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Dis-ease Begins in the Gut, but Perhaps in a Way You Didn’t Consider

I hope this is helpful and inspiring to you.  After you experience the video, please do post questions or comments below.  I want to hear from you!  In response to the questions that have already rolled in, I am sharing some additional tips and specifics below for you.

This is a key root cause of dis-ease in the body that you want to be not just aware of but savvy about catching early in your clients and resolving them fully using functional medicine know-how.  Wildly satisfied clients build wildly successful practices!

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  • If you want more information about dis-ease beginning in the gut specifically as it relates to digestion and absorption – and what the full definition of that really is – feel free to check out this other post. (If you want more inspiration, start at the beginning; if you just want to get right to the gut pearls, start the video at around 4:45).
  • Explaining leaky gut to your clients can be a challenge until you’ve had a lot of practice!  This article is very well-written and has many excellent diagrams to make the concepts more straightforward to your clients.
  • What causes leaky gut (or intestinal permeability, IP)?  Well, as I mentioned in the video, both insufficient Vitamin D and regular use of NSAIDs are common drivers.  Also other common medications (e.g. SSRIs, birth control pills), chemicals in food, environmental toxins, microbial imbalance/overgrowth/pathogens (in my experience, especially Candida, parasites), chronic stress, insufficient zinc, insufficient antioxidant intake, poor digestive enzyme secretion (esp. from the pancreas, more common in those with T2 diabetes), and excess alcohol intake.
  • You may find more information about food sensitivity testing in this detailed post.
  • I have written before about the value of quercetin (a natural anti-histamine) in helping your clients with seasonal/chronic allergies or chronic post nasal drip/congestion (which as an aside, in my clients, is very often a sensitivity to dairy foods but can certainly involve other foods/antigens as well e.g. mold).  Someone asked for a clinical link re: quercetin and leaky gut.
  • There are many wonderful alternatives to NSAID drugs for your clients with ongoing low-grade inflammatory pain (e.g. headaches, muscle/joint discomfort).  Of course, in their work with you, the two of you have the opportunity to identify the true root cause and make it go away!  But in the interim, it’s critical to help your clients to get some rapid relief so they stay enthusiastic about working with you and about the possibility of true healing.
  •  Once again, I highly recommend the Environmental Working Group (EWG) educational tools for your clients/patients, including the importance of prioritizing organic foods.  Here is where they can find the annually-updated (data based on current agricultural practices) Clean 15 and Dirty Dozen lists of foods given their pesticide/herbicide retention.
  • Here’s a clinical study (one of many) about the role of insufficient Vitamin D in promoting intestinal permeability (IP).
  • There are thousands (literally) of clinical write-ups from peer-reviewed journals about intestinal permeability causes, mediators, and therapies.  A few of you asked for a good overview, and this is my choice and also this one and this one (this latter one has some particularly good references re: specific probiotic strains and IP).  But feel free to do your own inspired online search.
  • Yes, there are many other supplements that can be helpful and healing for intestinal permeability beyond quercetin and probiotics (two of the safest and most straightforward to add).  I also very often recommend to clients the amino acid l-glutamine (e.g. 3g taken 2-3 times per day on an empty stomach), curcumin (esp. in the Meriva formulation e.g. 500mg 2x/day), Vitamin E (I always recommend full-spectrum Vitamin E e.g. Jarrow’s “TocoSorb”), and/or DGL (deglycyrrhizinated licorice – it needs to be this form to be effective, not whole licorice root; this form also removes the vast majority of contraindications for licorice use e.g. hypertension).  To avoid creating new food sensitivities during the IP healing process, it is also often helpful for your client to use digestive enzymes with each of their meals for 2-3 months.
  • Yes, there are definitely food choices that can help to heal IP.  I am a big fan of homemade bone broth (for clients who are willing to make it).  Overall, a high intake of vegetables will be valuable for providing prebiotic fiber.  Mucilaginous foods such as okra, chia seed, and flaxseed (ground).  In some susceptible individuals, gluten promotes intestinal permeability by triggering the release of zonulin in the intestines.  In general, I recommend all my clients with IP avoid all foods containing gluten (I really should’ve included that one in the video!).  The role of gluten is also increasingly being shown as one of the three necessary triggers for autoimmune disease activation (the others are genetic susceptibility and an environmental trigger, such as dysbiosis or toxins).  If you’d like to learn more about the connection between intestinal permeability and autoimmune disease activation, check this out.
  • The possible strong connection between glyphosate and IP and the epidemic of gluten-related inflammation?  Check this out  (and perhaps this too).
  • This is a very detailed primer about food sensitivities:  what they are, how to support them, what to do for elimination, and how (very important!) to do reintroductions in a way that is useful.

You can access the first video of this series here and the second video here.

P.S.  If you are passionate about transforming healthcare through the power of functional medicine, we encourage you to learn more about our training program here.

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Crystal Montgomery

Hello, I see that Parasites can contribute to inflammation. Currently I have a few patients with + endolimax nana protozoa and blastocystosis spp. All the information I find on this with the CDC reveals that this protozoa is non parthenogenic. However, these patients are symptomatic with a + Genova GI effects 1 day test. Certainly not looking for patient specific advice but am wondering what types of natural treatment options there are for these protozoas in general? aside from the obvious leaky gut, vit D, allergies, sensitivities, elimination diet, microbiome rebalancing…… Any resources that I can investigate would be helpful.

