Leaky Gut 101: Extremely Important to Understand and Heal, For All of Us With Autoimmune Conditions

Woman preparing fruits for the blenderMany aspects of the typical American lifestyle –the foods we eat, the things we drink (even the way in which we eat or drink), the personal care products we use and of course, many prescription drugs — can contribute to digestive tract malfunctions and ultimately leaky gut.  And not just in the obvious malfunctions such as indigestion, reflux, GERD, constipation, diarrhea or IBS (irritable bowel syndrome), but malfunction within the small intestines that affect absorption of nutrition and trigger various immune responses.

Each part of the digestive process is critical for good overall health: the mouth, throat, stomach, various sections of the small intestines, gall bladder, pancreas and the colon or large intestine.

Most medical attention is on the stomach, usually for indigestion or the large intestines for polyps, diverticulitis, or worst case, colon cancer.  Little attention is given to the small intestines.  Because most medical doctors listen for symptoms and place a corresponding medication, they hardly ever implement actual functional support.  The objective of most doctors is to identify a disease and prescribe a medication, rather than enable the body to return to correct function.

Basics of the digestive process

Proper hydration with quality clean, alkaline water throughout the day and little to no water with or during a meal is very important.  Often people wash foods down with various things they drink.  This alters the pH and dilutes the various enzymes in the mouth necessary to digest most carbohydrates, starches or sugars.

Once food enters the stomach, acid is released from the stomach lining to digest mostly proteins into various amino acids, and to extract various vitamins like B vitamins from food.  The stomach churns the food with the acid and enzymes it produces, and then releases it into the first section of the small intestines.  Here, very alkaline fluids from the gallbladder, along with pancreatic enzymes, mix with the food and significantly change the pH and further digest oils or fats.

The food should be very alkaline and in correct molecular size for the villi, which line the small intestines, to selectively absorb nutrients.

As you can begin to see, the exact balance of pH and the level at which food is dissolved play a big part in absorption.  Improper levels of pH, digestion in the mouth, stomach, gall bladder and pancreas function can result in foods being an irritant and triggering an immune response that otherwise would not be an issue.

Because 80-% of the immune system resides in the area of the small intestine, numerous potential antigens can form from the incomplete breakdown of food products.  Autoimmune states can be induced by food sensitivities that cause intestinal gut permeability and complicate leaky gut syndrome.  Along with alkaline water throughout the day, eating more organic fruits and veggies and various nuts and seeds will improve your nutrient reserves and support better digestion and overall health.

Food allergies

Once the digestive process gets off track, heightened reactions occur that may not be a true picture of food allergies.  A common food allergy test, the ALCAT, is often the standard in food allergy testing.  Those who have been eating the average American diet or even those who have started eliminating some things often test allergic to countless foods and feel that there is nothing to eat. The fasting soothing fiber plan discussed later will assist in resetting digestive allergy reactions.

Testing leaky gut

There are blood test and urine test that can determine leaky gut.  In my practice I use the Indican, also called the Obermeyer test.  The test is performed by mixing chemicals with urine, and test results are known within minutes.  These chemicals react to certain proteins that should be limited to fecal waste and not urine.  The more the mix turns shades of blue from light to darker, the more involvement one has of leaky gut.

Why get tested

Long before someone feels like they have digestive issues there can be countless other health concerns due to leaky gut, such as skin rashes, acne, headaches, chills, sweats, sleepless nights to feeling tried all the time.  That’s why in “natural health”, we say all health begins in the gut.

Sometime people will bring me lab work that shows what nutrients they are missing.  Even after diet and supplement changes and upon retesting they may not reach their desired nutrient levels because their leaky gut has not been fully addressed.

There is overwhelming evidence of how mental issues — from ADD, ADHD, depression, anxiety, fear, memory lapses, cognitive decline and even procrastination and excess fears — are influenced by digestion and immune responses within the digestive track.

Also, the severity to which someone has autism may increase because of leaky gut.  The increasing frequency at which autism is occurring in our population is being attributed to improper digestive process, poor assimilation and lack of available nutrition before and after conception.

Other research validates the high occurrences of food reactions to various foods and the relationship to autoimmune conditions, such as Hashimoto’s or Graves’ disease. Additional research reinforces eating an anti-inflammatory diet down-regulates many autoimmune responses.

Resetting the gut diet

Keeping your gut healthy is a lot easier than restoring it.  My recommendations will vary some, depending on various digestive complaints, but I usually start with the following.

The first week I recommend a modified fast, with at least two meals or snacks being a smoothie made from a non-allergenic protein such as pea protein, soothing fiber mixes, immune-regulating support nutrients, various oils, and herbs that fight yeast, parasites and harmful bacteria, often in water, papaya juice or juice. Use very little ice to assure the drink is not too cold; otherwise the drink needs to stay longer in the mouth to get closer to body temperature to assure best digestion and assimilation.

Other meals during the day should be soups made of veggie or chicken broth and finely chopped, very well-cooked veggies.  Remember to avoid the most common irritants: cow milks and cheeses, corn, rice, wheat and soy.  Another guide for food selection is using the Eat Right For Your Blood Type and eating from the beneficial list.

Over the next few weeks, slowly transition into more dense foods while avoiding the common reactive food just mentioned.

Then for two to six months, avoid all battered and fried foods, trans fats, fast carbs, alcohol, wheat and dairy.

Reset the gut supplementation

During this liquid diet phase, an herbal cleanse along with kidney and lymphatic drainage remedies is beneficial, since the leaky gut has polluted every organ in the body.  Digestive enzymes and probiotics, along with the amino acid L-glutamine, can be very supportive, too.

Also remember to stay hydrated with a general rule of dividing your weight in half and drink that number in ounces daily.  If you sweat due to heavy exercise or outdoor activities, add more water. Remember to pace the water consumption and limit intake during meals.

Retesting leaky gut

Retesting the leaky gut monthly is recommended to assure you are doing enough to heal the gut.  As mentioned, many health issues can be the result of the leaky gut, and those areas or functions may need additional supplemental support until the diet and corrected digestion take over.  In addition to many liquid supplements for better absorption, there are also sublingual supplements and transdermal lotions that bypass the digestive process and the liver, providing critical nutrients for the body to repair.


About the Author
Carl Schmidt, ND, CNHP completed a Doctor of Naturopathy from Trinity College of Natural Health, Certified Natural Health Professional through the National Association of CNHP, Inc.  He completed continuing education from Bridgeport College of Chiropractics Continuing Education Studies under the supervision of Apex Energetic Seminars Department in Functional Blood Chemistry, Auto-immunity, Digestive Health and Hormonal Imbalances.  He’s a master herbals and is an avid reader and researcher.  He has had the privilege to integrate supplement, diet and various wellness venues for patients  with  medical professionals in the areas,  general practice, rheumatology, psychiatry, physical therapist, dietetics,  and home health care.  Carl films TV shows monthly and is often a guest on several radio shows.  He offer a refreshing common sense approach to better health through various testing methods where he  implements and monitors diet, meal replacements, supplements and  hydration.

This post contains opinions of the author.  AutoimmuneMom.com is not a medical practice and does not provide medical advice, diagnosis, or treatment.  It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances.  Camino Real Ventures, Inc., the company that makes AutoimmuneMom.com available to you, does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website.  Your use of the website is subject to our Terms of Use and Privacy Policy


  1. how many people have this disorder or exactly what problems can be attributed to it?

  2. I have several autoimmune conditions and am concerned that my leaky gut is not healed as I seem to be developing more as time passes. I have 47 IgG food sensitivities that make eating challenging. There are no functional medicine providers in my part of the country to ask about it. Any suggestions how I can get some advice?

  3. As a physician well-versed in pathophysiology, it was difficult to read your article without gasping and shaking my head at the fuzzy “science” presented within. First and foremost, you offer no legitimate references or links of any kind, save for two links back to this site, and one linking to the ridiculous and completely baseless blood type diet, which has been repeatedly debunked (he even gets the age of various blood types completely wrong!), even by other naturopaths. (http://naturalsportsmedicine.blogspot.com/2010/05/critical-examination-of-blood-type.html & http://en.wikipedia.org/wiki/Blood_type_diet & http://www.med.nyu.edu/content?ChunkIID=214387 & http://www.dailymail.co.uk/health/article-2540757/The-Blood-Type-Diet-debunked-Study-confirms-fad-regime-no-scientific-evidence-it.html & http://www.skepdic.com/bloodtypediet.html & http://www.mayoclinic.org/blood-type-diet/expert-answers/faq-20057832 & http://www.nhs.uk/conditions/leaky-gut-syndrome/Pages/Introduction.aspx) It’s always a red flag when a clinician offers no compelling evidence to support his assertions, as I have in refuting the same. And even worse is the fact that increased intestinal permeability is a real concern for a handful of disorders and scenarios, which you cloud by suggesting that tons of people suffer from “leaky gut syndrome” and “blood toxins”. But there is so much else wrong with this piece, it’s hard to know what to comment on first. So let’s just go in order:

    -I can find no evidence of any kind that personal care products contribute to any of this; and the list of things we eat or meds we take that are known to be correlated (NOT the same as causation) with leaky gut is actually quite short. (http://www.nhs.uk/conditions/leaky-gut-syndrome/Pages/Introduction.aspx) Also, you forgot infections and alcohol, two of the primary triggers of actual leaky gut. Even advocates of LGS cite a relatively short list of known/suspected causes. (http://www.leakygut.co.uk/Causes.htm)

    -One of your “obvious” pathologies, IBS, has been shown to be a result of colonic permeability, not a leaky small intestine. (http://www.ncbi.nlm.nih.gov/pubmed/22179430) And even if it is from intestinal permeability, the cause, effect and mechanisms are not nearly understood well enough for you to proclaim that it’s an obvious manifestation. (http://ajpgi.physiology.org/content/303/7/G775 & http://www.ncbi.nlm.nih.gov/pubmed/19951903)

    -The gallbladder is in no way critical to the digestive process. It helps to have one for bile storage, but the liver is completely capable of producing and dispensing bile on its own.

    -What evidence do you have that food irritants evoke an immunological response? Aside from the handful of foods (shellfish, peanuts, etc.) known to provoke true hypersensitivity reactions, this is pure conjecture as far as I can tell.

    -As you note, a huge proportion of the immune system resides in the gut, mainly in the mucosal epithelium and the lamina propria. These areas are filled with all kinds of immune cells and tissues, including M cells, dendritic cells, T cells, Peyer’s patches, B cells and macrophages, among others. These components are collectively referred to as GALT (gut associated lymphoid tissue) and are entirely capable of producing both localized and systemic (via T cells) immunity all by themselves. If the majority of the immune system is in the gut, and these cells can detect antigens either in or just outside the lumen (in the mucosa), why would these supposed antigens need to travel through tight junctions and into the circulation before stimulating any type of immune response? It makes no sense at all. IF these many substances were going to provoke an immune response throughout the body, it would most certainly start in the mucosa, with no need to enter the circulatory system in order to trigger a response, meaning the leaky gut explanation explains nothing. The immune response would happen in certain cases even without permeability issues. (http://www.vivo.colostate.edu/hbooks/pathphys/digestion/basics/gi_immune.html & http://gut.bmj.com/content/30/12/1679.full.pdf &http://www.ncbi.nlm.nih.gov/pubmed/2059285 &http://www.nature.com/nri/journal/v4/n6/fig_tab/nri1373_F3.html) Then there is the fact that GALT doesn’t respond to every possible antigen in food or otherwise because of a normally homeostatic balance between tolerance and immunity. http://www.nature.com/nri/journal/v3/n4/abs/nri1057.html & http://jem.rupress.org/content/203/3/519.short)

    -Not only is ALCAT not the standard for allergy testing, but it has been largely discredited for any purposes because of a total lack of scientific backing. (http://en.wikipedia.org/wiki/ALCAT_test & https://www.aaaai.org/ask-the-expert/validity-of-testing-for-food-allergy-using-ALCAT-o.aspx & http://www.jiaci.org/issues/vol15issue02/1.pdf) In fact, the RAST test has been the standard for some time, though it is gradually being phased out in favor of more modern and reliable tests, such as DBPCFC and other enzyme assays. (http://en.wikipedia.org/wiki/Radioallergosorbent_test & http://www.ncbi.nlm.nih.gov/pubmed/3060514)

    -The urine indican test does NOT test for LGS; it tests for bacterial overgrowth, which may or may not result in increased intestinal permeability (true “leaky gut”). It is a result of tryptophan metabolism problems, where bacteria break down tryptophan into smaller particles that are absorbed through NORMAL mucosal mechanisms, not LGS. Also, it has even been demonstrated that this test has little validity or use for measuring overgrowth/dysbiosis, where a jejunal biopsy remains the gold standard. (http://gastro.ucsd.edu/fellowship/Documents/SmallBowel2.pdf & http://www.ncbi.nlm.nih.gov/pubmed/1199990)

    -Eczema and related atopic conditions have been shown to have little or no relation to intestinal permeability. (http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1985.tb04856.x/abstract & http://www.nature.com/jid/journal/v91/n2/full/5613595a.html & http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2133.1989.tb07767.x/abstract;jsessionid=601A8298B6AB6863D9FE873CE9875A2B.f02t04?deniedAccessCustomisedMessage=&userIsAuthenticated=false & http://www.ncbi.nlm.nih.gov/pubmed/3933045)

    -Although the connection between ASDs and increased intestinal permeability seems to be real, we do not really understand it, and stating that autism severity may be CAUSED by LGS is unscientific and irresponsible, not to mention simplistic. How did you establish possible causation without actual scientific evidence? All I found searching the literature were references to an association between the two; no legitimate studies asserted any concrete knowledge or findings regarding the chicken/egg debate. (http://www.sciencedirect.com/science/article/pii/S0022347601922279 & http://www.sciencedirect.com/science/article/pii/S0006322306009371 & http://cid.oxfordjournals.org/content/35/Supplement_1/S6.short) Correlation does not equal causation!

    -Fasting diets, cleanses and detox schemes have been roundly rejected by medical practitioners and researchers as ineffective at best and dangerous at worst. Even Andrew Weill, one of the godfathers of naturopathy/homeopathy, does not advise any such treatment. (http://www.sciencedirect.com/science/article/pii/S1542356513009269 & http://www.webmd.com/digestive-disorders/features/leaky-gut-syndrome?page=2 & http://www.quackwatch.org/01QuackeryRelatedTopics/detox_overview.html & http://www.biolayne.com/wp-content/uploads/The-Detox-Dossier.pdf & http://www.sciencebasedmedicine.org/the-detox-scam-how-to-spot-it-and-how-to-avoid-it/ & http://www.drweil.com/drw/u/QAA361058/what-is-leaky-gut.html) Yes, fasting will likely decrease permeability, but it returns as soon as you start eating again. So in order for this remedy to work, one would need to continually fast, which is pretty difficult. (http://informahealthcare.com/doi/abs/10.3109/03009748209098111); the rest of your proposed diet regimen basically just involves eating healthy foods while avoiding major triggers (which aren’t really triggers of LGS, but of actual food allergies or sensitivity, still relatively rare in the population). And of course the fact that you suggest following the blood type diet does nothing but reduce your credibility further.

    -How exactly did you establish that supposed LGS has polluted “every organ in the body”? Please provide your sources from credible peer-reviewed journals.

    -Lymphatic massage/drainage is a real medical therapy for those who have lymphedema, or swelling due to mechanical or functional blockages in the lymph system, where it has proven effective and perhaps more importantly, makes sense. Using the same technique to supposedly move/remove toxins from your lymph system is simply nonsense. If not, which toxins are you eliminating this way? How do you verify the end result (i.e. how do you know it’s working as you believe)? Convincing patients that rubbing their chests will remove “toxins” from their body is disingenuous and bad medicine. (http://en.wikipedia.org/wiki/Manual_lymphatic_drainage & http://www.quackwatch.com/01QuackeryRelatedTopics/massage.html & http://www.quackwatch.com/01QuackeryRelatedTopics/massageschool.html)

    I am not disputing the fact that there are likely a variety of contributors to such disorders (most of which we don’t yet understand), and I’m even willing to say that at some point in the future, LGS may be validated (though it’s unlikely, since it’s based on pseudoscience; but anything is possible). If you put it in more hypothetical terms, I certainly wouldn’t have as much criticism. But for you to make the kind of statements where you confidently explain things that are not yet understood demonstrates a clear lack of understanding of the scientific method and evidence-based research. When you make outrageous claims that can’t be backed up with any real science, two things happen: you convince patients of something that has no medical basis at all, offering treatments that do nothing; and you aid in the proliferation of junk science that is based almost entirely on anecdotal evidence and clinical observations. And you seem to completely disregard the notion that much of this is possibly the mind controlling the body, i.e. stress and anxiety, or depression may be the actual inciting factors that then lead to various intestinal disruptions and other ailments. To have LGS be responsible for all these disorders is too simplistic a theory, since there are probably numerous contributors, and possibly a common etiologic entity not yet discovered. If anything, the literature in total clearly suggests that permeability is the RESULT of a handful of conditions, not the CAUSE in most cases (though admittedly there are studies that suggest the converse, though they tend to be much less conclusive, focusing mainly on intermediate factors such as cytokines instead of actual causes). (http://archsurg.jamanetwork.com/article.aspx?articleid=593539 & http://gut.bmj.com/content/32/3/275.abstract & http://www.sciencedirect.com/science/article/pii/S0168827800802421)

    Just because you believe in something doesn’t mean it’s right or accurate. That is what we have research protocols for – to help eliminate some of the uncertainty and bias inherent to the investigation process, As far as I can tell, you have offered zero confirming evidence of your assertions, while also making statements that are clearly contradicted by peer-reviewed science. When you do this, you’re really not helping anyone, even though temporal associations may convince some of your patients otherwise. If you’re going to make outrageous claims, at least have some evidence (from legitimate sources and not “wellness” clinics or the like) to back it up. Otherwise, you’re just practicing bad “medicine”.

  4. dkeely says:

    I appreciate medicine, for what it is. After all, it saved my life, and helped my son with a rare nerve disorder. But I find that in order to have true healing the whole body has to be healed. A band-aid does not bring healing it just protects the wound from getting worse. It is the body that heals. I found myself in a position where my seemingly normal child had a four hour gut attack (pain in her intestinal track that no medication will help) after eating foods such as gluten, dairy, corn, tomato, nuts, oats, and soy, I began to question what is going on(yes these are real food sensitivities verified through medical testing and double verified when I see her face swell after she eats these foods). After a series of antibiotics to “heal” the gut and an ultrasound to rule out chrons disease,the gut pain increased and the sensitivities got worse. I know higher education teaches us to depend on case studies as our source of truth. So I continued down the medical path. In a period of six months my daughter, who is very athletic, gained 45 pounds, her insulin spiked and her period became irregular. The medicine prescribed correlated with at least 20 lbs of weight gain, loss of energy and frequent dr visits to check her kidneys. (Could it be pcos, sure, or is it leaky gut). We are proud to say that with enzyme use, an anti-inflammatory diet, probiotics, and a series of herbs, her stool sample has shown her good bacteria’s are on there way back to a healthy state. I still don’t know if these ideas are the “answer” but I have found that I need to keep an open mind, and that “truth” is not always backed by a funded scientific case study.

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