What is Leaky Gut
The largest part of the immune system in our body is in the
mucosal lining in the gut. The immune system makes sure all those undesirable
elements do not get across into the bloodstream to begin with. The intestines
are permeable to a certain degree so the proper nutrients get through. Spots in
the gut wall open and close selectively to admit the good stuff as the contents
of the intestines pass by. Normally, only certain nutrients are absorbed if they
are sufficiently broken-down and in the right form. Everything else is
selectively blocked out. But when the pores are too big or the screening process
breaks down, the intestines become hyperpermeable (overly permeable). Leaky gut
syndrome is a term used when the intestines become damaged, more openings
develop in the gut wall, and the wall becomes more ‘porous’ to the extent
that some of the contents passing through the intestines are allowed to get into
the bloodstream when they should be kept out.
Not just food particles slip through. Pathogens, toxins, and
other types of ‘waste’ get through that should normally be screened out.
Insufficiently broken-down food particles or toxins may cause the liver to work
much harder trying to clean everything out. The liver may not be able to keep up
with all the detoxification demands sent its way and the toxin load starts
building up in the body.
When the gut becomes hyperpermeable, all sorts of gunk can
get through and run loose in the body. When this happens, the immune system
kicks into gear to stop these invaders. Typically the immune system escorts the
invaded out of the body quickly. However, this task often falls to the liver,
which may be quite overworked and not able to do this immediately. If not
removed right away, the troublesome particles and complexes can migrate through
the body and settle in any of the different tissues they pass by. This leads to
inflammation in whatever part of the body they settle.
Now we have a new problem: inflammation. This puts even more
pressure on the immune system to cover even more ground in defending the body.
With the immune system running on ‘high’ on a regular basis, it may be
spread thin over a wide array of territory defending the gut, cleaning the
blood, fighting inflammation, warding off pathogens, and so on. Many autoimmune
conditions start this way. Which type of autoimmune condition a person ends up
with may depend on which part of the body the immune complexes settle into.
If you are having food sensitivities to more than a dozen foods, you may very
likely have a leaky gut. When the gut is injured in this way, any food eaten may
be a candidate to be insufficiently digested and absorbed leading to food
intolerances. If you find you are sensitive to a few foods, remove those, then
later notice some previously tolerated foods are now causeing problems, consider
a leaky gut. The core issue may not be the foods you are eating, but simply that
digestion is poor and the gut injured, so anything eaten (and eaten frequently)
may become problematic.
Anyone can develop a leaky gut at any time in their lives.
Several factors can lead to leaky gut, either occurring individually or working
together. Any chemical or physical activity that stimulates the pores in the
intestines and keeps them open for too long can lead to increased permeability.
Some common sources follow.
Yeast – This is
probably one of the primary causes of leaky gut.Yeasts are single-celled
organisms that usually reside in the mucosal lining. Yeast can grow out of the
single-cell form and into a fungal form. The fungal form grows root-like
tentacles (hyphae) that drill deep into the mucosal lining, poking ‘holes’
in the gut.
Excessive environment toxins
–With the detoxification system overloaded or dysfunctional, environment
toxins from either inside or outside the body may build up. They can irritate
the intestinal lining. The constant inflammation and immune system activity can
create a more permeable gut wall.
Chronic stress –
Stress suppresses the immune system and can alter intestinal physiological
function, increase gut permeability, and cause inflammation. A healthy immune
system can easily block out typical pathogens, but a weak one may be overrun.
When the immune system is overactive for an extended period of time, leaky gut
Anything causing inflammation may lead to leaky gut. This can result from
insufficiently broken-down food or infections of any kind. Maybe the stomach
just does not produce enough hydrochloric acid, resulting in improper digestion.
Larger particle sizes from any food can irritate the gut lining.
Yeast/bacteria/parasites/viruses can all cause inflammation. Besides the
physical damage created by an imbalance of microbes in the gut, bacteria and
yeast give off many toxins.
Medications, prescription and over-the-counter pain relievers such as
acetaminophen or ibuprofen, may also lead to increased permeability. They are
considered ‘hard’ on the gastrointestinal lining. Aspirin reduces the
thickness of the mucosal lining in the gut, thus making it more susceptible to
yeast, inflammation, and irritation by food passing through the gut.
