If you have food sensitivities—you have leaky gut. If you have bacterial overgrowth, candida overgrowth or a parasitic infection—you have leaky gut. If you have an autoimmune disease, you at one time had leaky gut and may still have it. Hyper-permeability of the small intestinal mucosal lining or leaky gut syndrome (LGS) is extremely common yet rarely diagnosed. It may be responsible for autoimmune diseases (not just celiac disease and inflammatory bowel disease), all food sensitivities (not just those with gastrointestinal-type symptoms) and the development of all sorts of nasty opportunistic critter take-overs. It is even a causal factor in psoriasis and the autism spectrum! So what say you? Shall we get our gut junctions closing again—stat?
Small Intestines Have a Big Job
The job of the small intestine is to completely digest food and absorb nutrients. Nutrients are absorbed through villi and microvilli in the intestinal wall. This lining of the small intestine also acts as a barrier to microbes, large food particles, foreign substances and allergens, preventing them from going into the blood stream. In a healthy functioning gut, only digested food is allowed through the intestinal lining into the blood to be chartered to various organs. For this to happen, the tight junctions between cells—desmosomes—open briefly and barely to allow the digested food to get through via the release of the zonulin enzyme.
The Messy Tale of Leaky Gut
If those tight junctions between cells open too wide or are open for too long, “toxins” can flood the bloodstream, overwhelming the detoxification efforts of the liver. This is caused by the mucosal lining becoming irritated or inflamed. “Toxins” include undigested food, bacteria, environmental pollutants and more. The most common causes of LGS are continued consumption of foods you have a sensitivity or allergy to, regular consumption of gluten (even when a person doesn’t have a sensitivity to it), regular consumption of gut-irritants such as all grains (not just wheat, rye and barley), non-steroidal anti-inflammatory drugs, steroid drugs, hormone prescription medications (e.g. birth control pills and synthetic hormones prescribed for menopause), candida overgrowth, h pylori bacteria, STRESS and antibiotics. Also, malnutrition limits the supply of blood and nutrients making it to the gut lining, which results in gut lining shrinkage, deterioration and increased permeability. And that increased permeability means fewer nutrients are fully digested and absorbed which continues this cycle of malnutrition.
Yikes!!! Yep, so practically everyone is at risk of developing leaky gut (unless you are a paleo monk living in the mountains).
Simplify… Leaky Gut is Simply Blending Without a Lid!
Did I lose you? Okay, so think of your gut (small intestine) as a blender. So in a fantastically functioning blender (such as my lovely Vitamix—ahh), you blend everything until FULLY smooth (and if it is a Vitamix—than you know what I mean when I say fully smooth!). After everything is blended you take off the lid and pour out the contents just like once our body has fully digested its food, the digested nutrients slip ever so easily through our intestine into our blood stream. But what happens if you lose the lid to your blender or maybe just the little lid in the big lid? Well, it doesn’t matter how well-functioning your blender is because the food in the blender will never have the opportunity to get fully blended. Instead, in a move of total mayhem, unblended large food pieces are going to spray all over you and your kitchen! Well, with leaky gut, all your undigested food gets sprayed (okay not really sprayed) into your blood stream. Got it? And then come food sensitivities that often manifest as fatigue, skin issues, joint pain, diarrhea, gas and may even turn into an autoimmune condition.
The Autoimmune Connection to Leaky Gut
Both Alessio Fasano and Loren Cordain separately discovered that all autoimmune diseases are caused by leaky gut (as long as the environmental trigger is also present and that there is a genetic predisposition to that autoimmune condition). How does that work? With LGS, oversized, unbroken-down (Remember? Not fully blended) protein molecules enter the blood stream. The body doesn’t recognize these molecules when they aren’t fully digested (blended) and creates antibodies against them. Whenever the food that contains those proteins are eaten again in the future, the body will attack it as an invader and send it to the liver for detoxification. This immune response causes inflammation and more toxins and undigested food molecules to get through to the blood stream. This in turn results in more antibodies.
