You may have heard a lot about “leaky gut” lately in the news. It’s kind of become one of the latest health “trends” along with the rise in “gluten-free” anything and everything, and gluten intolerance (or non-celiac gluten sensitivity, which YES, is a real thing).
To be honest, this blog post title isn’t completely true. Even now, more than two years after learning of my leaky gut “diagnosis” and working on it with various healing diets and lifestyle changes, I still have leaky gut issues. (Thanks, celiac! Whomp.) But I’ve come leaps and bounds from where I was using these tips and tricks I’m about to tell you about! Fret not, young grasshopper. I’m here to help!
Get ready…I’m about to get all science-y on you to explain what leaky gut (aka intestinal permeability) is, and why it happens. Want to just skip to the part on how to heal, and what I’m doing about it? Scroll down!
So what even IS leaky gut in the first place?
In healthy people with well-functioning gastrointestinal tracts, the small intestine functions as the main digestion, absorption, and immune-modulating organ in the body. The gut barrier “serves as the gatekeeper that decides what get into our body and what stays out.” (Kresser, 166). The enzymes on the brush border allow for the breakdown and assimilation of nutrients, allows “friendly” compounds like ““properly digested fats, proteins, and starches to pass through,” and the epithelial wall keeps foreign invaders like pathogens, bacteria, and larger food particles out. (Lipski, 41) With leaky gut, the villi on the brush border of your small intestine begin to break down, along with the structure of the epithelial wall. This allows unwanted particles to pass through into the bloodstream, and causing widespread inflammation, and also causes foods that area already digested to be malabsorbed, leading to micronutrient deficiencies. (Galland) Normally, the microvilli release lactase and cholecystokinin (CCK), which signals to the pancreas to secrete various digestive enzymes and helps you break your food down, as it should. With leaky gut and the breakdown of the brush border, all these functions are seriously diminished.
Gluten sensitivity, food intolerances, and allergies seem to be skyrocketing these days, and with them, the incidence of gastrointestinal and autoimmune disorders. Even in those who do not have celiac disease, the proteins gluten and gliadin can cause an inflammatory response in the small intestine, and can lead to “leaky gut”. (Laurière) When the body attempts to fight off what it perceives as a foreign invader (for example, gliadin, gluten, or another food you have a sensitivity to), it creates an antibody response similar to an autoimmune reaction, enlarging the blood vessels in the gut so that more white blood cells and other immunoglobulins (molecules that fight off infection) can rush to the scene. (Galland) This makes the gut more permeable or “leaky”, to allow these immune modulators to get to the scene of the inflammation. Fibrin filaments, the same material that is used to repair damage in blood clotting, form at the site of the injury to help in the repair of the intestinal lining.
The epithelial (gut) cells can regenerate fairly quickly, so within a day the immune response has died down and the gut begins to heal itself, so long as gliadin and gluten are out of the system. However, once another gluten-containing (or other offending) food is eaten, the entire inflammatory response begins all over again, except this time, your body has already made autoantibodies to the previously harmless food, so the anti-inflammatory reaction is even stronger, and more damaging to the gut wall. (Galland) This leads to “a vicious cycle…of never letting the gut heal before hammering it with more inflammation,” which can cause a cascade of negative health consequences reaching far beyond the gut (Beyond Training, 333).
What’s the deal with gluten?
The integrity of the gut lining is maintained by tight junctions between the epithelial cells, called desmosomes. When the gut becomes more permeable (due to gliadin exposure or other stressors), these junctions loosen up, which allows larger molecules to pass through, like undigested food, foreign particles, microbes, etc. (Lipski, 41)
One of the most powerful triggers that opens up these tight junctions is the ingestion of gluten, even in those who don’t have celiac disease. So gluten and gliadin not only run down the villi in the small intestine with repeated exposure, which can lead to malabsorption, nutrient deficiencies, and indigestion, but they also trigger the opening of these tight junctions, allowing foreign particles to pass through and creating a continuing inflammatory response in the body. As time goes on and the gut lining is continually exposed to gluten and gliadin, and other substances are allowed to pass through the intestinal lining, the more food sensitivities one will develop. Even if someone did not previously have sensitivities to those undigested foods, once they pass through the gut wall and enter the bloodstream, the body makes antibodies to them. Just like with gliadin exposure, the next time you eat that food, the body already has antibodies against it, which triggers the immune system and mounts an inflammatory response.
How do lifestyle factors contribute to leaky gut?
