Full episode transcript

Lightly edited for readability. The opening host catch-up (00:22 to 04:57) is omitted. Speaker labels are approximate. Timestamps follow the podcast audio; the YouTube video above runs about 23 seconds earlier. See the corrections note below for points clarified after recording.

Why most of what you've heard about leaky gut is wrong

[04:57] Liz: We are here to talk about something that might be a little bit controversial and also a topic that I think many people need to understand is multifaceted. There are a lot of things that can contribute to this, but most of what you've heard about leaky gut is wrong and incorrect and I would say in some ways oversimplified. And so, you know, what we are going to do is really talk about, especially if you've been struggling with GI symptoms. This could be bloating, food sensitivities, or oral intolerance to things that you used to tolerate.

[05:29] Liz: You're noticing that you're kinda gassy. Digestion is just off. Maybe you're having gurgling noise. You're more tired, feeling, you know, brain fog, joint pain, or just feeling like something has shifted, and you can't quite pinpoint what that is. This is the episode that's gonna change how you think about your gut health forever, hopefully. And I think that it's really important to give credit where credit is due here, so this, a lot of the information we have learned in many courses over the last decade studying functional nutrition, functional health, looking at the body, anatomy, all of the things.

[06:05] Liz: And we're gonna try to keep this kinda higher level so that it's digestible, all pun intended, for you. But I'd wanna give a special shout-out to Kiran Krishnan, he is the microbiologist that we had on our podcast, for really thinking about this differently and helping us understand We can look at testing and we can see, you know, a marker. Let's talk about low secretory IgA. Okay, if you're looking at a GI map, a Gut Zoomer, other stool tests, you're gonna see low secretory IgA being more of the immune system's exhaustion marker.

[06:40] Liz: Whereas if it's really high, it would tell us there's more of an acute response. The immune system is very active, and it is fighting an active in- an infection actively. So we wanna have a sweet spot here, right? We can also look at other markers like calprotectin. This is the gold standard for leaky gut or what we can also medically call intestinal permeability. And we wanna just kinda talk a little bit so that you understand even if your labs look normal, 'cause Beck and I both been there, right?

[07:10] Liz: I definitely was there for a decade. All the symptoms that I just mentioned and more, including weight loss resistance, everything looked normal. Everything was fine. My colonoscopy was seemingly fine I was just chronically constipated because I had a Miralax deficiency. So what we wanna help you understand is what are the contributors to leaky gut? What do we need to be really thinking about in our day-to-day lifestyle, in our routines, and maybe for some of you, that you're gonna have to work harder at this than others because of different genetic mutations.

[07:41] Liz: But most importantly, how do we actually fix this, right? In the right way, in the right order. As we always say on the show and in our work, there is a sequence. There is a strategy that we want to put things in, and many times when people are not fully resolving things, maybe they don't have all of the pieces, you know, of the puzzle figured out or maybe they're just throwing darts at the wall and doing things that aren't necessarily incorrect or harmful, but they're not doing it in the sequential order that's gonna get them the best result.

What is the gut barrier actually made of?

[08:14] Becca: Yeah, and I'll be honest, like when I explain this to clients, I'm guilty of explaining it simplistically. Like, you know, when you're trying to explain what actually is going on, a lot of times people will use kind of the conversation of like think of Swiss cheese, right? Swiss cheese is like, it's normal but then it has those holes in it, and it's not really what leaky gut is. Like, the gut wall is not a simple barrier. It's, it's four actual distinct layers, and they each play a different role, right?

[08:40] Becca: So the outermost layer is like the microbial layer. Your gut bacteria live in that outer mucus. Then you have the mucus layer itself. That's kind of what we consider like the moat around a castle. The inner mucus is sterile, meaning no bacteria is supposed to live there. And then you have your intestinal epithelial cells, which is like what we consider the lining, the, the lining of the gut, right? And those kind of have this like beautiful little finger-like projections called glycocalyx. All of the really science-y words, I look at it and I know it, and then I try… And, and I like look at it and try to sound it out, and then I'm like, "This is making it worse than it actually is."

