Customer Story

This first-time mom and athlete wanted to optimize her health during pregnancy.


Professional Ironman athlete Sarah Piampiano started working with Ixcela in 2018. She hoped Ixcela could help her improve her athletic performance and relieve intense symptoms related to IBS and autoimmune thyroid disease. With the help of the Ixcela team, Sarah began a low FODMAP diet. This was a game changer for her.

Over the next two years, many of Sarah’s health struggles (constipation, bloating, inflammation, erratic thyroid levels, low iron, low energy, etc.) completely cleared up or significantly improved. Her thyroid stabilized for the first time in six years. Her sleep and energy levels improved, and her inflammation significantly decreased. In 2019, she had the best season of her career.

In 2020, Sarah became pregnant. Because she understood the importance of gut health, she decided to test with Ixcela throughout her pregnancy. She was curious how the physiological changes of pregnancy would affect her gut health, and she knew that Ixcela would help her optimize her health during pregnancy.


During the first trimester, Sarah felt extremely nauseated. The only things she wanted to eat were toast with cream cheese, ice cream, and oranges. Her diet was carb-heavy, and she wasn’t sleeping well.

Sarah’s overall score on her first Ixcela test was 63. Energetic Efficiency was her lowest score, and this reflected that the nutrients in her diet were not meeting her body’s needs. The metabolites that affected her Energetic Efficiency score were serotonin and tyrosine.

When serotonin and tyrosine are below optimal levels, it contributes to:

  1. Poor-quality sleep (Serotonin is connected to the production of melatonin, a sleep hormone.)
  2. Low energy levels
  3. Low motivation


After meeting with her Ixcela dietitian, Sarah realized that she wasn’t eating enough protein for her body’s changing needs. Both serotonin and tyrosine are related to protein intake.

Sarah realized she was only eating about 60 grams of protein each day. Her Ixcela results showed that she needed about 120 grams per day.

Serotonin is a neurotransmitter that is important for sleep. Tyrosine, which supports motivation and feelings of well-being, is an amino acid found in protein-dense foods. These two metabolites were important not only for Sarah’s own health, but also to support her pregnancy.


Sarah and her dietitian spent time reviewing the results and recommendations in her report. A variety of valuable recommendations were offered to support Sarah’s metabolites, and her dietitian helped her prioritize the recommendations based on her current symptoms and what was realistic. They discussed how focusing on adequate protein intake would support her serotonin levels and sleep. Getting a good night’s sleep sounded amazing to Sarah, and she felt that focusing on protein intake would be realistic.

As an athlete, Sarah understood the importance of her nutrition. She was motivated to make changes to her diet because she knew these changes would support her growing baby and help with some of her symptoms.

Sarah agreed that she would:

  • Include one type of whole-food protein source (chicken, meat, Greek yogurt, or fish) at lunch and dinner.
  • On training days, she would consider including a protein shake to support her increased protein needs. Because protein shakes may not be utilized as well as whole-food protein sources, her Ixcela dietitian recommended limiting protein shakes to one per day.


As Sarah moved into her second trimester, her scores and metabolites improved. Her serotonin was within optimal levels, and her sleep quality was much better than it had been during the first trimester. This gave Sarah the opportunity to reintroduce a more consistent training schedule, and she had the energy to prepare high-quality meals to adequately fuel her training during pregnancy.


Sarah continued to test with Ixcela throughout her pregnancy. She found that keeping track of her metabolites and having personalized nutrition and lifestyle recommendations was extremely helpful. Although Sarah’s scores fluctuated during her third trimester, understanding her data and doing follow-up sessions with her Ixcela dietitian gave her insight into what she could do to support her symptoms.

Sarah’s follow-up tests showed that her metabolite levels continued to change throughout pregnancy, and this made sense because so did her symptoms. For example:

  • In her second trimester, Sarah’s results showed that she wasn’t drinking enough water. She was experiencing cramping, and she created a goal to start drinking at least 90 ounces of water daily.
  • In her third trimester, Sarah's results indicated that she needed to focus on restorative practices to help reduce stress. A 30-minute walk after dinner and listening to calming music worked for her.
  • In her third trimester, Sarah’s serotonin levels dropped as they did in the first trimester, and she started having issues getting to sleep at night. After reviewing her protein intake and finding that it was adequate, the Ixcela dietitian advised her to try reading 15 minutes before bed and to talk with her doctor about a natural sleep supplement to take before bed.

Sarah and her family welcomed a healthy baby boy in February 2021. She continued to work with Ixcela post-partum to aid in her recovery and support her as she reintroduced exercise and set her goals for 2022.

Here's what Sarah said:

It was extremely helpful tracking my metabolites during pregnancy. One of the things I love about the Ixcela report is that every suggestion clearly explains which gut metabolites are being impacted. It helps me understand why eating a certain food will have an impact on my gut health and how that might directly apply to other symptoms I might be having, or how mindfulness or exercise impacts certain metabolites. Understanding your results and understanding the direct impact of your dietary and lifestyle choices is very empowering. I particularly found this motivating during my pregnancy.


Back to all customer stories Choose your goal

Other stories you may enjoy: