HEAL YOUR LEAKY GUT - modaycenter.com … · symptoms to have a leaky gut. In our clinic, we have many patients who are confused why we run stool tests when they don't have GI symptoms,

HEAL YOUR LEAKY GUT

CLEAR ANSWERS TO A PERVASIVE PROBLEM

MODAYCENTER.COM

COULD LEAKY GUT BE AFFECTING ME?

Leaky gut is under-diagnosed and often not considered in conventional medicine yet it's a KEY

ingredient in today's most prevalent chronic diseases.

You'll benefit from this information if....

2019 THE MODAY CENTER // MODAYCENTER.COM

You have chronic stomach issues that, despite you and your doctors best efforts,

continue to bother you. (Ex: IBS, acid reflux, constipation, pain, etc.)

You have a chronic illness, such as an autoimmune condition.

You have nagging symptoms of allergies, skin issues, mood problems, brain fog,

arthritis, or weight gain.

You simply just don’t feel great.

You want to understand how to maintain a healthy gut.

HOW DOES LEAKY GUT HAPPEN?

When we refer to the gut we are talking about the entire GI tract from the mouth all the way to

the anus. The gut is made up of several different organs with unique jobs, but they all have to

work together like a well-tuned orchestra.

The gut has multiple roles in the body:

There are many reasons why modern humans start to have problems with proper function of

the gut. Improper use of medications such antacids and PPIs interfere with the production of

Hydrochloric acid which impedes protein breakdown. Poor eating habits and stress cause

impaired secretion of enzymes from the pancreas or gallbladder and further interfere with

absorption of fat, carbohydrates, minerals and vitamins. Disruption of the gut microbiome by

poor diets, alcohol, and medications impairs hormone production, brain chemicals and

detoxification potential.

If you think about it, the gut is really just a hollow tube that is technically outside the body. It is

the main area in the body where the external environment can have access into our tissues and

blood stream. The gut plays a huge role in the functioning of our immune system. Consider the

fact that greater than 70% of our immune system cells are located in the GALT (gut associated

lymphoid tissue)

The immune components found within the GALT help protect us from potential infection, but

they also help differentiate potentially harmful substances, such as bacteria, versus non-

harmful substances, like a piece of fruit. It's imperative for the immune system to tell the

difference between harmful bacteria, beneficial bacteria, toxins or food. When the body

mistakes certain food particles as invaders, that's how we get into trouble.

But why does this happen? What causes the immune system to see non-harmful substances like

food as harmful?

The short answer is a leaky gut.


Breaking down and absorbing nutrients, vitamins and minerals into our blood stream.

Creating an immune barrier between the outside world and the inside of our body.

Creating hormones that regulate hunger and weight.

Creating neurochemicals that regulate mood.

Detoxifying and removing toxins from the body.

The loss of structural integrity of the intestines, often referred to as leaky gut, is nearly always

found in people with gastrointestinal issues or autoimmune disease. When healthy, the

intestinal cells are held tightly together by what are called tight junctions (makes sense, right?).

Only very small particles typically make it through the intestinal barrier to get into the

bloodstream.

Research by Dr. Alessio Fassano has shown that leaky intestinal membranes (“ leaky gut”) is one

of the main steps needed for the development of an autoimmune condition, such as thyroid

disease or Celiac disease. However, when those tight junctions become loose, substances are able

to pass through easily which then stimulates our immune system to react.

These antibodies sometimes 'see' certain body parts as foreign and begin to attack. Sometimes

the antibodies attack the skin and psoriasis develops, and other times these antibodies attack the

pancreas and type 1 diabetes may develop. It is a combination of our environmental inputs (food,

toxins, stress, sleep, etc.) and genetics that determine how our body responds to a leaky gut.

What many people are often surprised by is that you do not have to have gastrointestinal (GI)

symptoms to have a leaky gut. In our clinic, we have many patients who are confused why we

run stool tests when they don't have GI symptoms, who are then surprised when they learn the

tests do indeed show they have a leaky gut. This is why it is imperative to optimize your gut

health, especially if you have a chronic disease.


Leaky gut is one of the main steps needed for the development of an autoimmune condition.

The million dollar question is then what causes

leaky gut?

