Leaky Gut: Science or Science Fiction?

Hello and welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today we're going to be talking about leaky gut— science or science fiction? But before we get to the show, I wanted to quickly let you know that if you're interested in health coaching to start to naturally reverse your autoimmune condition or resolve a gut health issue or lose weight without dieting, I offer free 1-hour breakthrough sessions to anyone who's interested to talk about what you've been going through and see if health coaching might be the answer. Or I offer 1-hour functional health and nutrition reviews related to gut health, autoimmunity, or other health issues if you just need some direction and ideas and a set of recommendations of where to go from where you are. I typically spend about 4 hours in addition to the 1 hour I spend with you researching and developing recommendations and education materials for you related to your health situation. Also, I just formalized a 5-appointment gut health coaching program that you can check out on my website. I'll put all of those links in the show notes, or you can see highdeserthealthcoaching.com under Work With Me. Now on to today's topic. So if you haven't been living under a rock or only visiting traditional doctors, you've probably heard the term leaky gut, and you may be wondering whether it's just one of those made-up pseudoscience-y things that alternative medicine practitioners made up in order to sell you supplements, or whether it's real. So first, let me go ahead and say no, it is not made up. It is a real thing based in science But yes, many people are exploiting it to sell you supplements that may not address the root cause of your leaky gut. So we're going to talk a good bit about that today. So the term intestinal permeability, which is another name for leaky gut, has actually been discussed in the medical literature for over 100 years. And you may also see it listed as intestinal hyperpermeability. And if you think you have it, you should definitely do something about it because it does put you at risk of developing an autoimmune disease, which is when our bodies attack our own cells, tissues, and organs. And it's estimated that about 50 million Americans have an autoimmune disease, which is more heart disease, or cancer. And the incidence of autoimmune disease has increased threefold over the last 50 years. 78% of the sufferers are women. So it's definitely worth addressing leaky gut before it proceeds on to something worse. So let me talk a bit about the mechanics of leaky gut. So the intestines are protected by a single layer of specialized epithelial cells, and most of them are made up of cells called enterocytes, which are linked together by tight junction proteins. So leaky gut symptoms are a consequence of either intestinal tight junction malfunction or destruction of the enterocytes themselves. So in other words, it's either killing the cells, and when you kill the cell, the enterocyte, it leaves a hole in the intestines, which in it— with a normal person, that would close up quickly. But with someone with certain food sensitivities or infections or nutrient deficiencies, the enterocyte death can become rampant, and then you end up with a lot of holes that the body can't patch quickly enough. In terms of the tight junction malfunction, the tight junction's job is to allow nutrients to enter your bloodstream. So they open up in order to let those nutrients through, so that's how we get our nutrition. But they're also supposed to simultaneously keep disease-causing or immune-stimulating compounds from getting out. So this could be live bacteria or substances called bacterial endotoxins, also known as lipopolysaccharides or LPS, and those are parts of the cell walls of gram-negative bacteria, which is one type of bacteria, and they're they're present even after the bacteria die. And then additionally, toxins from your food like pesticides or incompletely digested food particles can also get through. So normally our saliva, our gastric acid, our pancreatic enzymes, our bile salts, and our friendly bacteria all work to help break down our food and protect us from undigested food, food particles passing out. So before being absorbed into the body, you have your proteins being broken down into amino acids, you have your fats being broken down into fatty acids, and your carbohydrates are broken down into monosaccharides saccharides, or simple sugars. And our body has many other ways of keeping out the endotoxins and the toxins, including the contractions of our intestinal walls, which is called peristalsis, which keeps things moving through the gut to limit the amount of time that pathogens would have to cross the gut wall. Then we also have the mucus layer, which protects the intestinal