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The Leaky Gut Syndrome


Susan R. Johnson MD, FAAP 2/28/09 (rev 12/11/12)
*Also read the updated Allergy Treatment Article

I have learned a great deal from the Naturopathic and Osteopathic students who have visited my clinic. They have taught me most of what I know about the Leaky Gut Syndrome. In this syndrome, the lining of the colon and small intestine becomes inflamed and allows partially digested proteins to be absorbed into the body. The immune system reacts to these foreign proteins triggering allergy symptoms, autoimmune diseases, speech delays, and behavioral abnormalities. There are several good books on the topic of the Leaky Gut Syndrome such as Renew Your Life: Improved Digestion and Detoxification written by Brenda Watson, N.D., Children With Starving Brains by Jaquelyn McCandless, MD., and Gut and Psychology Syndrome by Natasha Campbell-McBride, MD.

There are many things about the American diet and Western medical practices which weaken the immune system and result in the Leaky Gut Syndrome. To begin with, exposure to antibiotics, especially in the first two years of life, destroys good intestinal bacteria and thereby promotes the overgrowth of yeast in both the large and small intestines. Yeast in the intestinal tract acts as a parasite and in essence steals many vitamins and minerals before they can be absorbed through the intestinal wall.

In addition, the American diet with its overabundance of and reliance on simple carbohydrates such as candy, breads, and pastas, depletes the body of zinc, magnesium, chromium, and several B vitamins. These simple carbohydrates rapidly convert to sugar and trigger the pancreas to secrete too much insulin. Because insulin requires trace minerals and B vitamins as cofactors in sugar metabolism, the more the body consumes sugar, the more the bodys B vitamins and trace minerals are depleted. The immune system as well as the metabolic system and brain can not function well when zinc and B vitamins are deficient.

This typical American diet, often consisting of fast foods such as hamburgers, french fries, sodas, and milkshakes, also lacks fiber and enzymes. Plant enzymes, which naturally occur in raw fruits and vegetables, help break down fats, proteins, and carbohydrates in the food we eat and allow this food to be more readily absorbed in the small intestine. Without a daily diet of raw vegetables and fruit, the body is stressed and overburdened by having to produce these enzymes in the pancreas. The pancreas now is overworked. In addition to secreting insulin for glucose metabolism, it must also secrete digestive enzymes to break down fats, proteins, and carbohydrates in the small intestine. As a result, metabolism becomes sluggish. Now, partially digested proteins and undigested fats and carbohydrates end up in the large intestine, where they ferment and create abdominal discomfort and odorous gas.

Because of a lack of fiber in the diet and the failure to drink enough water between meals, constipation occurs. The increased pressure it takes to push stool out of the colon often causes fecal material to travel backwards up into the small intestine by forcing the valve between the small and large intestine to open. Now yeast, parasites, and unhealthy bacteria set up residence in the small intestine as well and directly block the absorption of minerals, vitamins, amino acids (proteins), and fats. In addition, we often do not eat foods that would provide a consistent source of good intestinal bacteria, such as fermented vegetables and quality unsweetened yogurts.

With the good bacteria gone, yeast overgrows and burrows into the intestinal wall, causing inflammation. Now, instead of partially digested proteins being excreted in the stool, these proteins get reabsorbed back into the lymphatic and blood streams through this leaky intestinal wall. Partially digested proteins, including pollens that are swallowed, act like foreign proteins and trigger the bodys immune response (IgG antibodies) resulting in chronic allergies, asthma, eczema, and autoimmune diseases. Once children or adults have developed a leaky intestinal lining, their bodies will react to numerous proteins in food and the environment.

Some of the most difficult proteins to digest include casein from milk products and gluten from wheat, barley, and oats. Breakdown products from gluten are believed to cross the blood brain barrier and cross react with receptor sites for speech, causing language delay and the type of speech patterns noted in children with Autistic Spectrum Disorder. The milk protein, casein, if reabsorbed back into the body is thought to trigger eczema and create allergy-related conditions of sinusitis and serous otitis.

