Nutrition Support for GLP-1 Weight Loss Protocols - How to Minimize GLP-1 Side Effects

The Research is Clear

As promising as GLP-1 weight loss protocols are, for both weight loss and cardiometabolic markers, the research is starting to come back on long-term use of GLP-1s, and long-term discontinuation without functional support. What’s clear is that the benefits of GLP-1 weight loss protocols are not long-lasting on their own.

Unfortunately, the harmful effects caused by a drastically slowed digestive system on inflammation, hormone balance, and metabolic health last long after stopping a GLP-1… that is, unless the individual also receives guidance and functional support to address the systems being impacted.

It comes down to this - Long-lasting success without the harmful side effects of GLP-1 use is possible. The key is proactivity.

Hello, my little muffin tops. I’m Hilary Beckwith, ex-dieter and functional health expert. Women with PCOS/PMOS, IBS, and autoimmune conditions come to see me with signs of adrenal stress, insulin resistance, and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively and fill in the gaps between their lab values and how their body actually feels. Before you continue, click here to read my Medical Disclaimer.

In this article, you’ll learn:

• How GLP-1s work

• What the research is saying about GLP-1 use - during and after

• Steps to mitigate side effects and get lasting results

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the desire to feel seen…

For decades, women have been taught to stay small - both in size and in expression. As absurd as it is to see it typed out, the truly infuriating part is that many of us live in a constant state of belief that we are, indeed,too much.

Right or wrong, this belief and its ever-present desire to shrink is exactly what drives us to dangerous health trends like restrictive diets and weight-loss meds (remember Fen-Fen?). We develop eating disorders, we grasp at every diet, supplement, and workout protocol that promises a bikini body, all with the hope that we will finally become small enough to be seen and accepted. (I’m not crying, you’re crying!)

I see you, friend. And as infuriated as I am that we live in a world that works hard to keep us so small, I also understand the realities of navigating these expectations and beliefs. That’s why, instead of staying silent in my anger, I want to help you get the most benefit out of your GLP-1 weight loss protocol, without the harmful long-term effects.

how GLP-1s work

So here we are in a skinny-obsessed era, and GLP-1s are playing a major role. They’re touted as a miracle drug because, in addition to easy weight loss, they also improve cardiometabolic markers and blood sugar stability markers.

But those improved markers come at a big cost - the negative health impacts of drastically slowed digestion, if not mitigated with functional health support, can lead to increased intestinal permeability (leaky gut syndrome), damaged and inflamed intestinal tissue, bowel toxicity, sex hormone imbalances, and increased risk of SIBO, candida overgrowth, parasites, and gallstones. Not to mention a major disconnect from your body’s intuition and relationship with food. I go into more detail about the negative health impacts of GLP-1 weight loss protocols here.

This post is focused on practical steps you can take to stay proactive in your GLP-1 weight loss journey to support functional health and enjoy lasting benefits of GLP-1 use that would otherwise disappear with time.

In order to understand how to support functional health while undergoing a GLP-1 weight loss protocol, it’s important to understand how GLP-1s work.

HOW DO GLP-1S WORK?

• GLP-1, or Glucagon-Like Peptide, is a naturally occurring hormone produced in the body after meals to stop the release of stored glucose from the liver, fat, and muscle; it also stimulates insulin release and slows gastric emptying (the rate at which chewed food enters the intestinal tract). The effects of endogenous GLP-1 last for 1-2 minutes.

• GLP-1 agonists are a synthetic form of GLP-1 that can be injected to simulate the effects of endogenous GLP-1s. The effects of exogenous GLP-1s (GLP-1 medications) typically last for one week.

• When using GLP-1 agonists (going forward, I will refer to GLP-1 medications as “GLP-1s”) for weight loss, the goal is to drastically slow digestion in order to keep individuals feeling full for longer periods of time, in order to eat fewer calories, and thus, lose weight.

during and after GLP-1 weight loss

The clinical research has been largely unanimous in showing GLP-1 weight loss protocols improving cardiometabolic markers (inflammatory markers, HbA1c, blood pressure, and cholesterol, in addition to rapid and steady weight loss.

For this reason, GLP-1s have been touted as a miracle drug, as these improved markers can significantly lower an individual’s risk for cardiovascular disease. But patients are not being told the whole story.

The research is finally starting to surface on the long-term health impacts of GLP-1 weight loss protocols.

HERE’S WHAT RESEARCHERS ARE FINDING:

• MOST OF THE WEIGHT IS REGAINED - In a recent systematic review, it was found that roughly 60% of the weight lost using a GLP-1 weight loss protocol was regained within about 1-2 years.

• INCREASED RISK OF SARCOPENIA - Sarcopenia is a loss of muscle mass. Because most of the weight lost with GLP-1s is lean mass (i.e. muscle tissue), this results in a drastic loss of muscle which can be dangerous, and unsupportive of long-term metabolic health. Muscle mass is essential to maintaining insulin sensitivity, bone density, and mobility.

  • Additionally, it’s been found that much of the weight regained after discontinuing a GLP-1 weight loss protocol returns as adipose (fat) tissue, not the lean mass that was lost. This causes downstream issues with hormone imbalance, increased inflammation, and metabolic issues.

• CARDIOMETABOLIC MARKERS RETURN - Similarly, a recent meta-analysis showed that most pre-GLP-1 cardiometabolic markers returned after discontinuing a GLP-1 weight loss protocol.

• INCREASED RISK OF GALLSTONES - Slowed digestion and motility, paired with an increased movement of fat, double the likelihood of gallstone formation, which can lead to inflammation, increased toxicity, and impaired fat digestion.

• INCREASED RISK OF SIBO (SMALL INTESTINAL BACTERIAL OVERGROWTH) - While the GLP-1 itself can reduce certain inflammation markers, slowed motility greatly increases fermentation of food in the small intestine, feeding both harmful and beneficial bacteria, and giving them the perfect environment to thrive. This increase in harmful bacteria will ultimately lead to intestinal inflammation, bowel toxicity, and increased intestinal permeability, not to mention the discomfort of bloat, fatigue, suppressed immune activity (if unaddressed for too long), and constipation and/or diarrhea.

• INCREASED RISK OF GUT PATHOGENS - A healthy digestive system acts as a frontline defense against pathogens ingested by food - yeast, bacteria, viruses, and parasites, mainly. Drastically slowing digestion reduces your body’s ability to disinfect food with sufficient levels of stomach acid, and the damaged mucosal lining of the intestines due to increased fermentation (see above) no longer carries the immune cells needed to further fight off and eliminate such pathogens.

