GLP-1 Medications and Your Gut: Benefits, Side Effects, and What Actually Supports You

Half a million Australians are now taking a GLP-1 medication, and the evidence on benefit keeps growing: weight loss, blood sugar control, cardiovascular protection, and emerging research into chronic disease and mental health outcomes. But somewhere between 40% and 70% of people experience a gastrointestinal side effect, and almost nobody's talking about what's actually happening to the gut, the microbiome, and muscle and bone density while you're on one.

In this episode, Karly unpacks what the research actually shows: the direct, mechanistic relationship between GLP-1s, gut motility and the microbiome; why muscle and bone density deserve far more attention, especially for perimenopausal and menopausal women; and why this is exactly the kind of complex, individual decision naturopathic care is built for. This isn't an anti-GLP-1 or pro-GLP-1 episode. It's an informed one.

Key takeaways:

• GLP-1 use in Australia has grown fast: roughly half a million people are currently on one (UNSW, 2026)
• Gastrointestinal side effects affect an estimated 40–70% of users: common, not rare, and worth planning for
• There's a direct, mechanism-based relationship between GLP-1s, gut motility, and the microbiome, this isn't incidental
• Muscle and bone density loss is under-discussed: up to ~40% of total weight lost on these medications can be lean tissue, and the risk is particularly relevant for women in perimenopause and menopause
• A survey of ~800 women on GLP-1s found the real gap wasn't the medication, it was the lack of conversation around diet, movement and lifestyle support while taking it
• Up to 60% of lost weight can return within 12 months of stopping the lifestyle work matters as much for after as during
• Resistance training and adequate protein intake are genuinely protective, this is modifiable, not inevitable
• Not for use in pregnancy or while breastfeeding
• Naturopathic support (dietary, exercise, digestive) works alongside your GP, not instead of them

For practitioners: Karly is running a live training on GLP-1 agonists, the microbiome and SIBO risk, with special guest Carla Wrenn joining Thursday 1 October, $89.

Register Here: https://www.karlyraven.com/offers/NLC4G2Te/checkout

If you're on a GLP-1, considering one, or supporting someone who is, this episode is for you.

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

You've seen the promises — heal your gut in 30 days, the 6-week reset, the 14-day cleanse. Maybe you've done them. Maybe you even felt better, for a while. In this episode, Karly breaks down what "gut healing" physically involves, why symptom relief and actual restoration run on completely different clocks, and what real progress looks like month by month, so you can finally tell the difference between a protocol that's working slowly and one that isn't working at all.

In this episode, you'll learn:

• The three layers of gut healing — symptom relief, clearing the overgrowth, and restoring function — and why only one of them happens in 30 days
• The "housekeeping wave" (your migrating motor complex) and why retraining it is the missing piece behind most SIBO relapses
• Why rebuilding your microbiome is like regrowing a forest after a fire — and what that means for your timeline
• The real reason you improved and relapsed — and why it was never your fault
• The one question to ask of any gut program before you start it: where is the reintroduction phase?
• How to measure genuine progress: your food list getting longer, not just symptoms staying quiet

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

My literature review on SIBO has been published in the Journal of the Australasian College of Nutritional and Environmental Medicine for Gastrointestinal Awareness Month, and in this episode I unpack what it means for anyone stuck in the SIBO treatment cycle. The big idea: SIBO isn't one condition. It's three gas phenotypes, hydrogen, methane (IMO) and hydrogen sulfide, each driven by different organisms, picked up by different testing, and needing genuinely different treatment. Treat them all the same, and relapse is almost predictable. There's also a short segment near the end for the practitioners listening.

