LEAKY GUT- Autoimmune Diseases, Inflammation, and the Leaky Gut Connection

By Jack Challem at Natural Grocers

The immune system is as remarkable as it is complex. It is, after all, our body’s 24/7 watchdog. When the immune system functions normally, it distinguishes external foes from friends—mounting a powerful response to infections while allowing nourishing nutrients to enter our bloodstream. But as counter-intuitive as it might seem, the immune system sometimes turns against its host, sort of like a dog biting the hand that feeds it. When the immune system attacks the very body it’s meant to protect, it causes what doctors call autoimmune diseases.

Some autoimmune diseases are common, others less so, and they can affect almost any part of the body. Rheumatoid arthritis, multiple sclerosis, psoriasis, lupus, type-1 diabetes, Sjögren’s (pronounced show-grins) syndrome, scleroderma, pernicious anemia (involving a severe vitamin B12 deficiency), and thyroiditis are among the most common autoimmune diseases.

All of these autoimmune diseases have a strong inflammatory component, the result of the immune system revved up to respond to what it considers a threat. The problem is that a person’s own body is not a threat. But what might cause the immune system to act in such a misguided fashion?

Leaky Gut Syndrome

There’s intriguing evidence that autoimmune disorders may be related, at least in part, to a digestive system damaged by medications and unhealthy foods. This damage can also cascade into highly individualized symptoms that stump many physicians and may be a contributing factor to a great many diseases. The underlying cause may be what some physicians and researchers call “leaky gut syndrome,” also known as intestinal permeability.

To explain, your digestive tract is home to the vast majority of your body’s immune cells. After all, most “foreign” and potentially threatening microorganisms enter the body through the mouth. Our resident gut bacteria support the immune system by countering any disease-causing germs that piggyback on the food we eat.

Ideally, the gut wall functions as a gateway that allows only digested food molecules and nutrients to pass through and into the bloodstream. But this intestinal barrier can be compromised in a variety of ways. Antibiotics are among the worst offenders because they indiscriminately destroy many of the beneficial bacteria that inhabit our digestive tract. 1 Alcohol, caffeine, and many types of processed foods can damage the gut lining as well. 2

In fact, an article in the February 26, 2015 issue of the journal Nature reported that two emulsifying agents (cellulose gum and polysorbate-80), which are commonly used in processed foods, disrupted the normally protective interactions between intestinal bacteria and the gut wall. The result set the stage for inflammatory bowel disease and potentially obesity and metabolic syndrome. 3 And as it turns out, gluten is especially well documented for its role in causing leaky gut syndrome.

The Gut Wall

The wall of the gastrointestinal (GI) tract is lined with highly specialized protein complexes called “tight junctions” (TJs), which serve as a gateway that either enables or blocks the passage of nutrients into the bloodstream. TJs also influence the body’s immune tolerance and response to bacteria, viruses, and foods. For example, a substance called zonulin regulates the permeability of TJs, and some people over-produce zonulin when they consume the protein gliadin, the main culprit in gluten. The over-production of zonulin ends up punching holes in the normally tight barrier created by TJs. 4 5 6 7 8 9

As a consequence, gut-wall permeability increases, allowing large, incompletely digested food molecules to enter the bloodstream. Those incompletely digested food molecules trigger an abnormal immune response, an increase in inflammation, and sometimes a rise in immunoglobulin G (IgG). 10 11 Not surprisingly, IgG levels are often elevated in patients with celiac disease and non-celiac gluten sensitivity. 12

In fact, autoimmune diseases related to leaky gut syndrome may be only part of the problem. For example, the line between immune and autoimmune disorders gets blurred in inflammatory bowel diseases (e.g., Crohn’s disease), allergies, and asthma. All may be related to leaky gut syndrome, because the body’s immune system is misreading cues and reacting abnormally. Compelling research has also linked depression and autistic symptoms to gluten consumption and gut health—and possibly to leaky gut syndrome. 13 14

Dietary and Supplement Recommendations

Healing the gut typically requires dietary improvements and the use of certain supplements. It’s essential to adopt a diet that eliminates gluten (found in wheat, rye, and barley), as well as alcohol, coffee, and processed foods. Loren Cordain, Ph.D., a professor at Colorado State University, Fort Collins, and the leading expert on the Paleo diet, developed the Paleo Autoimmune Protocol (AIP), a stricter version of the diet that eliminates foods that can irritate and damage the intestine. (For more information, google the AIP term.) The diet emphasizes quality proteins, such as fish, chicken, and grass-fed beef, along with ample amounts of high-fiber vegetables. The following supplements can help modulate the immune response and also fine tune healing of the gut wall.

Vitamin D

This vitamin, which is actually a hormone precursor, is an important regulator of immune system activities. Instead of just enhancing the immune system’s response to disease-causing microorganisms, vitamin D actually helps the immune system function “smarter.” In a recent study, Kassandra L. Munger, Sc.D., of Harvard University, and an international team of researchers found that vitamin D influenced the activity of a large number of genes involved in multiple sclerosis (MS), an autoimmune disease that affects 400,000 Americans. Munger’s finding is significant because growing evidence indicates that low vitamin D appears to be related to the risk of developing MS, as well as to its long-term progression. 15

Try: 5,000 IU daily.


