Search SAFM

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!

Signature Small




  • 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 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 you 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 journal 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, high intake of vegetables will be valuable for providing prebiotic fiber.  Mucilanginous 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 a 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.

P.S. If you know that healthcare must be transformed to be sustainable and effective, and you believe strongly that Functional Medicine is key to making that happen, we urge you to learn about our semester program.

If you haven’t done so already, sign up to receive weekly clinical tips like this via email, and you’ll also get automatic access to a free mini clinical course.

Like us on Facebook to get more great clinical tips and to get notifications of my next Facebook Live!

15 Questions for “Dis-ease Begins in the Gut, but Perhaps in a Way You Didn’t Consider”

  1. 7
    Chris says:

    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!

    • 7.1
      SAFM says:

      Great – thanks for your feedback; I am delighted these are of help to you! It may be insufficient magnesium or suboptimal stomach acid (both of which of course the drug is making worse) or a food sensitivity itself directly contributing to your acid reflux. Absolutely the PPI use can potentially contribute to leaky gut (for example, by allowing more potentially pathogenic microbes to pass through the stomach to the intestines and causing dysbiosis and/or by rendering the pH of chyme less acidic (and thus digestive enzymes become less effective). I would boost your magnesium significantly (~300mg magnesium glycinate twice daily). Then, in my experience, both gluten-containing and dairy foods are common drivers of acid reflux. I would eliminate both categories 100% – cold turkey – as a starting point (the former you will want to do regardless to avoid exacerbating the intestinal permeability while you are working to assess and heal yourself). Perhaps until you can afford a food sensitivity test, try this combination for at least a full four weeks and see what you can learn (again, got to be cold-turkey!). Remember eating hygiene is critical too! Sending you many wellness blessings.

      • Chris says:

        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!!

  2. 6
    Kathleen Mitchell says:

    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

    • 6.1
      SAFM says:

      Yes, fully digested food should (and does) indeed make its way into the blood stream via the intestines. If the junctions between villi in the intestine are appropriately tight (and thus not leaky), then food will not “leak” through the intestinal lining prior to be being fully digested. Wider gaps between villi (aka the leakiness) allows food to cross the barrier before it’s fully digested; it also allows a variety of other triggering substances to trigger the immune system (e.g. microbes and microbial waste products) that shouldn’t be able to cross the intestinal barrier at all.

  3. 5
    Celeste says:

    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!

  4. 4
    Heather Conley says:

    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!

  5. 3
    Heather Conley says:

    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!!

    • 3.1
      SAFM says:

      In the vast majority of our clients, supplements in capsules will be just as well-absorbed as loose powders – with the major advantage that loose powders can carry very strong flavors, aromas, and textures that our clients may dislike (and eventually stop taking because of the displeasure). I can say from personal experience that quercetin does *not* taste good. Absolutely choose capsules over tablets whenever possible. But another consideration is that loose powders don’t contain binders and fillers. Some individuals with poor digestion can have trouble breaking down the binders (e.g. magnesium stearate) and thus poorly absorb the supplement. If you suspect poor digestion, then I just recommend going with a supplement brand that doesn’t use binders or fillers at all such as Thorne or Pure Encapsulations. Thorne makes an excellent quercetin/bromelain combo called Quercenase. And they go the extra step of using phytosomal encapsulation to help *ensure* effective absorption. Great question! We talk a lot about these types of Supplement questions and curiosity/confusion in the Core 101 Semester.

  6. 2
    Leigh Myers says:

    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.


    • 2.1
      SAFM says:

      Oh wonderful, Leigh – what a fantastic testament you are to what is possible! I am sure your story will be inspiring to many, many clients too who have perhaps been led to believe that remission is not possible. Congratulations to you! Thank you for sharing.

  7. 1
    Janice says:

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

    • 1.1
      SAFM says:

      Hi Janice – you are very welcome! I generally find that quercetin works from a wide variety of brands. Because of its ease and low cost, I often recommend Jarrow’s quercetin e.g. . However, if a client has GI symptoms and perhaps impaired digestion/absorption in the gut (e.g. IBS), then a formula without binders (e.g. magnesium stearate) is likely to be much better absorbed; in that case, I would use Thorne’s Quercetin Phytosome e.g. . Phytosome encapsulation allows a supplement to be attached to a phosopholipid that is very readily absorbed in the GI tract and then also more readily absorbed into cell membranes. Of course the latter choice is more expensive given the advanced technology. So I would choose one of these depending on the unique client’s needs/priorities.

Ask a Question

Practitioner clarification questions are welcome! Please do not post personal case inquiries.