wall, and it has antimicrobial compounds in it, and it also is the physical barrier. And then on top of that, 80% of our immune system resides in our gut, and it's constantly clearing up the pathogens so they don't get out. But you can have your gut barrier compromised when you have some type of gut dysbiosis. For example, an overabundance of proteobacteria, which are those gram-negative bacteria, or of other pathogenic bacteria, or an overgrowth of yeast, or biofilms combined— of combined bacteria and yeast, or if you have an electrical problem with peristalsis that causes slowing or reversal in a section of your intestine, or in reaction to certain foods. So when one of those situations is present, it can allow the leakage of materials into the bloodstream or lymphatic system and causes an immune reaction. And if there's a lot of leakage, it will cause system-wide inflammation, which is what an immune reaction is, and it sends your immune system into overdrive. So some of the symptoms that you may have a leaky gut— and I know this is a lot— but acute inflammatory conditions, of course, you know, where your gut's gone incredibly leaky, like sepsis or SIRS or multiple organ failure. Abdominal pain, acne, ADD or ADHD, allergies, anxiety and depression, autoimmune disease, bloating, brain fog, excessive burping, chronic fatigue syndrome, chronic inflammatory conditions like arthritis, or especially rheumatoid arthritis where you have an autoimmune arthritic condition, difficulty maintaining a healthy weight, dry or itchy skin, eczema, esophageal and colorectal cancer, fatigue, especially after you eat, gas, gastric ulcers, general aches and pains— this is all alphabetical if you're catching the drift— headaches including migraines, hives, infectious diarrhea, inflammatory bowel diseases like Crohn's and ulcerative colitis, insomnia, irregular stools, meaning constipation, diarrhea, or just generally soft stool, irritable bowel syndrome, joint pain, multiple food sensitivities or allergic reactions to many foods, nausea or vomiting, obesity-related diseases like fatty liver, type 2 diabetes, heart disease, Parkinson's disease, psoriasis, rashes, reflux or heartburn, respiratory infections, rosacea, small intestine bacterial overgrowth or SIBO, and symptoms of malnutrition or nutritional deficiencies, and thyroid disorders. So that's just some of the, some of the potential symptoms that you have a leaky gut. So in other words, it's relatively common. So why— what are the underlying causes of leaky gut? So first of all, let's talk about genetic predisposition. There's always that hanging in the background. So you may have a sensitivity to environmental factors or foods that trigger your body into initiating an autoimmune response. Second, low stomach acid is a potential underlying cause, which generally our stomach acid goes down as we age. But of course, there's medications like PPIs or proton pump inhibitors and all of the, you know, all of the the acid-reducing medicines, alcohol consumption, chronic stress. Those are all potential causes of low stomach acid. So when you have low stomach acid, big particles of undigested food can leak out. And in addition, when the stomach acid's insufficient, the stomach acid also signals the release of enzymes and bile, which also help digest food. So again, it also further impacts your digestive system, again, leaving these big particles of food which bacteria and yeast can feed on, which then leads to gut dysbiosis. So the symptoms of that would be similar to the symptoms of high stomach acid, which is heartburn, reflux, indigestion, diarrhea, constipation, bloating, burping, gas, bad breath, nausea, vomiting, rectal itching, and hemorrhoids. So those are signs you might have low stomach acid, and we'll talk later about what to do about those things. Then diet, of course, is a huge underlying cause of leaky gut. So there are a lot of foods that can disrupt the gut lining. So foods that contain lectins, which are in grains, legumes, and pseudo-grains. And then there's prolamins and agglutinins are the, are the specific types of lectins that are harmful. Then you have digestive enzyme inhibitors in certain foods, saponins, especially glycoalkaloids, and phytic acid. So basically there's 4 ways in which food can cause a leaky gut. So number 1, you could just have a very nutrient-deficient diet. So you just don't have the nutrients to repair the gut lining when it is damaged by those foods that, that damage it. Where a normal healthy person with a healthy diet could repair the gut lining quickly, even though there is that constant damage through eating certain foods. Then there's also the direct damage to the enterocytes, which certain foods do, and it does kill the enterocytes and it creates a hole. And then some of the foods cause