Love Your Gut

Ep.86: Connecting the patterns on your functional stool test to reveal the why to your symptoms

• Heather Finley

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If you’ve ever looked at a stool test and felt completely overwhelmed by all the bacteria names, numbers, and colors, you’re not alone.

In this episode, Dr. Heather breaks down exactly what your stool test says about your symptoms, from bloating and constipation to hormone imbalance, fatigue, and skin issues. You’ll learn why stool testing goes far beyond “good vs. bad bacteria,” and how it maps out your digestion, detox pathways, immune health, and overall gut terrain.

Dr. Heather explains what it really means when markers like beta-glucuronidase, H. pylori, calprotectin, or secretory IgA are high or low, and how these patterns overlap to reveal the root cause of your symptoms.

You’ll walk away with a whole new perspective on testing and why it’s not about just "treating the test" and more about understanding what your gut is trying to tell you about how your symptoms are connected. 

In This Episode, You’ll Learn:

  • Why stool testing is about function, not just “fixing” numbers
  •  The connection between high beta-glucuronidase and estrogen or histamine symptoms
  •  How low commensal bacteria can drive leaky gut, fatigue, and skin issues
  •  Why H. pylori suppresses stomach acid and leads to low iron or reflux
  •  What low elastase means for digestion, bloating, and nutrient absorption
  •  How low secretory IgA reflects stress, burnout, and food sensitivities
  •  The link between fat malabsorption and low sodium or bile flow
  •  Why calprotectin and anti-gliadin IgA reveal deeper inflammation
  •  How to interpret patterns instead of chasing isolated markers

Don’t Miss This Sunday’s (Oct 19) Live Training! SIBO Unlocked 

You’ll leave knowing exactly why SIBO (or chronic symptoms) keep coming back, and what to do about it so you can find relief for good! Register here

