Okay, well, I want to welcome everyone. This is Dr. Nik Hedberg, and tonight we’re talking about how to heal leaky gut syndrome. So, let’s get this started.
I really enjoy doing these webinars, trying to get some good information out there to everyone. And leaky gut, it’s a big issue. Its main connections are going to be with autoimmune diseases and a variety of chronic conditions, which we’ll talk about. I’m just going to cover what it is, what causes leaky gut, and then some of the things that you can do about it, and then how we manage it in the practice if it’s there.
Gastrointestinal Hyperpermeability: Leaky Gut
The medical term for leaky gut is gastrointestinal hyperpermeability. It is recognized in conventional medicine, but it’s really not going to be recognized by your average doctor. They kind of look down on it or laugh at it, so to speak, but it is definitely something very real.
So, let’s go ahead and jump right in. Getting to the symptoms, conditions associated, conditions connected with leaky gut syndrome, and as I mentioned, autoimmune diseases are a big one, like Hashimoto’s thyroiditis, Graves’ disease, lupus, Sjögren’s, alopecia, rheumatoid arthritis, et cetera.
A lot of the symptoms you’ll see are fatigue, brain fog. Brain fog is basically inflammation of the brain. Because we don’t have pain receptors in the brain, that’s basically how the body tells us that the brain is inflamed when there’s fogginess. And there’s a really strong connection there between the gut and the brain just in general.
Weight gain, depression and anxiety. There’s a lot of literature out there connecting chronic inflammation and inflammation in the gut and psychological issues like depression and anxiety.
Different digestive problems, like Irritable Bowel Syndrome, Crohn’s disease, all sorts of colitis, and then just general symptoms like gas, bloating, cramping, things like that.
Food allergies, of course. Arthritis and joint pain, migraine headaches, adrenal gland imbalances, and then what we call adrenal fatigue, and then of course asthma and allergies.
The gut barrier is called a mucosal barrier, and if there’s dysfunction there, there’s going to be dysfunction in the other mucosal barriers like the lungs, for example.
What is Leaky Gut?
So, what is leaky gut? What you see here on the left is what we will call a healthy gut lining. These are what we call villi, they’re like fingers, and that’s where all of the absorption occurs in between these gaps. This is also where the immune system is. So the gut barrier protects you from a lot of different things. It protects you from infections like viruses, bacteria, fungi, parasites, it protects you from absorbing undigested protein, and so it’s this mucosal barrier that’s very protective.
Now, leaky gut is when that barrier becomes broken down, and you can see it’s all flat here, all of the villi have been compromised. And so when you have leaky gut, you can also have malabsorption. That might be kind of difficult to understand for some people, but the intestinal barrier is selective, and when the immune system becomes compromised, then it can no longer protect you from the variety of things that we just talked about.
Malabsorption means that the absorptive capacity of the gut barrier is not what it used to be, so people will start to develop nutrient deficiencies and they won’t be able to absorb protein, carbohydrates and fat. So this is a visual of what we call leaky gut.
Now, these are some of the main causes. What you see here in the pink is a diagram of the intestinal barrier. I want to give credit to Dr. Aristo Vojdani, he is an immunologist for this slide, and Dr. Vojdani has spoken extensively on leaky gut.
So these are some of the main things that we see up here. Dietary proteins and peptides, so that’s going to be like gluten, dairy and other allergies; other foods that are highly allergenic; antibodies, and that’s if there’s some kind of infection in the intestine; drugs and xenobiotics, so environmental chemicals, environmental toxins; prescription medications, especially birth control pills. Women who have been on birth control pills for many years, like 5, 10, 15 years, they tend to develop gut issues and leaky gut. You can also throw aspirin in the mix there. There’s a bunch of them that will do that.
I would say the biggest one of all though is stress, as you can see here, physical, emotional stress. Americans, a lot of people are under a tremendous amount of stress, or if they’re not, they create their own stress.
