Plug the leak
The article and protocol are for informational purposes only, and not intended as medical advice. Please read the medical disclaimer below, and consult your physician before taking supplements or acting upon the information presented in this article and protocol.
Leaky gut syndrome, also known as intestinal hyper-permeability, is a growing problem; and many who have it may not realize the cause of their suffering. Leaky gut syndrome can develop at any age, including infancy. (1) Although many people only experience digestive issues, others may experience systemic problems, without noticeable bowel disorders.
Hippocrates, the father of medicine, said, “All disease begins in the gut.” Time and research has proved him correct, and in nothing was his statement more accurate than as it pertains to leaky gut syndrome.
Leaky gut syndrome is hyper-permeability of the small intestine, which leads to both localized and chronic systemic inflammatory changes. Leaky gut syndrome is often associated with autoimmune diseases, which may indeed have their origin in the gut. Usually leaky gut syndrome manifests as food allergies, digestive irritability, and fatigue. It can also present with thyroid disorders, autoimmune diseases, sinus problems, mood and psychological disorders, joint pain, “adrenal fatigue,” and low metabolism.
I was not taught about leaky gut syndrome in medical school, as conventional medicine did not recognize its existence until rather recently. However early in the 1990’s, I started seeing patients suffering from a combination of chronic digestive issues and at least one systemic problem. At first, I was not sure how to manage such patients, but through a bit of trial and error working with patients, using supplementation involving vitamins, minerals, antioxidants, amino acids (such as glutamine), omega-3 fatty acids, and probiotics, as well as making dietary changes and avoiding toxic artificial sweeteners, BPA’s, PCB’s, etc., we were able to achieve quite remarkable improvements with their health. People got their lives back. This is the basis for my protocols below.
As part of a workup of digestive issues, I tested for allergies to 90 different foods; testing their blood for IgG antibody reactions. I would have the patient eliminate those foods that they reacted to strongly with high IgG antibodies, and those that had a mild – moderate reaction to foods they desired, I would have them rotate those foods in and out of their diet, in combination with use of supplements. A muiti-pronged approach changed their health and lives.
When we eat food, our body has multiple steps to ensure optimal absorption of nutrients within the small intestine, which is where all absorption of macronutrients takes place. Salivary enzymes begin the process of breaking down food with chewing. Next, stomach acid helps dissolve food into a slurry, or nutrient soup before passing through to the duodenum, the first part of the small intestine, where a secretion of bile for emulsification of fats and pancreatic digestive enzymes is dumped to continue the breakdown of fats, proteins, and carbohydrates. All these steps prepare food for absorption across the mucous membrane epithelial lining of the small intestine.
The small intestine is a tube about 15 – 20 feet long, which is divided into 3 parts: the duodenum (where bile and pancreatic enzymes enter), the jejunum, and the last section prior to the large intestine, or colon, the ileum. Your food is absorbed in the jejunum and ileum of the small intestine.
To increase absorptive capabilities of the small intestine, the inner lining of the small intestine has many small folds to increase the surface area of the tube. And the whole surface of the folds is covered with small finger-like projections known as villi, which further increase the absorptive surface area of the small intestine. The villi increase the area so dramatically that if the absorptive surface area of the small intestine were laid out flat, it would cover the surface of a tennis court.
Each epithelial cell that lines the upper area of the villi have microvilli that appear like brush bristles, which act as a net to catch nutrients from the “soup,” or bolus of digested food as it passes through the intestinal tube (lumen). Digested food particles, macronutrients and micronutrients, also fall into the valleys between the villi.
The epithelial cells lining the bottom half of the villi do not have microvilli because the nutrient soup naturally moves more slowly than near the top where the “current” is. The increased contact time of the nutrients with the cells allows effective absorption of macro and micro-nutrients. The nutrients are transported into and through the cells, into the veins of each villi. Once the nutrients enter the veins, they are carried in the bloodstream straight to the liver for processing.