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Welcome to the Love Your Gut Podcast. I'm your host, Dr. Heather Finley, registered dietitian and gut health specialist. I understand the frustration of dealing with GI issues because I've been there and I spent over two decades searching for answers for my own gut issues of constipation, bloating, and stomach pain. I've dedicated my life to understanding and solving my own gut issues. And now I'm here to guide you. On this podcast, I'll help you identify the true root causes of your discomfort. So you can finally ditch your symptoms for good. My goal is to empower you with the knowledge and tools you need so that you can love your gut and it will love you right back. So if you're ready to learn a lot, gain a deeper understanding of your gut and find lasting relief. You are in the right place. Welcome to the love your gut podcast. If you've ever done a stool test and felt totally overwhelmed by the results, or you've wondered what a stool test could tell you about your symptoms, or wondered if those numbers. Actually explain your bloating, your skin issues, or your fatigue. You are not alone, and this is the episode for you. I can't tell you how many clients come to us saying, I've done all the diets, Heather, I've done all the supplements. I've tried every doctor, I've done all the things that the influencers on Instagram are telling me to do, and I'm still symptomatic. And I, I get it because I've been there too, and I know how frustrating that is. Then when we finally run a stool test, they say something like, I wish I'd done this years ago, or, this explains so much, even if they've done one prior. The stool test that we do is a bit different than what you're gonna get from your doctor, and I have a whole episode, couple episodes back on the GI Map, so you can go back and listen to that if you're curious. This one is gonna be more focused on symptoms. That you might have and what might show up on your test, but here's the truth. Your symptoms, your bloating, your constipation, your fatigue, your skin breakouts, anxiety. They don't really tell the whole story because those same symptoms can be caused by completely different imbalances in different people, and that's why you're stuck throwing spaghetti at the wall and not getting anywhere because you don't actually know what's causing your symptoms, and that's why stool testing is one of my favorite tools. It's not just about finding the bad thing or the bacteria or the infection, it's about seeing how it all works together. How does your digestion, your detox, your liver, your immune system, your microbiome, how are they all communicating with each other and are there possible downstream effects that are happening? So you can think of it like this. Your stool test is kind of like a map. It tells us not just what is happening, but also why and how it's all connected. And then we can create a plan for how we're gonna get there. But before we dive into the markers, I wanna make something super clear. You cannot just treat a test. And I talk about that in the other episode, but that is where stool testing goes wrong, is a practitioner sees h pylori and they say, here's the protocol, here's the plan. Follow the plan. But yet they're not considering how you got that. What else has happened as a result, a stool test doesn't tell you which pills or supplements to take. It tells you where your body needs support, and I've seen this mistake over and over again. Where someone gets their test back, they freak out about high markers or red markers. They just start killing off everything. Throwing antimicrobials or probiotics at the problem. And they're not asking the question, why are these markers off? And so you still end up playing Whack-a-Mole. Your stool test is really a window into your gut function, and it shows how your systems are working together or how they aren't working together. And that's where the real healing happens is not just in chasing different lab numbers or trying to totally get rid of something, but understanding the physiology behind them. And making targeted changes to your nutrition, your lifestyle, and your supplements all together. So let's go through the main categories I look at on every stool test and how they correlate to how you're feeling day to day. So the first one is beta glucuronidase. This is a big marker for hormones, liver, and detox. And this one is a big deal and it's often missed because beta glucuronidase is an enzyme that's produced by certain bacteria in your gut, and essentially its job is to unlock. Compounds that your liver has already detoxified and packaged up for you to eliminate. So things like estrogen or other toxins, even histamine. So for all my rashy, allergic, migraine, insomnia, girlies out there, this could be a big one for you. When this enzyme is elevated, it means that your body is recycling what it's trying to get rid of. So you can think of it like your garbage disposal, just throwing the trash back into your kitchen. We don't want that. And so what happens is Escher denominate. Histamine reactions, sluggish detox, gallbladder congestion, even skin breakouts can be a part of this. So your symptoms might include PMS or heavy periods, breast tenderness, mood swings, bloating, that gets worse around your period. Headaches, migraines, irritability, any histamine symptoms like flushing, sinus congestion, or even anxiety after wine or leftovers or fermented foods. So why does this happen? It's often a combination of dysbiosis or too many bad bacteria. That are producing that enzyme. It can be from poor bile flow and it can be from poor or low fiber diversity. And so that's why it's important to not just look at the beta Gluc glucuronidase and say, oh, you need this supplement for the beta glucuronidase. We gotta look at what else does your test say? And why is this happening? Oh, well your beta glucuronidase is high. Because you have really low beneficial bacteria, probably'cause your diet is really low in fiber or you have a lot of sticky stool, possibly some bile stuff. So we really wanna look at it in the context and we see this pattern all the time in our clients who've been on hormonal birth control, who have a history of constipation or who have done. Multiple gut protocols that were way too restrictive. So some support strategies that we always like to bring on board is definitely increasing fiber, especially soluble fibers like flax or chia or cooked oats, focusing on cruciferous vegetables and phase two liver support nutrients. So things that have B six and B12 and folate and magnesium. Adding in bitters or artichoke to get the bile flowing. And then calcium deg glucarate can be helpful, but only when your body is ready. So when we address this marker properly, women will often report lighter periods, improved mood. Less bloating improvement in their cycles. We actually see this marker elevated in a lot of clients that have hypothalamic a amenorrhea. There is such a distinct pattern if you fall into that category where you have a missing period or even irregular periods as a result, and your hormones are kind of wacky, this marker might be elevated on your stool test. The next finding that we see is low commensal bacteria, which