Five unexpected indicators of leaky gut

Photo Cred: Alicia Harper/Pixabay

By Bill Reddy, LAc, DiplAc

Though estimates vary, many gastrointestinal health specialists suggest that more than 100 million Americans suffer from leaky gut syndrome. However, diagnosis is not always clear-cut. Understanding that some presentations are an expression of a deeper health condition can help practitioners address the underlying cause, rather than target individual symptoms.

Below are some unexpected signs and symptoms practitioners should be on the lookout for with probable leaky gut patients.   

Major Depressive Disorders

A common phrase repeated in contemporary medical literature is “leaky gut-leaky brain.” Approximately 90 percent of serotonin is manufactured in the gut. When the gut epithelium becomes compromised, various contaminants and bacteria producing endotoxins enter the blood stream and trigger inflammation. These inflammatory proteins, cytokines, affect the production and distribution of neurotransmitters responsible for mood.

Studies have shown that those patients with major depressive disorders have increased levels of inflammation in their bodies and disturbed microbiota. The cause of leaky gut has to be carefully teased out from the patient’s history, including processed foods, alcohol consumption, nonsteroidal anti-inflammatory drugs (NSAIDs), a history of antibiotic use, exposure to glyphosate, sugar consumption, low fiber diets, fatty acid or zinc deficiencies, chronic stress, or history of candida or yeast infections should be evaluated as contributors to depression.  Patching up the small intestine can make a world of difference to these patients.

Dry Cracked Heels

Though literature does not directly link leaky gut to dry heels, it has been my experience that those patients with confirmed leaky gut will have this sign, so it’s worth paying attention. In a physical exam, practitioners should take a close look at the back of patients’ heels. If there are vertical cracks or even fissures, there’s a good probability they have leaky gut. While the etiology of dry heels remains up for debate, it could be that they have a malabsorption syndrome.

Patients typically think that they have a skin issue and slather moisturizer on it. Typically, beyond skin disorders such as psoriasis and eczema, leaky gut patients won’t have overly dry skin, just the posterior of their heels, wrapping medially and laterally.

Osteopenia and Osteoporosis

Massachusetts Institute of Technology researcher Stephanie Seneff, PhD, has published several papers on the effects of glyphosate on human physiology and found that it interferes with cytochrome P450 enzyme activation, which leads to a vitamin D3 deficiency.  Vitamin D3 inactivation leads to impaired calcium metabolism, which inhibits bone remodeling. 

Practitioners should make sure to ask their patients about their soda and sugar intake.  Phosphoric acid and caffeine contained in most sodas will increase calcium excretion and inhibit osteoblast proliferation, and studies show that cola-based soda drinkers have a higher rate of fractures and a reduced bone density compared with those who choose other beverages.  If a patient is recovering from a fracture or any orthopedic surgery involving cutting bone, recommend against caffeine during their recovery period.

Bad Breath

Halitosis can stem from a number of different etiologies, including poor oral hygiene, smoking, dental caries, sinus infections, gastrointestinal ulcers, small intestine bacterial overgrowth (SIBO), helicobacter pylori infections, and even drugs that diffuse from the blood into the lungs.  The red flags for leaky gut include H-pylori infections and SIBO. Leaky gut can cause dysbiosis, an imbalance between good and bad gut microbiota and yeast overgrowth that can lead to SIBO.

Patients typically complain of bloating, abdominal discomfort, and diarrhea.  H-pylori infections can lead to leaky gut and have a few symptoms in common with SIBO such as bloating and abdominal discomfort, especially on an empty stomach, but also include nausea, burping, loss of appetite, and unintentional weight loss.

Joint Pain

Like major depressive disorders, proinflammatory cytokines can be triggered from various endotoxins that leak past the disrupted small intestinal endothelium and find their way into the joints. Rheumatoid arthritis is directly attributed to leaky gut where we develop antibodies that end up attacking the foreign invaders hiding in the synovial fluid within our joints.

It would be appropriate to test patients for leaky gut with a lactulose/mannitol urine test and/or SIBO breath test. Please be aware that the breath test can produce both false positives, and false negatives.

If a practitioner finds their patient test positive SIBO, they can offer a 2-week course of antibiotic treatment or use natural methods to eliminate the bacterial overload and then reinoculated with prebiotics and probiotics. If they test positive for leaky gut, it’s more of a process.  The “four Rs” of leaky gut are:

• Remove
• Replace
• Re-inoculate
• Repair

The first step is to remove the irritant (alcohol, NSAIDs, allergenic foods, pathogens, etc.) and work on stress reduction.  The good news is that the small intestinal wall barrier cells are replaced every 72 hours, so the damage to the microvilli is not long-lasting after the irritant is removed. Recommending a detoxification or cleanse can go a long way for overall health and wellbeing. Bentonite clay, digestive enzymes, soaking in Epsom salts and baking soda, skin brushing, and buffered vitamin C are all helpful in reducing the toxic load.

The next step is to replace the hydrochloric acid and enzymes to proper levels in the stomach.  Fat absorption and gastric analysis tests can guide your treatment plan. After re-establishing HCL and enzyme balance, it’s time to re-inoculate, which can take six to 12 weeks to rebalance the microflora. Recommend fermented foods such as kimchi, pickles, sauerkraut, kefir and kombucha in addition to prebiotics (e.g. oligosaccharides, arabinogalactans, soluble fiber) and probiotics. The most effective probiotics have at least five different strains and a minimum of 25 billion colony forming units (CFUs). Lactobacillus acidophilus alone won’t cut it.  In extreme circumstances, a fecal transplant may be necessary.

At this point, it’s time to repair the damaged lining. This process can take as long as six months through a clean diet and supplements to reduce intestinal inflammation. I’ve found that L-glutamine, zinc, and colostrum are paramount for success, with vitamin D and pantothenic acid (vitamin B5) helpful. Slowly but surely, their food allergies and autoimmune symptoms will fade. Practitioners can measure patient progress with a complete stool analysis along the way.  Once their heels are in better shape, their joint pain is easing, or their depression and anxiety is lessoned, practitioners can feel confident that they’re out of the woods.

References

Hallström H, Wolk A, Glynn A, Michaëlsson K. Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int. 2006;17(7):1055-1064. doi:10.1007/s00198-006-0109-y

Macedo RM, Brentegani LG, Lacerda SA. Effects of coffee intake and intraperitoneal caffeine on bone repair process–a histologic and histometric study. Braz Dent J. 2015;26(2):175-180. doi:10.1590/0103-6440201300219

Samsel A, Seneff S. Glyphosate, pathways to modern diseases III: Manganese, neurological diseases, and associated pathologies. Surg Neurol Int. 2015;6:45. Published 2015 Mar 24. doi:10.4103/2152-7806.153876

Samsel A, Seneff S. Glyphosate, pathways to modern diseases II: Celiac sprue and gluten intolerance. Interdiscip Toxicol. 2013;6(4):159-184. doi:10.2478/intox-2013-0026

Editor’s note: Photo by Alicia Harper.