By Dietitian Jill Place
Since I’ve now been dubbed The Good Gut Queen by a colleague (and LOVE wearing my growing gaggle of crowns), I felt the need to answer the question, “What IS Leaky Gut?”. What causes it. And why it’s so important to address it.
Many alternative practitioners (and some enlightened doctors … thank goodness) say “Your Health is in Your Gut!”. It’s so absolutely true!
And when I was sitting at breakfast in one of my favorite restaurants yesterday, I started doing the infographic below in the “Why Leaky Gut is So Important” section. And couldn’t stop adding more and more horrible things that leaky gut causes.
When you look at it, you may be as shocked as I did when I finished. Because on there is every debilitating and life-threatening problem you can think of. Connected to leaky gut and the inflammation that results from it.
The Good Gut
Here’s a terrific ultra-simple illustration of what happens in your SMALL INTESTINE … the place where you absorb nutrients … before and after your “gut” starts to “leak”.
On the left you see healthy cells in the small intestine … held together by “tight junction” proteins. These tight junctions act like tiny filters … allowing only certain things to pass from your intestines into your bloodstream.
Therefore, tight junctions perform a vital balancing act … allowing life-giving nutrients to pass into the bloodstream. And keeping things like pathogens (disease-causing organisms), food allergens, molds, and other things that shouldn’t be there out.
Also … the little “fingers” … the villi … at the top of each cell are where nutrients are absorbed. And … you can’t see it … but 80% of your immune system resides within your gut too.
The immune system lives in that mucosal (aka snot … eww!) depicted by the pale blue blob surrounding the top of the normal gut cells. The gut … actually the small intestine … is a very busy place!
If the above diagram is a little too complicated, here’s a fun depiction of a Good Gut. And let me introduce you to one of the Immune sisters … Sturdey Strong below. She’s strong because her gut is protecting her from all things that might make her weak and downright exhausted. Read on …
What Happens When Your Gut is LeakyLeaky gut can actually be thought of as a 'tight junction' malfunction. When you have leaky gut, certain things like allergens and pathogens (toxins, molds, bacteria, etc.) that shouldn't 'leak' into your bloodstream do.Click To Tweet
You can see on the right side of the picture above that that mucosal layer (eww!) where the immune system lives (it’s the only system that doesn’t have organs) is now pretty much destroyed. And … since the immune system’s job is to attack foreign invaders … it begins to work overtime.
It also begins to go berserk and attack molecules like gluten that are chemically similar to invaders. We call this “molecular mimicry”.
The end result? The gut not only becomes inflamed because of this over-response but also from the constant immune attack on foreign particles, resulting in autoimmune (body-turning-on-itself) reactions. Here’s the other Immune sister … Wobbley Weak … sickened by those foreign invaders from leaky gut.
The villi also become damaged and unable to absorb nutrients properly to nourish your body. Chronic inflammation results, which is the root cause of most disease.
What this All Means to You
Well … just look at the infographic! Leaky gut … which causes inflammation … causes all the things you see below … and more! If you’d prefer to read the list from Dr. Josh Axe here it is … (not totally complete as more and more problems linked to leaky gut are found daily).
The links below (in orange) also give you more information on each problem. And the numbers are links to actual research (you know I just LOVE research!) about the topic …
- Gastric ulcers
- Infectious diarrhea
- Irritable Bowel Syndrome (IBS)
- Inflammatory bowel diseases (Crohn’s, ulcerative colitis)
- Small Intestine Bacterial Overgrowth (SIBO)
- Celiac disease
- Esophageal and colorectal cancer
- Respiratory infections
- Acute inflammation conditions (sepsis, SIRS, multiple organ failure)
- Chronic inflammatory conditions (such as arthritis)
- Thyroid disorders
- Obesity-related metabolic diseases (fatty liver, Type II diabetes, heart disease)
- Autoimmune disease (lupus, multiple sclerosis, Type I diabetes, Hashimoto’s, and more) (4)
- Parkinson’s disease (5)
- Chronic fatigue syndrome (6)
- Propensity towards weight gain or obesity (7)
Do Doctors Agree?
Unfortunately, even though more research has been done pointing to leaky gut and the inflammation that results from it as the cause for just about everything, doctors still disagree about it. One of my colleagues shared just yesterday that a doctor’s denial of it was almost rabid.
I can understand that as the concept of leaky gut shakes the very core of their medical model, have-a-symptom, take-a-pill mentality. And the fact that it takes up to 20 years for doctors to change their minds about things.
But the sad truth is that we don’t have 20 years. Autoimmune and toxic overload problems are sharply on the rise. And people are getting fatter than ever … another consequence of leaky gut that doctors haven’t yet acknowledged.
