What is Leaky Gut and How do you Know if you Have it?
This is part I in a 3 part series about leaky gut syndrome. This article provides up-to-date facts about what leaky gut is and what symptoms and signals it comes with. Read on in part II how leaky gut affects your health. And find the true causes and solutions in part III, together with our 5-step treatment protocol.
If you think you might suffer from leaky gut syndrome and are looking for answers, read on and discover the latest science-based facts about what it is and how to heal.
What is Leaky Gut Syndrome
Leaky gut syndrome is a popular term for intestinal hyperpermeability. It’s a very common condition where the lining of the intestinal tract becomes increasingly porous – more than it should be.
Some (conservative) medical practitioners and researchers are still skeptical about leaky gut as a health diagnosis. However, increasing research supports the conclusion that the intestinal wall uses complex mechanisms to regulate the passage of substances through the gut lining into the body, and that dysfunctional intestinal permeability leads to a variety of diseases. The term intestinal hyperpermeability is now finally recognized in regular medicine as well. Studies have shown that this afflicts more than 50% of the world population, and it drives chronic disease.
Structure of the Gut Barrier
The lining of a healthy gut is only one layer of epithelial cells thick and is semipermeable. It lets through water and nutrients from what you eat and drink, but it acts as a barrier against potentially dangerous bacteria and molecules. It’s healthy function is to let in the good stuff and to send the bad out as waste.
To accomplish all this, the intestine uses a mucosal barrier that provides chemical, physical, and immune reaction processes to separate vital nutrients from unhealthy particles. This barrier forms a continuous layer of mucus from the esophagus to the anus and it separates the bulk of the luminal contents (what’s travelling through the intestine) from the intestinal epithelium (the main barrier).
The intestinal mucosal barrier provides separation between the body’s interior and the world outside, so it has the important function of preventing the uncontrolled translocation of luminal contents into the body. Its role in protecting the mucosal tissues and circulatory system from exposure to pro-inflammatory molecules, such as microorganisms, toxins, and antigens is vital for the maintenance of health and well-being.
Your commensal gut bacteria reside in your mucosal barrier and form an integral part of this structure. This has been named your gut microbiota (gut microbiome or gut flora). The gut microbiota can influence barrier function both directly, by stimulating epithelial cell proliferation and secretion of IL-8, and indirectly by producing short-chain fatty acids (SCFA’s), which are an important energy source for colonic epithelial cells.
The selective permeability of the epithelium is created by two routes: the transcellular and paracellular routes. The transcellular route is used to transport nutrients, including sugars, amino acids, peptides, fatty acids, minerals and vitamins, across the epithelium (through the cells). This strains out large food particles and only allows small, well-digested molecules to pass through.
The paracellular route is involved in transport between adjacent epithelial cells and is regulated by a complex consisting of tight junctions (TJ’s) and adhesion junctions (AJ’s). The TJ’s regulate selective permeability by forming a barrier to harmful substances (by bonding epithelial cells together), but also creating a path for the entry of sodium, water, and glucose in case of high stress – to meet the increased energy demands. Once the stressful challenge is over, the body returns to homeostasis, as well as regulating intestinal permeability. This is pure physiology.
However, continued stress can disrupt the TJ barrier and lead to increased permeation of pro-inflammatory molecules in the blood circulation, activation of the mucosal immune system and ultimately persistent inflammation and tissue damage. As shown on the right side of the image below.
The situation becomes pathological: a hyperpermeable gut lining or “leaky gut” is created.
How Does Leaky Gut Impact Your Health?
Now you know that having a hyperpermeable gut during stress is pure physiology, so it makes sense that leaky gut is present in everyone to some degree. (Who doesn’t have stress these days?) It’s only a problem when your intestines stay “leaky” for too long and start to let out the wrong types of molecules and microbes. It’s the chronic factor that creates inflammation and contributes to many different health issues.
Researchers have observed that leaky gut affects people diagnosed with many different chronic diseases, such as skin problems, food allergies, IBS, Celiac disease (CD), Crohn’s disease (CD), ulcerative colitis (UC), SIBO, type 1 and type 2 diabetes, chronic fatigue syndrome (CFS), depression, congestive heart failure (CHF), fatty liver, auto-immune disease and cancer.
The image below shows how the intestines are connected to different organs and what diseases can arise. Everything in your mind and body is connected.
How to Know if You have Leaky Gut?
You know now that most people in Western industrialized countries have a hyperpermeable gut to some extent. When a chronic inflammatory condition is present, we can assume that leaky gut is present as well. Unfortunately there are not many guts in the Western world that are in pristine condition.