📄 READ THE FULL PUBLISHED REVIEW: 

⏱️ Chapters

• 00:00 — Welcome
• 00:55 — Something a little different today (the news)
• 03:01 — SIBO is not one condition: the three phenotypes
• 07:12 — Why this changes everything: testing, treatment and relapse
• 12:54 — For the practitioners listening
• 22:14 — Closing thought + where to from here

Key Takeaways

• SIBO isn't one condition. It's three gas phenotypes: hydrogen, methane (now called IMO) and hydrogen sulfide.
• Different gas, different organism. Hydrogen points to bacteria, methane to archaea, hydrogen sulfide to sulfate-reducing organisms, and they don't respond to the same treatment.
• Testing has to match. A breath test that only measures hydrogen can miss the other two, which is how you can be told you're "fine" while you're still struggling.
• Phenotype mismatch drives relapse. Treating every SIBO the same way is a major reason symptoms keep coming back.
• Eradication isn't the finish line. Lasting results come from restoring how your gut actually works, not just clearing the overgrowth. Restoration over restriction.

For the Practitioners

• Three phenotypes, three organisms: hydrogen (Proteobacteria, ~50–60%), IMO (the archaeon M. smithii, ~25–30%), and hydrogen sulfide (sulfate-reducers, least studied).
• Recurrence is the core problem: reported as high as 44% within nine months of antibiotic eradication in unstratified cohorts.
• Motility is the throughline: the MMC is the principal defence against overgrowth, and the evidence supports prokinetic support alongside antimicrobials, not after.
• Post-infectious autoimmunity: ~1 in 5 develop anti-CdtB antibodies cross-reacting with vinculin after gastroenteritis. Anti-vinculin testing is not currently available in Australia.
• Phenotype-specific evidence: hydrogen, berberine-containing protocols ranked highest in the 2025 network meta-analysis; IMO, rifaximin–neomycin or stabilised allicin; hydrogen sulfide, bismuth subcitrate and emerging Codonopsis evidence.
• Combination over monotherapy carries the strongest evidence, with mucosal terrain addressed alongside eradication.

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

This week, Karly takes a viral Instagram post, one about supplement prescribing, qualifications, and the TGA  and turns it into a raw, honest conversation about who you're really trusting with your health. She unpacks the supplement free-for-all online (yes, including the parasite cleanses), why people are reaching for AI and influencers in the first place, and what's genuinely lost when you swap a real practitioner for a chatbot.

A grounded, no-fear-tactics episode on the difference between health information and health care and why, in a world of endless content, a real human who knows how to think still matters more than ever.

Key takeaways:

• Why people aren't foolish for turning to AI or influencers, they're exhausted and underserved, and that matters in how we talk about this.
• Health information and health care are not the same thing and the line between them has never been blurrier.
• What TGA regulation actually does, and the hidden risks of buying supplements from overseas without practitioner oversight.
• The parasite-cleanse problem: how fear gets dressed up as a solution by the same people profiting from the sale.
• What a real practitioner can do that a bot structurally cannot; proper case-taking, clinical reasoning, accountability, and the therapeutic relationship.
• How to use AI well; bring it to your appointment, use it to ask better questions, but don't ask it to do the synthesis.
• A direct word to practitioners: your critical thinking is your moat. Build it before you lean on the tool.

This is a sensitive area for many women navigating their gut health alone after being dismissed by conventional care. If that's you — proper, qualified support exists, and you deserve it.

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

EPISODE SUMMARY

If you've ever wondered what the microbiome actually is, and why every practitioner seems to be talking about it, this is the episode to start with. Karly Raven breaks down what's living in your gut, why diversity is the number that matters most, what's disrupting it for so many women, and what it actually takes to restore it.

This isn't a 30-second explainer. This is the full picture, with the clinical context, the honest caveats, and the practical starting points that most gut health content skips.