While we haven't discovered all of the causes yet,

there are a handful that everyone should pay

attention to:

Additionally, any factor that negatively affects the

microbiome creates an opportunity for leaky gut

to develop including:

And, perhaps most importantly, all of the above

factors that contribute to leaky gut are also

cumulative. For instance, many people are

surprised to discover in their 40's and 50's that

they have developed diseases from lifestyle

patterns started 30 years earlier.

For example, if you only average 6 hours of sleep a

night, have been working a stressful job for 25

years, eat a lot of processed food, and rarely

exercise, your body is slowly getting stressed to

the point that it has lost its ability to heal properly.

The human body is amazingly resilient, but only

to a point. It is at this breaking point that we start

to develop things like high blood pressure,

diabetes, psoriasis, recurrent infections, and so on.

HOW DOES LEAKY GUT HAPPEN?

Certain food components, such

as gluten and casein

Chronic stress

Alcohol

Infections

Heavy metal exposure

(mercury, lead, etc.)

Medications

Diets high in refined

carbohydrates like sugar and

processed foods

Low intake of fermentable

fibers

HOW TO HEAL LEAKY GUT

If you are dealing with an autoimmune condition, GI discomfort, skin problems, cardiovascular

disease, chronic fatigue or hormonal issues, it is best to start your healing journey with the

gut. Unfortunately, focusing only on symptoms is not enough.

An important consideration when doing this is the order of interventions. Doing everything at

once, missing steps, or implementing treatments out of order can cause many conditions to

persist.

For instance, many doctors will treat SIBO (small intestinal bacterial overgrowth) with

antibiotics without addressing the factors that led to the development of the SIBO in the first

place. They don't address environmental stressors, allow the gut time to heal, and they don't

make sure the body is properly nourished so that it can detoxify properly. This is why many

patients often see a recurrence of their symptoms despite treatment.

To recover full health and vitality, the root cause(s) must be uncovered and resolved. While not

a comprehensive list, here are the root causes we consider and the steps we find are the most

crucial when healing the gut:


1. Revamp your environment. 2. Nourish the body. 3. Replace digestive power. 4. Repair leaky gut. 5. Reinoculate with beneficial microorganisms. 6. Address potentially harmful pathogens in the gut.

ALL DISEASE BEGINS IN THE GUTHippocrates 900 B.C.

STEP #1: REVAMP YOUR ENVIRONMENT

When we refer to the environment, we mean anything that can affect the way your genes are

expressed. Why is this important? About 97% of our genes are controlled by external factors!

Regardless of which genes you inherited from your parents, it is your environment that

determines whether or not you will develop that particular disease.

AIR

First, we stress the importance of having a high-quality HEPA filter in the house to improve

indoor air quality, which can be 2-5 times more toxic than outdoor air. Can’t afford an air filter?

Adding 2-3 plants to every room of the house (especially the bedroom!) also improves air quality.

Snake, ivy, aloe, and fern plants do the best job at sequestering harmful chemicals.

WATER

Next, given that nearly all water sources are contaminated with harmful chemicals, we also

encourage purchasing a high-quality carbon or reverse osmosis water filter (with a

remineralizer).

LIGHT

We also optimize the amount of light by adding more in the morning and removing some in the

evening. First, aim to get out into the sun first thing in the morning to set your circadian

rhythm—the control center for hormone expression. At night, limit or remove all sources of

artificial blue light at night or to wear blue-light-blocking glasses.

EMF

Minimizing exposure to electromagnetic fields (EMFs) (which means turning off wifi at night,

putting your cell phone on airplane mode during sleep and getting outside in nature as

frequently as possible) also improves clinical outcomes.

MEDICATIONS

Many pharmaceutical medications can significantly affect your gut health, such as antibiotics,

NSAID's like ibuprofen and Advil, PPI's and other antacids, and birth control pills, to name a

few. With the help of your personal physician, it is best to get off of these medications to help

promote gut healing.

FOOD

Last but not least, we recommend temporarily removing certain foods that can act as irritants,

such as gluten, dairy, eggs, soy, and peanuts. When you remove these foods for a certain period

of time, it is referred to as an elimination diet. Removing these foods and slowly reintroducing

them one at a time after a month or longer will help you determine if you are reactive to any of

these foods.


