Condition Guide

Leaky Gut: When Your Intestinal Barrier Breaks Down

Increased intestinal permeability — commonly called "leaky gut" — is increasingly recognized as a driver of chronic inflammation, autoimmunity, and systemic illness.

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What Is Leaky Gut?

Your intestinal lining is meant to be selectively permeable — allowing nutrients through while keeping out pathogens, toxins, and undigested food particles. Leaky gut occurs when this barrier becomes compromised.

Immune Activation

Foreign particles in the bloodstream trigger immune responses, driving chronic inflammation.

Autoimmunity Link

Research links intestinal permeability to autoimmune diseases including Hashimoto's, RA, and MS.

Gut-Brain Connection

Leaky gut can lead to "leaky brain" — neuroinflammation causing brain fog and mood issues.

Food Sensitivities

Undigested food particles entering blood trigger immune reactions to previously tolerated foods.

How It Happens

The intestinal lining is held together by "tight junctions" — protein structures that regulate what passes through. Various factors can damage these junctions:

Gluten (triggers zonulin release)

Chronic inflammation

Gut infections and dysbiosis

NSAIDs and certain medications

Alcohol

Chronic stress

Processed foods and sugar

Symptoms of Leaky Gut

Because leaky gut drives systemic inflammation, symptoms can appear throughout the body:

Digestive Symptoms

Bloating and gas

Diarrhea or constipation

Abdominal pain

Food sensitivities (especially new ones)

Systemic Symptoms

Chronic fatigue

Brain fog and poor concentration

Joint pain

Skin issues (acne, eczema, rashes)

Mood issues (anxiety, depression)

Headaches

Autoimmune conditions

The Autoimmune Connection

Researcher Alessio Fasano's work suggests that intestinal permeability may be a prerequisite for autoimmune disease development. Healing the gut is often a crucial step in managing autoimmune conditions.

Testing for Leaky Gut

Zonulin: A protein that regulates tight junctions; elevated levels indicate permeability

Lactulose/mannitol test: Measures how these sugars pass through the gut wall

LPS antibodies: Antibodies to bacterial toxins that shouldn't be in blood

Food sensitivity testing: Multiple new sensitivities suggest permeability

The 5R Protocol for Gut Healing

Functional medicine uses the "5R" framework to systematically heal the gut:

Remove

Eliminate triggers: gluten, dairy, sugar, alcohol, processed foods, infections, and problematic medications. You can't heal while continuously irritating the gut.

Replace

Add digestive support: digestive enzymes, HCl if needed, and bile support for proper breakdown of food. Inadequate digestion contributes to permeability.

Reinoculate

Restore healthy bacteria with high-quality probiotics, fermented foods, and prebiotic fiber. A healthy microbiome supports barrier function.

Repair

Heal the lining with targeted nutrients:

L-Glutamine: Primary fuel for intestinal cells

Zinc carnosine: Supports gut lining integrity

Collagen: Amino acids for tissue repair

Aloe vera: Soothes and heals mucosa

Rebalance

Address lifestyle factors: sleep, stress, movement, and ongoing dietary habits. The gut heals best in a state of rest and digest, not fight or flight.

Key Gut-Healing Nutrients

L-Glutamine: The primary fuel for intestinal cells; supports repair

Zinc carnosine: Specifically supports gut lining integrity

Collagen/bone broth: Provides amino acids for tissue repair

Omega-3s: Anti-inflammatory; support barrier function

Vitamin D: Supports tight junction integrity

Quercetin: Stabilizes mast cells; reduces intestinal inflammation

Foods That Help vs. Hurt

Healing Foods

Bone broth

Fermented foods (sauerkraut, kimchi, kefir)

Cooked vegetables

Wild-caught fish

Healthy fats (olive oil, avocado, coconut)

Foods to Avoid

Gluten (especially for those with sensitivities)

Processed foods and seed oils

Sugar and artificial sweeteners