The 4 MOST Effective Leaky Gut Treatments_en (auto-generated)
welcome back let's discuss the four most effective leaky gut treatments leaky gut may affect 25 up to 88 of those of us with symptoms whether they be gastrointestinal diarrhea constipation bloating gerd reflux or systemic fatigue headache brain fog joint pain or just a feeling of generalized inflammation leaky gut may be at the core of 25 to 88 of these symptoms so again let's equip you with the four most effective strategies you can deploy to improve your leaky gut welcome to Dr rooster radio providing practical science-based insights into Health exploring the importance of nutrition lifestyle and gut health through conversations with experts research reviews and personal stories we break through the bias and the noise to bring you simple trustworthy information that matters to set the stage here let's start by defining what leaky gut is if you went back 10 years ago this was much more hotly contested oh he gets not a thing there's no science and some people were saying well there's some science and now we have enough data to wherein we can conclude that yes increased intestinal permeability or the more colloquial way of saying it leaky gut is something that can implicate or be implicated in many syndromes symptoms conditions and disease States and I really appreciate this schematic from Frontiers in Immunology what you're seeing here is the intestinal Lumen specifically important to bear in mind this is the small intestine because remember the small intestine is where 90 plus of calories and nutrition is absorbed and that's where the leaky gut can occur because it's the selectively permeable membrane that has to be tightly regulated and as this schematic is illustrating when there's a disruption of microbial homeostasis the bacteria the fungus our imbalanced or overgrown that can be one of a few different steps that leads to A disruption of the health of the barrier and when this occurs you see endotoxin or LPS leak through so these are the actual particles or one of the particles and the immune system responds with inflammation and this is amongst a few the tnf alpha and interleukin-6 that you're seeing here which you'll see in the bloodstream and you can also directly quantify the leaky gut with serum zonulin and I sort of emphasize serum because we're learning that stool zonulin does not seem to be as accurate as blood or serum zonulin so this is part of the picture of what's happening in your small intestine when leaky gut is present and part of the time here I want to make you aware of is really the inflammatory component this might be how we reconcile seeing leaky gut correlate with both digestive symptoms but also that list of systemic symptoms like brain fog joint pain and skin issues that we covered a moment ago let's go one step deeper and just make sure that we run through some of the most common causes of leaky gut and then we'll Parry that into the protocol of the four most effective things that you can do by the way thank you so much for watching the video please comment like or subscribe I especially enjoy hearing what people think what their questions are future video ideas so please make a comment I'll do my best to respond to as many of those as I can okay so coming over to some of the best documented causes of leaky gut we touched on a moment ago this disruption of microbial homeostasis another way of saying that could be dysbiosis or overgrowth as in sibo in addition to this inflammation as we also covered a moment ago C-reactive protein tnf Alpha interleukin-6 amongst a handful of inflammatory cytokines that can be causal to leaky gut and leaky gut inflammation are kind of a bi-directional entanglement gastrointestinal conditions probably not surprising but IBS IBD celiac gerd everything any GI symptom throws up a flag that there could be leaky gut present additionally probably not obvious but worth just touching on a western diet a high level of alcohol consumption I'm not going to make the claim that any alcohol is going to be problematic I think we can probably have a reasonable intake of even Western food processed food as long as it's not excessive but too much bad food too much alcohol poor sleep and chronic stress all these factors start eroding at the health of this crucially important small intestinal membrane certain medications antibiotics NSAID and anti-inflammatories also chronic use of decongestants as we've covered on the podcast in the past and then chronic disease and aging all can aggregate coalesce to start weakening this barrier and leading to setting the stage four leaky gut okay and we should also just Echo the prevalence because there are some conditions that sound scary yet may only impact 0.3 percent of the population and it's not to take anything away from those but if we understand prevalence then we understand risk again and those with symptoms 25 to 88 percent of individuals have leaky gut whereas only about six percent of healthy controls demonstrate leaky gut so there's certainly a highly increased likelihood if you have symptoms a condition or a disease state that you could have leaky gut as a component underlying that the first step of the four is Diet now I'm going to give you some specifics because I know when someone or a doctor says just eat a healthier diet it's quite lackluster okay so specifically processed food and here is a great schematic we adopted from the journal Foods 2022 you see a few emulsifiers this might be one of the key factors emulsifiers and coloring agents this carboxymethylcellulose carrageenan glycerol monolorate polysorbital just to name a few have been documented to lead to increases in leaky gut and also in inflammatory bowel disease because while on the one hand yes they will help to improve shelf life these emulsifying agents they also irritate and can start to break down the lining of your gut now to be careful it's not to say you can never have any processed food we want to be careful to Stave off this sort of pernicious gravity toward a