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Leaky Gut 101 – the Core of Chronic Inflammation and Autoimmunity

What do people mean exactly when they talk about “leaky gut” or intestinal permeability? Just a decade ago most of the medical community looked at this concept as quackery and now, in the light of recent research, we now know that it is a very real and very common condition which leads to multiple health issues. Healing the gut and restoring its proper immune barrier is at the foundation of both Functional medicine and Chinese medicine. Although, only recently recognized by mainstream medicine and testing Chinese medicine recognized this condition for over 1000 years as an inability for the digestion to “separate the turbid from the clear.”
Leaky gut occurs when the immune barrier of the gut erodes to the point that it becomes permeable to intestinal contents allowing foreign contents to enter the bloodstream. These improper substances then lead to a strong inflammatory and immune response. This inflammatory response can lead to local symptoms such as bloating, IBS, and abdominal pain. Systemically, this draining immune reaction can tax all the systems of the body. It has major implications in autoimmunity, chronic allergies, skin conditions, fatigue, brain fog, joint inflammation, etc. Studies have directly linked intestinal permeability to rheumatoid arthritis, ankylosing spondylitis, vasculitis, etc. As more studies are completed we are realizing it is at the root of many chronic inflammatory and autoimmune conditions.
How do I know if I have leaky gut? Leaky gut can often be diagnosed though a careful history, however the diagnosis is typically confirmed through testing for Sig-A, an important binding protein of the intestines, specific markers on a Genova Organix profile, and sometimes measuring the levels of mannitol and lactulose after the ingestion of a premeasured amount. Here at Origins Medicine we evaluate the integrity of the gut by testing the adrenal function, the gut directly with GI-MAP test, and through an Organic acids panel.
Although leaky gut can impact all systems of our health it can be effectively treated. The gut lining is constantly renewing itself and this dynamic quality means it can heal quickly! When the systemic inflammation has been addressed, gut health improves, and the toxic burden on the liver diminishes. The first step is to test the gut lining as it can be impacted by imbalances of the stress hormones, common infections, food sensitivities, toxic exposures, etc. Once the culprit or culprits are identified the true healing can begin. It’s like falling off your bike and skinning your knee. You wouldn’t expect the skinned knee to heal if you keep falling off! The testing allows us to identify the root cause of the damage so it can be corrected and lasting health restored.
For the more science oriented readers I’ve attached the following journal article that summarizes very well our current understanding of autoimmunity and intestinal permeability:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4036413/

In Health,
Duncan Macdonald, L.Ac.

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