Brain Fog? The Gut-Brain Connection

Many of my patients come to me with concerns that feel both familiar and frustrating: mood swings, brain fog, and memory lapses. While these symptoms are often chalked up to changes in the brain itself, research is increasingly pointing to a less obvious but powerful player: the gut. In this article, I’ll explore the fascinating connection between our digestive system and mental health, known as the gut-brain axis, and share the strategies I use as a naturopathic physician to support this system, especially for those navigating the physical and hormonal shifts that often begin after 50.

The gut-brain axis represents a sophisticated, two-way communication system involving neural, hormonal, and immune pathways. At the heart of this dialogue is the gut microbiome, the trillions of microorganisms that reside in our digestive tract. This internal ecosystem influences nutrient absorption, immune health, and even the production of neurotransmitters like serotonin, a chemical strongly tied to mood regulation. In fact, the majority of the body’s serotonin is produced in the gut, underscoring the biochemical link between digestive health and emotional well-being.

As we age, or when lifestyle and environmental stressors take a toll, this internal balance can be disrupted. Digestive issues like bloating, irregular bowel habits, and indigestion may be more than minor annoyances. They can signal deeper imbalances in the gut ecosystem, known as dysbiosis. Two conditions commonly linked to these symptoms are Small Intestinal Bacterial Overgrowth (SIBO) and Intestinal Candidiasis.

SIBO arises when excess bacteria grow in the small intestine, where bacterial counts are typically low. This overgrowth can interfere with digestion and nutrient absorption and may contribute to symptoms like bloating, fatigue, and cognitive fog. Similarly, intestinal candidiasis involves an overgrowth of Candida, a yeast that can flourish under certain conditions such as antibiotic use, high sugar intake, or chronic stress. Research suggests that byproducts from microbial overgrowth and inflammation may influence brain chemistry and mood.

From a naturopathic perspective, the goal is to restore balance to the digestive system in a sustainable, individualized way. Nutrition is central to this process. Dietary adjustments can help shift the internal environment, reducing the fuel for unhelpful microbes and supporting the growth of beneficial ones. This approach is not about rigid or permanent food restriction but about working with the body’s needs to create an environment where health can flourish.

Natural compounds and plant-based supports may also play a role in re-establishing harmony in the gut microbiome. Sometimes short term use of targeted pharmaceuticals is needed to restore balance in the small intestine. These medicines are chosen thoughtfully based on a person’s individual presentation, with the aim of improving digestive comfort and overall health.

Equally important is the role of the mind. Chronic stress can disrupt gut function and microbial balance, creating a feedback loop that affects both digestion and mood. Practices such as meditation, breathing techniques, or mindful movement can calm the nervous system and support a more resilient digestive system.

In essence, optimizing the gut-brain connection is about more than managing symptoms. It involves cultivating a healthy internal ecosystem that supports sharper memory, greater emotional stability, and a more vibrant experience of life as we age.

Fatigue After 50

We’ve all felt tired at times. But if you’re over 50 and waking up just as tired as when you went to bed, or if you find yourself needing more and more coffee just to get through the day, it may be time to ask: what’s really going on?

Fatigue is one of the most common reasons people visit their doctor, yet it’s often brushed off as a natural part of aging. While energy levels do shift over time, persistent fatigue is not something you have to accept. It’s often a sign that something deeper needs attention.

As a naturopathic physician, my first step when a patient comes in with fatigue is a thorough assessment. That includes listening to their story, performing a detailed physical examination, and ordering targeted lab tests to uncover the root cause.

Iron and B12 are classic culprits, especially in women who’ve had years of heavy periods, or in anyone with digestive issues that impact absorption. Low iron can make you feel foggy, weak, or short of breath. B12 deficiency, more common with age, can sneak up with symptoms like numbness, low mood, and deep fatigue.

Thyroid function is another key area to check. The thyroid acts like your internal thermostat; when it’s underactive, everything slows down. You might feel cold, sluggish, constipated, or gain weight without trying. A proper thyroid assessment includes not only TSH, but often free T4, free T3, and thyroid antibodies for a complete picture.

Sleep apnea, surprisingly under-diagnosed, is a major cause of fatigue. Even people who think they sleep fine may not be getting deep, restorative sleep if their breathing is interrupted throughout the night. If a partner notices snoring or pauses in breathing, or if you wake up groggy or with headaches, it’s worth investigating.

Chronic stress over decades can tax the body. HPA axis dysfunction refers to a disruption in the normal functioning of the hypothalamic-pituitary-adrenal axis, a key system regulating the body’s stress response. When imbalanced, people may experience poor stress resilience, low morning energy, and that ‘wired but tired’ feeling.

In addition, persistent fatigue can be an early sign of more serious conditions like cardiovascular disease, cancer, digestive disorders, autoimmune disease, MS, and more. I believe in being very thorough with my fatigue patients to look for clues of deeper pathology. Once we’ve ruled out or addressed medical causes, it’s time to look at restoration. This is where naturopathic medicine shines.

Restoration means nourishing your body with quality sleep, balanced meals, and rhythm in your day. It may involve replenishing nutrients like iron or B12, supporting thyroid or adrenal function with herbs, or improving sleep hygiene and stress management.