the opening of the tight junctions between the gut enterocytes. And then again, some of those foods create gut dysbiosis by feeding an overgrowth of pathogenic bacteria or yeast in the small intestine. Think, you know, what does yeast eat? It eats sugar and carbs. So let's talk about which foods those are that are problematic. So grains, that's the first type that of course are potentially problematic. And we all know about gluten and wheat, but like, here are all the types of grains that could potentially be problematic. That includes semolina, einkorn, durum, barley, kamut, corn, millet, rice, rye, sorghum, spelt, teff, triticale, wild rice, and oats. So I did a whole podcast on gluten and how it triggers the release of zonulin, which opens up the tight junctions and keeps them open even longer in people with celiac disease, and possibly also in gluten-sensitive people. But it does open up the tight junctions for anybody for a short period of time. So if you're more interested in that, you might want to catch that podcast. And then there's the pseudo-grains that can also be problematic, and those are the starchy seeds of broadleaf plants including quinoa, amaranth, buckwheat, and chia. Then there's the legumes: lentils, beans, and peas. And by the way, I recognize that many of these foods are considered very healthy foods, and they are for a normal healthy person. But if you're having extreme leaky gut, you're having extreme symptoms, that's when you want to start looking at these foods. And these are all the foods I'm mentioning are foods that you remove when you do the autoimmune protocol. Okay, so going on, alcohol is another potential problem food, dairy products, nuts, seeds including seed spices, nightshades, which are tomatoes, potatoes, eggplant, peppers, and spices derived from them, synthetic food additives, added sugar, GMOs, which can cause gut dysbiosis, and refined seed oils. So those are all the potential problem foods. Other potential underlying causes include chronic stress because it causes your stress hormone cortisol to be elevated, which leads to decreased digestive function and elevated blood sugar. And then when you have decreased digestive function, you have poorly digested food, which can then leak out. Then toxic overload. Think about the 80,000 chemicals and toxins that we come into contact, but some of the worst offenders for leaky guts include things that of course we take ourselves, like antibiotics and tap water with the many chemicals it has in it. And then things we're exposed to like pesticides. And then of course medications including corticosteroids and NSAIDs like aspirin, ibuprofen, naproxen sodium, acetaminophen, etc. Those are all potential leaky gut causers, and I'm sure you've heard about people who have ended up with ulcers after taking too many NSAIDs, so definitely use those sparingly, if at all. And then bacterial imbalance is another underlying cause of leaky gut, which is also called dysbiosis, which is an imbalance between the beneficial and the harmful species of bacteria in your gut. Because you can always have a small amount of harmful bacteria, but as long as the good bacteria are keeping it in check, then you're fine. But when you have an overgrowth of the pathogenic bacteria, an overgrowth of yeast, then you begin to have dysbiosis, which causes leaky gut. And so, you know, there's a large body of evidence that shows that a gut microbiota is really important in supporting that epithelial barrier and preventing autoimmune reactions. Okay, now on to the part you want to know. I've got the leaky gut, you've named my symptoms, what do I do about it? Okay, so first of all, you need to clean up your diet, at least for a time. So you could be looking at the autoimmune protocol or something less severe, but I wouldn't recommend just taking out one thing like gluten, for example. Do a proper elimination diet, and I talked more about that in my podcast called Should I Give Up Gluten to Help My Gut Issues? That's Episode 21. You wanna do a proper elimination diet and eliminate at least some of the primary foods that are problematic, if not the full autoimmune protocol, if you're really sick and really struggling. And then use that elimination diet to determine the foods that you react to and plan to eliminate them for a good while after that. And then maybe limit them if you do find you can tolerate a little. So for example, I figured out for my autoimmune conditions, that I couldn't do gluten, dairy, or soy. So I went for a good while without touching those at all. And then, you know, I occasionally cheat and I take my digestive enzymes and my Lactaid pills and everything else and see how I react, test it against my antibodies, and I see how much I can tolerate and maintain good health. So that's the kind of thing you