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The 5R Gut Health Framework: A Functional Approach to Digestive and Hormone Health

Posted on Wednesday, February 19, 2025
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Gut health isn’t just a trending topic—it’s the foundation of your overall well-being. Scientists and health professionals are uncovering more about the gut microbiome’s crucial role in digestion, immune function, metabolism, and even hormone regulation. Yet, modern life is taking a serious toll on our digestive systems. 

Today’s food supply is depleted of essential nutrients due to industrial farming practices and soil degradation. Environmental toxins, lack of clean water, chronic stress, and poor sleep habits further contribute to gut imbalances. Without daily sunlight and a balanced lifestyle, our microbiome struggles to function optimally. 

It’s no surprise, then, that six in ten Americans have a chronic illness, with rates of insulin resistance and blood sugar dysregulation skyrocketing. The connection? A compromised gut. 

In Episode 4 of Amac’s Better For You Podcast, Dr. Robert Silverman puts it plainly: 

 “80 percent of your immune cells are in your gut. It’s where your macro and micronutrients are absorbed—your foods, your vitamins, and minerals. So we need our gut in its pristine condition to function well. So many conditions come from a leaky gut. For instance, inflammation, autoimmunity. 

Do you get gas and bloating after you eat? Do you get brain fog? Well, if you get gas and bloating, that’s a symptom that shows me something is wrong with your digestive tract. If you get brain fog, there’s something wrong with the superhighway to health—your gut-brain axis.” 

The good news? You can take control of your gut health. Resetting your microbiome doesn’t require complicated protocols—simple, sustainable practices can make a profound impact. In this article, we’ll break down the Institute for Integrative Nutrition’s  5R Gut Health Framework, a functional medicine approach designed to restore your digestive and hormonal balance. Let’s dive in. 

What Is the 5R Gut Health Framework?

The 5R Gut Health Framework is a step-by-step approach designed to heal, restore, and optimize gut function. Developed by functional medicine practitioners and widely used by health coaches, this framework provides a structured way to address gut imbalances that contribute to digestive distress, inflammation, and hormone dysfunction.

Rather than treating symptoms in isolation, the 5R approach looks at the root causes of gut issues and systematically works to bring the microbiome back into balance. Whether you’re struggling with bloating, brain fog, food sensitivities, or chronic inflammation, this framework serves as a roadmap to rebuilding a healthy gut ecosystem.

Step 1: Remove – Eliminating Triggers of Inflammation

The first step in the 5R Gut Health Framework is to remove the substances that contribute to gut irritation, inflammation, and microbiome imbalances. Think of this step as clearing out the clutter so your digestive system can start the healing process.

Removing inflammatory foods such as gluten, dairy, soy, corn, highly processed foods, refined sugar, alcohol, and excessive caffeine is a crucial first step in restoring gut health. These foods can irritate the gut lining, contribute to leaky gut, and disrupt the balance of beneficial bacteria, leading to digestive discomfort and systemic inflammation. By eliminating these common triggers, the gut has a chance to heal, reducing stress on the digestive system and improving overall function. 

This step is essential for easing symptoms like bloating, fatigue, and brain fog while also supporting immune and hormonal balance. Many chronic issues, including autoimmune conditions, skin problems, and metabolic concerns, can be linked to gut inflammation.

Removing these triggers sets the stage for the next step—replacing essential digestive components for optimal gut function.

Step 2: Replace – Supporting Digestion

Once inflammatory triggers are removed, the next step is to replace essential digestive supports that may be lacking. This includes digestive enzymes and digestive bitters, which help break down food and enhance nutrient absorption. Proper digestion also starts with simple lifestyle changes, like mindful eating and thoroughly chewing each bite—something many people overlook in today’s fast-paced world. Chewing food 20 to 30 times before swallowing can significantly reduce bloating, gas, and stomach discomfort while optimizing digestion. 

For those who still struggle with digestive discomfort, enzyme supplements can offer additional support by breaking down proteins, fats, and carbohydrates more efficiently. Some natural sources of digestive enzymes include fresh pineapple (rich in bromelain) and fermented foods like sauerkraut. In cases of low stomach acid, digestive bitters or diluted apple cider vinegar before meals may help stimulate acid production and improve digestion. However, symptoms like acid reflux, bloating, and frequent burping could indicate an underlying stomach acid imbalance that requires medical evaluation. 

Before incorporating any supplements or digestive aids, it’s essential to consult a healthcare provider to determine individual needs. Your doctor can recommend the best approach. Replacing missing digestive components is a key step in restoring gut health, paving the way for the next phase—reinoculating the microbiome with beneficial bacteria.

