Last weekend I went to a conference on GI dysfunction and was pleased to learn that something NDs have known for years is now being supported in the literature:

“Leaky gut,” or intestinal permeability, is a real thing.

It can be measured with a biomarker called zonulin, which is necessary for a tight intestinal barrier. Higher levels in the stool correlate with increased gut permeability, as do the presence of antibodies against it in the blood.

Defining Terms: Leaky Gut

The terms leaky gut and intestinal permeability refer to the same thing, and the idea is this: the junctions in your small intestine ought to be tight enough that nothing can get in or out without the aid of digestive enzymes. In a leaky gut, the junctions are loose enough that food particles can come in contact with the bloodstream prematurely (before they’ve been broken down into something your bloodstream would recognize and be able to use). Your blood therefore thinks the food particles are foreign invaders, and it creates antibodies against them.

Leaky gut also can be the gateway to autoimmune conditions, since allergies and autoimmunity are so closely linked. In a nutshell: allergies are when your immune system thinks a friend is an enemy; autoimmunity is when your immune system thinks you are the enemy.

Zonulin: What Is It?

Zonulin and another protein called occludin are the major building blocks of the intestinal tight junctions. Higher levels in the stool, or antibodies in the blood, have been correlated with autoimmune inflammatory bowel conditions such as Crohn’s and Ulcerative Colitis, backing up the idea that Irritable Bowel Disease is characterized in part by intestinal permeability. Of course, the same association exists with Celiac Disease.

Interestingly, though, increased zonulin levels have also been correlated with other autoimmune conditions that don’t necessarily have such a clear “gut” symptom picture, such as Type 1 Diabetes, Ankylosing Spondylitis, Lupus, and Rheumatoid Arthritis.

Healing Your Gut

If you’re not sure if you have increased intestinal permeability or not and don’t want to test for food allergies directly, zonulin testing would be the appropriate choice.

Otherwise, you next will need to identify the triggers. That means getting tested for which foods, for you, perpetuate the inflammation in your gut. People who have leaky gut have antibodies (IgG, usually) against the foods they eat the most. Those foods with lower antibody titers can usually be added back into the diet once the gut lining has healed.

For some people, pathogenic bacteria may be an additional culprit. This will require a comprehensive stool culture to identify the specific organism and how to get rid of it.

Next, this study shows that it’s necessary to repopulate your gut with good bacteria, since they are a huge part of your immune system. For the most part this is straightforward (unless you also have SIBO, in which case you’ll need to make sure you stick with just the lactobacillus family until it’s gone.)

There are a number of different additional supplements designed to heal up your gut lining. Some work better than others for certain individuals, based on your sensitivities and the specific pattern of foods that tend to trigger you.

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