Naturopathic doctors know that symptoms don’t present in isolation, and that whole person health is important for every patient. A big part of how your body functions is through the organized, diverse and interactive  “gut” that takes in food and removes waste. Literally, that’s what the gut does, but there is so much more.

Naturopathic doctors are especially interested in the microbiome or the entire environment that lives and evolves and interacts throughout your body and especially in your gut. In a compelling and intricate dance, our bodies are filled with many microorganisms including viruses, fungi, and bacteria. The gut provides a home for these microorganisms or microbes, primarily in the intestines and on the skin. The way we interact with these microbes is often referred to as gut health, and it has strong implications for the health of our overall bodies and minds.

Learn more about the gut from these licensed naturopathic doctors. Dr. Gran explains more about the neurons and the microbiome.

Our digestive tracts are lined with a network of neurons

Our digestive tracts are lined with a network of neurons, called the enteric nervous system, that is so extensive it has been nicknamed, “the second brain.”  In fact, many of the neurotransmitter communication molecules that are active in the brain are also active in the gut. Eighty-five to ninety-five percent of the body’s “feel good” brain chemical, serotonin, is found in the bowel!

This may explain why many pharmaceuticals that modulate this neurotransmitter (SSRIs like Fluoxetine Hcl ) can cause digestive side effects.  Research is consistently pointing to the immense influence that gut health has on our emotional wellbeing. And visa versa.  Those “gut-wrenching feelings” and “stomach butterflies” are common expressions for biological interactions at work. Our GI tract is sensitive to emotion, and our emotions, in turn, can trigger symptoms in the gut. Disturbed-gut-microbiome has been studied as an independent risk factor for anxiety. The bacteria that reside in our digestive tract also play a major role in our hormone synthesis and our body’s immune response.  

Understanding the gut-brain connection enables new approaches to the treatment of both GI and mood disorders by getting to the true root cause of a patient’s complaint.

Danielle E. Gran, ND


Danielle E. Gran, ND is an integrative doctor and healthy aging expert specializing in hormone restoration therapy and regenerative medicine in Los Angeles, California.


But how do naturopathic doctors know how to treat gut health? More than a simple plan to eat a healthy diet, NDs use science and detailed patient interviews to help navigate the gut-brain connection. Dr. Saunders helps us to navigate the gut-brain axis.

(Learn more about the advanced nutrition training naturopathic doctors receive in our FAQ series online.)

Navigating the gut-brain axis

We know that the gut-brain axis is a bi-directional pathway using hormones and neurotransmitters to communicate between our central nervous system (brain) and our enteric nervous system (gut). For example, we know that stress and sleep have an effect on mood and mood disorders. The same is true for how stress and lack of sleep can affect dysfunction of every gastrointestinal organ, which can result in conditions ranging from IBS, upset stomach, constipation, hemorrhoids and more.

In addition to the shared hormones and neurotransmitters that moderate this communication between our gut and brain, we have a third player in the mix, our microbiota, which has led some to call it the microbiota-gut-brain axis. This expanded axis gives rise to the notion that bacterial residents may also play a role in neurological and neuropsychiatric disease, as well as gastrointestinal dysfunction. Although further research is critical to better understanding, literature exists to support a relationship between the microbiota and challenges as diverse as autism, drug addiction, Parkinson’s, depression, ALS, Alzheimer’s, stroke and IBS, to name just a few.

“All Disease Begins in The Gut.”


Hippocrates

Microbes in our gut can synthesize numerous neurotransmitters including GABA, melatonin, serotonin, and acetylcholine. These neurotransmitters can act locally on things like intestinal motility or they can be absorbed systemically and communicate with the brain and the immune system. Everyone knows that serotonin is made in our brain, but it’s less well known that an estimated 90% of it is synthesized by specific microbial species in our gut. This highlights the importance of species diversity in each individual and suggests that certain microbes may influence the expression of disease.

Dee Saunders, ND, MS

Dee Saunders, ND, MS, is the associate dean of residency and the chair of graduate medical education at the National University of Natural Medicine (NUNM). She is a board certified naturopathic physician and medical researcher whose research includes a study exploring the relationship between small intestine bacterial overgrowth and intestinal permeability, food hypersensitivity and autoimmunity. She teaches neurology and mental health and is the course director for gastroenterology at NUNM. Dr. Saunders works with patients, students and residents as an attending physician in the NUNM Health Centers and a clinical assistant professor at Oregon Health and Science University.