If you want to know for sure if you have leaky gut and to what degree, then we can test for it. If identified, and if present, this is a PRIMARY target for our treatment plan. But just testing for it does not inform us about the causes of YOUR personal leaky gut, so it’s not essential and you can save the investment if you wish. More about the possible causes of leaky gut in part III.
Therefore, we believe there are really only two benefits from testing:
- To be able to track progress in healing the gut. Test again after finishing our protocol.
- To motivate individuals who need to see a diagnosis on paper in order to make the necessary diet and lifestyle changes.
If you choose to test for intestinal permeability, the best options are listed below.
Markers to test:
- Challenge tests:
- Lactulose/mannitol ratio increased in urine: this is the best option for testing small intestine permeability.
- 13C-Sucrose-breathtest
- Serum markers:
- Zonulin: zonulin should be between the enterocytes, not in the blood. Disadvantage of Leaky Gut diagnosis with zonulin: if the intestinal inflammation is far advanced with severely damaged intestinal epithelium, zonulin increases less than usual.
- Lipopolysaccharides: LPS pass through intestinal wall and enter the bloodstream.
- Fecal markers:
- Zonulin: marker of intestinal permeability.
- Calprotectin: non-specific marker of glut inflammation.
- Secretory immunoglobulin A (sIgA), which is central to the mucosal immunity barrier in the gut.
Inflammatory Markers Associated with Leaky Gut
Inflammatory mediators of the cellular defense provide an indication of granulocyte migration (immigration of white blood cells) into the intestine and the degree of an inflammatory process that can contribute to leaky gut.
- EPX Test (blood test): The Eosinophil Protein X test (EPX) measures eosinophil levels, which increase when the gut is damaged from parasites, allergic reactions, and other causes. Results from this test can provide a marker indicating damage to the gut lining that can increase intestinal permeability.
- Neutrophil Elastase (blood test): This blood test measure neutrophil elastase (NE,) a crucial component in immune function.
- Testing for Food Intolerance (Sensitivity): Eliminating reactive foods from the diet helps reduce intestinal permeability and heal from leaky gut syndrome by reducing chronic inflammation. If a leaky gut condition exists you may suffer knowingly or unknowingly from multiple food intolerances (see image to the right).
The fecal markers (from stool analysis) say less than the other ones, but as part of a comprehensive gut microbiome test we can gather a lot of information about your gastrointestinal health.
Symptoms
A leaky gut can result in wide-ranging symptoms throughout the body. Here is a summary of symptoms and disorders that may indicate you have leaky gut.
| Body System | Leaky Gut Symptoms & Conditions |
| Digestive | Bloating, constipation, diarrhea, abdominal pain, acid reflux, nutritional deficiencies, food allergies IBS, colitis, Crohn’s, IBD |
| Brain/Neurological | Lack of mental focus, brain fog, depression, anxiety, mood swings. Migraine, Pain syndromes, Alzheimer’s, Parkinson’s, autism, sleep problems |
| Energy Production | Lethargy, fatigue (especially after meals), chronic fatigue |
| Joints | Joint pain, arthritis, systemic inflammation |
| Skin | Acne, psoriasis, eczema and any impure skin |
| Immune System | Autoimmune disorders, such as diabetes type 1, thyroid, rheumatoid arthritis, Celiac disease, multiple sclerosis, fibromyalgia |
| Cardiovascular | Arterial inflammation, heart disease |
Can you fix leaky gut?
Despite what you may have seen advertised, there’s no quick fix to heal your gut. It’s possible to repair most of the damage in just 3 or 4 weeks, but often it takes a bit longer. By following this 60 days program, you can get back on the path of health and wellness.
The intestine is the most highly regenerative organ in the human body, regenerating its epithelial cells every 3 – 7 days, by repeating cycles of cell proliferation, migration, and shedding. But after repeated assaults, it won’t heal fast enough anymore. Your body is only able to tolerate so many toxic chemicals, such as partially digested foods and metabolites that irritate the system, heavy metals, and stress. Now you have pathogenic intestinal permeability – the weak link in your chain.
When your health is failing, do not assume that you body is failing you. Its effort to heal never stops, not even for a second. However, over the years most people with leaky gut have endured tens of thousands of repeated injuries to their gut lining and tissues, simply because of what they eat for breakfast, lunch and dinner, and their stressful lifestyle. For disease to progress, injury must outpace healing. For healing to occur, the opposite must happen: HEALING must outpace injury. It’s a simple matter of allowing your body to heal by stopping the regression by very clean living.
