The 5 Rs of Healing Your Gut

How To Heal Your Gut in Perimenopause & Menopause

Let’s heal your gut! 

Whether you are dealing with digestion issues, autoimmunity, brain fog, fatigue, or skin issues, the 5R gut healing protocol could be hugely helpful for you. When gut health is compromised, there’s no quick fix and there’s a specific order of operations as healing progresses. That’s where the 5 Rs come in!

What is the 5R Gut Healing Protocol?

The 5R gut healing protocol restores the natural balance of your gastrointestinal tract. Because many of us are exposed to environmental toxins, crappy diets, and daily stress, our gut health has a high likelihood of being less than optimal. The result is the issues mentioned above, in addition to hormone imbalance. And if you’re in perimenopause or menopause you don’t need that! 

The 5R protocol focuses on five parts to restore your natural gut balance, including:

  • Remove
  • Replace
  • Repopulate
  • Repair
  • Rebalance


You first want to remove all the bad actors that are causing your gut to revolt. Continued exposure to these insults will result in continuing problems. These may include:

Food:Food sensitivities are a major drawback to gut health. The problem is that many people don’t know they have any! Food sensitivities can cause a variety of symptoms including but not limited to: headaches, acne, joint pain, constipation and anxiety. 

Some of the most common sensitivities are from gluten, dairy, soy, and eggs, but every person’s body is unique. To know for sure which foods you are sensitive to, you can try an elimination diet of likely offenders or get a food sensitivity test performed. It’s better to test than to guess if you want the best results. 

Infections, Pathogens, Bacteria and Parasites: These issues show up on a stool test and you should eliminate them ASAP. You can’t truly heal if your gut has to battle these foreign invaders constantly. There are different protocols to remove yeast, parasites, and pathogenic bacteria. 

Stress: Stress weakens your intestinal lining which then allows gut bacteria to enter your circulation. This is not where you want them! Managing stress is challenging at best, but doable. Start by identifying your sources of stress and changing what you can. Breathwork, exercise, getting out in nature, prayer, meditation and scheduling a bit of down time for yourself can all be helpful. All of these are PRACTICES, so don’t expect perfection. That just increases stress!

Toxins: Toxins in your water, food, and home and beauty products can disrupt your microbiome, killing off the helpful bacteria. When your body is exposed to toxins day after day, they build up in your body if your detoxification pathways are not optimized. These toxins can disrupt the normal functioning of the gut leading to chronic diseases, allergies, obesity, and other GI issues. 


Next, you’ll want to replace missing elements that are vital to digestion. These can include replacing digestive enzymes, betaine HCL, and ox bile. Ox bile or bile acids, specifically, are critical in digestion since they increase the absorption of fat soluble vitamins. To replace these, you can use supplementation specific to your body’s needs.

YMicrobiome Testing & Good Gut Bacteriaou can also consume foods that stimulate stomach acid and digestive enzymes such as bitters. These supplements help your body break down fats, carbohydrates and proteins more effectively. 

Another reason why having an adequate amount of bile is critical is because it plays a role in toxin elimination. Bile is how many dangerous “fat-loving” substances and toxins get excreted from the body. It also has some antimicrobial properties to help keep gut bacteria balanced.


Good bacteria in your gut may get crowded out by opportunistic bacteria or killed off by drugs like antibiotics. Getting these back in balance can be accomplished with fermented foods or by taking probiotic supplements. Prebiotics are also important to help feed the good bacteria. Here’s a list of foods that have prebiotic properties

If you have your gut microbiome testing done with me, I will be able to see which beneficial bacteria are considered low and can recommend a brand of probiotics specific to your current gut make-up. When your gut contains good bacteria, it enhances your body’s digestive, immune, and metabolic processes. 


Fixing your damaged gut is essential for long-term gut health. This includes repairing your gut lining, mucosa, and damage from inflammation. To do this, you’ll want to include more vitamins A, C, E and D, zinc, collagen, and amino acids, particularly L-glutamine. There are also herbs that are soothing to the gut such as marshmallow root, slippery elm, and aloe vera. Bone broth is great for gut repair, but if you have histamine reactions, you may want to avoid this.


The 5R protocol won’t be successful in the long term if you go back to your old way of living. To truly rebalance your gut, consider your lifestyle behaviors. For example, the overuse of NSAIDs like ibuprofen can be detrimental to your health when they are not absolutely necessary. Rebalancing requires rooting around in all the corners of your life for sources of poor gut health.

Bottom Line

Healing your gut isn’t a quick fix or fad. That’s why my Healthy Gut program is 6 months long! It takes effort and occasionally some trial and error. Lifestyle change is hard, but with support and accountability, the payoff of feeling amazing is worth it. 

Dr. Anna Garrett is a menopause expert and Doctor of Pharmacy. She helps women who are struggling with symptoms of perimenopause and menopause find natural hormone balancing solutions so they can rock their mojo through midlife and beyond. Dr. Anna is the author of Perimenopause: The Savvy Sister’s Guide to Hormone Harmony. Order your copy at

Dr. Anna is available for 1-1 consultation. Find out more at

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