• DEHYDRATION - Sufficient, and even optimal, hydration is essential to blood volume, lymphatic flow (carries waste from tissues, carries immune cells to areas of need, etc.), nutrient transport throughout the body, and lubrication of muscle tissues and joints. GLP-1s significantly decrease thirst cues, leaving individuals on GLP-1 weight loss protocols dangerously dehydrated.

• INCREASED RISK OF OSTEOPOROSIS - More research is needed to confirm this hypothesis, but an interesting paper published recently by UC Davis pointed out that reduced food intake leads to undernourishment, and undernourishment puts individuals at risk for bone loss, as the body cannot maintain bone density without the necessary dietary nutrients.

minimizing negative health effects of GLP-1s

Medications like GLP-1 and even nutritional supplements will only go so far if the root-causes of the symptoms you are addressing are left untouched.

A GLP-1 weight loss protocol might drop scale numbers, improve metabolic markers, and reduce inflammatory markers for a time, but unless you also address the underlying causes of the dysfunction that got you to that point - the research is clear - the results will not last.

YOU CAN HAVE THE BEST OF BOTH WORLDS

If you have made the decision to use GLP-1s to help you lose weight, and you want to enjoy the benefits for many years without creating a new onslaught of health problems - you must stay proactive. Here’s how to do that:

1) OPTIMIZE GUT HEALTH:“Gut Health” is more than just digestion and probiotics. It is the health of your intestinal tissues, the state of your microbiota, and the ability of your mucosal immune system to fight off harmful infections.

• HOW TO DO IT: Gut health is highly individualized - there are no magic gut-support foods or probiotic supplements, because your gut has its own unique microbiome, mucosal health, and motility ability.

  • Seek out a functional practitioner who is trained to assess and address microbiome imbalances, dysbiosis, and inflammation. Address any findings and optimize inflammation, tissue health, and beneficial bacteria before disrupting it with slowed motility. (Click HERE to connect with me)

2) OPTIMIZE DIET: The weight lost on a GLP-1 weight loss protocol is primarily lean mass. Consuming good-quality protein and developing a strong routine for strength training will help to counter this. But when digestion is slowed, as it is with a GLP-1, there is little appetite for protein.

• HOW TO DO IT: Prioritize protein-forward meals. If all you have the appetite for is a few bites of food, prioritize good-quality proteins. Click HERE to learn how to choose good-quality proteins. Most mild-to-moderately active individuals require 1.2-1.8 grams of protein per 1 kilogram of desired body weight.

3) OPTIMIZE HYDRATION: Sufficient hydration is important for bowel movements, blood pressure, and detoxification, but thirst cues are stunted when on a GLP-1.

• HOW TO DO IT:Most individuals with normally functioning kidneys require a minimum of 0.5 fluid ounces per 1 pound of body weight daily. Electrolyte minerals are also essential to fluid balance within cells and tissues, especially if you may be undernourished from GLP-1 use. Click HERE to get a free pack of my favorite electrolyte supplement.

4) ADD RESISTANCE TRAINING: GLP-1 breaks down lean mass (muscle tissue), and most weight lost while on a GLP-1 weight loss protocol comes back as fat mass. Staying proactive in your strength training routine can help mitigate this loss. The best time to start this routine is before starting your GLP-1 weight loss protocol. The second best time is now.

• HOW TO DO IT: Add 30 minutes of resistance training to your routine, at least 2-3 times per week. Building muscle supports insulin sensitivity long-term and will help you build up a reserve of lean mass. Working with a trainer who is knowledgeable in GLP-1 use is essential, as it may be unsafe to work out too intensely without proper nourishment. Start small, listen to your body’s cues.

5) MAKE A PLAN FOR PLEASURE: Suppressing appetite with GLP-1 use can potentially eliminate a major source of pleasure if you are a food lover like myself. Food releases dopamine and endorphins that block pain. Without this resource, you might risk seeking out other, potentially harmful sources of pleasure and comfort, such as recreational drugs, prescription pain medications, alcohol, scrolling, self-harm, video games, or unsafe sexual behaviors.

• HOW TO DO IT: Make a list. Name 3-5 easy-to-access things that bring you comfort or joy, besides food. No need to reinvent the wheel, just keep it simple and fun, and try to avoid more addictive behaviors like scrolling or substances.

  • In the moment - When you find yourself reaching for those more harmful behaviors, or just wanting something to “take the edge off”, pick something from your list that feels accessible in that moment, and do it. “Catching” yourself in these moments and counteracting with a more positive behavior can help create new neural pathways, allowing the brain to learn new coping skills.

  • Staying proactive - Sometimes when we reach for these more harmful behaviors, it’s because we feel depleted - in the red, so-to-speak. Keeping your bucket full on a daily basis can help prevent those empty feelings. One way to do this is to schedule 1-3 of these items from your list into your day, every day.

• Your list might include:

  • reading a chapter of a book

  • single-song dance party

  • gratitude journal

  • sitting/walking in nature (without headphones)

  • grab a coffee or tea at your favorite shop

  • jumping on a trampoline

  • tell yourself a silly joke (really!)

  • tell someone else a silly joke

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was this helpful?

What’s your story navigating GLP-1 use? Has it been helpful? What’s been challenging about it, and how did you navigate it?

I hope you’ll share your thoughts in the comments below!

NUTRITION SERVICES

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What They Didn’t Tell You About GLP-1 | GLP 1 Weight Loss and Functional Health

What is a GLP-1, really?

My biggest concern is not the GLP-1 medications themselves - my concern is with the absence of informed consent. It’s true that GLP-1s can improve markers of cardiac and metabolic health - but it is not a magical unicorn 🦄. Every health decision has its risks, and you deserve to be informed of those risks in their entirety.

As a functional health practitioner, part of my job is to question everything - especially in a world drowning in oversimplified health advice on TikTok and docs who won’t (or can’t) address anything that doesn’t fit neatly into a 15-minute appointment.

I’ve scoured the research and listened to what my own GLP-1 clients are saying, and I’m here to share the nuances and risks of being on a GLP-1 weight loss protocol.

