Question: What is the Leaky Gut Syndrome (LGS) and how does it cause us harm?
Answer: The Leaky Gut Syndrome may be a contributing cause of many “etiology unknown” illnesses. LGS may also explain many of the symptoms patients have that confound and confuse many physicians. In my opinion, many cases of what doctors call IBS or IRRITABLE BOWEL SYNDROME is really LGS. The erroneous IBS diagnosis typically occurs after the doctor does the colonoscopy, the upper gastrointestinal study, and umpteen blood and stool tests that are all essentially normal. The doctor then comes up with this meaningless and incorrect wastebasket diagnosis of IBS. The physician really doesn’t know what’s wrong. Instead of saying “I don’t know what is causing your symptoms” they have to come up with an acceptable diagnosis code. The physician doesn’t get paid unless they put down a diagnosis code! They can get paid if they use the code for IBS. The IBS could just as easily stand for “I’m Baffled Seriously”. To add insult to injury, many egotistical physicians play the game I term “arrogance to cover up ignorance” and suggest to patients that since they couldn’t find an explanation the problem must exist only in the patient’s head.
To understand LGS we need to understand the concept of barrier function. The barrier demarcates the outside environment from the internal environment. The primary function of the barrier is to keep germs and detrimental particles from entering our internal environment. Most people would agree that the skin and what’s under it is internal to us. What is external to the skin is not part of us. Violation of that skin barrier by severe burns, or by penetrating wounds, allow elements of the external environment to enter. Once passed this skin barrier those elements can wreak havoc upon us. This is what happens if we step on a nail and get an inoculated infection. If we weaken the barrier with a burn or physical wound, we create a window of opportunity for germs or unhealthy particles to enter us. This also allows fluids, proteins, electrolytes, cells, etc. (part of us) to exit.
Brain, skin, and gut INNERVATION originate from the same embryologic tissue. Often diseases or conditions that affect one affect one or both of the other two. Food allergies can produce skin, neurological, and gut symptoms. For example, allergy to gluten manifests in inflammation of the gut termed celiac disease. CELIAC DISEASE, in my opinion, is just one (possibly the most common) presentation of LGS. Celiac disease manifestations in the skin are recognized as dermatitis herpetiformis, which has specific dermatologic presentations. Less than extreme gradations of this specific dietary disease are, in my opinion, extremely common and most often not correctly diagnosed. If we start looking for it we find that up to 1 in 4 people have antibodies to portions of the gluten protein conglomerate. Since grains used in the SAD (Standard American Diet) mostly contain gluten, people think it’s difficult to avoid gluten. Folks, it is Easy. It SEEK’s (Which is my acronym for any choice in your life. SEEK=Safe, Effective. Easy, and Kind.) Most of the world’s 6 billion people don’t use grains that contain gluten. They use rice or other grains as their primary staple. Unless and until they come to this country, I’d be willing to bet they have less of what we term IBS symptoms, as well as other major health problems that we now are appreciating in the USA in epidemic proportions. Flax, soy, corn, amaranth, millet, buckwheat, and quinoa also contain no gluten and are very nutritious.
Both skin and gut function as barriers. Envision the human body as an oddly shaped doughnut. The crust of the doughnut is the barrier. The gut is simply the hole in the doughnut. The doughnut hole is not part of the doughnut; it is part of the outside environment. We are obviously not shaped like a doughnut, but like a doughnut, we have a hole. The mouth is the opening at the top, and at the bottom, the opening is the anus. The gut lumen is our hole and its contents are external to us.
The two obvious anatomical distinctions between the doughnut hole and the human gut are that: 1. The human gut is irregular in shape, and 2.The crust or surface is variable in organization. These distinctions are due to the gut’s other functions of digestion, absorption, and excretion.
