hormone is produced).
Why our thyroid function matter to our IBD?[28:15] Four reasons really. Let’s talking about reason #1. I already mentioned this when talking about the functions of our thyroid gland, your thyroid hormones control your digestion. Of course, this gives it an immediate and forever connection with our Crohn’s and colitis as proper digestion is the key to helping our disease. Reason #2- Poor thyroid function affects our ability to absorb the nutrients in our food. Ding ding ding, another connection with our Crohn’s and colitis. Reason #3- a poor functioning thyroid also leads to a condition known as a leaky gut, literally the lining of your gut opening small holes where undigested food heads into the bloodstream.
And reason #4- a reason that typically hits very close to home for those of us with IBD and why we might miss the thyroid issue has to do with gluten intolerance that many of us with IBD face. The molecular structure of gliadin, and that’s the protein found in gluten, is almost identical to the molecular structure of the thyroid gland so when gliadin, that gluten protein, moves into the bloodstream because we’re sensitive to it and it causes that leaky gut I was talking about, our immune system says whoa, what is going on here? This is a foreign invader that shouldn’t be here. Our immune system, which is programmed to remove foreign invaders moves to strike down the gliadin. Because the gliadin and thyroid tissue are so similar, the immune system attacks the thyroid too.
Now we have a problem. We have a problem with our thyroid and all because we are sensitive to gluten. Does this make sense? I know it’s a little bit of a convoluted process, but the bottom line is that reason #4 why people with IBD might be impacted with unrecognized thyroid issues is because of our likely sensitivity to gluten.
And because gluten, when we eat it, can last up to six months in our body, and during all this time it can wreak a lot of havoc on our thyroid, it’s yet another reason to not eat gluten if we have IBD.
What are the symptoms of thyroid problems?
[31:45] And what are the symptoms here? What are we looking for to know if we have an undiagnosed thyroid challenge. Well, there’s lots of symptoms that could be an indication of a thyroid condition. Let me tell you about a few of the ones that I see most commonly. When it comes to thyroid challenges, I see things like lack of energy, trouble losing weight, hair loss, low sex drive, a number of gut challenges that we may mistake for our IBD because remember the thyroid controls our digestion. I also see mental health challenges and neurological challenges like depression and brain fog. The symptoms of a thyroid disorder really run the gamut which is why it’s one of those hidden conditions that we don’t know we have. And when it’s left unchecked, it can really cause difficulties for us down the line.
What do I do if I think my thyroid might be the issue?
So, what are you going to do if these symptoms resonate with you? What are you going to do if you think you have thyroid issues? Well, the first thing you’re going to do is get proper testing. And this is a tough one. Because you go to your doctor and many doctors test your thyroid. It’s a very common test during your annual exam at the gynecologist. But unfortunately, many doctors are only testing one thyroid level, your TSH. And if they find that your TSH is normal, they declare your thyroid function fine. We have to get better thyroid testing. We have to dig deeper when we suspect a thyroid challenge. We have to go to our doctor’s appointments armed and dangerous.
When it comes to proper thyroid testing, functional medicine doctors recommend these tests. I want you to write these down so that you can go to your doctor’s appointment ready to request these specific tests. Go ahead and pause the podcast if you need to get a pen and paper. If you’re driving just remind yourself where we’re at in the podcast so you can go back later. Proper thyroid testing should include a TSH, T4, T3, free T4, free T3, reverse T3, and thyroid antibodies. These are just the names of the tests but if you want to know more and exactly what these are looking for, I want you to check out the thyroid link in the show notes. There’s a great article by Dr. Will Cole that I’m going to link to. You can find out more about thyroid function as well as proper thyroid testing there.
This is crucial ladies. We all need to be getting proper thyroid testing. I know for me, I go to my yearly physical and gynecology screening with a piece of paper that has these tests on it. I want to make sure that I am getting my thyroid properly tested at least yearly. The earlier you detect a thyroid problem, the sooner you can begin taking measures to treat it. Please ladies, if you only listen to one thing from this episode please make sure you do this. Get proper thyroid testing. It’s done with a simple blood test. This is something that every doctor can do. Sometimes they just need a little direction from you.
How are thyroid issues treated?
If you go through this testing and you find out that you do have a thyroid challenge, there’s a lot that can be done. Talk to your doctor about eating right for your thyroid. Guess what? Eating for your gut and eating for your thyroid are very similar. You’ll strengthen both at the same time.
There’s a medication that can help with your thyroid as well, both synthetic and natural thyroid replacement hormones. There’s also supplements that can strengthen your thyroid hormones like zinc and magnesium, B vitamins and vitamin D.
Make a plan with your doctor that’s tailored to your needs. Make sure that they know you have Crohn’s or colitis because that will need to be taken into account when deciding on the best treatment plan for you. Everyone’s thyroid needs are different depending on the severity of their challenge. Make a plan together and make sure it includes all facets of help for you. Definitely diet should be in there as well. There’s a lot you can do to help your thyroid with diet alone.
