does “leaky gut syndrome” really exist?

• IMAGING A LEAKY GUT:  Although Cyrex, along with a couple other labs, have excellent (cheap, effective, simple) tests for determining LGS, were you aware that it can now be visualized?  Two German universities teamed up with the Mayo Clinic to publish Imaging the Leaky Gut in last November’s issue of Gastroenterology.  As amazing as it sounds, there are now endoscopes with enough power (confocal laser endomicroscopes that have 1000× with 1-micron resolution) to be able to watch a “leaky” intestinal barrier in real time.  “Thirty-six IBS patients with suspected food intolerance were exposed to food antigens during ongoing endoscopy; in 22 of these patients, CLE showed typical changes indicating remodeling of the epithelial architecture of the mucosa within 5 minutes of exposure. After starting an exclusion diet, symptom scores in these patients improved by  more than 50% after 4 weeks and 74% after 1 year.”  Did you catch that?   It only took five minutes for the body to react to the food, and the scope provided a live feed to the doctor’s computer screen.

• KIDNEY PROBLEMS AND LGS:  A Swiss study published in this month’s issue of Nephron — a journal for Nephrologists / Kidney Specialists (The Gut as a Source of Inflammation in Chronic Kidney Disease) provided some incredible information as far as the whole Gut Health / MICROBIOME / Leaky Gut connection is concerned.  “Chronic inflammation is a non-traditional risk factor for cardiovascular mortality in the chronic kidney disease (CKD) population. In recent years, the gastrointestinal tract has emerged as a major instigator of systemic inflammation in CKD. Postmortem studies previously discovered gut wall inflammation throughout the digestive tract in chronic dialysis patients. In CKD animals, colon wall inflammation is associated with breakdown of the epithelial tight junction barrier (‘leaky gut‘) and translocation of bacterial DNA and endotoxin into the bloodstream. The CKD diet that is low in plant fiber and symbiotic organisms [good bacteria] can alter the normal gut microbiome, leading to overgrowth of bacteria that produce uremic toxins. The translocation of these toxins from the ‘leaky gut‘ into the bloodstream further promotes systemic inflammation, adverse cardiovascular outcomes and CKD progression.  Prebiotic and probiotic formulations have shown promise in small clinical trials, in terms of lowering serum levels of uremic toxins and improving quality of life. The evidence points to a strong relationship between intestinal inflammation and adverse outcomes in CKD.”  For more on FIBER AND PREBIOTICS, follow the yellow brick road.

• MIGRAINE HEADACHES AND LGS:  A Dutch study published in last month’s issue of Beneficial Microbes (The Effects of the Multispecies Probiotic Mixture…  on Migraine: Results of an Open-Label Pilot Study) had this to say about the relationship of PROBIOTICS to MIGRAINE HEADACHES.  “Migraine prevalence is associated with gastrointestinal disorders. Possible underlying mechanisms could be increased gut permeability and inflammation. Probiotics may decrease intestinal permeability as well as inflammation, and therefore may reduce the frequency and/or intensity of migraine attacks.  In conclusion, probiotics may decrease migraine supporting a possible role for the intestine in migraine management. Feasibility and lack of adverse reactions justify further placebo-controlled studies.”  effectiveness and a lack of “ADVERSE EVENTS” is certainly a good starting point!

• ALS AND LGS:  If you know anyone who has died slowly and unmercifully at the hands of ALS (Amytrophic Lateral Sclerosis — an AUTOIMMUNE DISEASE otherwise known as “Lou Gerhig’s Disease”), the April edition of Physiological Reports (Leaky Intestine and Impaired Microbiome in an Amyotrophic Lateral Sclerosis Mouse Model) contains some truly amazing information from this recent Chinese study.  “Emerging evidence has demonstrated that intestinal homeostasis and the microbiome play essential roles in neurological diseases, such as Parkinson’s disease. Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by a progressive loss of motor neurons and muscle atrophy. Currently, there is no effective treatment. Most patients die within 3-5 years due to respiratory paralysis. Although the death of motor neurons is a hallmark of ALS, other organs may also contribute to the disease progression. We examined the gut of an ALS mouse model, and discovered a damaged tight junction structure and increased permeability with a significant reduction in the expression levels of tight junction protein [Zonulin]…..  These changes were associated with a shifted profile of the intestinal microbiome….  Principal coordinate analysis indicated a difference in fecal microbial communities between ALS and wild-type mice. Taken together, our study suggests a potential novel role of the intestinal epithelium and microbiome in the progression of ALS.”  Because PARKINSON’S DISEASE runs heavily in my family, I feel a need to share this amazing information with whoever will listen.  Has your doctor shared anything similar with you yet?