Because the gut barrier is thin and the contents of the gut is loaded with toxins and germs, our smart bodies have protective immune cells, called white blood cells (WBC’s) laden with killer chemicals ready to poison any potential invaders. WBC’s patrol just inside our gut lining. It is suspected that sometimes these WBC’s release their poisons, generically termed cytokines, inappropriately. This results in inflammation that can sever the cellular attachments of the barrier. Loss of barrier integrity in the gut creates a window of opportunity for toxicity (poisoning). This “window” allows organisms, their toxic products of metabolism, and other particles to enter our interior through the gut lining. Once inside, any foreign material meets our second line of defense, lymphocytes, and macrophages. Lymphocytes address the invaders by becoming programmed to make specific antibodies against them. Lymphocytes sense recognition points on the invaders’ surfaces. Once released, these antibodies are then programmed to lock onto the surfaces of the invaders and disable them. The combination of invader/antibodies attracts macrophages that engulf and destroy it. Unfortunately, those same beneficial antibodies are suspected of reacting and combining with “friendly tissue” parts of our body, when that healthy tissue is erroneously recognized as foreign. This aforementioned description of our immune system’s response was designed to protect us from infectious diseases. When the immune system is immature, as in infants/young children or aged/weakened in elder people, you see this inappropriate recognition when large protein or glycoprotein molecules present themselves to the immune system. Most often in healthy children, proper discrimination will occur as the immune system “matures”. They usually grow out of their allergies. When they don’t, often because they continue to be challenged by both endogenous and exogenous chemicals from the ever increasingly toxic environment, there will be tissue damage. This tissue collateral damage is termed autoimmunity.
Leaky Gut (LGS) related autoimmunity is suspected in ANKYLOSING SPONDYLITIS, RHEUMATOID ARTHRITIS, and many other diseases with antibodies and inflammatory cytokines that inappropriately damage joint and other tissues, in genetically, and nutritionally deficient, susceptible individuals. MULTIPLE SCLEROSIS could be related to LGS generated antibodies and cytokines attacking the protective myelin sheath of nerve cells in nutritionally deficient and genetically vulnerable individuals.
In LGS the gut has, as the name implies, a plethora of leaks. This massive leakage material induces our body’s immune system to produce large quantities of killer chemicals intended to target the illegal entrants. This huge production effort weakens the immune system by tying up energy and enzymes. In this manner, LGS may be a major factor in CHRONIC FATIGUE SYNDROME.
More typically, if we allow our tissue to deteriorate by LGS or by any other way with aging we will also see tissues of every kind damaged. This damage we term degenerative disease. In my opinion, it’s mostly preventable diseases of neglect. The tissue I regard as most important is the brain. This tissue is most often affected by man-made chemicals that enter through our nose and lungs, but also can be damaged by these exogenous chemicals entering through the gut or trans-dermal (through the skin), irrespective of LGS.
The brain may also be affected by the combination of the massive endogenous (produced by or inside the body) toxic chemical production of LGS and the mostly man-made exogenous (produced outside the body) toxic chemicals that we take into our bodies. When the brain is thusly affected it is termed an ENCEPHALOPATHY. (I call this the NBC broadcasting station because an encephalopathy usually manifests with any combination of Neurological, Behavioral, or Cognitive abnormalities. Most of us have been affected by transient encephalopathy (short term “brain fog”, “jet lag”, or “spring fever”) or by common transient intoxications, most often self-induced with alcohol or other drugs.
Celiac disease should be recognized as a multiple system disease that includes the central nervous system, as well as skin and gut. Children with celiac disease may be broadcasting on NBC and it will show in how they feel, act, look, write, and perform in school! It will not show up with any blood test and most imaging studies. It will not be improved with Concerta, Ritalin, amphetamines, etc. when it’s conveniently (for psychiatrists, teachers, parents, etc.) misdiagnosed. In children whose blood-brain barrier is not yet fully developed, LGS produced endogenous (produced by our body) cytokines, and leakage toxins can more easily affect mentation and thus behavior by direct brain cell toxicity. This mechanism is similar to brain cell poisoning (toxicity) by exogenous (produced outside our body) chemicals like formaldehyde, methanol, or ethanol. Such chemically toxic children present with varying degrees of encephalopathy. Their behavior and writings will be affected when their brain cells are not functioning optimally. The children with dense or prolonged encephalopathy have an increased rate of brain cells dying as a result of the toxicity. The death of the brain cells, along with their neural connections are diffusely distributed unlike a stroke, cerebral palsy, or brain physical trauma. The damage is more difficult to account for by conventional imaging studies and may vary greatly in the presentation. These children may be misdiagnosed with AUTISM, ADHD, PSYCHOSIS, or DEPRESSION. They even may go from one wrong diagnosis to another as the brain reestablishes some connections, the toxic load decreases, various inappropriate drug interventions are used, etc.
