GGS
15 Comments
Apr
15
2014

Jumping the Shark on Leaky Gut

The mainstream is always 10-20 years behind the cutting edge. Researchers are gleaning facts today that sadly won’t trickle down to doctors, clinical practice, and patients for years to come.

Just because something isn’t mainstream, however, doesn’t mean that evidence is lacking and that treatment options are not available. Consider how long it took conventional medical doctors to “accept” that vitamin D deficiency has major health implications and screen for it. Throughout history, the conventional mainstream has denied the existence of bacteria, sperm, Celiac disease and a variety of other objects, syndromes, and disease states.

During the trickle-down process, as the research nudges its way into day-to-day clinical practice, new or different ideas are met with a variety of reactions.  Common reactions include, but are not limited to: denial, dismissal, indifference, ridicule, and the suggestion that perhaps you are stupid or need an antidepressant for thinking such a thing or questioning convention.

leakygut

 

These gimmicks are old hat, and I am seeing them more and more in the discussion around leaky gut…or, in medi-speak: intestinal hyperpermeability. The same ol’ arguments that have been used before:

Argument: “There’s no research into it.”
Fact:  Typing “intestinal hyperpermeability” into PubMed, a clearinghouse for medical literature, will yield over 150 research articles.

Arugument: “There’s no test for it.”
Fact:  There are several.  The most famous is the lactulose-mannitol test, but Cyrex Labs also offers a variety of testing options.

Arugument: “There’s no magic bullet to cure it.”
Fact:  There is no magic bullet to cure arguably anything. Even our most successful drugs won’t work on a certain slice of the population. And lack of a magic bullet cure does not preclude the existence of a condition.  We are still working on every SINGLE chronic condition out there, and we still haven’t tagged bacteria and viruses yet.  (Indeed, they are doing a good job of tagging us.)

These buggers are still getting the best of us.

These buggers are still getting the best of us.

These arguments and insults are repetitive hooks and gimmicks used by deniers or whoever to keep the focus off of the facts and gleaning information that can be used to help people. This is called “jumping the shark” (i.e. using ridiculous tricks over and over to in an attempt to keep interest piqued).

And I’ll be honest — it can wear on the nerves.  Can you tell?

In a nutshell, leaky gut/intestinal permeability is a loss of integrity at the cellular level of the lining of the small intestine. The cells there are supposed to stand next to each other, shoulder to shoulder, to form a tight barrier. When that barrier is compromised, from improper nutrition to alcohol/substance abuse, to certain medications, chronic stress, lack of sleep, lack of digestive fire, immune dysfunction, particular disease states (like inflammatory bowel disease) or other factors, an immune response is stimulated which can culminate in accumulating food sensitivities, digestive trouble, brain fog, and other complaints.

In my experience while working with thousands of people with a variety of digestive and non-digestive issues, in order to restore gut function and optimize health, the integrity of the lining of the gut has to be ensured. Most particularly in those with digestive or autoimmune trouble, I find that it is the most overlooked step in the path to getting people better.

Without healing up the lining of the digestive tract, it is difficult to have top-notch digestive function, and thus achieve a state of next-level health and vibrancy.

While working with clients, my approach is this:

1. Find and eliminate food sensitivities.
2. Clean up the environment if necessary.
3. Create a happy microbiome.
4. Ensure good digestive fire.
5. Heal the lining of the digestive tract.

This last step is the crown jewel of the whole process because without it, the subsequent steps just aren’t as effective.

Luckily, these other steps also help heal the digestive lining.

In addition, I also like to take the extra steps  that are easily incorporated into the diet and lifestyle that can also support healing of leaky gut.

On the food front, there are several stand-outs that should be used several times weekly to help soothe and repair your small intestine. They are as follows:

1. Bone broth – contains vitamins, minerals and collagen building compounds to support healing. You can use the broth as a base for soup, to braise veggies or meats, or just drink it straight up.
2. Plain gelatin – you can add 1-2 tsp to water, smoothies or stews, or make gelatin bars using tea, fruit, and natural sugar substitutes like stevia.
3. Blueberries – contain proline and Vitamin C, compounds necessary for building soft tissues.
4. Okra – (in all it’s slippery goodness) can help quell small intestine inflammation.