Infections, we’ll talk a little bit about that. Parasites, bacteria, fungus, et cetera. Cytokines are basically mobilized, they go to areas where there’s inflammation, and then neurotransmitters, and then enzymes.
So these are kind of the main causes of leaky gut. We’ll talk about a few of those in more detail.
So these begin to break down the gut barrier. You’re probably all familiar with ulcers. Ulcers occur when the stomach – basically a hole is eaten away in the stomach and someone develops an ulcer. That can happen at a much sort of lower grade further down in the intestine where the gut barrier begins to break down, as you can see here.
So the immune system weakens, permeability increases, meaning almost anything can get in, and then you develop intestinal barrier dysfunction.
The first thing you’ll notice is food allergies and intolerances. You might start having indigestion when you eat certain foods, you might start reacting to foods that you didn’t normally react to, like gluten or dairy or pretty much anything.
70% of the immune system is in the gut, so as the gut barrier breaks down, there’s going to be a significant decline in immune system function. When the immune system just gets stressed and it can no longer really repair the body on a daily basis, you develop autoimmunity. Every day, your body goes through a certain amount of wear and tear, and it’s up to your immune system to repair everything. Autoimmunity occurs when the immune system can no longer keep up with all the daily wear and tear, so the body starts attacking itself. It can happen pretty much to any tissue or organ in the body. Some people will develop autoimmune thyroid disease and the body starts attacking the thyroid, some people will develop lupus and the body may start attacking the kidney, et cetera.
Then further on down the line is the blood/brain barrier, so you start getting brain fog and anxiety, depression, and then what we call neurodegenerative disorders like Alzheimer’s, and then even autoimmunity like multiple sclerosis.
So that’s kind of how it happens and what happens to your body when you start to develop leaky gut.
How to Heal Leaky Gut
Now, let’s talk about what we can do. I’ll just kind of take you step-by-step with what we do. The first thing that we do first and foremost is to identify, and we have the patient avoid food sensitivities. This is an easy blood test, just a finger stick. The blood is dropped on to a card, and 96 foods are tested for immune system reactivity. This way we know exactly what the immune system is reacting to.
So if you have a food sensitivity and you’re eating it all the time, this contributes to leaky gut because it creates inflammation in the intestine. The thing to understand about this is that there was a time when we could only eat foods seasonally, and now because of technology and agriculture, people can eat pretty much any food they want 365 days a year, and our immune systems and our intestines are just not designed for that. We’re supposed to give them a break, whether it’s a seasonal break or on rotation, just eating it once a week, you should do that no matter what. You should not be eating the same things every day. It doesn’t matter if something is considered a healthy food. Even something like celery, you wouldn’t want to eat that every day because over time you could develop a food sensitivity.
A lot of these major ones that you see here like gluten, dairy, corn, eggs and soy, the main reason why these are such big offenders is because people eat them all the time. Americans, you know, when you’re a kid, you grew up eating gluten-containing cereal and milk, and then people have eggs every morning for breakfast and grits, so people start to develop these food sensitivities because they’re eating the same foods all the time. Now, it’s true gluten is more difficult to digest for a lot of people, but it’s not difficult for everyone.
So these are sort of what we call the big five: gluten, dairy, corn, eggs and soy. And now we’re to the point where all of the soy in America is genetically modified. Corn is I think up around 98%, 99%. We don’t really know the long-term effects of the genetically-modified foods, we’ll have to see, so I’m erring on the side of caution and not eating genetically modified crops.
So that’s kind of the first thing we do, and whatever we find as a reactant, depending on the severity of the reaction, we avoid it for about three to six months and that allows the immune system to calm down and for the gut to begin to heal. It doesn’t really matter what you do like what supplement you take or if you reduce your stress levels, if you’re eating foods that you’re sensitive to, it will really set you back and prevent you from making progress.
