What is Leaky Gut?
Leaky Gut is responsible for a wide range of signs and symptoms. The term leaky gut refers to the breakdown of tight junctions that hold together the cells of the intestinal linining. When this border is compromised, it can no longer prevent unwanted materials from entering the bloodstream. Materials such as undigested foods, mycotoxins, inflammatory bacterial particulates like lipopolysaccharides, and potentially problematic proteins such as gluten and casein.
Root Causes of Leaky Gut Syndrome
It’s important to understand that a leaky gut is not a root cause in itself. There’s always something else that is promoting the degeneration of the intestinal barrier. For example, stress promotes elevated cortisol, which directly leads to the depletion of glutamine, the most abundant amino acid in muscle tissue and the gut lining. Other root causes may be intestinal infections, dysbiosis, and poor diet.
So, while we can and should give helpful supplements that rebuild the gut lining, it’s fruitless if we don’t address the root cause.
Digestive Symptoms
The most obvious symptoms you may experience include digestive symptoms like gas & bloating, diarrhea or constipation, and abdominal pain. But did you know that you can have leaky gut without any digestive symptoms. The leaky gut may be manifesting in other ways.
Leaky Gut and Autoimmunity
First on this list is autoimmune disorders. Autoimmunity has a “triad” of requirements, first proposed by Dr. Alessio Fasano. The triad consists of three components that are necessary to result in an autoimmune condition. The first is a genetic predisposition for the condition. The second is an environmental trigger, which could be considered the antigen that the immune system is responding to. The third is high intestinal permeability, in other words, leaky gut.
With everything that we put in our digestive systems every day, we are potentially presenting antigens that the immune system sees as foreign and requiring immune support in the form of antibodies.
These antibodies are made to specifically attack the foreign antigens. However, in autoimmune cases, the antigens are similar enough to proteins that belong in our body. The immune system ends up attacking proteins that belong. But it all starts with a failure to keep the foreign antigens out. With the intestinal barrier in place, the antigenic load being presented to the immune system decreases, which in turn decreases autoimmune antibody production.
So, whether it’s Hashimoto’s thyroiditis or rheumatoid arthritis or any other autoimmune condition, it’s important to check for a leaky gut and correct it.
Skin Manifestations of Leaky Gut
Another set of signs and symptoms show up on the skin. In some cases these are autoimmune in nature such as eczema or psoriasis. However, there are also allergic reactions from an abundance of antigens being exposed to the blood and creating a histamine reaction. But also, bacteria in the gut can create histamines as well. In these cases, it may be necessary to try out a low histamine diet.
Also, with leaky gut there is an increased exposure to toxicants that need to be processed by the liver. The toxicants can come out through the urine, stool, or sweat, but also through the skin. This is a case of too much coming in and needing to find a pathway out and they find that way out through the skin.
Food Sensitivities and Leaky Gut
Along the lines of allergic reactions and exposure to antigens, we can also see food sensitivities. If you’re someone who has a problem with eating a wide variety of foods, it may be due to a leaky gut.
Mind-Gut Connection: Mental and Emotional Symptoms
You’ll also want to be noticing mental and emotional problems such as anxiety and depression and brain fog. The gut-brain axis is real. What happens to one affects the other. For example, it’s common that someone who has a brain injury will have a deterioration of the intestinal barrier, resulting in leaky gut. Transversely, what happens in the gut affects the brain. If you have anxiety, depression, or brain fog, consider getting tested for leaky gut.
Nutritional Implications of a Leaky Gut
We’ve been talking about what happens when too much is absorbed into the bloodstream due to a leaky gut, but what about nutrients that don’t get absorbed? Assimilating nutrients from the gut lumen into the bloodstream is an active process. With the deterioration of the gut lining, those active mechanisms of nutrient absorption are compromised and can result in nutrient insufficiencies, even if you’re eating plenty of healthy foods. The most severe cases may see muscle atrophy. However, there can also be signs for any number of nutrient and vitamin insufficiencies.
Testing for Leaky Gut
The standard for testing leaky gut is a lactulose mannitol test. Lactulose and mannitol are large molecules that should have only a small percentage uptake through the intestinal barrier. We can test if a high percentage of the lactulose and mannitol leak through the barrier by testing urine before and after drinking a concoction with these molecules. There are other markers that have been suggested for checking a leaky gut. However, I don’t find them to be as reliable as this test.
Treatment Approaches for Leaky Gut
When it comes to treatment, we’ve all been trained to think we just need to take the right pill to correct our condition. And while it is true that there are some supplements that can reverse a leaky gut, it’s still important to go deeper. First of all, we need to explore a root cause. Second, we should treat the whole gut, including the microbiome and infections and any insufficiencies with pancreatic enzymes, hydrochloric acid in the stomache and bile salts for the gall bladder.
Root causes can come from a poor diet, gluten disorders such as Celiac disease, dysbiosis of the microbiome. And then there’s the connection to the adrenal production of cortisol. Excess cortisol can result in leaky gut by a couple of mechanisms. First, it promotes the breakdown of the intestinal barrier by depleting glutamine. Second, it directly inhibits the immune system in the gut by reducing the antibodies from secretory IgA. Secretory IgA or sIgA is one of the main parts of the immune system that helps to reduce infections and maintain the microbiome. So then we have to go upstream and ask ourselves what can cause excessive cortisol production. The answer is stress, blood sugar dysregulation, and poor sleep. So, potentially, to treat the root cause of your leaky gut, it comes back to managing stress, eating for stable regulation of blood sugar, and getting good sleep.
Supplements for Leaky Gut
When it comes to supplements, glutamine is the major player for rebuilding the intestinal barrier and mucousal lining. We can also use DGL, slippery elm, and marshmallow root which enhance the protective mucousal lining. And don’t forget, this may just be the tip of the iceberg. If there’s an infection, an imbalance in the microbiome, that will also need to be addressed. If sIgA levels show up lower, it’s important to get adrenals tested and treated as well.