Leaky Gut and Weight Gain - Is This Real?
What is leaky gut, do you have it, and is it something you should care about?
Leaky gut this, leaky gut that. If you have spent any time in the wellness space recently, you have undoubtedly heard of the term “leaky gut”. So what’s the deal with leaky gut? Is it real? Do you have it? Can it contribute to weight gain? These are all the questions I am going to answer in today’s post.
What is Leaky Gut?
Leaky gut, more scientifically known as intestinal hyperpermeability, describes a state where the intestines are more permeable than they should be. This means that things that should not be able to get through the gut lining are able sneak through. This can create a handful of downstream consequences.
Let’s think about this a little bit more. Our intestines have a very difficult job. I like to think of the intestine like the border of a medieval village. The border needs to be strong enough to keep all enemy invaders out, but permeable enough to let in all the resources the village needs to thrive. It is the exact same in our gut. We need to let all the nutrients into our bloodstream so that we can stay alive, but we need to keep out bacteria, viruses, and other toxins that will make us sick. In order to achieve this balance, our intestine/wall must be sturdy with healthy functional gates and guards.
As you can see in the illustration above, our gut lining looks a lot like a brick and mortar wall. Each blue gut cell (enterocyte) sits on top of the blood stream and lifts their finger-like projections (villi) into the middle of the intestinal space. These fingers sweep things along and grab onto important nutrients to pull them into the bloodstream. Each gut cell sits shoulder to shoulder so that nothing can pass between without permission.
Leaky gut occurs when the integrity of the gut lining breaks down. This can be for a variety of reasons. As you can see, this creates large gaps between gut cells that larger objects, like viruses and bacteria, can travel through. At the same time, the specialized process for vitamins and nutrients to pass through can be disrupted which can cause malabsorption of important nutrients like iron, zinc, and B12.
What Causes Leaky Gut
Leaky gut is typically caused by four main factors. These are toxin exposures, microbiome imbalance, dietary factors, or stress.
Toxins
We must remember that the inside of our intestines is still the outside of our body. Our digestive tract begins in our mouth and continues all the way to our anus. Therefore, any substance that we swallow will pass along the inside of our digestive tract and eventually along our gut lining in the small intestine.
Certain molecules cause a disruption to the gut lining which can result in leaky gut. Such toxins include pesticides, medications (particularly NSAIDs), alcohol, and food additives. I’m sure I could fill this list in further with more and more scary-sounding chemicals, but the point is that there are molecules we are regularly exposed to that can disrupt the gut lining.
Diet
The main job of the intestinal lining is to assimilate the nutrients in our food into our bloodstream. Remember, we are 100% made from the food that we consume. This includes our gut cells. If we do not have a high-quality diet, it is possible that we do not have enough nutrition to support a healthy gut lining.
Such nutrients include Vitamins A, D, C, B-vitamins, polyphenols, glutamine, fiber, and omega-3. Without adequate levels of these nutrients, our gut lining can become leaky.
Beyond proper nutrition, some people react to certain foods in their diet. These reactions can range from sensitivities to overt allergies. Both are capable of disrupting the gut lining and causing leaky gut. Dairy and gluten are some of the most likely culprits for food antigen-induced leaky gut.
Microbiome
Just like leaky gut, the microbiome has also gotten a lot of press lately. The microbiome plays an incredibly important role in systemic health, but also directly on gut permeability. A healthy microbiome controls levels of pathogenic (infectious) bacteria and viruses in the intestines and helps to coat the gut lining in a protective layer of mucus. If the microbiome becomes compromised, leaky gut will occur.
Various factors can cause the microbiome to become dysfunctional (dysbiotic). Dysbiosis can be caused by antibiotics, poor diet, stress, constipation, a sedentary lifestyle, or alcohol.
Stress
Like many other body systems, stress can wreak havoc on gut lining health. Stress molecules cause the mortar (gap junctions) between the gut cells to fall apart and thus create an avenue for invaders to invade through. Stress also activates the immune system which can cause inflammation to the gut cells which breaks down the gut lining — almost like a stress-rash. Lastly, stress disrupts the microbiome and mucus layer within the intestine.
Do You Have Leaky Gut?
Probably….
The truth is we all have leaky gut, on and off. Our intestinal permeability is constantly in flux. Our intestines are more permeable after a meal (makes sense), and even activities like exercise can cause gut leakiness. The issue is when our gut is chronically leaky. This is when leaky gut becomes an issue.