The second thing we talk about is improving digestive function. This isn’t anything high tech, but sometimes low tech things, practical things, are going to go the longest way. The first would be talking about chewing food very slowly until it’s liquefied. Eating in a calm, quiet and relaxing space. Don’t eat on the run. We’ve all seen the people eating fast food in their car while they’re driving, wolfing it down on their lunch break. You’re not going to heal your gut doing that. When you eat, don’t read or watch TV or text on your phone. We’re so caught up now in technology, we’re not really present with what we’re doing anymore, there’s so much going on. And that does affect digestion. So just focus on your meal.
One of the things that can help improve digestion is drinking ginger tea with your meal, possibly with some lemon in it. If your digestion is really sluggish, like you’re getting a lot of burping and gas and things just feel kind of backed up, one of the old-school ways is using herbal bitters. It’s also known as Swedish bitters. You can get them at pretty much almost any health food store. Have a little bit of those before you eat, and those will stimulate digestion. They’ll actually stimulate hydrochloric acid, which is what I’m mentioning here.
If it’s really bad, we’ll use Betaine HCl capsules with meals. If there’s a lot of gas and bloating and burping after meals, that will really help to digest food, especially if someone is severely hypothyroid. If you have hypothyroidism, you’ll also have low hydrochloric acid levels and that will affect digestion. Then sometimes we’ll use just straight-up digestive enzymes. A lot of these are pancreatic enzymes like lipase, amylase, protease, all the things that break down protein, carbs and fats. So these strategies will usually go a long way in improving digestive function and healing the gut.
The third thing that we’ll talk about is making sure there aren’t any infections in the intestine. If there is an infection, it’s very difficult to heal the leaky gut because the infection causes continuous inflammation and it really breaks down the immune system.
So what we do is a stool analysis, and the stool analysis identifies any types of infections that may be in the intestine. We’re looking for parasites like worms, amoebas, things like that. It will also tell us if there are any bacterial infections. It will tell you specifically what they are, like if it’s H. pylori or if it’s E. coli, et cetera, and it’ll also look at the fungi. So you’ll see Candida albicans or black mold, various types of different fungi that show up in the intestine.
If somebody has one of these, it’s cool because the lab does a sensitivity on the infection, it will test a bunch of different herbal medicines to see what actually kills the infection, and you’ll get a printout of what works and what doesn’t. For some people it might say oil of oregano, some people it might say wormwood or black walnut or caprylic acid or goldenseal, you just never know what will come back. So then we’ll know exactly what to use to wipe out the infection.
If there is a yeast, sometimes we’ll use what’s called saccharomyces boulardii, and saccharomyces boulardii is actually a beneficial yeast. It lines the gut barrier and it strengthens the immune system, and it actually will crowd out bad yeast. It’s cool because sometimes a lot of people will just go after the yeast trying to kill it, but saccharomyces is a little bit more delicate, a less aggressive approach that works by strengthening the immune system and just kind of pushing out the bad yeast, and sometimes that works really well for certain people.
All of these have been shown to directly heal the intestinal barrier, and the real big one that we’re talking about is glutamine. Glutamine is an amino acid and it’s the main fuel source for the cells that line the gut. We use all the way up to 20 to 30 grams a day. What we’ll do is we’ll have the patient mix the powder and water and sip on it all day so it’s kind of bathing the intestine the whole day, or we’ll have them mix it with a protein shake if they have a protein deficiency.
Now, we’re not going to get into a lot of detail about that, but protein deficiency, the gut barrier needs good protein to heal, and that’s a whole other thing that we focus on. I do have a video, I think it’s called ‘Protein Power’ on YouTube where you can learn all about that.
DGL is deglycyrrhizinated licorice, it works really well for ulcers and gut healing. Aloe, also known as aloe vera, very soothing, very reparative. Good probiotics, a good lactobacillus and bifido , these are important for a healthy gut immune system.
Zinc, we do a zinc taste test in the office. What you do is you put a little bit of liquid zinc in the mouth and you swish it around for about 30 seconds and if you taste like a metallic taste in the mouth, then you probably don’t have a zinc deficiency. If you don’t taste anything, if it just tastes like water, then that’s a good sign that you have a zinc deficiency, so we’ll use zinc for 30 to 60 days and that really helps the immune system and the gut.
