TheHealthyRD

A woman in her 40s came to me completely destroyed by stress. Doctor said she was fine. She was not fine. We fixed her cortisol, her gut, her nutrients, her sleep — comprehensively. She got her life back. Then she told me to write it all down. So I did. The Cortisol Fix — available for pre-order now, releasing May 15. 🧵👇

Most people trying to fix bloating start with a supplement. I start with the plate. After 25 years as a registered dietitian, here's what I've learned about enzyme-rich foods, and what the newest research says. 🧵 1. Enzymes are proteins that break food into pieces small enough to absorb. Your pancreas makes most of them, but raw and fermented foods bring their own. That head start matters when stress, aging, low stomach acid, or gut inflammation slow digestion down. 2. There are 4 families of food enzymes: 🍌 Carbs: amylase, lactase (mango, banana, raw honey, kefir) 🥝 Protein: actinidin, bromelain, papain (kiwi, pineapple, papaya, figs, ginger) 🥑 Fat: lipase (avocado, kefir, miso, aged cheese) 🥦 Antioxidant: catalase, SOD (broccoli, kale, mushrooms) 3. The biggest news is kiwi: In October 2025, the British Dietetic Association released its first evidence-based constipation guidelines, built on 75+ randomized trials. The recommendation was 2 to 3 kiwis a day for at least 4 weeks. Interestingly, it was not "eat more fiber." 4. Kiwi's enzyme, actinidin, is unusual. It stays active in stomach acid, where many plant enzymes slow down. In digestion studies, it sped up the breakdown of meat, tofu, pea protein, almonds, and quinoa. Green kiwi has the most. 5. "But doesn't stomach acid destroy food enzymes?" Some, yes. But kiwi's actinidin thrives in acid, bromelain and papain partially survive, and many enzymes do their work before they reach your stomach, during ripening, marinating, and chewing. 6. Fermented foods are the enzyme powerhouses. Their live bacteria keep making enzymes in your gut. In a Stanford trial, adults who worked up to ~6 servings of fermented foods a day for 10 weeks increased gut diversity and lowered 19 inflammatory markers. 7. Heat destroys most enzymes, so: ✅ Fresh or frozen fruit over canned ✅ Raw, unpasteurized sauerkraut from the fridge case ✅ Stir miso and raw honey in after cooking ✅ Eat the enzyme food with the meal it helps digest 8. A caution: fermented foods are high in histamine. If they cause flushing, headaches, or worse bloating, look at histamine intolerance or SIBO before pushing through. 9. And if you eat all the right foods and still bloat? The problem may not be enzymes at all. Food sensitivities, low stomach acid, and gut barrier damage are common hidden drivers. Test, not guess. The simplest habit: one raw or fermented enzyme food at every meal. Full guide with a meal-by-meal plan 👇 thehealthyrd.com/beneficial-… #GutHealth #TheHealthyRD

Holy basil might be the most underrated adaptogen for cortisol. Here’s what the research actually shows. 🧵 I’ve been drinking tulsi (holy basil) for years. I drank it almost every day during my years working as a clinical dietitian. I write about cortisol for a living, and this herb still earns a spot in my cupboard. I just updated my holy basil guide with the newest research. The key findings: 🧠 Stress: In an 8-week randomized, placebo-controlled trial, 100 stressed adults took 250 mg a day of a standardized holy basil extract. Their perceived stress dropped more than with placebo. 📉 Cortisol: Hair cortisol was markedly lower at week 8, and salivary cortisol spiked less during a lab stress test. 🌙 Sleep: Insomnia scores improved too. Fair caveat: the Fitbit data didn’t confirm it, so the benefit so far is based on how people felt. 🩸 Blood sugar: Small human trials show lower fasting and after-meal glucose. What I like most: holy basil tends to feel clarifying rather than sedating. It’s my pick for daytime stress, when I need to focus rather than wind down. ⚠️ Who should skip it: • Anyone pregnant, breastfeeding, or trying to conceive (animal studies show anti-fertility effects) • Anyone on blood thinners, diabetes meds, or thyroid meds without their provider’s OK And my usual reminder: test, not guess. If your cortisol already runs low in the afternoon, a cortisol-lowering herb isn’t automatically the answer. In the full guide: dosing from the studies, tea vs. tincture vs. capsules, how to grow your own, and the tulsi brands I actually use. 👇 thehealthyrd.com/10-best-hol… #TheHealthyRD #holybasil #tulsi #cortisol #adaptogens

