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 Rania
Rania
October 13, 2025 at 1:02 pm

Food reintroduction and flare ups

Hi Bernadette,

Hope you are well!

I wanted to check in and get your advice on reintroducing foods. I’ve been mostly on the safe foods base since my last flare-up about a month ago, chicken, beef, rice, green beans, zucchini, and carrots, I didn’t expand as wanted to keep things steady while I do my nervous system work.

Everything was calm up until five days ago, when I felt ready to start the reintroduction and I introduced dragon fruit (7–10th October, a slice each day). That caused discomfort starting on the 9th, my lower abdominal pain initially minimal, but gradually increased. I decided to stop the dragon fruit past 10th, yet I’m still experiencing pain and discomfort, even with safe foods- is this okay for it to last this long or is it more?

The last few days I’ve been feeling more physically depleted due to the restricted foods or more like prolonged duration of eating minimally, especially as my period is coming up, I am feeling physically really exhausted and tired, hence, I’m really eager to add more variety and safe foods from the list you previously sent, however I’d love your guidance on:

1. How to safely expand my food options- ways to manage or minimize flare-ups during reintroduction (I am sticking to the three day rule- but wanted to ask this if anything else I should think of)

2. Why something like dragon fruit, or other previously tolerated foods, might trigger pain- like my gut forgot foods after so long and just wants to ache at this point or is this normal and I just need time to adjust?

3. Whether you think it’s okay to gently push through some of this discomfort or approach it differently?- Should I wait till I add in the digestive enzymes to start reintroduction or Daniel mentioned starting with DGL possibly before even the enzymes, would love your input on this.

For context:

I am hungry again, a lot more- I’ve even increased the amount of safe foods as well, I’m back to craving a lot of things too.

I’ve started Dr. Mercola bitters on the tongue on October 10th, started with a drop and now, as of today at 4 drops, keeping it for around a minute and then spitting it out ( I know you advised to start with ginger root, however, it arrived before the ginger root so thought why not try it)

I started ginger root yesterday twice, but felt the Mercola one was more bitter, whereas the ginger gave some bitterness but mostly tongue tingling, since I’m not swallowing thankfully it’s been smooth- am I eventually meant to swallow? Both have been okay and tolerable.

I also took ten drops of Iberogast in around 100ml of warm water last night, as you mentioned it could be used for rapid relief. The recommended dosage is 20 drops, but I thought I’d start slow. It didn’t really make a difference though, what does help is a hot water bottle, the pain isn’t like the one before where it’s bloating and all over, it’s more typical lower IBS abdominal cramping.

Another insight I’ve noticed the last two weeks is my stool, sorry for the TMI, but I know this matters, it’s normal, however it’s become more clay-like, so I’m guessing that’s also due to the diet?

Thank you so much for your continued guidance.

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  • Daniel

    October 14, 2025 at 2:53 am

    Hey @R-S ,

    Although gut complaints with IBS can vary from person to person, flare-ups like this can sometimes last a few days and in some cases a week or even a bit longer. If you’re ever unsure whether it’s “just” IBS or something else, it’s always best to ask the opinion of a doctor you trust, especially someone who can see you in person and assess things directly.

    Introducing new foods when you’re already having a flare can be tricky because it’s hard to know what’s causing what. For now, the best course of action is to focus first on calming the cramping before adding anything new.

    It’s interesting that the hot water bottle helps. That shows the warmth is relaxing the gut muscles, which is exactly what’s needed right now. If you feel comfortable with Iberogast and have tolerated 10 drops well, it’s generally safe to increase gradually toward the recommended 20 drops with meals or when pain is present.

    A few other gentle ways to relax the gut and hopefully ease lower abdominal pain:

    • You could try a belly massage. Use your fingertips to make slow, small circles starting at your right lower abdomen, moving up the right side, across under the ribs, and down the left side (clockwise direction). This follows the natural movement of the colon and can help gas and spasm pass.
    • Since the hot water bottle helped: warm, soft foods might be your best friend right now.

    Regarding the supplements, my earlier suggestion of DGL was mostly to protect the stomach and upper gut lining since you’ve had some gastritis. The enzymes may help more directly with cramping and food breakdown. So if the cramping is your main issue at the moment, it’s perfectly fine to start with the enzymes first and bring DGL in later once things have calmed.

    Take it slow, keep meals warm and gentle, and give your body a few days to reset before reintroducing foods again. You’re listening carefully to your body, and that’s exactly what will lead you forward.

    • Rania

      October 16, 2025 at 12:13 pm

      Hi @Daniel

      Thank you so much for your reply and the tips!

