As mentioned in The American Chiropractor
Leaky Gut Article
by Dr. Lynn Toohey
The nutritional connection to “Leaky Gut”
The gut can develop “leaks”:
In 1997, Newsweek published an article called “Gut Reactions”, in which they reported that tiny leaks in the lining of small intestine might play a role in diseases as diverse as asthma and arthritis.1 This was one of the first times that the concept of “Leaky Gut” had permeated the mainstream literature. Although it is a phrase that conjures up visions of the intestinal lining with holes in it similar to a busted hose, the focus on the health of that lining has brought about a new awareness of one of the oldest immune weapons we have - our own gut lining! The lining of our intestine is meant not only to absorb food, but also to act as a barrier to keep out invading pathogens. The mucosal layer of a healthy gut filters out micro-organisms and undigested proteins. When things like aspirin, bacteria, or even the pesticides sprayed on our food batter this lining, the lining loses its integrity. This is when the door is open to let in the bacteria, the viruses, and the parasites - (even undigested food molecules) which can activate the immune system (and also the autoimmune system). We refer to this loss of integrity as “the leaky gut syndrome”.
When the gut lining loses its strength and becomes “leaky”, it opens the door to disease. Various toxins can make their way through the barrier of the intestinal lining when it is permeable and then travel to the liver to be detoxified. When the detoxification processes of the liver are impeded, toxins accumulate, and it results in manifestation of disease, depending on where the toxins exert their effect. The toxins can recirculate or deposit in various places in the body. Either way, they will upset the apple cart of balance. The toxins can even recirculate to the intestinal area where they increase the permeability of the intestinal lining even more. The relation to toxic overload on the liver and leaky gut is cyclical: A leaky gut will allow more toxins to enter the system, and, conversely, toxic overload of the liver increases leaky gut.
We are exposed to an amazing load of toxins in our everyday encounters, from environmental poisons to metabolic wastes that are not efficiently eliminated. As we are exposed to more and more toxic insults, we are losing the ability to ward off disease-causing agents. The body has no recourse but to malfunction and lose cell-to-cell communication. Zane Gard remarked that, “Although the human mechanism is known to be an accommodating species, ecological alterations are now occurring at a faster rate than our bodies are able to adapt. There is perhaps no single contributing factor, which has accelerated these environmental transformations more than that of our current widespread uses of harmful chemical substances”2.
The gastrointestinal lining is supposed to absorb our nutrients, and at the same time act as a barrier to toxins. Aside from the physical barrier to invading pathogens, the GI lining makes up a major part of our immune system. The word “GALT” refers to Gut-associated lymphoid tissue”, which actually contributes to the body’s defence against attack. The gut lining furnishes secretory IgA (antibodies) and white blood cells to attack foreign invaders before an attack can become systemic. Some of the things, which can disrupt that barrier, however, include:
· bacteria, virus, parasites
· NSAIDS (non-steroidal anti-inflammatory drugs like aspirin and ibuprofen), alcohol
· free radicals
· endotoxins, environmental toxins, cytotoxic drugs
· inflammation (i.e. lectin binding or food allergy reactions)
The inflammation that is caused by food allergies can increase the permeability of the intestinal lining even further. The process of food allergens being absorbed from gastrointestinal tract and initiating an immunological reaction is described in Gastroenterology by Walker & Isselbacher.3 Even in people who do not have excessive permeability, we know that the low grade absorption of undegraded protein into the blood occurs regularly in healthy adults, varying from 2% upward depending on the degree of “leakiness” of their gut.4
When we stop to consider the damage that can be done by a leaky gut, it’s not surprising that many diseases are associated with leaky gut. These diseases include: Celiac disease, food allergy, asthma, eczema, dermatitis herpetiformis, psoriasis, arthritis, irritable bowel syndrome, inflammatory bowel disease, chronic fatigue syndrome, pancreatic insufficiency, environmental illness, multiple chemical sensitivity, and various others. Even when the leaky gut does not directly cause the disease, the resulting leakiness exacerbates the disease. Symptoms of leaky gut can include: fatigue, arthralgia, myalgia, fever, abdominal discomfort, diarrhea, skin rashes, toxic feelings, memory deficit, and shortness of breath, among others. Undigested food proteins, which leak through the lining cause food allergies and other problems to occur.
Food and the Leaky Gut:
One of the first line nutritional defences to prevent the absorption of these large “macromolecules” of undigested food by supplementing hydrochloric acid, which uncoils protein and starts the digestive breakdown, and also by supplementing pancreatic enzymes, which continue the breakdown process. When the immune barrier is healthy, the brush border at the very surface of the lining secretes brush border enzymes which take the small proteins that have been broken down by pancreatic enzymes, and breaks them into individual amino acids. When people have protein-digestive problems even when they are on enzyme supplements, look to the integrity of the brush border that should be breaking down any remaining proteins to single amino acids. Single amino acids will NOT cause a reaction – it is protein structures, which activate the immune system! Later in this article we discuss nutrients that build a healthy intestinal lining and brush border.
