The father of modern medicine, Hippocrates, said, “All disease begins in the gut.” More than two millennia after his death, scientific research has now proven he was onto something all those years ago. For over three decades, study after study has been published (several thousand articles exist to date) discussing our growing understanding of immunity, gut function and how modern diets and lifestyles negatively contribute to overall health through our digestive system.
I (and many others in the medical field) refer to this particular phenomenon as leaky gut syndrome. Essentially, leaky gut symptoms (“intestinal hyperpermeability”) are a consequence of intestinal tight junction malfunction. These tight junctions (TJ’s) are the gateway between your intestines and what is allowed to pass into the bloodstream. Tight junctions have a very precise job – they have to maintain the delicate balance between allowing vital nutrients to enter your bloodstream, while remaining small enough to prevent xenobiotics (disease-causing compounds from your diet or lifestyle) from passing out of your digestive system into the rest of your body. (1)
Having leaky gut is kind of like having the gates broken from your intestines to your bloodstream – many of these particles that should never have been able to enter have now gotten through. This presents a major problem, as the vast majority of your immune system is found in the gut. The result? A disruption of acute inflammation, a normal part of the immune response that serves to fight infection and disease, turns into chronic inflammation, which is at the root of most diseases.
How serious is this? Well, according to a 2014 review of the facts and research about intestinal permeability (among other sources), the chronic condition of hyperpermeability is linked to: (2)
- Gastric ulcers
- Infectious diarrhea
- Irritable Bowel Syndrome (IBS)
- Inflammatory bowel diseases (Crohn’s, ulcerative colitis)
- Celiac disease
- Esophageal and colorectal cancer
- Respiratory infections
- Acute inflammation conditions (sepsis, SIRS, multiple organ failure)
- Chronic inflammatory conditions (such as arthritis)
- Obesity-related metabolic diseases (fatty liver, Type II diabetes, heart disease)
- Autoimmune disease (lupus, multiple sclerosis, Type I diabetes and more) (3)
- Parkinson’s disease (4)
- Chronic fatigue syndrome (5)
- Obesity (6)
While these diseases are linked, there is not yet a causal relationship established. This means that science has not yet gotten to the point of proving intestinal hyperpermiability (leaky gut syndrome) actually causesthese conditions, but rather than they have been linked as occurring simultaneously. (7)
So, how do you know if you have leaky gut? Here are seven leaky gut symptoms and early occurring conditions that may point to an issue with your gut health.
7 Leaky Gut Symptoms and Signs
1. Food Sensitivities – Because of the onslaught of toxins that enter the bloodstream, the immune systems of people with intestinal hyperpermeability are on overdrive mass-producing various antibodies, which may make their bodies more susceptible to antigens in certain foods (especially gluten and dairy). In studies involving rats and human children, leaky gut and food allergies have been linked. (8, 9) This is one of the most common leaky gut symptoms.
2. Inflammatory Bowel Disease – Researchers from Hungary uncovered in 2012 that elevated gut permeability is oftentimes localized to the colon in people suffering from irritable bowel syndrome and ulcerative colitis. (10) As far back as 1988, scientists suggested that Crohn’s disease may be more of a risk for people with leaky gut. (11) A small study (observing 12 patients) discovered that zinc supplementation may help resolve the tight junction dysfunction in these cases, although more research is required on a larger scale to confirm these results. (12)
3. Autoimmune Disease – The key to understanding how leaky gut can cause an autoimmune disease is through the research done on a protein known as “zonulin.” According to a 2011 article published in the journalPhysiologic Reviews: (13)
“Zonulin is the only physiological modulator of intercellular tight junctions described so far that is involved in trafficking of macromolecules and, therefore, in tolerance/immune response balance. When the finely tuned zonulin pathway is deregulated in genetically susceptible individuals, both intestinal and extraintestinal autoimmune, inflammatory, and neoplastic disorders can occur.”
Eating gluten may trigger this dangerous cascade. University of Maryland School of Medicine researchers have uncovered that gluten “activates zonulin signaling irrespective of the genetic expression of autoimmunity, leading to increased intestinal permeability to macromolecules.” (14)
The good news is that, at least as far as leaky gut plays a role in autoimmune conditions, it is reversible and could potentially alleviate some of these problematic immune responses. (15)
4. Thyroid Problems – One of the autoimmune diseases that leaky gut syndrome may directly affect is Hashimoto’s disease. (16) Also known as “chronic thyroiditis,” this disorder is displayed with hypothyroidism (low thyroid function), impaired metabolism, fatigue, depression, weight gain and a host of other concerns.
