If you have chronic gut problems, you could have a brain problem. This is especially true if you’ve had a head injury or if you also suffer from worsening memory, brain fog, cognitive decline, or other symptoms of poor brain function.

Chronic digestive complaints — indigestion, acid reflux, constipation, burping, gas, bloating, diarrhea, pain, or irritable bowel disorders — are common complaints of a brain that is not functioning well.

The brain gives orders to the gut through the vagus nerve, which then tells the gut to digest food, repair and regenerate the gut lining, push food through the intestines (motility), and many other functions.

When brain function declines, the brain does not give the gut enough input. As a result, constipation, leaky gut, food sensitivities, irritable bowel disorders, and other problems can arise. This is one reason why people with a head injury or dementia have chronic gut complaints.

Exercise the vagus nerve to address gut problems

In functional neurology, we conduct a neurological exam to evaluate areas of the brain that are not functioning well. We then provide activities to activate or dampen different areas of the brain, depending on your needs, to improve function. This in turn improves communication of the vagus nerve with the gut.

Fortunately, you can also work on activating the vagus nerve yourself at home with some very simple daily activities.

Vagus nerve exercises

A few simple tests can tell you if your vagus nerve may not be sufficiently active:

• You don’t have much of a gag reflex; when you say, “ahhh” the uvula (the little punching bag at the back of your throat) does not rise much.
• If you listen to your abdomen with a stethoscope, you hear virtually no rumbling noises — a healthy gut makes intermittent rumbling noises.

Here are some simple exercises to activate the vagus nerve, taken from Dr. Kharrazian’s book, Why Isn’t My Brain Working?:

Gargle vigorously several times a day. Gargling contracts the back of the throat, which activates the vagus nerve. Gargle each drink of a glass of water several times a day. Gargle vigorously and for a good length of time, ideally until your eyes tear (it may take a while to build up to that.)

Sing loudly. If you are alone at home or in the car, spend some time singing as loudly as you can. This also activates the back of the throat and hence the vagus.

Gag. Using a tongue depressor, which you can buy on Amazon, gently press on the back of your tongue to make yourself gag. Please do not poke the back of your throat. Do this several times a day, again, ideally until your eyes tear. Gargling and singing are like sprints for the vagus nerve, whereas gagging is strength training.

Coffee enemas. Please Google instructions for doing a coffee enema or read how in Dr. Kharrazian’s book. Hold the enema solution as long as you can. That, together with compounds in coffee that stimulate nerve receptors, will help activate the vagus nerve.

This is a simple overview of how to improve gut function by activating the brain. For more customized advice, please contact my office.

You’ve probably heard it over and over: Stress raises the risk of disease. But how do you know if your stress is the disease-causing kind? It’s helpful to know some signs and about the adrenal stress test.

Severe stress can either cause you to be fatigued all the time, wired all the time, or a mix of both. Or maybe stress manifests as sleep issues.

It’s not uncommon for people to become so used to being stressed out they fail to realize it’s an issue. They have forgotten how not to feel stressed out.

Symptoms of fatigue-based stress

• Fatigue
• Slow to get going in the morning
• Energy crash in the afternoon
• Craving sweets, caffeine, or nicotine
• Unstable behavior; moodiness
• Shaky, light-headed, or irritable if meals are delayed
• Inability to stay asleep
• Dizziness when moving from sitting to standing

Symptoms of wired stress

• Excess belly fat
• Insulin resistance (high blood sugar)
• Insomnia
• Not feeling rested in the morning
• Women grow facial hair; men grow breasts
• PCOS in women (polycystic ovarian syndrome)

How to do a lab test for stress

You can do an adrenal stress test to measure how well your body deals with stress using your saliva; it’s also called an adrenal salivary panel. Your adrenal glands are two small glands that sit atop each kidney that secrete stress hormones.

To get the most from the adrenal stress test, do the test a second time after following a health protocol for four to six weeks. This shows you whether you're on the right track with your healing approach.

This is because stress in the body is always caused by more than just the stress that we perceive, for example low or high blood sugar, an infection, or autoimmune disease.

Adrenal health should improve as you manage these conditions. If things do not improve, it means you must keep searching to find out what is taxing the body.

Measuring your sleep-wake cycle

Another way to gauge stress with the adrenal stress test is to look at your sleep-wake cycle, or circadian rhythm.

Are you alert in the morning and sleepy at night? An abnormal circadian rhythm is one symptom of adrenal stress.

