Intestinal hyper-permeability or “leaky gut”, is a condition in which macromolecules leak either between the cells or “tight junctions or through cells that line the gut called enterocytes.
This can lead to systemic inflammation and can lead to many chronic diseases. The most common endotoxin is LPS or lipopolysaccharide which, is a gram-negative bacteria.
Conditions Associated With Leaky Gut:
What Are The Causes of Leaky Gut?
Stress has proven to be one of the most common factors in creating intestinal permeability. This can be emotional, physical or chemical. Other common causes are antibiotic use, NSAIDs, and proton pump inhibitors such as Prilosec or Prevacid. Certain lifestyle factors such as chronic alcohol consumption, smoking, lack of sleep or over training can cause leaky guts
How Do We Test For It?
A simple lab test to measure leaky gut is to measure two sugar molecules, Lactulose and Mannitol. The Lactulose is a larger molecule is not readily absorbed and Mannitol is smaller and easier absorbed. Although this test is relatively inexpensive it is not entirely accurate as it does not measure the immune response. Also, ingesting the sugar molecules can be reactive if the patient has SIBO.
There is another test that we often recommend it is Array 2 from Cyrex Labs. This test will measure LPS, which will indicate infiltration of endotoxins through the intestinal barrier into the circulation.
It also measures Occludin and Zonulin. Occludin in a protein that keeps together the tight junctions making the intestinal wall not permeable. Zonulin is a protein that is responsible for regulating the permeability of the intestines.
The Array 2 will also measure Actinomyosin that helps regulate intestinal barrier function.
What Can Be Done To Fix The Leak?
As a Functional Medicine Practitioner we will run the proper tests to assess whether you have the leak. Then we will employ lifestyle choices such as managing stress with Neurofeedback, Heartmath, Vagal Nerve Stimulation and co-managing with a Therapist. Other lifestyle choices such as reducing the intake of alcohol, proton pump inhibitors and NSAIDs will be beneficial. We also stress the importance of good sleep and proper exercise techniques to avoid over training.
We incorporate strategies to increase secretory IgA levels. This will help to minimize the endotoxin LPS as it is our first line of defense and will minimize and neutralize the effects of LPS.
Nutrients that we use to increase secretory IgA levels are Colostrum, Omega Fatty Acids, Glutathione, Glutamine, Glycine and Zinc.
Next it is important to strengthen the intestinal lining or mucosal barrier. We recommend Threonine, Serine, Proline and Cysteine to increase the mucin or mucous production.
The final step is to improve the microbiome. With leaky gut we lean towards the spore based probiotics. Common probiotics lactobacillus and bifidobacteria have difficulty surviving due to the acidity of the stomach. Generally, we recommend Megaspore Biotic as it has been clinically proven to reduce leaky gut associated with chronic diseases.
Strategies that effectively handle leaky gut is a fundamental step in the process of treating chronic disease and pain.