Leaky Gut

Leaky Gut (Nutrition, Vitamins and Supplements)

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A leaky gut, or as it’s called in the scientific community: intestinal permeability. It is becoming more and more known what it is exactly, and how to treat it. But on the downside, a lot of misinformation about ‘leaky gut’ is floating around the internet. So let’s get real about leaky gut.

What Is Leaky Gut?

If you have a leaky gut (intestinal permeability), that means that your intestinal lining is damaged, and is letting through more than was initially intended.
Your intestinal lining is the barrier that is keeping the outside world (meaning everything that you’ve eaten and bacteria, toxins, etc. that is in your intestines) separate from your inside world (your blood, heart, organs). This is one of the most important parts of your immune system.

Usually, your intestine is very selective in what it lets pass. You could imagine it as a large wall, with thousands of guarded little doors. These doors will only open, once something safe (e.g. nutrients, vitamins, and minerals) wants to enter. 
If something unsafe (e.g. too large food particles, bacteria, parasites, fungi) wants to enter, the guards will keep the doors shut. 
The wall consists of your intestinal cells and the doors are your ‘tight junctions’.

With a leaky gut, this is where the problem lies. A leaky gut has some of those doors ajar (your tight junctions aren’t that tight anymore…), anyone and everything can enter. With all the unsafe substances getting in your bloodstream, your immune system and liver are working overtime to defend and detoxify you. And that’s where your symptoms start.

Tight Junctions Leaky Gut
Image of the intestinal lining from J. Agric. Food Chem. 2020, 68, 7, 1816–1829. Tight Junctions are seen as a ‘link’ between the intestinal cells.

Because your immune system is responding, it could take up to three days for your symptoms to show. Which makes it harder to pinpoint your trigger foods.

Symptoms Of A Leaky Gut

Leaky gut is more common in people who have IBD (Crohn’s or ulcerative colitis), celiac disease, or Irritable Bowel Syndrome (IBS). Many other diseases have been linked to leaky gut, but there is no scientific data to back that up.

A leaky gut is often hard to recognize since the symptoms can be very unspecific. The symptoms that are often heard are:
– Food intolerances
– Stomach aches
– Digestive issues such as bloating, constipation or diarrhea
– Chronic tiredness
– Autoimmune reactions or reduced immune system

Causes Of A Leaky Gut

A leaky gut, is usually is a combination of prolonged exposure to several triggers that damage your gut. A leaky gut does not develop overnight.
Common triggers of a leaky gut are:

Leaky Gut
A dietary pattern high in sugar, refined flour, unhealthy fats and little fiber
Crohn’s disease or Ulcerative Colitis
Inadequate liver function
Chronic infections or inflammation (even low-grade inflammation)
Too little healthy gut bacteria, especially akkermansia and bifidobacteria
Bacterial overgrowth (SIBO)
Food allergies or intolerances
Alcohol use
Use of certain medications (NSAID, antibiotics, PPI (stomach acid medication))
Vitamin and mineral deficiencies (like zinc, vitamin D and A)
Amino-acids and fatty acid deficiencies
Chronic stress
Prolonged intense exercise

Diagnosis Of A Leaky Gut

A leaky gut diagnosis is difficult to get. There are no reliable blood tests or stool tests you can do to diagnose a leaky gut. Most of the time it will just be trial and error to see how you respond to an intervention. 

The current ‘Golden standard’ for the diagnosis of leaky gut is through a urinary excretion test with lactulose and mannitol. Lactulose is a large particle that would normally not cross the epithelial layer in the intestines. Only an increased permeability (leaky gut) would let it through, and then it can be measured in the urine after it has been excreted by the kidneys. There is one sidenote, this will only work if the leaky gut is expected to be in the small intestine, since the bacteria in the large intestine ferment the lactulose. If large intestine leaky gut is expected, other large molecules (1Cr-EDTA, PEG molecules or sucralose) can be used.