Your primary stress hormone, cortisol, should be high in the morning and low at night on an adrenal stress test. Many people have a backwards rhythm causing fatigue in the morning and insomnia at night. Or, instead of a gradual decline of cortisol during the day, it may drop in the afternoon, causing an energy crash.

Where are you on the adrenal stress test scale?

By measuring several markers, the adrenal stress test can tell you whether you are in:

• The “alarm reaction” of high adrenal hormones
• Adrenal exhaustion and chronic tiredness
• Somewhere in between

You do not necessarily have to progress from alarm reaction to adrenal fatigue. It’s possible to jump between phases, or stay in one phase for years.

The adrenal stress test also measures immune cells called total SIgA. This is a measure of how stress has impacted your immune system over time. If SIgA is low, it can mean you are more susceptible to food intolerances, infections, and weakened immunity.

Start with blood sugar stability to manage stress

One of the most common causes of chronic stress is a blood sugar imbalance  Addressing high or low blood sugar are vital to addressing chronic stress.

Various herbal and nutritional compounds, such as adrenal adaptogens, can profoundly influence adrenal function. Ask my office about the adrenal stress test and how you can support your adrenal health.

Restless leg syndrome is a torturous condition that causes your legs to want to jump up and run away when you want to sleep. They can also itch, burn, or have a creepy-crawly feeling.

Drugs for restless leg syndrome dull the body and brain and don’t address the underlying cause of a condition that affects 5 million adults and 1 million children. Restless leg syndrome occurs in twice as many women than men and increases the risk for chronic disease and early mortality.

Diet and lifestyle links to restless leg syndrome

The cause of restless leg syndrome is different for each person, although it comes down to a few general factors. The first thing to look at is whether brain health is supported through diet and lifestyle:

Blood sugar stability. A diet high in sugars and processed carbs sends blood sugar spiking and crashing. These extreme fluctuations degenerate and inflame the brain, contributing to all manner of brain-based problems, including restless leg syndrome.

Poor gut health. Leaky gut and too many bad gut bacteria profoundly impact brain health.

Food sensitivities. An immune reaction to a food can inflame the brain. Gluten and dairy in particular are inflammatory for many people and can cause the immune system to destroy brain tissue in a neurological autoimmune disorder.

Other metabolic factors that may contribute to restless leg syndrome include poor nutrition, hormone imbalances, autoimmune disease, poor thyroid function, neurotransmitter (brain chemical) activity, and a previous head injury.

Additionally, research shows that iron deficiency as well as magnesium or vitamin D deficiencies may be related to restless leg symptoms.

Functional neurology for restless leg syndrome

If you’ve supported your brain health and still struggle with restless leg syndrome, you may need functional neurology help.

Restless leg syndrome can be traced to the basal ganglia, an area in the brain that governs involuntary movements. For instance, basal ganglia dysfunction also causes tics, spasms, and tremors.

In order for the basal ganglia to function properly, other areas of the brain must “fire” (communicate) sufficiently with the basal ganglia so it can do its job of inhibiting involuntary and repetitive movement.

However, these other areas of the brain may not fire adequately into the basal ganglia due to various reasons, including imbalanced brain development in childhood, brain injury, brain inflammation, brain degeneration, or other glitches in brain circuitry.

In functional neurology, we examine brain function through various tests that evaluate reflexes, movement and balance, responses to stimuli, and how the eyes move — the eyes are a window into how well brain circuitry functions.

Based on these findings, we perform therapeutic exercises in the office and give you techniques to practice at home. These practices activate or dampen different areas of the brain depending on what the basal ganglia needs to function optimally. This approach helps many resolve restless leg symptoms.

This is a very general overview to a complex neurological topic, but gives you a general idea of a non-pharmaceutical way to manage restless leg syndrome. Ask my office for more information.

You may have noticed the term “functional medicine” becoming more popular. What is functional medicine and how is it different from regular medicine? Functional medicine addresses health disorders by looking at their root causes rather than masking symptoms with drugs or surgery.

By looking at root causes, you improve your energy, sleep, vitality, and even libido. This is why seeing a functional medicine doctor for a gut problem can also improve your brain function and hormone issues. Everything in the body works together.

Root causes: Address engine, not engine light

If the engine light of your car comes on, do you find a way to turn off the engine light, or do you investigate under the hood?

That analogy works for functional medicine.

Functional medicine is not about giving you a drug for a symptom, but instead investigating why you have that symptom and working on that instead.

For example, suppose 10 different people have the same complaint, whether it is depression, fatigue, digestive problems, or persistent skin rashes.

Each of those 10 people can have the same symptom, but for 10 very different reasons.