To form a line of defense against partially digested food, bacteria, and toxic substances, the epithelial cells are tightly connected through a series of dynamic proteins that form what is called “the tight junction” near the luminal surface, and the “adherens junction,” lower down the cell, near the interstitial tissue of the intestinal wall and bloodstream.
Tight junctions are not a static barrier. They are dynamic, and are responsive to signals to allow entry to whatever may be needed. One’s dietary state, signals through the blood or nervous system, inflammatory modulators, and a variety of cellular bio-chemical pathways influence the opening and closing of the tight junctions. Unfortunately, bacteria and viruses are able to usurp these mechanisms to access the interstitial area below the epithelial cells and, move into the bloodstream, and cause disease. (2– 4)
Leaky gut syndrome is a case in which the tight junctions between cells lose their integrity. The proteins of the junction break down, and/or the regulatory mechanism of the proteins forming the junctions are dysfunctional, and open up. The gap creates a channel by which bacteria, toxins, and undigested food particles gain access below the barrier. This triggers an inflammatory immune response, which worsens the hyper-permeability of the intestines, and spreads throughout the body. (5, 6)
The immune system’s white blood cells, including macrophages, dendritic cells, neutrophils, etc., reside just beneath the epithelial cells, with “tentacles” reaching up into the lumen of the small intestine. Under normal circumstances, these defense mechanisms that reside just on the other side of the epithelial cells are able to capture the few microbes and toxins that might slip through the tight junctions or cause damage in other ways. The tight junctions and the immune system prevent foreign invaders from causing disease and damage by their entering the body.
Beta glucans are polysaccharide fiber micronutrients derived from the cell membranes of the Reishi and Shiitake mushrooms and from baker’s yeast extract. Beta glucans have been used for years in Chinese medicine as immune modulators and cancer fighters.
White blood cells, such as macrophages and natural killer cells, have beta glucan receptors, and when stimulated by beta glucans (shown as small chains of blue balls in image below), the cells are activated to actively and precisely attack and eliminate foreign microbes (bacteria, yeast, fungi, and viruses), as well as cancer cells.
Beta glucans are immune modulators; that is they cause the immune system to mount an active response against foreign microbes and abnormal cells, without triggering an over-reaction that could cause excessive tissue damage. This is why beta glucans are an important part of the Leaky Gut Syndrome supplement protocol.
The gut is intricately involved with the immune system and brain. As it is in the gut, so goes the rest of the body. Good intestinal health is important for a healthy immune system, metabolism, thinking, and mood. Excessive inflammation in the intestinal lining leads to disseminated inflammation throughout the body’s tissues and organs.
Genetic defects in at least one protein type of the tight junction between intestinal epithelial cells have been identified, which appear to be one cause of hyper-permeability. (7) The protein is susceptible to oxidative alterations, or changes in its 3-dimensional configuration, by oxidative stress.
Oxidation of molecules involves the stripping away of electrons. Molecules, such as proteins, are held in their unique 3-dimensional configuration by electronic charges. The stripping away of electrons changes the charge, which changes the 3-dimensional shape of the protein, which alters the function.
The genetic defect in one particular type of tight junction protein thus leads to:
Hyper-permeability of the gut is associated with many autoimmune disorders. Often hyper-permeability of the intestines is the first finding in the pathogenesis of several autoimmune problems, such as thyroid disorders and psoriatic arthritis. (7)
The microbiome of the gut can be considered another organ of the body. With nearly 3 pounds, numbering in the 50 – 100 trillion range, the diverse species of bacteria is considered the rain forest of the body. There is an intricate balance of friendly bacteria that we have a symbiotic relationship with in order to maintain a healthy digestive tract and proper digestion.
The microbiome plays a much larger role than just assisting digestion. It is a key component in maintaining a healthy immune system, producing serotonin for mood enhancement, and even helping to maintain healthy skin.
Antibiotics, eating unhealthy foods, stress, lack of sleep, coffee, alcohol, lack of hormones, and many other factors can alter the balance of bacteria in the bowel.
