By Becky Bell
A phenomenon called "leaky gut" has gained quite a bit of attention lately, particularly among natural health enthusiasts.
Leaky gut, also known as increased intestinal permeability, is a digestive condition in which bacteria and toxins are able to "leak" through the intestinal wall.
Mainstream medical professionals do not recognize leaky gut as a real condition.
However, there is quite a bit of scientific evidence that leaky gut does exist and may be associated with multiple health problems.
This article takes a critical look at the evidence on leaky gut syndrome.
What Is Leaky Gut?
The human digestive tract is where food is broken down and nutrients are absorbed.
The digestive system also plays an important role in protecting your body from harmful substances. The walls of the intestines act as barriers, controlling what enters the bloodstream to be transported to your organs.
Small gaps in the intestinal wall called tight junctions allow water and nutrients to pass through, while blocking the passage of harmful substances. Intestinal permeability refers to how easily substances pass through the intestinal wall.
When the tight junctions of intestinal walls become loose, the gut becomes more permeable, which may allow bacteria and toxins to pass from the gut into the bloodstream. This phenomenon is commonly referred to as "leaky gut."
When the gut is "leaky" and bacteria and toxins enter the bloodstream, it can cause widespread inflammation and possibly trigger a reaction from the immune system.
Supposed symptoms of leaky gut syndrome include bloating, food sensitivities, fatigue, digestive issues and skin problems (1).
However, leaky gut is not a recognized medical diagnosis. In fact, some medical professionals deny that it even exists.
Proponents claim that it's the underlying cause of all sorts of conditions, including chronic fatigue syndrome, migraines, multiple sclerosis, fibromyalgia, food sensitivities, thyroid abnormalities, mood swings, skin conditions and autism.
The problem is that very few scientific studies mention leaky gut syndrome.
Summary: Leaky gut or intestinal hyperpermeability, is a phenomenon that occurs when the tight junctions of the intestinal wall become loose, allowing harmful substances to enter the bloodstream.
What Causes Leaky Gut?
Leaky gut syndrome remains a bit of a medical mystery and medical professionals are still trying to determine exactly what causes it.
When it's activated in genetically susceptible people, it can lead to leaky gut. Two factors that trigger the release of zonulin are bacteria in the intestines and gluten, which is a protein found in wheat and other grains (3, 4, 5).
There are likely multiple contributing factors to leaky gut syndrome.
Below are a few factors that are believed to play a role:
- Excessive sugar intake: An unhealthy diet high in sugar, particularly fructose, harms the barrier function of the intestinal wall (8, 9).
- Non-steroidal anti-inflammatory drugs (NSAIDs): The long-term use of NSAIDs like ibuprofen can increase intestinal permeability and contribute to leaky gut (10, 11, 12).
- Nutrient deficiencies: Deficiencies in vitamin A, vitamin D and zinc have each been implicated in increased intestinal permeability (8, 14, 15).
- Inflammation: Chronic inflammation throughout the body can contribute to leaky gut syndrome (16).
- Stress: Chronic stress is a contributing factor to multiple gastrointestinal disorders, including leaky gut (17).
- Poor gut health: There are millions of bacteria in the gut, some beneficial and some harmful. When the balance between the two is disrupted, it can affect the barrier function of the intestinal wall (1, 8).
- Yeast overgrowth: Yeast is naturally present in the gut, but an overgrowth of yeast may contribute to leaky gut (18).
Summary: Medical professionals are still trying to determine what causes leaky gut syndrome. An unhealthy diet, long-term NSAID use, stress and chronic inflammation are some factors that are believed to contribute to it.
