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SM Entrepreneuraholic
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This is an article I wrote on leaky gut. It would have been easier to link to my website, but that bordered on violating rules for this forum. Below is the entire article.

Leaky gut means that your small intestine wall has become porous and may be leaking pathogens (bacteria, viruses, fungus), parasites, toxins, and undigested food into your bloodstream. In the medical literature, leaky gut is called intestinal permeability.
When you eat food, it makes its way down your digestive track until it reaches your small intestine. At that point, it should be completely digested – fat turned into free fatty acids, triglycerides, and glycerol, carbohydrates into monosaccharides (simple sugars), proteins into amino acids, and vitamins and minerals extracted and available to be absorbed.
The fatty acids, triglycerides, glycerol are absorbed through the gut wall into the lymphatic system and monosaccharides and amino acids are absorbed through the gut wall into the blood system. Vitamins and minerals the same, depending on if they are fat soluble or not.
The gut (gastrointestinal track), specifically the small intestine, is where food is absorbed. The small intestine wall is only one cell thick with tight junction proteins “patching” the holes between the cells, creating a fairly tight wall. This cell wall is critical in protecting the inside of our body from toxins and pathogens that we may have eaten with our food. It also keeps partially digested food from being allowed into the blood system.
Let’s Take a Closer Look
We need to know a few terms to understand the following illustration.
  • Enterocytes – the intestinal absorption cells (the parts with the pointy heads) where nutrients are absorbed.
  • Microvilli – the pointy things on the top of the enterocytes, used to increase surface area and for nutrient absorption.
  • Transcellular Route – through the cell.
  • Paracellular Route – between cells
  • Tight Junction – Proteins that provide a seal between the cells
  • The top of the enterocytes faces the small intestine and the bottom faces the blood system.

Gut Wall (Normal)
BallenaBlanca [CC BY-SA (Creative Commons — Attribution-ShareAlike 4.0 International — CC BY-SA 4.0)]

Now let’s take a look at a compromised gut wall. Notice that the tight junctions are either damaged or open. The enterocyte may also become damaged or die and allow leakage.

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Faulty Tight Junction
BallenaBlanca [CC BY-SA (Creative Commons — Attribution-ShareAlike 4.0 International — CC BY-SA 4.0)]

In the above illustration, notice that because the tight junctions are faulty, undigested food particles, microorganisms, and toxins can all leak from the small intestine through the gut wall into the blood system. Our immune system is sitting right there waiting to attack any foreign substances that make it through the gut wall, and this produces some level of inflammation.

Leaky Gut Symptoms
These are some of the symptoms that a person with a leaky gut might experience. Some people with a leaky gut may not experience any symptoms or they might be quite mild.
  • Bloating, gas, cramps
  • Food Allergies or Sensitivities
  • Fatigue
  • Skin Conditions
  • Brain Fog
  • Moodiness
  • Digestive Issues
  • Candida Overgrowth
I tested positive for autoimmune disease (unspecified) and had fatigue, brain fog, and oral thrush. I also had a 1-time reaction to shrimp and a 1-time reaction to cod. Testing confirmed I had a leaky gut.
Causes of Leaky Gut
According to research by Dr. Alessio Fastano, two factors have been shown to upregulate Zonulin, the protein that controls Tight Junctions. When the level of Zonulin increases, the tight junctions loosen up creating a more permeable intestine (leaky gut). These 2 factors are:
  • Wheat (gluten/gliadin)
  • Gut Bacteria Imbalance in the small intestine
Some of the other factors that may increase gut permeability are:
Healing a leaky gut is a 3 step process:
  1. Stop whatever is causing leaky gut
  2. Strengthen the immune system
  3. Rebuild the balance of good to bad bacteria
I recommend these web sites that take a scientific approach to heal leaky gut:
Autoimmune Disease
For years I ignored looking into leaky gut and did not realize how critical it was to my health. This quote explains just how serious a leaky gut can be.
“The classical paradigm of inflammatory pathogenesis involving specific genetic makeup and exposure to environmental triggers has been challenged recently by the addition of a third element, the loss of intestinal barrier function. Genetic predisposition, miscommunication between innate and adaptive immunity, exposure to environmental triggers, and loss of intestinal barrier function secondary to the activation of the zonulin pathway by food-derived environmental triggers or changes in gut microbiota all seem to be key ingredients involved in the pathogenesis of inflammation, autoimmunity, and cancer.
Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer, Alessio Fasano, 01 Jan 2011,