What can be done to heal the body and strengthen the immune system? Here is what I have learned so far:

1) To restore normal intestinal bacteria:

a) Take a good probiotic (usually the best are in powder form and refrigerated). A good probiotic contains resident strains of intestinal bacteria such as Lactobacillus acidophilus, Bifidobacerium bifidum, and Bifidobacterium longum (infants need Bifodobacterium infantis). Probiotics should be taken for 4 months after any antibiotic use. In my practice, I recommend Bio-Kult capsules (www.GAPSdiet.com) for older children and adults. The capsules can be placed in applesauce so they are easier to swallow. For infants, I recommend Life Start by Natrens.

b) Consume fermented foods and drinks containing good intestinal bacteria (e.g. fermented cabbage and lactic acid-fermented beverages). Look in the book Nourishing Traditions written by Sally Fallon, for recipes. When looking for fermented vegetables at health food stores, check to see that vinegar is not listed among the ingredients.

c) Make your own yogurt and kefir. I make yogurt or kefir by adding 1/2 cup of yogurt starter (one can use 1/2 cup of Strauss organic whole milk yogurt) or 1/2 cup of a live kefir culture (check the web site for sources of Doms kefir) to 16 oz raw organic whole milk from a certified dairy. Now pour the mixture into pint-sized jars and cover with a paper towel or cheese cloth. I place the jars with the kefir mixture on my counter for 24 hours and then refrigerate. You now have kefir. I heat the yogurt mixture gently to room temperature and then place jar(s) of the yogurt mixture into a cooler that contains another jar full of boiling hot water, which serves as the heat source. Close the cooler and recheck after 6 to 8 hours.

d) Eat plenty of organic raw nuts, seeds, fruits, and vegetables. They serve as a source of fiber for the good intestinal bacteria which cant survive without them. Fiber also bulks up the stool and stimulates the bowel to contract which ensures regularity. Flax seeds are a great source of fiber, both soluble and insoluble. It is recommended that 14 grams of fiber (an apple contains about 4 grams of fiber) be consumed for every 1000 calories of food eaten each day. Another great source of vitamins, enzymes, minerals, and fiber is to juice 9 organic large carrots, 6 stalks of organic dino kale, 1 organic cucumber, 1 organic red beet plus beet greens (ie. leaves), 1-2 organic red apples, 1 peeled lemon and 1 peeled orange in a juicer. Drink at least 8 to 12 ounces of this juice every morning. The left over pulp (fiber) from the juicer can be frozen overnight and then combined in a blender with fresh orange juice and a banana. This smoothie can be eaten with a spoon and is loaded with fiber. The fiber will stimulate increase contractility of the small and large intestine and could cause a stomachache if the intestinal lining is still inflamed.

e) Drastically reduce sugar in your diet and avoid concentrated fruit juices, white bread, candy, and sodas. Sodas, besides containing lots of sugar, contain phosphoric acid which leaches calcium from the bones and contributes to the development of osteoporosis and loss of cartilage.

f) Increase alkaline-forming foods such as organic fruits, vegetables, herbs, and almonds. Make these foods 80% of your daily diet. Alkaline forming foods provide lots of minerals that bind acids in our body. Keep the pH of your saliva between 7.0 and 7.4 for good health. Test your saliva upon awakening and 2 hours after eating a meal to determine baseline values. I use Vivid pH paper with a pH range of 6.0 to 8.0 that I order from Micro Essential Laboratory in New York. Their phone number is 718-338-3618 (www.MicroEssentialLab.com).

g) Drink an herbal tea which is highly alkaline or tea made from fresh lemon juice. These teas help to discourage yeast growth . In my practice I also recommend drinking Liver Tea from Uriel Pharmacy and/or taking Amara Drops from Weleda Pharmacy which both contain bitter herbs like dandelion and yarrow. Both support digestion and liver function. Chinese medicine also recommends teas made from bitter tasting herbs. Bitter herbs, in general, also stimulate bile secretion which helps with fat absorption in the small intestine and serves as a way for the liver to excrete toxins from the body.