SAFM Team

Indeed, seemingly benign pathogens can cause real symptoms in patients that already struggle with other inflammatory dynamics. Therefore, it’s key to consider the full picture to choose the right treatment approach. We highly recommend exploring the interpretive guide of the Genova GI Effects test for more information on these potential pathogens as well as these publications:
https://www.researchgate.net/publication/292176812_Systematic_review_on_Endolimax_nana_A_less_well_studied_intestinal_ameba
https://gutpathogens.biomedcentral.com/articles/10.1186/1757-4749-6-17
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3383306/
https://www.nature.com/articles/s41598-020-72286-y

Beatrix Szokola
Beatrix Szokola

I have a question about quercetin. I heard that people with a homozygous mutation in the COMT enzyme coding gene have to be careful with quercetin as it further inhibits a pathway that is already affected by the SNP. Do you have any knowledge about this?

SAFM Team

Yes, quercetin is a known COMT enzyme inhibitor that can decrease the efficacy of this enzyme-dependent detoxification pathway. COMT is primarily responsible for the methylation of phase 2 detoxification products and while it is considered to be the main enzyme it is not the only one in the body that can support this process. We need to keep in mind that even in the case of homozygous SNPs there are redundancy pathways that can compensate for the potential impairment of function that may result from a SNP. Here are a few references on this topic that may be of interest to you:
https://www.jbc.org/article/S0021-9258(17)44935-0/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3590855/#R12
https://pubmed.ncbi.nlm.nih.gov/27826992/

Meg Mill

When to add l-glutamine? If the patient has eliminated food they are sensitive to and is taking a probiotic is that the time to add the l-glutamine supplement?

Any recommendations if a patient has given up gluten for 6 months and still has high zonulin levels? Also if the person “cheats” at all will that make the zonulin go right back up? I am not sure how long it takes for this level to do down after gluten exposure.

SAFM Team
Reply to  Meg Mill

The timing of adding in L-glutamine will depend on other drivers of the food sensitivities. If there’s microbial dysbiosis you will first want to correct that along with the food elimination before adding in the L-glutamine or other supplement that is aimed at supporting the Gi mucosal lining. We go into great detail of various scenarios and how to support them in the Disease Begins in the Gut 101 and 202 deep dive clinical courses.

As for the zonulin marker, you may want to be careful with the interpretation because while it is a marker for gluten exposure, otherwise it fluctuates greatly and may not be the indication for leaky gut as it was once thought:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5214347/
This is also very well referenced blog post worth exploring:
https://kresserinstitute.com/clinical-utility-zonulin-testing/

Carolyne Shapiro
Carolyne Shapiro

Way back in the day I worked as a psych nurse when insurance was amazing and all seemed well — staff was great and we did a great job. The only prob is after four years — the inside of that building started to look normal and the outside world started to look weird and not normal — spent so so much time there that it was actually unhealthy and yep – I had major burnout so I ended up leaving sadly.
I would learn though how to do self-care and take time for me thankfully.
All you say is spot on and amazing Tracy. No question — just saying. I think it is so important, yes to wildly satisfy absolutely but to also take care of ourselves so that we can indeed be of the best service to our clients!! 🙂
TY!!!

Chris
Chris

Hi Tracy, I love your video series, but this one about Leaky Gut spoke to me the most. I had my right hip replaced in April and the left one also shows advanced arthritis. I have suspected having leaky gut, and have tried different ways of treating myself, but haven’t found much relief. Thank you for these 5 steps. I now have a place to start. My questions is this: I had been on a proton pump inhibitor for 17 years and recently have been able to get off the major ones with digestive enzymes, but still have to take Zantac once a day. Do you think the PPI use also can contribute to Leaky Gut? I think I need to do the food sensitivity test also, but have to be able to pay for it since it’s fairly expensive. Thanks for all of your information!

Chris
Reply to  SAFM Team

That’s what I was thinking – thank you! I’ve been on the right track, just haven’t had all of the puzzle pieces together at once. I’ve been supplementing with magnesium, but it hasn’t been the magnesium glyconate form and hasn’t been enough. I cut out dairy for a little bit, but not long enough. I’ll try your recommendation and see how it goes. Thanks again!!

Kathleen
Kathleen

When I think of Leaky Gut, I always picture things leaking into intestines before they should – and creating an immune reaction. But when exactly is it too soon to be entering the gut? In my mind everything goes into the bloodstream eventually except mostly insoluble fiber. Thanks

Celeste

I find something new and exciting every time I hear or read your info. THANKS Plus I love the validation I get when I read things I believe and now see in print!

Heather Green

I also had a question about igg4. Is the test run by Genova an igg4? I think I’ve seen both ige and igg from them. Thanks!

Heather Green

Love love love gut issue talk! I myself have suffered from leaky gut and do all the things suggested above so very excited for extra info on this topic. Tracy I have read that quercetin in it’s powdered form is more readily absorbed. Thoughts on this? Thanks so much and looking forward to your next video!!

Leigh Myers
Leigh Myers

Tracy
I loved your video. I”m connected to you through IIN. I suffered from Leaky Gut for a decade eventually becoming sensitive to all foods because no one understood my challenges.

I studied Leaky Gut for my own survival…my MS has been in full remission for 18 months after 35 years of disease. Your description of five important steps are exactly the protocol I stumbled on through years of reading websites and experimenting with my own health. thanks for the great video.

Leigh

Janice
Janice

Very helpful and informative. Thank You Tracy.
Is there a particular brand of Quercetin that you would recommend?