“Leaky gut” is a popular buzzword nowadays in health circles—Tossed around by nutritionists, Women’s Health Magazine and Dr. Oz, alike.
Pop question: What is it?
Let’s start with the basics.
Gut Health & Function Basics
Your “gut” is essentially your entire digestive tract that runs from your mouth to your colon, or anus. It is comprised of several major organs and components, including:
- Esophagus
- Stomach
- Small intestine
- Liver-gallbladder
- Pancreas (regulates blood sugar)
- And, your exit, anus
Your gut or “micro-biome” covers a surface area of about 400 m² (about 1/4th mile in both deep and wide) and your gut barrier, or intestinal tissue lining is strong—serving as a “gatekeeper” to keep toxins out of your blood stream, while allowing nutrients in and out to nourish all the cells in your body.
To keep in tip-top shape, your gut requires about 40 percent of your body’s energy expenditure—double the energy expenditure of your brain (only 20 percent).
In other words: Your gut takes up a lot of space, is strong and works hard to function properly.
(And, a healthy gut is able to do so—especially when it’s supported with real-foods nutrition, probiotics and pre-biotics, low stress, water and enough stomach acid and digestive enzymes).
However…when a “bump” or dysfunction happens in your gut, and it goes unaddressed, then a malfunction is inevitable if not addressed.
Leaky Gut 101
Leaky gut, or “intestinal permeability” is a common “malfunction”—a leak that happens when you hit a speed bump or get a “nail in your tire,” such as:
- Not chewing your food thoroughly
- Eating too fast or in a hurry (preventing proper food breakdown)
- Frequently eating gut-irritating ingredients and chemicals your body DOESN’T recognize as “food” or can’t easily digest (conventional meat with hormones and antibiotics, Quest Bars, Halo Top, Instant Oatmeal, sugary granola bars, Diet Coke, frozen dinners, hydrogenated oils)
- Long-term use of medications or antibiotics
- Chronic stress (under-sleeping, overtraining, constant worry or anxiety, high alcohol or smoking exposure)
- Erratic eating habits (binging, purging, restriction, etc.)
- History of Infections or Illness (bacterial, virus, heavy metals, fungal overgrowth)
- Lack of fermented foods and fibers (probiotics and pre-biotics)
- Other digestive issues, like SIBO (small intestinal bacterial overgrowth), liver/gallbladder dysfunction, parasites, food intolerances, etc.
Over time, stress wreaks havoc on your strong gut lining, and like picking at a scab over and over and over, eventually the gut lining loses its tight junctions that were once able to decide what did and did not escape outside your digestive tract.
So What’s the Big Deal?
Without tight junctions and its role as the “gatekeeper” of unnecessary particles out of the bloodstream, all hell breaks loose.
If “leaky gut” is present, food particles; toxins in our food, water and products; and other “foreign invaders” easily leak into the bloodstream, where your body responds with an “autoimmune attack” inside…itself.
Hello: Inflammation!
Skin breakouts, food and seasonal allergies, brain fog, difficulty concentrating, hormone imbalances, a “slow metabolism” and even diseases—like Diabetes, neurological and cognitive disorders, Alzheimer’s, Parkinson’s, cancer, Arthritis, ADHD, autism spectrum disorders, fibromyalgia, IBS and more are all linked to a leaky gut (Bischoff et al, 2014).
The thing is: You DON’T always feel “leaky gut” in your gut if you have it.
In fact, 70 percent relatives of celiac disease patients do NOT have “gut symptoms,” but test positive for intestinal permeability (i.e. they DO have gut issues).
And, although “leaky gut” used to be considered a “quack” philosophy in medicine or health research, today, more and more studies are pointing to INCREASED intestinal permability (leaky gut) as a root cause of many of our modern day epidemics—like obesity and Diabetes (Ohlsson et al, 2017), gestational diabetes during pregnancy (Mokkala et al, 2017), and essentially, any other “chronic inflammatory disease” (Sturgeon et al, 2017).
How do I know if I have it?
There are several signs that point to a leaky gut.
Sign 1: Leaky Gut Testing
The gold-standard test, I use the Cyrex Array 2 Antigenic Permeability Screen to determine whether or not leaky gut is present.
The Antigenic Permeability Screen is an autoimmune-response test, indicating if the body has inflammatory response pathways, commonly associated with the autoimmune attack of leaky gut.
In addition, another popular method of testing is Genova’s Intestinal Permeability Assay lactulose-mannitol test, which measures levels of these two sugars in your urine after you consume them orally.
Since lactulose is naturally a LARGER substance (and should NOT easily end up in your urine), if it does on the test, leaky gut is suspected.
Both are currently the two primary tests that officially screen for “leaky gut,” and while testing is not 100% necessary (see Sign 4), testing for whichever gut pathologies may be present can save you time, money, viruses and stress in the long run.
