Leaky Gut... Really?

Monday, 25 February 2019

We learn in biology at school that the role of the gastrointestinal tract is associated with the digestion and absorption of nutrients, as well as, the function of elimination of waste products. But, another key function of the intestine is to police the transport of environmental antigens across the gut wall or what is correctly termed – the mucosal barrier.

What the hell are environmental antigens I hear you musing? It is a term for a protein structure be that infectious (viral or bacterial, dietary, chemical or an allergen like pollen or mould.

The structure of the gut wall

The gut (lumen) is lined and protected by a single layer of specialized epithelial cells that are held close to each other by tight junction proteins.

These tight junctions are the gateway between your intestine and your bloodstream, containing your immune system (in this area of the gastrointestinal system, it’s termed the mucosal immune system). As mentioned in the first paragraph these tight junctions and epithelial cells control what is allowed to pass into the bloodstream from your digestive system. They have to maintain the delicate balance between allowing vital nutrients to enter your bloodstream while remaining small enough to prevent environmental toxins / antigens from passing out of your digestive system into the rest of your body.

Intestinal permeability (also referred to as “leaky gut”) then means that the normally tightly knitted cells of the intestines are weakened and don’t hold substance as they should. This allows large compounds, such as proteins from food, bacteria and LPS (the cell membranes of some gut bacteria contain molecules called lipopolysaccharides - LPS and are really provocative to the immune system) entry into our bloodstream. This molecular information should not be in the blood and so the immune system responds. It does this in a variety of ways:

  • Forming immune complexes that can lodge in joints and tissues and cause pain.
  • Producing inflammatory molecules called cytokines that bombard the hypothalamus setting off hormonal / endocrine disruption.
  • Produce antibodies against self-tissue.

The result?

A feed-forward cycle of acute inflammation, permeability, and immune system involvement that results in poor detoxification, hormone disruption and chronic inflammation, which is at the root of most disease.

Some of the underlying causes of Intestinal permeability include:

Defeciencies in vitamin  A and / or  D

Vitamin A & D are crucial to a very sophisticated bi-directional mechanism that takes place in the digestive system and leads to immune tolerance across the entire gut lining and protects the mucosal barrier. (https://www.ncbi.nlm.nih.gov/pubmed/24755435)

Brandtzaeg P. ‘ABC’ of mucosal immunology. Nestle Nutr Workshop Ser Pediatr Program. 2009;64:23-38; discussion 38-43, 251-7. Epub 2009 Aug 19

Poor diet

A diet that includes higher levels of added sugar, refined oils and synthetic  food additives is a risk factor for intestinal permeability (https://www.ncbi.nlm.nih.gov/pubmed/30504122)

Gliadin

Commonly know as Gluten, has a peculiar structure: it is unusually rich in the amino acids glutamine and proline. This property renders part of the gluten molecule impervious to our protein-chopping machinery, leaving small protein fragments, or peptides, intact. For some, this can cause sensitivity and can be a cause of Intestinal Permeability.

Chronic stress

Stress can impact on the developmental trajectory of the intestinal barrier (Smith et al., 2010; Lennon et al., 2013) and has been associated with an increase in gut permeability (Söderholm et al., 2002).

Toxin overload

The worst offenders for causing leaky gut include, antibiotics, aspirin, NSAIDs and alcohol (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2614138/)

Gut microbiome imbalance or poor diversity

Also called dysbiosis, which means an imbalance between beneficial and harmful species of bacteria in your gut. A large body of evidence now shows that gut microbiota is important in supporting the epithelial barrier and preventing autoimmune reactions.

How do I approach repairing and preventing Intestinal Permeability?

  1. REMOVE foods and factors that can damage the epithelial barrier: limit alcohol, avoid using NSAIDs like sweeties, eat real foods – not packet and promises foods and get your Vitamin D levels checked.
  2. REPLACE these with nutrient dense foods such as: those with omega – 3 fatty acids like salmon and other wild-caught fish, vitamin A foods (mackerel, salmon and butter).
  3. REBALANCE your microbiome with prebiotic type foods, fibres and polyphenols that will naturally encourage the proliferation of bacterial species that both produce antimicrobial peptides and those that produce short-chain fatty acids – which are fuel for the gut barrier.

Prebiotic Rich Foods (FOS and GOS):

Prebiotic type foods are those rich in fructooligosaccharides (FOS) and galacto oligosaccharides (FOS):

  • FOS foods: Jerusalem artichokes, tubers, chicory roots, garlic, onions, leeks, asparagus, globe artichokes
  • GOS foods: Legumes, brassica family vegetables, beetroot, rye and sourdough
  • Prebiotic foods like almonds, blackcurrants, brown rice and carrots

Polyphenol rich foods and drinks

  • Fruits: Black elderberries, blackcurrants, blueberries, cherries, strawberries, blackberries, plums, raspberries, red apples and black grapes
  • Nuts and Seeds: Flaxseed, chestnuts, hazelnuts, pecans,
  • Vegetables: Purple, red and orange carrots, Purple and red potatoes, Red cabbage, spinach, red onions, broccoli, red lettuce
  • Grains:Red rice, black rice, red and black quinoa, whole grains, Rye bread (sourdough)
  • Other: Black olives, cacao and olive oil

Finally there are some Nutraceuticals you can use

1. Probiotics

These strains have consistently positive research to support their use in intestinal permeability.

Lactobacillus rhamnosus GG in the brand Cultrelle

Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19, Lactococcus lactis W58 all of which are in the product  Biome Barrier.

2. Digestive Enzymes

Take one or two capsules of digestive enyzmes supplements before your meal. Enzymes help completely break down proteins, complex sugars and starches, which can, in turn, reduce intestinal inflammation.

I would recommend a full spectrum enzyme supplement that contains the following:

  • Protease — breaks down proteins (including gluten)
  • Amylase — breaks down starches
  • Lipase — breaks down fats
  • Lactase — breaks down lactose in dairy

I like the product Digestzyme by Designs for Health, this product contains the special protease DPP IV (dipeptidyl peptidase IV), which aids in the breakdown of gluten and casomorphin (from casein). Digestzymes™ also includes the enzyme lactase, which helps break down the dairy sugar lactose and lipase for fat breakdown too.

3. Licorice

Licorice can also help support the body’s natural processes for maintaining the mucosal lining of the stomach and duodenum.

Licorice contains glycyrrhizin, which has been known to cause edema and hypertension when taken in very large quantities, however most licorice root or gut formulated supplements only contain between 500 milligrams – 1 gram per dose.

I like this product PeptEase which also contain Zinc Carnosine

4. Zinc Carnosine

Zinc-carnosine helps stabilize the gut mucosa and to stimulate healing and repair in the GI tract. In humans, zinc-carnosine has also been shown to protect the gut from damage caused by non-steroidal anti-inflammatory drugs.

5. Collagen Powder

Collagen also contains the amino acids proline and glycine which are essential building blocks to repairing damaged intestinal lining. Taking 2 tablespoons of collagen protein twice daily is helpful

6. L-Glutamine

An essential amino acid, Glutamine is used as fuel by the cells that line the intestines to keep them healthy — and can help repair leaky gut, in particular.

N-acetyl glucosamine can help protect the lining of your stomach and intestines and marshmallow root acts as a natural antihistamine

Both of these are often combined with L-glutamine in combination formulas such as:

Inflama-GI™ Powder By Innate Response

GI Repair Powder By Vital Nutrients

GI Revive By Designs for Health

In health, Tanya x