Hello, my little love handles. I’m Hilary Beckwith, ex-dieter and functional health expert. Women with PCOS/PMOS, IBS, and autoimmune conditions come to see me with signs of adrenal stress, insulin resistance, and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively and fill in the gaps between their lab values and how their body actually feels. Before you continue, click here to read my Medical Disclaimer.

In this article, you’ll learn:

• What is a GLP-1 agonist?

• Short- and long-term effects of GLP-1 for weight loss

• Things to consider before undergoing a GLP-1 weight loss protocol

• How to minimize harmful effects if you are already on a GLP-1 weight loss protocol

• Root causes of weight gain that are often overlooked

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what is a GLP-1?

THE SCIENCE-Y BITS

To understand what a GLP-1 is, it helps to understand receptor sites. Every cell in your body has receptor sites for various hormones, molecules, and proteins. A common example of this that you may already be familiar with is insulin - insulin is a hormone that binds to insulin receptor sites to allow glucose to enter and be metabolized.

Think of the receptor site as a lock, and the hormone/molecule/protein is the key meant to fit into that lock. Receptor types vary from cell to cell, depending on what the cell’s function is.

The difference between a door lock and these receptor sites is that, to unlock a door, you would need a specific key, or an exact replica of that key, and both keys would both have the outcome of opening the lock. But in the case of receptor sites, there are many types of keys that will fit, and each produces a different action, depending on which key is used.

SO, WHAT IS A GLP-1?

Glucagon-like peptide, or GLP, has a similar structure to glucagon (a hormone produced by the pancreas) that enables it to bind to glucagon receptor sites on cells. Put differently, GLP is one of the many types of keys that can unlock the glucagon door, but has a different outcome than glucagon itself.

The number ‘1’ is simply a differentiation between this GLP and other GLPs that stimulate a different action when binding to receptors. GLP-1s are made naturally by the body and are released after eating, binding to glucagon receptor sites. Here’s what that does:

• inhibit glucagon release

• stimulate insulin release

• slow the rate at which your food empties from your stomach into your intestines (called gastric emptying)

SO, WHAT IS GLUCAGON?

Glucagon is a hormone produced by the pancreas in times of low blood sugar or stress, that stimulates the release of stored glucose from the liver and fat tissue. Blood glucose levels rise, insulin is released, and shuttles glucose into cells to be converted into fuel called ATP (adenosine triphosphate). This is the same glucose metabolism that we referred to earlier.

I don’t want to minimize the “stress” component I just mentioned - it is a very important consideration in blood sugar management, but too complex to get into for this post. If you want to learn more about how stress impacts blood sugar, hormone balance, sleep, and inflammation, click HERE.

OKAY, SO WHAT IS A GLP-1 AGONIST?

A GLP-1 agonist is the medication we are discussing in this post - exogenous sources of GLP-1 that have been shown to lower cardiac risk, improve A1c values, and, yes, help people rapidly lose weight. Common examples of GLP-1 agonists include semaglutides, liraglutides, tirzepatides, and exenatides.

The biggest difference between a GLP-1 agonist (exogenous), and GLP-1 produced by your body (endogenous), is that the impacts of endogenous GLP-1 are meant to last only 1-2 minutes, whereas the impacts of exogenous GLP-1 last for about 1 week.

Chances are, your prescriber has only told you that the benefit of exogenous GLP-1 is that it will cut “food noise” and help you feel full for longer so that you’ll eat less (yay?).

What they didn’t tell you is how that prolonged effect negatively impacts digestion, inflammation, gut health, and causes undernourishment, impacting a wide range of body systems.

LET’S SUMMARIZE:

• GLUCAGON: a hormone produced by the pancreas in times of stress or low blood sugar, that stimulates the release of stored glucose from the liver and fat tissue, and to some extent, muscle.

• ENDOGENOUS GLP-1: a molecule released after meals that binds to glucagon receptor sites to inhibit glucagon release, stimulate insulin release, and slow gastric emptying for about 1-2 minutes, helping to jumpstart glucose metabolism after eating.

• EXOGENOUS GLP-1: a synthetic form of endogenous GLP-1 that has the same effect, but for a much longer period - about 7 days.

For the sake of simplicity, I will refer to exogenous GLP-1s (GLP-1 medications) as “GLP-1s” throughout the rest of this post.

GLP-1 weight loss protocols have their downsides

GLP-1 meds are not new. They’ve been used for 10+ years at much lower doses than they currently are for weight loss, to help those with Type II Diabetes manage blood glucose levels more effectively.

They’ve become trendy in recent years because it was discovered that at higher doses, a patient can lose weight rapidly without even trying. And isn’t it our goal, especially as women, to be as small as we can be? (where is the sarcastic font?)

Sarcasm aside, the fact is that people want to lose weight, and they want it to be easy - and GLP-1s make weight loss easy. I get why that’s appealing. For those who have tried ALL the diets, and ALL the workouts, ALL the supplements, this might seem like a dream come true.

Let’s look at the research and talk about what to consider when starting a GLP-1 weight loss protocol.

health effects of GLP-1 weight loss protocol

• IMPROVES CARDIOMETABOLIC MARKERS

  • YAY! For someone who is at severe, or even moderate, risk for cardio events, suffers from chronic illness that can make preventative actions more difficult, or for someone who has limited capacity to understand and execute this process - great!

  • HERE’S WHAT’S MISSING:

    • Cardiometabolic markers include markers like blood pressure, HbA1c, and lipid markers (cholesterol, triglycerides). For someone who is not at severe or even moderate risk for a cardiac event, these markers can be improved more effectively by addressing early signs of metabolic dysfunction. A GLP-1 might stabilize those numbers while actively taking a GLP-1, but it all falls apart once you discontinue the GLP-1 and have made no changes to your diet or lifestyle.

    • Early signs of metabolic dysfunction include:

      • “hangry” between meals

      • trouble falling asleep, or staying asleep

      • sugar cravings

      • inflammatory conditions (acne, eczema, persistent pain, autoimmune diagnoses)

      • hormone imbalances (PCOS/PMOS diagnosis, irregular periods, mood instability, PMS symptoms.

    • Addressing these early signs through a functional health lens will ensure the results last beyond the duration of the GLP-1 meds.

• QUIETS “FOOD NOISE”

  • YAY! Many of us are drowning in social media posts and marketing that uses fear-based tactics to get us to eliminate certain food groups, or that one superfood ingredient or supplement will change. our. lives. - this gets us overthinking about food - and that sh*t gets noisy! So, yeah, a medication that cuts that noise is appealing to those of us who feel overstimulated and confused.