somewhat pathological or unhealthy relationship with food in moderation won't be a problem but if you're consuming processed food every day a few times per day even then this is when I would strongly encourage you to start making some changes because this might be the most foundational piece it's the process foods which actively can irritate and contribute to leaky gut and that's what you're seeing portrayed here in a bit more of an involved schematic but the take home is emulsifying agents amongst other ingredients in processed foods irritate the lining of the gut contributing to leaky gut now the flip side of this is consuming Whole Foods which will be more nutrient dense usually will have less calories or will be less prone to overeating will contain phytonutrients fiber healthier proteins healthier fats so a simple thing you can do is just move from a diet that has more processed food over to a diet that's higher in whole fresh unprocessed foods you may have heard this Axiom of shopping the perimeter of the grocery store this is where you'll have food that can spoil and the interior will be your packaged foods that last longer on the Shelf because of in part the emulsifying agents and what's nice about this is It's dietary agnostic you can move from processed food to Fresh Whole Food in any sort of diet plan paleo vegan Mediterranean high carb low carb whatever you like the other component here that you've likely heard of but it's worth mentioning a elimination and reintroduction of foods that are known to be irritating the short list here gluten dairy eggs soy fish shellfish nuts and also perhaps seeds now not all of these foods have been demonstrated to contribute to leaky gut but they are known to in some people provocate symptoms and I think symptoms is a pretty good proxy for leaky gut but to be careful we don't have data all the way down this list gluten has been shown to provocate leaky gut importantly in the model of non-celiac gluten sensitivity meaning you don't have full-blown diagnosable Celiac but they're still an aversion to gluten however we always have to balance this because if you look at the messaging online oftentimes it will have people believe that anyone not feeling well suspecting leaky gut what have you probably has a gluten intolerance and when you look at the data on ncgs non-celiac Gluten Sensitive it averages at about five percent of the population so something to consider cutting out and reintroducing but the second half of that statement is really crucial reintroduce because you don't want to be avoiding a food in perpetuity just based upon fear based upon faith and this is what's nice about many diet plans I think the paleo diet is a good template to cut out most problematic foods for about a month and then reintroduce them and see when I bring back in bread do I notice my symptoms clearly flare when I bring back in Dairy do I notice I have loose bowels or abdominal pain when I bring back in nuts or shellfish do I notice I don't feel well you know for whatever the reason because remember leakia can manifest as gastrointestinal and systemic symptoms so it's really not about the symptom specifically but about the timing I'm feeling good I reintroduce I feel poorly I wait a week or two I try again I'm feeling good again we're going to introduce one more time again I elicit that same negative reaction that's what you want to look for so that you can be somewhat certain that a given food is causing a problem and the other component to diet that I think is really underappreciated is low FODMAP dieting this really speaks to the person who may have observed sadly the better I eat the worse I feel you'll see this sometimes wherein someone improves their diet the reading less processed foods they're eating more fruits and vegetables yet their symptoms are getting worse and sometimes what happens here is people are eating more fruits and vegetables and many of these are high FODMAP FODMAP stands for fermentable oligodi monosaccharides and polyols structures of carbohydrate that we know are conducive to feeding intestinal bacteria but the problem is for some people too much feeding occurs thus flaring symptoms now this is all conjecture until I show you some evidence so let's look at this really impressive clinical trial where they found 12 weeks on a low FODMAP diet reduced serum zonulin blood zonulin reduced lipopolysaccharide the actual measure of stuff leaking through and reduced interleukin-6 a inflammatory cytokine that usually accompanies the leakage and the other point without getting tuned to the weeds I wanted to Loop you in on stool zonulin did not change one of many a growing data point showing us that stool zonulin does not correlate with improvements in health but blood zonulin does so just be careful because stool zonulin testing is fairly readily done and just be careful because we're learning that doesn't seem to be an accurate marker for tracking zonulin or for leaky gut if you are eating more healthy foods more broccoli cauliflower avocado apples all these things are high fodmount and you can easily find and we'll put some links to low FODMAP diets amongst others that guide you in the description of this video and the podcast but trial three to four weeks in a low FODMAP diet when it works it works and people really notice a resolution in their symptoms as evidenced by this one clinical trial and the final component for your diet probably a little bit obvious but we should point it out is the consumption of fermented foods there is a fairly long history where we have observed people consuming fermented foods are healthier Zoom or forward modern day and we're seeing data like this a clinical trial of 28 subjects they were given either kefir a fermented milk or regular milk and they found in those consuming kefir a reduction in the marker of leaky gut zonulin quoting our study is the first showing that kefir supplementation causes an improvement in serum zonulin levels and I would argue the same likely holds if we had further data for other fermented