Most people think the gut heals during a fast. The newest research says that’s only half the story. 🧵 In a 2024 study in Nature, MIT researchers found that gut stem cells regenerate most strongly in the 24 hours after a fast, when you start eating again. That was in mice, but it changed how I think about fasting. Your break-fast meal lands when your gut lining is primed to rebuild. So feed it like it matters: ✅ Quality protein ✅ Colorful, fiber-rich plants ✅ A healthy fat like olive oil ❌ Charred meat, ultra-processed snacks, sugary drinks There’s more new research too. A 2026 randomized trial in Nature Medicine tested a 5-day-a-month fasting-mimicking diet in adults with mild-to-moderate Crohn’s disease. About two-thirds improved. My own confession as a dietitian: fasting wasn’t my biggest lever for inflammation. MRT testing and the LEAP protocol were. And in perimenopause, I fast less often, and my fasts are shorter and gentler, because long fasts pushed my cortisol the wrong way. Fasting is a tool, not a religion. Test, don’t guess. I just rebuilt my post with 13 science-backed benefits of fasting for gut repair 👇 thehealthyrd.com/13-interest… #TheHealthyRD #GutHealth #IntermittentFasting

I stayed nearly 20 years in a job I didn't love. Not for lack of skill. Just quiet fear of the unknown. I see the same pattern with food: "I'll start Monday." "What if I'm hungry all day?" The 10 food fears I see most, and the first step for each 👇 alignwellnessai.substack.com…

PCOS has a new name: PMOS. In May 2026, polycystic ovary syndrome was officially renamed polyendocrine metabolic ovarian syndrome after a 14-year global consensus published in The Lancet. As a dietitian for 25+ years, I cheered. The old name made it sound like a cyst problem. The new one puts the real driver front and center: metabolism. Here's what most young women with PMOS are never told 🧵 1/ It's incredibly common, and rising. An estimated 8–13% of women have PMOS, and up to 70% are undiagnosed. Among girls and young women aged 10–24, cases rose about 59% worldwide from 1990 to 2021. Most of the young clients who come to me have it, even when they booked for acne, belly weight, or fatigue. 2/ The pill is a bandage, not a fix. Combined birth control pills work by stopping ovulation. That monthly bleed is a withdrawal bleed, not a true period. It can help symptoms, but it doesn't touch insulin resistance or inflammation. Many women come off it years later to find everything right where they left it. 3/ Lower-carb eating has the strongest evidence. • A 2025 meta-analysis of 7 RCTs (495 women): keto lowered weight, visceral fat, insulin resistance, LH, and testosterone, and raised SHBG. • A low-carb Mediterranean diet beat a low-fat diet for weight, testosterone, insulin, and cycle regularity. • On a low-GI diet, 95% of women had more regular cycles vs. 63% on a conventional healthy diet. 4/ Build your plate around protein and whole-food fats. ⅓ protein (30–40 g), ⅓ vegetables, a generous serving of olive oil, avocado, nuts, or ghee, and a small portion of slow carbs. In a 2025 study, high protein preserved muscle during weight loss: 1.5 kg lost vs. 4.4 kg on standard protein. 5/ Intermittent fasting? It can help, but it isn't magic. A 2026 Nature Medicine trial found a 1–7 p.m. eating window matched calorie counting for weight loss and also lowered the free androgen index and A1c. It didn't fix cycles in six months. 6/ The piece most plans miss: hidden food sensitivities. Even "healthy" foods can keep inflammation and insulin resistance stuck. In my practice, MRT testing with the LEAP protocol often works better than any generic diet. I saw it in my own CGM data. 7/ Supplements can speed things up once the foundation is in place. Myo-inositol, vitamin D, and omega-3s have the strongest evidence. I graded 15 of them in the full guide. Test, not guess. Full evidence-based PMOS diet guide 👇 thehealthyrd.com/pmos-diet/ #PMOS #PCOS #TheHealthyRD

