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Endoscopy/ Colonoscopy
Hi Bernadette,
I wanted to update you since our last discussion, thankfully there has been improvement in my abdominal discomfort however also not stable nor constant, I’ve started doing osteopathy this week (structural, visceral and craniosacral), and I’ve noticed a massive difference in terms of calming my abdominal issues and overall wellbeing too- I even started feeling hunger again- haven’t had that in a while. The difficulty with swallowing has also slightly improved since starting osteopathy. That said, the discomfort is still there and I’m mainly still sticking to chicken, beef, zucchini, and carrots to avoid any aggravation and even with that- I did try to have an olive which was okay- and a tbsp of rice and felt horrible although never had an issue from it- or maybe I did, there is still obvious discomfort in the difficulty swallowing symptom, with or without food but definitely worst when eating- abdominal discomfort is there but not as intense as it was, and the continuous weight loss that is still ongoing. No attacks or flare up’s that haven’t been manageable or pass fast- while also continuing 4-5 hours spacing between meals. Even my palpitations upon rising have also improved.
I also decided to visit the gastroenterologist again to further check for any possible structural issues. He recommended doing an endoscopy and colonoscopy to rule out anything serious inside or even just to get a further understanding of what’s going on inside, like ulcers, gastritis, celiac, microscopic colitis, polyps, or anything structural and if those look clear, then I can focus fully on the issue being functional.
Ideally, I would like to do the procedure just to kill any doubt and have peace of mind, however I’m hesitant, partly because of the possible side effects, and partly because I worry about interrupting my abdomen even with something that seems minimal. I have also postponed the SIBO breath test till I decide on doing it or not but still doing the baking soda for now.
I would really value your advice:
Do you think I should move forward with the endoscopy/colonoscopy?
What are the pros and cons from your perspective?
Do you think I’m likely to struggle with side effects afterwards, or is it generally safe to just go ahead so I can have that reassurance?
Thank you
R
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This discussion was modified 3 weeks, 4 days ago by
Bernadette_Abraham.
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This discussion was modified 3 weeks, 4 days ago by
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23 Replies
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Hi @R-S – I’m glad to hear that you’re starting to feel some relief, and that osteopathy is helping.
The decision to pursue additional medical testing is something only you can decide, but I’ll lay out a few things to consider to hopefully help you decide what the next step should be:
1. Ask yourself what’s the goal of this test? If having definitive answers and ruling out serious medical conditions would bring you peace of mind and help guide the next steps, that’s an argument in favor of doing the procedure.
2. Does that goal warrant the risks? These procedures are routinely done but there are always risks. Short-term risks include sedation effects (grogginess, nausea), some mild abdominal bloating, or very rarely bleeding/perforation. Most people recover quickly and resume normal activities within a day. I suggest you speak with your gastro doc to explain how exactly they minimize risks (type of sedation, prep, recovery, their complication rates, etc). This will help you assess the risks vs benefits.
3. Given that you’re starting to feel better with osteopathy treatments and dietary changes, you could also continue with your current approach for a set time (say, another 4 to 6 weeks) and only proceed with the procedures if your symptoms plateau or worsen. Alternatively, you could also do the procedures now to rule things out while symptoms are active, which will sometimes give clearer findings. What does your gut feeling say?
4. When I’m trying to make a tough decision, I always write down pros and cons on a piece of paper including my fears/concerns. I then sit with it for a few days, until I’m comfortable with my decision.
5. I would also ask your osteopath and homeopath for their opinions and perspectives since they are both treating you and know your health history.
I hope this provides you with some direction to help you come to a comfortable decision. We’re here to support you either way.
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Firstly, thank you for always laying things out in such a way that allows a person to feel less overwhelmed.
The truth is I just want answers and relief, and I feel after extensive research over the past few months, including the excellent information and programs from B Better, in my humble opinion, things that relate to me and what I feel is happening with me are functional in nature. Again, these are just my assumptions. I believe the root cause is my prolonged use of medications combined with withdrawal stress, which amplifies all symptoms and drives the imbalance.
The chronic stress of withdrawal and the possible food poisoning triggered this cascade. I could be wrong with the following but here it goes:
• Low stomach acid (hypochlorhydria) → delayed digestion, belching, nausea, discomfort after meals
• IBS-like gut sensitivity → bloating, abdominal discomfort, hypersensitivity to food
• Gut dysbiosis / SIBO → bacterial balance contributing to gas, burping, and digestive discomfort
• Histamine / mast cell activation → dizziness, itching, heightened sensory sensitivity (especially smells), food reactions
• Digestive enzyme insufficiency → impaired protein/fat breakdown, post-meal discomfort
• Delayed gastric emptying / motility issues → immediate burping and fullness with and without meals
• Autonomic / neurological involvement → lightheadedness, heightened stress response, low BP
• Stress-related fluctuations → symptom intensity worsening the gut-brain dysfunction
Based on labs and imaging there is no evidence of urgent structural or systemic disease. That said, I am considering an endoscopy and colonoscopy purely for peace of mind, to confirm nothing serious is being missed and to remove lingering uncertainty. This would allow me to focus fully on the functional approach.
My baking soda results:
• Sept 17: belch at 3 min
• Sept 18: small belch at 3 min, big one at 4 min
• Sept 19: with 200 ml water → belched within seconds, then again a few seconds later, then nothing (I will continue another two days)
Given that I’ve been following this dietary plan for a couple of months now (increasingly strict over time), I feel ready to start targeting the root cause of things. I would greatly appreciate your guidance on:
• A treatment plan addressing these issues, which should be prioritized first? For example, should I begin with supporting low stomach acid (HCL) or wait until other aspects are addressed?
• Interventions for symptom relief, I have Iberogast on the way but it may take weeks to arrive. In the meantime, I’m considering Dr Mercola digestive bitters, would this be appropriate?
Alongside this, I am also working on nervous system regulation strategies to support the gut-brain connection.
Thank you for your continued support and expertise. I just need help kickstarting a treatment plan to shift things in the right direction.
All the best,
R
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@R-S I’m really impressed with your level of knowledge and the connections you’re making. They’re spot on.
As I’ve discussed in the Gut Health Masterclass, since you are struggling with digestive-related issues, it’s important to remember the North to South function, beginning in the brain.
This is why, in my very first reply to your very first post, I shared what the priorities need to be: 1) nervous system regulation and 2) gut healing because of the acute state you were in.
It seems that things have settled a bit for you, so you can proceed “South” while continuing your nervous system/vagal tone work and layer in support for the 3 major digestive players; stomach acid, bile & enzymes.
How far along did you get in the SIBO/IBS Relief program?
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Thank you so much, I am trying to connect all the dots. I’ve been following your advice and focusing on nervous system regulation alongside gentle dietary support.
I wanted to give you an update: I’ve recently completed further testing, including a CT scan and the labs I shared (blood sugar, lipids, liver enzymes, insulin, thyroid, etc.)- along with the previous results I have shared in other chat threads.
The current confusion is are these results enough? As momentarily this is honestly all I am able to do or access in testing.
I am a bit confused with the low fasting insulin result as well- HOMA score wasn’t able to be calculated due to it- not sure how to address this. I am following up with the internist today to get further information on her perspective, however, yours is my priority 😁
Regarding going south to start treatment – should I focus first on supporting stomach acid first then enzymes and bile, or is there another approach you recommend? I am overwhelmed with where and what and how to begin.
Not sure if I should follow the Betaine HCL or ACV for example? I would appreciate some guidance on how to safely start treatment without triggering further dysregulation.
I want to make sure I am taking the right actions and addressing the root cause effectively and also start consuming food beyond chicken/beef-carrots and zucchini 😂
Thank you so much for your continued support.
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Small update, I just finished my appointment with the internist- unfortunately the radiologist had informed the doctor that there seems to be an infection in the ileum- so I will be moving forward with the endoscopy and colonoscopy to further investigate and check what’s going on- I was told that it is a bacterial infection possibly? Will update after this but would love your feedback on the above results please as I’m sure that all are connected definitely.