LET’S RECAP THOSE 3 HIDDEN CONDITIONS ONE MORE TIME.
OK my dear, those are the three hidden conditions that may be impacting your ability to feel completely well when you know you’re doing everything right to help heal your IBD. Let’s go ahead and recap the 3 hidden conditions one more time. Hidden condition #1 was small intestinal bacterial overgrowth – SIBO for short. SIBO is an overgrowth of bacteria in your small intestine, and it often mimics your IBD symptoms and makes it difficult for you to know you have this condition. Proper testing is a must. Follow the steps outlined in the episode and you will be on track for SIBO busting success.
Hidden pitfall #2- Hidden condition #2 was Candida. Candida is another condition where the symptoms mimic your Crohn’s or colitis. This makes it really difficult to know if you have it and may be the hidden problem you didn’t know you have. It might be the difference between 80% remission and full remission from your IBD challenges. Again, like SIBO, you want to see a very qualified medical provider to help diagnose and help you with treatment of this condition. Know that it is treatable and that you can get over it. You don’t have to suffer with Candida your whole life.
The last condition we talked about was hidden condition #3- thyroid challenges. Thyroid challenges are notorious for laying low and getting undiagnosed, especially for those of us with Crohn’s or colitis. Thyroid conditions have a very strong gluten connection which makes it even more important for us to avoid gluten when we have IBD. The sooner your thyroid condition is diagnosed and treated, and that’s with a multipronged approach that includes food, the better your overall health will be.
Remember the thyroid controls many functions in your body including your digestion, so we all want the healthiest thyroid possible. Research the testing I mentioned in this episode, don’t be afraid to take this information directly to your doctor to ensure that you get a full range of thyroid testing. Thyroid health can be complicated, but when we put all the pieces together with proper testing, we get a really good picture of what’s going on with our thyroid.
DO IT LIKE A MOM.
Bottom line here, when it comes to issues that might be holding you back from feeling as good as you can with IBD, I want you to do it like a mom. I want you to know just how fierce and strong you are. I want you to know that you are in charge of your medical care. You are in charge of your total health. Don’t let the challenges we talked about today, the ones that aren’t talked about in mainstream medicine stop you from feeling 100% better. You deserve 100% health. You deserve to be there, 100%, first and foremost for you, for your partner, and for your kids.
Keep striving for health. Keep striving to feel better. I know that I am with you every step of the way. Together, we are stronger. Together, we’ve got this. If you have any questions about this episode or about IBD in general, please get in touch. I’m always available to chat. Reach out at karynhaley.com Let’s bust your IBD together.
Until we meet again, I’m wishing you a cheeky and healthy IBD healing journey.
Thank you so much for joining me today and for listening to today’s episode. When it comes to IBD, I know there’s a lot of resources out there, and I’m truly honored that you chose the Cheeky Podcast to get your IBD information today. If you found this information helpful, please give us a rating and review. It helps other moms find the podcast and see what we’re doing over here to help IBD moms everywhere. And if you feel called feel a call to do it, share this podcast with an IBD mom who you know could really use an uplifting message today, ’cause that’s what we’re all about over here at the Cheeky Podcast.
[42:45] One last thing, if you’re still with me, and if you are, you’re definitely my kind of gal. We have to get to know each other better. If you’re tired of living on the hamster wheel of IBD with all the ups and downs between flares and remission, if you’re struggling to get control of your abdominal pain, gas, bloating, diarrhea and other troubling IBD symptoms, go to my website. It’s karynhaley.com, and my mom had to be just a little bit different, she spelled my name with the Y. So it’s K-A-R-Y-N H-A-L-E-Y.com and schedule your very own free 30-minute IBD root cause trouble-shooting session with me where we discuss the challenges you’ve been having, we set goals to help you move forward, and we talk about how we can work together to help you get your life back. It’s a power packed 30 minutes. You don’t have to live in IBD status quo. There’s so much that can be done to transform your life so you can thrive in motherhood and thrive with IBD. I’ve seen my clients walk this path and it gives me so much joy to take that journey with them.
My entire coaching practice is run online, so you never have to leave your house and you never have to get out of your jammy or yoga pants for us to work together. You know I’m wearing them to. If you’re ready to take your first amazing step towards healing, I’m ready to chat with you. Schedule your free 30-minute IBD root cause trouble shooting sesh today at karynhaley.com. Click on the work with me tab and I’ll see you soon. It’s important to note that the information in this podcast and in this episode is for general information purposes only and not intended to be a substitute for professional medical advice. The statements made in the Cheeky Podcast for moms with IBD, either by me or my guests, is not intended to diagnose, treat, to cure, or prevent any disease. Before implementing any new treatment protocols, do yourself a favor and consult your physician first.
Thank you so much for listening, for being here, for saving this space for us to spend some time together. Until we chat again, I’m wishing you a cheeky and healthy IBD journey.
These statements have not been evaluated by the Food and Drug Administration.
This podcast, video, and blog post is not intended to diagnose, treat, cure, or prevent any disease.