Or likewise, through a leaky gut, microbes that aren’t supposed to be chilling in our blood get through and our body goes into a hyper immune reactivity state attacking those lounging microbes.
And what happens if your liver can’t process all of those “toxins” because it is dealing with too many toxins, too often or you have liver disease or you have a sluggish liver? It stores them there toxins to “get to processing them later”… kind-of like my filing system of putting everything in a big box, with plans to deal with that pile of paper later….
With the immune system constantly on “high alert,” the immune system begins to attack the body where it is storing the “toxins”. This may result in joint pain (such as arthritis) if the “toxins” are being stored in the joints. And at some point, the body may lose track of whether it is attacking the “toxin” or the body and start confusing the two. At this point the body starts creating antibodies to its own tissue (as in all autoimmune conditions). This attack on tissue causes more inflammation throughout the body including in the gut and in turn increases leaky gut (remember inflammation or irritation of the gut is a cause of leaky gut).
Likewise, dysbiosis (microbes that aren’t supposed to be kicking it inside our body or not in such high quantities) may trigger the immune system leading to overstimulation and inflammation that also makes the LGS worse, which furthers dysbiosis.
How to Create an Honorable Gut (Restore Gut Integrity)
Now before getting on to digestive health solution creating, I would be remiss (and my attorney would get angry with me) if I didn’t mention that you should never change your diet (or practically improve your health) without first consulting with your medical team. I mean gosh… What would the pharmaceutical companies do if you got off your med’s? Gee… There… Said it….
Here are some herbal/nutrient suggestions to help restore your gut integrity:
Dandelion Root Tea
This is a bitter so will help stimulate an increase in enzyme production and gastric juices which promotes digestion. Also, it helps repair liver damage and is a tonic to the liver to help in the releasing of toxins. This is necessary since the liver has to cleanse and release all of the perceived and actual toxins so that they don’t just get stored (like my filing system). Now be aware, dandelion root and other liver tonics can vastly improve the health of your liver and how fast your body processes toxins, which can be problematic if you are taking any medications that are stored in your liver (such as hormones).
Use this as a sweetener with dandelion root tea if it is too bitter for you (I’m naturally sweet enough that I don’t need any licorice root in my life! Right.). Licorice helps with digestion, but also is really good for adrenal exhaustion. Licorice root is also demulcent, which means that it soothes our intestines—allowing them to say “ahhh”. If you have high blood pressure use deglycerized licorice instead, which means not using it in its root form as a sweetener and using it as a supplement, tincture or powder.
Oregon Grape Root
It is a bitter, so like dandelion, it will also promote digestion. Also, it stimulates the gut to release more mucous for the mucosal lining which helps wash away toxins from the gut and also helps repair the gut lining. It also helps kill bacteria and parasites. Okay, so dandelion root actually tastes quite delicious to me (just like coffee actually), but Oregon Grape Root… not so much. You might want to do this one as a tincture instead of a tea. Also lovely about this plant is that it grows plentifully (like dandelion), making it a sustainable herbal option. And it has the word Oregon in it (and grows in Oregon as well as everywhere) and I love Oregon!
Good bacteria helps ward off the opportunistic critters that can cause leaky gut. Also, dysbiosis usually accompanies leaky gut meaning that if you have leaky gut you probably also need to boost-up all the good bacteria in your body through probiotics and fermented foods.
Marshmallow Root or Slippery Elm
These increase the amount of mucous your body has available to produce for the gut lining and helps repair the gut lining. They are considered “mucilaginous” herbs which pretty much means mucousy… I only say that to indicate that the texture is off-putting to some. Marshmallow root is actually much more tolerable than slippery elm. Marshmallow root I find just makes the water thick instead of viscous like slippery elm. And both are an acquired taste, but I find them quite tasty and one or the other is absolutely essential to restore a leaky gut. If you choose these in a tea, as opposed to in a pill or a powder (tinctures aren’t the best option for accessing the mucilaginous quality of these herbs, which is important), the mucilaginous qualities come out best in cold water instead of hot water. Now that doesn’t mean you can’t reheat the tea after you make it or you could start out with adding hot water to it but not drink it until it is cold. Either way is fine. My own preference is to steep a ½ cup or so of the herbs in a quart of cold water overnight.
