Leaky Gut and Leaky Gut Syndrome
What is Leaky Gut Syndrome? Causes, Symptoms, and Solutions
You will learn:
Introduction
It might surprise you that the intestine is the biggest immune system organ in the body. However, scientific research confirms the link between a healthy gut and robust immune function. This discovery has significant implications for improving our overall physical and mental well-being. In addition, recent studies also point to a disease process called leaky gut syndrome as a substantial factor in digestive issues and their effect on the health of the body and mind.
This article provides up-to-date facts about causes, symptoms, and solutions for improving gut health and healing the intestinal hyperpermeability that leads to a leaky gut. You’ll learn what it means to have a leaky gut, how it can affect your health, which foods are best and worst for managing it, and effective treatments to improve gut health. In addition, you’ll find out about a protein that plays a crucial role in how the intestines regulate nutrients and other substances passing through the gut lining.
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.
1. What is a Leaky Gut?
Scientific Base of the Leaky Gut Syndrome
Leaky gut syndrome is a digestive health condition in which the intestinal mucosal barrier becomes more permeable than it should be. When this intestinal hyperpermeability occurs, the gut lining allows harmful environmental factors like toxins and pathogenic bacteria to enter the bloodstream along with life-supporting nutrients. [1]
Some 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. For example, part of the gut barrier function is regulating immune response and thus acting as a gatekeeper of good health. [2]
Other research shows that the permeability of the gut lining can become compromised, allowing unhealthy substances into the blood, affecting many aspects of health beyond gut health. So, while leaky gut syndrome is not an official diagnosis, more and more health practitioners and their patients recognize an identifiable set of causes, symptoms, and solutions for this condition.
They have observed that leaky gut symptoms are most likely to affect people diagnosed with other chronic disease conditions such as Celiac disease, cancer, type 1 diabetes, inflammatory bowel disease, and chronic fatigue syndrome. In addition, chronic stress is associated with a leaky gut. [3]
Some of these chronic diseases suggest there could be a genetic predisposition for acquiring a leaky gut. However, age is another factor, and older individuals are at greater risk of developing this condition.
First, let’s look at the structure of the intestinal barrier and how intestinal permeability regulates substances moving from the digestive system into the bloodstream and tissues of the body. Then we’ll dive into the causes, symptoms, and treatment options.
First, let’s look at the structure of the intestinal barrier and how intestinal permeability regulates substances moving from the digestive system into the bloodstream and tissues of the body. Then we’ll dive into the causes, symptoms, and treatment options.
2. Structure of the Intestinal Barrier
Structure of the Intestinal Barrier
The lining of the intestine is a complex structure with a big job to perform. This organ is responsible for determining which substances we ingest are healthy nutrients and which are not. It must then let in the good stuff and 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 according to Nature. This barrier forms a continuous layer from the esophagus to the anus, dividing the body’s interior from the world outside. [4]
Beneficial bacteria in the intestinal lining are an integral part of this structure, working within an epithelial layer that secretes chemicals such as mucous and immunoglobulins. Below this layer, immune cells form the next protective barrier by creating an antibody response when foreign substances are detected.
Part of this physical barrier of intestinal permeability are structures called tight junctions. Tight junctions are small openings from the intestine’s interior into the bloodstream that allow nutrients and water to enter while keeping out unhealthy particles like toxins, harmful bacteria, and undigested food. [5]
When tight junctions become too open and large due to inflammation or exposure to some form of toxin, a person can develop leaky gut syndrome with unhealthy substances entering the blood and being transported to organs and tissues with far-ranging effects on overall health.
The Intestine and Immune Function
Our immune system must distinguish between self and non-self and initiate an immune response when foreign substances are detected in the body. For example, the food we eat is one of the most significant ways that environmental substances come into contact with the interior of our body. This close contact with food is why the gut plays such a central role in immunity.
There are two types of immunity. One is hardwired in at birth and is called innate or non-specific immunity. This type of immunity responds to foreign bodies without identifying them beyond the fact that they are not part of the self. [6]
The other type of immunity is acquired after birth, called acquired or specific immunity. This form of immunity develops as the body encounters specific foreign substances, learning and remembering what they are and building antibodies to counteract them. Examples of specific immunity are becoming resistant to a virus after the flu or receiving a vaccination.
The gut microbiome develops shortly after birth and is involved in specific and non-specific immune functions. When a disruption happens in the gut microbiome, the immune system cannot respond as it should, and various autoimmune disorders become more likely. [7]
The Link between Leaky Gut and Chronic Inflammation
The small intestine and the large intestine are home to billions of beneficial bacteria that help break down foods as part of the digestive process. This gut microbiome is an intricate balance of specific microorganisms that can become disrupted, leading to various health issues, especially autoimmune diseases.