Step 3: Reinoculate – Restoring Healthy Gut Bacteria

Reinoculating the gut involves introducing beneficial bacteria through probiotic-rich foods, such as kimchi, sauerkraut, kefir, and yogurt, as well as prebiotic foods that nourish these microbes. Prebiotics, found in fiber-rich foods like garlic, onions, asparagus, and bananas, help beneficial bacteria thrive, promoting a balanced and diverse gut microbiome. In some cases, probiotic supplements may also be necessary to restore microbial balance, especially after antibiotic use or periods of digestive distress. 

This step is essential for strengthening the intestinal barrier and improving overall gut health. A diverse microbiome supports digestion, immunity, and even hormone regulation. Reinoculation is particularly beneficial after eliminating inflammatory foods, following antibiotic treatment, or for those struggling with frequent infections, irritable bowel syndrome (IBS), or hormonal imbalances. By replenishing beneficial bacteria, this phase helps create a stronger foundation for long-term gut health.

Step 4: Repair – Healing the Gut Lining

The fourth phase of the 5R Gut Health Framework, Repair, focuses on nourishing and healing the gut lining with targeted foods, herbs, and supplements. One of the most commonly recommended foods in this phase is bone broth, which contains gelatin and glutamic acid—key nutrients for maintaining and sealing the intestinal barrier. 

L-glutamine, another powerful gut-repairing nutrient, is an amino acid that feeds intestinal cells and supports gut permeability. Found naturally in foods like eggs, beef, tofu, and corn, it can also be taken in supplement form for short-term use. Other beneficial supplements include aloe vera juice, which has antioxidant and antibacterial properties; zinc carnosine, which helps repair damaged intestinal cells; and quercetin, a flavonoid that supports gut health by reducing inflammation and preventing histamine release. Turmeric, well-known for its anti-inflammatory properties due to its active compound curcumin, can also aid in gut healing when consumed with dietary fat and black pepper for better absorption. 

Beyond these, additional nutrients such as vitamin D, omega-3 fatty acids, licorice, and marshmallow root can further support gut repair. Since individual needs vary, it’s important to consult with a healthcare provider before incorporating new supplements to ensure safety and effectiveness. This phase lays the foundation for a stronger, healthier gut, improving digestion, reducing inflammation, and supporting overall well-being.

Easy Slow Cooker Bone Broth

Grass fed beef bones

Fill the slow cooker with water to 1” above the bones

2 TBSP Apple Cider Vinegar

2 TSP salt

Cook on low for 8 hours

Strain and refrigerate

*I like to store broth in glass jars in the fridge. You can also freeze for future use.

Step 5: Rebalance – Addressing Lifestyle Factors

The final phase of the 5R Gut Health Framework, Rebalance, focuses on factors outside of diet that support overall gut health and healing. While the previous phases addressed food, supplements, and healing, Rebalance emphasizes lifestyle changes, particularly stress reduction, which has a profound effect on both hormonal and gut health.

In this phase, it’s essential to address stress. Small, simple steps like practicing five minutes of breathwork or journaling for one minute a day can help you move toward rebalancing your health. These manageable changes can make a big difference over time, bringing you closer to healing and optimal gut function.

Overall, the 5R Gut Health Framework is a comprehensive approach to improving digestion, nutrient absorption, gut barrier integrity, and reducing inflammation. By focusing on each phase with intention, individuals can make lasting changes that improve gut health and overall quality of life

Why the 5R Framework Is Essential for Hormone Health

The 5R Gut Health Framework is essential for hormone health because of the deep connection between the gut and key systems in the body, including the endocrine, immune, and nervous systems. The gut plays a significant role in hormone regulation through the gut-brain axis, which links digestive health with brain function and stress response. Chronic stress can disrupt this balance, affecting digestion and hormone regulation by influencing the hypothalamic-pituitary-adrenal (HPA) axis, which controls cortisol levels and inflammation.

This approach can support digestion, strengthen the immune system, regulate metabolism, and balance hormones. However, it’s important to approach this process thoughtfully, considering how gut health affects overall well-being. Working with a healthcare provider or health coach is recommended to ensure that changes are appropriate for individual needs.

For those considering the 5R framework, a practical first step might be tracking food reactions or gradually introducing gut-supporting habits, such as adding more fiber-rich foods or reducing stress with small daily practices. The 5R framework can be a transformative approach to health when personalized to your unique needs and symptoms.

Want to take your gut health to the next level? Tune in to my conversation with Dr. Robert Silverman for expert insights on healing your gut, reducing joint pain, and boosting overall wellness. Listen now on Apple Podcasts.

Melanie Griffin, certified in Hormone Health from the Institute of Integrative Nutrition, holds a B.S. in Sports & Fitness. As the host of The Better For You Podcast, she helps midlife and senior adults improve their health through simple nutrition and lifestyle strategies.

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