There are 3 factors that must be present in order for gut issues, such as autoimmune diseases related to the gut, to actually occur:
1. A genetic predisposition
2. An exposure to an antigen
3. A pathway in which the antigen can pass through to the gut
Of those 3 factors, the first 2 we have little to no control over- however, the third point, in which we recognize now as leaky gut, can be.
What is leaky gut? A dysfunction in the permeability of the gut lining. Our gut lining is composed of 3 parts: the physical barrier which consist of the mucosal and epithelial lining, the chemical barrier which encases the immune system, digestive enzymes, antimicrobials as well as our inflammatory responses, and lastly, our microbial layer which holds our gut bacteria. Hence, the dysfunction, in most cases, is the destruction of all 3, which can lead to a multitude of issues.
What does ‘leaky gut’ leak? Lipopolysaccharides, aka LPS for short. LPS is a bacterial endotoxin that is released into the bloodstream when bacteria die. This is fine and dandy when it occurs in the lumen, but when LPS leaks through the gut lining it can be problematic. If our gut leaks LPS, undigested particles f food, or even antigens, can seep through. Whether it is antigens or food that has been undigested, our immune system creates antibodies to fight against the predators. Our liver goes into over drive and our immune system produces inflammatory responses preparing for MORE danger. This isn’t good, as we stay in “defense mode”.
But how does the gut become leaky? Well, in between epithelial cells are proteins structures that seal up the cells called tight junctions. Tight junctions are supposed to stay tight and closed during digestion, as nutrients make their way through a process called diffusion via cell, or active transport, which is when they are carried through a protein or molecule. Zonulin, a protein that regulates the movement of these junctions, is responsible for this. A decrease in zonulin solidifies the barrier of these tight junctions, as an increase allows things to seep through.
However, as it is normal for zonulin to go up and down, if it is increased for too long, the immune system kicks in which can damage the intestinal wall, and even the microvilli, which can eradicate nutrient deficiencies.
Of the many causes of what can trigger this are dietary factors (such as lectins from grains, nightshades, legumes, dairy, or processed food), imabalanced microbiome (due to candida overgrowth, or candida secreting toxins that cause the epithelial cells to shrink), or our everyday lifestyle (such as antibiotic use, NSAIDs, antibacterials or even stress).
Symptoms of leaky gut can be a multitude of things such as brain fog, skin rashes, joint pain, thyroid issues, food intolerances, bloating, GI issues, diarrhea, or even nutrient deficiencies. This sounds like pretty much anything, but thankfully, there are a few tests one can ask their MD to do to see if one has leaky gut.
1. A zonulin test called ELISA test: a blood test that measures a person’ level of zonulin. If zonulin is high, it is a good indicator that one has leaky gut, since zonulin is what controls the tight junctions.
2. A lactulose/mannitol test: This is a urine test that evaluates the intestinal permeability by measuring the ability of the lactulose and mannitol to cross the gut lining. The ratios of these 2 sugars in the urine can clue in on whether one has leaky gut.
3. An IgE test: A blood test that shows whether the body is producing antigens for specific foods.
So what to do if one has leaky gut?
I present to you the 4 R’s: Remove, Replace, Re-inoculate and Repair.
First, REMOVE what may be irritating the gut. Try an elimination diet if specific food groups seem to aggravate the gut, but if not, just take out anything that may further inflammation.
Second, REPLACE nutrients of enzymes that may be missing or lacking, such as supplementing with digestive bitters to help the body produce more enzymes, use hydrochloric acid supplements to help ease symptoms of heartburn, acid reflux, GERD, nausea, etc., if one has low stomach acidity, and even look into L-glutamine, which is a amino acid that helps coat our gut lining and even repair it.
L-glutamine has been shown to be utilized most in times of stress, we must be replenishing it when our bodies are under both physical and mental intensity.
Third is to RE-INOCULATE with probiotics, which in most cases, are lacking, as our gut is permeable in allowing the bad bacteria to come in.
Lastly, REPAIR the mucosal lining with nourishing foods or supplements, such as nutrient dense vegetable broths, filtered water, proteins, fermented foods, and an abundance of healthy fats. As for supplements:
zinc carnosine has been shown to help heal wounds and calm oxidative stress (this is due to the amino acid carnosine),
aloe vera gel (particularly the inner leaf), can help soothe the inflammation in the gut,
marshmallow root, as well as slippery elm bark, can help coat the gut lining due their high mucilage content.