Diet – A diet high in
sugar, refined flour and processed foods, complete with their rainbow of
artificial food colorings, flavorings, and preservatives places a lot of stress
on the immune system as well as the liver. Our bodies see most of the artificial
chemicals as pure toxins. The more you consume, the more the body must process
out. Most processed foods have less nutrition in them as well. So, you use more
energy and nutrients processing these foods from your body and receive less
energy from the food. A diet high in refined sugar, flours, and artificial
chemicals can actually cost you nutrients and energy rather than supply them.
Zinc deficiency – Zinc
is necessary in maintaining intestinal wall integrity. Supplementing with zinc
could contribute significantly to healing a leaky gut in about eight weeks (Sturniolo
2001). Zinc is also instrumental in a maintaining a healthy immune system (Prasad
2002). The synthesis of serotonin involves zinc. Since serotonin is also
necessary for melatonin synthesis, a zinc deficiency may result in low levels of
both of these compounds, causing problems with the sleep cycle, calming, and
Having Leaky Gut
Leaky gut is a condition that can directly lead to many
other specific disease states, or indirectly aggravate or worsen other
conditions. You may have leaky gut and not be aware of it. Many food
intolerances and sensitivities are a consequence of a leaky gut to some degree.
You may just feel run down, out of energy, have many food and chemical
intolerances, or a multitude of other seemingly unrelated problems. Symptoms of
leaky gut syndrome may include:
• aggression • anxiety • asthma • atypical sensory
reactions • bed-wetting • bladder infections • bloating or gas • chronic
joint, muscle, or abdominal pain • confusion • diarrhea or constipation •
fatigue • fevers of unknown origin • fuzzy thinking or ‘brain fog’ •
indigestion • memory problems • migraines • mood swings • nervousness
• poor exercise tolerance • poor immunity • skin rashes
Besides particles being too large, escaping into the
bloodstream, wandering loose in the body, and causing havoc, there is another
side to consider. Because the food was not digested and absorbed properly, the
person may experience nutrient deficiencies. In one area, the nutrients are
bound up in a manner the body does not recognize and hailing in the immune
system to remove them. Yet, in another location, the body is starving for those
same nutrients. The biological system is overworking unnecessarily in one area
while shutting down somewhere else because of insufficient raw materials.
Vitamin therapies may target some of these other systems
starving for raw materials. By supplying just the one or two specific raw
materials, we may temporarily fix that part, if the vitamin can even reach the
intended area of the body, but the system as a whole is still malfunctioning. If
the gut is not absorbing food well, then the supplements may not be absorbed
well either. A better plan is to fix the hole in the boat (heal the gut).
the Holes in the Boat
Some of the solutions people pursue just address the
superficial symptoms. Often better and quicker results will be seen if healing
the leaky gut condition is part of the overall treatment program, rather than
just focusing on treating the various diseases or symptoms that result from the
injured gut. There are several different paths to healing a leaky gut. Some of
the primary ones found by research are:
- digestive enzymes
There are other supplements such as essential fatty acids or
aloe vera which help some people.
Digestive enzymes may be extremely helpful with leaky gut
situations because they tackle the problem on several fronts. Enzymes break down
the food particles so they do not exist as larger particles that will physically
irritate the gut lining or activate the immune system. Plant or microbe
(fungal)-based enzymes are especially effective because they do much of this
breakdown in the stomach before the food even enters the intestines, a good 60
to 90 minutes before pancreatic enzymes emerge on the scene. Then, by breaking
the food down, enzymes are also freeing the individual vitamins, minerals, and
other nutrients so the body can use them as the raw materials it needs as well
as releasing the energy from your food. Normal biological processes can proceed.
Because your nutrition comes from food, you then do not have to supplement extra
vitamins, minerals, and whatever else to make up for what you eliminated through
diet. Nutrition from whole foods is generally more effective than from many
Because enzymes can process the food particles down to their
essential forms, anything that does leak through the gut while it is healing is
less likely to provoke a negative reaction. Enzymes work on the foods you do
suspect as well as those you don’t, or unknown sources. Food intolerances
usually drop off dramatically when enzyme use begins. Many people report
improvements the very first day of taking enzymes. However, because some food
intolerances are processed out of the body a few days later, it is very common
to hear of significant improvement by the end of the first week on enzymes.