  • HERE’S WHAT’S MISSING:

    • The mechanism by which GLP-1s eliminate “food noise” is by increasing and prolonging the feeling of satiety. One method it uses to do this is by delaying gastric emptying and slowing digestive motility - for an entire week!

    • Slowing down your digestion is a BIG problem. A healthy digestive system is wired to disinfect your food, move waste out of your system, and absorb nutrients that come from the food you are ingesting. Here’s what happens when your digestion moves too slowly:

      • Constipation - Feces are an important elimination pathway for toxins. When you are constipated, toxins become reabsorbed into your bloodstream, and can then become reactivated. It’s not just toxins from your food that are eliminated by feces - many toxins that are deactivated by the liver, also use feces as an elimination pathway, including:

        • excess steroid hormones that your liver has deactivated in order to maintain balance (estrogen, progesterone, cortisol, etc.)

        • debris from harmful viruses, bacteria, or other pathogens that your immune system has fought off

      • Increased SIBO risk (and other harmful microbes) - Stomach acid and motility are the two primary mechanisms your digestive system uses to eliminate harmful microbes, including opportunistic bacteria (leading to SIBO), parasites, candida/yeast, and viruses. The proliferation of these microbes leads to increased inflammation, increased cortisol levels, and a damaged gut lining (leaky gut, intestinal permeability). The longer food sits in your intestines, the more it will ferment and give these microbes the perfect environment to proliferate.

• WEIGHT LOSS

  • While it may not be true across the board, weight loss is the main appeal for GLP-1 use in the populations I work with. And at higher doses, GLP-1s have been effective for weight loss ultimately by decreasing appetite and thereby restricting calorie intake.

  • HERE’S WHAT’S MISSING:

    • Calorie restriction over time actually slows metabolism. While the pounds practically melt off during a GLP-1 weight loss protocol, the research shows that calorie restriction over time will actually slow your body’s natural ability to burn calories. And since the primary weight loss mechanism of GLP-1 meds boils down to calorie restriction - it’s worth considering what life looks like after you stop taking it.

    • Liver congestion, toxic burden, chronic stress, and underlying infections are common non-calorie causes of weight gain.

      • If you are someone who really struggles to lose weight even though you’re doing all the “right” things - then calories are likely NOT the reason you can’t lose weight. Your body will hold onto fat stores and inhibit fat breakdown in cases of infection, stress, and hormone imbalances. Click HERE to read more about non-calorie causes of weight gain.

    • UNDERNOURISHMENT - I cannot overstate how important this topic is. While your scale numbers are going down, your lack of appetite will eventually lead to a body that is using its resources faster than you can replenish them.

      • Every function in your body requires nutrients. To name a few examples, glucose metabolism requires magnesium and many B- vitamins. Liver function and detoxification requires B vitamins, amino acids, cholesterol, and many minerals. Mood regulation largely relies on amino acids. “Full” does not equal “fueled”.

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what the research shows

We’ve talked about the common claims of a GLP-1 weight-loss protocol, and the reality is all of them track. At the right dose, GLP-1s do live up to the hype of weight loss, improved cardiometabolic markers, and cutting the “food noise”.

Each of those claims comes with its own nuance that we also covered. The claims themselves are making it into the informed consent - but the nuances are not.

ADDITIONAL NEGATIVE HEALTH EFFECTS OF GLP-1s:

• DEHYDRATION: By increasing satiety, GLP-1s also decrease thirst cues, leaving you dehydrated. Why is hydration so important? Optimal hydration is needed for removal of waste through your lymphatic system, sweat, urine, and feces. Optimal hydration can also improve blood pressure by increasing blood volume, and helps lubricate joints, muscles, skin, and eyes. Sufficient hydration requires water AND well-balanced electrolyte minerals to draw the water into cells and tissues - nourishment and hydration go hand-in-hand.

• INCREASED RISK OF GALLSTONES: Gallstones form when bile cannot move fluidly through the common bile duct and into your digestive tract. Because bile is formed from cholesterol, the increased movement of fat due to GLP-1s increases the concentration of fat in bile, making it more sluggish and increasing the likelihood of developing gallstones.

• WEIGHT REGAIN AFTER GLP-1: A recent systematic review found that 60% of weight lost while on a GLP-1 weight loss protocol was regained in participants. What’s more, another study found that the weight regained came back asfat mass, not the lean mass that was lost.

• RETURN OF CARDIOMETABOLIC MARKERS: The HbA1c, the blood pressure, the cholesterol, the lipids - those markers might improve while on a GLP-1 weight loss protocol, but this meta-analysis found that these markers, in addition to 2/3 of lost weight, were regained after discontinuing GLP-1.

• BONE DENSITY LOSS DUE TO UNDERNUTRITION: A paper published in December, 2025 by UC Davis pointed out that essential nutrients are being missed when people are underfed, and especially those that support bone health.

how to prepare your body for success even after GLP-1s

As you’ve seen here, the research is very clear - GLP-1s at higher doses help people improve cardiometabolic markers, support the function of insulin, and help people lose weight.

The research is also very clear that slower motility and rapid weight loss have many negative health effects, and that benefits seen while on a GLP-1 nearly reverse after discontinuing.

These are risks worth considering when exploring a GLP-1 weight loss protocol.

Medications like GLP-1 and even nutritional supplements will only go so far if you are not also addressing root causes of the symptoms, issues, or conditions they are meant to support. GLP-1s on their own are only going to help while actively on them, but addressing functional health in addition to GLP-1s can set you up for long-term success.

STEPS FOR ADDRESSING FUNCTIONAL HEALTH WHILE ON A GLP-1 WEIGHT LOSS PROTOCOL:

OPTIMIZE GUT HEALTH: “Gut Health” is more than just digestion and probiotics. It is the health of your intestinal tissues, the state of your microbiota, and the ability for your mucosal immune system to keep you from harmful infections.

• CURRENTLY ON A GLP-1: Seek out a functional practitioner trained to assess and address microbiome imbalances, dysbiosis, and inflammation.

• BEFORE GLP-1: Seek out a functional practitioner trained to assess and address microbiome imbalances, dysbiosis, and inflammation. Address any findings and optimize inflammation, tissue health, and beneficial bacteria before disrupting it with slowed motility.