need to do. The other part in terms of cleaning up your diet is using organic vegetables, at least the dirty dozen, which the Environmental Working Group lists. Of the ones that have the highest pesticides, and using pasture-raised meat and eggs and wild-caught seafood. And you also want to make sure that you actually are eating a variety of nutrient-dense foods, so because sometimes the problem just is if there's not enough nutrients in your diet. So think about meat and fish and healthy oils— olive oil, avocado oil, coconut oil. Organ meats are super healthy. If you can't tolerate them, you can You can try pâté if you can tolerate that, or you might look at using pills, or some people just freeze liver and take it like a pill. I cut off a little— take it like a pill. Of course, lots of fruits and vegetables, and if you're having trouble digesting raw vegetables, you might just look at cooked vegetables. And then you might also consider a low FODMAP or a biphasic diet if your symptoms seem more like SIBO or small intestine bacterial overgrowth. I've done other podcasts on that you can check out. Or if you actually have a SIBO diagnosis, that may be the direction you want to go for a time. Okay, so number 2 is detoxifying your home. So it's great if you've gotten your, your diet all super organic, and for a while I did that and I thought, but I'm not changing my cleaning products, it's just too much. Those things are too expensive. But finally I did it. And so you really do want to switch over to natural or organic cleaning or personal care products. You can check out the Environmental Working Group database if you want to see how bad the stuff you're currently using is and why. Also, some of the big no-brainers: don't microwave things in plastic. Watch out for the BPA, bisphenol A, in receipts. It's still on all the receipts that you're touching for the most part if they have that sort of slippery paper. So wash your hands after you've touched receipts and don't put on antibacterial hand gel before or after touching them because that's just going to help it absorb in better. And then stop using toxic pesticides around your home and your garden. Just look at, look at what natural options you have, like weeding. And also get rid of your Teflon or your aluminum pans, especially especially if the Teflon's scratched up, and look for cast iron or stainless steel or ceramic or other green nonstick pans. And then you can use a high-quality water filter to eliminate chlorine and fluoride, like a reverse osmosis filter. Or if you wanna look for a little cheaper option, I researched a bit and there's an AquaGear pitcher filter that actually filters to, I think it was something like 1.5 or 2 microns, which is very fine. So I'm gonna put a link to that in the show notes. And then number 3 is to stay away from medications that cause leaky gut, like the corticosteroids and the NSAIDs. Okay, number 4 is determining whether you have some type of gut dysbiosis. So to do that, you may need to undergo gut testing with a functional medicine practitioner if your gastroenterologist hasn't found anything, or even if you have a diagnosis like irritable bowel disease, Crohn's or colitis. The kinds of tests that a functional medicine person would do can determine if you have some type of overgrowth of pathogenic bacteria, if you have SIBO, if you have yeast or parasite. Then you can take herbal or pharmaceutical antimicrobials to take care of that, plus probiotics to rebuild your gut. And then number 5 potential underlying cause: determine if you have nutrient deficiencies. So the company SpectraCell does a full nutrient test, but you'd need to get that order through a doctor. Or you can ask potentially through your doctor and insurance, you can get individual nutrient tests and just see where you stand on, on the important nutrients. So if you look at the vitamins and minerals that are most lacking in the American diet based on the percentage of people not meeting even the recommended daily allowances, there's zinc, calcium, magnesium, vitamin A, vitamin B6, and iron. Some of the most commonly found deficiencies for people are iron, iodine, vitamin D, vitamin B12, calcium, vitamin A, and magnesium. So if you have any suspicions there or there's certain things you wanna test with your doctor, that may be a good route. Then if you do find a deficiency, you should obviously supplement and ask your doctor or your practitioner what kind of doses, and then periodically retest because some of those vitamins and minerals you can't overdo. So it's important that you know, is this something I can get too much of, and that you keep periodically tracking and retesting and figuring out what a good maintenance dose, dose is. Then here are some other supplements that may help restore the gut lining. And in