• ALZHEIMER’S DISEASE AND LGS:  In February, the Journal of Neural Transmission carried an Austrian study on the relationship between Leaky Gut and ALZHEIMER’S DISEASE (Elevated Fecal Calprotectin in Patients with Alzheimer’s Dementia Indicates Leaky Gut).   Here is a little bit of what Wikipedia has to say about Calprotectin.  It is a protein with, “complex antimicrobial properties.  Calprotectin comprises as much as 60% of the soluble protein content of neutrophil cytosol and is secreted during inflammation, and can be found at a lower concentration in monocytes, macrophages, and squamous epithelial cells.   Fecal calprotectin has been used to detect intestinal inflammation, and can serve as a marker for inflammatory bowel diseases.  Calprotectin was first described in the 1980s as a mammalian antimicrobial protein.  For instance, calprotectin is secreted in the mouth during inflammation of the gingiva and during oral candidiasis infection.”  As you can see, the protein can work as a biomarker to determine whether or not one’s intestinal wall is “leaking”.  “Fecal concentrations of calprotectin were examined in 22 patients with Alzheimer’s disease (AD) and compared with serum concentrations of aromatic amino acids.  73 % presented with concentrations outside normal, which correlated inversely with serum levels of tryptophan, tyrosine and phenylalanine [essential amino acids]. Increased concentrations of fecal calprotectin indicate a disturbed intestinal barrier function in AD patients.”  If some of this information is not beginning to freak you out a bit about LGS, something is wrong.

• AUTISM AND LGS:  When we hear that AUTISM is linked to Leaky Gut Syndrome, we cannot in any way be surprised.  The alternative health community has been talking about this for decades.  MERCURY in VACCINES has a propensity to foul the Gut, which occurs in two different but intimately related ways.  It not only fouls the Microbiome (the type and number of bacteria living in the Gut), but affects Gut Permeability as well (if you want more information on this, read my LETTER TO THE WEST PLAINS QUILL).  The study, published in last month’s issue of Medical Hypotheses (An Agent-Based Modeling Framework for Evaluating Hypotheses on Risks for Developing Autism: Effects of the Gut Microbial Environment) says this in its abstract.  “The number of cases diagnosed with Autism Spectrum Disorders is rising at an alarming rate.  Recently, it has been hypothesized that gut bacteria may contribute to the development of autism. Specifically, the relative balances between inflammatory microbes and anti-inflammatory microbes may become destabilized prior to autism development. The imbalance leads to a leaky gut, characterized by a more porous epithelial membrane resulting in microbial toxin release into the blood, which may contribute to brain inflammation and autism development.  Simulation results suggest that disturbances such as a prebiotic or antibiotic treatment may only transiently affect the gut microbiome. However, sustained prebiotic treatments may correct low population counts of bifidobacteria.”  Did you catch the word “transient“?  This is why I told you that often times Probiotics are simply NOT ENOUGH.  If you want to see what might be, start reading THESE POSTS.  By the way, a study in this month’s issue of Nutritional Neuroscience (Environment, Dysbiosis, Immunity and Sex-Specific Susceptibility: A Translational Hypothesis for Regressive Autism Pathogenesis) linked Autism with ANTIBIOTIC-fueled DYSBIOSIS (not to mention the antibiotic effects of NON-ANTIBIOTICS), as well as LGS.

