The other acronym that spells trouble for your gut.

What you feel: Gassy, bloated, plagued by diarrhea, fatigued, and just kind of out of it, so much so you find it hard to concentrate.

What you did: You assumed you had a food allergy and stopped eating gluten, sugar and dairy. Still, there are days where even a banana feels like a bomb to the gut. "That's a clue that there's something going on in your GI tract," says Robynne Chutkan, MD, a Maryland-based gastroenterologist and the author of Gutbliss.

What it might be: **SIBO (small intestinal bacterial overgrowth), which occurs when your natural intestinal flora has been disrupted and you end up with too much of the bad kind of bacteria. This interferes with your ability to digest food and absorb essential nutrients like B12, vitamin D and iron, and these deficiencies are contributing to your gut misery and your brain fog. Chutkan says that the major trigger for SIBO is antibiotics. Eating a diet high in starch and sugar or taking acid-suppressing heartburn drugs makes you more likely to get it because your system is already hospitable to the bad bugs, she says.

What to do: Antibiotics like rifaximin that target the intestines can provide short-term relief, but, Chutkan says, patients often relapse. She prefers a dietary overhaul to create a healthier microbiome, so she has patients swap the sugar and starch for lots of leafy greens, vegetables and high-fiber legumes, usually in combination with a prescription-strength probiotic.

The thyroid condition that can fly under the radar.

What you feel: Fatigued, stiff, chilly all the time, bummed-out, backed-up from your head to your bowels (you have trouble thinking clearly, using the bathroom regularly, and your period is off) and maybe a little puffy (your face or other body parts may seem a little swollen).

What you tried: Eating less, exercising more, sleeping later and longer. You've also tried boosting your immunity with echinacea and vitamin C.

What it might be: **Hashimoto's disease, (or Hashimoto's thyroiditis) which is a combination thyroid issue plus an autoimmune disease. Basically, your immune system is reacting against your thyroid gland, explains R. Mack Harrell, MD, president-elect of the American Association of Clinical Endocrinologists. Doctors don't know exactly what causes them, but autoimmune and thyroid issues often run in families, and both are more common among women. Harrell says that you may have had one since your teens, but it was such a low-grade attack that it didn't trigger any symptoms. Over time, however, the thyroid tissue has been destroyed, and that's interfering with the gland's function and production of hormones.

What to do: Your primary care physician will probably check your hormone levels and evaluate your thyroid. If your thyroid turns out to be malfunctioning and you have evidence of a hormone deficiency, you may be sent to an endocrinologist, who will prescribe thyroid hormones. But your thyroid may appear normal, or the test won't pick up on the immune part of this disorder. That's when you need a specialist to check your antibodies, as well as your vitamin D levels (Harrell says he often sees a deficiency in Hashimoto's patients, and supplements can help).

**The explanation for your discomfort could be any number of things, but this is one to bring up with your doctor, who is, of course, the person you should be talking to.


Next Story