Slippery elm is more of an anti-inflammatory soothing herb, same thing as marshmallow root. Marshmallow and slippery elm, these are what we call mucilaginous herbs, meaning that they have mucus-like properties that soothe the gut lining.
MSM, methylsulfonylmethane, MSM and glucosamine are used for cartilage repair and healthy joints, but it also works really well for the gut barrier. Anyone who’s had okra knows that okra is a little slimy, but that’s actually really good for the gut barrier.
Quercetin is a great antioxidant. It’s actually also antiviral, it helps to heal the gut. Quercetin works really well for allergies or if there’s a lot of histamine in your system. It also works for chronic pain. Quercetin is one of my favorite antioxidants.
So, there are products that contain all of these in one or most of them in one, or sometimes we’ll just use the glutamine by itself with probiotics.
The most important thing, probably just as important as the food sensitivities, is managing stress. A lot of people have leaky gut because their stress levels are out of control. Cortisol is a stress hormone made by the adrenal gland, and cortisol eats away at the intestinal barrier. If someone has high cortisol levels it’s going to be virtually impossible to heal the leaky gut, so you’ve got to get stress under control. Adrenal adaptogens can help with cortisol imbalances, like ashwagandha or rhodiola and eleuthero. These help your body respond to stress. Another product that works well is called Seriphos, which is phosphorylated serine, and that basically prevents too much cortisol production in the body. So that can be useful as well.
Don’t multitask. We talked about what to do when you’re eating. Make sure you’re taking enough time off from work, plenty of vacations. I have a lot of patients who go on vacation and almost all of their symptoms just disappear, so that’s an important thing to think about.
Eat protein at every meal. Meditation can be very beneficial, not only for your mood, but for your immune system. It doesn’t take a lot, maybe 15, 20 minutes a day. And exercise, as long as you’re not overdoing it. Exercise will help your body deal with stress and it’s also good for your immune system.
So these are really key points, and all of these things have to be in place for true healing to occur. If we miss one thing, like if we miss an infection or we miss a food sensitivity or if there’s too much stress, then it’s going to be very difficult to heal the leaky gut. So all pieces have to be in play.
Resources and Questions
I’ve got on this link, drhedberg.com, patient resources, some good ebooks, downloadable documents and things like that that you can read, talking about the alkaline diet. There’s a good podcast on there from my good friend, Suzannah Tebbe Davis, who will help you manage stress. And then I have a free eCourse, ‘7 Steps to Burn Fat & Boost Energy’, on the bottom of the homepage. In that course we talk about the best way to eat to burn fat and get your energy levels up, and some of that will tie in with healing the leaky gut.
So, we’re about 30 minutes in which is perfect, that’s usually what we’re shooting for, I know everyone’s really busy. As far as questions go, all you have to do is type your question into the chat box. If you have any questions about any of the material that we covered, I’d be happy to answer that in the chat box. If you type that in and press ‘send’, that should queue up here in just a minute.
So, I love doing these webinars. We do them about once a month, and we’ve covered a lot of different topics. I’m not sure what we’ll be doing next month, but it will definitely be something with some information that you can use to help you get better.
No questions coming in so far. We’ll give it just a few more seconds here and see if any questions come in.
This presentation is being recorded. The video will be up on YouTube and on my website sometime later in the week.
Okay, great, so here’s our first question. What would you recommend to clean the blood for blood disorders?
That question is not really specific enough, Joanne. Can you reword that? That can be a very detailed, kind of long-winded question, so to speak, because so many things can affect the blood. Leaky gut will definitely contribute to issues with the liver and the blood. Those three kind of are connected in their own sort of ecosystem, the digestive system, the liver and the blood. But if you’d clarify that a little bit more, I might be able to answer you better.
Okay, here’s another good question. How long should someone be on supplements for leaky gut? Is there a timeframe for gut healing?
