It's a mysterious condition that plagues many fit people, but some doctors don't even think it's real. Here's what you need to know.
Leaky gut is an ailment a lot of people suspect they have, but often can't prove in the doctor's office. What are the symptoms? An assortment of things that might seem totally unrelated at first. Here are the common ones:
- Severe joint and muscle pain
- Frequent migraines and sensitivity to light
- Chronic constipation or diarrhea
- Brain fog and lethargy in the daytime
- Sleeplessness at night (often because of the pain)
- Food intolerances and sensitivities
When people begin to notice that a lot of these symptoms are triggered by specific foods or ingredients, that's when they start to suspect that the pain is related to digestion.
Do These Symptoms Sound Familiar?
The good thing is, there are a growing number of specialists who can help you overcome leaky gut. The bad thing is, most doctors aren't up to date.
Much of the medical community doesn't recognize leaky gut syndrome as a real condition yet. They want to blame your symptoms on something they're familiar with... and although you may indeed have the problems they say you do, those problems may just be byproducts of a leaky gut.
So you can treat the problem they're blaming, but if it's caused by leaky gut, then you may have to deal with ongoing occurrences until you solve the underlying issue.
What sucks is that if you're suffering, you want relief right away. And since doctors often don't understand it, they may give unhelpful advice. This means you may be forced to use trial and error, become your own best expert, and learn what to do in order to gain some semblance of normalcy.
So let's talk about what this phantom ailment is believed to be, and where to start if you think your gut might be leaky.
A Very Broad Explanation
Think about your intestines... specifically the small intestine. As part of the digestive system it's supposed to help you absorb all your nutrients through its walls and deliver them to the bloodstream. Now, digestion is actually a process of nutrient breakdown and absorption that begins in the mouth and continues till you either use and assimilate the nutrients, or discard the poo.
So, think back to your last biology class. You might remember that the small intestine's walls are made up of different layers, like the mucosa and the "finger-like" projections called villi, and on them are even smaller projections that can only be seen via microscope, called microvilli. It also contains carrier proteins that help you absorb vitamins and minerals, you know, little things that help you live.
But there aren't just layers of the walls extending from beginning to end of the small intestine, there are also junctions that segment these layers. Think of them like the seams of your clothing that are tightly joined together.
Well, these junctions aren't supposed to separate and allow bigger particles through. This is what the "leaky" part of leaky gut really comes down to. The intestines become permeable through these junctions, allowing bad bacteria, yeast, and larger food particles through that aren't supposed to be absorbed into the bloodstream in such a manner, if at all.
So when there's inflammation and damage within the structures of the small intestines, not only do you become susceptible to deficiencies, you get unwanted particles into your bloodstream that shouldn't be there.
Then What Happens?
It gets complicated after this. Your immune system will perceive these particles as invaders and go on the attack, which can lead to a lot of different symptoms. You may end up with pain or irritation throughout different systems of the body including the brain, muscles, joints, and nerves. Not to mention, your immune system may be suppressed because it's busy fighting these particles off.
This is an enormous oversimplification and there's a lot more to it that experts are still discovering.
What's The Cause of Leaky Gut?
Experts say many things can cause it, from the overuse of antibiotics and painkillers to irritating foods, like processed carbs and sugar. They also blame more obvious things like excess alcohol and drugs.
But it hits even closer to home for us iron addicts. Recently, researchers have been referring to "heavy exercise induced" gut permeability. It shouldn't be too hard to imagine that there's a point of diminishing returns with training. Too much volume, load, and metabolic intensity can wreak havoc when they're not balanced with an appropriate amount of recovery.
Training is stress. It elevates cortisol production, suppresses the immune system, and decreases blood flow to the digestive system. But aside from excessive training, what else can elevate cortisol? Mental stress and the overuse of stimulants.
Look, cortisol is a good and necessary hormone, and the right proportions of things that increase it won't hurt you. Coffee, working out, and feeling pressure to meet deadlines are part of normal life. But living in a state of high cortisol without the appropriate downtime to match it is what can wreck your health.
Even if you're a person who's able to avoid conflict or anxiety, think of how easy it'd be to have chronically elevated cortisol. Let's say you're pushing the intensity and volume in the gym, and you feel great because you're revved up on caffeine. Not only are you getting the stimulus before the workout, you get it from the workout itself, and then later on in the day you may treat yourself to another caffeine hit.
