Hello – I’m sorry you’ve been suffering for so long. Allow me to share some possible root causes, to hopefully begin to peel the layers of the onion and get you feeling better again. In terms of causes, gastroparesis is often multifactorial. Common drivers include:
• Nerve damage. Diabetes is considered to be one of the biggest risk factors because hyperglycemia causes nerve damage. The vagus nerve controls the muscles of the stomach and small intestine. If the vagus nerve is damaged, the muscles of the stomach and small intestine do not work as well and the movement of food through the digestive tract is slowed. Similarly, if nerves or pacemaker cells in the wall of the stomach are damaged or do not work normally, the stomach is slow to empty. In addition to diabetes, other things that affect nerve health such as chronic smoking or low vitamin B12 can also contribute. Ideally, I like to see serum B12 above 600.

There is an important connection here too where gastric emptying plays a major role in stimulating the release of incretin hormones which directly triggers first-phase insulin release.  In fact, gastric emptying accounts for about 35% of the variance in the glycemic response to oral glucose and/or carbohydrate-containing meals in clinical study. Gastroparesis can contribute to less incretin release and thus less insulin release which can contribute to hyperglycemia over time, driving the progression of insulin resistance, and potentially creating a vicious cycle.

->Have you ever tested your fasting glucose, fasting insulin and HbA1c?
• SIBO. Small intestinal bacteria overgrowth can slow motility along the entire GI tract due to high methane production from intestinal bacteria.

->Do you know what type of SIBO you have?
• Insufficient stomach acid.

->Have you confirmed the H. Pylori is negative currently. Are you taking anything to stimulate or support stomach acid?
• Mitochondrial dysfunction can cause cellular energy deficiency that causes lower motility. This is seen in patients with chronic fatigue syndrome.

->Have you done an Organic Acid urine test by any chance?
• Hypothyroidism can also slow motility due to cellular energy deficiency and present as gastroparesis as well as other forms of low motility (e.g. constipation).

->Have you test your thyroid levels? These include: TSH, Total T4, Total T3, Free T4, Free T3, Reverse T3, anti-TPO, anti-TG
• Several medications are associated with gastroparesis, such as tricyclic antidepressants, anticholinergics, narcotics, lithium, nicotine, calcium channel blockers, dopamine agonists, and progesterone.

->Are you taking any of these?
• Other less common causes include gastric surgery, viral infections in the stomach, and autoimmune disorders such as scleroderma.

->Do any of these resonate with you?
If gastroparesis continues untreated, downstream consequences include malnutrition, dehydration, poorly controlled blood sugar, bacterial infections, and in rare cases, a bezoar (where undigested food accumulates in the stomach, forming a solid mass).
Here are some recommendations to start:
• Explore possible contributors to neuropathy (e.g. increased oxidative stress, insufficient Vitamin B12 or B6. The organic acid test would have all of these markers)
• Check RBC magnesium level (not serum) and replace to optimal levels (ideally, upper third of the reference range)
• Continue to focus on easy to digest nutrition – smoothies, soups, broths, veggie purees, and soft, well-cooked foods.
• Bitter herbs such as ginger in whole food or supplement form can stimulate gastric motility.
• Focus on ensuring optimal eating hygiene.  In particular, taking time to see and smell foods and stimulate the cephalic phase of digestion that will also support optimal grehlin release.  This resource may be helpful about grehlin.
• Consider if serotonin might be low, contributing to slow motility. Pure Encapsulation’s Motilpro (which combines B6, 5-HTP, and ginger) may be a consideration for this.
• An herbal remedy called Iberogast has been demonstrated in clinical study to be effective in improving motility

In addition, I would highly encourage you to make time to watch the Gut Health Masterclass. It is long and intense, but will help you understand the whole digestive process so much better, and how easily it can dysfunction.

If time is an issue for you, then start by watching the summary of how digestion works, and then the summary of how digestion dysfunctions.

And since your main struggle is with the upper GI, you can also watch how digestion works in the stomach, and how it dysfunctions (in the stomach & causes of hypochlorhydria (low stomach acid)).

And here are solutions for stomach acid support.

I will leave it here for now as to not overwhelm you. Please make time to watch these videos, answer my questions above about tests, and let’s keep the conversation going.

Hope this helps give you some direction.

