The Nutritional Connection to "Leaky Gut"

The gut can develop "leaks" In 1997, Newsweek published an article called "Gut Reactions", in which they reported that tiny leaks in the lining of small intestine may play a role in diseases as diverse as asthma and arthri­tis.' This was one of the first times that the con­cept of "Leaky Gut" had permeated the mainstream literature. Although it is a phrase that conjures up visions of the intestinal lining with holes in it similar to a busted hose, the focus on the health of that lining has brought about a new awareness of one of the oldest immune weapons we have— our own gut lining! The lining of our intestine is meant not only to absorb food, but also to act as a barrier to keep out invading pathogens. The mucosal layer of a healthy gut filters out microorganisms and undigested proteins. When this lining gets battered by things like aspirin, bacteria, or even the pesticides sprayed on our food, the lining loses its integ- rity. This is when the door is open to let in the bacteria, the viruses, the parasites (even undigested food molecules!) which can activate the immune system (and also the autoimmune system). We refer to this loss of integrity as "the leaky gut syn­drome". When the gut lining loses its strength and becomes "leaky", it opens the door to disease. Various toxins can make their way through the barrier of the intestinal lining when it is permeable, and then travel to the liver to be detoxified. When the detoxification processes of the liver are impeded, toxins accumulate, and it results in mani­festation of disease, depending on where the toxins exert their effect. The toxins can reeirculate or deposit in various places in the body. Either way, they will upset the apple cart of balance. The toxins can even reeirculate to the intestinal area where they increase the permeability of the intestinal lining even more. The relation to toxic overload on the liver and leaky gut is cyclical: A leaky gut will allow more toxins to enter the system, and, conversely, toxic overload of the liver increases leaky gut. Disruption of the Barrier The gastrointestinal lining is supposed to absorb our nutri­ents and, at the same time, act as a barrier to toxins. Aside from the physical barrier to invading pathogens, the GI lining makes up a major part of our immune system. The word "GALT" refers to "Gut-associated lymphoid tissue", which actually contributes to the body's defense against attack. The gut lining furnishes secretory IgA (antibodies) and white blood cells to attack for­eign invaders before an attack can become systemic. Some of the things that can disrupt that barrier, however, include: • bacteria, virus, parasites • NSAID's (non-steroidal anti-inflammatory drugs, like aspirin and ibuprofen), alcohol • free radicals • endotoxins, environmental toxins, cytotoxic drugs • inflammation (i.e., lectin binding or food allergy reactions) When we stop to consider the damage that can be done by a leaky gut, it's not surprising that many diseases are associated with leaky gut. These diseases include Celiac disease, food allergy, asthma, eczema, demiatitis herpetiformis, psoria­sis, arthritis, irritable bowel syndrome, inflamma­tory bowel disease, chronic fatigue syndrome, pan­creatic insufficiency, environmental illness, mul- tiple chemical sensitivity, and various others. Even when the leaky gut does not directly cause the disease, the resulting leakiness exacerbates the disease. Symptoms of leaky gut can include fatigue, arthralgia, myalgia, fever, abdominal discom­fort, diarrhea, skin rashes, toxic feelings, memory deficit, and shortness of breath, among others. Un­digested food proteins, which leak through the lining, cause food allergies and other problems to occur. Food and the Leaky Gut One of the first line nutritional defenses to prevent the absorption of these large "macromolecules" of undigested food is by supplementing hydrochloric acid, which uncoils protein and starts the di­gestive breakdown, and also by supple- menting pancreatic enzymes, which continue the breakdown process. When the immune barrier is healthy, the brush border at the very surface of the lining secretes brush border enzymes, which take the small proteins that have been broken down by pancreatic enzymes, and break them into individual amino ac­ids. When people have protein-digestive problems, even when they are on enzyme supplements, look to the integrity of the brush border that should be breaking down any remaining pro­teins to single amino acids. Single amino acids will NOT cause a reaction—protein structures activate the immune system! Later in this article we discuss nutrients that build a healthy intestinal lining and brush border The Leaky Gut and Autoimmune Disease The leaky gut and food proteins are also highly implicated in autoimmune diseases. Some people have more of a genetic tendency