An amino acid in red meat, turkey, chicken, fish and the raw brassica family. L glutamine is KEY to gut integrity and strengthening the gut lining tissues. Also, as an added benefit it is critical to the body’s ability to gain muscle mass and balance blood sugar. Don’t try to restore gut integrity without this one (and one of the above mucousy herbs!).
Another amino acid helpful in restoring gut integrity. But I prefer L-Glutamine if you are just going to do one.
Helpful to the body in repair of stomach lining issues. After magnesium, this is the most deficient nutrient there is in our body! A sign you are zinc deficient is if you have a reduced sense of taste or smell. And if you had celiac disease, you also likely became zinc deficient. This article provides some deficiency signs and suggestions for increasing the zinc in your diet.
An important antioxidant useful for helping fight all of the toxins released in the body when dealing with leaky gut. However, its easy enough to get from foods, so no reason to do as a supplement. Foods rich in quercetin include capers (1800mg/kg), lovage (1700mg/kg), apples (440mg/kg), tea (Camellia sinensis), onions, especially in red onions (higher concentrations of quercetin occur in the outermost rings), red grapes, citrus fruits, broccoli and other leafy green vegetables, cherries, and a number of berries including raspberry, cranberry (cultivated 83 mg/kg, wild 121 mg/kg) and the fruit of the prickly pear cactus. According to a 2007 study from the University of California-Davis: Organically grown tomatoes have 79% more quercetin than “conventionally grown” so likely organic is a better choice when trying to increase quercetin levels. A study by the University of Queensland, Australia, has also indicated the presence of quercetin in varieties of honey.
Anti-Inflammatory Herbs and Spices
There are a lot of options here and great things to add into your cooking. The ones especially anti-inflammatory and useful for soothing digestion are ginger, fennel and turmeric. There are other ones too but these are my favorites.
In addition to chewing really well… I also suggest taking a good digestive enzyme, such as Digest Gold by Enzymedica to help you better break down the food particles, to decrease the potential for developing food sensitivities to those foods that make it through your gut lining.
Want to Test for Leaky Gut?
The herbs and nutrients listed above are not dangerous to do if you don’t have leaky gut and as stated above, if you have an overgrowth of something or you have newly developing food sensitivities, you definitely have leaky gut. If you take any of the things that cause leaky gut, then yes, you have it. If you have an autoimmune disease and never worked to restore gut integrity, then yes, you have it. But if you want to see if you successfully got rid of it—it can sometimes be helpful to test. Here are some tests to consider:
Lactulose/Mannitol Urine Test or the Polyethelyne Glycol (PEG) test: ‘
You are given a solution containing lactulose (a disacharride – sugar) and mannitol (a monosaccharide – sugar), which are both water soluble. Mannitol is easily absorbed and penetrates cells, while Lactulose has larger molecules and should only be partially absorbed. Ideally, your test would indicate high levels of lactulose (since you couldn’t absorb it) and low levels of mannitol (since you easily absorbed it). If both levels are high, that means you have increased gut permeability, letting the lactulose through easily. If both levels are low, it’s indicative of malabsorption.
Comprehensive Stool Test:
Uncover whether you have an active bacterial infection, bacterial overgrowth, parasites or yeast overgrowth. If any of these are active, you won’t be able to restore gut integrity until you first deal with the dysbiosis.
Food Sensitivity Tests:
Nope, not a scratch, RAST test, but a test to either uncover whether you have IgG or IgA antibodies to certain foods or whether you experience white blood cell inflammation in the presence of certain foods. The IgG/IgA test usually tests up to 20ish foods. The white blood cell test, tests 200 foods. Remember that if you are consuming a food that you have a sensitivity to, that will promote inflammation in your digestive tract and maintain leaky gut. Also, if you have leaky gut, you’ve developed some food sensitivities and every time you consume them, your immune system ramps-up. You can also test specifically for celiac disease, in addition to non-celiac gluten sensitivity.