STEP #2: NOURISH THE BODY

One of the best ways to nourish our body is through whole foods. Unfortunately, knowing what

is nourishing and what is harmful has become more confusing than ever due to the sheer

volume of information on the internet. People promote everything from veganism to a

carnivorous diet, and everything in-between.

In truth, the ideal diet for each person must be individualized and can change depending on the

season, stressors, geographic location, and other factors. Because of these factors, we use

functional labs to hone in on what our patients need. In addition to these specifics, we also teach

some basic tenants that can benefit everyone:

LISTEN TO YOUR BODY

Have you ever eaten something routinely, like oatmeal or eggs in the mornings and suddenly

lost the taste for it? That's your body telling you something, so listen to it! Pregnant women are

very attuned to this, as they will often be turned off by certain foods and crave others. This is

their body telling them they require certain nutrients. Because of the busy-ness of life, many of

us have stopped listening to our bodies and the feelings we get after eating certain foods. It's

time to slow down and start to listen. Caveat: Now, don't take this the wrong way and think,

"Well, my body is saying it wants ice cream and donuts." We're talking about REAL food, not

junk. Which brings us to our next tip.

EAT REAL FOOD

Avoid all processed foods, fast foods, and simple carbohydrates (anything made with white

flours). Focus on eating vegetables, fruits, meats and fish, nuts/seeds and gluten-free grains if

you tolerate them.

KEEP A FOOD JOURNAL

Take note of what you eat and how it makes you feel afterward. Do you feel tired or energized,

comfortable or bloated? Tracking how you feel after eating certain foods will give you insight in

what to avoid.

AVOID DOGMATIC THINKING

Some people do better on a more plant-based diet. Others do better with more meat. Despite

what the "experts" say, there is no one optimal diet for everyone.

EAT LOCAL, SEASONAL, ORGANIC

The goal is to eat the cleanest and most nutrient-dense foods as possible. You maximize the

nutrients of plants by eating them as soon as they are picked. You also want to minimize the

number of pesticides you are exposed to, as they have been found to destroy healthy intestinal

bacteria, which can cause many health issues.


EAT THE RAINBOW

Aim to eat a variety of colored fruits and vegetables. The different colors indicate varying

nutrients and phytochemicals. By eating more variety, you are usually getting a spectrum of

nutrients.

EAT PASTURE-RAISED, ORGANIC ANIMAL PRODUCTS

If you are eating meat or eggs, make sure that the animals were pasture-raised or grass-fed and

organic. Organ meats are specially nutrient-dense for those that tolerate them. Avoid marketing

terms like 'free-range' and 'all-natural', these are unregulated terms that don't guarantee the

health of that animal.

EAT WILD CAUGHT SEAFOOD

Source wild-caught fish and focus on eating smaller fish that have less amounts of mercury.

Remember the acronym SMASH - Sardines, Atlantic Mackerel, Anchovies, Alaskan Salmon, and

Herring are low mercury choices. Oysters and clams are also very nutrient dense and can be

very beneficial.


BUT, WHAT ABOUT FIBER?

Discussing fiber intake can get confusing really quickly. There is soluble and insoluble fiber,

fermentable and non-fermentable fiber, and then there's resistant starch. Each blog will tell you

something different, one stating that if you have a certain condition you should avoid insoluble

fiber, whereas another site says everyone should be eating more resistant starch. Even more

confusing is the fact that plants are made up of a mixture of these types of fiber.

Before we get into what type of fiber to eat and how much, we need to define a few of these

terms so you know what to look for.


FIBER

Fiber is a specific type of carbohydrate that comes from the cell walls of plants. The

difference between fiber and other carbohydrates is that fiber cannot be digested by

our body's digestive enzymes, so that it makes it's way through the digestive tract

mainly intact. Fiber has two main benefits: It adds bulk to stool so we can poop easier

and it acts as fuel for our microbiome.

SOLUBLE FIBER

This type of fiber is readily-fermentable by gut bacteria. It also has been found to slow

down the transit time of the intestines. Sources of soluble fiber include fruits and

vegetables, legumes (peas and beans), barley, oat bran, and chia seeds.

INSOLUBLE FIBER

Unlike soluble fiber, insoluble tends to speed up the transit time in the intestines.

