What Causes Leaky Gut Syndrome? The Top Triggers Of This Insidious Gut Problem + How To Treat It

You’ve probably heard of leaky gut syndrome. After all, it is one of the most talked about conditions in the wellness world. But leaky gut syndrome - also known as intestinal permeability - is far more than a buzzword. In fact, it is a complex condition that manifests in a variety of symptoms and health problems.

As a functional medicine expert, leaky gut syndrome is something I see on a daily basis in my telehealth clinic. What people don’t typically realize is that this condition is ultimately a complex interplay between diet, lifestyle, genetics, and environmental factors. Therefore, in order to heal we must identify what causes leaky gut syndrome in the first place. So without further ado, let’s learn more about what triggers leaky gut syndrome and ways it can show up in your health so that we can finally achieve long-term, sustainable healing.

What causes leaky gut syndrome

Everyone’s microbiome configuration is unique, kind of like a fingerprint, but there are certain elements that can cause trouble for most of us. While every person is different, these are the top lifestyle and medical contributors to an unhealthy gut.

1. Poor diet

Like it or not, food can either fuel health or fuel disease. One very common way food fuels disease is by damaging the balance of the microbiome. Processed and sugary foods are the most obvious culprits because they feed the more pathogenic types of bacteria as well as Candida albicans, but underlying food sensitivities to even so-called healthy foods can also lead to gut-damaging inflammation.The best diet isn’t always obvious, and depends on your personal microbiome makeup, genetics, and lifestyle.

2. Gut-meddling medications

Medications are sometimes necessary, but even the ones that help you can have side effects. One of the most common side effects of both prescription and over-the-counter (OTC) medications is compromised intestinal barrier. In other words, medications can make your gut more permeable, leading to “leaky gut syndrome.” A few of the most notorious culprits:

Antibiotics: These can save lives, but frequent use and overuse of these drugs kill gut bacteria without distinguishing between good and bad. With more good guys gone, pathogenic bacteria and fungi can take over, especially if you are not making efforts to restore the balance through probiotic supplements or fermented foods.
Non-steroidal anti-inflammatory medications: Ibuprofen, naproxen, and aspirin relieve pain by blocking the enzyme cyclo-oxygenase, but this also inhibits it from doing its important job of protecting your stomach from the corrosive effects of its acid. The result can be an increase in intestinal inflammation and consequent permeability. Research estimates that 65 percent of people who consistently use NSAIDs have intestinal inflammation and 30 percent have ulcers. If left unchecked, gut permeability can trigger an autoimmune response.

3. Chronic stress

We are all meant to handle stress now and then, but when stress becomes chronic and you experience consistently high levels of the primary stress hormone cortisol along with decreased oxygen delivery to the gut, damage can be the unfortunate result. Blame the gut-brain axis because the emotional turmoil of chronic stress can directly impact gut inflammation.

4. Alcohol overuse

A glass of wine every once in a while probably won’t do much to your gut in the grand scheme of things (unless you are already experiencing inflammation and severe gut dysfunction). However, consistent alcohol consumption in even the healthiest people can be an intestinal irritant, as well as suppressing the hormones that protect against inflammation and gut permeability.

5. Grains

The negative impact of gluten is well documented now, but in a few years, I believe research will confirm the similar, possibly even worse, negative impact of all grains, including those that are gluten-free. With their abundance of amylose sugars that cause inflammation, anti-nutrients such as lectins and phytates that bind to the intestines (1) and make nutrients inactive (2) in the body, and a low nutrient density trade-off for the calories that contain (especially when refined), grains can cause a wide array of damage to your gut and your general health.

6. Autoimmune conditions

Chronic inflammation can destroy the integrity of the gut lining and cause undigested food particles and the toxic by-products of digestion to leak out of the gut into areas where they are not meant to be. This can cause your body to mount an attack against these perceived “invaders,” increasing levels of pro-inflammatory cytokines that destroy your gut lining to even higher levels, in a vicious cycle of inflammation.

7. Hormone imbalances

Imbalances in the hormones estrogen, progesterone, testosterone, thyroid hormones, and cortisol have all been linked to sluggish healing of intestinal damage. This can lead to leaky gut syndrome, as the chronic inflammation in the gut lining damages it, causing it to become more permeable. This may explain why you may not be able to heal despite your best efforts—it’s those pesky hormones! Many people need to focus on balancing their hormones before they can successfully heal their guts.

8. Imbalanced blood sugar

When blood sugar skyrockets due to excessive carbohydrate intake or insulin resistance, compounds known as advanced glycation end products, or AGEs, go sky-high too, which can increase the permeability of your gut as well as inflict free radical damage on other tissues, accelerating aging.

9. Neurological problems

Your gut and brain are forever linked. They were formed from the same fetal tissue while you were growing in your mother’s womb. They continue this special bond throughout your life through a connection known as the gut-brain axis. Because of this bond, brain problems like depression, anxiety, autism, ADHD, stress, and dementia can lead to leaky gut syndrome and vice versa.

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Additional health problems that may result from poor gut health

Because your gut controls so many areas of your health, you don’t have to have typical gut symptoms to have gut problems. These are just a few of the far-reaching health problems your gut has influence over.