In leaky gut syndrome, the bacteria are not only unbalanced, but they make their way beneath the hyper-permeable epithelial layer, and trigger inflammation. Improving the intestinal microbiome by supplementing with probiotics is a critical component for the treatment and management of leaky gut syndrome. (26)
In my protocol, I recommend probiotic strains which scientific studies have backed as the two most important strains to replace in order to establish a foundation for growth of numerous other bacterial strains, Lactobacillus rhamnosus LGG and Bifidobacterium BB-12.
Numerous probiotic strains are available, many of which have very little-to-no clinical data regarding their benefit or physiological activity. These two strains have numerous human trials to prove viability and benefit in humans. They are designed for long shelf-life, and importantly, for withstanding the harsh acidic environment of the stomach so they can pass into the intestines intact, where they multiply and create a healthy environment for the microbiome to flourish.
Probiotics help heal the hyper-permeable intestinal lining, which reduces inflammation and immune activation. (15)
Genetic factors combined with environmental insults from toxic food, bad air, polluted water, certain medications, bacteria, and viruses, causes inflammation, and can lead to many chronic disorders of the bowel. Proper nutritional supplementation, combined with a good diet, avoidance of toxic sweeteners (aspartame, etc.), BPAs, PCBs, phthalates, and foods known to trigger allergies in sensitive people, reduce inflammatory changes both in the intestine and systemically. Healing of the gut, and restoring a healthy intestinal microbiome (good gut bacteria), is the key to restoring health throughout the body. You cannot have an unhealthy gut and expect to have true health.
If you have a serious case of leaky gut syndrome, especially if it involves significant systemic disorders, including autoimmune diseases, then I would highly suggest you and your doctor consider the optimal-dose protocol. There is no harm in following the high-dose protocol even if you have a mild case of leaky gut syndrome.
This is to be used in conjunction with the principles mentioned above in the conclusion of the article above.
The article and protocol are for informational purposes only, and not intended as medical advice. Please read the medical disclaimer below, and consult your physician before taking supplements or acting upon the information presented in this article and protocol.
Protocol for Leaky Gut Syndrome, Ages 3 – 5
Protocol for Leaky Gut Syndrome, Ages 6 – 9
Protocol for Leaky Gut Syndrome, Ages 10 – 12
Protocol for Leaky Gut Syndrome, Ages 13 – 16
Minimal Protocol for Leaky Gut Syndrome
Basic Protocol for Leaky Gut Syndrome
Average Protocol for Leaky Gut Syndrome
Advanced Protocol for Leaky Gut Syndrome
Ingredients that I like to see provided collectively by vitamin-antioxidant & chelated mineral tablets
Vitamin A, mostly as Beta Carotene
Vitamin C
Vitamin D3
Vitamin E
Vitamin K (K1 & K2)
B-Complex Vitamins
Curcumin (turmeric extract)
Quercetin
Green Tea Extract
Olive Extract
Rutin
Resveratrol
Choline
Lutein
Lycopene
N-Acetyl-L-Cysteine (NAC)
Calcium
Magnesium
Iodine (as potassium iodide)
Zinc
Selenium
Copper
Manganese
Chromium
Molybdenum
Including Ultra Trace Minerals
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Information on this website, written, spoken, or in any other communication by Dr. Ladd McNamara or any other information or reference is for informational purposes only. The information is a result of years of practice experience and study by the author. This information is not intended as a substitute for the advice provided by someone’s personal licensed physician or other healthcare professional or any information contained on or in any product label or packaging. Do not use the information on this website, or any other form of communication for diagnosing or treatment of a health issue or disease, or for the prescribing of medication or use of supplementation without discussion with a licensed medical doctor. Always speak with your physician or other healthcare professional before taking any medication or embarking on a nutritional, herbal or homeopathic supplement program, or before using any treatment for a health problem. If you have, or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read or heard on this website, or any other form of communication with Dr. Ladd McNamara or his representatives. Information provided on this website or the V.I.P. Program, and the use of any products or services mentioned on this website (or as a result of information provided this program, article, or website) by you DOES NOT create a doctor-patient relationship between you and Ladd McNamara, M.D. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.
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