Next, enzymes proactively support intestinal health. They
can act as trash collectors removing dead tissue, debris, chemicals, and toxins
from the body. This cleaning out allows the gut to heal faster. Another bonus is
that enzymes are effective at clearing out pathogens that may cause and
contribute to damaging the gastrointestinal tract. Bacteria and parasites are
made of proteins, viruses have protein coatings or ‘films,’ and yeasts have
outer shells consisting of cellulose and protein. Proteases and cellulases can
help break these intruders down, and then carry off the toxins and dead cells
the destroyed pathogens leave behind.
If the digestive enzymes themselves are absorbed into the
bloodstream along with the other things, this can be very beneficial. Enzymes,
especially the proteases that break down proteins, travel through the
bloodstream cleaning out any gunk, toxins, and waste that may be accumulating
there. They selectively latch onto toxins and escort them out of the body
leaving the good tissue and red blood cells to carry on. This assistance in
cleaning the blood helps relieve the burden on the liver and the immune system.
Enzymes help clear out the traffic jams so everything can get back on schedule.
Proteases are often given in between meals for just this purpose. If you give
proteases with food, the enzymes will act on the food first, so giving them
between meals sends them directly into the bloodstream to do cleanup.
Substantial scientific research has established that the bloodstream takes up
enzymes intact where they work in this way (Leibow and Rothman 1975; Rothman,
Liebow, and Isenman (2002).
Another benefit of taking proteases between meals is to
reduce inflammation. Bromelain and papain (protease enzymes derived from
pineapple and papaya) have undergone study in great detail for this purpose and
are found to be incredibly effective at reducing inflammation. Proteases can
reduce inflammation in the gut directly. Bromelain and papain are well-known
agents for assisting in healing gastric ulcers. Material leaking through the
intestinal lining can make its way to joints and aggravate them to the point of
inflammation, or add to inflammation already started. The proteases in the
bloodstream break down these sources of inflammation as they pass by in the
bloodstream. Then the debris is transported out of the body, freeing the immune
system up to do other things, and allowing you to enjoy your life without so
The nice thing about enzymes is they address the damaged
gut, problematic peptides, food intolerances, and nutrient deficiencies all at
the same time. You cover a lot of territory by taking just this one type of
A good probiotic will help restore the needed balance among
the bacteria, yeast, and other microorganisms. Out with the bad and in with the
good. A consistent supply of probiotics is like tending a lawn. You need to kill
the weeds, and then keep seeding with the ‘good’ grasses. A healthy lawn
will need just a little maintenance. However, doing no maintenance will very
soon give you a yard overrun with weeds again.
Is Malabsorption the Same as
Although you can have both conditions, and they are related,
they are technically different. Leaky gut can be caused by a variety of things
and can very often lead to malabsorption. Leaky gut is the state where the
protective gut lining looses its integrity. It is less capable of properly
selectively screening out those elements that should be screened out, and
allowing those elements in that should be let in. So items that should be
screened out gain access in.
Malabsorption means 'bad absorption of some type for some
reason'. It doesn't indicate the cause though. Nutrients are not being absorbed
properly. You might have leaky gut involved, but you can also have malabsorption
without leaky gut. If you have a pancreatic problems, poor stomach acid, various
diseases, or other causes, you might have an intact gut lining but for some
reason, some nutrients are not being absorbed properly. This might be many
nutrients or only a few in particular.
What is nice about digestive enzymes is they can help both a
leaky gut and malabsorption at the same time.
Leaky Gut Syndrome and Environmental Illnesses
Leaky gut syndrome is likely to play a part in all of the
environmental illnesses. All of these illnesses are characterized by a high
frequency of allergy, symptoms brought on by chemical exposure, subclinical
nutritional deficiencies and gastrointestinal symptoms. The increased toxic load
on the body produced by a leaky gut has the general effect of making the nervous
and immune systems hyperstimulated. Neuroimmune dysfunction, or more
specifically, neuroimmune hyperactivity, is implicated in all the leading
theories about the etiology of environmental illnesses like CFS and
Glutamine is a common amino acid that is found in many protein
containing foods. It is important for a large number of bodily functions, an
important example being the detoxification of ammonia. It is
one of the most important nutrients for healing leaky gut syndrome because it is
the preferred 'fuel' for the cells lining the mucosa of the small intestine (enterocytes).