[09:26] Becca: So that house your brush border enzyme. So I think of like oh gosh, I'm forgetting the analogy, but I, I think of like these little finger-likes. Finger-likes. They're little, they're little fingers that kind of grab things. And then underneath all of that you have the GALT, which is basically your gut's immune tissue. And so the cells are… The, kind of the cells that line are held together by these ki- types of junctions, and there's three of them There's tight junctions at the top, there's adherence junctions in the middle, and there's desmosomes at the bottom, and they are actual gates.

[09:59] Becca: Like, they're supposed to be selective, letting nutrients through, hydration through, while keeping toxins, and bacteria, and undigested food out. So it's essentially this barrier. It is a barrier, but it is not just a single barrier. There are multiple layers to this barrier, and that's where kind of we have to look at this differently because leaky gut doesn't start when those junctions fail. That's late stage. That's, like, way down the line. Leaky gut starts much earlier with dysbiosis and a breakdown in communication between your microbiome and your immune system.

Can you feel terrible without full-blown leaky gut?

[10:31] Liz: So what do we talk about all the time on this podcast? We talk about the immune system and how it's basically the root of literally every dysfunction in the body to an extent one way or another. So this is, again, going back to what I said earlier, is where the sequence matters so much clinically because it tells us where we have to start to actually fix things. You can't just patch the wall if the thing that's tearing it down, that underlying infection, imbalance of bacteria, immune dysfunction, I would also argue here key players that we are missing because we are walking around so stressed.

[11:08] Liz: I don't know if you saw the reel that I shared on my story earlier, but here is a true depiction, and I know Becca feels this to her core as well as I. This mom, or this woman I should say, was in the shower, and she had her computer in her lap, a dumbbell in her hand, and a squeegee thing in the left hand, and she's, like, doing all the things all the time. And then there's, like, a folder next to her, you know, and then she's, like, typing on the computer doing shoulder presses.

[11:33] Liz: And it's, it's truly… When I watched that, I was like, "Oh my God." I talk about this all the time in the way that we have way too many tabs in our brain, and then all these people think that they just suddenly have ADHD or we have brain fog, and it's like, well, actually, I've created the problem myself because I haven't set boundaries and I haven't slowed down to realize that I cannot do it all, all the time. And so much like that makes us feel crazy, it also impacts your gut microbiome.

[12:03] Liz: And when we have such stress, that is a direct contributor to this barrier breakdown, number one. But two, it depletes us of many vital key nutrients that help us properly absorb our food. And so now we not only have leaky gut and things that are getting out into the bloodstream that are causing that brain fog, the joint pain, the fatigue, the hair loss, the skin issues, we also have a body that is completely depleted. And then we turn around and expect our body to build hormones to make us feel good and wanna have sex.

[12:37] Liz: That doesn't work out very well, right? Like, so we have to kinda go back to the drawing board and say even though maybe that person does not have horrific GI symptoms like someone else, where they're either afraid to go to the bathroom becau- or, you know, afraid to leave the house because they don't know where the nearest bathroom is, or they cannot go to the bathroom, or whatever the situation may be, heartburn, GERD, acid reflux, abdominal pain, you can name it all here. You don't have to have leaky gut to have imbalances and insufficiencies and your body feeling that stress or even to feel terrible, right?

[13:15] Liz: Like, you may be talking to a friend, and they're saying all of these things that are happening to them, and you're like, "Oh, wow. Like, maybe I don't feel as bad, so I'm good." And you classify yourself as like, "My body's compensating. I got it all." Well, as Becca mentioned before, there's different stages here. And so when we see this kind of like late stage, this is really where people are finding disease, right? They're now in a GI doctor's office getting scoped, and they're identifying Crohn's, IBD, colitis, ulcerative colitis, those types of things.

[13:48] Liz: So we just really wanna think about this stress on our body as being not just what we feel nervous system-wise and what we feel mentally and emotionally, but more so the things that are happening under the hood. Because this is really, like I said before, kinda wild to think about, that you don't have to have your entire gut be leaky to feel terrible. Okay? And then not to mention, the gut is two tennis courts long if you're really to kinda like lay everything out. It's kinda like what people say in terms of their analogy to visually see that.

