The term “leaky gut” has become a popular buzzword phrase, but what most people don’t realize is that poor gut health may very well be underlying their mysterious health issues.
From weight gain to autoimmunity to food allergies, skin problems, depression, and more, a leaky gut is often at the root of the problem. Perhaps that’s why the Father of Western Medicine, Hippocrates, said over 2,000 years ago: “All disease begins in the gut.”
What Is Leaky Gut Syndrome?
A leaky gut is basically what it sounds like: your intestines develop tiny holes that allow for stuff that should stay contained in the gut (like food and toxins) to slowly leak through the gut wall and into the body.
It’s important to realize that up to 80 percent of the immune system is located within the gut wall, and the immune system’s first and foremost job is to produce inflammation in response to anything foreign that passes through the gut wall (like undigested food particles, toxins, bacteria, etc.). (1)
It’s not difficult to imagine that if the gut is “leaky” and toxins are continually flooding into the body, the immune system will constantly produce inflammation. Eventually this inflammation becomes chronic (long-term), and it’s chronic inflammation that underlies most “diseases of modern society,” including obesity, autoimmunity, heart disease, diabetes, cancer, depression, anxiety and MANY more diseases and disorders plaguing modern humans. (2, 3, 4)
9 Symptoms of Leaky Gut
Surprisingly, most people suffering from leaky gut syndrome have no digestive symptoms at all. The manifestations of leaky gut can appear virtually anywhere in the body. (5)
Digestive symptoms of all kinds can be a sign of an underlying leaky gut (although most people with leaky gut experience no specific issues with digestion). Diarrhea, constipation, gas, bloating, changes in bowel movements, abdominal pain, cramping, bloody stools, smelly stools, inflammatory bowels diseases, SIBO (small intestinal bacterial overgrowth) or another form of dysbiosis, candida overgrowth, gastroparesis or slow GI motility, and virtually any and all digestive symptoms and disorders under the sun can have a leaky gut at their root. (6, 7)
Much research suggests that a leaky gut must be present in order for autoimmune disease to be active. Over 80 different autoimmune diseases have been identified, including Celiac disease, rheumatoid arthritis, lupus, Hashimoto’s thyroiditis, alopecia, psoriasis, multiple sclerosis, type 1 diabetes, Crohn’s disease, and many more. (8)
Chronic Diseases and Disorders
Practically any disease or disorder in the body can be related to an underlying leaky gut, including (but not limited to): diabetes (type 1 and 2), cardiovascular diseases, many types of cancer, respiratory disorders (asthma and others), thyroid disorders, hepatitis and other liver conditions, osteoporosis, periodontal diseases, digestive disorders, urinary conditions, reproductive disorders and infertility, and obesity. (9, 10, 11, 12, 13)
If you’re suffering from skin issues, you’re likely also suffering from a leaky gut. The connection between gut health and skin health has been well established and many skin conditions have been connected with leaky gut such as rashes, acne, hives, eczema, rosacea, psoriasis, hair loss, dermatitis, dry skin, and many more. (14, 15, 16)
Food Allergies and Sensitivities
Studies have shown that nearly all people with food allergies, sensitivities and intolerance have some degree of leaky gut syndrome. (17) Once the leaky gut is healed, many people are pleased to discover that their food sensitivities resolve themselves.
In Functional Medicine, a common indicator of leaky gut syndrome is low trace minerals across the board when tested via blood. (18) Leaky gut is often accompanied by inflammation along the length of the digestive tract, which makes it difficult for vitamins and minerals to be absorbed through the gut wall and into the body.
Brain and Mood Disorders
Conditions such as brain fog, depression, anxiety, autism, chronic fatigue, headaches, migraines, mood swings, ADD and ADHD, Alzheimer’s, schizophrenia and many more brain-related symptoms are thought to have leaky gut at their root. (19, 20, 21)
Body and Joint Pain
Arthritis, joint pain, muscle pain or weakness, nerve pain, fibromyalgia, and other musculoskeletal conditions have been connected to increased intestinal permeability. (22, 23)
Sugar cravings can be a symptom of dysbiosis (an overgrowth of “bad” bacteria in the gut) and they often disappear once a person has addressed the health of their gut lining.
A Positive Test for Leaky Gut
Functional Medicine testing now exists that can assess gut health via the breath, blood, stool and urine. Two of the more popular tests for assessing intestinal permeability include the Lactulose/Mannitol urine test and the zonulin test (which can be performed via either a stool or blood test, and which detects a molecule called zonulin responsible for increasing intestinal permeability).
What Causes Leaky Gut?