I have a 2004 cover of TIME magazine that screams “THE SECRET KILLER …The surprising link between INFLAMMATION and HEART ATTACKS, CANCER, ALZHEIMER’S and other diseases”. I bought it, framed it, and hung it over my desk. 2004! WHY DON’T THEY GET IT!
The Reality of Leaky Gut Treatment
The reality is that there are no standard diagnostic medical-model tools for testing and treating leaky gut. Or specific treatments available except for those that stop symptoms.
So most MD’s play it safe, follow their training … which may be many decades old … and prescribe drugs that treat leaky gut symptoms like acid reflux or diarrhea. Sadly, they don’t solve the problem.
One of my favorite shows is Real Time with Bill Maher. It’s kept me sane throughout these crazy few years. Last night, he had on Dr. Dariush Mozaffarian, Dean of the Tufts University School of Nutrition.
Maher has lately wondered on his show why people are not addressing boosting immunity as a solution for COVID-19. I agree. Mozaffarian had a interesting … and logical … take on that.
He explained that, in the last century, nutritional healthcare was focused on preventing starvation and nutrient deficiencies. So the focus was on providing loads of cheap vitamin-fortified shelf-stable food. We didn’t know then that these types of foods would damage health.
We also didn’t know that this … as Mozaffarian said … “simplistic approach doesn’t work for chronic diseases”. And called the astronomical growth in diabetes and obesity over the last 40 or 50 years “the slow pandemic”.
Doctors Know NOTHING About Nutrition
I wrote an article awhile ago called Doctors Know NOTHING About Nutrition. And know this to be true as I’m always adjusting supplements doctors prescribe as they don’t know how to dose them.
They also only prescribe them (and the worst forms by the way) only to people with diagnosable deficiencies with little regard to how these supplements interact with each other. Supplements ARE in my scope of practice … thank GOODNESS!
Doctors also have NO sense of what a certain therapeutic diet entails … or whether my kitchens can produce it. They often write these absurd diet orders.
The diabetic diet at my hospital is called 60:60:60 for the gram limit for each meal. But several docs write 90:90:90 when they want the person to have more food without understanding the diet at all … I have to change it.
I also discontinue Ensure during meals for people not eating. Doctors just prescribe it without questioning patients why they’re not eating in the first place.
Does it make any sense to you to give someone MORE food if they’re not eating what they have already? Me … I always want to find out the root cause of the problem.
Years ago I was covering for another RDN at a weight-change meeting. Everyone was amazed that I actually asked a patient who was losing weight why … she shared that she had stomach pain. They were amazed because no one had ever asked a patient why before.
So I wasn’t surprised when Mozaffarian explained that only 12% of us are metabolically healthy. And that it only takes 4 to 6 weeks to change this if we focus more on food as medicine. I couldn’t agree more.
But in the current medical environment, it’s just not happening. Alot because a lack of knowledge. And otherwise because doctors don’t get that focusing on lifestyle change will actually heal people.
How Functional Medicine Practitioners Heal Leaky Gut
So … where does that leave us? Insurance only pays for the stuff that doesn’t work for leaky gut. Which leaves us with two alternatives … self-treat and spend much time (and money) picking trial-and-error treatments that eventually fail. Or pay out-of-pocket for an alternative/functional practitioner.
Those of us that treat leaky gut practice root-cause and individualized medicine. It’s like a big 1000-piece red puzzle that we all put together. That’s why my logo contains a puzzle and my tagline is “solving unsolvable health puzzles”.
Puzzles that begin … and return to … getting the gut good. Also, the reality is that … according to Tom O’Bryan, M.D. … that you DON’T have to have bloating, gas and maldigestion to have a leaky gut. It can manifest in other ways, like having food sensitivities and autoimmune diseases like Hashimoto’s thyroiditis.
And there ARE functional tests for leaky gut. Tests that most doctors don’t do, as Dr. Mozaffarian has said, because they’re focused on deficiencies (it took 20 years for them to routinely test for Vitamin D deficiency; functional practitioners did that more than 25 years ago).
But, unfortunately, many of these tests are not covered by insurance. So you have to pay for them out-of-pocket. As well as the treatments you get from functional practitioners.
And, with many still out of work and struggling these days, the thought of spending a lot of money on yourself is anathema. Yes, treatment and supplements are pricey, but a lot less than having to pay for medical treatment if you don’t have insurance. Hey … my broken ankle cost me $30,000 … WITH what I thought was good insurance.
But … ultimately … healing your gut and boosting your immunity will reduce the possibility of a bad outcome from COVID and other debilitating health problems and enable you to live a longer, happier, and healthier life. Free of chronic disease. Isn’t a little gut-healing and lifestyle change worth it?
And here’s my surprise … FINALLY …