      Thankfully I am sure it’s IBS, I was just wondering if I should push through the discomfort regardless to retrain my gut out of being very sensitive and if it’s normal for my gut to react even to previously known safe foods after a prolonged period of minimal food, if it’s just become too hypersensitive like it almost forgot food and simply wants to react after deprivation or this is really just still ongoing sensitivity still and my gut needs more time to settle. I wasn’t having a flare up until I introduced a previously safe food. Guess that should tell me It’s not ready yet.

      I’ll focus on settling the gut further before introducing more food varieties and I will slowly increase the Iberogast too.

      Also, I am sorry I had no idea there were private messages here, thank you for clarifying that too about the enzymes, I’ll follow your advice on taking the full capsule then and update!

      I appreciate your support and guidance.

      Thank you!!

      • Daniel

        October 17, 2025 at 11:37 am

        Yes, what you describe is actually very common. After a longer period of limited foods, the gut can become hypersensitive and, like you described, almost like it “forgets” what a normal variety feels like. The digestive nerves and immune cells in the lining can react to reintroduced foods simply because the system has been quiet for a while. It doesn’t mean you’ve caused harm or that the food itself is suddenly bad; it’s more about retraining tolerance slowly.

        You’re absolutely right to take the hint and focus on settling things again first. It’s important to wait until the discomfort has completely passed before testing that food again. Once your gut feels calm and predictable for a few days, you can reintroduce the same food in a very small amount and build up gradually. Each small exposure helps the system relearn that food is safe.

        Increasing Iberogast a little is a good step as long as it continues to feel comfortable. Keep meals warm, simple, and well-chewed, and give your gut time to rebuild its confidence.

        • Rania

          October 22, 2025 at 11:52 am

          Thank you Daniel.

          I’ve been on the digestive bitters for about two weeks and the enzymes for one week, both going well with noticeable improvement in bloating and fullness. I’m reintroducing foods slowly and carefully, so far so good.

          Could you please share some general guidelines on:

          1. Whether it’s better to introduce DGL or selenium next, and if any tapering or transition is needed, including ideal timelines, adjustment cues, and what to prioritize next. I am a little confused on this specifically as Bernadette had recommended ideally starting with Selenium, however gave me the choice to also do DGL or Zinc Carnosine, would love guidance on how to take that decision as I would like to start with the next addition.

          2. How long I should ideally stay on the bitters, enzymes, DGL, zinc-carnosine, and selenium before reassessing. What does the next phase look like, should I eventually be on all of these together, or transition between them within a specific timeline and for how long before reassessing or stopping and if needed tapering? What cues or signs indicate it’s time to reduce, pause, or stop any of them?

          4. Dosing details and timing for each product considering Duloxetine, for example, whether to take with or away from food, and spacing from it.

          I really appreciate your help.

          Thank you for all your guidance and support!

          • Daniel

            October 23, 2025 at 12:29 am

            Hey @R-S ,

            Congratulations! It’s great to hear how much progress you’ve made. The fact that both the bitters and enzymes are going well and that bloating and fullness have improved shows your digestion is responding nicely.

            Let’s go through your questions step by step.

            1. What to add next: DGL or selenium
            Since Bernadette mentioned starting with selenium, it’s best to stay close to her plan. Selenium and DGL work in different areas:

            • Selenium mainly supports thyroid and antioxidant balance.

            • DGL mainly supports the stomach and gut lining.

            Because your digestion is now improving and you’re still on duloxetine (which can mildly stress the stomach), both could help, but in sequence, not together.

            If you feel your digestion and energy are stabilizing, it makes sense to start with selenium first for 6–8 weeks. If any stomach tenderness or irritation returns later, add DGL at that point. No tapering is needed between them, just introduce one new product every 10–14 days so you can clearly see what’s helping.

            2. How long to stay on each supplement and what to watch for
            It’s a bit hard to talk about time periods. I would always assess where possible if symptoms improve. But I’ll give you a general guide:

            • Digestive Bitters: Try 6-8 weeks and then reassess
              Signs it’s time to pause/reassess: If you feel increased warmth, burning, or reflux.
            • Digestive enzymes: try 8–12 weeks, then test a few meals without them. If you can eat a mixed meal without heaviness or bloating, you may not need them daily.
            • Zinc-carnosine: Try 6-8 weeks. If your stomach feels settled and meals no longer irritate you, you can stop without tapering.
            • DGL: Try 6–8 weeks or as needed. Usually not needed long-term once the lining has healed and meals feel comfortable.
            • Selenium: Here, I need your help a bit. Do you have a slow Thyroid? If so, try selenium 8-12 weeks and see if your thyroid markers improve

            Spacing and timing with duloxetine

            • Bitters: take just before meals (1–2 minutes).

            • Enzymes: sandwich method. I think you know what I mean!

            • Zinc-carnosine and DGL: best taken about 15–30 minutes before meals.