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OPTIMIZE DIET: Lean mass is primarily what is lost when on a GLP-1 weight loss protocol. Consuming good-quality protein and developing a strong routine for strength training will help to counter this. But when digestion is slowed, as it is with a GLP-1, there is little appetite for protein. Here’s how to get ahead:

• CURRENTLY ON A GLP-1: Think “protein-forward” meals. If all you have the appetite for is a few bites of food, prioritize good-quality proteins. Click HERE to learn how to choose good-quality proteins.

• BEFORE GLP-1: Get in the habit of consuming sufficient protein before starting your GLP-1 (this will require optimizing digestion, too). Most people with a regular strength training routine need about 1.2-1.8 grams of protein per 1 kilogram of desired body weight.

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OPTIMIZE HYDRATION: Sufficient hydration is important for bowel movements, blood pressure, and detoxification, but thirst cues are stunted when on a GLP-1.

• CURRENTLY ON A GLP-1: Begin putting tools into action that will help remind you to drink. Phone or watch alarms, visual cues, notes - whatever works best for your lifestyle and habit development. Most individuals with normally functioning kidneys require a minimum of 0.5 fluid ounces per 1 pound of body weight, daily. Electrolyte minerals are also essential to fluid balance within cells and tissues, especially if you may be undernourished from GLP-1 use. This is my favorite electrolyte product.

• BEFORE GLP-1: (same as above)

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RESISTANCE TRAINING: GLP-1 breaks down lean mass (muscle tissue), and most weight lost while on a GLP-1 weight loss protocol comes back as fat mass. Staying ahead of strength training and muscle-building can help mitigate this effect.

• CURRENTLY ON A GLP-1: Begin building a strength training routine 2-3 times per week. Working with a trainer knowledgeable in GLP-1 use is essential, as it may be unsafe to work out too intensely without proper nourishment.

• BEFORE GLP-1: Get in the habit of strength training before you start a GLP-1, at least 2-3 times per week. This will support insulin sensitivity, build up a reserve of lean mass, and condition your body to handle resistance training, rather than starting new while on a GLP-1.

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PLAN FOR PLEASURE: For many (myself included), food is pleasure, and even comfort. In fact, food can actually release dopamine and endorphins to block pain. If this is you, a GLP-1 will remove an important source of joy and comfort in your life by suppressing your appetite for food. The key is to plan ahead and make sure you have other sources for coping when appetite is suppressed.

• CURRENTLY ON A GLP-1: It’s not too late for you. Before you do anything else, make a list. Name 3-5 easy-to-access things that bring you comfort or joy, besides food. No need to reinvent the wheel, just keep it simple and fun, and try to avoid more addictive behaviors like scrolling or substances. Your list might include:

  • reading a chapter of a book

  • single-song dance party

  • gratitude journal

  • sitting/walking in nature (without headphones)

  • grab a coffee or tea at your favorite shop

  • jumping on a trampoline

  • tell yourself a silly joke (really!)

  • tell someone else a silly joke

• BEFORE GLP-1: Same as above, but now you have time to implement these alternative behaviors before the appetite suppression from a GLP-1 makes it more challenging.

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learn something new?

What was your biggest takeaway from this article? Leave your thoughts and questions in the comments below, and I will do my best to respond soon!

Want help getting off a GLP-1 weight loss protocol?

NUTRITION SERVICES

• Private Coaching

• Functional Lab Testing

• Jumpstarter Kit

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Thyroid Symptoms Are Not Caused by Your Thyroid Gland

Thyroid symptoms are not caused by the thyroid gland

I see you, dear reader…

You got your annual bloodwork results back from your doc. They say you’ve got high TSH and low T3, and that you need to be put on thyroid medication to fix it.

No one asked about your stress levels. No one questioned your energy, sleep, or diet. No one asked about your digestive health or work life.

You take the medication as instructed for several months, and your thyroid levels improve, but you still feel like garbage.

But, why?

Why are your thyroid numbers off in the first place? Without understanding and addressing the root cause of your thyroid symptoms, you’re likely to stay on thyroid medication for years, even decades (I’ve seen it happen!).

Being prescribed a thyroid medication doesn’t have to be a life sentence. This article will help you avoid that scenario and know which questions to ask at your next check-up.

Hi friends. I’m Hilary Beckwith, ex-dieter and holistic nutrition expert. Clients come to see me with signs of adrenal stress and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively, and fill in the gaps between what their doctor is saying and what their body is saying.

In this article, you’ll learn:

• what thyroid symptoms can look like

• how the thyroid gland works

• what affects thyroid hormones throughout the body

• what to ask for on your thyroid blood panels

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thyroid symptoms

What do thyroid symptoms look like?

Throughout my life and career, I’ve learned something very important: Everything is a spectrum.

Thyroid symptoms don’t look the same for everyone, and this article should not be construed as a diagnosis or medical advice. If you think you have thyroid symptoms or other medical conditions, consult with a trusted physician or other qualified healthcare provider before making any changes. Read my medical disclaimer here.

**Much of the information in this article has been referenced from the Thyroid Debacle, although additional research has also been linked where applicable.**

HYPO-THYROID (slow or sluggish thyroid) SYMPTOMS CAN INCLUDE:

• weight gain, difficulty losing weight

• brain fog

• poor circulation

• constipation

• depression

• fatigue (frequently tired for no apparent reason)

• dry skin

• coarse hair

• reduced libido (low sex drive)

HYPER-THYROID (overactive thyroid) SYMPTOMS CAN INCLUDE:

• unexplained weight loss

• irritability

• anxiety

• excess sweating or heat intolerance

• nervousness

• insomnia

• increased appetite

• increased heart rate

• heart palpitations

• tremors

• fatigue

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how the thyroid works

To understand the cause of your thyroid symptoms, we first need to understand what the thyroid is and does.

The thyroid gland is small and butterfly-shaped, and is located on the front (anterior) side of the neck. Its main function is to regulate cellular metabolism, which is the chemical processes cells undergo to create energy.

The thyroid gland acts in response to stimulation from the hypothalamus and pituitary gland, collectively known as the HPT axis.