Have questions about leaky gut? Scroll all the way down and leave a comment and I will do my best to answer it. Or share your own story with overcoming leaky gut!
Would you like more information on leaky gut? Visit these references:
1) Townsend Letter for Doctors, August/September 1995, p. 63. “Leaky Gut Syndromes: Breaking the Vicious Cycles.” Galland L.
2) J Affect Disord. 2007 Apr;99(1-3):237-40.”Increased serum IgA and IgM against LPS of enterobacteria in chronic fatigue syndrome (CFS): indication for the involvement of gram-negative enterobacteria in the etiology of CFS and for the presence of an increased gut-intestinal permeability.” Maes M, Mihaylova I, Leunis JC.
3) Neuro Endocrinol Lett. 2008 Jun;29(3):313-9. “An IgM-mediated immune response directed against nitro-bovine serum albumin (nitro-BSA) in chronic fatigue syndrome (CFS) and major depression: evidence that nitrosative stress is another factor underpinning the comorbidity between major depression and CFS.” Maes M, Mihaylova I, Kubera M, Leunis JC.
4) Neuro Endocrinol Lett. 2008 Feb;29(1):117-24.”The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression.” Maes M, Kubera M, Leunis JC.
5) Neuro Endocrinol Lett. 2008 Dec;29(6):902-10. “Normalization of leaky gut in chronic fatigue syndrome (CFS) is accompanied by a clinical improvement: effects of age, duration of illness and the translocation of LPS from gram-negative bacteria.” Maes M, Leunis JC.
6) Gastroenterology, 1989. 97(4): p. 927-31.”Intestinal permeability in patients with Crohn’s disease and their healthy relatives.” Katz, K.D., et al.
7) Br Med J, 1982. 285(6334): p. 20-1. “Intestinal permeability in children with Crohn’s disease and coeliac disease.” Pearson, A.D., et al.
8) Dig Dis Sci, 1990. 35(5): p. 582-8. “Relationship between intestinal permeability to [51Cr]EDTA and inflammatory activity in asymptomatic patients with Crohn’s disease.” Pironi, L., et al.
9) Gut, 1994. 35(1): p. 68-72. “Intestinal permeability in patients with Crohn’s disease and ulcerative colitis and their first degree relatives.” Munkholm, P., et al.
10) Ann Intern Med, 1986. 105(6): p. 883-5. “Increased intestinal permeability in patients with Crohn’s disease and their relatives. A possible etiologic factor.” Hollander, D., et al.
11) Gut, 1992. 33(3): p. 320-3. “Intestinal permeability in patients with Crohn’s disease and their first degree relatives.” Teahon, K., et al.
12) Parasite. 2008 Sep;15(3):261-5 “Pathophysiology of enteric infections with Giardia duodenalius.” Buret AG.
13) Clin Exp Rheumatol, 1990. 8(1): p. 75-83. “A short review of the relationship between intestinal permeability and inflammatory joint disease.” Rooney, P.J., R.T. Jenkins, and W.W. Buchanan
14) Br J Rheumatol, 1987.26(2): p. 103-7. “Increased intestinal permeability in patients with rheumatoid arthritis: a side-effect of oral nonsteroidal anti-inflammatory drug therapy?” Jenkins, R.T., et al.
15) Clin Exp Rheumatol, 1990. 8(5): p. 523-4.”Reflections on the link between intestinal permeability and inflammatory joint disease.” Mielants, H.
16) Gut, 1991. 32(12): p. 1470-2. “Increased intestinal permeability in ankylosing spondylitis–primary lesion or drug effect?” [see comments]. Morris, A.J., et al.
17) Rheumatol, 1985. 12(2): p. 299-305. “Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis.” Smith, M.D., R.A. Gibson, and P.M. Brooks, J.
18) Rheum Dis Clin North Am, 1991. 17(2): p. 363-71.”Fasting, intestinal permeability, and rheumatoid arthritis.” Skoldstam, L. and K.E. Magnusson
19) Q J Med, 1985. 56(221): p. 559-67. “Small intestinal permeability in dermatological disease.” Hamilton, I., et al.