KEY TAKEAWAYS

• Your microbiome contains around 100 trillion microorganisms and their diversity directly shapes your digestion, immunity, mood, skin, hormones, and more
• Dysbiosis is driven by far more than antibiotics: chronic stress, processed food, restrictive diets, and gut infections all play a role
• Diversity is the metric that matters most. A high-diversity microbiome is more resilient, more anti-inflammatory, and better at restoring itself after disruption
• The most evidence-based way to increase diversity is to eat 30+ different plant foods per week. Variety matters more than quantity
• Restoration is not just about food. Sleep, movement, and nervous system regulation are all essential parts of rebuilding microbiome health

IN THIS EPISODE

• Part 1: What the microbiome is and why it matters
• Part 2: The most common drivers of microbiome disruption
• Part 3: Why diversity is the key metric to focus on
• Part 4: Evidence-based strategies to restore and rebuild

REFERENCES

• Sender R et al. (2016). Revised estimates for the number of human and bacteria cells in the body. Cell, 164(3), 337-340.
• McDonald D et al. (2018). American Gut: an open platform for citizen science microbiome research. mSystems, 3(3).
• Wastyk HC et al. (2021). Gut-microbiota-targeted diets modulate human immune status. Cell, 184(16), 4137-4153.

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

If you’ve treated SIBO and felt better, only for your symptoms to return — you’re not alone.

SIBO relapse and recurring IBS flare-ups are extremely common. Many people complete a round of antimicrobials, follow a strict low FODMAP diet, or take targeted supplements, and experience temporary improvement. Then the bloating, discomfort and food sensitivities slowly return.

So why does SIBO keep coming back?

In this episode, I explain the most common reasons for SIBO recurrence, including unresolved motility issues, long-term restriction without rebuilding digestive resilience, reduced digestive capacity, and the role of the nervous system in gut function.

If you’ve been wondering:

• Why does my SIBO keep recurring?
• Why do my IBS symptoms flare up again after treatment?
• Is low FODMAP enough to heal SIBO?
• How do I prevent relapse long term?

This episode will give you clarity.

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WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

This week, Karly sits down with Clinical Naturopath & Nutritionist, Steven Judge, to discuss histamine and oestrogen balance. We chat about histamine intolerance and the common symptoms and red flags, the microbiome's role in histamine metabolism, and the incredible potential of food as medicine. 

Tune in to find out:

• The relationship between histamine and oestrogen
• Impacts of the microbiome on histamine metabolism
• Research regarding histamine in circulation and detoxification pathways
• Steven’s streamlined clinical processes
• All about beta-glucuronidase and its effects
• Common symptoms associated with histamine intolerance
• General tips to experience some symptomatic relief
• The wonderful benefits of broccoli sprouts and sulforaphane
• Understanding the advantages of using food as medicine

Connect with Steven and become a client or follow him on Instagram @stevenjudgenaturopath

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DISCLAIMER

This podcast information is provided for educational purposes only, and is intended to be used only in conjunction with individual support from a professionally qualified and trained practitioner. It does not claim to diagnose, treat, cure or prevent disease and is not a substitute for appropriately qualified medical advice. It is a condition of use that you take full responsibility for your own health, safety and wellbeing, conduct your own research, consult your healthcare provider and make informed choices about what is right for you before making any changes to your diet or lifestyle.

_________________________________________________________________________

WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

Visceral hypersensitivity can be an ongoing battle for people that suffer from IBS, so this week Bernadette joins us with some tips to alleviate the daily struggles of those dealing with this condition. While exploring herbal remedies and dietary adjustments aimed at easing discomfort and pain, to finding alternative options to a common herbal mixture amidst supply issues, listen in to learn about the integrative therapies that can offer you the much-needed relief you’re seeking.

Tune in to find out:

• What visceral hypersensitivity is, how it presents and why it occurs
• The intricate relationship between gut health and pain perception
• Reducing visceral hypersensitivity
• Gut treatments, herbs and foods to ease the discomfort and pain
• Alternative options to Iberogast due to supply issues
• Integrative therapies that are able to provide relief

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DISCLAIMER

This podcast information is provided for educational purposes only, and is intended to be used only in conjunction with individual support from a professionally qualified and trained practitioner. It does not claim to diagnose, treat, cure or prevent disease and is not a substitute for appropriately qualified medical advice. It is a condition of use that you take full responsibility for your own health, safety and wellbeing, conduct your own research, consult your healthcare provider and make informed choices about what is right for you before making any changes to your diet or lifestyle.

