The Hormone Cafe

In this episode of The Hormone Café, Dr. Sarah Pederson, holistic OB-GYN at Vera Health and Fertility, breaks down why gut health is foundational to hormone balance, fertility, and overall well-being. From how often you should be pooping to advanced gut testing and treatment options, this episode explains how digestion, absorption, inflammation, and the gut microbiome directly impact your hormones and reproductive health.

At Vera, gut health is never overlooked. If your body cannot properly digest and absorb nutrients, it cannot make hormones correctly — no matter how healthy your diet may be.

In This Episode, You’ll Learn:

💩 What a “Healthy Gut” Actually Looks Like
Dr. Pederson explains what normal digestion should feel like — and what is not normal.

A healthy gut means:

• Bowel movements 1–2 times per day
• Soft, well-formed stool
• No straining
• No diarrhea
• No undigested food visible
• Consistent color and texture
• No blood (black, brown, or bright red)

You should never:

• Go a full day without pooping
• Be bloated or gassy
• Have abdominal pain related to digestion

If these symptoms are present, your gut needs to be tested.

🧠 Why Gut Health Is Critical for Hormones & Fertility

• Your gut breaks food down into:
  • Amino acids
  • Fats
  • Short-chain fatty acids from fiber
• These nutrients are the building blocks of hormones
• Poor digestion or absorption = poor hormone production
• Gut inflammation is closely linked to:
  • PCOS
  • Hashimoto’s
  • Endometriosis
  • Infertility
  • Failed IVF cycles

🧪 How to Test Your Gut

The most comprehensive tool is a stool (poop) test, which is done at home and mailed to a lab.

Gut testing evaluates:

• How well you digest food
• How well you absorb nutrients
• Gut inflammation levels
• Your gut microbiome profile
• Bacterial overgrowth
• Parasites and infections

Additional testing may include:

• Blood work for inflammatory markers
• SIBO breath testing (for severe bloating and gas)
• Food sensitivity testing (basic or advanced)

🥗 Why Elimination Diets Often Fail

Dr. Pederson explains that diets like Whole30 or randomly cutting gluten or dairy are often too broad and not actionable long-term.

Food sensitivity testing allows:

• A personalized food protocol
• Structured reintroduction phases
• Clear identification of trigger foods
• Long-term clarity around what your body tolerates

This creates empowerment — not restriction.

⚙️ Common Gut Issues Seen in Fertility Patients

🔹 Poor Digestion

• Inadequate pancreatic enzyme function
• Leads to poor hormone production
• Treated with:
  • Over-the-counter digestive enzymes
  • Prescription digestive enzymes (when needed)

🔹 Leaky Gut & Inflammation

• Can cause bloating, food sensitivities, hormone imbalance
• Often treated with targeted supplements such as:
  • IgG
  • Gut-healing protocols
  • Personalized food plans

🔹 Parasites & Infections

• Extremely common and often undiagnosed
• Can persist for years
• May require:
  • Antibiotics
  • Herbal antimicrobials
  • Multiple treatment rounds

🔹 Bacterial Overgrowth

• Examples include Enterobacter and other pathogenic bacteria
• Treatment is guided by sensitivity testing
• May include:
  • Antibiotics
  • Herbal options (berberine, oregano, uva-ursi)

🦠 Why Probiotics Are Not One-Size-Fits-All

• Many probiotics contain lactobacillus
• Some patients already have an overgrowth
• Taking the wrong probiotic can worsen symptoms

Gut testing determines:

• Which bacteria are low
• Which are overgrown
• Whether you need:
  • A probiotic
  • A prebiotic
  • Dietary fiber instead

Key beneficial bacteria discussed:

• Lactobacillus
• Bifidobacteria
• Akkermansia

🌾 The Role of Fiber & Short-Chain Fatty Acids

• Fiber feeds healthy gut bacteria
• Fiber is converted into short-chain fatty acids
• Low fiber intake leads to:
  • Low gut bacteria
  • Increased bloating and gas
  • Poor nutrient absorption

Prebiotic, fiber-rich foods include:

• Vegetables
• Beans
• Seeds
• Whole grains

📖 Patient Case Study: Healing the Gut to Restore Fertility

Dr. Pederson shares a powerful case of a patient who:

• Pooped only every 7–10 days
• Experienced vomiting from constipation
• Had:
  • Severe metabolic imbalance
  • Elevated beta-glucuronidase
  • Low short-chain fatty acids
  • A gut infection (Enterobacter)

Treatment included:

• Targeted antibiotics
• Gut-healing foods
• Fiber supplementation
• Calcium D-glucarate
• Probiotics
• Temporary dietary changes

After 3 months:

• Daily bowel movements
• Improved hormone balance
• Successful pregnancy after failed IVF
• Long-term gut health maintained postpartum

🍽️ Daily Habits That Support Gut Health

• Eat enough fiber daily
• Support digestion with:
  • Apple cider vinegar
  • Fermented foods (kimchi, sauerkraut, pickles)
• Use probiotics only when appropriate
• Focus on whole, anti-inflammatory foods
• Avoid feeding bad bacteria with:
  • Excess sugar
  • Alcohol
  • Highly processed foods

Key Takeaways:

Gut health is essential for hormone balance and fertility.
Daily bowel movements are a non-negotiable sign of health.
Bloating, gas, and constipation are not normal.
Personalized testing leads to targeted, effective treatment.
Healing the gut can dramatically improve fertility outcomes.