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Where Does the Deficiency Begin?<p>Nobody knows exactly how much vitamin D a person actually needs. The question of when a deficiency starts is correspondingly controversial. However, vitamin D is becoming increasingly popular.Not only is the pseudo-scientific literature on the "sun vitamin" experiencing an upswing, but the number of published studies has also increased enormously in recent years. For example, in 2019 <a href="https://academic.oup.com/edrv/article/40/4/1109/5126915" target="_blank">a study found that</a> Vitamin D is responsible for keeping the skeleton functional and is associated with cardiovascular diseases, type 2 diabetes and various types of cancer. <br></p>
An All-Rounder<p>Vitamin D levels in the body rise and fall according to sun exposure. If sufficient UV rays reach the skin, the body is able to produce the vitamin itself. However, the human body only derives an estimated 10 to 20 percent of its daily requirement from food.</p><p>The vitamin D that we synthesize from sunlight or food is not biologically active at first. Before the kidneys can produce the biologically active form of the vitamin, known as calcitriol, and release it into the blood, some metabolic processes must take place beforehand.</p><p>In addition, many organs have receptors to which the precursor of calcitriol binds. Further, this substance is also present in blood.</p><p>From this precursor, the organs then produce calcitriol themselves, which the body then uses for countless other processes in the body. This form of vitamin D thus regulates insulin secretion, inhibits tumor growth, and promotes the formation of red blood cells as well as the survival and activity of macrophages, which are important for the <a href="https://www.mdpi.com/2072-6643/5/7/2502/htm" target="_blank">immune system.</a></p>
Low Vitamin D, Severe COVID-19 Disease?<p>A research study carried out <a href="https://www.sciencedirect.com/science/article/pii/S2352364620300067?via%3Dihub" target="_blank">at the University of Hohenheim</a> has now established a link between vitamin D deficiency, certain previous diseases, and severe cases of COVID-19.</p><p>According to the study, "there is a lot of evidence that several non-communicable diseases (high blood pressure, diabetes, cardiovascular diseases, metabolic syndrome) are associated with low vitamin D plasma levels. These comorbidities, together with the often accompanying vitamin D deficiency, increase the risk of severe COVID-19 events."</p><p>"This statement is completely correct," said Martin Fassnacht, head of endocrinology at the University Hospital of Würzburg. However, he qualifies that it is a pure association, "i.e. a mere observation that these events occur together.</p><p>Dr. Fassnacht is very critical of the hype surrounding vitamin D, but not because he denies the vitamin serves important functions. However, studies on humans have not been able to show that vitamin D has the healing powers many often propagate.</p><p>Fassnacht says, "If you take a closer look, the hopes that the administration of vitamin D has a healing effect have not been confirmed so far."</p>
Association Versus Intervention Studies<p>Many studies on the vitamin are association or observational studies. "By definition, these studies cannot prove the causal relationship, but only point to mere correlations," said Fassnacht. The physician tries to illustrate this with an example:</p><p>"Imagine two groups of 80-year-olds. One group is spry, active and does sports. If you compare them with another group living in nursing homes, the difference in vitamin D levels will be dramatic. Life expectancy would also be extremely different."</p><p>But to try to explain the difference in fitness by vitamin D status alone is far too simplistic. "Vitamin D levels are a good measure of how sick someone is. But not more," says Fassnacht. </p><p>According to Fassnacht, none of the intervention studies carried out to date -- that specifically examined the effect of vitamin D on various diseases -- has been able to confirm the previous association and laboratory studies or the presumed positive effect of vitamin D.</p>
Further Research Is Needed<p>"If a coronavirus infection is suspected, it is therefore absolutely necessary to check the vitamin D status and quickly correct any possible deficit," said the recommendation of the paper published by the University of Hohenheim.</p><p>"Studies are underway to see whether vitamin D helps in COVID-19 infection, but I personally do not believe that this is really the case," says endocrinologist Fassnacht. Nevertheless, he says it is of course useful to carry out these studies.<br></p><p>"I don't want to rule out that there are actually subgroups of people who benefit from an additional vitamin D dose," he says. After all, this has been proven to be the case with a severe deficit.</p><p>In view of the study situation, Fassnacht does not think much of preventive, nationwide vitamin D substitutes. "My belief that the vitamin helps somewhere is very low. But, of course, I can be wrong."</p>
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