Many things can trigger a leaky gut, but the most well studied are:
In particular, the antinutrients found in grains and legumes and foods that one is allergic or sensitive to. (24)
Several drugs, including alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, antibiotics, methotrexate, estrogen compounds (birth control), and others. (25, 26, 27)
Dysbiosis and Infections
An imbalance in the gut microflora, yeast overgrowth, parasitic or viral infections can also contribute to increased intestinal permeability. (28)
Poor digestion, such as low stomach acid or digestive enzyme production, pancreatic or hepatobiliary deficiencies, and carbohydrate malabsorption. (29, 30)
Poor Oral Hygiene
The mouth represents the beginning of the GI tract, and research suggests that dysbiosis in the mouth can contribute to increased intestinal permeability. (31)
Stress in any form (mental or physical) can trigger leaky gut syndrome. (32)
How to Heal a Leaky Gut in 4 Steps
There’s a concept that we practice in Functional Medicine called the 4R approach to healing the gut. It involves:
Step 1: Remove irritating foods and other toxins from our diets and lives
Step 2: Replace toxic foods with digestive support and healing foods
Step 3: Repair the intestines by providing the nutrients needed to heal the gut wall and the underlying immune system
Step 4: Reinoculate to restore a healthy balance of the gut’s microflora
Eating a Paleo diet is a great place to start. One of the benefits of the Paleo diet is that it follows the 4R protocol by removing the main food triggers that contribute to leaky gut. Here’s a quick breakdown of how you can use the 4Rs and the Paleo diet to reverse leaky gut syndrome:
The Paleo diet removes the main dietary triggers of leaky gut and chronic disease, including grains, legumes, processed and refined foods, and dairy, in sensitive individuals. As mentioned, any form of stress can trigger leaky gut and chronic disease. In particular, the focus should be on relaxing before, during and after meals to optimize digestion.
Replacing non-Paleo foods with nourishing gut-healing whole foods will alone work wonders. If you’ve been eating a gut-damaging diet for years, you may find that your digestive system needs some additional temporary support in the form of hydrochloric acid, digestive enzymes or bile salts. Many people unknowingly suffer from low stomach acid production (which has many of the same symptoms as high stomach acid production) and benefit from using apple cider vinegar (or something similar) before meals.
Certain nutrients and herbs can be helpful by providing the gut lining with the fuel it needs to repair itself. The amino acid glutamine is the main fuel source for gut wall cells and supplementation has been shown to aid in restoring its integrity. (33)
The following nutrients have been shown to help enhance gut wall repair: vitamins A, C, E, D, B1 through B12, all of the amino acids, and the minerals zinc, selenium, chromium, molybdenum, manganese, and magnesium. (34, 35, 36, 37)
Adequate mucus production is essential for gut wall protection, and mucilaginous botanicals have a long history of use for improving overall GI health by reducing inflammation, including aloe vera, slippery elm, deglycyrrhizinated licorice, and marshmallow root. (38) N-acetyl-D-Glucosamine helps to strengthen connective tissues, is a major constituent of the mucosal barrier layer of the gut wall, and has been shown to decrease intestinal permeability. (39) Other dietary components shown to decrease leaky gut include the EPA and DHA found in fish oils, medium chain triglycerides (MCTs), curcumin (turmeric), ginger, quercetin, bone broth, and fermented foods. (40, 41, 42)
The use of fermented foods and/or probiotics to reinoculate the gut with healthy bacteria and restore a healthy ratio of gut bacteria can be extremely helpful. Four ways to improve the health of your microflora include: 1) Eating a wide variety of foods and fibers, 2) Not using antibacterial cleaners (and do play in the dirt!), 3) Eating live/raw/unpasteurized fermented foods, and 4) probiotics and prebiotics. It’s important to use caution with probiotics because it’s way too easy to overconsume any one type of bacteria if you take the same probiotic pills over and over. I recommend getting probiotics from a rotating variety of fermented whole food sources.
The Bottom Line
If you think you might have a leaky gut, first off, don’t panic (remember, stress is one of the triggers of leaky gut syndrome)! Luckily, there’s a lot that you can do to heal your gut, which repairs itself quite quickly. In fact, the body uses over 20 percent of the energy derived from food to completely replace the gut wall every one to four days! (43) Most people feel like a new person after four to six weeks of living a Paleo lifestyle once the immune system has a chance to reset itself. Of course, depending on how long your gut has been leaky, and taking into consideration the specific conditions you’re dealing with, it may take several months before you’re feeling 100 percent again. So keep the faith and hang in there – the body truly is capable of miraculous healing!
In good health,
Kinsey Jackson, MS, CNS®, CFMP®