Understanding how the gut-brain connection works, and how your GI tract can impact your overall health is the first step. The next is learning to take care of your gut. Check out these tips from Dr. Biller.

Tips for a healthy gut

As a naturopathic doctor, I emphasize that healthy gut flora is critical to overall health and wellbeing. Every day, each meal is an opportunity to use #foodasmedicine and to stimulate optimal gastrointestinal health through the following behavior interventions:

  • Mindful eating by developing healthy eating environments, knowing your body’s hunger signals, consciously chewing your food, and enjoying meals in the community or with family around the kitchen/dining table.
  • Eat organic when possible or use the Environmental Working Group (EWG) guidelines for the ‘Clean Fifteen’ and the ‘Dirty Dozen’.
  • Eat seasonally, most fresh seasonal fruits and vegetables retain more nutrients than canned, long distance shipped hothouse, or frozen fruits and vegetables.
  • Fiber is your friend, fiber is what helps our body make and maintain good bacteria. Your gut bacteria, in turn, affects your body’s overall health.
  • Use antibiotics only when necessary as antibiotics ‘kill’ both good and bad bacteria in the gut.
  • Use a mantra before each meal, “I eat to nourish, energize and heal my body!” Personalize it and make it your own.

As always, consult a local licensed naturopathic doctor when making any changes to your diet, behaviors, or lifestyle.

Erin Rhae Biller, ND

Using a multitude of tools, Dr. Biller assists with a wide spectrum of health issues using the body’s own healing potential and natural effective treatments. She is the first naturopathic doctor in the Academy of Integrative Health and Medicine (AIHM) fellowship program. She practices in California, Arizona, and telehealth globally through video conferencing.


There also any number of at-home remedies that naturopathic doctors recommend, from ginger teas to hot water bottles to the castor oil pack. Dr. Frodermann, below, describes this soothing and anti-inflammatory treatment.

Recall the castor oil pack

For all distresses of the belly – from heartburn to constipation, from IBS to IBD, and for simple complaints of bloating to PMS-related GI disturbances – my most commonly prescribed naturopathic remedy is the abdominal castor oil pack. A ten to 60-minute application of a flannel soaked with high-quality castor oil placed over the whole of the abdomen, topped with a mild heat source like a warm water-filled hot water bottle, this treatment is the ultimate de-stressor and purifier.  Many folks hold tensions from their life in the solar plexus area. For others, weak digestion, food reactions, or improper elimination block the path toward healing and increased vitality.

Using the Castor Oil Pack daily, or on alternate days, gently changes compromised patterns held in the gastrointestinal organs. While engaging in this deeply healing therapy, I encourage an unoccupied mind while reclining and practicing belly-breathing techniques, mindful meditation, or listening to calming music with eyes closed. These are my preferred complementary techniques I recommend my patients to practice while ‘packing’.

My only restrictions while using the pack are: avoid all work-related tasks, stressful conversations, screening or drama TV. As the GALT (Gut Associated Lymphatic Tissue) houses around 70% of the body’s lymph tissue, and together with the spleen and liver, these organs are critical to health.  They are tasked to cleanse blood and lymph, integrate nutrients, and eliminate waste, in which the castor oil pack is known to assist. Thus, reclining with the castor oil pack is my most preferred gentle, yet deeply holistic rejuvenating therapy. While initially resistant to using the pack, clients are invariably amazed at how this simple therapy has improved their health and well-being.

Sheila M. Frodermann, MS, ND, DHANP, CCH

Dr. Sheila M. Frodermann is a licensed naturopathic physician, a board-certified classical homeopath, and a certified Bowenwork practitioner. She is the co-founder and director of
Providence Wholistic Healthcare, the oldest naturopathic medical clinic in Rhode Island, where she holds her private practice. She continues to serve on the board of Rhode Island Association of Naturopathic Physicians (RIANP) after dedicating ten years in executive board positions while fighting for licensure of naturopathic doctors, which was achieved in 2017.