Hi friends! So, recently I’ve been sharing a bit more nutrition-related knowledge on the gram instead of just recipes, and the response has been exciting. Although the videos don’t get the views that some of my recipes get, the messages in my inbox asking for more information seems like a good indication I should keep up that kind of content/education.

Leaky gut is likely a term you’ve heard. It’s thrown around a lot in the media as the cause for just about every ailment one could have. You’ve probably wondered at one time or another if you have a leaky gut or if a leaky gut is real, both are likely questions. Today, I will answer both, plus discuss symptoms, treatment, and preventing reoccurrence.  

What is Leaky Gut? 

The cells that line the intestinal wall of the GI tract are held together by protein matrixes called tight junctions. Tight junctions have two roles, but usually, only one is discussed. The first role of tight junctions is to hold together the cells lining the GI tract, known as intestinal integrity. The second role is to act as part of the immune system, allowing immune system surveillance of the GI tract. 

Tight junctions, when functioning correctly, can and should open about 10% of the time or on demand, allowing the immune system to monitor the contents of the GI tract for things like pathogens, toxins, etc. Like a window for the immune system to look through and respond and kill things that may be harmful. However, when there is damage to the tight junctions, and they remain open more than 10% of the time, you get more immune system surveillance than you want. The immune system then begins to see things it wouldn’t normally see on a regular basis and identifies it as a foreign invader, even if it’s just blueberries. This is known as a “leaky gut” because the contents of the GI tract are leaking between the cells. The more scientific way of saying this is increased intestinal permeability. 

If you are wondering if it is real, there are over 200 published studies on the topic. Go ahead and take a look at PubMed or any other database. I promise you, it’s real, and the concept is here to stay. Why isn’t it treated in conventional medicine? Because we don’t have a medicine that will magically heal it. It requires a combination of determining and removing triggers (murky waters) and support with lifestyle changes and tissue healing. The protocol for recovery is different for each person, so in the conventional medicine setting, it’s not realistic to treat. I could go on about that, but I’ll stop there.  

What Causes Leaky Gut?

What causes those tight junctions to be open longer than they should be? That’s the golden question. There are many potential causes, and it’s usually not just one thing for one person. Here are some possible triggers that have been identified in the research: 

• Stress
• Gut Microbiome dysbiosis 
• Medications: SSRIs, PPIs, Oral Contraceptives, statins, NSAIDs, steroids
• Emotional or Physical Event (like surgery)
• Severe infection or illness 
• Toxic Chemicals
• Food Additives and Preservatives such as food coloring and gums 
• Undigested Food Macromolecules 

Once exposed to barrier-damaging agents, you can get inflammation in the epithelium and barrier damage. After that, it becomes kind of a game of chicken and egg. Because it doesn’t matter what initially caused that breakdown in intestinal permeability or leaky gut; once you’ve got it, the immune system will start hyper-responding to things it would have before, simply by the window of monitoring being open for longer. The immune system will identify everyday chemicals, foods, and more as foreign invaders. In some cases, severe cases, it will even start making antibodies to the protein structure within the tight junction.  

How Do We Identify Leaky Gut?

In my opinion, the best test out there is the Cyrex Array 2 Permeability Screen. This panel measures antibodies to bacterial toxins, structural proteins, and tight junctions in the blood. Some stool testing companies offer tight junction protein testing within their panels. However, research doesn’t correlate as strongly with stool levels, nor does it correlate as strongly with measuring levels of the proteins found in tight junctions in the blood. I would take note of these markers if I saw them in panels, but I wouldn’t consider them diagnostic as antibodies. Antibodies tell you if there is immune system activation, which is the entire premise of how a leaky gut causes symptoms. Some practitioners will assume a leaky gut based on symptoms, disease, or sometimes overblown food sensitivity panels (when you test positive for more foods than you test negative too on a food sensitivity panel.)  

I used to do this too, but I find that’s a great way to get lost in the weeds. By assuming instead of testing, you can never be sure what path you are on. Depending on budget constraints, now my preference is ALWAYS to test. Testing allows you to see the severity of the leaky gut and will enable you to monitor healing through retesting. It can be used as a guide to know when it may be safe to reintroduce foods, how aggressive the supplement regimen should be, and where to look for triggers/inflammation-causing agents for that patient.  

What Are The Symptoms of Leaky Gut? 

The GI tract and the immune system affect almost every organ in our body. Symptoms of a leaky gut and a hyperactive immune system can vary far and wide. That’s why lists are so vague and vast. The immune system in hyperdrive causes increased inflammation throughout the body, but where the inflammation starts to create symptoms and pathology is probably genetic and individual.   Research has identified the following as co-conditions or common symptoms associated with increased intestinal permeability.  

• Food sensitivities
• Inflammatory bowel disease
• Autoimmune disease (any and all)
• Preautoimmune markers (such as a positive ANA)
• Thyroid problems
• Nutrient malabsorption
• Acne
• Psoriasis
• Other Inflammatory Skin Conditions
• Obesity-related metabolic diseases (fatty liver, type II diabetes, heart disease)
• Chronic inflammatory conditions (such as arthritis and gout) 
• Mood issues 
• Fatigue 
• Autism
• Bacterial imbalance 
• Gas/Bloating 
• Parkinson’s
• Neurodegenerative conditions.  
• Allergies
• Respiratory/Infection
• Hormone imbalance

So, a leaky gut doesn’t necessarily cause every symptom here but tends to co-occur with the ones above. And having one of those symptoms or conditions may increase the likelihood of developing a leaky gut (the stressful trigger that damages the GI tract.)  So, again, the chicken and the egg. 

