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Evidence Based

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What Are the Symptoms of an Unhealthy Gut? Signs To Look For

Written by Dr. Ruscio on January 1, 2021

Written by Dr. Ruscio on January 1, 2021 — Reviewed by Aimee Gallo

Dr. Michael Ruscio is a DC, Naturopathic Practitioner, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

Poor Gut Health Affects Your Mood, Energy, Brain, Hormones, Skin, and More

• Meet Your Microbiota|
• Symptoms of Unhealthy Gut|
• Why Is Poor Gut Health Common|
• How To Get Your Gut Health Back on Track|
• Your Gut Holds the Key|

Your gut health has a tremendous impact on your overall health. If you think that digestive symptoms are the only signs of an unhealthy gut, you are only partially right. Your gut health also affects your mood, energy, brain function, hormonal health, immune health, skin health, and much more. In fact, some people with gut problems don’t have obvious digestive issues. Instead, they struggle with symptoms and conditions that most people don’t associate with gut health.

In this article, we’ll help you explore if your health symptoms and conditions may be connected to your digestive system. Then, we’ll explain the fundamental steps you can take for a healthy gut and better overall health.

Meet Your Microbiota

Problems in the gut, and many symptoms outside the gut have their root in an unhealthy microbiota, the community of microorganisms that live in your digestive tract. Your microbiota (sometimes called a microbiome) is a complex ecosystem that science is only beginning to understand.

What we do know is that your digestive tract contains roughly a thousand different species of bacteria. We live in symbiosis with these living microorganisms, meaning it’s a win-win relationship. They help us with important bodily processes, and we provide them with food and shelter. However, when bad bacteria take over, a parasitic relationship develops. In this case, bacteria thrive, but you don’t.

Changes in the microbiota have been observed in a vast array of diseases, health conditions, and symptoms. There are a few different changes in the microbiota that can affect your health:

• Reduced diversity in the species of microorganisms
• Imbalance of good and bad bacteria
• Infection where bad bacteria take over
• Bacterial overgrowth — when normal bacteria grows where it shouldn’t

What Are the Symptoms of an Unhealthy Gut?

Unhealthy changes in your gut microbiota can have far-reaching effects on your health by causing inflammation, immune dysregulations, and poor nutrient absorption. These changes can cause a wide array of symptoms. Let’s take a closer look.

Inflammation—Signs and Symptoms

For many people, the digestive tract is the leading cause of inflammation in the body. When your gut microbiota is unbalanced, it becomes inflamed. This can cause inflammation throughout your entire body and lead to a wide variety of symptoms, including:

• Fatigue: Inflammation causes fatigue by creating imbalances in stress hormones. Sometimes called adrenal fatigue or chronic fatigue, the root cause is usually in the gut. Research shows that fatigue is extremely common in patients with IBS [1, 2], non-celiac gluten sensitivity [3], leaky gut [4], and people with gastrointestinal complaints [5].
• Depression or anxiety: When inflammation from the gut travels to the brain, it can alter your neurotransmitters, like serotonin that affect your mood. Research connects poor mental health (anger, irritability, tension, depression, and anxiety) to IBS [6, 7, 8], IBD [9], and non-celiac gluten sensitivity [10, 11].
• Brain fog: Inflammation in the brain can also cause brain fog [12, 13], characterized by slowed thinking, forgetfulness, inability to focus, and poor mental stamina [14]. Even worse, chronic brain inflammation over decades of life can lead to Alzheimer’s disease [15].
• Insomnia: Inflammation in the digestive tract can affect your body’s sleep/wake cycle and can lead to insomnia [16].
• Skin problems: Your skin health is a reflection of your gut health, and research supports this connection [17, 18, 19]. Skin issues related to gut health include acne [20], eczema [21, 22, 23], psoriasis [24, 25], and other autoimmune skin conditions.
• Female hormone imbalances: Gut inflammation can disturb the balance of female hormones [26]. Conditions associated with unbalanced hormones, such as PMS, PCOS, obesity, endometriosis, and breast cancer, are associated with imbalances in the digestive tract [27].
• Male hormone imbalances: Inflammation can also cause male hormone imbalances [28], resulting in fatigue, low libido, erectile dysfunction, muscle loss, and poor memory.
• Hypothyroid symptoms: Hypothyroid symptoms, such as fatigue, hair loss, dry skin, and weight gain, without evidence of low thyroid function on lab tests can often be linked to inflammation in the gut. Inflammation damages your body’s ability to use thyroid hormone, and this can lead to hypothyroid symptoms [29].

