Gut Feelings

The science of intuition and gut communication.

By Elizabeth Sierakowski, MD

I’m Doctor Elizabeth Sierakowski, a medical doctor double boarded in family practice and integrative medicine with years of functional medicine and bioidentical hormone training and expertise as well. I am the co-owner of Essential Health and Wellness, a medical practice designed to help people feel their best and prevent disease, and provide the kind of care we all deserve with real relationships, empowerment to heal yourself, and strategic planning for your future. I practice primary care for a small group of clients so I can know them and their families well and do a large number of consult visits for the many who just want my occasional help or have a particular problem.


Let’s talk about one of my favorite topics – the gut. (I still remember learning basic gut anatomy in grade school and memorizing facts about the gallbladder when I was 8).


Did you know 90% of serotonin, the ‘happy chemical’ enhanced by antidepressants, is made in our intestines? For every signal our brain sends to our belly, our belly sends 5 or more back! What’s more, while we know cells in the brain (neurons) can ‘fire’ signal in fractions of a millisecond – we now know that so can certain cells in your intestines (enteroendocrine cells)! This triggers sensory nerve cells and calls various parts of the body to action right from our guts.


We also know that the bacteria that live in our guts are supposed to be there symbiotically, meaning it should be a give and take relationship where they get nutrients from us and give back vitamins and metabolism help like converting thyroid and vitamin D to their active forms for us. These bacteria can also send signals directly to our brains and glands and nerve cells by little messenger particles and by an energetic move called nonlocal signaling using biophotons and other methods of near-instantaneous communication.


This is what science knows so far about Gut Feelings – that they are very real, highly nuanced, and much more sophisticated than historically given credit for.

Similar to brain inflammation making learning difficult, gut inflammation makes intuiting difficult, along with disrupting our mood, making us jumpy or panicked, causing brain fog, and send inflammatory signals to all parts of the body leading to joint pains, muscle fatigue, skin rashes, and more.

But what if our gut feelings aren’t very sensitive, or feel “off?”


Similar to brain inflammation making learning difficult, gut inflammation makes intuiting difficult, along with disrupting our mood, making us jumpy or panicked, causing brain fog, and send inflammatory signals to all parts of the body leading to joint pains, muscle fatigue, skin rashes, and more. Imagine if that delicate lining of our insides so full of electric signaling, chemical reactions, and talking bacteria were to be made raw and inflamed by irritants in our environment? What if the population of bacteria in our colon moved to live in the wrong place, or were composed of too many inflammatory types and not enough supportive types?


What if we are taking in enough nutrients to survive but not enough to thrive, forcing our cells to ‘make do’ and pull resources from other parts of the body to make our signaling chemicals? These things happen every single day. Yet, much of it is within our power to change!


One of the most powerful ways we have to take care of ourselves is mindfulness and meditation. By reducing the static noise of daily life we clear the way for our body’s very sophisticated and subtle signaling pathways to work properly. In fact, the more tools I learn and the more people I help I have come to understand this is the single most critical and foundational piece to healing.


No amount of supplement, antibiotic, or food restriction will overcome an intestine inflamed by too much conflicting signal. By this, I mean that the way we live our daily lives is telling our intestines to simultaneously digest food and shunt supplies elsewhere for thinking and moving, to rest and work to repair cells while also signaling the body to be ‘on’ for this or that work project or traffic or child-corralling or chores. Do you see? Like anything, the intestines can work in a stressed environment, but they don’t do it very well especially over a long period of time.

While we can’t easily change the structure of our lives, there are a few changes that we can make easily!


  1. Eat purposefully. Practice mindfulness while you are preparing your food even if that means simply stepping a few feet back from the microwave, closing your eyes, and breathing deeply and slowly while thinking positive thoughts about the nourishment this food is about to provide you. Sit down. Take a breath (or 10). Chew your food. Appreciate the energy it is giving you. Thank your food when you are done. Remember it isn’t possible to make enzymes and stomach acid and properly digest food while also answering emails and taking phone calls. Much better to take even 5 minutes to only focus on eating!
  2. Have regular bowel movements. Sometimes this requires the help of a physician like me to help get things going, but always start with the basics: drink 2-3 quarts of water every day, move your body every day by at least walking, use a stool in the bathroom to get your knees higher than your hips (like a ‘Squatty Potty’), and aim for 35 grams of fiber every day. Extra help can come safely from vitamin C, magnesium like Natural CALM, and abdominal massage.
  3. Eat fiber. Fiber, both soluble and insoluble types, helps to feed the kind of bacteria we want to foster. It also helps bind toxins, sweep the body of cholesterol, and metabolize estrogens in a healthy way. This helps with everything from mood to heart disease risk to hot flashes!
  4. Eat mostly plants, some fermented foods, and little sugar. Sugars and starches provide energy and are not evil foods, however in excess they cause much damage including feeding yeasts which are known to communicate directly with the brain to induce panic and anxiety unless more sugar is consumed. Fermented foods like kimchi, sauerkraut and pickles (look for brands that don’t use vinegar, just saltwater ferment), goat kefir and yogurts all help to provide natural probiotics in abundant variety. Plants, meaning any vegetable and fruit, nuts and seeds, and legumes or beans if tolerated, and all manner of herbs are associated with long life, lower rates of just about every disease, and optimal health. Full of phytonutrients, fibers, prebiotics, enzymes, and more, plants must make the majority of our fuel and nutrient intake if we are to feel our best – the less processed and closer to fresh and organic the better, but a salad and fruit cup from a fast food place is still a great option. Don’t eat with guilt, it disrupts digestion. 


I don’t make general supplement recommendations because I have found that intestinal care is very much like gardening and there is no one ‘fertilizer’ that I can safely recommend for every garden. Probiotics can be helpful but it takes the right kind for the right situation and the same goes for most vitamins and concentrated herbs. Instead, I recommend food and lifestyle-based healing for everyone to do on their own and if you find those are not helping please seek advice from a trained professional. Kind of like coloring your own hair, it makes correcting the course more difficult than just getting help in the first place. Now go take a walk, think about those billions of bacteria and intestinal cells signaling on your behalf, and make a meal that feeds your body, bacteria, and soul.


In gut health and good health,


Dr. Elizabeth Sierakowski

Dr. Elizabeth Sierakowski is a physician and owner in the North Raleigh office of Essential Health and Wellness. She is trained in the trifecta of Family Medicine, Integrative medicine, and Functional medicine. Dr. Sierakowski has completed a combined Family Practice and Integrative Medicine Residency at the University of Arizona Alvernon followed by a Fellowship in Integrative Medicine through AZCiM, and is currently pursuing Fellowship in Anti-Aging, Regenerative, and Functional Medicine through A4M. She is board certified in both Family Medicine and Integrative Medicine. She carries certificates in functional endocrinology, mitochondrial health, bioidentical hormone replacement therapy, and an array of integrative modalities and specializes in the treatment and prevention of professional burnout and gut dysbiosis.

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