Thank you so much
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@R-S – ok, we’re starting to get some answers. What stood out from the lab results you just shared is the clinically low Free T3. Your TSH and Free T4 are optimal, but the conversion to free T3 is sluggish. We have a saying in Functional Medicine… “sluggish thyroid, sluggish everything”, and in your case, this will definitely contribute to sluggish stomach acid, sluggish digestive system, sluggish motility, etc.
Therefore, addressing poor thyroid conversion will help address one of the likely root cause(s) for sluggish stomach acid production, and the downstream consequences.
I’m not sure if you’ve explored our Thyroid Balance course yet, but I encourage you to watch these lessons to understand what can cause low T3 levels and how to correct it:
- Reasons for Low T3
- Reasons for Low Free T4/T3
- Foods for a Healthy Thyroid
- Supplements for a Healthy Thyroid
You could also speak to an endocrinologist about starting T3 medication temporarily to help stabilize overall metabolic function. Most will want to prescribe T4, but with poor conversion to T3, that might not be sufficient to bring free T3 levels up to optimal levels. This is something to discuss with your doc, but I’m mentioning it so you can advocate for yourself.
In terms of addressing N to S dysfunctions, yes beginning North and the moving down is a wise strategy. So brain work is #1. Stomach acid support would be next given that the symptom questionnaires pointed to this being a need. If H Pylori overgrowth has been ruled out and there is no ulcer or gastritis, then HCL Betaine can be taken mid-meal. The dose is usually determined with this challenge.
Supporting the nervous system, T4 to T3 conversion and stomach acid is a strong gameplan to hopefully stop the revolving door of SIBO challenges.
With good signals from the brain to produce digestive juices, and good thyroid function to support metabolism & digestion, and good strong stomach acid to trigger the release of bile & enzymes, there should be a positive momentum forward. Remember, bile is antimicrobial and can help cleanse the gut bugs that don’t belong in the small intestine. And if that’s not enough, then digestive bitters or bile, and/or digestive enzymes can also be added in as additional support to the 3 main digestive players “GPS” (stomach, gallballder/bile, pancreas). But one step at a time, and one new addition at a time always!
Hope that makes sense?
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I wanted to update you that I’ve completed the endoscopy and colonoscopy today. Thankfully, everything is clear, and H. pylori, ulcers, celiac, and gastritis have been ruled out. There was a minor upper GI polyp that has been removed and sent for testing.
I’ve watched the Thyroid Balance videos, very informative, however I’m still unsure which supplementation to begin or choose given my digestive sensitivities and how to choose what would suit me personally. Ideally, I would love to support this through food, but as my digestion isn’t in its best state, I’d really appreciate your guidance on safely personalizing supplementation for both thyroid support and digestion.
On my current ordering list, I have Dr. Mercola digestive bitters and Betaine HCL and would love feedback on thyroid supplement to order. Is it safe to start both digestive and thyroid work simultaneously, and since the ideal advice from you is to start one thing at a time- which should come first? Also, if you think medication would be better to begin with, how does one decide that? Is it personal preference or best for a starting point?
And final question regarding the digestive bitters, given my low FODMAP and histamine diet, is it more suitable to choose a single bitter instead?
Really looking forward to hopefully seeing some improvement in digestion soon and make sure I’m taking the right steps to do so.
Thank you so much!
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@R-S glad to hear that major issues have been ruled out!
Since H Pylori, gastritis and ulcers have been ruled out, then in general HCL betaine can be safely used and can be very supportive for overall digestion.
To answer your question of which to begin first – HCL, bitters or thyroid support, I’d say there’s a tie between HCL and thyroid support because both fuel each other. We need good strong stomach acid to absorb the nutrients needed for thyroid conversion, and we need optimal thyroid function to support overall digestion. So it’s absolutely OK to start both at the same time but just spaced out to give the body a chance to adjust.
And the decision to start thyroid medication vs. supplement vs. food support is one to be discussed with the doctor. Medication will obviously provide the quickest stability, while food and supplements will require more time.