The problem is that there is no FDA-approved method to test for leaky gut. You can measure zonulin levels on stool tests, look for certain antibodies in the blood, do certain food challenges, etc. These tests may or may not diagnose leaky gut. As it stands, there is not enough evidence to show that these tests results mean much.
Instead of lab testing, it is more important to look towards clinical symptoms to see if gut leakiness is an issue.
Oh, wait. That’s the other issue… Leaky gut can cause a plethora of vague, non-specific symptoms:
Brain fog
Eczema
Allergies
Weight gain
GI discomfort
Autoimmune disease
Hormone imbalance
Anxiety
Fatigue
Since the symptoms are vague, testing is not validated, and pathology exists on a spectrum, I like to assume that everyone has a degree of leaky gut. Therefore, leaky gut is something we should all be working on.
Does Leaky Gut Contribute to Weight Gain?
It absolutely does. While calories are still king when it comes to weight gain, leaky gut can make it really difficult to lose unwanted weight.
When leaky gut is present, bacterial fragments (endotoxins) escape into the bloodstream and cause damage to our fat cells (adipocytes). This causes chronic, low-grade inflammation that promotes insulin resistance, fat storage, and general weight gain. This is likely a vicious cycle that further causes a worsening in leaky gut.
How Can You Treat Leaky Gut?
Treating leaky gut is a lifelong endeavor as I stated previously. However, I still like to break treatment down into two stages: acute and long-term.
Acute Treatment
If I suspect leaky gut is actively and significantly contributing towards symptoms one of my patients is experiencing, I will opt for an acute treatment plan.
Toxins: During the acute phase, I emphasize the removal or avoidance of all major toxins. This means no alcohol, removal of unnecessary medications (this MUST be a conversation with the prescribing doctor), organic food, simplification of personal care products, removal of certain fragrances, and a whole foods diet.
Diet: During the acute phase I often remove gluten and dairy to promote rapid healing. I also guide my patients through an anti-inflammatory diet since inflammation plays a large role in leaky gut.
I also will supplement with certain nutrients I suspect to be deficient. These often include glutamine, omega-3, and certain fat-soluble vitamins (particularly D).
Microbiome: If I suspect dysbiosis, I will order a stool test. I will take action based on the results of this test. I will usually support microbiome health with a probiotic. A spore-based probiotic is safe for most and I will usually start there.
Stress: Stress reduction is key for acute and long-term success in treating leaky gut. In the acute phase I often utilize emotional freedom technique (EFT) as a way to rapidly reduce cortisol spikes throughout the day.
Long-term Treatment
Once acute symptoms have mostly subsided, it’s time to go on the long-term defensive.
Toxins: Let’s be real, toxins are a part of life. We are all swimming in the same toxic soup of the modern world. My general advice here is to buy organic, have air purifiers in your spaces, limit alcohol, and avoid NSAIDs when possible and safe.
Diet: The 80-20 rule comes into play here. That is, if you consume an 80% healthy, whole foods diet, you are likely in the clear. The other 20% can be more processed and unhealthy. Food is more than just nutrition and we have to make space for living life.
Microbiome: Maintaining good gut health requires a diet rich in fiber, phytonutrients, fermented foods, and prebiotic carbs. There is a lot of information on the internet about gut-friendly diets.
Stress: Long-term stress management is paramount for living in the 21st century. Whether this is a daily yoga practice, meditation, journaling, therapy, medication, or massage, it is essential. You should add self-care into your budget and take it seriously. If your life is burdened with stress, it will be difficult to move past most health obstacles.
Supplements for Leaky Gut
Supplements are very useful for the acute treatment of leaky gut. As always, talk with your medical team before adding any supplements to your regimen as not all supplements are safe for everybody.
L-Glutamine
L-glutamine is an amino acid that our gut cells rely on for energy production. Under stress, this amino acid becomes an essential nutrient that we must consume in our diet. Supplementing L-glutamine gives our intestinal cells the energy necessary to rebuild our gut lining.
GI Relief
GI Relief is a combination of demulcent herbs that help to coat the gut lining and rebuild the mucus layer. This soothes the gut lining and provides a fuel source for beneficial microbes to defend against pathogens. Many of these herbs are potently anti-inflammatory as well.
Zinc Carnosine
Zinc carnosine is a potent antioxidant compound that helps with the healing of a leaky gut. This is one of the most widely used supplements for the treatment of leaky gut and is effective at relieving inflammation and aiding in gut lining repair.
MegaSporeBiotic
MegaSporeBiotic is a spore forming probiotic that helps to inoculate the microbiome with healthy species without causing major disturbance. These probiotics can promote optimal gut health and restore microbial balance for optimal gut balance.