I literally just finished writing up the Constipation symptom handout for the Symptom Dictionary. It’s getting designed and will be sent out in the November Insider Email on Tuesday.

You can also watch these 2 videos on constipation: common causes and rapid relief solutions for constipation, both inside the larger Gut Health Masterclass course.

And here is a list of the common causes I listed in the upcoming handout for constipation:

-Dehydration
-Magnesium insufficiency or deficiency
-Insufficient intake of dietary fats
-Insufficient insoluble fiber
-Hypothyroidism
-Dysbiosis (imbalanced microorganisms or an overgrowth like SIBO/SIFO), parasites
-Food sensitivities
-Hypochlorhydria (low stomach acid)
-Chronic stress (sympathetic dominance) resulting in decreased peristalsis
-Retroflexed uterus (or other structural blockages)

Given your history of low fat diet and liver issues, I would suspect bile support is needed. Do you have any liver markers to share?

These would be: ALT, AST, GGT, Alk Phos or ALP, Total and direct bilirubin, Albumin, Total Protein.

The digestive bitters I suggested above would help in this case too with constipation. Please watch this short video for a deeper dive on liver/gallbladder solutions.

just to be on the safe side, I think it’s best that you see a doctor about that symptom with difficulty swallowing and rule out neurological deficits, obstructions of the esophagus or a motor disorder.

Usually, the assessment goes as follows:
Difficulty with solids only: can indicate an obstructive lesion
Difficulty with liquids and solids: can indicate a motor disorder
Difficulty initiating swallowing: can indicate a neurological deficit

If the above are ruled out by a doc, look to a parthyroid dysfunction and/or biliary stasis. The parathyroid glands are a pair of small glands, located in the throat near the thyroid.

If you feel there’s a lump in your throat, this could be associated with a potassium insufficiency and/or gallbladder dysfunction with biliary statis.

Please watch this video on the the major players of digestion to understand the role of the gallbladder in digestion. And here’s a video on solutions for supporting the liver/gallbladder if this is at play in your case.

Have you ever tested your liver markers? These are ALT, AST, GGT, Alk Phos or ALP, Total and Direct bilirubin, Albumin, Total protein. If so, please share your results so we can help guide you better.

Hi – it usually takes a minimum of 1 month to start noticing a difference with normal/moderate intake, but of course that all depends on the dosage and therapies being used.

I encourage you to watch this short video on how to correct an iodine deficiency using a combination of food therapy and supplements.

Hope this helps.

Hi  – what type of IUD do you have? And can you please share your iron markers: iron, ferritin, TIBC, and % saturation

I also want to encourage you to watch this short video on the risk factors of iron deficiency to help you start thinking about the possible root causes in your case specifically. It’s not always iron related.

And then watch this video for solutions on how to correct an iron deficiency (if it’s truly a need for more iron). Cooking in a high quality cast iron skillet like the Lodge brand can also help bring on board more iron.

Of course, I am going to encourage you to increase heme based iron from animal sources, because they are superior to non-heme plant sources in terms of absorption and bio-availability.

Don’t kill me, but please please please try my liver pate recipe. If you like butter, you’ll likely enjoy this recipe. Spreading a little on a cracker or sourdough bread every day can really help boost your levels of not only iron, but B vitamins, vitamin A, copper, and zinc. True superfood. Plus the butyric acid in grass-fed butter is pure love for your colon.

I’m so happy to hear that you’re gaining some clarity! THAT is exactly what I want for all of you here in B Better.

Can you please share why you believe you need digestive enzymes after watching the videos? The reason I ask is because I truly want you to get to the root cause, and often times, enzymes simply offer rapid relief until you address the actual root cause.

Keeping the North to South approach in mind, are you sure it’s not stomach acid support that you might need instead? Or perhaps bile support? When in doubt, I prefer to start with digestive bitters since these will stimulate all digestive secretions, including digestive enzymes. It covers a wider base than only digestive enzymes. I like Quicksilver’s Dr. Shade’s No. 9 and this is available in B Better’s Fullscript dispensary. You’ll need to create an account here.

based on the scan, all 3 immune nutrients (zinc, vit A & vit D) are low which makes me question nutrient intake (diet) and nutrient absorption (gut health and more specially liver/gallbladder health!). The videos I shared above will help you understand why.

Do you consume animal proteins? Do you get regular sun exposure?

so yes, I do recommend water filtration but the type really depends on your geographical location and current municipal water guidelines/standards.