_________________________________________________________________________

WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

In this episode, Karly dives deep into the complexities of root causes, exploring why your gut symptoms might not always be the result of just one underlying issue. She emphasises the importance of understanding the root cause of your uncomfortable  symptoms to effectively address, manage and resolve the issues that are at play, and explains how microbiome imbalance assessments in the Nourished Gut Program could provide valuable clues and insights into your gut health issues. If you’re ready to assess your body's signals and navigate the path to better digestive health, this episode is for you.

Tune in to find out about:

• Why finding the root cause is essential for resolution
• Reflecting back to when your symptoms began
• The most common root causes and their symptoms
• Symptoms linked to the recycling of toxic waste 
• The effects of structural issues on the gut
• How medications could be affecting your intestines and microbiome
• Managing stress to improve your gut symptoms
• Environmental toxins and pathogenic infections
• How we assess microbiome imbalance at the Nourished Gut Clinic

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DISCLAIMER

This podcast information is provided for educational purposes only, and is intended to be used only in conjunction with individual support from a professionally qualified and trained practitioner. It does not claim to diagnose, treat, cure or prevent disease and is not a substitute for appropriately qualified medical advice. It is a condition of use that you take full responsibility for your own health, safety and wellbeing, conduct your own research, consult your healthcare provider and make informed choices about what is right for you before making any changes to your diet or lifestyle.

_________________________________________________________________________

WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.

Do you want to balance your love for coffee with your body's needs? This week, Karly explores the morning ritual of millions of people: coffee. Going beyond its energising effects, she delves into new research revealing coffee's positive outcomes on your gut, as well as some not-so-gut-health-promoting effects. She shares why you shouldn’t rely on coffee to stimulate your bowel movements and uncovers some practical tips for enjoying your daily brew in a gut-friendly way. 

Tune in to find out:

• Recent studies based on coffee consumption and microbiome changes
• Why the type of coffee and caffeine levels matter
• The prebiotic-like effects of vitamin B2 in our gut
• Negative associations linked to high coffee intake
• Specific outcomes of gut bacteria impacted by coffee consumption
• The importance of further research in this area
• Understanding the laxative effects of coffee
• Karly’s top tips for regular coffee drinkers

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DISCLAIMER

This podcast information is provided for educational purposes only, and is intended to be used only in conjunction with individual support from a professionally qualified and trained practitioner. It does not claim to diagnose, treat, cure or prevent disease and is not a substitute for appropriately qualified medical advice. It is a condition of use that you take full responsibility for your own health, safety and wellbeing, conduct your own research, consult your healthcare provider and make informed choices about what is right for you before making any changes to your diet or lifestyle.

_________________________________________________________________________

WORK WITH KARLY Ready to stop managing symptoms and start rebuilding? Karly takes a limited number of one-on-one clients each month through the Nourished Gut Program — applications are open: https://www.nourishedgutclinic.com/nourishedgut 

FREE RESOURCE Not ready for that yet? Start here. Grab Karly's free 3-Day Bloat Fix — a short, practical protocol targeting the most common drivers of daily bloating: https://www.nourishedgutclinic.com/bloat 

VISIT US ONLINE Gut health support for clients → https://www.nourishedgutclinic.com Mentoring & clinical education for practitioners → https://www.karlyraven.com 

FOLLOW ALONG @karlyravennaturopath — clinical insights, gut health education & behind the scenes @nourishedgutclinic — the clinic page, client wins & what's on 

ENJOYING THE PODCAST? A rating and review takes 30 seconds and helps more people find the show who really need it. Thank you. 

DISCLAIMER Content shared on the Nourished Gut Podcast is for educational purposes only and is not medical advice. Always consult a qualified health practitioner before making changes to your health or treatment plan.