There are many other things that can further increase gut permeability and contribute to the development of a leaky gut, such as other food sensitivities, chronic stress, use of NSAIDS (painkillers like tylenol), antibiotics, or proton pump inhibitors (prescribed to treat heartburn), high intensity exercise, infection, lectins, low stomach acid, toxic exposure, parasites and yeast infections, overconsumption of alcohol and immune overload. (Greenfield, 334, Lipski 43, 45). YIKES, right?! All things we are definitely guilty of at some point. Inadequate chewing, eating while stressed, and inadequate HCL (hydrochloric acid, the stuff that’s in your stomach and helps break down proteins) production can lead to inadequate protein digestion, putting a strain on the enzymatic functions of the small intestine, which becomes more problematic as the gut becomes progressively more leaky, and these particles are allowed to pass through the gut wall. Poor diet, like following the standard american diet with its “refined flours and sugars and industrials seed oils…has been shown to cause undesirable changes in the gut microbiota,”, making the gut barrier more permeable. (Kresser, 168)
Leaky Gut: the widespread effects on the body
The effects of leaky gut are widespread throughout the body, and affect not only the gastrointestinal tract, but can create an immune response that affects the skeletal system, the brain via the enteric nervous system, the pancreas, kidneys, and the liver. Intestinal permeability can also lead to a compromised immune system, inflammation, joint and arthritic pain, skin issues like eczema and acne, mediated by immune sensitivity reactions in the joints and in the skin. The immediate symptoms of leaky gut may begin in the gut, resulting from a lack of digestive enzymes in the damaged villi and leading to malabsorption, malnutrition, bloating, gas, indigestion, abdominal pain and IBS, while the impact of zonulin on opening up the tight junctions in the epithelial wall can lead to the development of food sensitivities and allergies as foreign particles get into the bloodstream. (Kresser, 168) This can also induce dysbiosis, upsetting the balance of the microbiota. A leaky gut can not only cause “leaky skin”, but also a “leaky brain” via the enteric nervous system and the vagus nerve, causing issues like depression, brain fog, anxiety, poor memory, and chronic fatigue. (De Palma)
Leaky gut can even lead to more severe conditions like autoimmune diseases, chronic fatigue syndrome, celiac disease, fibromyalgia, IBD, kidney stones, MS, and psoriasis. (Galland) Some researchers, like Dr. Alessio Fasano, are finding new evidence that leaky gut may be a precondition to autoimmunity; that the “intestinal barrier operates as the ‘biological door’ to inflammation, autoimmunity, and cancer,” therefore you do not develop an autoimmune condition without having a leaky gut first. (Fasano) In fact, many autoimmune diseases like celiac disease, rheumatoid arthritis, crohn’s and colitis, and multiple sclerosis, are all characterized by “abnormally high levels of zonulin and a permeable gut barrier.” (Kresser, 167).
What I’ve been doing: Natural ways to heal leaky gut
YIKES, right? Well 1) that was a welp of science. My brain needs a break. And 2) Can you believe the amount of damage a leaky gut can do, or the many different ways it can happen? Sheesh. It’s no wonder so many people are dealing with leaky gut issues these days. So what can we do about it, especially since so many general (western) practitioners will look at you like you have four heads if you ask about leaky gut?
Leaky gut is like the middle man in the cascade of inflammation. Something had to come before to cause both it and the symptoms it leads to, so even if we “diagnose” someone with leaky gut, you have to go deeper to see what the real root of the problem is, by examining if the person shows many of the symptoms listed above. I recommend working with a functional medicine doctor to figure out and treat the root cause. But even before (or while) you’re doing that, there are a couple natural ways you can help heal up your leaky gut and support it during times of stress (read: stressful deadlines at work, high-intensity exercise or chronic steady-state cardio like training for a half or full marathon, not sleeping enough, having one too many drinks on cinco de mayo, etc.)
One of the biggest changes you can make is eliminating the foods that are inflammatory to you. Gluten is a biggie, and if you’re curious of other foods, you can try a food sensitivities (blood) test through your doctor, or an elimination-provocation diet to see which kinds of foods you react to. Be wary, though: if a TON of foods come up on that blood test, that means your gut is super leaky. But once you start to heal, you’ll most likely be able to eat many of these foods again with no problem.
WORK ON THE STRESS IN YOUR LIFE. Are you in a job that you dread going to every day? You’re making your gut more leaky. Are you beating yourself into the ground with your exercise routine? Hit straight to the gut. Exercise is inflammation too, and if you’ve already got a lot of that going on, you aren’t doing your gut any favors. Are you eating oodles of noodles and pizza every day, and then taking TUMS or prilosec to get rid of that heartburn? Your gut is crying. Give it a break! For more lifestyle changes on how to help your leaky gut, I highly recommend checking out the further reading section I’ve included below! Ask your doc about l-glutamine (the preferred food of the enterocytes), and stock up on probiotics and probiotic rich foods, to help balance those good gut bugs and get the bad ones out. But what else can you do?
What’s the deal with bone broth, collagen and gelatin?
Ah, bone broth. Mother nature (and 1950’s mom)’s cure-all for a stomach bug, the cold, everything and anything relating to your immune system. But why is that? What are the magical properties of this drink that either freaks you out or gets you super excited to drink every day (weirdos like me, oh heeeey). It’s the collagen & gelatin in bone broth that gives it the superfood healing properties you hear about. These superfoods can also help balance your hormones, improve skin elasticity (wrinkles be gone!), and help with arthritis pain by cutting down on inflammation, when they are included in your diet.
