How do I Know if I Have Leaky Gut?

It’s a question a lot of us might be asking ourselves if we’ve scoured the internet for hours trying to figure out what exactly is wrong with our gut. 

While you can do certain testing to identify a possible leaky gut, that’s not always an option for some people. 

In this article, I’ll go over what leaky gut is, why we get it and share a few signs and symptoms to be on the lookout for so that you can get yourself on a path to healing!

What is leaky gut?

Leaky gut is the layman’s term for intestinal permeability. When the gut is leaky, this means that the intestinal barrier is weak and has small cracks or breaks in it. This allows food and other particles, pathogens and toxins to leak through the intestinal lining into the bloodstream where they do not belong.

When this happens, it sends signals to the body’s immune system to release certain antibodies to fight off “foreign invaders.” Normal healthy foods like broccoli or tomatoes are recognized as harmful substances because they do not belong in our bloodstream and our body’s protective mechanisms go into action, creating systemic inflammation and a wide variety of health issues that impact our digestion, skin, mood and cognitive functioning.

There’s also an increased risk for autoimmune disorders like inflammatory bowel disease (IBD), celiac disease, autoimmune hepatitis, type 1 diabetes (T1D), multiple sclerosis (MS), hashimoto’s, lupus, and many more. If you are wondering why this happens, it’s because our body’s immune system is essentially “over responding” to what it thinks are foreign invaders but are actually healthy normal substances — they just don’t belong in our bloodstream! Eventually, our cells begin to attack themselves, which is what we generally mean when we talk about autoimmune conditions. 

This also opens the door (literally, because our intestinal barrier is compromised) for a myriad of other chronic health diseases to develop, including arthritis, asthma, autism, chronic fatigue syndrome, depression, metabolic disorders, skin disorders, thyroid problems, and weight loss resistance. 

If my clients aren’t meeting their weight loss goals (and also have persisting digestive issues),  but feel like they are doing everything right, I always evaluate leaky gut as a potential factor. You’d be surprised how many people suffer from leaky gut. It’s a lot. And I was one of those people!

Why do we get leaky gut?

Conventional medicine will tell you that we don’t know why people develop leaky gut, but that’s simply not true. We know that a variety of factors play into the development of intestinal permeability, including chronic stress, chronic wheat consumption, a poor diet that is high in processed foods/refined carbohydrates and low in nutrients, toxic overload, certain medications such as antibiotics, and dysbiosis (an imbalance in the good and bad bacteria in our microbiome). 

In fact, antibiotics are one of the biggest leading causes of leaky gut because they essentially kill all of our good gut bacteria, creating an imbalance in our microbiome. You can read more on how antibiotics contribute to leaky gut as well as how to heal from it in a previous article I wrote. 

And I’d be remiss if I didn’t also give a special call out to the link between wheat consumption and leaky gut. Wheat causes transient leaky gut, meaning that everytime we consume gluten the barrier of our intestinal lining opens up. Now, in the absence of gluten, it can repair itself, but repeated exposure to gluten leads to systemic leaky gut, which opens the floodgates for digestive and mental/mood disorders, food sensitivities, joint pain, and more severely, neurological disorders. 

Studies show that 51% of people eating wheat suffer from neurological disorders like Alzheimer’s/dementia, MS, Parkinson’s disease, etc.

There are also genetic predispositions at play that make some people more susceptible to developing leaky gut. Depending on how you were raised and what your diet growing up looked like, if you were born via C section, and even the state of your mother’s health and diet during pregnancy can all affect how susceptible your body is to being triggered by environmental factors. 

Signs and symptoms of leaky gut

As I mentioned above, you can of course get testing done to determine if you suffer from leaky gut. You could get a stool test such as the GI Map done to assess the overall state of your gut. Oftentimes people who have leaky gut also have a history of parasites or other GI bacterial/fungal issues like small intestinal bacterial overgrowth (SIBO) or Candida, so getting tested for those can also help narrow things down. 

Another area to look at in terms of testing is the presence of two sugars, lactulose and mannitol, which are released in someone who has leaky gut. It’s a simple urine test that you can have your doctor or healthcare practitioner order for you.

Some people also have skin prick, or allergy tests done to identify food sensitivities. I am personally not a fan of using these in my own practice because I believe there are easier and cheaper ways to identify food sensitivities but if you are curious to know, it’s absolutely an option. 

In addition to testing, these are the biggest indicators of a leaky gut: 

1. Chronic Stress. This is probably one of the biggest reasons why people develop leaky gut over time. The brain and the gut share a special connection. Perhaps you’ve heard of the gut-brain axis before or you’ve heard the gut referred to as the “second brain.” There’s a good reason for it!
   
   When we are stressed — whether it’s physical or emotional — the adrenal glands release certain stress hormones, the primary one being cortisol. Cortisol activates our immune system so that it can protect us from whatever threat is present. This is okay if we are fighting off the flu or running for our lives, however over time, that chronic stress leads to chronic health issues. When our body’s in survival mode, it shuts off nonessential functions, such as digestion, which can keep food around in the GI tract for too long, where it eventually ferments and creates dysbiosis, changing the environment of our gut microbiota. Keep in mind that 80 percent of our immune system lives in our gut so if something is off, our immune function will be compromised. Stress also erodes the intestinal lining of our gut, paving the way for leaky gut to emerge and increase our risk for autoimmune issues. 