Sign 2: Zonulin Levels
A key marker of “leaky” gut is decreased zonulin levels—an essential protein found in the gut lining that helps keep it nice and strong.
A serum blood test such as the Doctor’s Data Zonulin Test can also point you in the right direction towards healing.
Fun fact: Zonulin is the ONLY regulator of intestinal permeability that known to be reversible (in other words: if you have low zonulin, and increase zonulin, you CAN improve leaky gut and heal).
Sign 3: Other Signs: Gut Issues
Often times, in the case of leaky gut, there is a bigger underlying GI issue or ongoing stressor at play (poor diet, chronic stress, poor sleep, etc.).
Common underlying “issues” to consider include: SIBO, parasitic infection, fungal overgrowth, low stomach acid or chronic food intolerances. As for stress—check in with your lifestyle. How is your nutrition? Your stress? Your sleep? If no bueno, then leaky gut has more room for potential.
Work with a functional medicine practitioner or nutritionist to uncover the true state of your own gut health. A variety of underlying GI tests can help point you in the right direction faster beyond self-speculation, including a comprehensive stool sample, a SIBO breath test, Cyrex food intolerance testing and OATS-organic acids testing. If testing is not in the cards, see “What to Do About It” below to commence gut-healing for a “leaky gut” to see if symptoms improve.
Sign 4: How Do You Feel?
Lastly (the biggest marker of them all): How do you feel? As previously discussed leaky gut is highly linked to other signs of inflammation and diseases in your body.
From chronic seasonal or environmental allergies, to adult acne, to achy and popping joints, chronic yeast infections, horrible migraines, crazy PMS, no period, thyroid dysfunction or a sluggish metabolism, there is a potential that leaky gut —along with another underlying “gut issue” (like SIBO, parasitic infection, low stomach acid, etc.)—is present.
Often times, YOU are your own best advocate for checking in with yourself and assessing…how do you feel?
What to do about it?
If you suspect you have a leaky gut, you can treat the issue with a few lifestyle and gut-health support basics as if you do. Often times, if leaky gut was present and you implement healthy dietary, lifestyle and some supplemental changes, issues resolve on their own.
In fact, you can try this approach before testing for “leaky gut.” If symptoms improve, you may be on to something.
If symptoms don’t improve, there may be something more going on underneath the hood.
There IS a difference in merely “supporting” your gut to be healthy, and healing your gut with a targeted approach—intended to strengthen the gut lining.
Here is a little “workout” to build back the strength of your intestines:
5 Things You Can Do to Heal A Leaky Gut
- Take a Probiotic & Pre-biotic Daily + Eat Fermented Foods + Pre-biotic Foods. Incorporate kombucha, kimchi, kefir, sauerkraut, fermented veggies and fermented yogurt, along with pre-biotic foods like cooked and cooled potatoes/sweet potatoes and white rice, green tipped bananas and plantains, onions, leeks asparagus and supplemental form of fiber, like Partially Hydrolyzed Guar Gum.
- Eat Real Foods. A non-sexy answer, but tremendously impactful. Simplify your diet for 2-4 weeks simply to see how you feel by aiming for little to no foods out of a package, and preparing most of your meals, comprised of sustainably raised proteins, veggies (that don’t make you feel bloated) and 1-2 healthy fats with each meal (avocados, coconut oil, butter, ghee, avocado oil, olive oil, olives, raw nuts and seeds—soaked, coconut butter, etc.)
- Boost Stomach Acid. Swig 1 tbsp. Apple Cider Vinegar in 2-4 oz. of water before meals, and also consider an HCL Supplement if bloating, gas or loose stools are common for you.
- Get in Your Vitamin A & D. Cod Liver Oil supplementation to the rescue! The best of both worlds, plus healthy fats to diminish inflammation.
- Add L-Glutamine Powder to Herbal Tea, Water or Smoothie (about 1/4-gram per pound of body weight). I like Thorne’s Enteromend.
- Supplement with Colostrum. Mom’s milk was the perfect food for your gut lining. Colostrum returns us back to the “way things were” before stress happened to your gut and helps support a strong gut barrier (such as protecting against NSAID-induced permeability as early studies have shown in rats).
- Zinc Supplementation . In those who are deficient or present with other gut imbalances (like diarrhea), zinc has been shown to improve mucosal repair. Zinc deficiency is also linked to anorexia and malnourishment and leaky gut, together. A short-term (i.e. 4 weeks) of zinc supplementation at 15-30 mg/day could be supportive.
- Butyrate Supplementation (sodium potassium form). Butyrate plays an especially important role in regulating barrier function. Low butyrate causes tight junction lesions and impaired intestinal permeability. Like zinc, a short-term supplementation of butyrate with sodium potassium, followed by ongoing consumption of fermented foods and pre-biotic foods can help boost butyrate.
*As with anything on this blog, please consult with your personal healthcare practitioner to determine the “just right” custom approach for you.