The Leaky Gut and autoimmune disease:
The leaky gut and food proteins are also highly implicated in autoimmune diseases. Some people have more of a genetic tendency than others to activate normal resting T cells, which then attack cells. These cells are supposed to be foreign invaders, but sometimes T cells are activated against the body’s own tissues, as in autoimmune disease. J. Hoofar implicated the leaky gut and undigested food proteins in this T cell attack when he said, “It is thought that some dietary proteins escape the enzymatic digestion in the gastrointestinal tract and could possibly launch a polyclonal activation of the resting T lymphocytes in susceptible individuals”5
It has been said that, “The immunological mechanisms of rheumatoid arthritis probably begin when antigens cross an excessively permeable intestinal mucosa.6 In 2000, the author of this article published an article in the British Journal of Nutrition relating food proteins to the etiology of rheumatoid arthritis.7 In the next issue of American Chiropractor, we’ll discuss the close connection of food proteins with this particular autoimmune disease.
Diabetes is another autoimmune disease closely connected to the food proteins that can leak through a weak intestinal lining and initiate disease. A prominent researcher in the field of diabetes, F.W. Scott linked the leaky gut to type I diabetes and proposed it as a possible trigger in development of the disease. He said that post-weaning time is a crucial time, because the intestinal barrier is not yet strengthened, and proteins can pass through the gastrointestinal barrier and initiate the process of destruction of the beta cells in the pancreas.8 It is important to keep in mind that this is not the only trigger for diseases such as diabetes, however it may be an important one. One of the proteins leaking through the gut barrier to initiate diabetes is suspected to be the beta casein protein in cow’s milk. Antibodies to the milk protein are thought to cross react with pancreas beta cell proteins in the body and destroy them.9
Fortunately, there are positive solutions for protecting the immune barrier of the gut. Several nutrients help to maintain and fortify the integrity of the intestinal lining, including:
Glutamine is the main fuel that the intestinal cells need for maintenance and repair. Glutamine reinforces the immune system, and there is considerable evidence that glutamine can enhance the barrier function of the gut against viral, bacterial, and food antigen invaders.10
Lactobacillus bifidus is a name for friendly bacteria, which offset populations of bad bacteria, boosting the immune system. Friendly bacteria especially counteract candida, which can spread long mycelial arms right through the intestinal lining and perforate it, increasing leaky gut and permitting wide-open entry to micro-organisms and toxins.
NAG (N-acetyl glucosamine), aside from being able to heal the extracellular tissue surrounding intestinal cells, has the unique ability to decrease the binding of some lectins to the intestinal lining, which can cause inflammation. NAG is one of the few nutrients with the power to bind to the powerful wheat germ agglutinin (WGA) lectin, which can activate T cells and influence autoimmunity in susceptible people.
C and E, lipoic acid, zinc and ginkgo biloba are all antioxidants which
can protect the lining from free radical damage. Ginkgo biloba
also increases circulation in the smaller vessels and capillaries, which
increases nutrient delivery and tissue healing. The
DGL (deglycyrrhizinated licorice) increases the integrity of the mucosal cells - it increases the life span of the intestinal cells, improves the quality of protective substances, and improves blood supply of nutrients.12 Additionally, it has a high healing rate and significantly low relapse rate for ulcers.13
Slippery elm is a soothing, protective demulcent renowned for its beneficial effects on the gastrointestinal lining. Slippery elm calms the inflamed mucous membranes of the stomach.14 In addition to a soothing texture that coats the stomach lining, slippery elm contains the fiber-rich ingredient mucilage which stimulates mucus secretion (especially protective against ulcers).
Cat’s claw is a novel herb that has been researched for its, “remarkable ability to cleanse the entire intestinal tract and help those suffering from different stomach and bowel disorders”, including Crohn’s disease, gastritis, ulcers, parasites, candidiasis, diverticulitis, hemorrhoids, leaky gut, and intestinal flora imbalance.15
TOTAL LEAKY GUT By Nutri-West
(Researched by and formulated for Dr. John Brimhall)
Each tablet supplies: L-Glutamine 150mg, N-Acetyl Glucosamine 75mg, Buffered Vitamin C (Sago Palm) 25mg, Vitamin E Succinate (natural) 10 i.u., Lipoic acid 2mg, Cats Claw 15mg, Gingko Biloba Herb 50mg, Deglycyrrhizinated Licorice Root 50mg, Jerusalem Artichoke 25mg, Slippery Elm 100mg, Zinc Chelate 5mg, Lactobacillus Acidophilus 1 million units, Lactobacillus Bifidus 1 million units.
Recommendation 1 to 2 tablets, 3 x day or as directed.
All of the above nutrients work to support a healthy, strong intestinal wall that not only helps digest our food, but also boosts our immune system and plays an important role in our defence against disease.
2 Gard, Zane R et al., Explore for the Professional. 1995;6(4):39-45.
3 Gastroenterology 1974;67:531-50).
4 Husby S. et al. Scand J Immunol 1985;22:83-92.
5 Hoorfar J et al., Diabetes Research. 1992;-41, p. 38.
6 Carli P et al. Presse Med 1995;24:606-610.
7 Cordain, L., Toohey, L., Smith M.J., Hickey M.S. Modulation of Immune Function by Dietary Lectins/Proteins in Rheumatoid Arthritis. British Journal of Nutrition April 2000;83:207-217.
8 Scott FW et al. Diabetes Res, 1988;7:153-157.
9 Cavallo et al. The Lancet 1996;348:926-928.
10 Hall JC et al. Br J Surg 1996 Mar;83(3):305-312.
12 Glick L. Lancet ii:817, 1982.
13 Kassir ZA Irish Med J 78:153-56, 1985; Irish Med J 1985;78:153-156.
14 Balch JF Presc for Nutr Healing 1990, Garden City, NY.