What Dr Fastano is saying is he has found that for autoimmune disease to occur, there needs to be:
  1. A specific genetic makeup
  2. An environmental trigger
  3. Loss of intestinal barrier function (leaky gut)
Inflammation is the root of chronic diseases. And we know that a leaky gut causes an immune response which means inflammation.
Evidence has been mounting that these common chronic conditions—including Alzheimer’s, cancer, arthritis, asthma, gout, psoriasis, anemia, Parkinson’s disease, multiple sclerosis, diabetes, and depression among them—are indeed triggered by low-grade, long-term inflammation. Harvard Magazine

So now we have a link between chronic diseases, autoimmune diseases, a leaky gut, and low-grade inflammation. Now, do you see why leaky gut is so important?
For me, the link to heart disease is even more important than those listed above. Here are a couple of links to studies on heart disease and leaky gut.
I will be going deeper into heart disease when I cover endotoxicity in a future post.
Environmental Triggers
So what are the environmental triggers that can leak through the gut wall.
  • Bacteria
  • Viruses
  • Parasites
  • Toxins
  • Undigested/Partially Digested Fats
  • Undigested/partially Digested Carbs
  • Undigested/Partially Digested Proteins
  • Outer Shell of gram-Negative bacteria
They are all serious, but let’s focus on the final 2 above
  • Undigested proteins – Our body creates proteins from amino acids. Some of the undigested/partially digested proteins that leak through the gut wall, look very similar to these proteins. Our adaptive immune system develops specific antibodies to fight invaders, in this case, the undigested/partially digested protein. The problem occurs when the specific antibody created to fight the undigested protein also attacks the good protein that has a similar structure. The result is an autoimmune disease.
  • The outer shell of gram-negative bacteria – Bacteria are either gram-negative or gram-positive, and this applies only to gram-negative bacteria. The outer shell produces lipopolysaccharides (LPSs), also called endotoxins. When LPSs leak into the bloodstream, the immune system attacks creating inflammation.
“By entering the bloodstream, Gram-negative bacteria cause immune system reactions and lead to the activation of different chains of non-cellular reactions. One of the components of the cell wall of this family of bacteria is lipopolysaccharides, which form complexes of high molecular weight known as bacterial endotoxins, due to the toxic effect that they cause in other organisms. Almost any environment is appropriate for the development of Gram-negative bacteria, given that contamination with these bacteria is very common. There are several diseases related to the endotoxins of Gram-negative bacteria affecting humans. Pyrostar
  1. Coronary artery disease
  2. Neonatal Necrotising Enterocolitis
  3. Crohn’s Disease and Ulcerative Colitis
  4. Cystic Fibrosis
  5. Autoimmune Diseases
So you can see we now have a triple whammy! First, we have a leaky gut leaking toxins, pathogens, and partially digested food into the blood system, then we have partially digested proteins mimicking actual proteins, and finally, we have LPSs causing more inflammation and toxicity.
Summary
We have seen that gluten and bacteria imbalance can cause an increase in Zonulin which leads to tight junctions becoming loose and leaky. We have also seen other conditions that cause the gut wall to become permeable. These 2 conditions allow toxins, pathogens, and partially digested food to leak through the gut wall into the blood system. A person with a leaky gut will often experience bloating, gas, cramps, food allergies or sensitivities, fatigue, skin conditions, brain fog, moodiness, digestive issues, or candida overgrowth. If a person has a genetic predisposition to an autoimmune disease, the leaky gut and environmental factors are likely to trigger it resulting in an autoimmune disease.
 

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On my raw fruit and vegetable diet with limited other whole foods and limited meat and virtually no dairy or wheat is working for me well. No bloating and my need for NSAID's is greatly reduced. Have not touched anything for constipation in years.
 

