Gut-Hormone Advanced Practice Cohort

Lecture Outline:

• Clinical definition and relevance of the gut-hormone axis
• Overview of endocrine physiology, hormone rhythms, and regulatory feedback loops
• Key digestive components influencing hormone balance: microbiome, mucosa, and terrain
• Detoxification pathways and hormone metabolism via liver and gut
• Immune activation, inflammatory signaling, and hormonal disruption
• Functional and conventional diagnostic tools to assess hormone-gut imbalances
• Clinical pattern mapping for hormone dysfunction and digestive disruption
• Core nutraceutical and dietary protocols for foundational hormone support
• Lifestyle strategies for hormonal rhythm restoration and systemic regulation

Lecture Q & A Questions:

• When a patient presents with both hormone imbalance and gut symptoms, how do you determine which system needs to be prioritized first—or do you always treat both concurrently?
• What clinical patterns have you consistently seen in estrogen-dominant clients who also have constipation or sluggish detox markers? How do you sequence your approach?
• In your experience, are there any GI-MAP markers that reliably correlate with hormone-related symptoms like PMS, PCOS, or irregular cycles?
• How do you pair hormone testing like DUTCH with stool analysis to get a full picture of the gut-hormone axis? Are there any lab combinations you find especially telling?
• If β-glucuronidase is elevated but other stool markers are relatively stable, how do you interpret that in the context of hormonal symptoms? Is that a red flag or just a clue?
• How do you approach clients with signs of HPA suppression (low cortisol, fatigue, amenorrhea) who also have gut symptoms? What are your first-line strategies for these cases?
• When histamine issues or mast cell activation appear tied to estrogen fluctuations, what tools or interventions have you found most helpful in reducing symptom severity?
• If a gut-focused protocol isn’t producing hormonal shifts after 6–8 weeks, what are your clinical next steps—do you retest, pivot to endocrine-focused support, or give it more time?
• Are there any foundational interventions that consistently support both gut and hormone balance—especially in complex or non-responsive clients?
• What’s one clinical pearl or lesson you’ve learned when working with gut-hormone overlap cases that you wish you had known earlier in practice?

Lecture Outline:

• What is the thyroid and how it functions in the body
• How the thyroid influences systemic physiology and gut health
• How to perform a physical assessment of the thyroid in practice
• Signs and symptoms of thyroid dysfunction — including GI symptoms (e.g., constipation, bloating, motility issues)
• How to rule in or out thyroid dysfunction:
  • Labs: Key markers (TSH, Free T3, Free T4, Reverse T3, TPO, TG antibodies), what they mean, and how to interpret them
  • Stool testing: Relevant markers to assess (e.g., beta-glucuronidase, steatocrit, microbial balance), and what they may indicate in thyroid cases
  • Other considerations: nutrient deficiencies, basal temperature, symptom correlation
• Overview of conventional medicine management options
• Nutraceutical approaches to support thyroid hormone production, conversion, and utilization
• Nutrition strategies: foods to include, foods to remove, and key considerations for thyroid healing diets
• Lifestyle modifications that support thyroid health (sample protocols, recommended ways to implement in patient care, etc.)

Lecture Q & A Questions:

• When a patient already has a thyroid diagnosis, what’s the first system or area you address—do you begin with nutrition, immune support, gut health, or something else?
• What’s your go-to thyroid lab panel, and how often do you find it necessary to go beyond standard labs like TSH and free T4?
• What are your thoughts on practitioners who only order TSH when working up thyroid concerns—what key insights do they risk missing?
• How do you approach the use of “natural” thyroid medications like Armour or NP Thyroid—do you find them effective or potentially problematic in certain clients?
• Do you typically address nutrient deficiencies before adjusting diet—or do you tackle both simultaneously when working with thyroid clients?
• How do you support the immune system in clients with Hashimoto’s or suspected autoimmune thyroid patterns—what are your go-to interventions?
• In your experience, how commonly do gut infections or dysbiosis interfere with thyroid function or medication absorption—and how do you address it?
• What are your thoughts on using desiccated thyroid versus synthetic T4/T3 combinations—and how do you decide which route is appropriate?
• Can you explain how molecular mimicry contributes to autoimmune thyroid conditions—and what clinical patterns or exposures practitioners should be aware of?
• What’s one thyroid-related clinical lesson or mindset shift you wish more practitioners understood when approaching complex or resistant cases?