A healthy population of gut bacteria is essential for maintaining a normal intestinal barrier. Lactobacillus and Bifidobacteria species are the most popular types of probiotic supplements, and they appear to be “keystone species” that help maintain a supportive environment for other types of healthy gut bacteria. They also appear to have remarkable anti-inflammatory effects. 16 L. rhamnosus may be of particular help in healing the gut barrier, 17 and a particular type of probiotic yeast, Saccharomyces boulardi, also has been found useful in reducing gut inflammation and acute diarrhea. 18 19 A French study found that a multi-species probiotic significantly reduced symptoms of IBS in women.

Try: A probiotic formula containing at least several species of Lactobacillus and Bifidobacteria can support general gut health. 20 For documented gut inflammation (e.g., inflammatory bowel disease), S. boulardi supplements may be of particular benefit.

Digestive enzymes

Our digestive tract and liver secrete a variety of digestive enzymes to break down different types of food molecules, such as proteins, fats, and carbohydrates. Some specific digestive enzyme formulas have anti-inflammatory benefits, possibly because of how they promote gut healing. Highly specialized enzymes, such as dipeptidyl peptidase IV, enhance the breakdown of gluten. Although they won’t protect against the gluten in a slice of pizza, these enzymes might offer protection against occasional exposure to trace amounts of gluten.

Try: For general use, consider a product with several digestive enzymes. Products vary greatly, so follow label directions.


Found in the fluid before breast milk comes in, colostrum contains a variety of immune factors and is involved in normal cell growth and repair, all of which benefits newborns. Lactoferrin, which helps fight bacterial and viral infections, is one of the constituents of colostrum. A study of athletes found that colostrum reduced post-exercise gut permeability by more than 80 percent. 21 Supplements are derived from cow’s milk.

Try: 500 mg daily.


This amino acid was first used to heal stomach ulcers back in 1957. 22 It’s now widely used by nutritionally oriented physicians to heal gut injury, including leaky gut syndrome. L-glutamine is the most abundant amino acid in the body, and its extra nitrogen atom helps the body assemble other amino acids. The benefits of L-glutamine may be enhanced when combined with bovine colostrum. 23

Try: Up to 400 mg four times daily.

N-acetyl glucosamine (NAG)

This little-known natural substance (not to be confused with glucosamine sulfate) also appears helpful in resolving leaky gut syndrome. In one study, researchers described its benefits in treating a condition similar to multiple sclerosis. 24 A second study of 12 children with either Crohn’s disease or ulcerative colitis received 3 to 6 grams of N-acetyl glucosamine daily. Eight of the children improved significantly. 25

Try: 3 to 6 grams daily, depending on the severity of symptoms.

Soluble fiber

This type of dietary fiber supports the growth of beneficial gut bacteria. Together, soluble fiber and gut bacteria can have a potent anti-inflammatory effect. Low-fiber, high-sugar diets deplete anti-inflammatory gut bacteria. 26 27 28

Try: A soluble fiber supplement, following label directions for use.

Herbal remedies

Several herbal extracts have a long history of use in easing gut problems, and they may be of use in healing leaky gut syndrome. Licorice root is a folk remedy for heartburn, and it may provide benefits throughout the digestive tract. The most common supplemental form is called deglycyrrhizinated (DGL) licorice root. DGL licorice has had its glycyrrhizin removed because, in some people, it can increase blood pressure. Another herb, slippery elm, is derived from the inner bark of Ulmus rubra. The extract contains mucilage, which is believed to coat part of the digestive tract. Finally, herbal bitters, taken by the teaspoon, typically contain gentian but they may contain as many as 40 different plants. As the name suggests, bitters are anything but sweet, but do promote better digestion.

Try: Any of these herbs, but follow label directions.


Few natural substances have the broad anti-inflammatory benefits of the omega-3s. The omega-3s are part of the body’s natural pathways for making a variety of powerful anti-inflammatory substances, including prostaglandin E3, resolvins, and protectins. Studies have found the omega-3s helpful in autoimmune diseases, such as MS, as well as in such GI disorders as Crohn’s disease. 29 30 31 32

Try: 1 to 5 grams daily.

It’s not always easy to sift through one’s symptoms, eating habits, and overall lifestyle to establish definitive links between autoimmune diseases (e.g., rheumatoid arthritis, MS, or lupus) or other inflammatory diseases and leaky gut syndrome. Often, an open-minded physician can be helpful.

Whether you’re suffering from an autoimmune disorder or other inflammatory disease—or just want to maintain excellent health—it only makes sense to give your digestive tract a lot of TLC. An integrated approach should focus on three areas: (1) dietary changes, such as avoiding gluten-containing foods or adopting an elimination diet to identify specific food sensitivities; (2) helpful supplements to support gut health; and (3) lifestyle changes, such as good sleep habits and stress reduction, to reduce the damaging effects of cortisol (the key stress hormone) on the digestive tract.



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