[14:23] Liz: Even just having a six to 10-inch section of intestinal permeability can set off cascading systemic inflammation throughout your entire body. And when we think about autoimmune, because I had children's rheumatoid arthritis as a child, we know that this is a direct correlation to also what's happening in the gut. Because if we were able to keep that GALT and the gut lining and the function of the gut in check, the body would take care of things. We wouldn't develop autoimmune at the rates that we do.

[14:57] Liz: So this is also where when people are coming in and they're saying they have all of these symptoms, but they're like, "No, no, I'm good. My digestion's good. We don't have to worry about that," that's false because you will never solve the bigger problem if you don't solve the root that's driving that problem, right? And this is why so many people can feel awful, they go to their doctor, and the doctor is running that standard test, and they're not looking for this. They're not looking deep enough.

[15:23] Liz: They may run a calprotectin, and it's not bad enough to diagnose IBD, so we send them on their way and say, "Hey, you know, take an SSRI, take some pain medication," which is a direct assassin to the gut that we're gonna get into, and certain, you know, things that actually drive this. So I just would empower you today to think about if you don't have dramatic GI issues but you have more systemic issues that we've mentioned here, you have to go back and start in the gut.

[15:55] Liz: Because as I've said this before, Hippocrates said, "All disease begins in the gut, but it doesn't stay in the gut." There's the second portion of that sentence that has not been really, you know, well-known, and it needs to be, because we need to understand just how widespread the gut im- you know, it can be, the, the GI dysfunction can be Yeah.

Where does leaky gut actually start?

[16:17] Becca: So let's talk about kind of where the breakdown starts, right? So the first thing that tends to shift that becomes a problem is the microbial community. Basically, the bacteria in that outer mucus layer start to go out of balance, and this is what clinically is called dysbiosis, but it's, like, essentially you get an imbalance of bacteria. You, you want to have bacteria. You don't want no bacteria. That's like post tons of antibiotics. You wipe out all of your bacteria, good and bad. You want some of each.

[16:43] Becca: You, you need it for the balance.

Why am I suddenly reacting to foods I used to eat?

[16:45] Becca: And so when that happens, something called oral tolerance starts to fail, which is basically your immune system's ability to look at things coming through your gut and say, "That's fine. Let it pass." When tolerance breaks, your immune system gets confused. It starts seeing things like food proteins. This is where, oh, I never had an issue with dairy. I never had an issue with insert food here, normal bacterial components, things that were never a problem, and your immune system treats them like a threat now. That's where food sensitivities come from, not from the food itself, but from an immune system that's lost its calibration, and this is why I hate, hate IgG tests for food sensitivities because if you have a dysregulated immune system, guess what's gonna show up?

[17:29] Becca: Everything. Everything's gonna show up on that im- on that food sensitivity test because it's typically all the foods that you're eating that your immune system that's dysregulated is like, "Hey, this is a problem now," when in reality it's not the food. It's the m- imbalance that has started to be created, the oral tolerance that has been lost, and now you're eating a list of three foods because you're like, "Well, this said I'm allergic." It's like, first of all, you're not allergic. It's very… There's a very different thing between being allergic to something and having a food sensitivity to something.

[17:55] Becca: They're very different.

[17:56] Liz: Years ago it showed up as eggs, right? So today I still don't eat eggs because 20 years ago this food test said I was sensitive.

[18:06] Becca: No, okay, this is… We're, we're laughing, you guys, and so I apologize if you feel attacked because maybe this is you. It's frustrating. You were misled. It's frustrating because you were misled, you were misinformed. Yes. Yes. We are frustrated by the doctor that did that to you or the practitioner that did that to you, and then you run your life based off that test that was an incorrect analysis of what was going on, and that those foods, now you have a worse situation because you have completely limited the types of foods that you're eating, AKA the diversity of things going into the gut that has kept the microbial balance intact is now even worse.

[18:45] Becca: And so we get frustrated by the situation because people will bring these tests to us and I'm like, "I'm sorry, this test is useless." Like, it is, "I'm sorry that you wasted your money. I'm sorry that you have been living off of just these foods because this is what you believed. It is incorrect." And so we use a very different food sensitivity test, but I tell clients off the bat, like, "Hey, this is not a forever thing." Like, unless you have gluten or wheat or whatever is on that MRT, like, through the roof and we know we have a very clear sensitivity to it and we have for a long time, like, sure, we might not be able to bring that food back in.