20) Gut. 1999 Jul;45(1):70-6 “Small intestinal transit, absorption, and permeability in patients with AIDS with and without diarrhoea.” Sharpstone D, Neild P, Crane R, Taylor C, Hodgson C, Sherwood R, Gazzard B, Bjarnason I.
21) Dig Liver Dis. 2010 Mar;42(3):200-4 “Intestinal permeability in patients with chronic liver diseases: Its relationship with the aetiology and the entity of liver damage.” Cariello R, Federico A, Sapone A, Tuccillo C, Scialdone VR, Tiso A, Miranda A, Portincasa P, Carbonara V, Palasciano G, Martorelli L, Esposito P, Cartenì M, Del Vecchio Blanco C, Loguercio C.
22) J. Pediatr., 1992. 120: p. 696-701. “Correlation of intestinal lactulose permeability with exocrine pancreatic dysfunction.” Mack, D.R., et al.
23) Lancet, 1981. 1(8233): p. 1285-6. “Intestinal permeability in patients with eczema and food allergy.” Jackson, P.G., et al.
24) Digestion, 1989. 42(2): p. 104-9.”Intestinal permeability to 51Cr-labelled ethylenediaminetetraacetate in food-intolerant subjects.” Scadding, G., et al.
25) Lancet, 1981. i: p. 1285-1286. “Intestinal permeability in patients with eczema and food allergy.” Jacobson, P., R. Baker, and M. Lessof
26) Clin Allergy, 1986. 16(6): p. 543-51. “Gastrointestinal permeability in children with cow’s milk allergy: effect of milk challenge and sodium cromoglycate as assessed with polyethyleneglycols (PEG 400 and PEG 1000).” Falth-Magnusson, K., et al.
27) Clin Allergy, 1985. 15(6): p. 565-70. “Gastrointestinal permeability in atopic and non-atopic mothers, assessed with different-sized polyethyleneglycols (PEG 400 and PEG 1000).” Falth-Magnusson, K., et al.,
28) Clin Allergy, 1984. 14(3): p. 277-86. “Intestinal permeability in healthy and allergic children before and after sodium-cromoglycate treatment assessed with different-sized polyethyleneglycols (PEG 400 and PEG 1000).” Falth-Magnusson, K., et al.
29) J Allergy Clin Immunol, 1991. 88(5): p. 737-42. “Identical intestinal permeability changes in children with different clinical manifestations of cow’s milk allergy.” Jalonen, T.
30)J Pediatr Gastroenterol Nutr, 1990. 11(1): p. 72-7. “Modifications of intestinal permeability during food provocation procedures in pediatric irritable bowel syndrome.” Barau, E. and C. Dupont
31) Ann Allergy, 1990. 64(4): p. 377-80.”Intestinal permeability in irritable bowel syndrome. Effect of diet and sodium cromoglycate administration.” Paganelli, R., et al.
32) Am J Physiol Gastrointest Liver Physiol. 2007 Feb;292(2):G518-25 “Increased intestinal permeability in obese mice: new evidence in the pathogenesis of nonalcoholic steatohepatitis. Brun P, Castagliuolo I, Di Leo V, Buda A, Pinzani M, Palù G, Martines D.
33) Gut. 2009 Aug;58(8):1091-103 “Changes in gut microbiota control inflammation in obese mice through a mechanism involving GLP-2-driven improvement of gut permeability.” Cani PD, Possemiers S, Van de Wiele T, Guiot Y, Everard A, Rottier O, Geurts L, Naslain D, Neyrinck A, Lambert DM, Muccioli GG, Delzenne NM.
34) Textbook of Natural Medicine, 3rd Edition, Volume 2, J. Pizzorno and M. Murray, editors, Churchill Livingstone Elsevier, St. Louis, 2005, pp. 655-660. “Intestinal Protozoan Infestation and Systemic Illness”, Galland L.