            • Selenium: with food (to avoid nausea).

            Keep all supplements at least two hours apart from duloxetine to avoid interference with absorption. Morning or lunchtime is often best for the supplements, with duloxetine at a consistent time of day that suits your schedule.

            4. Next phase
            If things continue to go well, the next phase is about maintenance and reconditioning. Assess by how symptoms improve, but if the time is right, you could gradually reduce support while expanding your food range and seeing how the gut performs on its own.

            For now: Continue making one small change at a time. I think you’re doing excellent!

            Daniel

            • Rania

              October 23, 2025 at 12:39 pm

              Thank you for laying things out so clearly!

              I wanted to share my most recent thyroid and selenium results as you asked:

              • TSH: 1.00 µIU/mL

              • Free T4: 1.33 ng/dL

              • Free T3: 1.70 pg/mL- I understand this is slightly below normal

              • Anti-TPO antibodies: 12.7 IU/mL

              • Anti-Thyroglobulin antibodies: 18.8 IU/mL

              • Selenium: 79.4 µg/L

              Given these results and how my digestion is currently improving and the information you shared, I’m wondering if it might make more sense to continue focusing on gut healing first, with DGL or zinc-carnosine, before introducing selenium to just make sure I at least gave my gut the proper healing it needs to be able to move onto the next phase (thyroid), I understood from Bernadette that sluggish thyroid does also affect digestion, however, I think my “gut feeling” is to continue with the gut healing, keeping in mind to introduce one at a time, would it be most suitable to begin with DGL or Zinc and are they meant to eventually be taken together? And are they okay to be taken at the same time prior to meals along with bitters? And is the Selenium and enzymes also okay to be taken mid meal together as well?

              I just want to make sure I’m sequencing things in the most supportive way.

              Thanks again for your guidance, it’s been extremely helpful!

            • Daniel

              October 24, 2025 at 12:11 am

              Hi @R-S

              You’re welcome! Thank you for sharing your thyroid and selenium results: I know you shared earlier somewhere, but it’s very helpful!

              Since your digestion is improving, it’s best to finish the “gut-healing” phase before adding anything for the thyroid. Think of it as giving your system a solid foundation before layering in the next step. It’s also worth remembering that duloxetine can influence gut function and microbiome balance. You can absolutely make progress and heal while using it, but it may mean you won’t reach textbook “perfection” in gut health (and that’s perfectly fine!). The goal is “good enough” stability rather than flawless labs or zero symptoms. Once digestion feels reliably calm, that’s the moment to introduce selenium.

              Here’s a simple way to sequence things from here:

              Step 1 – Continue bitters and enzymes
              They’re clearly working.

              Step 2 – Add either DGL or zinc-carnosine (not both at once)
              Both protect and soothe the lining but by different routes:

              • DGL coats and shields the surface mucosa. Start with this one if you still notice gut discomfort

              • Zinc-carnosine supports tissue repair a little deeper in the lining.

              You can start with DGL first (15–20 min before meals) because it’s gentle and gives quick feedback. If you still feel mild tenderness after a week or two, add zinc-carnosine. They can eventually be used together if tolerated, but introduce them at least a week apart so you can read the signals of your body.

              Timing guide

              • Bitters: 1–2 min before meals.

              • DGL: 15–20 min before meals.

              • Zinc-carnosine: with or right after meals.

              • Enzymes: sandwich method

              • Selenium (later): with food, at least 2 hours away from duloxetine.
                Use a small gap between DGL and bittes so the DGL can coat before the bitters trigger stomach acid flow.

              When to bring selenium in
              Once your stomach feels consistently calm and you’re tolerating a wider range of foods, you can start selenium

              And finally, because duloxetine can affect sleep quality, paying attention to sleep hygiene becomes extra important. Good sleep supports thyroid conversion (Free T3) and overall energy. If you notice changes in your sleep, a short sleep journal can help you spot patterns and small improvements.

              Let us know if we can help you in any other way!

              Daniel

            • Rania

              October 24, 2025 at 12:19 am

              Thank you so much for taking the time to lay everything out so clearly, this really helps me feel more confident and grounded in the process and timeline ahead.

              I’ll continue with the bitters and enzymes for now and move on to DGL, and later zinc-carnosine if needed, before bringing in selenium once my digestion feels stable.

              I’ll be taking some time now to focus fully on healing and integrating everything we’ve discussed, and will reach back out if and when I need further guidance. I truly appreciate the thoughtful support, patience, guidance and clarity I’ve received, it’s made a big difference in helping me move forward with more confidence and calm.

              All the best,

              R

  • Daniel

    October 14, 2025 at 3:02 am

    Hey @R-S,

    Quick note: I messaged you after Saturday and was checking if you’d had a chance to see it. I can’t view my private messages right now.

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