Now that we understand exactly WHAT leaky gut is and how it affects so many of us, it’s important to be proactive and learn about how to heal it. Many functional medicine doctors use the model of “4R” to treat leaky gut. I personally have followed this protocol, and found that IMMENSE healing has taken place as a result of it. Foods I never thought I would be able to tolerate again (dairy, eggs) have made their way back into my life thanks in part to this protocol. I suggest looking for a great Functional Medicine doctor near you, who will be familiar with this protocol. You can always look into it yourself and present research and ideas to your regular doctor.
REMOVE // all offending substances, allergens, toxins, and chemicals
This, especially, means identifying food allergies. Most people with leaky gut have developed food allergies, and you cannot know how they are truly affecting you until you remove the foods completely from your diet for a period and then reintroduce them. I suggest following a therapeutic Elimination Diet such as AIP- common food sensitivities are dairy, eggs, grains, beans, nightshades (potatoes, eggplants, peppers, nut and seed based spices), cacao, yeast, sugar, nuts, and seeds. Once the gut has healed, it is usually able to tolerate many of these foods again! Blood tests like the ELISA can also help identify reactivity to certain foods- I, for example, had over 30 food allergies like eggs, cranberries, beef, pineapple, green beans, etc that the test helped me to identify. I’ve since been able to reintroduce them with success after treating with this protocol. I have also had great success with NAET a form of acupuncture that treats food and environmental allergies. Stay tuned for a post on my website about this soon.
It is important to identify any issues like mold toxicity, gas leaks, heavy metal toxicity, undiagnosed infections etc. Equally important is removing and treating any intestinal parasites, dysbiosis, candida overgrowth, or SIBO (small intestinal bacterial overgrowth) that may be present. Your doctor can order stool, blood and breath tests to identify if these are an issue for you. I love the GI Effects panel by Genova labs, which also measures your microbiome content and enzymatic breakdown efficiency in addition to parasite testing.
REPLACE // cofactors and nutrients that are missing or insufficient in the digestive process
Your body produces many substances in order to digest your food- hydrochloric acid and pepsin in the stomach to “denature” or break down proteins, digestive enzymes in the pancreas to break down carbohydrates, fats, and proteins, and bile from the liver/gallbladder to emulsify fats. If there are insufficient amounts of any of these substances, the digestive process will be compromised and result in even more undigested food particles passing into the bloodstream.Supplementing with enzymes, HcL, and sometimes even bile supplements if necessary can lessen the burden on your digestive system, allowing it time to heal and regenerate its production and supplies of these essential cofactors. I take 2 digestive enzymes with every meal, and HcL with protein containing meals. Many, many people are deficient in hydrochloric acid. As we age, we naturally start producing less hydrochloric acid, so adults over 50 in particular can benefit from HCL supplementation. Vegans and vegetarians in particular have a predisposition to low HCL levels from not consuming animal products that stimulate its production.
If you do not have a gallbladder, ox bile supplements in particular are super helpful. Other herbal remedies include Apple Cider Vinegar, digestive bitters, and chewing fennel seeds half an hour before and after meals to stimulate enzyme secretion. Ask your doctor if they think these could be of benefit to you!
- Thorne HcL + Pepsin - Start with 1 capsule in the middle of a protein-containing meal. Continue adding 1 capsule until you feel acidic or a slight acid-reflux feeling, then go back to the previous dose and use as needed when eating proteins. Slowly taper down as your body begins producing more.
- E3 Live Digestive Enzymes- 2 with meals, especially with difficult to digest foods.
- Ox Bile Extract / Beet Flow as directed, if bile production is compromised.
REINOCULATE // the digestive system with beneficial bacteria.
We are now hearing a lot about probiotics and “good bacteria”. This is what is known as your microbiome- and most of it should exist in your colon (large intestine). When we take antibiotics, they aren’t able to discern between good and bad bacteria- and oftentimes kill off huge amounts of the beneficial bacteria that we need in order to be healthy. Replacing these bacteria can drastically help improve our immune systems, our ability to digest foods, and even our mood. They are absolutely essential to good health. Consuming fermented, naturally probiotic-rich foods like sauerkraut, yogurt, kombucha, and kim chee- as well as probiotic supplements- can start restoring the variety and strength of our individual microbiomes. However, some people’s bacterial balance is so out of whack that probiotics can actually worsen symptoms- its important to choose the right kind and the right dosage. Talking to a qualified nutritionist or functional medicine doctor can help you determine the best kind for you. It’s always best to start small and work your way up as adding probiotics can drastically alter the gut flora.