And yes, given your very sensitive nature right now, using 1 bitter instead of a combo formula would be a wise approach as well.
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I have been reading and it seems the majority of research has shown that taking thyroid medication does have a high tendency to increase anxiety so I would rather avoid going down that route given my circumstances- I am currently looking at ordering and following this plan and would love your feedback if this is the safest (low and slow approach) to follow:
1. Starting with NOW Betaine HCL for a few days to test that and it’s affect.
2. Gentian root as a bitter- I found Frontier Co-op have it in cut and sifted form so do I make it into a tea? Consume as a bitter prior to meals? I have been reading that it is safe regarding histamine and FODMAP- please let me know if you recommend any others and if my research is wrong regarding bitters and if I should pause the bitters as a starting point, not sure which one would be the gentlest.
3. Following the above plan for a few days then introducing Thorne Selenium- could that be the safest starting point for thyroid supplementation with least possible side effects?
Thank you for your continued guidance.
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Following my previous message, I have just received the results from biopsy and seemingly there is mild chronic gastritis and non specific inflammation (according to the report) doctor said it was not visible in endoscopy as everything looked clear, however now again not sure how to go on about this- obviously the doctor wants to prescribe an antibiotic which I am against- he said to take Rifaximin- now I am a little confused again, do I still continue with Betaine HCL or change the course of action?
Thank you!
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Hi Bernadette, hope you are well!
I wanted to follow up on the above for some guidance please, I am feeling a little stuck about the next step to take given the above results. I had a follow up with the gastroenterologist and he mentioned that an antibiotic is not necessary (unless I want to) since the gastritis was not visible in the endoscopy at all and that the biopsy shows mild inflammation?
I would really appreciate your advice on what you recommend doing next.
Thank you
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Hi @R-S – sorry for not replying to your earlier message. I didn’t receive a notification or somehow missed it.
Since the biopsy report did detect mild gastritis, this means the gastric lining has some mild inflammation which could become aggravated with HCL betaine. So it’s best to start with a gentler option such as digestive bitters before meals to help stimulate digestive secretions without irritating the gastric lining. And definitely continue with gut healing foods to continue supporting that irritated tissue and calm the inflammation.
For a more therapeutic effect, a bitter tincture will be stronger than brewing it as a tea. And yes, it’s to be taken before meals (5-10 mins) to help stimulate digestive secretions.
With regards to thyroid support, is there a reason you’re only focusing on selenium as a starting point as opposed to a thyroid nutrient combo formula? Have you measured selenium? Remember, we need zinc, iron, vitamin A, and selenium for proper thyroid conversion. It’s always best to know your levels if you can get these checked so you can know what exactly type of support you need.
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The various bitter blends seem a bit risky for me, and unfortunately the Dr Mercola is currently out of stock for another few weeks as that’s what I had access to, would it be safe to start with for example, chewing some ginger prior to meals as a digestive stimulant- as I went through the handout ginger and gentian root stood out as low histamine, IBS and gastritis friendly?
I did find other brands with lots of blends such as Swedish bitters, Nature’s answer- Bitters & Ginger, WishGarden Badass bitters, also found a blend by Nature’s Answer- Liver support herbal blend, I have no access to gentian root as a tincture, or anything but bitter melon or ginger root tincture, I just want to be safe in what I take so I don’t aggravate my stomach lining further given everything, low histamine, IBS, mild gastritis and what not- so the whole bitter situation has been confusing in choosing one and with limited options.
Regarding the Selenium, absolutely no reason but random selection, again for the same reasons as above, wasn’t sure how to choose a thyroid combo formula given everything.
Do you think it’s still worth testing selenium and vitamin A, or can I proceed with supplementation if you could please guide me towards a formula that is suitable for me?
My results:
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Iron, serum: 73 µg/dL (normal 33–102)
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Zinc, serum: 100.8 µg/dL (normal 70–120)
Thank you
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@R-S – yes ginger can be used as a gentle digestive stimulant. Also a little can go a long way with digestive bitters. Just a few drops on the tongue can help trigger the brain to release bile and other digestive secretions. I like Sweetish Bitters and Quicksilver’s Dr. Shade’s Bitters No.9.