An overgrowth of gut bacteria may be causing depression in one person, while it is a gluten intolerance in another.

Fatigue can be the result of low blood sugar in one person, and autoimmune B12 anemia disease in another.

You must know why you have a health problem

Until you understand why you are suffering from a health problem, chasing after drugs or therapies can keep landing you at dead ends.

Functional medicine relies on published, peer-reviewed science to help us understand how the body works and where breakdowns occur.

Lab tests, questionnaires, in-office exams, and a discussion about your case history help the functional medicine practitioner learn where the root cause lies.

Five common functional medicine root causes

Although different people can have the same symptom for different reasons, functional medicine often finds common root causes. Some of them are:

• Food intolerances, especially to gluten and dairy
• Low blood sugar
• High blood sugar (insulin resistance, or pre-diabetes)
• Intestinal bacterial and yeast overgrowths
• Autoimmunity (when the immune system attacks and destroys body tissue)

Addressing one or all of these factors, depending on the person, can relieve not only the symptom that brought you to the office, but a number of other symptoms as well.

There are no specialties in the human body

The body is a highly complex web in which all systems and parts are related.

The body does not have specialties in the way medicine does. The digestive system — or any other system in the body — does not function independently of the rest of the body.

For instance, if autoimmune disease is destroying the thyroid gland, it’s not just the thyroid you address, but also the immune system. If the gallbladder is acting up, addressing a gluten intolerance and chronic inflammation can sometimes prevent gallbladder surgery.

Functional medicine is about reversing or stopping the progression of disease as much as possible without the use of drugs or surgery (although medication and surgery should not be avoided when needed).

It’s also about feeling as good as you should feel. For more information, please contact my office.

If you are sleepy after eating, always hungry, and can’t lose weight, you may suffer from insulin resistance, which raises your risk for diabetes. The good news is insulin resistance is often reversible through simple dietary changes.

How do you know if you have insulin resistance? See if any of these symptoms apply to you:

• Fatigue after meals
• General fatigue
• Constant hunger
• Craving for sweets not relieved by eating them
• Must have sweets after meals
• Waist girth equal to or larger than hip girth
• Frequent urination
• Increased appetite and thirst
• Difficulty losing weight
• Migrating aches and pains
• Trouble falling asleep

Why is insulin resistance dangerous?

Insulin resistance, also known as pre-diabetes, is uncomfortable, but it’s also dangerous. It is linked with Alzheimer’s disease, heart disease, chronic pain, hormone imbalances, and many other common modern maladies.

But that’s not all. Insulin resistance can also kill your libido and make you chronically tired.

If you’re a woman, insulin resistance causes testosterone to spike so you lose your hair and develop male characteristics. If you’re a man  it raises estrogen levels so you get “moobs” and cry at commercials. These are some pretty undesirable consequences for a sugar habit!

What causes insulin resistance?

The good news and the bad news is insulin resistance is caused by poor diet and lack of exercise. This is bad news because it means giving up some comforts, but it’s good news because it means radically changing your health is highly doable!

A diet high in sugars and carbohydrates—sugars, sweets, sodas, pastries, bread, pasta, rice, potatoes, corn, grains, beans, and other starchy foods —leads to high blood sugar and insulin resistance.

Because high blood sugar is dangerous to the body, the pancreas secretes insulin to lower it. Insulin escorts sugar out of the bloodstream and into the body’s cells. Excess sugar is converted into fat for storage.

When this response happens regularly every day, as it does for millions of Americans, the cells become overwhelmed from the constant bombardment of insulin. In defense, they become resistant to insulin and refuse it entry. Now you have high blood sugar and high insulin in your bloodstream, causing inflammation, throwing off hormone balance, and degenerating the brain.

This is why insulin resistance causes fatigue after meals. The insulin-resistant cells are deprived of glucose for energy, converting all that extra sugar into fat is draining, and the whole process saps brain function.

Many people have both insulin resistance and low blood sugar. This means their energy crashes not only after meals, but between meals too. Either way, stabilizing blood sugar is your key to better health and losing weight.

Reversing insulin resistance

The most important thing is to ditch the sugar and eat only as many complex carbohydrates as your body needs (it varies from person to person). Eat tons of veggies for fiber and to build good gut bacteria. Start checking your fasting blood sugar in the morning and shoot for a level between 80 and 100. Anything over 100 is too high. Also, exercise daily, with bursts of high intensity and some weight training, to sensitize your cells to insulin.

Various herbs and nutrients can help reverse insulin resistance — ask my office for a recommendation.