- Soil Based Organisms - Germ-phobia has resulted in us over-sanitizing everything we come in contact with, especially our food. Healthy soil also has ample amounts of healthy bacteria- Prescript Assist is a fantastic product that I highly recommend to introduce harder-to-find strains of beneficial bugs from the soil.
- Saccharomyces Boulardii - A beneficial yeast that lives in the colon, Saccharomyces strains are effective at reducing the more pathogenic yeast Candida Albicans and can greatly benefit gut health.
- Probiotic blends, without fillers, that contain strains like L. Bulgaris, L. Paracasei, Lactobacillus, Acidopholous. Refrigerated blends tend to be more potent. The more billion, the merrier! There is a great brand called VSL3, but it has cornstarch so anyone sensitive to corn should avoid that product.
- Prebiotics are types of insoluble fiber that feed the beneficial bacteria you already have, allowing them to proliferate. Amazing prebiotic foods include artichoke, asparagus, chicory, bananas, leeks, tigernuts, garlic and onions as well as potato starch and boiled and cooled potatoes and rice.
REPAIR // any damage to the digestive tract
Our small intestine is made up of a close-knit lining of cells and villi which protect us from foreign invaders and assimilate the nutrients from our food. In Leaky Gut and conditions like Celiac, Crohn’s, and Inflammatory Bowel Disease especially, these junctures and fibers can become damaged, porous, and spacious. It is important to help restore their integrity. There are a number of nutrients, supplements, herbs and natural medicine compounds that can assist in healing the digestive tract. These include :
- Bone Broth & Gelatin - broth from pasture raised animals is one of the most healing foods we can consume. It provides ample amounts of minerals and draws out the marrow from the bones. Bone broth is rich in bioavailable protein- AKA complete amino acids, including glycogen and glycine. These form COLLAGEN- the protein that makes up all of our connective tissue, fascia, muscles, and joints. Consuming bone broth is an incredible way to boost and even repair damaged tissues- particularly those in the gut. It assists in healing a myriad of ailments including leaky gut/ intestinal permeability, candida, SIBO, calming autoimmune flares, mineral deficiencies, thyroid challenges, and any type of immune crisis. Additionally, grass fed gelatin such as Great Lakes brand can be used to make “jell-o” snacks, thrown into smoothies or as an egg replacer for an extra boost of gelatin.
- Thorne L Glutamine - An amino acid that is used as the preferred form of fuel for the GALT (gut associated lymphatic tissue)- it can greatly help in repairing and sealing the gut lining.(link to http://wellnessmama.com/24522/l-glutamine-for-leaky-gut/). I like 5 grams, 2x a day in water. Be sure to consume it immediately as it degrades rapidly in liquid.
- MSM powder : an amazing source of sulphur, which is used by the body for phase 2 liver detoxification. It has also been shown to reduce arthritis and joint pain.
- Marshmallow Root & Slippery Elm- naturally mucilaginous, these herbs help soothe and repair the gut mucosa. I love to steep a tea with them and drink regularly.
- Colostrum: The first milk that is excreted by a mother cow after giving birth, colostrum is rich in immunoglobulins that promote strong immune function and prevent infection. It has been researched for its incredible ability to help patch holes in damaged gut lining, prevent inflammation, and heal the gut overall. Generally even people who are allergic to dairy can tolerate colostrum. Choose a grass-fed, organic source.
- Zinc: one of the body’s most important minerals, Zinc is a powerful anti-inflammatory and can help tighten up the intestinal junctions. Sprouted pumpkin seeds and oysters are potent food sources of Zinc.
OTHER THERAPEUTIC SUPPLEMENTS //
Speak to your doctor and see if these supplements fit into a customized healing plan for you. Some of the below supplements are amazing additions to a therapeutic diet for healing leaky gut!