Green tea is also considered a bitter. And in small quantities, 99% dark chocolate or coffee can also be used. Again, just enough is needed on the tongue to signal the brain.
As for thyroid support combo formulas, I discuss a few different options here. And yes, whenever supplementing with nutrients, it’s always good to know baseline levels.
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Ooo I get it now- okay will just do ginger for now, and later add Dr Mercola once it’s back in stock for further support as I don’t have access to the other two you mentioned either.
Regarding the thyroid, I did watch the supplement recommendations video, however as some are either inaccessible or unsuitable- the blends and formulas I do have access to, may have ashwaghanda, or ginseng and forkolin which may overstimulate, that’s why I also got further confused on how to choose the safest one- so I ended up choosing just one thing such as Selenium but now I understand all are needed.
I guess best to test Selenium and Vitamin A and then get back to you for a recommendation?
Thank you
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@R-S – given that you have limited options where you live, feel free to share what you do have access to and we can share the benefits/risks to help you make an informed choice.
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I really appreciate that!
From the supplements recommended in the video, the following are the ones I have access to:
Maine Coast Sea Seasonings Organic Kelp Granules – iodine
Thorne Selenomethionine – Selenium
Designs for Health Thyroid Synergy
Allergy Research Group Thyroid Glandular
Metagenics UltraFlora Intensive Care
Thank you!
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Hi @R-S – ok let’s break down each one of those to help you make the best choice:
Maine Coast Sea Seasonings Organic Kelp Granules: this is a great food-based addition if T4 is suboptimal since it provides plenty of iodine. If someone has thyroid antibodies though, it’s best to start with selenium for 2 weeks first before adding in iodine-rich sources.
Thorne Selenomethionine: this is a great addition when someone needs help with T4 to T3 conversion. It’s also an antioxidant and can protect the gland from oxidative stress. And for those with autoimmune thyroid, it’s also helpful at supporting immune balance. But since it’s a single nutrient, it’s always best to test first to know one’s baseline levels before supplementing.
Designs for Health Thyroid Synergy: this is a combo formula that supports both T4 production (thanks to iodine and tyrosine) and T4 to T3 conversion (has all the main nutrient cofactors needed to do that). The addition of the adaptogen herb American ginseng helps balance a stressed nervous system, and forskolin directly helps promote better thyroid hormone production and boosts metabolism. It’s a great combo that “covers all the bases” with reasonable dosages of each.
Allergy Research Group Thyroid Glandular: a glandular is essentially thyroid tissue taken from a cow. This is best used when someone’s thyroid function is extremely depleted, as it’s said to mimic the body’s own thyroid tissue.
Metagenics UltraFlora Intensive Care: this is a great probiotic to help modulate and calm an overactive immune system such as in cases of autoimmune activation.
Hope this helps you narrow it down a bit better.
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Thank you for the clear explanation.
Based on my results of low FT3 that means my body is not converting enough T4 to T3.
Antibodies: 18.80 IU/ml, FT3: 2.61 pmol/L, FT4: 17.11 pmol/L, TSH: 1 mIU/L
It seems the right next step would be supplementing with Selenium, but only after testing first.
I will do the test and update with results to get further clarification that it is still the right choice.
Thank you so much
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@R-S glad that was helpful. Sounds good!
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Good morning,
My Selenium results are back- although they look clinically sufficient- I am wondering if these are suitable from a functional perspective and if I should go ahead with supplementing Selenium for thyroid support?
Thank you!
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Hi @R-S – we like to see minerals such as selenium in the upper half or upper 2/3rds of the reference range, so it is suboptimal. To calculate that, you add the lower and upper reference range numbers and divide it by 2 to get the half (50+120 = 170 divided by 2). Ideally should be higher than 85. Yours is 79.
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Great so I will order Thorne Selenium 200mcg. Love the explanation, that’s amazing information to understand, will definitely keep that in mind for minerals.
Thank you so much 🙏
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