Coming up on this episode of The Doctor’s Farmacy.
Dr. Mark Hyman:
Anybody with chronic gut issues like irritable bowel, diarrhea, constipation, bloating, inflammatory bowel disease, if you have skin issues like eczema, acne, psoriasis, for sure, you have a leaky gut.
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman. That’s Farmacy with an F, a place for conversations that matter. And today, I’m bringing you a health bite, little bites of health information to improve your health over time, because taking small steps every day can make a big difference in the long run.
Now today, we’re going to talk about one of my favorite topics, which is leaky gut. It’s something that doctors used to laugh about when I spoke about it 30 years ago, and now, it’s pretty much mainstream, which is pretty cool, and it’s one of the most important things to understand about your health and whether you have it or don’t, and it’s because it drives so many of the diseases we see today in modern civilization. So many things, from diabetes, to obesity, to heart disease, to cancer, to autoimmune disease, to asthma, to depression, to autism, to ADD, I mean, you name it, basically, it’s connected to our gut and our microbiome. And most people don’t really understand what that is, or what a leaky gut is, or what to do about it, and that’s what we’re going to talk about today.
Now, functional medicine really focuses on leaky gut because it’s so central to treating people. In fact, the first thing I do when I evaluate a patient is I want to make sure their gut’s healthy, because if their gut’s not healthy, then the rest of the stuff we’re going to do may not work as well. And it’s really important to understand how to assess, diagnose and treat a leaky gut. Now, you’re probably wondering, what the hell am I talking about? We’re going to get into that in a minute. But basically, your gut is the seat of your health.
It’s where 70 to 80% of your immune system lives, 90% of the serotonin. You have a whole second brain there. It’s called the second brain or the enteric nervous system. It regulates mood, digestion, sleep. It’s pretty impressive. So we have to get our gut healthy. We have to understand that if we don’t, our immune system’s going to be activated, because our immune system is there to defend us from outside invaders. And the place where you’re exposed to the most stuff is your gut. Every day, you’re putting pounds of stuff in there, lots of food. You have bacteria in your gut. And all that’s kind of foreign, and your body’s supposed to know what to do with it, which is keep it out.
Now, the food’s supposed to be digested. It’s supposed to break down into its component parts, amino acids, fatty acids, simple sugars, carbohydrates, that we actually can absorb and then are deconstructed from the original identity. In other words, when you eat a piece of chicken, you don’t become chicken, right? It breaks it down into its component parts so we can reuse them for ourselves. Now, when you have a leaky gut, that doesn’t happen. You start to get things leaking over the membrane and causing inflammation, and the immune system is right there to protect you, and you get lots of problems when you have a leaky gut, which is a driver of so much a disease.
So what is exactly a leaky gut, and what does it mean? Well, basically, you’ve got an entire intestinal tract that has only one cell lining. In other words, only one cell between you and a sewer. So on one side is poop and food, and the other side is your bloodstream and your immune system. And if those interact, it’s a problem. You want the food to go through your cells. They get filtered through the cell, not between the cells, and the broken down food components that are the basic building blocks of what you need to survive are just filtered through the cells and get into your bloodstream and everything’s hunky dory.
When those cells, that single cell lining which basically spreads out the size of a tennis court, when it’s damaged, and like Legos stuck together, the Legos come apart, and then food and bacteria and other toxins leak in and get exposed to your immune system, which triggers an immune response.
So we talked a lot about, on the podcast, inflammation, its role in aging, its role in chronic disease, pretty much in everything. If you have inflammation, it’s really driving everything that’s going wrong with you today in society. Every chronic disease, heart disease, cancer, diabetes, dementia, obesity, autoimmune disease, allergies, autism, depression, you name it, it’s inflammatory. And aging itself is inflammatory, we call it inflammaging. And a lot of that is because of problems in the gut. In fact, one of the hallmarks of aging now is problems with the microbiome. I added that in my book, and it wasn’t in the hallmarks when I wrote the book, but it was just so obvious to me that it was. Then they finally added it when the scientists got back together.