Some forms of insoluble fiber feed beneficial bacteria, whereas others do not and only

function to add bulk to stool. Sources of insoluble fiber include whole-grain foods such

as brown rice, quinoa, millet, bran, many vegetables, and fruit with skin. Also lentils,

almonds, garbanzo beans.

FERMENTABLE FIBER aka PREBIOTICS

Prebiotics include any type of fiber, whether soluble or insoluble, that can act as fuel

to the microbiome. Sources of prebiotics include dandelion greens, chicory root,

onions, garlic, leek, asparagus, oat bran (gluten free), raw plantains or plantain flour,

green bananas and their flour, cassava/tapioca starch, jicama, yam, and Jerusalem

artichoke.

RESISTANT STARCH

While not technically a fiber, this compound found in the cell wall of plants is broken

down by the digestive system and provides food for good bacteria. Some sources

include green bananas and plantains, cooked potatoes, yams, and other root

vegetables.

FIBER GUIDELINES FOR LEAKY GUT

Eat a variety of vegetables (at least 6 servings of vegetables (and some fruits) daily). Want a real

challenge? Aim to get 9 cups of vegetables per day to maximize benefits. Getting enough varied

vegetables will ensure that you're getting both soluble and insoluble types of fiber, including

resistant starches.

Focus on whole food sources of fiber rather than taking fiber supplements. Supplemental fibers

tend to feed only certain strains of bacteria, meaning that over time our guts become

imbalanced. Whole food sources of fiber allow for the growth of a diverse microbiome, which is

the goal.

If you have IBS, IBD, or any other condition that makes it difficult for you to digest insoluble and

fermentable fibers, studies show you should not avoid it completely. Instead, you take the

following steps:


Eat slowly, relax, chew your food well, and don't drink too much with your food.

You should also avoid drinking alcohol, caffeine, smoking, and limit stress, as all

of these things impair digestion (by way of decreasing the amount of acid

produced in the stomach). Consider digestive support, as detailed in section 3.

Increase fiber slowly. Remember that we need fiber to feed our microbiome.

Avoiding high-fiber foods for too long will decrease our microbial diversity,

which is detrimental to health. However if you have bacterial overgrowth,

bombarding yourself with fiber will have you doubled over in pain. Start by

incrementally increasing your fiber intake.

STEP #3: REPLACE DIGESTIVE POWER

Normal digestion requires a carefully coordinated release of stomach acid and digestive

enzymes. While eating a meal, acid is released into the stomach to help break down the food

particles, especially proteins. Without the presence of adequate stomach acid, the food particles

cannot be broken down completely, leading to poor absorption of the food particles, along with

impaired absorption of important vitamins and minerals, such as vitamin B6, B12, folate, iron

and, calcium.

Furthermore, because the duodenum—the first section of the small intestine—requires the food

entering from the stomach to be fairly acidic in order to signal the release of digestive enzymes

from the pancreas, low stomach acid often results in impaired digestive function in the small

intestine.

Symptoms associated with low stomach acid include bloating, belching, burning, or flatulence

soon after a meal, a 'heavy' feeling in the stomach after eating high-protein meals, indigestion,

constipation, diarrhea, iron deficiency, and multiple food allergies.

There are many causes of low stomach acid:


Age - Research has shown a decline in stomach acid release as a person ages. In

one study on men and women over the age of 60, 30% suffered from atrophic

gastritis, a condition which results in reduced stomach acid production.

Pharmaceuticals - Antacids like PPI's (ie. Prilosec/Omeprazole), H2-inhibitors

(i.e. Zantac) are known to significantly reduce the release of stomach acid.

Chronic stress - Long-term stress has been associated with low stomach acid

production

Low animal protein intake - Many people who are on vegetarian or vegan diets

tend to have a hard time digesting animal meats when reintroduced, which is

believed to be due to a decrease in the release of stomach acid.

H. Pylori infection

DO I HAVE LOW STOMACH ACID?

It is often difficult to test for low stomach acid. The most reliable test is called a Heidelberg

Stomach Acid Test, where you swallow a computerized pill that monitors the pH of your

stomach as it makes it's way through your gut. Unfortunately, this test is expensive and often

not covered by insurance.

To test your stomach acid at home, you can perform an HCl challenge test (consult with your

doctor before performing this test and refrain from taking HCl if you have peptic ulcer disease

or are taking NSAID's or corticosteroids):

1) Eat a protein-rich meal (at least 3 ounces of protein)

2) Halfway through the meal, take a capsule containing approximately 500 mg of HCl (it

may also contain betaine).