[19:18] Becca: But in the majority of these cases, with an MRT test, which is what we run, I want those foods back in within six to nine months. Like, we should have resolved things by that point to where your immune system no longer is having this oral intolerance to these things and in turn attacking them. And so- Someone essentially will develop these food sensitivities to these different foods, and then you keep cutting more and more out, and then you're barely eating anything, and you're wondering why you're reacting to things that are supposed to be healthy, right?

[19:47] Becca: It's not the food. It is the immune dysfunction, and this tends to happen with healthier foods, honestly. believe it or not, we actually see the least reactivity in most cases to protein, like to actual animal protein. It, it tends to be the least reactive, which is why like a carnivore diet a lot of times is used in extreme autoimmune cases and skin conditions and things of that nature. But besides the point, as the immune signal keeps firing, you get inflammation in that gut lining. That weakens the mucus layer, essentially thins it out.

[20:15] Becca: Goblet cells, the cells that produce your mucin, can't keep up. The inner mucus that's supposed to be sterile, bacteria start moving in, and once bacteria colonize there, that sterile zone, you have no longer have a sterile critical barrier. And so then and only then does the structural start, start, structural stuff start to happen. Tight junctions start to open. Epithelial cells start getting damaged, and now you actually have increased leakiness or permeability, physical translocation of things that should not be crossing that line. I always say the GI tract is like a mucusy tunnel.

[20:52] Becca: Things should not get in and out of it unless it is selected to do so. And as this progress, things do get out of it, and then we have a problem. Now we have a real problem systemically that started a while ago by the imbalance of the bacteria.

Why isn't L-glutamine fixing my leaky gut?

[21:09] Becca: And so that is kind of the progression that starts to happen. It's like imbalance, what we call dysbiosis or, you know, it could be overgrowth of bad bacteria. It could be not enough good bacteria. It could be a combination. The immune system gets confused. The mucus layer thins, and now we have structural breakdown, and that is why taking L-glutamine does not fix this. And the number of people that come in on L-glutamine is astonishing. and they're, they're with us for a reason because the L-glutamine has not moved the needle, so here we are.

[21:37] Liz: I was actually talking to a client that recently started with me, and she deals with insomnia and anxiety. And I was explaining to her in terms of genetics and the GAD1, I said, "Some people can have these mutations and be okay with a small amount of glutamine. They don't notice a difference. While others, unknowingly, you know, we don't know their genetics, but may or may not have it, and it is something because of the state of the body that leaves them more excitatory, wired and tired, tossing and turning." And she's like, "Oh my gosh, I did notice that when I started it."

[22:07] Liz: I'm like, "Yes, because your body is getting stuck in the glutamate pathway. It's not fully converting it." And so this is actually why Becca and I were talking before the show. We have some products that we're wanting to formulate. I'm being very intentional about saying I don't want that in a product because I want my products to solve multiple problems in a simple way, and that also is going to resal- or result in compliance long-term. And that's exactly what I shared with the person that I was emailing about some of the formulations because I think that's really important when we think about giving someone something to help heal their gut.

[22:44] Liz: We don't want- Y- the risk there, right, of this maybe not-- like you, it's kinda like we talk about with HRT. You take something that could be beneficial, or supposed to be beneficial, and then realize that because of the person's chemical reactions and how their body currently is processing things, this creates more problems. And so we don't wanna do that. So just be cautious with L-glutamine. We know it's cheap. We know a lot of people talk about it. Yeah, it can be beneficial. It does have a lot of great benefits for people who can tolerate it, but it is contraindicated for some, and so we just wanna be mindful of that.

[23:18] Liz: But we see this a lot just in general, I would say, for the functional medicine community, where they're trying to heal leaky gut, yet they're not thinking about all of the different layers and the things that need to be a part of that solution, right?

What modern triggers wreck the gut barrier?