foods so sauerkraut kombucha kimchi are all things to consider integrating into your diet and in recap reduce processed food consumption and correspondingly increase Whole Food consumption reduce the amount of common allergens at least for a little while and then you can reintroduce and figure out what if any triggers you may have reduce consumption of fodmaps and again with this it's usually anywhere from one to three months and then people can reintroduce and tolerate fodmaps without difficulty and finally four make fermented foods a commonplace foodstuff that you consume so that's the dietary piece and that breaks it down to the four probably most important components let's move on to the next aspect of this the second factor is lifestyle and I want to just make a quick comment that it's such a slippery slope into supplements supplements supplements supplements for improving whatever it might be right because it's just a market pressure influence that we have to be aware of but we can't Overlook the fact that exercise has been shown to reduce leaky gut and the data that we have here are pretty darn compelling 2021 systematic review appearing in the Journal of Frontiers and nutrition 23 studies were summarized and they found that exercise reduced leaky gut let me break down a quote moderate exercise May preserve the intestinal mucosa so right there when the mucosa erodes that is leaky gut so that right there is point one but let's continue by accelerating gastric emptying and improving intestinal motility meaning the food moves through your stomach and intestinal tract at the appropriate pace if things move too fast or too slow this can contribute to overgrowth and dysbiosis probably unironically when you move your intestinal contents move also continue with the quote increasing the abundance and diversity of the gut microbiota so there's the healthier bacteria also increasing burate producing bacteria and the synthesis of short chain fatty acids so you see multiple positive shifts occur improving that you got when you exercise I think a minimal for most people not necessarily for leakya but just for General Health two resistance training sessions per week and two endurance or cardiovascular sessions per week as a minimum if you can do that anywhere from maybe 20 to 40 minutes as a starting point moderate intensity that is going to be a great start don't forget about how powerful exercises for improving the health of your gut now in step with this I guess pun intended would be stress here is what I found to be one of the most compelling studies looking at the correlation between stress and how inflammatory someone's blood was when that LPS lipopolysaccharide leaked through and again contacted the person's blood now what you're seeing here in all narrate for those not watching this has a video you're seeing a few different cytokines inflammatory mediators interleukin-6 tnf Alpha interleukin-8 you want lower levels of these higher levels means there's heightened inflammation when these researchers took blood samples from low stress or normal stress people and compared them to highly stressed individuals and then they expose the blood to LPS they found consistently higher levels of inflammatory cytokines tnf Alpha and leukon 6 and Luke 8 in the more stressed individuals now if you are stressed I don't mean to pile on top of that the good news here is other data have shown simply taking a walk in nature it could be a park it could be a river it could be a lake it could be Woods it could be the ocean any Naturescape can reduce levels of stress as verified by functional MRI scans of the brain so again I understand the the weight that stress can pose if you can just take a walk outside in nature most days preferably every day that will start to mitigate this there's other things you can do also of course therapy meditation time with friends Hobbies I think time and nature is one of the simplest because it doesn't cost anything and doesn't require any special training but just make sure to take a little bit of time to decompress if you're not doing so because this is another powerful tool to help reduce leaky gut and then in addition to exercise to stress mitigation there's also sleep probably not surprising but poor sleep whether it be timing intensity or duration does correlate with disruption of the bacteria in the intestinal tract there's also a bi-directional relationship where when people have irritable bowel syndrome inflammatory bowel disease gastrointestinal conditions that does seem to cause poor sleep so you can intervene in both directions you can aim to get to bed consistently at the same time leave yourself enough time for Sleep practice good sleep hygiene so dimming the lights relaxing activity before bed no caffeine too late in the day usually past 12 and you can also take steps like we've talked about to improve your gut health and that should also help you sleep more soundly because again it is it is bimodal you may be doing everything right and then going to sleep and saying I can't sleep well that could be because there's an issue in the gut that has to be remedied thus allowing you to sleep so come at it via this dual pronged approach go through this four-step plan that should improve your gut health helping with your sleep and also just tend to basic good sleep hygiene practices okay so point three is a supplement and I would use this after addressing points 1 and 0.2 meaning diet and lifestyle because that will be sufficient for some absolutely but probiotics are a powerful tool maybe one of the best if not the best studied tool for improving one's gut health a 2023 meta-analysis appearing in Frontiers in Immunology summarized 26 randomized control trials and found that probiotics do the following decrease direct leakage as measured by LPS or endotoxin reduce the corresponding inflammatory cytokines tnf tnf Alpha interleukin-6 and also C-reactive protein and reduced blood zonulin also this was another data point that did not find stool zombulin correlated so blood donelon