general, I, I think of this as after you've looked at everything else, after you've figured figured out if it's gut dysbiosis and you've corrected your diet and you've figured out a few food sensitivities, if you're still struggling, then here's some things that can potentially help restore the gut lining. So glutamine is the first one. It's an amino acid that helps gut integrity. It can be found in bone broth and meat. And in studies, supplementation with L-glutamine has helped IBD patients with dosages ranging from 0.3 to 0.5 grams per kilogram of body weight, which means approximately 10 to 40 grams per day. So it's a lot. And you can get L-glutamine in powder form to mix with water, and it's ideally taken on an empty stomach. And by the way, that was in divided doses. You don't take the whole 40 grams per day at one time. Okay, then number 2 is zinc. So the powerhouses of zinc are oysters, but also organ meats, especially liver, red meat, poultry, and pumpkin seeds are good sources of zinc. And then of course you can buy supplements. Quercetin, which is especially in onions, apples, and citrus fruits. And again, you can get in supplement form. Butyrate is a short-chain fatty acid that certain gut microbes can produce from fiber and helps feed your gut enterocytes. It's also found in butter, but mostly you just need to eat more leafy greens, other vegetables, including fermented ones, root vegetables, fruit, nuts, and seeds. And also, if you're on a ketogenic diet, you can get the butyric acid that's just produced by the ketogenic diet, or you can supplement with butyrate as well. Turmeric and curcumin. If you're looking at a supplement, it's called curcumin, or you can buy turmeric as a supplement as well, but as a spice, turmeric, and it's a great anti-inflammatory. It helps relax the muscles in the intestines. It allows food to push through without causing damage to the wall lining of the gut. It encourages the glands on the surface of the colon to regenerate in the presence of leaky gut, and it stops enzymes that cause stomach pain by facilitating the secretion of stomach mucus. So an all-around great thing to eat and take. Another potential healer of the gut lining is bovine colostrum, which is that first milk that comes out right after baby's born. So it may be helpful if your leaky gut is caused by NSAIDs, but not if it's caused by endurance exercise, which can also cause a leaky gut. And let me give you a list of some of the rest of the potential helpful gut sealing supplements. That includes Aloe, slippery elm, DGL, which is deglycerinated licorice, NAG, berberine. But be careful about the large doses. Like, I see a lot of people recommending 500mg 3 times a day, and you can end up with an overgrowth of yeast if you use that because it will kill off a lot of bacteria. Shilajit is something else that you could look into. But in general, I think that supplements like, like these should be tried after everything else has been tried. Like I said. Okay, and finally, you can take a good quality probiotic or two. A couple that I recommend would be MegaSporeBiotic, which is one of the spore-based, and I've got a link to that in the show notes, and Bifido Maximus, which is the highest dose on the market bifido probiotic that you can take, and it's got none of the strains that produce lactic acid or that are harmful to people who have histamine intolerance, so it's a, it's a nice one. And then also thinking about having a high fiber diet including 30 to 40 grams of prebiotic fibers through foods like onions, garlic, starchy vegetables like winter squashes, root vegetables, sweet potatoes, and fruit, but not too high, uh, fructose fruits. And then of course if you're on a low FODMAPs diet, obviously you need to adjust and avoid those foods that are high in FODMAPs. And then let's talk about I mentioned low stomach acid. So if you do have low stomach acid or you suspect you have low stomach acid, and one of the ways you can tell is that you eat meat and it kind of just sits in your stomach and it feels like it's there the whole day, or it doesn't— you know, I did, I did mention the heartburn and all that, but in a meal in which you are eating meat, you can take betaine HCl, and you would start with 1 capsule of it between 650-750 milligrams with a meal containing protein, and then you would increase the dose to what you would call tolerance. So think that a healthy stomach is producing 1.5 liters of gastric acid daily. So these are not huge quantities you're supplementing with. And basically the way you test it is you would keep adding— you would use a certain dose for a day, or if you're only eating, say, one meat meal a day, then you might do it for a couple days. And if you feel good on that, then add another pill the next day. And if you feel any heartburn or