h) Consume plenty of fresh garlic (see my detox mineral bone soup recipes) since garlic discourages growth of yeast. There also are anti-yeast formulations of herbs that come in capsules. These capsules often contain grapefruit seed extract, garlic, uva ursi, neem leaf, olive leaf, oregano leaf, berberine, and calcium undecylenate from the castor bean. These capsules are often taken orally before breakfast and before bedtime for a period of 15 to 30 days. Another approach is to take natural plant enzymes for three weeks at bedtime, on an empty stomach. These enzymes will help the body break down the cell wall of yeast and destroy parasites in the intestine.

i) Make organic chicken mineral bone broth by putting a whole organic chicken in a large stainless steel soup pot filled with good quality water and 1 Tbs. of apple cider vinegar. Remove the chicken meat after 8 to 12 hours and consume or refrigerate for later, but continue simmering the bones and the broth for another 12 to 16 hours. Now strain the broth of bones and put in the refrigerator. Remove the soft chicken fat that forms a thin layer on the top of the broth. Now the broth is ready to heat and serve in other soup recipes or on rice. This bone broth helps to heal the intestinal lining as well as providing a lot of minerals. Dr. Campbell-McBride recommends consuming 1/4 to 1/2 cup of bone broth before every meal. See Nourishing Traditions Cookbook by Sally Fallon and Gut and Psychology Syndrome by Natasha Campbell-McBride for recipes.

2) To reduce casein and gluten protein sensitivities:

a) First, stop all milk products for at least three weeks then add back milk products on day 22 and see if congestion increases, eczema worsens, or snoring increases. Naturopathic physicians have taught me that it takes at least two months to clear the casein protein from the bloodstream and the lymphatics, but symptoms will worsen when milk products are reintroduced on day 22. Repeat this same process with all products that contain gluten (e.g., wheat, oats, barley, and rye). Children and adults may need to stay off casein and gluten products for the next four to six months while the intestinal wall heals and the beneficial intestinal bacteria are restored. A great web site to help with the casein/gluten-free diet is www.Tacanow.org. Also read about the GAP diet in Gut and Psychology Syndrome by Natasha Campbell-McBride and the book called The GAPS Guide-Simple Steps to Heal Bowels, Body, and Brain by Baden Lashkov at www.gapsguide.com. Another great cookbook written by a parent is called Eating the Best We Can; Recipes from one imperfect familys adventure in grain-free, refined-free eating (This cookbook can be ordered by Sending $13 to Carol-Jean Boevers, 4365 Doolittle St. Santa Rosa, CA 95407). Be careful of store bought gluten free products that may contain other ingredients that are harmful to the intestinal lining. When reintroducing milk products, homemade yogurt or kefir made from raw organic milk is the easiest to digest.

b) Take supplemental plant-based enzymes for a few months, preferably from organically grown plants, at the beginning of each meal to help with digestion (especially when not eating any raw vegetables during the meal) or better yet get fresh plant enzymes by drinking at least 8 to 12 ounces/day of the juiced raw vegetable and fruit drink I mentioned earlier.

c) Make homemade almond milk by soaking almonds overnight in water containing unrefined Celtic sea salt (I use 1 tsp of salt per cup of almonds). The next morning briefly blanch the almonds in hot water so the skins can be more easily removed. Using a blender, mix the peeled almonds with water or organic rice milk. Crispy nuts can be made by slowly roasting the almonds in an oven on the lowest setting for 24 to 36 hours after soaking them overnight in salty water. Almonds are a great source of protein and fat as well as calcium, magnesium, and other trace minerals. Good fats like almonds, avocados, and eggs slow the emptying time of the stomach and thereby lower the concentration of sugar that triggers insulin release. Proteins and fats, by themselves, do not stimulate insulin release, and eating complex carbohydrates which are high in fiber also reduces the amount of insulin that the pancreas needs to secrete.