But basically, think about your gut lining as a coffee filter. It lets in the right stuff and keeps out the bad stuff. Imagine if you’re coffee filter had holes, you’d be coffee grounds and your coffee not a good thing. When these kind of connections, these tight junctions we call them, loosen up, then you get into trouble. And that is what causes all the problems, what we call increased intestinal permeability, that’s the medical term for it, or leaky gut, which is easier way to think about it.
And then, you get bacterial toxins, viruses, food proteins leaking through. The immune system goes crazy, and that creates all these downstream problems. It may show up as food sensitivities. It may show up as inflammation that leads to obesity or diabetes. But essentially, it’s all driving inflammation.
And why do we get a leaky gut? What causes a leaky gut? Well, there’s no single cause, but a lot of things cause problems. First, our diet. Our diet just sucks. We have highly processed diet. We have a diet that’s low in fiber, high in inflammatory foods, high in food components that actually damage the gut. In fact, they add in something called microbial transglutaminase, which is like glue that sticks the food together that’s processed food. Transglutaminase is one of the components of gluten, and so that’s what causes celiac disease. So they’re basically putting it in the food. You can’t even tell because it’s not on the label, but it actually is there and it damages the gut. Emulsifiers, all the thickeners, additives, that all damages our gut and cause a leaky gut.
There’s other things too besides our… Highly processed, low fiber, high sugar, chemical-laden diet. Antibiotics, lots of antibiotics, certain medications like Advil, steroids, certain hormones, acid blocking drugs like Pepcid, all these things disrupt the gut microbiome and lead to changes that can lead to leaky gut.
Also, environmental toxins, whether they’re petrochemical toxins, pesticides, plastics, heavy metals, all disrupt the gut lining. And glyphosate particularly is bad. Glyphosate is a microbiome destroyer that’s on 70% of food crops. It’s in everybody’s urine. A recent study from the EPA found that most people have glyphosate in the urine. I check mine. I’m really careful of what I eat. And I travel, but I can’t always control where the food’s coming from, and since most crops have glyphosate, I’m going to get it.
Also, gluten is a big one. Gluten is probably, from a food perspective, the biggest driver of leaky gut. It basically produces something called zonulin, which interrupts the tight junctions and ends up causing problems with this leaky gut. And that’s really why we see so many autoimmune inflammatory diseases with gluten.
Also, if you have imbalanced gut flora, bad bacteria, if you have used overgrowth, bad bacterial overgrowth, just imbalance in this microbiome and dysbiosis, that can also really cause a problem. So there’s a lot of things, even stress, chronic stress, like just itself, if they take healthy young recruits and they march them overnight in the military, they’ll have a leaky gut in the morning. It’s just because stress also causes that.
And the other thing that’s really bad is high fructose corn syrup. So why is high fructose corn syrup bad? Well, basically, it takes a lot of energy to absorb fructose. And high fructose corn syrup, it’s free fructose. It’s not embedded in a matrix of fruit where you normally find it. And the fructose doesn’t get absorbed easily like glucose, it requires energy. And it basically depletes ATP or the energy source in our gut. And when you deplete ATP, those tight junctions that are keeping, like Legos, your gut cells together, they get weak. And so then the energy can’t hold the tight junctions together because you’re not making enough ATP to deal with all the fructose being absorbed and the demand for ATP from fructose absorption, and you end up getting a leaky gut. So literally, fructose can punch holes in the gut if you’re having a lot of high fructose corn syrup. So kind of bad news.
So how do you know if you have a leaky gut? Well, sometimes it’s obvious because you have all sorts of symptoms, but anybody with chronic gut issues like irritable bowel, diarrhea, constipation, bloating, obviously inflammatory bowel disease. Skin issues, if you have skin issues like eczema, acne, psoriasis, for sure, you have a leaky gut. If you have arthritis, joint pain, autoimmune disease, headaches, fatigue, trouble concentrating, brain fog, if you tend to have hormonal issues, it may be a factor.
Autoimmune diseases, for sure, it’s number one on my list if you have an autoimmune disease. If you’re overweight, if you have diabetes, there’s a whole phenomena called metabolic endotoxemia, which essentially shows that you have bacterial toxins crossing this leaky gut, being absorbed, activating your immune system. The immune system makes you insulin resistant, and you get more weight gain in diabetes. Also, it’s been linked to heart disease, to Alzheimer’s, obviously depression, ADD, autism, all these symptoms, and there’s lots more that are clues that you might have a leaky gut.