It might be fine for a while, but doing high intensity, high volume training, then bombing your body with caffeine can catch up with you. Then you're really screwed if something comes up out of the blue. Let's say a dentist has to put you on antibiotics for dry socket. Or you have to take medication for a UTI. Whatever the case, you create the perfect set of conditions that can lead to leaky gut.
Signs of Leaky Gut
Not every symptom is a conclusive sign of leaky gut. Sometimes a headache is just a headache. Look for multiple ongoing symptoms and patterns. Here's what to be aware of so that you can talk to a health care provider, or at the very least, make adjustments that will relieve some of your own pain.
- Sudden mental fatigue: Occasional tiredness is inevitable, but daily lethargy to the point of being dizzy, unable to drive, think, or remember is a major cause for concern. This is what "brain fog" is like.
- Food sensitivities: It's not unusual to have a food allergy. What is unusual is to suddenly have adverse reactions to foods that were once staples in your diet.
- Headaches: Continuous and frequent headaches or sensitivity to light (when you're not even hung-over) can be a sign that you're reacting to a food or ingredient you've been consuming.
- Digestive distress: If you experience ongoing constipation or diarrhea consider it a red flag.
- Crappy immunity: A recurring sore throat, sinus congestion, or flu-like symptoms that ebb and flow on a consistent basis.
- Candida: This is a systemic overgrowth of fungus. Symptoms include lethargy, joint pain, poor immunity, and oral thrush (white patches on the tongue).
- Deficiencies: If blood tests show that you have low iron, for instance, and you're eating a diet containing an abundance of iron-rich food, this may be a sign that you're dealing with a damaged gut.
Listening to My Gut. Then Wrecking It. (Repeatedly.)
I believe I have a recovering leaky gut after several years of painful flare-ups that have been like a personal hell for months at a time.
The First Time It Happened
It was during competition prep. It started with burning in my quads. It was so bad that, for relief, I'd have to get out of bed and sit in an ice-cold bath. This was the middle of winter. I had debilitating brain fog and experienced constipation so severe that I got regular colonics. I had to reject my competition coach's diet plan because I became sensitive to almost everything in it – eggs, almonds, rice, oats, any type of carb. My prep diet became mostly fish, meat, and mustard.
But by the time a doctor was able to fit me in, my competition was over, and with the elimination of everything that was irritating, my problems had stopped. So I canceled the appointment and was able to gradually add all the food back in that had been an irritant.
The Second Time It Happened
There was burning and searing specifically in my biceps, elbows, and forearms. I could hardly hold the dog's leash. There were also continual headaches and brain fog. It felt like I had the flu after eating certain foods.
The doctor couldn't see me for several weeks, so again, I was forced to eliminate what caused pain, and got my diet back down to mainly just protein sources.
By the time the doctor saw me, he tested me for low iron, which I did have, and diagnosed me with candida, which I also did have. He treated these two things which helped the symptoms. But he never connected the dots. He never asked why these were occurring at the same time, or wondered if there was something bigger going on with my digestion.
And while his treatments were helpful, they were a temporary fix. Because the flare-ups kept coming about once or twice a year for approximately three-month periods at a time.
Fast Forward to Last Spring
After a very hard workout, I had an incessant searing pain in both breasts. Even the feeling of clothing brushing up against them was painful, and the only thing that would lessen the pain was numbing it by holding ice packs against them. This was how I had to sleep too – with ice packs on my boobs.
I didn't know if it was a gut-related systemic problem or an implant problem, so just in case, I went back to eating only "safe" foods, and scheduled an appointment with a plastic surgeon, wondering if she'd have to remove my lady lumps. Fortunately, she said that the girls were undamaged, but she suspected that I stretched the nerves in both nipples during the workout. So she advised me to take about 400 milligrams of ibuprofen a day for a few weeks.
I did, and the breast pain skyrocketed immediately and worse than ever. I wanted to die. It seemed like the only way to get relief. The burning pain kept me awake at night and was unrelenting at all hours of the day. I was never not crying.
At my wits end, I scheduled an appointment with my regular doctor, then started looking on the back of the bottles of my painkillers to see if my elimination diet needed to include them. And that was when I discovered a common ingredient in the painkillers and all capsules I was consuming (iron supplements and supplements for nerve health). Turns out, the very thing I was taking for relief was making the pain even worse. The pain finally relented after only a few days of getting these products out of my system.
When I finally saw my regular doctor, he tested me for low iron again but couldn't give me any guidance, other than a piece of paper that talked about breast pain caused by PMS, ill-fitting bras, and excess caffeine. He didn't want to look any closer into my condition, nor was he willing to consider a diagnoses he was unfamiliar with. His favorite verdict was low iron, so that's what he stuck with.