Immune System and Autoimmunity—Signs and Symptoms

The greatest density of immune cells in your body can be found in your small intestine [30]. Bacterial overgrowths or chronic inflammation in the small intestine can send the immune system into a constant state of hyperreactivity and immune reactions.

Research shows that those with IBS have overactive immune responses in the gut [31]. A large body of research makes a strong association between autoimmune conditions and imbalances in the gut microbiota.

Here are some of the symptoms and conditions that can occur because of immune dysregulation that starts in the gut:

• Food reactivity: Food allergies or food intolerances are often caused by immune system imbalances in the intestines [32, 33].
• Celiac disease and gluten intolerance: Both can occur because of immune dysregulation in the small intestine [34, 35].
• Histamine intolerance: Histamine symptoms like hay fever, hives, itching, and even heart palpitations are an immune response that can be triggered by poor gut health [36, 37, 38, 39, 40].
• Autoimmune thyroid disease: Hashimoto’s disease and Grave’s disease are autoimmune conditions that are closely linked to gut imbalances [41]. Treating certain gut infections has been shown to improve thyroid autoimmunity [42, 43, 44, 45, 46].
• Joint pain—Joint pain is a common symptom in patients with gut issues. Research shows a connection between rheumatoid arthritis, a painful autoimmune disease, and gut imbalances [47, 48, 49]. Gut dysbiosis may also contribute to the development of osteoarthritis [50].

Poor Nutrient Absorption—Signs and Symptoms

Your gut health affects how well you absorb nutrients [51, 52, 53]. Poor digestion and nutrient absorption, or malabsorption, can lead to a number of symptoms:

• Dry or thinning hair: This may be due to protein and fat malabsorption or iron deficiency [54, 55]
• Dry or aged skin: This may be due to fat malabsorption and micronutrient deficiency [56, 57]
• Fatigue: This is the result of general malnourishment [58, 59]

Gut Symptoms

Let’s not forget that problems in the gut can cause digestive symptoms too. Bloating, abdominal pain, excessive belching and farting, constipation, loose stools, reflux, indigestion, and heartburn are obvious signs that all is not well in your digestive tract.

Experiencing any of these digestive symptoms on an ongoing basis strongly indicates an unhealthy gut.

Why Is Poor Gut Health So Common?

People living in Westernized societies tend to have less bacterial diversity in their gut compared to those living in non-Westernized societies [60, 61].

Why are our microbiotas less diverse in more developed societies? As Westernized societies have become increasingly sterile and hygienic, we’ve become more disconnected from environmental sources of microbes — through contact with soil, animals, and nature. In contrast, a modern-day hunter-gatherer is in constant contact with all of these sources [62, 63, 64].

Our decreased bacterial exposure starts at birth, with more C-sections and less breastfeeding [65]. Antibiotic use, antibacterial products, and higher sanitation standards have provided many benefits. However, there are negative impacts on the health and diversity of our gut microbiome [66].

Finally, our Western lifestyles of fast food (poor diet), stress, prescription medications, deskbound days, and sleepless nights take their toll on our gut health [67, 68, 69, 70, 71, 72, 73, 74].