accurate stools onnula not accurate and that's what you're seeing in this schematic they found that two types of probiotics can reduce leaky gut either blends of bifidobacterium and lactobacillus or soil based probiotics which are typically some type of bacillus species so two different formulas because remember they summarized 26 clinical trials so these different trials used different products different dosages but they summate to all being either soil based formulas or blends of lactobacillus and bifidobacterium and across all these trials benefit was demonstrated or at least most of the trials and again reduction of inflammation reduction of leakage and reduction of the direct measure zonulin indicating leaky gut was improved the other aspect of probiotics that especially this year the ability of probiotics to improve the stress response and to attenuate a overzealousness in the limbic system in the brain which governs fear anxiousness and emotionality and that's what you're seeing depicted here by this 2023 randomized control trial and the Journal of Psychiatry and Neuroscience they assessed via functional MRI the impact that probiotic supplementation is compared to placebo had on the activation of the hippocampus the hippocampus is one of a few regions contained in the limbic system and in conditions of stress and anxiety the hippocampus can be overactive so something that helps to decrease or attenuate that hyperreactivity can be very beneficial and what they found is that the group supplementing with probiotics had a reduction of the activation of the hippocampus so a normalization and this did not occur in the placebo group leading these researchers to quote as follows the hippocampus appears hyperactive in patients with oppressive symptoms the hippocampal deactivation over the time in the probiotic group is assumed to reflect the beneficial effect of the probiotics on depression-related cognitive impairments so just one more reason that stems from the gut all the way up to the brain that probiotics are something to consider after steps one and two the dietary and lifestyle changes in terms of a probiotic protocol this is our evidence-based protocol wherein we looked at a number of Trials across different conditions using different formulas to give you this summary of the three different types of probiotics and the corresponding dosages and time intervals if it's a blend of lactobacillus and bifro bacterium between 1 to 10 billion will be sufficient for most some Studies have used higher but as this data set is evolving we're seeing that we don't need a very high dose and something more moderate one to ten billion for two to three months is a good Target the other probiotic we covered in the leaky gut meta-analysis was a soil based probiotic and the range to Target here is between two and six billion again for two to three months and then third and finally saccharomyces bellardi which is a healthy fungus at a dose of between 10 and 15 billion per day for two to three months regarding time to response most people will see an improvement inside of a month and I would encourage you to look and to assess if a therapy especially a probiotic is helping you you will see some movement of the needle within a month however other data are showing that you may not see a peak in Improvement until two or three months in so like I've said many times before your first checkpoint is about at the four week Mark is this helping yes or no if yes continue and then you may see a pinnacling or a peeking of benefit by the second to third month and then you can work to wean yourself off and then the final Point here and I look at this as kind of a a rescue therapy would be doing a gut reset with an elemental diet now gut reset is the term that I've used it's not necessarily published an elemental diet is a pre-digested hypoallergenic meal replacement and the analogy I use is if you sprained your ankle and you kept running three miles per day your ankle may never heal similar to gut health if there's inflammation and leakage and you're eating three meals per day it may be difficult for your gut to fully heal and this is where using a easy to absorb hypoallergenic and pre-digested formula like an elemental diet may help when other therapies have not and there's three evidence points here I want to share I also want to disclose that the elemental diet has not been studied specifically for leaky gut but there's enough circumstantial and anecdotal evidence that it's become one of the Mainstays of what I use clinically a 2004 clinical trial that found a resolution of sibo and IBS symptoms when using the elemental diet a 2007 clinical trial finding that in rheumatoid arthritis so this inflammatory arthritity that affects the joints and its autoimmune nature the elemental diet was as effective as prescription steroids and then thirdly a 2018 Cochrane meta-analysis of 27 randomized control trials that found a disease when using the elemental diet so I would be remiss if I didn't mention this even though the research has not yet studied directly the impact on zoninglin when we see improvements in IBS improvements in sibo improvements in ra and improvements in inflammatory bowel disease I think this is another tool to consider as step four if you haven't yet seen the level of results that you would like to so in recap diet reducing your processed food eating more Whole Foods reducing triggers lowering your FODMAP content and also making sure you're going to get fermented foods in there lifestyle exercise and Stress Management third Factor probiotics and then if you're still in Need You can try a reset with a Elemental diet and if you do this my observation has been 70-ish percent of individuals will see very clear and long lasting improvements in their gut health there are other tools but I feel these are the most well studied and the most efficacious and so this four-step plan is what I would follow if you're trying to improve your gut health really with the most root causative interventions possible [Music] thank you