really this is the foundation of gut health. The largest study done to date on gut health shows that the wider variety of foods that you eat and the wider amount of bacteria that you have, the healthier your gut is. That's what it comes down to. And I mean, it's way more complicated than that. That makes it sound so simple. But these are your beneficial bacteria, your commensal bacteria, and these are the good guys that help to make short chain fatty acids like butyrate, which feed your gut lining. They regulate your immune system. They reduce inflammation. They help to support your gut brain access. And when these are low, it tells me that your gut terrain is really depleted. So this can show up as, I can't tolerate fiber. Every time I eat fiber, I get cramping, I get bloating. I'm in pain for days. It could be skin issues like eczema or acne. It could be fatigue or brain fog. It could be leaky gut or food sensitivities or intestinal permeability, or even mood symptoms like anxiety or depression. Then of course, gut symptoms, bloating, constipation, diarrhea, stomach aches, et cetera. And the reason for this is because your gut microbiome is the source of. So many important compounds, serotonin, butyrate, B vitamins, and even signaling molecules that help to calm inflammation. So if you feel inflamed, the key may actually be your gut bacteria. Low commensals are often the result of restriction. Low carb diets, repeated antibiotic use, chronic stress. When there's not enough food for your bacteria, they starve. So when we see something like this, we want to gradually increase diversity, colorful produce, herbs, resistant starches. We want to add polyphenol rich foods like blueberries, pomegranates, olive oil, green tea. We wanna consider spore based probiotics, which encourage the native bacteria to regrow. And then we really wanna replete minerals because these are super foundational to your gut health, and your microbes rely on them too. So rebuilding this foundation takes time, but it's what allows every other part of your digestion to improve. The next one that we see is h pylori. So this is the stomach acid, iron and energy connection point. And let's talk about it. H Pylori is a bacteria that lives in the stomach. It's incredibly common, the most common infection in the world, but it's not always a bad thing. But when it overgrows or becomes virulent, it can suppress stomach acid production. And that's the problem because stomach acid is your first line of defense. So it sterilizes food, it triggers digestive enzymes, and it allows you to absorb nutrients like iron or zinc or B12. When it's low, everything downstream suffers. And that's why you might see symptoms like reflux or burping after meals or bloating, especially after protein. Fatigue or low ferritin that doesn't respond to iron supplements, brittle nails, or hair thinning. If h pylori is present, it doesn't always mean that we jump straight to killing it. We have to rebuild the stomach environment and support minerals, use bitters, improve digestion at the top because if you don't address why it overgrew. It's gonna come back, and one of the reasons that it can come back is continued exposure, and that's very easy, especially if you're sharing saliva with somebody. The next one that we see is bacterial overgrowth in dysbiosis, which can be connected to sibo, but not always. It's not always sibo. Sometimes it's just lebo or large intestinal bacterial overgrowth. When your stool test shows high levels of certain bacteria, especially opportunistic ones, it's often a sign that your motility is sluggish or your microbial balance has shifted because maybe your upstream digestion, your stomach acid, your bile, et cetera, is not working. So these bacteria can ferment food, which produces gas and bloating, especially later in the day. So you might see this as food intolerances or alternating bowel patterns or discomfort after eating certain carbs. But here's where it gets a little bit tricky, because the same bloating could also come. From low enzymes or low bile or stress-induced slow motility. And that is why stool testing is so powerful because it helps us to see the pattern and when we see overgrowth bacteria, we really wanna restore normal motility. Supporting your minerals, gentle pro kinetics, things like ginger, sometimes five HTP, sometimes artichoke, whatever it might be. We want to support your nervous system. Your gut cannot move properly when you're stuck in fight or flight. And then we wanna gradually reintroduce balanced fibers instead of cutting them out completely because we need to crowd out the bad bacteria. And just killing things alone does not fix the terrain issues, but we have to rebuild it. Another one, which is probably the most common thing that we see is low secretory IGA. And this is the immune system of your gut. So secretory, IGA is your gut's immune coating. It's kind of like the bodyguard standing at the entrance to your gut lining. And when it's low, it means your gut. And your immune system is exhausted. So the bouncer, the bodyguard, is very understaffed, which is when you might notice getting sick more often. Frequent colds, sinus infections, especially this time of year. Food sensitivities that seem to expand over time. This is where you're like, no matter what I eat, I'm having symptoms because IGA kind of wraps food proteins in a blanket and transports it to tell your immune system, Hey, we're good. There's no need to cause a reaction. But like I said, if the bouncer at the bar is understaffed, then you're gonna have food sensitivities. You might feel really reactive to what you're eating. You might have worsening symptoms during stress. So stress is one of the biggest drivers of low IGA. Even just a week of poor sleep or emotional stress can really drop these levels, but really what we see is chronic undereating. Chronic protocols, like just killing protocols and killing SIBO and not leveraging the lifestyle pieces that matter, your circadian rhythm, the diversity of foods that you eat, having happiness and joy in your life. Even negative thought patterns can lower this IGA level. So you really have to not just rely on supplements, we wanna address stress. We want to support your mucosal layer, whether that's with immunoglobulins or lactoferrin or vitamin AA and other minerals. We want to also keep meals consistent because long fasting windows can lower this further, and when IGA rebounds, people often notice that food tolerance improves dramatically, which tells us that the gut barrier is healing. The next one is low elastase. So this is where we're looking at digestive enzymes and how your body is breaking down food. Now, low elastase means that your pancreas is not producing enough digestive enzymes to break down food, so this can lead to incomplete digestion, fermentation, and of course bloating. Which is why a lot of you I know are listening to this podcast. And some common signs can include feeling full for hours after eating, seeing undigested food in your stool, floating or oily stools, cravings for sweets or crip quick carbs.'cause your body is trying to get easy energy. So without enough enzymes, your gut bacteria will get first dibs on your food, which leads to overgrowth