Here’s a brief overview of how this works:

• Hypothalamus (brain) senses the need for energy, releases TRH (Thyrotropin-Releasing Hormone)

• TRH tells the Pituitary to release TSH (Thyroid Stimulating Hormone)

• TSH stimulates the production of T4 (thyroxine, the inactive form of thyroid hormone) by the thyroid gland

• Some T4 is converted to T3 (triiodothyronine, the active form of thyroid hormone) within the thyroid, but mostly this conversion happens within the tissues and cells where it is used

• Most T3 and T4 are bound to a protein called thyroglobulin and circulate throughout the body until needed. Unbound, or free, T3 and T4 are able to bind to receptors and be used when needed. 

T3 is required for many functions, but regarding your metabolism, it is required for the transport of glucose into a cell in order to make ATP (Adenosine TriPhosphate: the energy our cells use to function). 

But it first has to be converted from T4, and avoid being converted to reverse T3 in cells (we’ll get to that).

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3 things that affect thyroid hormones

#1 - high estrogen:

• Tyrosine and iodine are two main components of thyroid hormones. Elevated estrogen stops iodine (iodide) from entering the thyroid gland.

• Elevated estrogen increases circulating thyroxine-binding-globulin (TBG), decreasing the amount of FREE (usable) thyroid hormone in the body.

• Elevated estrogen increases the activity of deiodinase 3, the enzyme responsible for deactivating thyroid hormone in cells in an effort to preserve energy. The hormone produced in this process is called reverse T3 (rT3).

#2 - high oxalates:

• Oxalates, or oxalic acid, is found in many foods (including soy, leafy greens, rhubarb, parsley, and cassava), but is also produced by certain strains of fungus, including aspergillus, penicillium, and candida. Exposure to mold, mold toxicity, or candida overgrowth are common causes of high oxalates.

• Oxalates have been found to cause tissue damage in the brain, nerves, kidneys, and thyroid gland, and elevations have been strongly correlated with autism cases.

• When oxalates are elevated, they can bind to calcium to form oxalate crystals, which have a strong affinity for the kidneys and the thyroid gland. These crystals damage the gland tissues and interfere with their function. If you’ve ever had kidney stones, these are oxalic crystals.

#3 - prolonged chronic stress:

• Any kind of stress activates your fight or flight system, which signals your adrenal glands to release cortisol in order to shift energy and blood flow to tissues and organs essential to fight or flight. Elevated cortisol levels signal the thyroid gland to produce more TSH (thyroid-stimulating hormone) and stop the conversion of T4 to T3.

• This same stress response is modulated by the HPA axis (hypothalamus, pituitary, adrenal). Chronic stress means a chronic activation of the HPA axis, which interferes with the HPT[hyroid] axis we discussed earlier.

• Unaddressed chronic stress causes cells to activate the Cell Danger Response (CDR) in order to preserve energy. CDR causes cells to stiffen cell walls to prevent nutrient transfer, release deiodinase 3 to deactivate thyroid hormone, and send out signaling hormones to summon immune cells to help. It’s your cells’ version of texting 9-1-1.

• Examples of chronic stressors that often go unaddressed include:

  • pathogenic infection (Lyme, parasites, mold, candida, SIBO, etc.)

  • tension in relationships (romantic, friends, or family)

  • work stress (deadlines, overworking, high pressure, commute)

  • caregiving

  • people-pleasing behaviors

  • unaddressed emotional or physical trauma

  • overexercising

  • excess busyness

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what should be included in your thyroid labs?

When you have thyroid symptoms, testing for TSH and T4 are typically the only two things Western Medicine practitioners will test for. Occasionally, you might find a provider willing to also test for T3, free T4, and free T3.

Why so stingy with the testing? Because in the United States, most insurances require TSH to be elevated, and T4 to be low in order to diagnose hypothyroidism. Because these are the only two factors they require for diagnosis, insurance companies in the U.S. may not cover additional factors to be tested.

Being put on thyroid medication should not be a life sentence. Finding a practitioner who is willing to look for root causes of your thyroid symptoms is important. TSH and T4 are not enough to get a clear picture of the thyroid gland.

Here are some additional factors to request with your thyroid bloodwork:

• TSH

• T4, fT4

• T3, fT3

• rT3

• thyroid antibodies

• vitamin D (25OH and 1,25OH) - a high 125OH:25OH ratio suppresses thyroid antibody production. If this ratio is elevated, the thyroid antibody levels on your bloodwork may not be accurate.

• estrogen (estradiol) - high estrogen affects thyroid function (as we discussed earlier). Estrogen levels are supposed to vary throughout your menstrual cycle. When testing for estrogen levels, it’s important to know which part of your cycle you’re in.

• free iron (UIBC on labs) - elevated free iron levels may indicate increased cellular stress, and help you narrow the root causes of your thyroid symptoms.

• CRP (C-Reactive Protein) - Elevated levels indicate increased inflammation, and may be indicative of cellular stress, pathogenic infection, or other internal stressors.

• homocysteine - similar to CRP, elevated homocysteine may indicate increased inflammation due to tissue damage in the blood vessels. Elevated levels may also indicate a vitamin B12 and folate deficiency.

• B12

• folate

In addition to bloodwork, functional lab testing is essential to finding pathogenic infections that may be at the root of your thyroid symptoms.

I use functional lab testing to help my clients find parasites, overgrown bacteria, viruses, mold, and candida overgrowth. These are common pathogens that can contribute to cellular stress, inflammation, and thyroid symptoms.

Want to know more about how to support thyroid health? Read this article.

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was this helpful?

Feeling more confident about addressing your thyroid symptoms? Do you have questions I didn’t address in this article?

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Low FODMAP Diet and IBS Symptoms

IBS symptoms are the result of chronic stress

Has anyone ever told you that IBS (Irritable Bowel Syndrome) is an umbrella term for symptoms of digestive distress? Put differently, it’s not the cause of your IBS symptoms, it’s simply the name we’ve given them.

What that means is, there are ways to get rid of IBS symptoms by addressing their root causes. But chances are, that wasn’t explained to you when you received (or gave yourself) your IBS diagnosis. Addressing those symptoms requires a more individualized approach than simply following a low FODMAP diet.

This article will dig into potential root causes of IBS symptoms and provide information on how to address them so you can have more freedom and flexibility in your food choices and stop saying ‘no’ to social invites.

Hi friends. I’m Hilary Beckwith, ex-dieter and holistic nutrition expert. Clients come to see me with signs of adrenal stress and inflammatory conditions, and my job is to find the root causes so we can address their symptoms more effectively, and fill in the gaps between what their doctor is saying and what their body is saying.