d) Avoid soy milk or any other unfermented soy product. Miso soup is okay because it is fermented. Unfermented soy products block thyroid hormone function, protein and calcium absorption, and have strong estrogen effects. Organic rice milk is okay but it mostly consists of carbohydrates. Homemade almond milk is healthier. With regard to cows milk, I learned during my training at the Lukas Clinic in Arlesheim, Switzerland that the healthiest milk to drink is raw organic whole milk. Ultra-pasteurized, homogenized non-organic milk is seen as the least healthy milk to drink because all the natural enzymes and vitamins are destroyed by processing, and the fat is disrupted by homogenization. The book Nourishing Traditions also discusses the advantages of raw milk as does the journal Wise Traditions published by the Weston A. Price Foundation.

3) To strengthen immune system so it is not so reactive:

a) Keep hands, feet, and kidneys as warm as the skin over the heart.

b) Consume omega 3-fatty acids from a molecularly-distilled, pharmaceutical-grade fish or cod liver oil. If the oil has been carefully processed, it will not smell fishy. In my practice, I use Nordic Natural Arctic D Cod Liver Oil, but there also are other goods brands. Be sure and look at the ratio of vitamin A to vitamin D in the cod liver oil products. The ratio needs to be around 1:1 and not 1000:1 (many cod liver oil products have too much vitamin A relative to vitamin D). I recommend taking 1 tsp/day for children 6 years and older and adults, and 1/2 tsp/day for children 3 to 5 years of age. For toddlers, I recommend Barleans flax seed oil mixed with butter and used as a spread on toast. Look at the skin and hair for signs of omega 3 fatty acid deficiency. Hair will be coarse and dull while skin may develop sandpaper-like bumps all over the upper arms, back, and abdomen. Sometimes the child needs to be taking a plant-based enzyme with lipase to improve fat absorption.

c) AVOID partially hydrogenated oils and trans-fats. Do not cook in corn oil or canola oil since these oils are heat sensitive and quickly convert to trans-fatty acids. Cook only in coconut oil (high temp), olive oil, or butter (low-med temp). Use ghee if one is sensitive to milk products. Ghee does not contain casein.

d) Eat at least a handful of soaked and slow-roasted almonds every day. Almonds are a great source of calcium and magnesium. Hemp organic protein powder by Nutiva is reportedly a good source of magnesium, protein, and fiber and is recommended in Ayurvedic medicine.

e) Prepare Vegetable or Chicken Vegetable Detox Mineral Bone Soups for extra vitamins and minerals.

f) Increase magnesium in your diet by eating soaked/slow roasted almonds, green colored pumpkin seeks, kale, seaweed, spirulina, and mineral bone broth (See my recipes for chicken vegetable mineral bone soup and detox vegetable bone soup and Nourishing Traditions Cookbook). Magnesium along with Vitamin D3 is required for calcium absorption in the bones and teeth. One of the main causes of dental decay is magnesium deficiency. Magnesium also calms the nervous system. The production of serotonin, dopamine and other neurotransmitters is dependent on magnesium as well as other minerals and vitamins. Magnesium also supports adrenal gland function. Magnesium deficiency can cause increased anxiety, fears, panic attacks, insomnia, headaches, heart palpitations, and even seizures.

Magnesium deficiency also causes constipation because it slows down peristalsis. It contributes to attention problems and mood swings and magnesium is crucial for detoxification of heavy metals like mercury, lead, and aluminum. Leg and foot cramps, growing pains, and the restless leg syndrome also result from magnesium deficiency. Magnesium supports sugar metabolism and insulin secretion. Magnesium deficiency causes insulin and glucose to build up in the blood contributing to diabetes types I and II. Fatigue is one of the earliest symptoms because magnesium is a cofactor in many enzymatic reactions throughout the body and in the immune system. Therefore, magnesium deficiency can predispose us to infections and even cancer. I sometimes recommend Calm for Kids (which is ionized magnesium) for the first few months. Usually I recommend 1/2 tsp mixed in water at bedtime.