 

In terms of herbs and supplements, there are multiple options that help support good integrity of the small intestine and can be used to repair leaky gut. Likewise, there are multiple leaky gut formulations out there on the market. Look for something that contains the following:  l-glutamine, NAG (n-acetyl glucosamine), zinc-carnosine, MSM, marshmallow, aloe, licorice, chamomile, cat’s claw and quercetin.
In terms of your overall lifestyle, getting enough sleep, not drinking tons of booze or taking pharmaceutical drugs injudiciously, doing restorative exercises like leisure walking and meditation all serve to ensure good integrity of the digestive lining.
So are these a magic bullet (ahem!)?

I can’t say that, of course, but I can say that by utilizing this approach, countless people have been able to create a happier gut for themselves.

Remember:

First they ignore you; then they laugh at you; then they attack you; and then you win.” -Gandhi

I would humbly add to this brilliant quote – “Then the tides change, then all benefit.

 

 Jillian Teta

Dr. Jillian Teta is a medically trained naturopathic doctor and the author of, “Natural Solutions for Digestive Health”, which is being releasedin 2014 by Sterling Publishing.

She practices at the Naturopathic Health Clinic of North Carolina where she focuses on digestive health. Through working with thousands of clients, she has created the Fix Your Digestion Gut Restoration Program, an online educational and practical program that guides you step-by-step on how to heal your digestive tract. She blogs at www.fixyourdigestion.com.  You can also keep up with Jillian on FacebookTwitter, Instagram (JillianTeta), and YouTube.

 

 


  • Joy Victoria

    So she can’t offer ANY evidence to support her claims, even though there are plenty of pubmed articles? Where’s the citations? Where’s her evidence-based examination of the diagnosis of leaky gut? Come on. She starts off by making sure she shoots down the need for research, then claims you can find plenty (but doesn’t provide any) and then offers you a cure-approach for something she didn’t even define well. She makes huge assumption jumps about when “your barrier is compromised” and a host of symptoms but doesn’t provide any 1.) proper medical definitions (but one can argue is a naturopathic doctor actually a doctor) and 2.) any evidence or discussion to support her opinion. Her client anecdotes are not valuable as evidence, as we all know anecdote is the lowest form of evidence (can’t even be called evidence actually). Girls Gone Strong, we expect better!!!!!! Women have enough trouble wading through bullshit as it is, and if you want to post about popular topics (leaky gut is certainly a term you hear thrown around, along with gluten-free, cleanses, fruitarian diets etc) than PLEASE keep to a higher standard. Dr. Teta commits quite a few fallacies including appeal to authority (she is a naturopathic doctor), appeal to accomplishment (I have worked with thousands) and in her first sentence (!!!!) an appeal to fear (you are always behind the cutting edge!). She seems to make sure the reader is properly fearful of anyone who asks for “science” or “evidence” because she goes on to provide none. Not even clear definitions. I would love to have a resource to point to when women ask about this topic…and this is certainly not it.

    • Jillian Sarno Teta

      Hi Joy! Leaky gut certainly IS a contentious issue. The diagnosis of leaky gut can happen a few different ways:
      1) You can do a lactulose-mannitol test
      2) You can use Cyrex Labs intestinal permeability arrays.

      My intention with this article was certainly not to shoot down the need for research. Research is critical in the scientific process. What I was trying to highlight is that there IS a TON of research out there for leaky gut already.

      I am a medically trained naturopathic doctor, not a medical doctor. I have completed 4 years of post-graduate medical school, taken a licensing exam and done a residency. I’m a graduate of one of 5 of these such schools in the country – medically trained NDs are few and far between, and there are a lot of non-medically trained NDs out there as well.

      The point of the entire article was to offer a discussion about this contentious issue and more importantly, HOW things become contentious…dismissal, trying to discredit people or concepts, shaming, etc. I also used this issue as a vehicle to talk about how the mainstream lags behind the cutting edge, as a highlight.

      In terms of my few fallacies that you outlined: I am a naturopathic doctor. I have worked with thousands of people, and I never said that YOU were behind the cutting edge, but the mainstream was. The research that is being done right now will not translate into clinical practice for a while. It is the way medical research works.

      In terms of finding the research, I included how to find it in the article. It’s there ;)

      The primary goal of this article was to illustrate how far we have to go in mainstream, conventional medicine, using leaky gut as an example.