In this article, we’ll discuss:

• how to know if you might have IBS

• common root causes of IBS symptoms

• where western medicine is missing the mark when working to address your IBS symptoms - why low FODMAP and probiotics aren’t enough

• steps you can take to address root causes of IBS symptoms

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do you have IBS?

Cleveland Clinic classifies the following as IBS symptoms:

• frequent constipation, OR

• frequent diarrhea (or a combination of both)

• excess gas

• excess bloating

• abdominal pain and/or cramping

• mucus in your stool

• unable to feel like you’ve completely evacuated a bowel movement

The word “syndrome” included in the term IBS, indicates these symptoms consistently occur together.

DISCLAIMER

Now is a good time to point out that the information you read in this article and throughout the website should not be construed as diagnosis or medical advice. But rather to provide information and education to help you make more informed decisions about your health, and to empower you to advocate for your own health in the presence of a medical practitioner. Click here to read the full disclaimer.

Do you need a diagnosis of IBS to be able to address underlying causes? Absolutely not.

If you are interested in getting an official IBS diagnosis, consult with a trusted licensed physician who can provide an IBS diagnosis after a proper examination.

While Cleveland Clinic contradicts itself by calling IBS both a cause of symptoms and a “group of symptoms”, I have to give them credit for pointing out the interaction between the gut and the brain, further pointing to “childhood stress” as one common cause of IBS symptoms.

THE DIFFERENCE BETWEEN IBS AND IBD

IBS is an acronym for Irritable Bowel Syndrome, a group of symptoms that consistently occur together, that does not cause damage or inflammation to the intestines.

IBD is an acronym for Inflammatory Bowel Disease, which is an umbrella term that includes Crohn’s Disease and ulcerative colitis, both of which cause inflammation and damage to the intestines. According to Cleveland Clinic, IBD is incurable.

I would argue that there are ways of reducing underlying stress and systemic inflammation that may help symptoms of IBD in addition to addressing digestive health and adrenal health as a whole.

Addressing these symptoms goes deeper than following a low FODMAP diet. It requires an individualized look at your body’s symptoms, history, and needs. That’s the work I do.

common causes of IBS symptoms

Earlier we discussed how Cleveland Clinic describes the causes of IBS symptoms, but let’s break it down a bit more. I’ve used the list of common IBS symptoms we looked at earlier in the article, and provided common root-causes I see in my clients who have these symptoms.

• potential causes of constipation

  • candida overgrowth

  • low stomach acid

  • slow motility (food does not move quickly enough through your digestive system)

  • lesions in the gut lining

  • dehydration

• potential causes of diarrhea

  • intestinal inflammation (it’s possible IBS doesn’t cause inflammation and tissue damage, but it can certainly be caused by it)

  • food intolerances

  • unaddressed infection, such as bacterial overgrowth, Lyme, h. pylori, clostridia, or parasites

  • heightened adrenal response (chronically active fight or flight response)

• potential causes of excess gas

  • low stomach acid and digestive juices

  • poor protein digestion

  • slow motility

  • diet high in fermentable foods (high FODMAP)

  • bacterial overgrowth in small or large intestine

• potential causes of excess bloating

  • (see potential causes of excess gas)

• potential causes of abdominal pain and/or cramping

  • Because the abdomen consists of many organs, it’s difficult to provide generalized information about what may be causing abdominal pain or cramping.

    • If you experience abdominal pain or cramping, please consult with a trusted healthcare practitioner.

• potential causes of mucus in your stool

  • mucus membranes are home to part of your immune system (think congestion when you get a head cold). Mucus in your stool can indicate immune activity, fight off a gut infection such as bacterial overgrowth, candida, parasites, or mold.

  • constipation - if you’re constipated, your body may secrete mucus in order to help you evacuate a bowel movement

  • ulcerative colitis

• potential causes of feeling unable to completely evacuate a bowel movement

  • parasitic infection

  • congested liver

  • dehydration

  • chronic sympathetic nervous system response (fight or flight) due to stress

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low FODMAP and probiotics aren’t enough to address IBS symptoms

Here’s where Western medicine and health influencers are missing the mark.

I commonly hear clients and friends who experience digestive symptoms (including IBS symptoms) tell me that they’ve tried probiotics and low-FODMAP diets for their symptoms, with little or short-lived success.

It’s also common for me to hear that they were instructed to do so by their Primary Care Physician or that they saw it on socials somewhere.

Without also addressing digestive health and underlying stressors, changing your diet and adding supplements is a giant waste of your money. Probiotics and low-FODMAP foods might help your symptoms, but they are not going to resolve the cause of your IBS symptoms.

When clients come to me with IBS symptoms, I commonly look at their adrenal health, digestive health, liver health, dietary habits, sleep habits, and look for signs of pathogenic activity. When necessary, I also look at specialized lab testing to find sources of these underlying stressors that are part of the root cause of their IBS symptoms.

The process of eradicating these pathogens is specific to each person, the severity of the infection, and includes personalized dietary support. Once the pathogens are successfully eradicated (confirmed with lab testing), THEN we rebuild the gut microbiome with probiotics.

So, while low-FODMAP diets and probiotics might temporarily help with your symptoms, they are not fixing the problem.

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steps you can take to address root causes of IBS symptoms

• ADDRESS DIGESTION - This may seem rudimentary, but it is fundamental to addressing IBS symptoms. Mindful eating (sitting down to meals, undistracted, chewing adequately, relaxing) are all ways to effectively support your digestion.

  • Additionally, clients who show indications of low stomach acid production or intestinal inflammation are also recommended supplements to temporarily support those functions, as well.

  • This Digestion Troubleshooting Guide will help you understand the basics of healthy digestion, and troubleshoot your own symptoms.

• ADDRESS ADRENAL HEALTH - This is a broad feat, and requires more than a simple blog paragraph can offer, but like digestion, it is essential to long-term solutions for IBS symptoms.

  • Addressing adrenal health requires a look at sleep, blood sugar regulation, mental health, activity levels and timing, and light exposure. The adrenal glands regulate sleep, stress, hormone balance, fluid balance, and energy production.

  • If you want a closer look at supporting adrenal health, check out this article.

• GET TESTED - Before you can address gut pathogens, we first need to know what they are. Addressing mold is different than addressing bacterial overgrowth (same for candida, h. pylori, parasites, and other factors). Lab testing is the only way to know for sure what we’re dealing with.