The gut lining and bacteria living there are responsible for many types of immune system processes as part of their job in keeping harmful substances out of the body. When these healthy bacteria become disrupted, it can lead to an increase of intestinal permeability and initiate an immune response that leads to ongoing inflammation, resulting in many adverse health conditions. [8]
3. Compromized Intestinal Barrier – Causes, Consequences, Symptoms
Causes of Leaky Gut Syndrome
Researchers are still investigating the exact causes of leaky gut syndrome. However, a protein called zonulin, discovered in 2000, appears to be involved in this health condition. This is the only chemical established as a regulator of the permeability of the intestinal barrier. [9]
When levels of this protein are higher, intestinal permeability increases. Two factors known to increase zonulin are certain unhealthy intestinal bacteria and gluten. Gluten is a protein found in grains, primarily wheat but also barley and rye, perhaps explaining the connection between sensitivities to gluten and leaky gut syndrome.
Some research indicates that gluten only increases intestinal permeability in people who already have irritable bowel syndrome, celiac disease, or other autoimmune diseases. However, it is not yet clear whether these diseases increase permeability by themselves or if they make a person more susceptible to leaky gut.
One research study observed that 42 percent of participants diagnosed with Type 1 diabetes had levels of zonulin that were much higher than non-diabetic participants. [10]
This finding has been reproduced in animal studies of diabetes as well. This line of research leads some researchers to conclude that an immune reaction in diabetes might be caused by toxins leaking from the gut into the bloodstream. [11]
However, many scientists researching this issue think multiple factors are working together, leading to leaky gut syndrome and unhealthy intestinal permeability.
Some of the other factors contributing to leaky gut include: [12]
- High consumption of sugar, especially fructose
- Chronic high-stress levels
- Long-term use of NSAID drugs such as aspirin and ibuprofen
- Alcohol consumption
- Deficiencies in vitamins A and D and the mineral zinc
- Low levels of beneficial gut bacteria
- Overgrowth of yeast in the intestine causing candida
- Chronic bodily inflammation
Consequences of Leaky Gut Syndrome
Some of the chronic diseases linked to chronic inflammation and leaky gut syndrome include autoimmune diseases such as: [13, 14, 15, 16]
- Crohn’s disease
- Irritable bowel syndrome
- Celiac disease
- Food allergy and intolerance
- Diabetes
- Chronic fatigue syndrome
- Inflammatory bowel disease
- Skin problems like psoriasis, eczema, and acne
- Ulcerative colitis
- Type 1 diabetes
- Osteoarthritis
- Autoimmune diseases
Hormonal imbalances are also linked to gut health because beneficial gut bacteria are one of the primary regulators of estrogen in the body. [17]
In addition, leaky gut syndrome is linked to several mental health conditions such as depression and anxiety. [18] The connection between mental health and gut heath appears to involve what is known as the gut-brain axis: a network of nerves connecting these two organs in two-way communication. The messages from the gut to the brain include information about hunger, satiety, and inflammatory processes.
Symptoms of Leaky Gut Syndrome
According to Clevenland Clinic a leaky gut can result in wide-ranging symptoms throughout the body, including: [19]
- Chronic constipation or diarrhea
- Joint pain
- Eczema, psoriasis, and acne
- Headaches
- Lack of mental focus
- Nutritional deficiencies
- General fatigue
- Abdominal bloating
Many studies also link increased intestinal permeability to several serious, chronic diseases. For example, the intestinal tract becomes chronically inflamed and more porous in Crohn’s disease. [20]
4. Leaky Gut Tests
Diagnosis of Leaky Gut Syndrome
Fortunately, you can test for markers of leaky gut syndrome in several ways.
Small Intestine Bacterial Overgrowth & Dysbiosis
- Respiratory gas test SIBO/IMO (digestive symptoms due to bacterial overgrowth in the small intestine)
- Testing of digestive residues, e.g. fatty acids, bile acid
- Testing for enzymatic or genetic intolerances: Metabolic intolerances to food components can promote the development of leaky gut syndrome. The most common intolerances involve fructose, gluten, lactose, and histamine.
Gut Mucosal Defense
This test measures the antibody immunoglobulin A (sIgA), which is central to the mucosal immunity barrier in the gut, which prevents pathogenic bacteria from leaking through the gut lining into the body. [23]
Gut Barrier Permeability Tests
Lactulose Mannitol Urine Test
The lactulose mannitol test is a proven diagnostic of leaky gut to determine the permeability of the intestinal wall.
This test involves taking two urine samples before and after drinking a mixture of two types of sugar, lactulose, and mannitol. The urine samples are then sent to a lab and tested for how much of the sugar passes through the GI tract, providing a measure of intestinal permeability. [22]
Zonulin Test [21]
This test indicates the intestinal permeability of the mucosal barrier by testing for zonulin levels. Zonulin is released on the command of specific bacteria and is considered an indicator of leaky gut.