than others to activate normal resting T cells, which then attack cells. These cells are supposed to be foreign invad­ers; but, sometimes, T cells are activated against the body's own tissues, as in autoimmune disease. J. Hoorfar implicated the leaky gut and undigested food proteins in this T cell attack when he said, "It is thought that some dietary proteins escape the enzymatic digestion in the gastrointestinal tract and could, possibly, launch a polyclonal activation of the resting T lym- i i i cs in susceptible individuals."2 It has been said that, "The immunologi-cal mechanisms of rheumatoid arthritis probably begin when antigens cross an excessively permeable intestinal mu-cosa."1 Diabetes is another autoimmune disease closely connected to the food pro­teins that can leak through a weak intesti­nal lining and initiate disease. A promi­nent researcher in the field of diabetes, F.W. Scott, linked the leaky gut to type I diabetes, and proposed it as a possible trigger in the development of the disease. It is important to keep in mind that this is not the only trigger for diseases such as diabetes, however it may be an important one. One of the proteins leaking through the gut barrier to initiate diabetes is sus­pected to be the beta casein protein in cow's milk. Antibodies to the milk protein are thought to cross react with pancreas beta cell proteins in the body and destroy them.4 Healing the Leaky Gut Fortunately, there are positive solutions for protecting the immune barrier of the gut. Several nutrients help to maintain and fortify the integrity of the intestinal lining: Glutaminc is the main fuel that the intesti­nal cells need for maintenance and repair. Glutamine reinforces the immune system, and there is considerable evidence that glutamine can enhance the barrier func­tion of the gut against viral, bacterial, and food antigen invaders.5 Lactobacillus bifldus is a name for friendly bacteria, which offset populations of bad bacteria, boosting the immune system. Friendly bacteria especially counteract Candida, which can spread long mycelial arms right through the intestinal lining and perforate it, increasing leaky gut and per­mitting wide-open entry to microorgan­isms and toxins. NAG (N-acetyl glucosamine), aside from being able to heal the extracellular tissue surrounding intestinal cells, has the unique ability to decrease the binding of some lectins to the intestinal lining, which can cause inflammation. NAG is one of the few nutrients with the power to bind to the powerful wheat germ agglutinin (WGA) lectin, which can activate T cells and influence autoimmunity in susceptible people. Vitamins C and E, lipoic acid, zinc and ginkgo biloba arc all antioxidants which can protect the lining from free radical dam­age. Ginkgo biloba also increases circula­tion in the smaller vessels and capillaries, which increases nutrient delivery and tis­sue healing. The New England Journal of Medicine notes that zinc is involved in clearance of infection, increased levels of brush-border enzymes, regeneration of epithelial tissue, and improved absorption of water and electrolytes.6 DGL (deglycyrrhizinated licorice) in­creases the integrity of the mucosal cells— it increases the life span of the intestinal cells, improves the quality of protective substances, and improves blood supply of nutrients.7 Additionally, it has a high healing rate and significantly low relapse rate for ulcers." Slippery elm is a soothing, protective de­mulcent renowned for its beneficial effects on the gastrointestinal lining. Slippery elm calms the inflamed mucous membranes of the stomach.'' In addition to a soothing texture that coats the stomach lining, slip­pery elm contains the fiber-rich ingredient mucilage which stimulates mucus secre­tion (especially protective against ulcers). Cat's claw is a novel herb that has been researched for its, "remarkable ability to cleanse the entire intestinal tract and help those suffering from different stomach and bowel disorders", including Crohn's dis­ease, gastritis, ulcers, parasites, candidi-asis, diverticulitis, hemorrhoids, leaky gut, and intestinal flora imbalance.'" All of the above nutrients work to sup­port a healthy, strong intestinal wall that not only helps digest our food, but boosts our immune system and plays an impor­tant role in our defense against disease. Dr. Lynn Toohey received her Ph.D. in nutrition from Colorado State University in Ft. Collins, CO. She has lectured to chiropractors and other health profession­als across the country and also in Canada and Europe on nutrition-related topics and complementary medicine. Various lec­ture engagements have included speaking for the International College of Applied Kinesiology (ICAK), the United Chiro­practors of New Mexico (UCNM). and the Florida Chiropractic Association (FCA). You may reach Dr. Toohey by e-mail at drtoohey(a)nutri-west. net.