To be honest, I knew all these benefits and that I should be using them to help my still-leaky gut, but I never really got around to using collagen or gelatin much until I met the awesome folks at Vital Proteins at Expo West this year. Since I’ve been using them regularly now in many different ways and recipes (look for those coming soon!) in addition to avoiding gluten (duh), dairy, and adding more probiotic foods in, I can tell I have less inflammation going on all over my body – I can tolerate more foods (meaning my gut is healing up!), I don’t get random illnesses all the time like I used to (wahoo, immune system is building up!), and I don’t break out in an angry red rash on my face when I eat tomatoes (this was a huge sign for me of food intolerance!) I luckily don’t have (that many) wrinkles yet, but you bet I’m fending those babies off with my daily dose of collagen. People still tell me I look 18 even though I’m 26…youthful skin FTW. So what’s the deal with collagen and gelatin?
This is the BLUE container from Vital Proteins. Collagen, unlike gelatin, does not gel, and it can be used in either hot or cold uses. It blends in perfectly, and it doesn’t taste gritty or have a weird flavor at all (you know the nasty, gritty aftertaste you get with some protein powders? eugh). There’s a wild-caught marine collagen (yes, from fish!) and a grass-fed, pasture raised product as well.
“Collagen peptides are short chain amino acids naturally derived from pasture-raised, grass-fed collagen protein…Collagen peptides contain the same amino acids as gelatin which are identical to the protein found in skin, nails, hair, bones, cartilage, and joints.” (Vital Proteins) You can stir it into any kind of drink, hot or cold, or mix it into smoothies, soups, sauces, whatever your little heart (and gut) desires!
Need more of a reason to eat more collagen, this super trendy food-based supplement, rather than just healing up your gut? Well, how about building lean muscle mass? Yep, you can use it like a protein powder, but without all those weird, non-pronounce-able, UFI’s (unidentified freaky ingredients? ha.). Collagen helps stimulate your body to do it’s thing and produce more creatine, an amino acid (building block of protein) that helps boost energy, repair and rebuild muscle after exercise. It’s great for your joints too. Collagen is most highly concentrated in the body where the joints meet, and in the body’s connective tissue. This makes collagen especially important if you’re prone to or recovering from injury, so you can have a little extra cushion in those joints to help prevent and heal from injuries (or overuse – I’m looking at you, exercise fiends like me!).
How about sleep? Yep, collagen can help with that too. Collagen is ample in glycine, the amino acid (those protein building blocks) that studies have shown can both help improve the quality of your sleep and and cut back on that feeling we all know too well of being so tired during the day you can barely function following a night of little sleep. No over-the-counter sleep meds necessary.
Gelatin? You mean like jell-o?
Well, yes and no. Yes in the sense that it makes things gel like jell-o does, but no in the sense that this grass-fed beef gelatin has zero added junk (unlike jell-o), no artificial colors or sugars, and is probably not going to be used in jello shots like you did in college. Mom, just pretend you didn’t read that. The Vital Proteins gelatin collagen protein (the GREEN container) is a 100% pure, pasture-raised, grass-fed gelatin powder. It has the same gut-healing properties as the collagen, they’re just used in recipes in different ways. If you wanted to make some gut-healing gummies, you’d use the gelatin. If you just want a gut-healing boost to your tea but don’t want it to gel up, use the collagen.
What about recipes on how to use these and incorporate them into your gut-healing diet? Check out the vital proteins recipe page for toooons of different ways to use them. Or, for now, sneak some collagen into my Mocha Banana Protein Smoothie instead of protein powder, your morning coffee or tea, or just about anywhere!
Basically…this stuff is awesome. And so incredibly versatile, it’s almost stilly not to use it all the time, since you can only be doing your body some good by including collagen and gelatin in your diet. So get at it!
Sources & Further Reading
De Palma, Giada, Stephen M. Collins, Premysl Bercik, and Elena F. Verdu. “The Microbiota–gut–brain Axis in Gastrointestinal Disorders: Stressed Bugs, Stressed Brain or Both?” The Journal of Physiology 592, no. 14 (July 15, 2014): 2989–97. doi:10.1113/jphysiol.2014.273995.
Fasano, Alessio. “Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer.” Physiological Reviews 91, no. 1 (January 1, 2011): 151–75. doi:10.1152/physrev.00003.2008.
Galland, Leo (1995). “Leaky Gut Syndromes: Breaking the Vicious Cycles”. Townsend Letter for Doctors 63
Greenfield, Ben. Beyond Training: Mastering Endurance, Health & Life. Victory Belt Publishing, 2014.
Kresser, Chris. Your Personal Paleo Code: The 3-Step Plan to Lose Weight, Reverse Disease, and Stay Fit and Healthy for Life. Little, Brown & Co, 2013.
Laurière M, Pecquet C, Bouchez-Mahiout I et al. (2006). “Hydrolysed wheat proteins present in cosmetics can induce immediate hypersensitivities”. Contact Derm. 54 (5): 283–9
Lipski, Elizabeth. Digestive Wellness: Strengthen the Immune System and Prevent Disease Through Healthy Digestion. Fourth Edition. McGraw Hill, 2012.
This post was sponsored by Vital Proteins. All thoughts and occasionally sarcastic opinions are my own (can’t you tell??)