5. Nutrient Malabsorption – In my own patients, I’ve observed various nutritional deficiencies resulting from leaky gut, including vitamin B12, magnesium and digestive enzymes. Those common nutrient deficiencies are one reason why many functional medicine practitioners prescribe a whole-food multivitamin in addition to probiotics for people suffering leaky gut problems.
6. Inflammatory Skin Conditions – First described over 70 years ago, the gut-skin connection theory has described how intestinal hyperpermeability can cause a slew of skin conditions, particularly acne and psoriasis. (17) Creams and drugs with endless lists of (sometimes dangerous) side effects are often prescribed for these skin disorders, yet there has been evidence for several decades that part of the root cause might exist in the gut.
7. Mood Issues and Autism – According to a study published in the journal Neuroendocrinology Letters, leaky gut has been shown to cause various neurocognitive disorders. For example, the inflammatory response characteristic of intestinal hyperpermeability triggers the release of pro-inflammatory cytokines and other chemicals that are thought to induce depression. (18)
A study was just published this past January in the journal Nutritional Neuroscience describing the “vicious circle between immune system impairment and increasing dysbiosis that leads to leaky gut and neurochemical compounds and/or neurotoxic xenobiotics production and absorption.” The authors go on to describe findings from a number of studies that point to their theory that autism may be connected to problems in the gut microbiome, particularly within the first year of life. (19) It is actually a common hypothesis in modern science that leaky gut is strongly related to autism. (20)
What the Medical Community Has to Say About Leaky Gut Syndrome
WebMD refers to leaky gut as “something of a medical mystery.” (21) This isn’t surprising, since it’s not a diagnosis doctors are taught in medical school.
“From an MD’s standpoint, it’s a very gray area,” says gastroenterologist Donald Kirby, MD – Director of the Center for Human Nutrition at the Cleveland Clinic – “Physicians don’t know enough about the gut, which is our biggest immune system organ.” (21)
And to make matters worse, government agencies have also contributed to the confusion. According to the United Kingdom’s National Health Service (NHS), “There is currently little evidence to support the theory that a porous bowel is the direct cause of any significant, widespread problems.” (22)
Yet, not everyone agrees. A roundtable review quotes the researchers at seven different European universities in 2014 agreeing upon the following: (23)
“Alteration of the gut barrier seems to have multiple consequences facilitating the onset of a variety of diseases depending on other hits and on genetic or epigenetic constellations, respectively. The growing significance of the gut barrier and bacterial translocation raises the questions of how we can improve gut barrier functions and gut microbiota.”
While it’s encouraging that science is coming around, we’re by no means at a point where there are standard diagnostic tools for leaky gut syndrome. In the medical world, if there are no standard diagnostic criteria for a disease, there are no specific therapies or treatments. Moreover, if there are no “proven” treatment models, then most MD’s are left with no other choice than to travel along what they believe to be the “safe path” and prescribe drugs that only treat leaky gut symptoms, such as acid reflux medications like proton pump inhibitors or antacids.
Because much of the medical community denies its very existence, it’s critical that you understand what leaky gut is and what to look out for in case you or a loved one is affected by it. The good news is that many functional and integrative medicine practitioners have a greater understanding of this condition than they did even a decade ago, and are likely to help you determine if you are suffering from leaky gut and give you tools to help repair it.
How Do You Repair Leaky Gut?
After years of research and patient care, I developed a four-step process that includes gut-healing food recommendations called 4 Steps to Heal Leaky Gut. The basic points are these:
- REMOVE foods and factors that damage the gut
- REPLACE with healing foods
- REPAIR with specific supplements
- REBALANCE with probiotics
If you’re concerned that you or a loved one may have leaky gut symptoms, I encourage you to read the detailed instructions, food suggestions and useful supplements listed in that article.
Leaky gut is classified by malfunction in the intestinal tight junctions in the digestive tract, allowing larger-than-usual particles to pass from the digestive system into the bloodstream. When this occurs, the balance of inflammatory immune responses is disrupted, leading to chronic inflammation and poor immunity. Although no causal relationships have yet been officially established, leaky gut is correlated with a large number of issues and diseases, including digestive disorders, depression, autism, celiac disease, autoimmune disease and more.
Common leaky gut symptoms include food sensitivities, digestive issues, autoimmune disease, thyroid dysfunction, nutrient malabsorption, inflammatory skin conditions and brain-related issues such as depression and autism.
Leaky gut syndrome is not a recognized diagnosis in the medical community yet – but I’m confident it will be recognized someday, due to the vast body of research that has already been conducted.
If you suffer from any leaky gut symptoms, I encourage you to consult with your naturopathic doctor about options for treatment. Many of my patients have seen improvements when adjusting to a healing, rather than disease and inflammation-causing, diet. In addition, there are helpful dietary supplements many people implement to support better gut health.