Disadvantage of Leaky Gut diagnosis with zonulin: If the intestinal inflammation is far advanced with severely damaged intestinal epithelium, zonulin increases less than usual. Zonulin can also be tested in stool. However, it is less reliable.
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. [26]
Neutrophil Elastase (Blood Test)
This blood test measure neutrophil elastase (NE,) a crucial component in immune function. [24]
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). [25]
5. Prevention & Treatment of Leaky Gut
Treatment for Leayk Gut Syndrome
Unfortunately, there is currently no single cure for leaky gut syndrome. However, a wide range of evidence from scientific studies, observations by medical practitioners, and testimonies for people suffering from this condition indicate that lifestyle and dietary choices can significantly improve or eliminate symptoms for many people.
Among the most highly recommended approaches is adopting a leaky gut diet that follows these guidelines: [27]
- Avoiding anything that inflames the gut lining, such as food additives and highly processed foods
- Protecting and regenerating the intestinal flora with regular consumption of probiotic and prebiotic foods or supplements
- Eating an alkaline diet rich in plant-based, high-fiber foods
- Reducing or eliminating intake of meat, dairy, eggs, and gluten
- Avoiding sugar, artificial sweeteners, alcohol, and caffeine
- Supplementing with the amino acid L glutamine as well as L actoferrin and omega-3 fatty acids
- Supplementing with digestive enzymes at mealtimes to aid digestion.
A healthy diet high in antioxidants such as vitamins C and E, beta-carotene, manganese, selenium, coenzyme Q10, and glutamine are highly beneficial for healing a leaky gut and reducing intestinal permeability. [28]
Healthy dietary choices help to protect the mucosal layer of the intestine and maintaining an abundant population of beneficial gut bacteria.
In addition, the following healthy lifestyle practices can have a significant positive impact on healing leaky gut syndrome: [29]
- Getting regular exercise
- Getting sufficient sleep
- Reducing stress through exercise, meditation, and spending time in nature
- Avoiding antibiotics as much as possible
- Stopping smoking, alcohol, and recreational drug use
Working with a health practitioner who has experience helping people heal leaky gut is also highly advisable. Each person must tailor their treatment methods to match their body type, medical history, and other individual factors.
Expect healing to take between three to six months once you start eating a healthy gut diet and implementing positive lifestyle practices.
Tip: The Alcat Test identifies pro-inflammatory foods which may contribute to leaky gut and provides a list of “recommended foods”. You can identify intracellular nutrient deficiencies and learn which nutrients benefit.
Personalized Diet Based on Lab Data to Improve Leaky Gut
The Alcat food intolerance test is an important tool for prevention and identification of foods that can trigger inflammation in the gut. In a simple blood test, immune cells are exposed to foods, additives, medications, substances in dietary supplements, and more.
Food intolerances are mediated by cellular defenses. The inflammatory processes that occur are often hidden – hence the term silent inflammation -, and are more difficult to detect than an immediate-type food allergy.
Cells on fire: In the resting state, neutrophil granulocytes (innate immune cell type) have a round shape. As they ingest danger-molecules or pathogens, they swell – the cell activation process begins. During a strong reaction, granulocytes can burst. Consequently, the highly toxic proinflammatory mediators – the cell’s own “arsenal of weapons”, free radicals and even DNA are released. Chronic activation of the immune system caused by food components can be associated with a wide variety of diseases (image right).
The Alcat Test includes a precise interpretation of the test results and makes a clear distinction between allergy, enzyme mediated intolerance and food intolerance, also adressed as sensitivity. It also includes the creation of a personalized profile with dietary recommendations and integrates lifestyle questions (eating out, vacations, celebrations, consumption of stimulants, stress reduction).
The Alcat Test has been validated in double-blinded studies for determining specific dietary recommendations relevant to food intolerances that might help prevent disease. → More information
This personalized diet concept allows you to address effectively underlying inflammatory processes and prevent the development of chronic diseases.
Information about the Alcat Food Inflammation Test and Cellular Micronutrient Tests
Conclusions about Leaky Gut Syndrome
Leaky gut syndrome occurs when the gut lining becomes too permeable, leading to pathogenic bacteria, toxins, and undigested food particles entering the bloodstream. This condition has far-reaching impacts on overall health, and people with certain preexisting health conditions like type 1 diabetes and celiac disease are more susceptible to increased intestinal permeability.
It is possible to heal a leaky gut by increasing your consumption of probiotic and prebiotic foods, eliminating chronic stress, getting sufficient sleep, and engaging in other healthy lifestyle practices such as regular exercise. In addition, various tests 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.
German version of this article: Leaky Gut Syndrom
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Literature / Sources
[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/