So what if you do? When you have a leaky gut, how do you heal it? Well, the only way to heal it is to follow the functional medicine framework, which we call the 5 R Program, to heal the gut. And we’ve talked a little bit about this, but I’m going to review it, but you probably will need to work with a functional medicine doctor., but you can reset your microbiome. You can repair your leaky gut, and you can do it by basically the few steps.
The first is remove the bad stuff, right? Get rid of bad bugs in there. Get rid of overgrowth of yeast, overgrowth of bacteria, parasites, whatever’s in there that shouldn’t be in there, get rid of it. Also, you want to get rid of foods that are irritating to the gut, potential food sensitivities, gluten, dairy, soy, eggs. Also, sugar is really bad. It just causes things that are a problem. Alcohol is really bad. So make sure you get rid of those things and see if that reduces the inflammation.
Also, watch out for the gut busting drugs, right? Antibiotics, anti-inflammatory drugs like Advil, steroids, acid blockers, really bad. So reduce or eliminate those drugs, and most of the time we don’t need those.
And finally, environmental toxins can be a factor. So I, for example, had leaky gut from having really high levels of mercury, and so you want to make sure you reduce your exposures. Ewg.org has a whole great website for identifying how to reduce exposure from food, from household cleaning products, from skincare products. You might want to make sure you filter your water, get a HEPA filter for your air, just reduce your overall toxic exposure. And also, sort of mitigate the stress in your life, we’ll talk about that in a minute.
Then once you’ve kind of done that, you want to help rebuild and repair your gut. And so you want to kind of focus on biome builders. And how do you build your healthy gut back? First is, make sure you have enough fiber, 25 to 50 grams of fiber, ideally from veggies, not obviously processed grains, nuts and seeds, lots of veggies. The gut loves polyphenols. They love the colorful fruits and vegetables, so make sure you have plenty of those with polyphenols. Berries, try to eat organic when possible. Use EWG’s guide for the Clean 15, for the least contaminated fruits and veggies, or the dirty dozen, avoid those which are the most incontaminated.
Have prebiotic fruits, right? Things like Jerusalem artichokes, garlic, onions, leeks, dandelion greens, jicama, chicory, asparagus, plantains, all are great sources of prebiotics. Probiotic foods, also important. Sauerkraut, kimchi, pickles, fermented soy like natto, tempeh, unsweetened yogurt, kefir, miso, these are all great, great sources of probiotics.
Bone broth is great. Bone broth has a lot of gut healing components in it, collagen and very anti-inflammatory. You might need certain supplements as well. Things like zinc, glutamine, curcumin, evening primrose oil, vitamin A, the list goes on. But basically, that is, you can really rebuild your gut through managing a better diet, a better lifestyle, and figuring out what the root causes are. Now, sometimes you might need a functional medicine doctor, but a lot of times you can do this on your own.
Now, 1,500 years ago, or maybe it was a while ago, Hippocrates had all diseases beginning in the gut. Ayurveda also talks about if your gut’s not healthy, you’re not healthy. And he was right. The data is really clear today that our guts are a mess, that we need to optimize our gut function, that we need to basically fix the problems that we have with our microbiome. And that fixing and treating a leaky gut is a critical part of staying healthy.
So I encourage you to do a gut check, see where you’re at, see what’s going on with your digestion, and follow the guidelines we just talked about. I’ve written also a lot about it. There’s lots of blogs. I’ll link to them in the show notes. And I think, if you do that, you’re going to be better in every way. And I can’t tell you how many patients I’ve seen get rid of so many issues, whether it’s skin issues, mood issues, digestive issues, autoimmune diseases, ADD, autism. It’s just by fixing the gut.
And that’s it for today’s health bite. If you liked it, please share with your friends and family. Leave a comment, how have you dealt with your leaky gut? What’s worked for you? What hasn’t? What have you learned? We’d love to know. And we’ll see you next week on The Doctor’s Farmacy.
Hi, everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.