      • Joy Victoria

        Hi Jillian,

        Thanks for the reply. I am not really concerned about me being behind cutting edge. After all, I make it a point to read and understand research (at least try to), but many of those who read this post cannot just take a gander on pubmed and be able to digest, and understand what they are reading. That is what blog posts written by professionals are for! This is not dismissal or ridicule, this is asking you to defend your assertions properly. Your article has several “red lights” that make me wonder about your claims. What is digestive fire? Is that a medical term…? When has mainstream medicine denied the existence of sperm? (never heard this, but I am not medically trained). All the symptoms you name are highly vague (similar to diagnosing fibromyalgia!), and so are your recommendations. This is not ignoring the facts, this focusing on them. Where are the facts? Saying someone experiences this, and that, and it is because of this and that, requires facts. So perhaps an edit of your article to direct us to the research specifically will allow for a more thorough read, and a platform from which to ask about and address your claims. Why take such a defensive stance? If “leaky gut” is real, provable and can be diagnosed and cured, you should have no problem showing that.

        • Jillian Sarno Teta

          Hey Joy – this post was not intended to be a dissertation on the facts bout leaky gut :) It was a lament about how long it takes “new” concepts to be brought into the mainstream, and how these concepts are often dismissed, ridiculed, etc, and how people who bring them forth or challenge convention are “stupid”. This is the same thing that has happened over and over again in the course of medicine and science. For example, it was thought either you had diabetes or your didn’t. Like, one day you wake up and have diabetes but the day before you didn’t. Sounds kinda strange, but that was the thinking. The fact that it could be a slow progression – and that there is actually a name for it (metabolic syndrome), was largely dismissed by the medical community. It’s been known for at least 25 years (as another example) that Crohn’s disease has a genetic component, yet the CCFA – Crohn’s and Colitis Foundation of America – presents the information as if it were just discovered. Before sperm was “discovered”, careers were ruined by those who presented the idea of sperm. It was widely accepted that ethers and spirits impregnated a woman. Celiac disease was denied, non-celiac gluten sensitivity was denied, PMS was denied…doctors said cigarettes are fine and don’t cause lung cancer. It’s only been 30-40 years since then. More recently, the debate about BPA, pesticides, etc, still rages on IN SPITE of the fact that there is excellent science out there regarding it.

          So, my article was not to establish that leaky gut exists – many before me have already done that!!! This post was to show the same ol’ shtick, different outfit…this time, the outfit is leaky gut instead of all of the other contentious issues in the past.

          “Digestive fire” is a term that I myself have coined and have discussed in other posts, both on GGS and my own blog. It refers to the body’s ability to break down proteins, carbohydrates and fats into their constituent molecules of amino acids, sugars and fatty acids so they can be absorbed.

          Of course the symptoms of leaky gut are vague…the symptoms of many, many diseases and functional disorders are. This is not new, and doesn’t mean that something does not exist. Through thorough history taking and testing, a diagnosis can be reached. Functional/integrative treatment options are aimed at reducing inflammation in the small intestine (the main driver of leaky gut and all chronic conditions), ensuring that the desmosomes (button-like structures that link the cells lining the small intestine together…medical terms for this lining is epithelial layer) are linked together and promoting optimal cell growth and differentiation. There are very specific herbs and supplements that do this…that also can be used for other things, too ;) Biology is redundant. The same compounds can be used for many different things. Glucosamine, for example, is great for delayed onset muscle soreness and also great for the digestive system because it is the preferred fuel of the cells that line the gastrointestinal tract (the cells are called enterocytes)

          If you are interested in learning about the anatomy of the small intestine, and the physiological & immunological mechanisms through which it manifests, you can check out a blog that i wrote about it here: http://bit.ly/SLbT8R

          So again, this post was not to establish that leaky gut exists, because it’s clear that it does, but to use it as a vehicle to demonstrate the same tactics are used by naysayers and deniers that have been used for millennia against any idea or concept that challenges a belief system (hence the title). There is being skeptical and having a discussion, and then there is something more insidious, the collective dismissal of different or new ideas, the idea that if we tear down the people or establishments that present them they will somehow go away. People have done it before, are doing it now, and will do it again in the future – in not just medicine and science, but politics, religion, philosophy, nutrition, parenting, dog training, etc. This post was my lament, which is why it comes off as combative. Thanks again for your comments :)

  • Kylara7

    A naturopath is not a medical doctor, it’s a “woo doctor”, as shown by the complete lack of understanding of medical terminology (clue: intestinal permeability is not the same thing as ‘leaky gut'; the former is a life-threatening situation that requires hospitalisation/treatment and the latter is a made-up food fear and marketing term) and human physiology. As Joy Victoria pointed out, there are no citations, no evidence, just lots of hand waving and testimonials. I expect a high level of reasoning and critical thought from Girls Gone Strong, and this article is a distinct disappointment.

    • Jillian Sarno Teta

      I am a medically trained naturopathic physician, not a medical doctor. I am a graduate of Bastyr University, one of 5 medical schools in the US accredited to train primary care doc in complementary, functional and integrative medicine. It is a 4 year, post-graduate medical school (I received a Bachelor’s and Master’s degree in Biology and Environmental Biology from Boston University), complete with licensing exams and residency. In addition to basic, clinical and diagnostic training, I was also trained in nutrition, counseling, supplements, exercise, herbs/botanical medicine. Like MDs, I have training in minor surgery, pharmacology, etc. In Washington, where I hold my license, I have the prescriptive rights of a conventional doctor that practices family medicine.

      There are tons of non-medically trained NDs out there, to your point.

      “Leaky gut” is the laymans term for “intestinal hyperpermeability”. Intestinal hyperpermeability is not a life-threatening condition. All people with inflammatory bowel disease have it.

      As I mentioned to Joy as well, in my article, I tell you how to find the research on leaky gut. Go to pubmed.gov, type in “intestinal permeability”, and you are off to the races. In articles like this, space is a huge consideration, and i would rather have all of the things that I want to say in the article over article citations. Especially since I thought I made it clear exactly where to find the evidence ;)

      Lastly, this article was a commentary more on how the mainstream lags behind the cutting edge using leaky gut as an example, rather than a dissertation on leaky gut. In this article, leaky gut is accepted prima facie as a distinct, objective, quantifiable phenomenon that can be measured via laboratory testing.

      I hear that you didn’t like the article, and you are certainly entitled to your opinion, but I stand by it. Thank you for your comments.

      • Kylara7

        The burden of proof is on the claimant. You make a lot of strong claims in your article and fail to back them up with evidence. Also, as I mentioned in my comment, intestinal permeability as defined and researched in the medical literature is NOT “leaky gut” as defined by alternative practitioners. With your background, I would expect that you can understand the literature to this point. Your article is misleading and not backed by any evidence. I stand by my critique.

        • Kylara7

          As a biomedical scientist/PhD, I suspect that the reason you conveniently did not include any of the myriad of actual research citations on intestinal permeability is because they do not support your assertions and hypotheses about “leaky gut” because they address the more formally defined and understood severe medical conditions that fall under this term and the associated diseases and not a common trendy idea of “healing yourself” with special foods and avoidance of food villains.

          • Jillian Sarno Teta

            As I mentioned above, this article was not to assert that leaky gut exists – that has been established by many before me. Anatomical, physiological, immunological and inflammatory mechanisms are well established. The post was a lament that the denial of leaky gut exists now as the denial of many diseases, conditions and facts of science have been denied in the past (it’s trendy, a fad, not based in science, a stupid idea, etc). The post is not a thesis. I respect your opinion and your willingness to comment, but if you are telling me that leaky gut does not exist, I respectfully disagree. Thank you again for your comments.

  • Mary Kate

    Thank you Dr. Jillian for writing this article. I suffered with gut issues for a long time and knew it was from what I was eating and I felt like leaky gut was my problem-my lower abdomen had a burning sensation….like it was leaking…very weird. I finally eliminated gluten about 2 years ago and have slowly felt better. I went to the Dr. but they didn’t know what was wrong and wanted to treat the symptoms with medication. I remember people thinking I was crazy when I said I didn’t feel good after eating wheat-heck I felt crazy! But now it is more mainstream and I don’t get the weird looks. Our bodies are so unique and we have to take the time to figure out what works-nutritionally and physically(exercise). These are 2 principles GGS teaches so I am grateful for this article!

    • Jillian Sarno Teta

      Thank you Mary Kate! I hope that you are getting the help that you need now :)

  • Jo

    I can’t help but feel those who poo-poo Naturopaths do so out of ignorance and/or bias. Speaking of doing your research… :)

    Wonderful article and info, Dr. Jillian! As always! Thank you muchly!!!

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  • Dana

    Ugh.

    Let’s talk about research, shall we? Search “intestinal hyperpermeability” and “bone broth” on PubMed and you will find 0 research articles.

    Search for “intestinal hyperpermeability” and “plain gelatin” and nope, not one!

    Search for “intestinal hyperpermeability” and “Blueberries”…..not one study.

    Search for “intestinal hyperpermeability” and “okra” and yet again…no research.
    This DRIVES ME CRAZY! The whole article talks about how us in the medical field are ignoring solid research….and yet there is NO evidence or research that supports her treatments for leaky gut.