heat or abdominal discomfort at a certain dose, then that would indicate you've gone too far and you should back down to the previous dose. And ideally what you can do is you, you take that for a while until you feel that heat or that heartburn, and then you back down and your body hopefully will start to compensate and make the correct amount. So, so the highest asymptomatic dose is the baseline for your HCl supplementation. And do note though that that HCl challenge test, which is what I just described, is contraindicated in patients who have active gastritis or esophagitis or duodenitis. Okay, and so I'm gonna put a link to Betaine HCl in the show notes. And then you can also take digestive enzymes including protease, amylase, lipase, and lactase. And I put a link to an Amazon product that's got that. Okay, finally, reducing stress and managing stress is really important also in healing leaky gut, because sometimes that's actually at the root because of those stress hormones. So it may involve changing your mindset, it may involve yoga or gentle exercise, meditation, that kind of thing. And then avoiding being sedentary or over-exercising like triathlons and that type of thing. Is another, is another important piece. So really the exercise that you enjoy is the exercise that's going to help your gut bacteria thrive. And there is plenty of research showing that gut bacteria actually do better when you exercise. And also think about weightlifting and high-intensity interval training are particularly good and more efficient in terms of the benefit than previously believed. So if exercise seems like a big obstacle, just think about what about 10 minutes of 30 seconds on, 30 seconds off, high-intensity rest, high-intensity rest, like 10 minutes. There you go. Okay, so that's it for all of the recommendations around leaky gut. I hope that helps solve some of your problems. But I did want to say a little bit about the current hysteria over COVID-19, or the coronavirus. I know people get nervous, and you may want to know what's sort of just the basic stuff I can do to protect myself. So I wanted to offer a couple quick ideas. If you're going to be traveling or you're going to be in big crowds, one thing that you can do in those situations is to just protect the entry points for a virus, with your mouth being one of the primary ones. And bee propolis is a product that you can use to do that. So it's— the propolis is what the bees use and what they produce to protect the entrance to their hives, and it's actually antiviral and antibacterial. And so you can get a throat spray with bee propolis from Beekeepers Naturals, and I'll link to that in the show notes, and use that to protect your throat. Another product that I like and I use a lot also for, for my throat is called BioCidin, and I spray that in my throat whenever I start to feel a sore throat coming on, and within 5 minutes my throat stops hurting. It's not going to prevent a cold from happening, happening entirely, but it definitely makes the cold a lot more pleasant and takes away that like swollen gland painful throat thing. And it's also great protection for your throat while traveling. So you could use it in the same way bee propolis does. And they also have a formula through Biobotanical Research that makes BioCidin spray with the BioCidin drops. And you can make a saline— take a saline nasal spray and put some drops in there. And it's great to protect your nasal passages as well if you're concerned. As you've been exposed or you're traveling. And it's also a great antifungal and antibacterial for your nose, by the way, like if you have a sinus infection or you've had sinus pain, especially following dental work. So I'll include details in that on the show notes about how to make the, the spray out of the Biocidin drops and a link to my Fullscript dispensary where you can get it at a good price. Then other thing that I've been reading about, if you are— if you do actually get COVID-19 is to use intravenous vitamin C. So apparently there's already 3 studies approved and underway in China on the use of IV vitamin C to help fight the coronavirus. So the first approved study was giving between 12,000 and 24,000 milligrams a day of IV vitamin C, with the doctor who's running the study urging you to use vitamin C as preventative for COVID-19 as well. I don't have any recommended doses just on that, but there's all those different products out there that you can find that are Megadoses of vitamin C if you think you've been exposed or if you're feeling sick. And yeah, so that's— those are some thoughts on how to protect yourself and what to do if you do get it. So please do stay well, and if you like the show and you're on iTunes, I'd appreciate a 5-star rating. And until next time, here's wishing you the perfect stool.