These cells have the ability to take up glutamine directly rather than waiting
for it to be supplied through the blood. Glutamine is also required for the
production of both intestinal mucus and Secretary
Immunoglobulin Type A (SIgA). As a result of these functions, a
generous supply of glutamine will help repair and maintain a healthy small
intestinal lining. These functions, as well as glutamine's ability to prevent
translocation of bacteria from the gut to the bloodstream, have been established
in a substantial number of clinical studies both in animals and in human
patients with diseases involving impaired intestinal permeability (1, 2, 3, 4).
You can purchase glutamine, in the form of l-glutamine, as capsules or powder
and it is widely available in health stores. The powder is arguably a better
option as quite large amounts need to be taken and it also ensures the glutamine
is readily available when it enters the small intestine. The suggested dosage
for moderate-severe leaky gut syndrome is in the range of 5-20g per day.
An essential nutrient for the production of the GI tracts protective
antibodies (SIgA). Vitamin A also helps to maintain a healthy intestinal mucosa
and soothes inflammation (5).
Vitamin A can is available in a number of different forms, probably the best
of which for this application is an emulsion. Although more expensive, this form
is more effective as it effectively coats the intestinal mucosa and gets to
where it is needed. Vitamin A can be used safely in doses of up to 20,000-25,000
IU's per day.
In the body zinc is required amongst other things for growth and
healing and is more essential to cells with a rapid turnover. The
cells of the small intestinal mucosa have an extremely rapid turnover, being
replaced about every four days, so zinc is extremely important to the integrity
of the intestinal lining. Clinical studies have shown that zinc supplementation
can help heal leaky gut in Crohn's disease patients, Crohn's is an illness with
a lot of evidence to support the role of leaky gut syndrome (6). To underline
it's importance, zinc is easily depleted in the body and Dr. Keith Eaton working
for Biolab, London has found zinc to be one of the most common nutritional
deficiencies in people with dysbiosis/leaky gut syndrome (7).
Dosages in the range of 50-80mg per day are usually taken to correct
deficiencies of zinc. Be careful not to take more than 100mg each day. Up to
this level zinc has a positive effect on the immune system but above 100mg per
day and it actually inhibits immune function. It is also wise to take 1mg of
copper for every 15mg of zinc as they antagonize each other so taking zinc
supplements alone will deplete copper in the body.
There are two distinct types of fibre in our diet, soluble and
insoluble. Dr. Leo Galland has found that soluble fibre increases gut
permeability (makes leaky gut worse) whereas insoluble fibre decreases gut
permeability (heals a leaky gut). The insoluble fibre that Dr. Galland uses with
his patients is cellulose and many supplement manufacturers now make cellulose
powder and capsules. Cellulose always helps to remove toxins from the intestinal
tract before they can be absorbed into the body. Common sources of soluble fibre
that should be avoided include psyllium and bran. Ironically
these are often suggested by naturopaths and other therapists for people
suffering from leaky gut syndrome.
This substance is what is known as an 'amino-sugar', a combination of
an amino acid and glucose. NAG is essential for the secretion of the mucus that
creates a protective lining on top the the cells of the gut.
NAG is widely available and is most commonly sold in capsules.
N-Acetyl Cysteine (NAC)
NAC is a very powerful supplement. It is a form of the amino acid
cysteine that is highly bio-available, meaning the body can make use of it much
more efficiently than other forms. NAC is a potent antioxidant and detoxifier
and provides the body with vital cysteine which is the most essential nutrient
for the formation of glutathione, the body's master detoxifying chemical. With
regards to leaky gut specifically, NAC helps to detoxify toxins produced by
intestinal yeast/bacterial overgrowth and stimulates immune function in the gut
lining, increasing white blood cell numbers. This detoxifying action also helps
beneficial bacteria to establish themselves in the gut if NAC is taken
concurrently with a probiotic supplement. Another benefit is that NAC powerfully
enhances liver function through production of glutathione and other conjugation
enzymes by supplying vital sulphur molecules. This helps heal a leaky gut as the
liver can cope with toxins better and hence spills fewer into the bile therefore
irritating the lining of the small intestine to a lesser extent. Research has
shown that oxidation may play an impoirtant role in increased intestinal
permeability and that treatment with NAC can prevent this damage due to it being
a powerful antioxidant (8).