Sometimes, we use natural supports like ashwagandha, rhodiola, or magnesium, and can prescribe pharmaceutical treatments when appropriate.

The goal isn’t just to mask the fatigue, but to help your body function optimally again. Because yes, energy changes with age, but you should still feel vital, sharp, and engaged with life. Fatigue is a signal. The question is: are we listening?

Dr. Deidre Macdonald is a naturopathic physician who has practiced in downtown Courtenay since 1997. www.getwellhere.com or 250 897-0235

 

My doctor says my thyroid is normal but…

Every week people arrive at the clinic wondering if their thyroid is okay.  They’ve often had their conventional doctor check their thyroid, and are told that everything is fine.  However, they aren’t convinced.  They feel tired, cold, achy, gain weight easily, have headaches, depression and more symptoms that seem to reflect low thyroid function.

As a naturopathic physician, I offer these patients a full thyroid panel.  When we test further, we often find that the thyroid really isn’t working optimally.  Why the different in approaches?

Our MSP system only allow conventional doctors to run one test to screen for thyroid problems.  Naturopathic physicians prefer a full panel to test for TSH, T4 (inactive thyroid hormone), T3 (active thyroid hormone) and a thyroid antibody called TPO.  Often we are able to unveil issues in the complex dance of the thyroid hormones, which can then be treated in a variety of ways, both holistic and pharmaceutical.

Our philosophy is to try to determine if your thyroid is working optimally, not just wait until it is diseased.


Curious about your thyroid? You can book an appointment by emailing back or calling Terry at (250) 897-0235.

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Irritable Bowel Syndrome: An Irritating Problem!

Cathy sought out naturopathic medical care for problems with her bowels. Ten years of problems had left her drained and frustrated. She knew where all the public bathrooms were everywhere she went and lived in fear of “accidents”. She suffered from alternating constipation and diarrhea, embarrassing gas, abdominal pain and bloating and she generally felt tired and toxic. Her conventional medical doctor had done tests to rule out cancer or serious disease and labeled her symptom picture Irritable Bowel Syndrome. She was given a variety of medications to counteract her symptoms. Laxatives for constipation, anti-diarrhea medications, antacid pills all helped in the short run, but after 10 years Cathy was no closer to understanding why she felt the way she did or how she could help herself get out of this painful cycle.

Cathy’s case is not unusual. Approximately 15% of the population has Irritable Bowel Syndrome (IBS) and many more people experience similar symptoms. IBS is characterized by abdominal pain or bloating, constipation and/or diarrhea, gas, nausea, and is often accompanied by varying degrees of anxiety or depression. Since many other conditions can mimic IBS, it is important to rule out more serious diseases like cancer and colitis.

The naturopathic approach to treatment is very different from the conventional methods because our goal is very different. While conventional medicine treats symptoms with drugs, naturopathic doctors seek to understand why the body is creating these symptoms and correct the underlying imbalance. There are several potential causes of IBS that affect people in varying degrees.

The most common cause of IBS that I have observed clinically is food allergies or intolerances. With proper identification of offending foods and coaching to change the diet, many of my patients have found lasting relief from their symptoms. Another common cause of intestinal distress is a disturbance in the bacteria that line the intestine. Antibiotic use coupled with a high sugar diet can result in an overgrowth of yeast and fungus in the intestine. The result is often gas, bloating and irregular stool, as well as fatigue and other mental symptoms. This condition can be rectified by specific dietary modifications and by working to re-establish the healthy bacterial balance in the intestine.

Often IBS is a result of a poorly functioning upper digestive system. If the stomach lacks adequate hydrochloric acid, foods are not broken down properly and can cause symptoms in the lower digestion. This condition is common as we age. Symptoms to look for of low stomach acid are:

  • Fullness after eating
  • Belching or flatulence after meals
  • Indigestion, constipation or diarrhea
  • Iron deficiency
  • Multiple food allergies
  • Weak fingernails

I have had many patients complain of IBS after having surgery to remove their gall bladder. The gall bladder stores and regulates the secretion of bile, the fluid used to digest fats. The bile is made in the liver but if the liver is toxic, the bile it makes will also be toxic and caustic. The “toxic bile” takes its toll on the gallbladder, and the conventional solution to gall bladder problems is to simply remove it. Now that same “toxic bile” is now able to drip into the intestine in an unregulated fashion. The intestine becomes irritated by the bile and lets us know by presenting with the symptoms we call Irritable Bowel Syndrome. The naturopathic approach to this health challenge is to treat the underlying cause by detoxifying the liver to help it to make better bile.

In Cathy’s case, after a thorough physical exam, we did some blood work and tested her for food allergies and yeast overgrowth. She had taken antibiotics for a series of infections many years ago and had a significant yeast overgrowth. She was allergic to wheat, rye and bananas. She did not have a personal history of gall bladder problems, but her sister and mother had had their gall bladders removed. Cathy was coached on a program to reduce her yeast, change her diet, cleanse her liver and soothe her irritated bowel. With natural medicine alone, she became symptom free for the first time in many years. Not only did her bowels improve, she reported feeling much more energy and mental clarity. She was able to take charge of her health by getting to the root cause of the problem!

Dr. Deidre Macdonald is a naturopathic physician with a natural family medical practice in downtown Courtenay. Her office can be reached at (250) 897-0235 or via this website. 

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