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Note that so called Leaky Gut Syndrome is difficult (at best) to show in vivo and relies mostly on lab evaluation of biopsy material (can we extrapolate that to life?)...Everyone's gut "leaks'" to some extent-- some people may have more problems than others in response to increased osmotic pressures caused by diet...Note that there's little evidence that dietary manipulation does much good (difficult to assess when most symptoms are subjective, with little objective evidence for support)
Leaky gut: mechanisms, measurement and clinical implications in humans - PubMed (nih.gov)

Good advice to everyone-- If it bothers you, don't eat it.

Addendum-- Brain Fog?...Doesn't that suggest something when we have to rely on that for a diagnosis?
 

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Discussion Starter · #6 ·
Note that so called Leaky Gut Syndrome is difficult (at best) to show in vivo and relies mostly on lab evaluation of biopsy material (can we extrapolate that to life?)...Everyone's gut "leaks'" to some extent-- some people may have more problems than others in response to increased osmotic pressures caused by diet...Note that there's little evidence that dietary manipulation does much good (difficult to assess when most symptoms are subjective, with little objective evidence for support)
Leaky gut: mechanisms, measurement and clinical implications in humans - PubMed (nih.gov)

Good advice to everyone-- If it bothers you, don't eat it.

Addendum-- Brain Fog?...Doesn't that suggest something when we have to rely on that for a diagnosis?
If you test for pathogens when Zonulin is high, do treatment for leaky gut, retest for pathogens and Zonulin, and the result is lower levels of pathogens and a lower Zonulin level, that's good enough for me. Look up the research on lipopolysaccharides getting into the blood and it is frightening.
 

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If you test for pathogens when Zonulin is high, do treatment for leaky gut, retest for pathogens and Zonulin, and the result is lower levels of pathogens and a lower Zonulin level, that's good enough for me. Look up the research on lipopolysaccharides getting into the blood and it is frightening.
??? If you have internalized pathogens-- that's an infection. The damage done is to disrupt the integrity of the gut ("It leaks.")...Treat the infection, and the gut integrity is restored.

You're actually just describing the mechanics involved in some GI pathogenesis, but presenting it as if it's a disease entity in and of itself...It's like saying mucus causes pneumonia.
 

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Discussion Starter · #8 ·
??? If you have internalized pathogens-- that's an infection. The damage done is to disrupt the integrity of the gut ("It leaks.")...Treat the infection, and the gut integrity is restored.

You're actually just describing the mechanics involved in some GI pathogenesis, but presenting it as if it's a disease entity in and of itself...It's like saying mucus causes pneumonia.
Infection didn't cause the leaky gut, leaky gut caused the infection by letting the pathogen into the blood stream.
 

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Brain Fog?...Doesn't that suggest something when we have to rely on that for a diagnosis?
No. Brain fog is not a medical or scientific term (much less a diagnosis); it is a term often used by individuals to describe how they feel when their thinking is sluggish, fuzzy, and not as sharp as usual. Very subjective. It can be a symptom of a nutrient deficiency, sleep disorder, bacterial overgrowth from overconsumption of sugar, depression, or even a thyroid condition. Other potential causes include eating too much and too often, inactivity, not getting enough sleep, chronic stress, and a poor diet.
 

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Infection didn't cause the leaky gut, leaky gut caused the infection by letting the pathogen into the blood stream.
You don't normally have pathogens in a healthy gut, by definition.
It's not just pathogens, per say. But partially digested food, toxins, various proteins, etc. This stuff leaking out can result in numerous health issues and inflammatory responses.

More from Harvard Medical.
 

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I didn't know the derivation of the term hypochondria-- very interesting-- and very applicable to this subject.

Leaky gut is real...I'm just saying it's an effect, not a cause...We all get bloated, for instance, when we eat certain foods in excess...Bloating is gas (waste product of bacterial metabolism) IN the intestines, not thru the intestines, for instance. An inflamed gut, from infection, autoimmune disease, chemical poison, etc is a gut with altered integrity- unable to keep out the things it normally keeps out....Any proof those things are causing symptoms? Do you get diarrhea because things are leaking in or because they are leaking out?

Publish or perish...and they're running out of things to publish.
 

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Publish or perish...and they're running out of things to publish.
Or...it could be that some believe that there's always more to learn.
 
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