That’s a great question. It really depends on the individual. The gut can heal in a relatively short period of time, just a matter of a couple weeks if everything is done right. It depends on the individual. Sometimes a few weeks, sometimes a few months, sometimes a year, year and a half. So, it really depends on the person.
Okay, a lot of great questions coming in. How do you work with people who are down to a few foods? Bone broth, green veggies, salmon, raw milk?
So that’s an extremely restricted diet. The key with that is figuring out what has been missed up to this point, and it usually means that something has been overlooked, whether it be a gut infection or something going on in the patient’s life. A lot of endocrine issues, like adrenal problems, blood sugar, hypothyroidism, et cetera, often go undiagnosed and overlooked, so usually we’re able to pinpoint the one or two things that’s really driving the person’s health problems, and that’s really what we’re focused on. Whenever you see something like leaky gut, it’s not something that you just directly automatically go after because it’s there for a reason, and that’s why we have to do the detective work to find out why.
Okay, next question. What length of time is appropriate to supplement with adaptogens?
I just stay on them almost all the time, because we all have stress. Adaptogens are a part of different cultures on a regular basis, like in China, ginseng is consumed virtually every day just as a regular part of the day because adaptogens have so many benefits. If you watch my webinar on YouTube called ‘Herbal Medicines for Fatigue’, I go into detail on all the adaptogens as far as how much to take and for how long.
Next question, do you also advocate doing a detox at the same time?
No, I don’t do detoxification. That’s sort of a misnomer, it’s sort of an antiquated way of looking at the body. It’s very popular in the alternative medicine world, so-called detoxes and cleanses, and that’s really a lack of understanding of how the body does detoxify. The main reason why people feel better on so-called detoxes or cleanses, number one, they remove all the most common food allergens. So right off the bat, they’re going to start feeling better because they eliminate gluten, dairy, sugar, all the bad foods, and they start eating better. The second reason they feel better on detoxes and cleanses is because they’re eating more protein, and the protein powders that are used, all the detox powders that are out there, have really good protein in them. Your body is able to detox very efficiently, and it’s detoxing right now. I’m detoxifying right now, you’re detoxifying right now, and when you get the body healthy, it will remove what doesn’t need to be there. So, no, we don’t do detoxes or cleanses.
So, next question, the immune system is in the gut, what would you recommend to strengthen the immune system for leukemia?
I have no experience with leukemia. That’s something that you would want to discuss with your oncologist.
Next question, do you see a connection between the timeframe that GMO foods have been out, the rise in Vitamin D deficiency, and leaky gut?
No, that’s not a connection that I’ve ever looked into. The rise in Vitamin D deficiency however, that is published in the literature. The first is the more body fat you have, the greater the chances of a Vitamin D deficiency. And of course, Americans are getting fatter and fatter, so obesity, weight gain, that causes a Vitamin D deficiency. That’s really the main reason. The second reason is inflammation. If there’s inflammation anywhere in the body, then that will also contribute to a Vitamin D deficiency.
Next question, does leaky gut contribute to fructose malabsorption? It seems like every third person has this condition. Do you have an opinion why?
Fructose malabsorption is going to tie in with pretty much any malabsorptive syndrome, and we’re talking about fat malabsorption, cholesterol malabsorption, pretty much any kind of malabsorption. Leaky gut, when you ask does it contribute, that’s kind of the chicken or the egg. Again, you’re trying to figure out what caused the leaky gut, and malabsorption can be turned around relatively quickly with the high doses of L-glutamine that I talked about before as well as working on all these other things.
So the blood/brain barrier, that can completely heal in about two weeks. So can the gut. Usually the gut takes a little bit longer, but that is something to be aware of.
A lot of great questions. If you have any more questions, type them into the chat window, and I’ll do my best to answer them.
Okay. Well, that’s it for tonight. Thanks, everyone, for joining us. Again, this is recorded. It will be up on YouTube and on my blog very soon. Thanks, everyone, for joining, and I’ll see you at our next webinar. Take care.