If you develop a slight burning or tingling sensation in your stomach, abdominal pain, or nausea,

then that indicates you are producing enough stomach acid. If you notice significant reflux

symptoms during the test, you can take 1 teaspoon of baking soda in 6 ounces of water for relief.

If you do not develop any symptoms after taking the HCl pill, then you are most likely not

producing enough stomach acid.


HOW DO I INCREASE STOMACH ACID?

SUPPLEMENTAL HCL

If one capsule produces no symptoms, titrate up slowly (adding an additional capsule per meal)

until you notice a slight burning sensation. Then, reduce the amount of capsules by one and

continue with this dose while the root cause(s) of low stomach acid are investigated.

DIGESTIVE BITTERS

Digestive bitters—a liquid created from bitter herbs—can also help increase acid production

within the stomach. In our practice, we like to use the brand Better Bitters and advise our

patients to use it 10-15 minutes before meals.

BITTER FOODS

Additionally, focusing on bitter foods like chicory, dandelion, arugula, radicchio, endive,

artichoke, lemon and black radish can train the stomach to produce the proper amount of acid

over time.

MINDFUL EATING

Paying attention to the sensory aspects of eating and slowing down (chewing more!) also

supports proper stomach acid and digestive secretion release.

STEP #4: REPAIR LEAKY GUT

It is imperative to heal intestinal barrier function in order to restore and promote overall health.

At this point in the protocol, all harmful inputs should have been removed and now we begin to

focus on strategies to repair a damaged gut.

Getting adequate nutrients is paramount, especially those that have been shown to reduce

intestinal permeability. Vitamin A, vitamin D, zinc, and iron should be evaluated to ensure a

deficiency is not present.

Those deficient in vitamin A can consider a high-quality cod liver oil supplement (such as

Rosita’s). In addition to vitamin A, cod liver oil is also a good source of omega-3 fatty acids—EPA

and DHA—which have also been shown to improve gut permeability.

Vitamin D is best acquired through sun exposure, as discussed previously but in the winter

supplementation is usually prudent. Beef liver is another nutrient-dense food that is high in

vitamin A, zinc, and iron.

One of the most commonly recommended supplements for healing a leaky gut is the amino acid

glutamine and for good reason. Glutamine is one of the main energy sources for intestinal cells,

it improves the barrier function of the gut, helps regulate the intestinal immune response, and

more. Glutamine is typically dosed between 5- 20 grams daily. Collagen powders and bone broth

are also natural sources high in glutamine and other important amino acids.

Many phytonutrients are also commonly used to improve intestinal permeability. One of the

most studied is quercetin, a yellow flavonoid found in high concentrations in onions, asparagus,

and lettuce. Other flavonoids that have also been found to be beneficial include ECGC (a green

tea extract), curcumin, boswellia, resveratrol, Chinese skullcap, and ginger.

When it comes to probiotics, there have been numerous studies that indicate that certain strains

or combinations of strains can improve leaky gut. Specific strains that have been shown to be

beneficial include L. plantarum, S. boulardii, and a mixture of L. plantarum, L. Acidophilus, and

B. Longum. Similarly, when it comes to the treatment of SIBO and other related conditions, both

L. plantarum and S. boulardii are often well-tolerated.


STEP #5: REINOCULATE WITH BENEFICIAL MICROORGANISMS

The guts of most Americans are lacking in essential microorganisms. The benefits that these

microorganisms—called the intestinal microbiome—impart is vast. A healthy microbiome helps

crowd out harmful microorganisms, aids in the digestion and conversion of food into usable

nutrients, supports and maintains intestinal barrier function, metabolizes toxins, and provides a

litany of other benefits.

Thus, maintaining a healthy microbiome is imperative if we are to heal and maintain a healthy

gut.

Many people erroneously believe that supplementing with probiotics—microorganisms

consumed for the intended health benefit of improving the gut microbiome—is the best way to

establish and maintain a healthy microbiome. Unfortunately, recent studies have shown that

the vast majority of ingested probiotics take residence in the gut only for a few days before

being crowded out by other microorganisms, indicating that probiotics are not typically a

reliable strategy for improving the neighborhood long-term.