and inflammation downstream. So if this is something that you're experiencing, you really wanna make sure that you are really emphasizing the cephalic phase of digestion, chewing, taking your time, not being distracted while you're eating. Eating in a relaxed state. Adding digestive bitters or something to stimulate digestion. Even just eating bitter foods, maybe using enzymes, rebuilding minerals to help your body produce more enzymes. Sometimes you even need glandulars, but you definitely would wanna check with your doctor before you tried something new. So this marker is. Something that improves quickly once digestion is supported at the top. Kind of along those same lines. Another one is scr, and this is looking more at fat absorption and bile flow. Scrt measures how well you're digesting and absorbing fats, and if it's high, it means fat is showing up in your stool instead of being used for energy and hormone production. So you might have sticky stool, oily stool, peanut butter, texture, stool floating stool. Off colored stool. You might have fatigue or energy crashes. You might have low vitamin D levels. Dry skin, hair loss, brittle nails, skin issues. This is usually a bile flow problem, and this doesn't just happen in people without a gallbladder. Your body is either not releasing or recycling bile properly, and bile is really crucial because it's dishwashing detergent of your digestive tract, and not only digest fats, but also helps you to detox. Estrogen and eliminate toxins through the stool. So I hope you're realizing here, like this is all connected, right? If your scr is high and your beta glucuronidase is high, those are two big flags for estrogen detox. If your scrt is high and you also have a low vitamin D and your elastase is high, and you have h pylori. That's more of a pattern of poor digestion in the whole system kind of slowing down. We often see high steato root in people with low sodium on their mineral tests because you actually need sodium to make stomach acid in bile. So some support strategies would be supporting stomach acid, maybe using nutrients like toine or choline or artichoke, making sure your minerals are supported. Sometimes you might need bile salts or bile supports. And then of course, healthy fats like olive oil, egg yolks to help stimulate bile naturally. Next up is anti glidden, and this is an interesting one because if you've listened to. Any of my podcasts, you know, I'm not a fan of elimination diets for unnecessary reasons. So this marker tells us how your immune system is responding to gluten. And a positive result doesn't always mean celiac disease, but what it does suggest is that your immune system is reactive. And that might be because your gut lining is compromised. Maybe your IGA A is low, maybe your immune tolerance is low. So symptoms can go way beyond digestion, brain fog, joint pain, fatigue, anxiety. So instead of just cutting out gluten forever, the goal is to rebuild your immune system so it's not on high alert all the time. Now, there might be specific instances where we would recommend going and getting celiac testing, maybe. Anti Glidden is high, calprotectin is high, and or IGA is high. In that case, I'm at least ruling out Celiac antibodies to make sure that that's not something we're dealing with. And fortunately and unfortunately, we have found Celiac in several clients where. Their GI doctors just totally missed it, never tested them, and years and years had gone by and lots of damage. And I mean, thank God they know that they had it now, but wish they would've known it sooner. So when we see anti glide high, we may recommend a short term elimination of gluten if that's not gonna cause more stress. We wanna calm the immune system. We want to heal the gut lining. We want to support secretory IGA and just reduce overall inflammatory load, thinking about stress and alcohol and toxins and all the things. Next up on those same lines, which I already mentioned is calprotectin, and this is the gut inflammation marker. So calprotectin is measuring inflammation from neutrophils in the gut lining. If it's mildly elevated, it might just be from infection or dysbiosis. Maybe you have a parasite or something. If it's very high, we often think about inflammatory bowel disease or if it's coupled with that anti gladin, possible celiac or other autoimmune stuff. But either way, it's telling us your gut needs calm. Chronic inflammation can drive fatigue, poor nutrient absorption, mood changes because it affects neurotransmitter production. So the support strategies that we need here are, why is it high identifying? Is it sibo? Is it an infection? We need to soothe the gut lining. We also wanna lower stress support and really focus on things like sleep and stress reduction. So how do we bring this all together? And this is where stool testing gets really powerful. When you look at the results as a whole, you really start to see patterns. For example, I've already mentioned a few, but what if you have high beta glucuronidase? High scr? I'm really thinking about sluggish bile flow and poor estrogen detox. What if you have low elastase or pancreatic enzyme output and bacterial overgrowth? This is gonna be poor digestion leading to that fermentation. Or what if you have low secretory IGA and low commensals are beneficial bacteria, then we're really just looking at a really weakened gut barrier in immune system. And those patterns explain why your symptoms overlap and we're not just gonna slap, oh, you have low IGA take this. Oh, you have h pylori. Take this. How does it all work together? Because bloating and fatigue and hormone issues and constipation and diarrhea and all the things are not separate problems. They're connected through the same systems. So if you're listening to this and thinking, wow, this explains so much, I've never had this kind of data. And you don't know what's driving your symptoms. There's a couple options for you. Number one is I'm running a free webinar this coming Sunday on October 19th, so if you're listening to this on the day it comes out, you've got a couple days to get registered, it's totally free. This is a brand new training where I'm gonna walk you through exactly how to interpret your symptoms and why they keep coming back, and some success stories of our clients. And then opportunity to work with our team. Or if you're just ready to cut to the chase and get support, you can do that too. We will leave the link to apply to work with our team one-on-one in the show notes, and we can help you get to the root of this. If you come to the webinar on Sunday, it's completely free. You do need to register if you want to get the replay. And I'm gonna walk you through the most common root causes that are not addressed, the most common patterns. In the step-by-step framework that we use to turn really confusing symptoms into an actual plan. So I hope to see you Sunday, or I hope to see your application come through to work with our team. But either way, I hope that this has been helpful and encouraging for you, and I'll see you next week on the next episode of the Love Your Gut podcast.

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Dr. Heather Finley

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