The Gut Check

A letter on gut health, performance & longevity

Decoding the evidence.

Prose a runner can use before tomorrow’s long run and a clinician can quote in clinic.

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From the letterIssue №003 · ~6 min read

What your gut does at 2am on a call night.

It is 2:14am and the pager fires. Upper GI bleed. I roll out of the narrow call-room bed, walk past a communal kitchen where someone has left half a pizza in its box, and eat two cold slices standing up before I head to the endoscopy suite. I spend my days counseling patients on dietary timing and the microbiome — and a good share of my nights systematically dismantling that advice in my own body.

The gut keeps its own clock. Gastric acid output peaks in the evening; colonic motility runs nearly silent between midnight and 6am — which is why most people move their bowels in the morning, not at 3am. Eating cold pizza now, I am asking the factory to run during its maintenance hours.PMID 16968601 · circadian GI rhythms

It is not just timing. A landmark 2014 study showed the microbiome oscillates across the day, driven by feeding rhythm — and that inducing jet lag distorts those oscillations enough to transfer metabolic dysfunction into germ-free mice given the stool.Thaiss 2014 · Cell · PMID 25417104

[ Take this away ]

Your gut has a clock. Respect it when you can. Repair it when you cannot.

Every letter reads like this — the evidence lives in the margin, where you can check it. See how we write.

The letters.

The first letters, twice weekly
№003

June 16, 2026

The Evidence

The circadian biology of the call night — and what the evidence says about limiting the damage.

№004

June 19, 2026

The Evidence

The case against a default built for people who train twenty hours a week.

№005

June 23, 2026

Field Notes

Splanchnic shunting, mechanical load, and the autonomic shift — what actually causes it.

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Why this exists

I will not recommend anything I would not take myself, give to my own patients, or hand to a training partner before a long race.