WE ARE SEEING ENTIRELY TOO MANY CHILDREN WITH ENVIRONMENTALLY INDUCED ILLNESSES, INCLUDING LGS MISDIAGNOSED. I strongly believe that something is seriously being “missed,” as we are seeing an inordinate number of children (and adults) being diagnosed with mental illness, most often DEPRESSION, and placed on psychoactive drugs. The occurrence statistics don’t make any common sense. The drugs often do more harm than good. The momentum for this movement is strong in the mainstream-medicine community. I believe it is powered by the drug companies that make the drugs involved.
The good news is that the brain damage involved is diffuse and is more likely to repair itself with time, and good NUTRITION (See my article Nutrition – More Than Just Food on this site), if drugs given in misdiagnosis don’t exacerbate and prolong the condition, by masking the real cause of the symptoms.
Quite often an ENCEPHALOPATHY is misdiagnosed, even in adults. BIPOLAR DISORDER MISDIAGNOSIS is often made as the behavioral changes associated with the ENCEPHALOPATHY often increase or decrease as a reflection of brain function. This often is the case in the MCS (Multiple Chemical Sensitive) patients. The MCS patient’s behavior can change quite rapidly upon exposure to chemicals that elicit ACUTE ENCEPHALOPATHIES. With an overload of toxins, the brain functions poorly. With episodes of rest, less stress, improved nutrition, exercise, improvement of circadian rhythm, etc., the brain functions improve and reflect in better NBC broadcasting. The personality, mood, and behavioral changes are the most striking manifestations of the ENCEPHALOPATHY. At close inspection, however, other neurological signs as well as other abnormal signs of other systems of the body (dermatologic, gastro-intestinal, cardio-vascular, etc.) may be present and found if they are looked for. The misdiagnosis is most often brought about when the clinician making the diagnosis fails to carefully listen to the patient or caregiver for the history of chemical exposure and/or gastrointestinal symptoms and fails to look for concomitant neurological signs of abnormalities. Most often, unfortunately, the naive clinician will focus on the psychiatric signs and discount or ignore the patient as a whole. Most often the misdiagnosis worsens the symptoms as the clinician then inappropriately and naively prescribes strong intervention drugs that further tax the detoxification system.
The learning “pearl” for such clinicians is to strongly suspect a BIPOLAR DEPRESSIVE DISORDER MISDIAGNOSIS in any child or in an adult over 50 years old. These individual’s poorly developed (child), or weakened with age (50 or older), blood-brain barriers make them more vulnerable to adverse effects of both exogenous (including drugs) and endogenous chemicals. Also in the older groups, quite often the lifelong bioaccumulation of neuro-toxins and the decline in detoxification enzymes that occur with aging allow for the brain to become more easily affected. Likewise, in the middle age group always rule out illicit drug/alcohol abuse induced encephalopathy.
In all age groups, ALLERGY, whether it is food or inhalant type, will weaken the blood-brain barrier, mostly around the brain’s LIMBIC area.
The mechanism of allergy-related encephalopathy involves the release of cytokines from immune cells, such as mast cells, which are induced by the allergy process. The resultant inflammatory process causes “leaks” in the blood-brain barrier, allowing chemicals to enter. Most of us are familiar with the lethargy of “spring fever” (a lay term for seasonal allergy). That lethargy/brain fog/out of sorts feeling associated with a seasonal allergy is a very mild form of encephalopathy. The limbic area modulates libido and motivation. Since the process often involves the limbic brain, it’s no surprise that excessive romantic thoughts and a lazy attitude are part of the clinical presentation of SEASONAL ALLERGY ENCEPHALOPATHY. The natural process, in overview, may serve a very necessary teleological purpose in nature, i.e. – the preservation of the higher animal species. Natural occurring chemicals acting upon the brain, such as pheromones, endorphins, and oxytocin powerfully support this natural purpose.
Unfortunately, these allergy-induced leaks also allow manmade ubiquitous neuro-toxic chemicals, like formaldehyde, VOH’s (Volatile Organic Hydrocarbons), or pesticides to enter and poison the neurons.