In my Beginner’s Health roadmap, I have a pillar all about hydration, the different types of water sources, and the common water filters available.

If you don’t have time to watch it all, then I suggest you watch this video specifically to understand the 2 common types of water filters, how to test your water, and brands of filters and certifications I recommend looking for.

Please let me know if this helps and if you have any other questions. Happy to help you find the perfect filter for your needs. ❤️

Hi  – I’m so excited you’re here with us too!

Just a few pointers about the community spaces since I noticed you posted this comment in the IBS post thread… no biggie. I know it takes some time to get used to the forum.

If you notice on the left (from computer desktop view), there’s a left-side panel with different “themes/topics” or what we call “spaces”.

For any health-related questions, please create a new post in the “Ask Your Questions” space. (I’ve linked it for you here) To create a new post, there are 2 places to do that which I’ve circled in red in the image below. Once you click on ‘new post’, a pop-up will appear and you can type away, add a cover, images, etc.
[image.png]Hope this helps!

Hi – would you mind sharing your latest thyroid results please? Given what you’ve shared so far, I would be curious to know the status of the following markers:

-Iron, ferritin, TIBC, %saturation
-RBC zinc, serum copper, ceruloplasmin
-vitamin D
-vitamin A

Also, do you take any medications and/or supplements? If so, can you please provide a list so that we can have a broader perspective of possible contributing factors?

As Daniel mentioned, the gut is definitely playing a major role with all of your symptoms. If you have the time to watch the Gut Health Masterclass in its entirety, please do so. Otherwise, you can watch the summary videos of “how digestion works” and “how it dysfunctions” for now.

And since your immunity is affected, I would also recommend watching this video here discussing how the microbiome health impacts immunity, and then this video for some solutions to help support gut immunity.

Hope this helps. Let’s keep this conversation going…

Hello Joanie – welcome to B Better! I’m so thrilled that you decided to join us and we will do our best to help you overcome your struggles with IBS and continue living a healthy and vibrant life!

To be able to help offer rapid relief solutions, can you please share if you struggle with more days of loose stools or constipation in a week?

If you have the time to watch the Gut Health Masterclass, please do so. The “nuts & bolts of how digestion works” section, will help you understand the major players responsible for proper digestion. If you don’t have the time, then please watch the summary video here. And then it will help to watch how easily dysfunctions happen or just the summary of the dysfunctions video here if your time is limited.

IBS is typically caused by multiple causes:
• dysbiosis (imbalance in gut microbiome), pathogens, SIBO (small intestinal bacterial overgrowth), and perhaps immunosuppression (ex. stress, medication, viral challenge). Have you checked your vitamin D, RBC zinc and vitamin A levels? Have you ever done a functional stool test like the GI map?
• Maldigestion (poor eating hygiene/frequent snacking, insufficient stomach acid, enzymes, and/or bile) – the videos above will explain this well.
• Food sensitivities or intolerance (are you consuming dairy and gluten? these tend to be the worst culprits)
• Dysmotility (ex. stress, hypothyroid, a need for magnesium, chronic stress)
• Estrogen dominance

The first step is to address digestion from a North to South perspective. You’ll understand what I mean by this once you review the videos I shared above. If any of the 3 major players of digestion are affected (stomach, liver/gallbladder (bile), pancreas) it will impact everything down south and lead to IBS symptoms. Please take this Gut Health Quiz and let us know your score so we can help provide more targeted solutions.

I’ll leave it here for now and wait to hear from you. Let’s keep the conversation going…

Tagging you so you see my response:

 please keep us posted with your results. We’re here to support you.

generally yes, but as always, the best way to know what’s best for your unique needs is to test both iodine, selenium and thyroid antibodies. I share how to test for iodine here.

 thank YOU for your lovely message. It’s my pleasure to be able to help guide and support you and your family.

Please email support@bernadetteabraham.com with the following details and we’ll help you get access to the OAT test:

-email address
-her name
-her date of birth
-shipping & billing address (if they are different)

 yes, it’s the correct one. The one I bought must be a new branding, but the dosage per capsule and formula is the same.

IAG is something I keep in my medicine cabinet (actually in my fridge) for immune support, so I always have it on hand. It’s not essential for the protocol, but it’s always my go-to for times when my kids get sick or extra immune support is needed…