Leaky gut — or intestinal hyperpermeability — is at the root of a surprising number of chronic health conditions. Here's what it is, what causes it, and how to heal it.
The intestinal lining is a single cell layer thick — roughly the size of a tennis court when unfolded. These cells are held together by tight junction proteins that act as gatekeepers, allowing nutrients to pass through while keeping bacteria, toxins, and undigested food particles out.
Leaky gut occurs when these tight junctions break down, allowing substances that should stay in the gut to enter the bloodstream. The immune system recognizes these as foreign invaders and mounts an inflammatory response — which, when chronic, contributes to a wide range of conditions.
Conditions linked to leaky gut include autoimmune diseases (Hashimoto's, rheumatoid arthritis, lupus), food sensitivities, IBS, IBD, eczema, psoriasis, depression, anxiety, brain fog, and chronic fatigue.
Common causes include gluten (which directly triggers zonulin, a protein that opens tight junctions), NSAIDs, antibiotics, alcohol, chronic stress, dysbiosis, and a diet high in processed foods and refined sugars.
Testing for leaky gut: The most accurate test is the Lactulose/Mannitol intestinal permeability test, which measures how much of these two sugars pass through the gut wall into the urine. Elevated zonulin in stool or blood is also a reliable marker.
The 5R Protocol for healing leaky gut: Remove trigger foods and pathogens. Replace digestive enzymes and stomach acid. Re-inoculate with beneficial bacteria. Repair the gut lining with L-glutamine, zinc carnosine, and collagen. Rebalance the nervous system and lifestyle factors.
Healing leaky gut is not a quick fix — it typically takes 3 to 12 months depending on the severity and how long it has been present. But the results are transformative: reduced inflammation, resolved food sensitivities, improved energy, clearer skin, and a calmer immune system.
Dr. Teresa Rispoli
PhD., ND, LAc. — Functional Medicine & Nutrition