In the more serious leakage cases (allergies plus chemical intoxication) it’s like a one-two punch in boxing. The allergy punch lowers the brain’s defense and sets up the “knockout” chemical blow. In these cases dramatic and often life-changing encephalopathy can occur. The limbic region is involved in many other functions such as memory; MOOD; autonomic control of blood pressure, body temperature, hunger, thirst, and sleep. Allergy/chemical induced damage can present with, in ascending order of severity: moodiness, sleep disturbance, irritability, depression, and the toxicity induced mixture of complete emotional liability seen in BIPOLAR DISORDER. Such cases are, in my opinion, rarely correctly diagnosed, except by doctors trained in EM (ENVIRONMENTAL MEDICINE). EM doctors almost always incorporate allergy testing and desensitization for inhalant allergies and elimination diet schemes for food-related allergies. Of course, the EM doctor also works to preserve those brain cells still alive, but still at risk, by enhancement of the body’s detoxification processes. Ultimately, eliminating any ongoing toxic chemical exposure is also fundamental to successful treatment.
In all such cases of suspected encephalopathy, all clinicians need to look carefully for neurologically or other signs that suggest chemical or allergy-related toxicity to rule out encephalopathy!
The LGS or other chemical toxicity etiology of patients’ symptoms only becomes apparent if, and when, the LGS or toxicity issue is discovered and is resolved.
In LGS the weakened gut lining, like a chronic festering skin sore, allows for the colonizing of unnatural microbes. CANDIDA is the main microbe of concern. Not only does Candida produce a plethora of toxins, but Candida also becomes the main adversary against the body’s repair of the leaky gut.
Candida thrives in moist, warm places. I find this organism’s presence or absence to be the best observable indicator of the status of our immune system. If our immune system is weak it will entrench itself in the mouth, vagina (a cul-de-sac of the “crust”), or our gut. It looks like cottage cheese. Mouth Candida (thrush) has a typical appearance. It’s a mixture of Candida spores, mucus, and inflammatory exudates. If you scrape the “cottage cheese” off the tongue, the tongue will remain inappropriately white. What remains and makes the tongue whiteness appearance persist, is the rhizoid form of Candida. Rhizoids are like roots for the Candida organisms in the gut to anchor to the gut lining. Like spears, the rhizoids penetrate and make more leaks in the gut. Like tubes they poor in toxins.
This Leaky Gut/ Candida phenomenon allows more of the outside environment into our interior. Inside it combines with, invited and uninvited, pharmacologically active chemical guests to potentiate each other in a “polypharmacy of chemical toxicity” in our ATLAS DRUGGED.
I recommend that anyone manifesting gastrointestinal, skin, or that is “broadcasting on NBC” first eliminate gluten-containing foods. Foods that contain gluten include the following: highly processed foods, wheat, oats, barley, spelt, rye, Kamut, and triticale.
The SEEK what to eat answer is first to eliminate all toxic foods. This list includes: all meats except the most mildly contaminated fish (Unless you are Vegan or vegetarian, which is even easier and more complete), all cow milk and cow derived dairy products, AGE’s (Advanced Glycation End products), MSG and other “flavor enhancers” or isolated amino acids, acrylamides, artificial sweeteners, preservatives, trans fats, chemically altered foods, genetically modified foods, sulfites, products from cooking or containing foods in plastics or Teflon, sulfites, etc. Secondly, eliminate all gluten containing foods, and the most common allergy causing foods. These are the “big eight”, which are: cow’s milk, eggs, wheat, peanuts, tree nuts, soy, shellfish, and fruits. Lastly, consider the nutrient value of all the remaining thousands of choices and select as you wish. Be sure to include lots of varieties of deeply colored vegetables, eat slowly, and enjoy your food.
Also fundamental to the specific bowel treatment, a serious attempt to reestablish the normal intestinal flora should be made. We live in a communalistic relationship with these “good guy” germs in our gut. Pro-biotic organisms, such as acidophilus, and Bifida are our friends. In addition, an exercise that incorporates any part or the entire reciprocating gate will help detoxify all parts of the body including the gut, skin, and, most importantly, the brain. Coffee enemas and other “cleansing” measures will be of benefit, in most cases.
Tincture of time is the only drug I feel will offer help. Most pharmaceutical drugs prevent the body from healing itself even with this magical remedy.
Author: James A. Ferrel MD, CNC
Dr. James A. Ferrel MD, CNC is a retired physician who specialized in environmental medicine. He is the author of Neogenesis - Reconstructing the Self.