• HEART DISEASE, STROKE, AND LGS:  How about your Cardiovascular System?  Another recent study from Austria (Cardiovascular Complications in Inflammatory Bowel Disease) published in Current Drug Targets said this about the relationship between one’s Microbiome, heart health, and Leaky Gut Syndrome.  “Over the past years, a growing number of studies have indicated that patients suffering from inflammatory bowel disease (IBD) have an increased risk of developing cardiovascular disease. Both are chronic inflammatory diseases and share certain pathophysiological mechanisms that may influence each other. High levels of cytokines, C-reactive protein (CRP), and homocysteine [all are markers of INFLAMMATION] in IBD patients may lead to endothelial dysfunction, an early sign of atherosclerosis. Finally, the gut itself may have an impact on atherogenesis during IBD through its microbiota. Microbial products are released from the inflamed mucosa into the circulation through a leaky [Gut] barrier. The induced rise in proinflammatory cytokines could contribute to endothelial damage, artherosclerosis and cardiovascular events. Although large retrospective studies favor a link between IBD and cardiovascular diseases, the mechanisms behind still remain to be determined.”  Has your cardiologist mentioned anything along these lines?  Of course not.  And if you mentioned it to him, you already know you would be frowned at and told to keep on with your STATIN DRUGS.

• CANCER AND LGS:  We surely could not leave here without talking about the relationship of LGS to CANCER.  In October of last year, the Brazilian medical journal, Revista Brasileria Hematol de Hemotologia Hemoteropia, ran a study on cancers of the blood vascular system called ‘Leaky Gut’ in Hematological Malignancies.  In it they concluded that, “In humans, the intestinal epithelium is a single layer of cells that constitutes one of the most important barriers between internal and external environments. The so-called ‘intestinal barrier’ (IB) is a dynamic structure composed of different types of cellular junctions that can be regulated by physiological and pathological stimuli, and act as a selective barrier to antigens and pathogens. Physiological mechanisms that regulate IB function are important for nutrient absorption and antigen permeation, with potential roles in the regulation of tolerance to non-self antigens. However, pathological stimuli such as pathogens, cytokines and immune cells are also capable of affecting IB function as demonstrated in studies about tumor necrosis factor alpha (TNF-α)-mediated IB disruption. Accordingly, a model known as ‘leaky gut syndrome’ has emerged based on the concept that TNF-mediated cycles of increased IB permeability may lead to translocation of macromolecules from the lumen into the lamina propria, and to amplification of mucosal immune activation. In the absence of appropriate regulatory signals, this vicious cycle may result in local or systemic immune-mediated diseases, such as Celiac disease, Crohn’s disease, food allergies, and even type-1 diabetes mellitus.”  I get it — it’s a bit too technical in places.  But I think you get the point.   And I left out the part on Cancer because it would have lost too many people.

• CHRONIC PAIN, FIBROMYALGIA, CENTERAL SENSITIZATION, AND LGS:  Although this study is not so new (January of 2009), Current Opinion in Psychiatry published a study (Inflammatory and Oxidative and Nitrosative Stress Pathways Underpinning Chronic Fatigue, Somatization and Psychosomatic Symptoms).  This study’s abstract states that, “Activation of IO&NS pathways is the key phenomenon underpinning chronic fatigue syndrome (CFS):  These IO&NS pathways are induced by a number of trigger factors, for example psychological stress, strenuous exercise [READ THIS], viral infections and an increased translocation of LPS from gram-bacteria (leaky gut). The ‘psychosomatic’ symptoms experienced by CFS patients are caused by intracellular inflammation (aches and pain, muscular tension, fatigue, irritability, sadness, and the subjective feeling of infection); damage caused by O&NS (aches and pain, muscular tension and fatigue); and gut-derived inflammation (complaints of irritable bowel).“

The point is, If I would have spent any real time, I could have found studies linking virtually every disease you could name (and most you couldn’t) to altered Intestinal Permeability.  Plainly stated, if you have a chronic health issue, it is more likely than not that you have a “Leaky Gut”.  Although there are very specific ways to deal with the LGS, HERE is a good general place to start if you are interested in getting your health back.