The reason this happens is that the gut is tightly regulated by environmental factors such as

food, stress, sleep, toxins, pharmaceuticals, and more. These environmental inputs dictate which

bugs can grow in the gut and which ones don't. For instance, antibiotics have been shown to

disrupt the microbiome for up to a year after ingestion. On the other hand, those who switch to

a diet high in phytonutrients will have a vastly improved microbiome—60% of your microbial

diversity is thanks to diet alone!

So, in order to achieve a healthy microbiome, the goal should be to address each environmental

input that affects the microbiome. If you have addressed the previous 4 steps to healing your

gut, your microbiome should already be significantly improved.

This is not to say that probiotics cannot be beneficial, especially in the short term. There is

plenty of research supporting the use of specific strains or combinations of microorganisms for

certain medical conditions. For instance, the probiotic L. plantarum has been found to improve

GI symptoms in those with IBS and also lower cardiovascular risk. Other strains, such as S.

Boulardii are often used for antibiotic-associated diarrhea and to help prevent yeast infections

after antibiotic use.

If you are going to use probiotics therapeutically, it is important to choose the right strain for the

job and to use them for only a few months. A good website that shows which probiotics are

useful for a certain condition is http://usprobioticguide.com/ or consult with a healthcare

professional.


WHAT ABOUT FERMENTED FOODS?

Fermented foods have been around for thousands of years, eaten by many traditional cultures

throughout the world. Fermented foods are a rich source of probiotics, though the specific

bacteria and/or yeast strains vary depending on what is being fermented and how. For instance,

Kombucha is fermented by a yeast strain, Zygosaccharomyces, while the fermentation that

occurs in a traditional sourdough bread is caused by a combination of a bacteria (L. reuteri) and a

yeast (S. cerevisiae).

If you are just starting off with eating fermented foods, it is best to start with a small amount,

such as a tablespoon, with each meal. Some people do not tolerate fermented foods well,

especially fermented foods high in yeast such as Kombucha. If you notice unwanted symptoms

while eating certain fermented foods, it's best to not eat them until you gut is healed, and

instead focus on other healthy foods.


STEP #6: ADDRESS POTENTIALLY HARMFUL GUT PATHOGENS

If you have gotten to this point without significant improvement of your symptoms, further

assessment and treatment is warranted. In order to assess whether you may have a gut

infection or dysbiosis, advanced testing is typically needed.

Proper assessment for improper levels of both harmful and beneficial bacteria is typically done

with a comprehensive stool test from a lab company such as Genova or Doctor's Data. On the

other hand, stool tests often do a poor job of detecting fungal overgrowth, so a test like an

Organic Acids test by Genova can provide more information regarding the impact of yeasts.

If you have IBS symptoms and believe you may be dealing with small intestinal bacterial

overgrowth (SIBO), then you may also benefit from a lactulose breath test.

Keep in mind that none of these tests are perfect and thus must be taken in context of your

history, symptoms, and other laboratory evaluations. Additionally, these tests are also fairly

complex and require an expert to interpret.

Depending on the results of these tests, treatment may be required. Because of the individuality

of treatment, it is best to seek out a medical professional to determine the best course for your

specific case.


BRINGING IT ALL TOGETHER

As you can see, when it comes to gut issues and autoimmune disease, there is a wealth of

interventions that can help control symptoms and work to rectify the root cause(s).

Keep in mind, healing is not a linear path and sustained improvement is reliant on consistent

action. Don't lose hope if you don't notice improvement within a few weeks. In most cases, it has

taken your body years to get to this point and it will take some time for it to heal.

If you find that even after following these recommendations that you are still struggling with

your symptoms, it is best to find an experienced functional medicine provider who is well-

versed in your condition.

To learn more about our programs or to find more articles on restoring your health, please visit

ModayCenter.com. Please feel free to share this eBook with a friend or loved one who may

benefit from this information.

In good health,

The Moday Center


The information in this ebook has not been evaluated by the FDA and is not intended to diagnose, treat, prevent, or cure any disease.

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HEAL YOUR LEAKY GUT - modaycenter.com … · symptoms to have a leaky gut. In our clinic, we have many patients who are confused why we run stool tests when they don't have GI symptoms,