How To Get Your Gut Health Back on Track

I developed the Great-in-8 Action Plan as a system for restoring good gut health. It’s a step-by-step approach that addresses the most fundamental issues first. Here’s an overview:

The Great-in-8 Action Plan

1. Reset — Improve your diet and lifestyle.

2. Support — Support your gut with probiotics and digestive enzymes/acid.

3. Remove — Remove/reduce unwanted gut bacteria with antimicrobial herbs.

4. Rebalance — Rebalance gut bacteria after treatment with antimicrobial herbs.

5. Reintroduce — Reintroduce the foods you removed.

6. Feed — Feed the good bacteria.

7. Wean — Wean yourself off the supplements in your plan.

8. Maintenance and fun — Maintain your improvements, and enjoy your newfound health.

Anyone can get started with the Great-in-8 Action Plan at home to improve their digestive and non-digestive symptoms by improving their diet, addressing stress and lifestyle issues, and boosting beneficial bacteria through probiotic supplementation.

For some people, these first steps, described below, are enough to get gut health back on track. Those with more complex gut issues may need to take additional steps described in my book, Healthy Gut, Healthy You.

Diet Options for Better Gut Health

Sugar, alcohol, and processed foods feed bad bacteria in the gut and increase inflammation. There are several anti-inflammatory diet options that can improve your digestive health. However, the most important strategy is to focus on eating whole, unprocessed foods and to listen to your body.

There are four important principles when it comes to healthy eating:

1. Eat to control inflammation.
2. Eat to control and balance blood sugar.
3. Find your ideal intake of carbohydrates and prebiotics.
4. Identify your food allergies and intolerances. (This relates to #1.)

I often recommend the Paleo diet to patients, as it can help you address all four dietary principles.

Lifestyle Options for Better Gut Health

Poor lifestyle habits can contribute significantly to poor gut health, for example:

• Chronic stress increases cortisol and other stress hormones which contribute to poor gut health [75, 76]. Over-exercising is a form of chronic stress that has been shown to negatively impact gut health [77].
• Sleeping poorly or not getting enough sleep can also impact your gut health and lead to intestinal permeability [78].

Taking time to take care of yourself is important for your gut health. Strive for 7-8 hours of sleep per night, spend time in nature, enjoy hobbies and friendships, and move your body. Moderate exercise, such as walking and yoga are both known for their stress-busting benefits.

While medications have their place, they are often overused, for example:

• Antibiotics negatively affect your beneficial bacteria populations [79].
• NSAIDs (nonsteroidal anti-inflammatory drugs) and aspirin increase intestinal permeability [80, 81, 82].
• Long-term use of PPIs (proton pump inhibitors) create conditions that invite bacterial overgrowth [83, 84].

You might be using medication to relieve what are the symptoms of an unhealthy gut while causing further damage to your gut health. For example, NSAIDs like Ibuprofen and Aleve temporarily calm inflammation but cause leaky gut and more inflammation in the long term. If this is the case for you, work to wean yourself off while taking other steps to heal your gut.

Probiotics for Better Gut Health

Another fundamental approach for better gut health is taking high-quality probiotic supplements.

Probiotics can help improve the balance of organisms in your gut, reduce overzealous immune system activity, and reduce the inflammation which many of us suffer from. The benefits of probiotics are clearly shown in hundreds of clinical studies and include:

• Increase bacterial diversity, or health, of your gut flora [85]
• Fight bad bacteria and other harmful gut bugs [86, 87, 88]
• Promote more rapid recovery from imbalances in your microbiome [89]
• Promote a healthy immune response in your gut [90, 91, 92]
• Reduce gut inflammation [93]
• Encourage the growth of healthier microbes in your gut [94]
• Reduce leaky gut and damage to your gut lining [95, 96, 97]

Probiotic foods like kimchi, kefir, sauerkraut, and kombucha are healthy dietary choices that provide small doses of beneficial bacteria. However, for higher daily probiotic doses and therapeutic effects, probiotic supplements are the best choice.

Your Gut Holds the Key To Better Health

The health and diversity of the microorganisms in your digestive tract don’t just help with digesting food. They play a major role in your overall wellness.

Poor gut health can show up as digestive symptoms or as seemingly unrelated symptoms like fatigue, poor mood, insomnia, or brain fog. Poor gut health can also manifest as hormonal, inflammatory, or immune conditions.

There’s lots you can do to support better gut health. Start by eating a whole foods diet, getting enough sleep, managing stress, and taking probiotic supplements. If you need more help, schedule an appointment with our clinic.