May 15, 2018

Wait, My Gut is Leaking?!?

Ozark Holistic Center

Maybe you have heard of leaky gut or maybe not, but its prevalence today is increasing. Until recently, not much was known about it. There is a growing body of research surrounding leaky gut its negative effects. Many practitioners have known about this for a long time. Some have been very successful in treating it. Others knew there was something wrong with the gut and it was causing the patient’s symptoms. The latter has been known for many years. Our gut affects so much. But how much? To give you an idea I will quote an old adage “you are what you eat.”

Our entire digestive tract, from the mouth to the anus, is exposed to the outside world. Therefore we need some type of protection against the environment. In the gut we have a barrier system that is supposed only allow certain substances through it. It protects foreign invaders such as microorganisms. It is also a selective filter that allows essential nutrients through while keeping non-essential substances out.1  The cells that line the barrier have several structures to regulate what passes through it. Among these are desmosomes, adherens junctions, and tight junctions (TJs). These structures must be able to adapt quickly in order to allow substances we need past the barrier. Dr. Alessio Fasano is one of the leading researchers on this topic. He states, “To meet the diverse physiological challenges to which the intestinal epithelial barrier is subjected, TJs must be capable of rapid and coordinated responses. This requires the presence of a complex regulatory system that orchestrates the state of assembly of the TJ multiprotein network.”2 When we eat, we need to digest and absorb our food. If this barrier does not respond quickly and adapt we cannot absorb the nutrients. This barrier can become disrupted causing intestinal permeability or leaky gut. Diet, food sensitivities, pesticides, herbicides, stress, and pathogens are known causes of increasing intestinal permeability. These substances create local inflammation that can become cyclical in nature disrupting more and more of the barrier.

One aspect is the role of zonulin. Researchers have yet to determine its physiological role precisely. It seems to be involved in tight junction regulation allowing movement of fluid macromolecules, and white blood cells. But it is the improper use of zonulin that makes it a culprit in leaky gut. It was first discovered indirectly by a toxin that is released by a bacteria called zonula occludens toxin. This toxin is capable of opening the tight junctions.2 With tight junctions opened foreign invaders such as bacteria and large protein structures such as gluten can find their way past the barrier.

These foreign substances should not get past the barrier and so they are targeted by the immune system. The immune system kicks on and immune cells are drawn to the site of barrier breakdown. Further chemicals are released to perpetuate the increased intestinal permeability. As more substances pass the barrier, more immune cells are called into action, inflammation is increased, and more of the intestinal barrier is broken down, creating a vicious cycle.2 Unless, the causative agents are found and stopped the cycle will continue leading to further and further problems. Furthermore, exacerbation of the problem can happen if careful measures are not taken to ensure an intact barrier. I will include a video animation that shows what is taking place.

So What?

A little inflammation in the gut can’t be that bad can it? As I mentioned the inflammation will continue to grow. As more substances find their way past the barrier they can get into the bloodstream causing systemic inflammation or body-wide inflammation. Another problem that arises from this disorder is autoimmune disease. Autoimmune disease is when the body attacks itself. Common autoimmune diseases include Hashimoto’s, rheumatoid arthritis, lupus, type-1 diabetes, multiple sclerosis, and celiac disease. Autoimmune disease is very prevalent. Some have estimated over 50 million Americans have an autoimmune disease.3 Researchers are finding the connection between leaky gut and autoimmune diseases to be causative. That’s right, these diseases start in the gut often times from a chronic infection or food sensitivity. A lot of research has been going on showing the connection between multiple sclerosis (MS) and gluten.6 Gluten sensitivity is a huge problem today, but it is also a fad diet. So beware of what you read. I will explain in another post some of my ideas in regards to why gluten sensitivity is so prevalent today. Another problem associated with leaky gut is that the same mechanisms that disrupt the barrier can also disrupt the blood brain barrier.5 Doctors like Dr. Kelly Brogan have been treating depression and anxiety as symptoms of leaky gut.  She has a fantastic book called A Mind of Your Own.

So you have leaky gut, what should you do now? Firstly, I recommend all my patients to switch to a anti-inflammatory nutrient dense diet. Simply, it is a whole food based diet with certain restrictions. Whole30 has a great how-to on their website. The idea is to get back to the way our roots, the way our ancestors ate. That has some caveats though. Many of our ancestors ate poorly and the environmental conditions were often deplorable. Weston A. Price wrote an excellent book called Nutrition and Physical Degeneration where he observed isolated indigenous people around the world. These people were untouched by the western diet. He observed that chronic disease was rare among them.  They ate vegetables, fruits, grass-fed meat, fermented foods, they soaked and fermented their grains, and some of them ate a lot of animal fat. They were different from each other. Some had more fat and others had more carbs. This all depended on physical needs and what was available to them. But enough of a history lesson, the moral of the story is our diet needs to change. It is harming us. We get too much of the wrong foods and we do not process the food we eat the way our ancestors did. This is one of the biggest causes of the increase in chronic disease in the world.

So paleo diet is one step, the next step is to find a holistic or natural medicine practitioner that can help identify what is causing your leaky gut. Diet can only go so far. I see it all the time with my patients. Both are crucial but diet alone often does not do the trick. A knowledgeable practitioner can quickly identify the problem, as well as other nutrient deficiencies and issues to speedily get you on the right track. In my office, I use a variety of diagnostic tests to accurately identify the culprit as well as other nutrient needs there maybe. I use various herbs and nutrients to help support the body’s natural healing process. So find someone that help you with this and get you one the track back to good health! If you have any questions shoot me a line. I have included some extra sources below if you want to check them out. In the end remember the key to health is Eat Well, Move Well, Live Well.

  1. Groschwitz, K. R., & Hogan, S. P. (2009). Intestinal barrier function: Molecular regulation and disease pathogenesisJournal of Allergy and Clinical Immunology, 124(1), 3-20. doi:10.1016/j.jaci.2009.05.038.
  2. Fasano, A. (2008). Physiological, Pathological, and Therapeutic Implications of Zonulin-Mediated Intestinal Barrier ModulationThe American Journal of Pathology, 173(5), 1243-1252. doi:10.2353/ajpath.2008.080192.
  3. Autoimmune Statistics. (n.d.). Retrieved March 28, 2017, from
  4. Fasano, A., & Shea-Donohue, T. (2005). Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseasesNature Clinical Practice Gastroenterology & Hepatology, 2(9), 416-422. doi:10.1038/ncpgasthep0259.
  5. Daneman, R., & Rescigno, M. (2009). The Gut Immune Barrier and the Blood-Brain Barrier: Are They So Different? Immunity, 31(5), 722-735. doi:10.1016/j.immuni.2009.09.012.
  6. Reichelt, K., & Jensen, D. (2004). IgA antibodies against gliadin and gluten in multiple sclerosisActa Neurologica Scandinavica, 110(4), 239-241. doi:10.1111/j.1600-0404.2004.00303.x.
  7. Fasano, A. (2011). Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and CancerPhysiological Reviews, 91(1), 151-175. doi:10.1152/physrev.00003.2008.
  8. Fasano, A. (2012). Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences, 1258(1), 25-33. doi:10.1111/j.1749-6632.2012.06538.x.
  9. Vaarala, O. (2012). Is the origin of type 1 diabetes in the gutImmunology and Cell Biology, 90(3), 271-276. doi:10.1038/icb.2011.115.

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