How Do We Heal Leaky Gut? 

Number one, you can’t heal it unless you identify it. I have switched to a testing base model in which I run a leaky gut screen on almost every client before I do any further testing, or at least in combination with another testing. Once that’s complete, then there are three main steps.

1.  Identify if leaky gut truly exists and to what severity. 
2.  Identify and remove triggers or exacerbations. –> this is the hardest step because it generally requires more testing, such as some combination of food sensitivity testing, chemical sensitivity analysis, pathogen screening, and gut microbiome analysis.
3.  Support healing and repair of GI permeability. Bring supplements on board to promote healing and recovery. Monitor gut dysbiosis and replenish the microbiome. 
4.  Monitor through retesting until levels are normalized.  
5. After levels are normalized, ween off supportive supplements and reintroduce triggers such as benign foods like blueberries. For some people, some things that may be cross-reactive with human tissue and studied to relate to their condition (particularly autoimmune conditions) foods might not come back, such as celiac disease and gluten. And you may have to be more aware of chemical and toxin load in general for a long time.   But the goal is to give you as much food freedom as possible.  

How Long Does It Take To Heal Leaky Gut?

Depends on the severity and the cause. But, I usually offer a retest of intestinal permeability within three months.  

Where a lot of people go wrong is they do food sensitivity testing without monitoring the presence of a leaky gut. Then the reintroduction phase is based on symptoms, which at first is fine. However, in the long run, if you haven’t healed the GI tract before reintroduction, you’ll likely get more food sensitivities developing and new symptoms or symptom reoccurrence. Remember, food sensitivities are BOTH a symptom of a leaky gut and a trigger for its continuation.  

Symptom relief usually starts around three weeks after triggers are removed, and healing protocol has started with full symptom resolvent in 3-12 months, again depending on severity.  

Final Words On Leaky Gut

There is no disputing the evidence that gut health affects the health of every other organ we have in our bodies. However, leaky gut or intestinal permeability status is just one piece. And yes, it’s a large piece, so much so it’s the first thing I like to screen any of my functional medicine clients for because our toxic world and stressful lives have predisposed most people to it. But it isn’t the only thing. I have seen stool tests (gut analysis tests) come back with a lot of opportunities for improvement based on pathogens, gut dysbiosis, and intestinal health markers. In contrast, the simultaneous leaky gut screen comes back totally negative. There are several reasons why this could happen:

1.  We caught the issues early before leaky gut developed.
2.  The client previously had a leaky gut, removed enough triggers, and did enough support to heal it, but is at risk of reoccurrence. 
3.  The issues are just not affecting gut permeability.  

I honestly think most people should screen for leaky gut every 1-2 years because we live in a toxic world where it can develop at any time. It’s incredibly powerful knowledge about your body since your GI health affects every other organ in your body. A gut-centered approach is the best approach to root cause medicine. However, while leaky gut screening is about as standard in my practice as going to your doctor and getting a yearly blood workup, it’s not the end all be all. Fixing a leaky gut doesn’t fix every single issue people may come to me with. Sometimes we need to keep looking for the root cause of symptoms. But, healing a leaky gut can significantly impact health, longevity, symptoms, and well-being.  

Leaky Gut Packages

Exciting announcement! I will release nine new “leaky gut packages” with comprehensive testing coverage and unlimited nutrition appointments for six months very soon.  I have finally finished putting together my Comprehensive Gut Packages! These packages are for people sick of trying random protocols off the internet and random things that may or may not help based on symptoms.  It will use a gut-centered and personalized testing approach to get to the bottom of symptoms and see significant improvement fast.  

These programs are for the people who just want to do “everything” at once to get to the bottom of their health concern and gut health interaction.  It’s kind of the “best case scenario” set of testing I would do if “money wasn’t an option.”  Because doing that much testing up front isn’t cheap, I designed these packages to have unlimited ongoing nutrition support for 6 months.  

The packages are as follows: 

1. Longevity and Preventative Wellness
2. Autoimmune 
3. Autoimmune plus
4. Fertility/ Hormone Balance
5. Fertility/ Hormone Balance plus 
6. IBS/SIBO
7. IBS/SIBO plus 
8. Arthritis/Gout 
9. Arthritis/Gout Plus

 If you are interested you can find out more information here.  But remember, you don’t have to do one of those programs you can always sign up for a leaky gut package consult.During the consult process we will figure out what testing if any makes sense for you.  

You can also check out my 4-week gut health meal plan and the functional fab five for gut health.  

MORE INFORMATION ABOUT GI HEALTH:

• Why I Don’t Recommend Elimination Diets
• What Is Inflammation?
• What are Anti Inflammatory Foods?
• What to Do After Food Sensitivity Testing 
• Food Sensitivity Testing and IBS
• Food Sensitivity Testing and Hashimotos/Thyroid
• Food Sensitivity Testing and Weight Loss
• Why You Need Probiotics for Optimal Health 
• Prebiotics to help retain the probiotics
• Healthy Fats for Digestion
• What You Should Know About Food Sensitivity Testing
• My Antibiotic Rebuild Protocol