g) Consider taking a liquid mineral supplement for a few months since an overgrowth of yeast in the small intestine may have blocked the absorption of many minerals and vitamins. The supplement should be derived from organic plants and should not contain preservatives, sweeteners, or flavorings. The one I recommend is Fulvic Mineral Complex by Vital-Earth.

h) Do Therapeutic Eurythmy movement therapy (especially the allergy sequence) with a trained Therapeutic Eurythmist. Trained Eurythmy Therapists are affiliated with Waldorf Schools, and a physicians evaluation is needed. Any harmonious, noncompetitive, rhythmic movement, like walking and hiking, stimulate lymphatic flow and are very beneficial.

i) See an Osteopathic physician for Biodynamic Cranial Osteopathy (www.JamesJealous.com) or a very experienced practitioner in Upledger Cranial-Sacral Therapy. These treatments can help drain fluid from the middle ear by relieving cranial compressions that compress the Eustachian tubes or alter the angle of the tubes causing fluid to accumulate behind the ear drums.

j) Consider visiting a N.A.E.T practitioner. N.A.E.T. is an energetic technique that reportedly decreases the immune systems reactivity to specific proteins like dairy, wheat, and soy. In my experience, a childs allergy symptoms to a particular protein can be immediately reduced, but the child still needs to follow the guidelines for healing the leaky gut. Otherwise children will just develop sensitivities to other proteins they eat or breathe in from their environment.

k) Be aware of the immune-suppressive effects of electromagnetic fields (EMF). Avoid using electric blankets and be aware of other EMF sources from household appliances, computers, and cell phones. Make sure your home and office are up to code with respect to electrical wiring. Electric companies will screen your home and office with an EMF meter at no charge. Microwave radiation from cell phone towers may also affect the immune system and overall health.

4) Symptomatic relief for allergies, sinusitis, and congestion:

a) Try Homeopathic, Anthroposophic, and herbal remedies.

b) Take a good sublingual (under the tongue) supplement containing B12 (methyl not cyano form), B6, and Folic acid, as well as a whole food complex type of vitamin C (antioxidant). A pharmaceutical-grade, molecularly- distilled cod liver oil such as Nordic Natural also has anti-inflammatory effects.

c) Keep well hydrated by drinking plenty of good quality, non-chlorinated water and decaffeinated herbal teas. As a guideline, it is recommended to drink half of ones weight in ounces of water that is sipped throughout the day. Do not drink too much water during meals, since water dilutes the acid concentration in the stomach and makes it harder for the stomach to break down proteins.

5) May need a dental consult:

a) When children develop chronic allergies as a result of the leaky gut syndrome, the adenoids and tonsils enlarge, obstructing the nasal passages. This causes children to breathe more through their mouths than their noses. Mouth breathing causes the upper palatal arch to increase (high arch) which causes crowding of the upper teeth. Dentists are now trained to use small wire retainers (ALF) which gently re-expand the upper jaw, reducing overcrowding, tooth extraction, and the need to remove the tonsils and adenoids.

6) Ways to maximize health:

a) Be sure to get plenty of sleep and avoid getting into a second wind at night, remember that sleep before midnight counts as double, walk an hour every day, meditate, sing, plant a garden, breathe deeply, laugh, practice yoga, tai chi, or eurythmy, do things you love like art, music, handwork, etc., put your life into rhythm with regular meals and a regular sleep schedule, reduce stress, slow down (remember less is best), practice being in the present moment, turn off the television, VCR, and computer games, spend more time in nature, work on yourself and work on your relationships so they are win/win instead of lose/lose, forgive yourself, forgive others, find work that you love and do it.

Note: I decided to give a few names of products I am using in my clinic but I have no financial interest or connection with any of these products. They are just the best I have found so far.


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© Susan R. Johnson, M.D., F.A.A.P.
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