[23:34] Liz: And there's many different things, but before we get into that, we wanna talk about what are the modern triggers that are wrecking our gut. And for some of this, you may already be thinking, oh yeah, we've heard you talk about stress, chronic s- you know, inflammation, poor sleep, antibiotics, NSAIDs. Like, some of these things that we know inherently there is a cost, right? Because we've felt it. of course, dietary inputs is gonna be major because a lot of the one-ingredient whole foods can provide us with vitamins and minerals and fibers and short-chain fatty acids and things that can really help us with, you know, in terms of resistant starch.

[24:12] Liz: Creating some of these postbiotics that have anti-inflammatory effects antioxidative effects if we're looking at, you know, having antioxidants at play, lowering inflammation, and just supporting the things that the body needs to keep this barrier strong. So diet is absolutely critical. It's foundational. The sleep, the stress, all of those things.

How does chronic stress weaken gut immunity?

[24:33] Liz: But there's a few more here that I really wanna hone in on. So just to elaborate a little bit more on the chronic stress side, when you are stuck in flight or fight, this is your body's signal to say, "We are fleeing from a threat," right? So we need to get away or we need to actively fight. And stress lowers our secretory IgA. That is your gut's first line of the immune system defense. And when this drops, we lose our ability to control what microbes grow and where they grow.

[25:09] Liz: Some microbes, it's not that they are bad, it's that they are growing in the wrong place. For example, small intestinal bacterial overgrowth. This is where we should have more of a sterile environment. We should have a lot of good microbes to help us break down fiber, carbohydrates, produce th- you know, short-chain fatty acids, really focus on nutrient absorption. And then later in the large intestine as things continue to move through, this is where the bacteria should be fed. But what happens is when bacteria is backing up from the large intestine to the small intestine, things are overgrowing there.

[25:42] Liz: And it's not that it's necessarily a bacteria, it's at the place that it's growing is incorrect. So opportunistic bacteria, or let's think of these as the bad guys, literally wait for stress signals from their hosts. They evolve to know when you're stressed. Your immune system is down, so they ramp up their virulence, and they take advantage, and they multiply. And so this is equally, I would say, fascinating and also horrifying. This is also something that would answer why when someone gets food poisoning, this is kind of the cascade for infections to take hold.

[26:20] Liz: And ever since that event, I can't tell you how many cases, we have several on our website with testimonials, where… And I'm thinking of one specific, Brittany, the scholarship winner from last year. Post-infectious IBS is what she was diagnosed with because she traveled to Mexico, and she got whatever it was. I don't think they ever necessarily, like, identified was it Giardia or some type of food poisoning you know, E. coli or, or things like that. And so it's nature, right? These Bacteria like us, they want to live.

[26:56] Liz: They want to survive. And so when your defenses are down in that kind of situation, this would be why you feel, you know, things have never kind of righted itself, if you will.

Does poor sleep damage the gut lining?

[27:09] Liz: So circadian rhythm, this is another big one in terms of sleep, and I think that this is wildly underestimated for individuals. When we think about this just high level here, we know we've heard the term circadian rhythm, right? This internal body clock. If you go and you Google the Chinese medicine clock, you can see the different hours that your body and the organ systems are cleansing, and your gut microbiome actually goes into a maintenance and housekeeping mode when you're asleep. So when you're not sleeping well, that repair process is hindered and it doesn't happen properly.

[27:42] Liz: The tight junction expression changes and mucin production drops. Epithelial cell turnover slows down. And so this is really important, too, when you're thinking about certain seasons of life or certain careers. We know night shift workers, this is a known carcinogen. It's, it's up there. New moms, right? When we're not sleeping, we're having disrupted sleep. We're up a lot in the middle of the night. some people who, again, are maybe going through certain seasons like perimenopause and hormones are shifting, and they've got too much glutamates or too much cortisol or too much whatever keeping them awake.

[28:16] Liz: Maybe they're just this, quote, "night owl." They're doom scrolling. They're watching TV. Too much blue light coming in. These people are all at a greater risk for having this gut barrier dysfunction.

Can unresolved trauma affect gut health?