- Selenium - 200mcg, once a day. Selenium is a powerhouse antioxidant, and is especially important for anyone dealing with the oxidative damage from an autoimmune disease. People with autoimmune and thyroid conditions will especially benefit from selenium supplementation! Brazil nuts and seafood are the two richest food sources.
- Glutathione - Known as the “master” antioxidant, glutathione is essential for phase 2 detoxification in the liver, where it helps to convert toxins from fat soluble to water soluble so that they can be safely excreted from the body. Liposomal glutathione is the most absorbable form, behind IV glutathione injections. Bulletproof makes a great one.
- Aloe Vera - a mucilaginous food like Marshmallow, aloe vera can soothe and calm an inflamed gut and also help with constipation.
- Magnesium - essential for over 300 reactions in the body, and a majority of the population is deficient in it! supplementing with a more bio-available form like Magnesium Glycinate can help replenish the body’s stores, and is also extremely helpful for digestive motility, aka constipation. Topical magnesium gels and oils are also well-absorbed forms.
- Liver supporting herbs like burdock, milk thistle, and dandelion root strengthen and tonify the liver with their bitter properties, helping promote bile production and detoxification. There is an awesome company called Delicious Obsessions who makes an herbal “coffee” substitute full of liver-supportive herbs that I drink daily blended with coconut oil, cinnamon and hemp seeds.
THERAPEUTIC DIET & LIFESTYLE //
Food is truly medicine. The main focus should be on eating a nutrient-dense, low-sugar therapeutic diet that supplies ample amounts of all of the micronutrients, phytonutrients, antioxidants, minerals, fiber, and vitamins that are crucial for optimal function of the human body. Science supports that the most effective and health-supporting way of achieving optimal wellness is to consume the most digestible, assimilable and bio-available forms of macro and micronutrients. This means ample amounts of raw and cooked vegetables and herbs, small amounts of low sugar fresh fruit, pasture-raised meat and organs from humanely raised animals eating their natural diet and living in their natural habitat, eggs from happy hens, healthy fish and seafood with minimal contaminants, high quality fats & oils, enzyme-activated sprouted nuts & seeds, fermented foods, and small amounts of easily assimilable/ sprouted whole grains and cultured dairy if your constitution supports it. Many find that leaving out eggs, grains, legumes and dairy helps their digestive system to recover. Other people have issues with certain foods like probiotics and fermented foods, and those may need to be left out until the gut has healed more efficiently. I repeat, whatever dietary plan one follows should ultimately revolve around a large and diverse amount of fresh vegetables! Remove trigger foods, whatever they may be for you. Each and every one of us has a unique constitution, and we will each need to find our own individualized path. Just because our personal experience doesn’t resemble another person’s, does not mean it’s not working or valid.
We absolutely cannot neglect our lifestyles in this whole equation. You can eat the cleanest, most nutrient-dense diet under the sun; but if you aren’t managing your stress and changing the lifestyle factors that contributed to leaky gut in the first place, it will surely derail your whole process. Focusing on getting adequate sleep, managing stress, reducing high-impact exercise that damages the gut, and practicing self care are all crucial components to healing. Meditation is an incredible way to calm the mind and the nervous system, allowing your body and mind to return to a more balanced place. Play around, try a few different things, and find a few practices that work for you.
When we look at the body as a bunch of non-cooperative organs and try to tackle them all independently, we are missing the bigger picture: Everything is connected. Contrary to the Western medical model that addresses everything separately, we must come to peace with the fact that our bodily systems work in synergy and not in a vacuum. When the body is no longer viewed as specialized organs and systems independent of each other but rather as one interconnected, holistic being, we can finally begin to heal. As Hippocrates said over 2,000 years ago, “All disease begins in the gut.” When it comes to reclaiming our health, surely healing our digestive system is the first place to start.
Sarah Ballantyne, “The Paleo Approach”
Bauman, E., Friedlander, J. Therapeutic Nutrition. Penngrove, CA: Bauman College, 2012. McGraw Hill,
Murray, Michael, N.D. The Encyclopedia of Healing Foods. New York: Atria Books, 2005.
Murray, Michael, N.D. The Encyclopedia of Nutrtional Supplements. New York: Atria Books, 2005
Kharrazian, Datis. http://thyroidbook.com/podcast-gluten-connection-hashimotos-hypothyroidism/