2. Food sensitivities. If you remember above, I mentioned that leaky gut can create sensitivities to otherwise harmless substances because they leak into the bloodstream where they don’t belong. The most common “substance” is food. So if you suddenly developed a bunch of food sensitivities or allergies to foods that you could previously eat like spinach, almonds, nightshade vegetables, bananas — anything really — then you have a much higher probability of leaky gut. I experienced this personally when I was dealing with leaky gut. The good news is that once you heal and seal the gut, you should be able to go back to eating those normal healthy foods you love (gluten might be the one exception!).
   
   
3. Persistent skin issues. There is a connection between the skin and gut. If your gut is leaky, so is your skin, meaning you are more prone to developing skin issues like acne, psoriasis, keratosis pilaris, eczema, etc. The skin is a really good indication of our overall gut health. Skin conditions are also conditions of inflammation and research shows that our skin health is impacted by the kinds of bacteria in our gut. So if the gut is leaky, then we are not absorbing nutrients and our microbiota is altered as well. 

4. Unexplained nutrient deficiencies. This is another huge sign of a possible leaky gut. Nutrients are absorbed in our gastrointestinal tract. If our intestinal barrier (also referred to as tight junctions) is broken, then those nutrients are not being absorbed for proper use by the body. I saw many doctors during my own health journey and most of them insisted that I wasn’t eating enough food because I was so low in essential vitamins and minerals. I was eating. I just wasn’t absorbing the nutrients, which were leaking out into my bloodstream along with partially digested food. Some common deficiencies include magnesium and vitamin B12.
   
   
5. Confirmed or suspected IBS or IBD. Another common complaint of people who have leaky gut (diagnosed or otherwise) is irritable bowel and GI issues, such as ulcerative colitis, Crohn’s, IBS or IBD. If you have constipation, diarrhea or both and aren’t exactly sure why, this could be it. The research shows that an imbalance in the gut microbiota leads to the activation of our immune systems and low grade inflammation, which impedes digestion and elimination. We also know that if food is only partially digested and is leaking into the bloodstream, it’s not going through the proper elimination channels, and again, activates our immune system, leading to systemic inflammation. IBS is a symptom, not a root cause and a lot of people will find that their IBS subsides once they work on healing the gut, and eliminating any pathogens such as fungal, bacterial or parasitic infections.
   
   
6. Depression, anxiety and other mood disorders. If you’ve been struggling with mood disorders, there’s a strong chance it’s connected to your gut. Going back to the brain-gut axis discussion, we know that this is a two way signaling path. All chronic diseases, including mental ones, are diseases of inflammation. So if your gut is leaky, there’s a very high probability that your brain is leaky, too. In patients with chronic stress, severe depression and intestinal permeability, we see an elevated level of certain immune antibodies (IgM and IgA) than we do in healthy individuals. This means that when bacteria from the gut enter the bloodstream and set off our immune response, this impacts our entire system, including the brain.
   
   There are also studies on the connection between immune system impairment, leaky gut and autism especially if the child has been treated with antibiotics.

Unfortunately, the above list is not completely exhaustive. The way leaky gut manifests for many people is highly individualized. If you experience any (or multiple) of the following issues or diseases, you may want to get tested for leaky gut.

• Gastric ulcers
• Allergies (food or airborne)
• Diarrhea
• Constipation
• Recurring respiratory issues or infection
• Irritable bowel syndrome (IBS) 
• Inflammatory bowel disease (IBD), celiac disease and ulcerative colitis
• Acute inflammation (sepsis, SIRS, MOF)
• Arthritis and other joint pain
• Cancer (esophagus, colorectal)
• Obesity-associated metabolic diseases (NASH, diabetes type I and II, CVD)
• Ongoing skin conditions such as acne, eczema, or psoriasis 
• History of parasites, bacterial or fungal infections
• History of small intestinal bacterial overgrowth (SIBO)

Leaky gut and autoimmune conditions 

While it’s beyond the scope of this article to discuss the connection between leaky gut and autoimmunity in depth, I did want to quickly address it. If you have leaky gut and are on the autoimmune spectrum, this doesn’t mean you are destined to have an autoimmune disorder for the rest of your life. If you are able to catch it fast enough and treat it properly, you should be able to reverse a lot of the autoimmune responses taking place in your body. 

One of the best ways to test for autoimmunity driven by leaky gut is to have your zonulin levels tested. Zonulin is a protein molecule that regulates the exchange of fluid, macromolecules and leukocytes between bloodstream and intestinal lumen. There’s also research on how gliadin (one of the active proteins in wheat) interferes with zonulin in the body, which contributes to intestinal permeability and increases the risk of autoimmunity. 

What to do if you suspect leaky gut?

I am always a fan of getting testing done because it gives you very specific information and lets you know where to start. But I understand testing can be expensive and it might not be an option.

I also recommend you start a conversation with a holistic healthcare practitioner on how to create a unique healing protocol for your needs. There are many resources out there on how to heal leaky gut, but I firmly believe in working with a professional instead of relying on Dr. Google alone. Information is powerful but you might not have the complete picture of what’s going on internally with your body. 

If you are interested in taking action, I specialize in gut health and have personally healed myself from leaky gut, parasites, SIBO, IBS and anxiety/depression. You can check out my services and pricing page to learn more and schedule a free 20 minute discovery call to see if we’d be a good fit working together!