  • In order to know which type of testing best suits your symptoms, we need to have a face-to-face conversation. Book a free 30-minute consultation so we can figure it out together.

  • Click here to explore testing options.

• YES! EAT A LOW-FODMAP DIET! - By writing this article, I’m not suggesting low-FODMAP diets or probiotics won’t help. I’m pointing out why those two remedies are not enough to resolve your IBS symptoms. As you can see, IBS is more complex than that, but there is hope! And eating low-FODMAP can help reduce your symptoms.

  • FODMAP is an acronym that stands for:

    • Fermentable

    • Oligosaccharides

    • Disaccharides

    • Monosaccharides

    • And Polyols

  • IBSDiets.org put out a comprehensive FODMAP food list here that will help get you started.

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learn something new?

Share your thoughts and questions in the comments below!

NUTRITION SERVICES

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• Functional Lab Testing

• Get a Health Assessment

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Ashwagandha for Anxiety and Anxiety Symptoms

Potential root causes of anxiety symptoms

I love ashwagandha! 

In fact, I've used ashwagandha and a variety of other adaptogenic herbs recommended to me by an herbalist, to support my own healing and anxiety symptoms.

But what I'm also doing is finding and addressing the root causes of my symptoms. My anxiety and blood sugar issues were not caused by not taking ashwagandha, nor will they be resolved long-term by taking it. 

Hi friends. I’m Hilary Beckwith, ex-dieter and holistic nutrition expert. Clients come to see me with signs of adrenal stress and inflammatory conditions, and my job is to find the root causes of their anxiety symptoms so we can address their symptoms more effectively, and fill in the gaps between what their doctor is saying, and what their body is saying.

Click here to view our website disclaimer.

In this article, you’ll learn:

• one commonly-overlooked cause of anxiety symptoms

• my favorite lab test for finding root causes

• long-term relief for anxiety symptoms

Follow my email feed to stay up-to-date on new articles like this one. Click here to subscribe.

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the root cause you won’t see on your annual bloodwork

There are many potential causes for anxiety symptoms, many of which should be addressed by a mental health professional. If you are experiencing depression or anxiety symptoms, please seek help immediately from a qualified specialist.

In this article, I’ll be looking at one specific potential cause of anxiety symptoms in relation to gut health and nutrition. A factor that often gets overlooked by other healthcare professionals, because it’s not commonly tested for.

If you experience anxiety symptoms, blood sugar issues, and sleep issues, this is something worth considering.

I’m talking about… CLOSTRIDIA INFECTION.

Some species of clostridia bacteria are known to cause symptoms of anxiety, blood sugar issues, and sleep issues, due to their relationship with dopamine. 

I'd bet good money that your GP is not testing for clostridia on your annual bloodwork (and that's why practitioners like me are here!)

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a closer look at clostridia

The image below is a snapshot of specialized lab results from a person I worked with who had all of the symptoms mentioned above. 

Specifically, we're looking at the 'HPHPA' marker.

You’ll notice that for HPHPA, 208 is the MAX we should see on this test. This test detected levels of 1511, it’s literally off the charts!

Here's what having high levels of HPHPA means for your anxiety symptoms:

HPHPA is a metabolite of a certain group of Clostridia bacteria found in the GI tract, including Clostridia sporogenes, Clostridia caloritolerans, and Clostridia botulinum, among others.

Additionally 4-cresol (also shown in the image above) is a metabolite produced specifically by Clostridia difficile (you may have heard this called “C-diff”).

High markers of HPHPA and/or 4-cresol means that there is a likely infection of certain types of clostridia bacteria in the GI tract.

These types of Clostridia are known to inhibit the enzyme responsible for breaking down dopamine, called dopamine-beta-hydroxylase.

Too much dopamine might seem like a good thing, right?

Dopamine feels great at the moment, but when it's chronically maxed, it infiltrates the sympathetic nervous system, resulting in a constant fight or flight response, modulated by the sympathetic nervous system. 

PUT MORE SIMPLY:

Elevated Clostridia metabolites prevent the breakdown of dopamine, causing a chronically stimulated fight or flight response, potentially resulting in anxiety symptoms, sleep issues, and blood sugar issues.

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addressing root causes for anxiety symptoms

I am a big advocate for seeking licensed professional support for your mental health and wellness. And to be clear, I do not claim to be a mental health professional, nor do I offer treatment from that perspective.

What I can (and do!) help with is supporting nutritional factors for signs and symptoms of neurotransmitter dysfunction and hormone imbalances, often rooted in the gut or diet.

I believe that addressing mental health and wellness often requires a multi-faceted approach that requires care from an integrative support team. So, in addition to your other licensed mental health practitioners, it may also be worth considering a nutritional approach to addressing your anxiety symptoms.

HERE’S WHAT THAT MIGHT LOOK LIKE

If Clostridia infection has been detected on this specialized blood panel, this very well may be one factor in your anxiety symptoms, and the heightened fight or flight response may also be causing blood sugar issues and sleep issues.

Clostridia is a type of bacteria, and the types found here that disrupt dopamine breakdown, are found specifically in the digestive tract.

Eradicating Clostridia, or any type of bacterial overgrowth in the gut, requires a strategic and holistic approach.

The short-term fix would be a round or two of prescription antibiotics from your GP or other physician and/or anti-anxiety medications. These can both be helpful, but may not support the long-term issue.

THE LONG-TERM SOLUTION OFTEN ENTAILS:

• addressing digestive health as a whole, including digestive enzymes, stomach acid support, intestinal tissue healing, bowel movements, and liver health

• temporary restriction of carbs and sugars that feed bacteria

• nutrients to break down biofilm, a sticky film in which the bacteria live and hide

• potent antimicrobial botanicals shown to eradicate bacterial pathogens

• carefully curated probiotics to rebuild the microbiome after we’ve killed off the invaders (antibiotics, even botanicals, kill all bacteria, even the beneficial ones)

FAST FORWARD

After 4 weeks of addressing root cause factors, we re-tested the client whose lab results were shown above, and found the HPHPA markers came down significantly:

So, you can continue taking ashwagandha for the rest of your days to help with your anxiety symptoms, blood sugar issues, and sleep issues. 

OR...

You could seek long-term solutions by finding a qualified practitioner who is trained to find the root causes of your anxiety symptoms.

WANT TO TALK ABOUT IT?

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was this helpful?

Please share your thoughts and questions in the comments below!

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BLOG REFERENCES

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