Lecture Outline:

• Clinical overview of PCOS and androgen excess: definitions, subtypes, diagnostic criteria
• Male hormonal dysfunction: testosterone deficiency, estrogen dominance, adrenal dysregulation
• Root cause contributors such as insulin resistance, inflammation, gut microbiota, stress, etc.
• GI-MAP patterns in hyperandrogenism and functional lab interpretation
• Hormonal feedback loops: SHBG, DHEA-S, testosterone, insulin, and gut-liver axis
• Nutraceutical and pharmaceutical approaches for androgen modulation
• Dietary frameworks: blood sugar regulation, anti-inflammatory and PCOS-specific protocols
• Male fertility and hormone optimization: nutrient repletion and environmental support
• Gut-focused treatment strategies for improving hormone clearance and balance
• Clinical integration strategies for dual-support protocols in couples

Lecture Q & A Questions:

• When a client presents with suspected PCOS, what are the first labs or clinical patterns you prioritize to confirm the diagnosis and root causes?
• In cases where PCOS presents without overt insulin resistance, what other root causes or drivers are typically on your radar?
• How do you determine whether to begin with blood sugar regulation, adrenal support, or gut repair when multiple imbalances are present?
• What role does microbiome diversity or dysbiosis play in PCOS in your experience—and how does that impact your protocol design?
• What’s one intervention—nutritional, supplemental, or lifestyle—that has consistently moved the needle for your PCOS clients, especially with irregular cycles or acne?
• When evaluating male clients for hormone-related issues like fatigue, low libido, or weight gain, what are the most important labs you order?
• How do you approach supporting testosterone levels naturally—what’s your clinical starting point?
• In your experience, how does gut health impact male hormone balance, and are there specific microbial or inflammatory patterns you often see?
• When low testosterone is present alongside high estrogen, how do you interpret and address that imbalance clinically?
• What’s one clinical pearl or underappreciated factor practitioners should consider when working with men experiencing hormonal decline or dysfunction?

Lecture Outline:

• Clinical definition of endometriosis and how it differs from estrogen dominance
• Disease staging systems and conventional diagnostic workups (imaging, laparoscopy)
• Core pathophysiology: estrogen signaling, chronic inflammation, mast cell activation, and immune dysfunction
• GI and microbiome contributors to endometriosis progression
• Environmental and nutritional triggers, including endocrine-disrupting chemicals and xenoestrogens
• The role of detox pathways: liver, bile, lymphatics, and methylation (COMT, MTHFR)
• Functional testing considerations: GI-MAP, DUTCH, hormone panels — when to order and how to interpret
• Overview of conventional management: hormonal suppression, IUDs, laparoscopic surgery
• Functional medicine treatment approaches: gut-liver axis healing, hormone detoxification, immune modulation
• Targeted supplement, nutrition, and lifestyle strategies for symptom relief and cycle regulation
• Special considerations: infertility, IBS/SIBO overlap, post-surgical support, and when to co-manage with OB/GYN or REI

Lecture Q & A Questions:

• When a client presents with suspected or diagnosed Endo, what are the top 2–3 root causes or system dysfunctions you immediately assess?
• If your client is already working with a gynecologist or on hormone therapy, how do you structure your integrative support so it complements—not competes with—their conventional care?
• How do you approach protocol development when multiple factors—like immune dysfunction, estrogen dominance, and gut permeability—are all at play?
• What labs beyond the GI-MAP do you find most helpful in Endo cases, particularly for mapping hormone metabolism, inflammation, or detox capacity?
• If a gut-healing or hormone-balancing protocol exacerbates Endo symptoms initially, how do you distinguish between a flare, die-off, or a wrong clinical direction?
• What’s your strategy for clients who are on hormonal IUDs, birth control pills, or GnRH agonists—can root-cause healing still be effective?
• Do you find certain microbes—like Prevotella, Candida, or Proteobacteria—consistently correlated with worse Endo symptoms or flares?
• What dietary or lifestyle changes do you prioritize first for Endo clients to help regulate inflammation and support hormone metabolism?
• What are your favorite interventions—nutraceutical, pharmaceutical, or otherwise—for reducing pain and inflammation while root-cause work is underway?
• What’s one clinical pearl or overlooked intervention that’s made a big difference in stubborn or relapsing Endometriosis cases?

Lecture Outline:

• Clinical definitions of PMS, PMDD, and luteal phase dysfunction
• Hormonal physiology across the menstrual cycle: estrogen, progesterone, LH, FSH
• Underlying drivers of cycle irregularities: stress, gut inflammation, nutrient deficiencies
• Common patterns on GI-MAP and hormone labs contributing to PMS
• Functional medicine assessment: hormone tracking, BBT, symptom journals
• Nutraceutical strategies for progesterone support and estrogen balance
• Nutrition protocols for stabilizing blood sugar and reducing inflammatory load
• Lifestyle strategies for nervous system regulation and cortisol optimization
• Pharmaceutical considerations and timing of interventions
• Building effective care plans for cycle repair and symptom relief

Lecture Q & A Questions:

• When a client presents with PMS as their primary complaint, what are the first 2–3 systems you assess to guide your clinical workup?
• Are there any GI-MAP or stool patterns you frequently see in PMS clients—and how do those results influence your protocol direction?
• How do you differentiate between PMS driven by hormone imbalance versus one rooted in inflammation, histamine, or gut dysbiosis?
• What’s your approach when PMS symptoms worsen after starting a gut or hormone protocol—how do you determine whether to pause, push through, or pivot?
• Which lab markers—whether serum, DUTCH, or functional—tend to offer the most clinically useful insight for PMS cases?
• What’s your go-to starting point for someone with severe mood symptoms around their cycle—like rage, irritability, or tearfulness?
• Do you find any consistent links between specific microbes (like Candida, Prevotella, or histamine producers) and PMS symptom flares?
• How do you support PMS clients who are also on hormonal birth control—can a gut or detox protocol still be effective?
• What are your top 2–3 interventions for immediate PMS relief while deeper root-cause work is underway?
• What’s one underutilized clinical pearl that’s made a meaningful difference in stubborn or relapsing PMS cases?

Lecture Outline:

• Clinical definitions of infertility, subfertility, and pregnancy loss
• Key hormonal contributors: progesterone, thyroid, adrenal dysfunction, insulin resistance
• Gut-immune involvement in fertility outcomes: sIgA, inflammation, microbiome patterns
• Functional lab assessment strategies: GI-MAP, hormone panels, semen analysis, thyroid, vitamin D, ferritin, homocysteine
• Root cause and immune tolerance considerations in recurrent loss
• Integrative interventions for luteal phase repair, ovulation support, and adrenal balance
• Nutrition and lifestyle protocols for PCOS, male factor infertility, and hormone stability
• Trauma-informed considerations in fertility care
• Supporting Document: Three Functional Fertility Case Studies
• Supporting Document: Optimal Fertility Lab Ranges & Clinical Insights

Lecture Q & A Questions:

• Why do you think infertility is on the rise—and are there any patterns you’re noticing clinically that are contributing to this trend?
• If you could only focus on 1–3 root areas in a couple struggling with infertility, where would you start and why?
• In your experience, is the male’s role in infertility being overlooked—and what key labs or patterns should practitioners be evaluating in male clients?
• When working with clients who have experienced premature pregnancy loss, are there any consistent clinical patterns, labs, or root causes you’ve observed?
• Do you believe GI infections or dysbiosis can play a role in infertility or pregnancy complications? If so, which organisms or patterns raise red flags for you?
• How do you approach fertility care differently in clients who also have PCOS, endometriosis, or thyroid disorders? Where does gut support fit into that picture?
• What nutrient deficiencies do you commonly see in fertility cases, and how do you prioritize replenishment—especially if absorption is impaired?
• Are there specific stool markers, such as SIgA or β-glucuronidase, that you evaluate differently in preconception clients compared to general gut clients?
• Do you modify gut protocols when a client is actively trying to conceive—and if so, what are your rules of thumb for timing and safety?
• What’s one surprising intervention—clinical or lifestyle—that’s made a measurable difference in your fertility cases that you wish more practitioners used?

Lecture Outline:

• Clinical stages of hormonal aging: perimenopause vs. menopause
• Symptom progression, timeline, and associated hormonal changes
• Gut and liver changes that impact hormone clearance in aging women
• Functional interpretation of hormone testing: DUTCH, serum, GI-MAP
• Common patterns: low estrogen/progesterone, poor detox, mitochondrial decline
• Pharmaceutical and bioidentical hormone considerations and risks/benefits
• Nutraceutical and dietary protocols to support detoxification, bone, and brain health
• Lifestyle guidance: stress response, circadian rhythm, movement, and inflammation
• Weight gain, mood changes, hot flashes—clinical pearls for symptom support
• Hormone care planning across different menopausal stages

Lecture Q & A Questions:

• What are the most common root causes you see driving difficult menopausal transitions—and how do you identify which one to prioritize first?
• How do you decide when to begin hormone replacement therapy (HRT), and what factors help you determine if a client is a good candidate?
• For practitioners who aren’t prescribing HRT, what non-hormonal strategies do you find most effective for managing symptoms like hot flashes, insomnia, and anxiety?
• What are your go-to labs when working up a perimenopausal or menopausal client—and how do you interpret them differently in this phase of life?
• How do you approach weight gain and metabolic changes that often show up during menopause—especially when diet and exercise aren’t moving the needle?
• Do you find that gut health plays a more significant role than most people expect during menopause? If so, what patterns do you look for on GI testing?
• What’s your framework for supporting clients who are in menopause but are still struggling with monthly flares of symptoms like bloating, breast tenderness, or migraines?
• How do you counsel clients who feel frustrated or hopeless during menopause—especially when they’re not seeing the symptom relief they expected?
• Are there any specific botanicals, supplements, or nutrients you lean on consistently for menopausal symptom support?
• What’s one clinical insight or perspective shift about menopause that has changed the way you practice—and that you wish more practitioners understood?