Another way to diagnose intestinal permeability is through a biopsy of some epithelial tissue. As you might expect, this is far more invasive than the previously mentioned test, since they actually need to take a little chunk (biopsy) out of your intestines. After they have taken the biopsy they will set up the biopt in a Ussing chamber (some sort of machine) where they can test the permeability.

Do you want to work on your food pattern and lifestyle to try and feel better? Schedule a free symptom assessment and I’ll show you how I can help.

Treatment Of A Leaky Gut 

The treatment of a leaky gut consists of advice regarding nutrition, lifestyle, and sometimes supplements. It is advised to follow the treatment for at least 2 months, before expanding your diet again.

If you have a leaky gut, it is good to listen to your body, reduce stress, and take some time for yourself. Only when your body is not stressed, it can repair itself.
Also, it is well-advised to get enough physical activity. Physical activity actually promotes the growth of your own healthy gut bacteria and improves the overall health of your body. Aim for the type of physical activity that does not cause massive strain on your body, but go for the relaxing type like hiking, cycling, yoga, swimming or roller-skating.

Nutrition To Treat Leaky Gut

The diet for leaky gut would classify as a healthy diet. Try to stay away from processed foods and alcohol and consume plenty of vegetables, fruits, and natural products. Aim for enough fiber intake, to provide enough fuel for your gut bacteria to produce the anti-inflammatory and gut health-promoting short chain fatty acid butyrate.

Digestion of your food starts in your mouth, so make sure you chew your food properly (aim for 20-25x per bite) and sit down during your meals. 
Your body works on a circadian rhythm, make sure you have a rhythm in your daily meal plan and schedule your meals. Aim for small meals with 3-4 hours in between your eating moments. Don’t drink with your meals but do drink enough water between your meals.

Food choices you make should be based on the following principles for at least 2 months:

Eat as natural as possible
Drink plenty of water
Drink green tea or matcha
Consume enzyme-rich foods to aid your digestion, like pineapple, papaya, mango, kiwi, avocado
Make sure to eat plenty of vegetables and fruits. Choose all the colors of the rainbow (for antioxidants) and make sure to add fermented veggies
Eat healthy fats such as nuts and seeds, fatty fish (wild-caught)
Add (fresh) herbs and spices to your meals. Think of ginger, turmeric, basil and mint (can also use as herbal tea)
Use probiotic rich foods like kimchi, sauerkraut, kombucha or water kefir. Or use a probiotic supplement
If you’re eating meat, make sure it’s organic and preferably poultry or game
Refined sugar
Red meat
Linolic acid (an omega-6 fatty acid)
Large quantities of fat
Processed foods
A Western diet in general
Food Leaky Gut

Supplements and vitamins To Treat Leaky Gut

There are several supplements and vitamins that can aid in support of the reduction of a leaky gut. There is no hard scientific evidence for most of these, but it is hypothesized that the supplements mentioned below can help and won’t harm.

Recommended supplements:

Digestive Enzymes.
Aids with digestion and prevents further inflammation
Repairs the intestinal mucosa, reduces oxidative stress and inflammation that is linked to tight junction opening
Prebiotics (Link to article).
Helps repair gut microbiota by providing a food source. But consuming enough dietary fiber is more effective!
(for my article on probiotics, click here)
Supports your own healthy gut bacteria. Some studies have shown that mostly Akkermansia and Bifidobacteria are important for a healthy gut barrier.
Reduces oxidative stress and inflammation that is linked to tight junction opening
Vitamin D.
Aids the immune system and a deficit promotes IBS
Reduces inflammation. Is only necessary if you don’t eat fatty fish weekly.

The effect of an intervention can be noticed quite fast since your intestinal cells are renewed every 3-4 days. Nonetheless, you should adjust your diet for a longer period of time to also calm down your immune systems.

If you are looking for other supplements to take, or are interested in taking supplements that are especially advertised for Leaky Gut, make sure to do some research if those supplements are actually suitable for you. Some supplements may have side effects or have a negative interaction with certain medications.

Hopefully, this article will help you fix your leaky gut. What worked for you? Let me know!

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