NAC is widely available as capsules. The daily dosage is usually between 500
and 1000mg in divided doses.
Epithelial Growth Factors
These molecules are found in a wide range of sources including peptides
deglycerated licorice (DGL), glandular extracts and stevia, which is a natural
sweetener and alternative to sugar. Epithelial growth factors have been
effectively used in the treatment of various bowel disorders including irritable
bowel syndrome and inflammatory bowel disease. There are likely to be a very
useful treatment option for leaky gut syndrome also.
Botanical remedies can be very effective treatments for a wide range of
conditions. Below are the most useful herbs for healing a leaky gut and
restoring the mucosal barrier. A few of them also powerfully enhance
detoxification pathways which is a further benefit for the leaky gut patient.
DGL has a powerful anti-inflammatory effect and is very soothing to the
upper GI tract. It has been comprehensively researched and shown to be an
effective treatment for ulcers of the GI tract and also to prevent damage to the
intestines by aspirin (9, 10).
Silymarin (Milk Thistle)
This is one of the most powerful healing herbs there is. Most well
known for its ability to protect liver cells from potent toxins, it also has a
strong anti-inflammatory effect on the gut lining. Silymarin is a very good
antioxidant and also increases levels of glutathione in the cells (11).
Slippery elm has a soothing, calming effect on inflamed and damaged gut
lining. It is used widely for a range of gastrointestinal disorders. This
soothing action can be attributed to its antioxidant action in the gut which has
been proven in a number of clinical studies, some on inflammatory bowel disease
patients where severe inflammation is present (12, 13). In addition, slippery
elm provides mucilage which coats and protects the intestinal lining from toxins
and pathogenic organisms.
Aloe is a fantastic natural healing agent that has found uses treating
a wide range of different conditions due to its multiple beneficial actions. One
of aloe's active component are called mucilaginous polysaccharides which give
the plant its powerful anti-inflammatory healing action. It has been widely
shown to have a beneficial affect on a number of conditions involving
inflammation of the gut (14, 15). In addition to its healing effect on the gut
lining, aloe is also an immunomodulator and antimicrobial, both of which are
beneficial to anyone suffering from leaky gut syndrome and environmental
The digestive tract is the most responsive system in the body to the
influences of the brain and the mind-body connection. In fact the digestive
system is the only part of the body that contains and uses identical tissues and
chemicals to the brain. This has led to the gut being referred to as the 'second
brain'. There is a lot of interest in this area at the moment with researchers
trying to determine the extent that the brain plays in digestive disorders.
As a result of this strong connection, stress and negative emotional states
can have a profound effect on the health of the GI tract. One of the major
physiological reactions to stress is the diversion of blood away from the
digestive system to the skeletal muscles in readiness to either fight or flee.
Effectively, the digestive system is shut down. Without the normal flow of
blood, the digestive system is deprived of oxygen, glucose and essential
nutrients. Chronic stress therefore leaves the tissues of the digestive system
starved of the things it needs to maintain a healthy intestinal wall and produce
adequate amounts of protective mucus. It's clear therefore that chronic stress
plays an important role in leaky gut syndrome and other digestive disorders like
irritable bowel syndrome.
Dr. Walt Stoll, one of a growing number of doctors turning to an integrative
style of medicine, believes that stress is THE most important factor in
recovering from leaky gut syndrome. He suggests that everyone suffering from
leaky gut syndrome should practice a relaxation technique twice a day that puts
the brain into an 'alpha' or 'theta' state. These names relate to the frequency
of the brain waves with alpha waves having a frequency of 8-12Hz and theta of
4-8Hz. In these states the brain is able to release the stored stress response
24 times faster than normal sleep which creates 'delta' waves with a frequency
Any technique which is able to produce alpha or theta waves will be very
beneficial to the leaky gut sufferer. Some of the techniques that are effective
- Self Hypnosis
- Breathing Techniques
- Meditation and other spiritual practices
- Listening to specially prepared sound frequencies that induce the same
frequencies in brain waves. (Audio cassettes/CD's and sound devices are
available for this purpose)
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Copyright © 2005
HealthSmart Nutrition. All rights reserved.
Revised: May 18, 2006