Everyday Wellness: Midlife Hormones, Menopause, and Science for Women 35+
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Ep. 664 POTS, MCAS, and Gut Dysmotility with Dr. Zachary Spiritos | Perimenopause, Menopause, Gut Health
Today, I’m delighted to connect with Dr. Zach Spiritos. A double board-certified gastroenterologist in internal medicine with a fellowship in neurogastroenterology, he founded Ever Better Medicine, a practice built around treating complex, chronic, and often underrecognized conditions at the intersection of the gut and the nervous system. In today’s conversation, Dr. Spiritos and I speak at length about how patients get dismissed by the medical system. We explore irritable bowel syndrome as immune dysregulation and common symptoms that he sees with this diagnosis. We discuss hypermobility and the 13 subtypes of Ehlers-Danlos syndrome, with hypermobility closely linked to inflammation, MCAS, and immune dysregulation. We cover several commonly missed GI complications in hypermobile patients, including how POTS and MCAS often overlap with GI dysmotility, MALS, and how nutrition and stress influence symptoms. Dr. Spiritos also shares his views on constipation and the importance of staying curious. Stay tuned for today’s fascinating conversation with Dr. Zach Spiritos about complex medical conditions and how they intersect with the gut. IN THIS EPISODE, YOU WILL LEARN: How Dr. Spiritos recognizes when symptoms may reflect underlying physiology rather than being purely psychological Common symptoms that point toward dysautonomia, POTS, or MCAS in women How connective tissue laxity and hypermobility can contribute to gut dysfunction GI complications that may be missed when patients do not fit neatly into an IBS diagnosis How POTS fits within the broader picture of dysautonomia, hypermobility, and MCAS Meal-related patterns that may point to abnormal gastric motility associated with dysautonomia The value of using a food and symptom diary when appropriate, and treating elimination diets as trials rather than permanent restriction How fixating on bowel symptoms can create cycles of anxiety and GI distress How Dr. Spiritos approaches constipation in patients Why clinicians should remain open-minded when patients present with multiple medication sensitivities, allergies, and complex symptoms Bio: Dr. Zachary Spiritos, MD, MPH, is a neurogastroenterologist who specializes in treating patients with complex and chronic conditions, including disorders of the brain-gut interaction (DBGI), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), Ehlers-Danlos syndrome (EDS), and gastrointestinal dysmotility. He earned his medical degree and Master of Public Health (MPH) from the University of North Carolina at Chapel Hill, where he developed a passion for addressing the systemic challenges patients with underrecognized illnesses face. He completed his Internal Medicine residency at Emory University and his Gastroenterology fellowship at Duke University, where he focused on neurogastroenterology and disorders of gut-brain interaction. Dr. Spiritos is particularly dedicated to supporting patients who have been dismissed, misdiagnosed, or lost in the medical system. He takes a whole-person approach to care, combining the best of conventional medicine with targeted interventions to regulate the nervous system, improve sleep and movement patterns, address nutritional imbalances, and manage stress physiology. He works primarily with patients whose symptoms span multiple systems and don’t fit neatly into one diagnosis—individuals who require time, nuance, and interdisciplinary collaboration. Dr. Spiritos partners closely with his patients to build individualized, sustainable care plans that address both symptoms and underlying causes—helping them reclaim their health and quality of life. ** For more information about Cynthia's upcoming retreat, visit https://www.cynthiathurlow.com/ and click the Events tab. Connect with Cynthia Thurlow Cynthia’s website. Check out the Everyday Podcast on Instagram! www.instagram.com/everydaywellnesspodcast Follow on X, Instagram & LinkedIn Submit your questions to support@cynthiathurlow.com Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow. Purchase Cynthia’s book, The Menopause Gut. Cynthia’s Intermittent Fasting Transformation Book The Midlife Pause Supplement Line Connect with Dr. Zachary Spiritos On the Ever Better Medicine website Instagram
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