I don't blame the painkillers though. Nor do I blame carbs, eggs, or any other foods that have triggered these crazy symptoms. I blame leaky gut and the stressors that have caused it. Because a damaged digestive system can turn benign things into your body's own poison. And I've very carefully been able to add most foods back into my diet.
So please don't use my story to villianize any food group or ingredient. Don't cut out the things that I had an adverse reaction to, unless you're sure they're problematic for you too.
Things That Can Help
This list is continually growing and you may find that there are a number of therapeutic foods, supplements, and behaviors that help you personally. But this is a good start:
- Pay attention to your food: If symptoms are recurring, notice when they start and what you're eating beforehand. A huge first step is figuring out what makes you hurt. Don't eliminate everything at once, otherwise you'll be famished and then pig out, and then inadvertently eat the things that give you problems. Just ask yourself if there's one specific ingredient that's abundant in your diet. Then start there.
Grains and sugar are a common sources of irritation, but they may not be yours. Eggs are irritating for some people too. Just remember, your sensitivity could be a totally random ingredient like Stevia, and what irritates you today may not be the same thing that irritates you four years from now. Or you may simply have a low tolerance for certain things.
- Recover: Rest won't make you fat unless your eating is out of control. And if you've been pushing the training too hard for too long, easing up may help you reduce your appetite for the things that are causing your pain. If you're having a flare-up of multiple symptoms, and you're able to work out at all, then at least limit high intensity cardio. Lift, walk, and be active, but maybe don't sign up for a competition.
- Reconsider your coffee habits: If you're a stimulant junkie, then excess caffeine may be counterproductive. And if you've gotten to the point where your coffee makes you tired instead of alert, it's no longer of benefit to you anyway.
- Collagen: Studies have shown that collagen can help repair the lining of the gut, in addition to improving your joint and hair health, so there's a win-win.
- Zinc: Researchers say that supplementing with zinc can make the intestinal lining less permeable and that deficiency of zinc promotes leaky gut.
Your success with these will really depends on your body and current set of circumstances.
- Probiotics: A lot of TV commercials will tell you to load up on probiotics willy-nilly as if they're all the same. But this is tricky because the wrong bacterial strains could make you feel worse. I've had success with VSL#3 probiotics, but everybody's gut is different.
- Colostrum: This used to be a popular supplement among bodybuilders who thought it helped with muscle growth. Whether or not it actually does that, researchers have said that it may combat gut permeability. So, it's worth researching.
- Extra fiber: This is a tough one because if your digestive system is already inflamed, then extra roughage may not be what's going to soothe it.
- Fermented food: It's a good idea for most people to have fermented food, but if your digestion is compromised and you start gobbling it up, it may lead to more irritation. It might be fine up to a point, but again, proceed with caution.
- Glutamine: May help repair and strengthen the small intestine and prevent future damage once it's healed.
So at this point there are multiple tests that indicate you have leaky gut based on your symptoms. And if these are your symptoms, then altering your diet and lifestyle are going to be necessary for relief, whether or not a doctor wants to acknowledge the condition or not.
The lactulose/mannitol test is the most common and it can actually show your doctor if you have excessive gut permeability. Of course, your doc may poo-poo it, but there are now companies who offer at-home testing.
Do a quick search and you'll find that labs can take oral or stool samples and tell you about your gut permeability, gut flora, malabsorption, bacterial imbalances, yeast or mold present, and more. There are also blood tests you can get which show whether or not you have food allergies or candida.
- Davison, G., et al. (2016). Zinc carnosine works with bovine colostrum in truncating heavy exercise–induced increase in gut permeability in healthy volunteers. The American Journal of Clinical Nutrition,104(2), 526-536. doi:10.3945
- Reasoner, J. (2014, November). Should You Get Tested for Leaky Gut? Retrieved October 26, 2017
- Skrovanek, S., et al. (2014, November 15). Zinc and gastrointestinal disease. Retrieved October 26, 2017
- Yoon, J. Y., Park, S. J., & Cheon, J. H. (2014, January). Effect of Colostrum on the Symptoms and Mucosal Permeability in Patients with Irritable Bowel Syndrome: A Randomized Placebo-controlled Study. Retrieved October 26, 2017
- Sturniolo, G. C., et al. (2001, May). Zinc supplementation tightens "leaky gut" in Crohn's disease. Retrieved October 26, 2017