IBS is often called “just functional.” A 2020 study suggests the gut tissue tells a different story. 🧵 Researchers took biopsies from three sites in the gut (terminal ileum, cecum, and rectum) in three groups: People with IBS People with inflammatory bowel disease (Crohn’s and ulcerative colitis) Healthy controls They measured three inflammatory signaling molecules: TNF-α, IL-6, and IL-1β. What they found: → TNF-α was HIGHER in IBS gut tissue than in both IBD and healthy controls. → Within IBS, TNF-α was highest in constipation-predominant IBS (IBS-C) and lower in diarrhea-predominant IBS (IBS-D). → IBD had a different pattern. IL-6 was the dominant inflammatory signal there. → IL-6 and IL-1β in IBS looked similar to healthy controls. What this means: IBS and IBD are not the same disease. IBD causes visible, destructive inflammation. IBS doesn’t. But “not IBD” doesn’t mean “no inflammation.” IBS appears to have its own inflammatory fingerprint, and TNF-α may play a meaningful role in how it develops. That fingerprint is easy to miss. A standard colonoscopy can look normal, and so can routine bloodwork. Then patients hear “everything looks fine” while they’re still bloated, in pain, and running to the bathroom (or not going at all). Why it matters for treatment: If low-grade inflammation is part of the picture, it’s worth asking what’s driving it: Food sensitivities and reactive foods Microbiome imbalances Gut barrier (“leaky gut”) issues Chronic stress and cortisol dysregulation Post-infectious changes Those are things you can actually work on. A few honest caveats: This was a small study, and it measured cytokines in tissue samples using staining, not blood levels. It doesn’t prove TNF-α causes IBS. But it adds to a growing body of research showing IBS is a real, biological condition, not something that’s “all in your head.” But it's not an isolated study either. There are many other showing that IBS is inflammatory. If you’ve been told your gut is fine but you don’t feel fine, your symptoms are real, and they deserve a deeper look. 📚 Mitselou A, et al. Proinflammatory cytokines in irritable bowel syndrome: a comparison with inflammatory bowel disease. Intest Res. 2020;18(1):115-120. doi.org/10.5217/ir.2019.0012… #IBS #GutHealth #Inflammation #FunctionalNutrition

Not all liver herbs are created equal. Milk thistle, artichoke, dandelion, and burdock show up in nearly every “liver cleanse” on the shelf. But when you look at what happens when they’re tested in people, the gap is huge. Here’s how they rank by human evidence: 🥇 Milk thistle: 26 randomized trials found lower liver enzymes and less fatty liver. In a 48-week trial in NASH, it reduced liver scarring in 22% of people vs. 6% on placebo. 🥈 Artichoke leaf: lowered ALT and AST across 8 trials, and it’s my go-to for sluggish bile and bloating after fatty meals. 🥉 Turmeric: lowered liver enzymes in 15 trials, but high-dose extracts with black pepper have been linked to rare liver injury. 4️⃣ Berberine: 10 trials and 811 people showed lower liver enzymes, triglycerides, and insulin resistance. Then the drop-off: Schisandra: promising animal data, but serious drug interactions Dandelion: great as food; almost no human liver research Burdock: a root vegetable first; some teas have been contaminated One I’d skip for the liver: skullcap. Supplements have been found contaminated with germander, a plant that damages the liver. Two more things nobody puts on the label: → Milk thistle tea barely works. Its active compound doesn’t dissolve well in water, so choose a standardized extract. → Many of these are in the daisy family. Ragweed allergy? Be careful. I made a one-page chart with the evidence, best forms, and cautions for each 👇 Full research: thehealthyrd.com/herbs-for-l… Test, don’t guess. #TheHealthyRD #LiverHealth

So is smiling-give everyone a big smile always and a big hug when you can ⬇️

Most “liver detoxes” get it backwards. Juice cleanses, detox teas, 3-day flushes. Here’s what actually happens when your liver detoxes. It works in three steps: 1️⃣ Break it down. Liver enzymes start taking harmful substances apart. The catch: partway through, some briefly become MORE harmful, so you need antioxidants from colorful plants. 2️⃣ Make it harmless. Your liver attaches protective molecules like glutathione. This step runs on protein. A juice cleanse starves it. 3️⃣ Remove it. Waste leaves through bile, stool, and urine. If you’re not having a daily bowel movement, some of it gets absorbed back into your body. That’s why my 14-day protocol is food-first: ➡️Protein at every meal ➡️Cruciferous veggies + broccoli sprouts daily ➡️Bitter greens for bile ➡️30+ g fiber and plenty of water ➡️Fermented foods for the gut-liver connection ➡️Sleep, sweat, and fewer chemical exposures One standout: in a 12-week trial of 291 adults, a daily broccoli sprout drink helped people clear 61% more benzene, a common air pollutant. And here’s the part most programs miss: apart from short-term tools like activated charcoal, almost all of this should become your everyday life, not a 2-week event. Test, don’t guess. Get a liver panel before and after. Full protocol 👇 thehealthyrd.com/liver-detox… #TheHealthyRD #LiverHealth #Detox

Lion’s mane mushrooms for the win yet again. I always notice that they improve my focus and clarity!