To reestablish your intestinal barrier function the key is to address underlying mechanisms that contribute to intestinal permeability. We need to address the things that are irritating it. That means taking care of any dysbiosis, infections, stress and following a proper diet to turn on your genes to heal your gut.
Do not try to Treat it Yourself (DIY).
We’ve made the most complete Leaky Gut Recovery Protocol freely available for you as a resource, but this protocol is not meant to do-it-yourself, but meant to use together with your healthcare practitioner. You always need a personalized approach. Dozens of things can contribute to leaky gut and it’s different for everyone.
How Long Does It Take to Heal Leaky Gut?
It’s important to remember that your gut did not become chronically hyperpermeable overnight. Chances are this is the result of years of exposure to inflammatory foods, toxins, and other stressors. So healing leaky gut will certainly take some time as well. That’s why it’s important to be patient with yourself and stick to your personalized gut-recovery protocol. This commitment to your health will be worth it as your health is restored and you are feeling like your best again (or even better!).
Want our help reversing your leaky gut?
If you are ready, willing, and able to invest in your best health, we offer Health Transformation Programs over Zoom. We provide comprehensive, customized treatment plans, and collaborative, caring support. If you are ready to beat Leaky Gut and reclaim your best life please book a complementary 20–minute discovery call with us to gain clarity, confidence, and explore the possibility of working together.
Summary & Conclusion
Leaky gut syndrome occurs when the gut lining becomes too permeable, leading to pathogenic bacteria, toxins, and partially digested food particles entering the bloodstream. This condition has far-reaching impacts on overall health, increasing risk of chronic disease.
There are various tests that can help you determine whether or not you have a leaky gut and identify inflammation causing food intolerances which can harm the gut barrier, and other factors that could be an obstacle to healing.
It is possible to heal a leaky gut, but it’s recommended to consult a healthcare practitioner because leaky gut syndrome is affected by a wide range of different factors.
References
[1] Human gut-in-a-dish model helps define ‘leaky | EurekAlert!
[2] https://www.tandfonline.com/doi/abs/10.1080/21688370.2017.1373208
[3] https://diabetesjournals.org/diabetes/article/57/10/2555/13406/The-Perfect-Storm-for-Type-1-DiabetesThe-Complex
[4] https://www.nature.com/articles/nri2653
[5] Alterations in intestinal permeability – PMC (nih.gov)
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923430/
[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337124/#:~:text=The%20gut%20microbiota%20that%20resides,dysregulation%2C%20leading%20to%20autoimmune%20disorders.
[8] The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome | Bentham Science (eurekaselect.com)
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/
[10] Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives – PubMed (nih.gov)
[11] Increased gastrointestinal permeability is an early lesion in the spontaneously diabetic BB rat – PubMed (nih.gov)
[12] https://www.mdpi.com/2076-2607/7/8/271
[13] Chronic fatigue syndrome is in your gut, not your head — ScienceDaily
[14] Gut permeability and food allergies – PubMed (nih.gov)
[15] The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions – PMC (nih.gov)
[16] The gut microbiota in osteoarthritis: where do we stand and what can we do? – PMC (nih.gov)
[17] Estrogen-gut microbiome axis: Physiological and clinical implications – PubMed (nih.gov)
[18] Gut microbiota’s effect on mental health: The gut-brain axis – PMC (nih.gov)
[19] https://my.clevelandclinic.org/health/diseases/22724-leaky-gut-syndrome
[20] Increased intestinal permeability in patients with Crohn’s disease and their relatives. A possible etiologic factor – PubMed (nih.gov)
[21] https://drmeaghandishman.com/lab-testing-for-leaky-gut-intestinal-permeability/#:~:text=Circulating%20Zonulin%20is%20a%20clinically,junctions%20between%20intestinal%20epithelial%20cells.
[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047110/#:~:text=Background,preclude%20meaningful%20comparisons%20between%20studies
[23] https://healthmatters.io/understand-blood-test-results/fecal-secretory-iga
[24] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0049646
[25] https://bastyr.edu/news/health-tips/2020/03/it-food-allergy-intolerance-or-sensitivity
[26] https://keep.lib.asu.edu/items/165846
[27] https://www.health.harvard.edu/blog/putting-a-stop-to-leaky-gut-2018111815289
[28] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369670/#:~:text=Glutamine%20is%20considered%20the%20most,children%20(53%2C%2054).
[29] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4303825/
https://en.wikipedia.org/wiki/Intestinal_mucosal_barrier
