When you're living with complex chronic conditions like Ehlers-Danlos Syndrome (EDS), POTS, or Mast Cell Activation Syndrome (MCAS), the nutrition advice you find online can feel overwhelming—and contradictory. Should you eliminate histamine forever? Are leftovers really that dangerous? And why does everyone keep telling you to wear compression socks that are impossible to put on?

I recently had the pleasure of speaking with Louisa O'Grady, a registered dietitian who specializes in these exact conditions, and her approach completely challenged some of the rigid thinking I've seen in our community. What I loved most about our conversation was how practical and individualized her recommendations were.

I've been working exclusively with chronically ill populations for years now, and I keep seeing the same pattern. Clients come to me after being bounced between specialists - their GI doctor says it's anxiety, their PCP says it's IBS with no treatment plan, and somehow they end up in my therapy office talking about the stress of not being able to eat without pain.

Here's what I've learned: we're missing some crucial pieces in how we assess, refer, and treat at this intersection. And honestly? It's costing our clients years of unnecessary suffering.

I get this question a lot, and honestly, I think I know why. For years, people have been going to their doctors, getting told "you have IBS, sorry, there’s nothing more we can do for you - here’s a pamphlet," and then somehow ending up in therapy when what they really need is education around their particular condition and how to eat appropriately for it.

Don't get me wrong - I'm a therapist, and I love the work I do. But sometimes people end up in my office talking about stress when what they actually need is medical care. They just haven't gotten to the right medical professional yet.