1. Autoimmune conditions

As of now, there are around 100 recognized autoimmune conditions and about 40 other diseases that have an autoimmune component. Since your immune system mainly resides in your gut, it is no surprise that a damaged microbiome and leaky gut syndrome are preconditions for autoimmunity.

2. Mental health disorders

The gut-brain axis links your gut and brain, which is why, in the medical literature, your gut is actually referred to as “the second brain.” An unhealthy microbiome has been linked (3) to mental health conditions such as anxiety and depression.

3. Skin conditions

Skin problems like acne, (4) psoriasis, (5) and eczema (6) all have microbiome and inflammatory-autoimmune components to them. For many, the missing link to healing their skin issues is healing their microbiome.

4. Weight gain and obesity

Weight loss resistance and obesity have been linked to an imbalance of bacteria in the microbiome. Studies (7) in mice found that overweight mice had a higher number of the bacteria Firmicutes, while thin mice had a higher proportion of the Bacteroidetes bacteria. In human cases, the beneficial bacteria called Lactobacillus rhamnosus was found to support weight loss in women. The microbiome factor may turn out to be a key component for many people seeking to lose weight their body has been holding on to for years.

5. Acid reflux and GERD

Millions of people suffer from acid reflux, or the more serious GERD, and these problems have been correlated with a microbiome dysfunction called SIBO, or small intestinal bacterial overgrowth.

6. Heart disease

Scientists recently discovered (8) a possible link between the microbiome and cardiovascular disease. Certain bacteria in the gut produce TMAO (trimethylamine-N-oxide), which is linked to a higher risk of heart attack and stroke. It is still unclear which microorganism produces these excessive levels of TMAO, but researchers are hoping that, in the future, manipulation of the microbiome species can help in the prevention and treatment of heart disease.

7. Poor immune health

The opposite of autoimmunity (an overactive immune system), suppressed immunity can be gut-related, too. If you find yourself sick often, you’ll want to support and improve your microbiome health. Chronically low immune system health can be largely due to (9) imbalances in the microbiome, especially due to an overgrowth of opportunistic bacteria, yeast, or fungus, or a parasite.

8. Asthma and chronic sinus infections

Dysbiosis (imbalance) of microbiome bacteria and an overgrowth of Corynebacterium tuberculostearicum, were shown (10) to be a frequent underlying culprit for asthma and chronic rhinosinusitis (CRS). An unhealthy gut is also a major contributing factor to seasonal allergies.

Do you have leaky gut syndrome?

As we’ve seen, leaky gut syndrome can result in a variety of health conditions, even ones that seem completely unrelated to digestive distress. These are the symptoms I see in my telehealth functional medicine clinic that are most often associated with leaky gut syndrome.

Acid reflux
Anxiety
Bloating
Brain fog
Depression
Constipation
Fatigue
Food sensitivities
Gas
Headaches
Joint pain
Nutrient deficiencies
Skin problems (acne, rashes, eczema)
Weight loss resistance

In order to determine if you do have leaky gut syndrome, I recommend running labs to look for the presence of the following antibodies to rule out similar gut dysfunctions or other health problems.

Zonulin and occludin: These two proteins control gut permeability, and the presence of antibodies can indicate damage to the tight junctions that keep your gut lining sealed.
Actomyosin: This can indicate that there has been destruction of the gut lining.
Lipopolysaccharides (LPS): The presence of these antibodies outside of the digestive tract can also indicate leaky gut syndrome.

If you are in the early stages of your wellness journey, you can also take my Leaky Gut Quiz which will give you a better idea of what your symptoms could mean in relation to leaky gut syndrome.

Next steps to take care of your gut

With so many wellness tools aimed at healing your gut, it can be overwhelming knowing where to start. If you are just beginning your gut healing journey, I recommend focusing on these three tips to

1. Reassess your diet

In functional medicine, food is foundational - especially when it comes to gut health. It’s important to be mindful of whether the food you are eating on a daily basis is soothing your gut or aggravating it. Don’t know where to start? Check out my list of foods to avoid and foods you should eat more of to help heal from a leaky gut!

2. Focus on probiotics and prebiotics

Your microbiome needs two things to flourish: probiotics and prebiotics. Probiotics are live bacteria that reintroduce new, good bacteria strains into your gut whereas prebiotics are a form of dietary fiber found in certain foods that act as a food source for your gut’s healthy bacteria so they can multiply.

I recommend eating more fiber rich foods like flaxseeds and asparagus and adding in a daily probiotic supplement like The Probiotic from my supplement line, The Collection.

3. Manage stress levels

I believe that stress is the most overlooked killer of gut health because it is something we don’t normally associate with gut dysfunction. By managing your stress levels through mindfulness practices like meditation and breathwork - and even cutting out toxic relationships that no longer serve you - you’ll be on your way to a happier, calmer gut in no time.

Seeking help from a functional medicine doctor

Ultimately, everyone’s gut health is unique, so working with a functional medicine practitioner can help you identify what causes leaky gut for you and help you come up with an action plan that best addresses your particular needs. Instead of spending years on Dr. Google trying every gut healing remedy under the sun, my team and I are here to take the guesswork out of wellness so you can start healing your gut without the unnecessary trial and error.

If you are ready to learn more about how we can help you heal your gut with functional medicine, schedule a telehealth consultation today.

As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

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BY DR. WILL COLE

Evidence-based reviewed article

Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, Gut Feelings, and The Inflammation Spectrum.