[28:27] Liz: And then this one is one that really nobody wants to talk about, but it is true, and I have a handful of cases that we've had these conversations, and I have said to them, "This is an area that I know you're resistant to address, but this is the area, if you think about a three-leg stool, that must be addressed." So we can have our physical, right? Our training, our workouts that can be stressors, lack of sleep. We can have the inputs in terms of our diet, our hydration, like all the things.

[28:59] Liz: But we cannot overlook the nervous system and suppressed emotions, and this would be unresolved trauma. Trauma that is stored unprocessed is wreaking havoc on your body chronically. It's one of the most potent suppressors of secretory IgA that we know of, and it works through the same cortisol and nervous system pathway as stress. But it doesn't go away when the stressor is removed, which means someone can do everything right with their diet, their lifestyle, their habits, their behaviors, their supplements, their HRT, their peptides, whatever it might be, and still not build their gut immune defenses because the nervous system is stuck in survival mode.

Do NSAIDs, alcohol and antibiotics damage the gut?

[29:44] Liz: And then we won't beat a dead horse here 'cause we wanna move on to what you can actually do about this, but common things that we know of, NSAIDs, alcohol directly damaging our mitochondria inside of our epithelial cells. They essentially induce cell death in the gut lining. They're toxic to the body. And antibiotics, we know the research is very clear. Six months to two years is damage to the microbiome just after one dose, wiping out that microbiome diversity, dramatically reducing our butyrate production, which is a short-chain fatty acid.

[30:16] Liz: We talk about this a lot. This plays a role in not only your gut health and inflammation, but it also plays a role in all chronic disease. It can be anti-cancerous. It can help in terms of the neurological conditions that people suffer with, so whether this is MS, ALS, Parkinson's, this is very important. They actually did a study, and with butyrate being low, butyrate producers, butyrate-producing bacteria being low, they found in chronic disease that their symptoms were heightened. So for example, some person with Parkinson's who is supplementing orally after six months saw a reduction of their tremors and their physical symptoms, while the person who was not supplementing at all, the placebo group, they continued to see those physical manifestations get worse.

[31:04] Liz: And this is just really important because it's one of the most critical things for the gut lining. I will say before we move on that this is a bit challenging for some individuals. We want to be cautious with how fast you introduce a supplement, and there's different ways that you can do this in terms of liquids, like an MCT oil with butyrate. You could do solely through food. That would take a lot of effort, I'm gonna tell you. You could do some capsules or you can do gel caps.

[31:33] Liz: There's a variety of things here that can be supportive. But don't-- I think a lot of people give up on this too quickly, or if they've tried it, they're just like, "I can't ever tolerate it," and they don't go back and try to reintroduce it later in the healing phases. So that is one thing that I believe is often overlooked in long-term kind of maintenance in terms of not only having a diverse diet and resistant starch and all of these things, but also continuing to support at some level your butyrate

Should you keep eliminating foods?

[32:06] Becca: And, you know, you can do things with diet, and not just for butyrate, right? You can do amino acids, which help with mucin production. You can do polyphenols, help with immune modulation. But the elimination of things is what we have to stop. Like, we, we need to stop constantly honing in, like, "I'm only eating these foods. I don't eat any of these foods." We have to have diversity. But if there are things that are extremely reactive for you, then yes, your body is showing you, like, this is not the right fit.

[32:38] Becca: That is why we like the MRT in our really reactive cases, because sometimes you don't know necessarily what's driving an immune response. and so you can more strategically do it. But if you're just in this endless cycle of elimination without actually repairing anything, you're not fixing things. You're just avoiding them, right? And that is going to leave you in a frustrated place, 'cause again, every time you try to enjoy something, every time you wanna have something, you keep having these reactions, and then it gets frustrating, right?

What is LPS, and why does it matter?

[33:03] Becca: So the next thing we need to talk about is LPS. And we've mentioned LPS. I think we did a whole podcast on LPS, actually. but LPS is it is a little bit of a dense concept and topic. but I think a lot of people actually don't even know what it is or what it can do. So LPS stands for lipopolysaccharide. It's actually an endotoxin, so it is a toxin that is produced by what are called gram-negative bacteria in your gut. You have gram-negative, you have gram-positive.

[33:33] Becca: Gram-positive tend to be more commensal, you know beneficial bacteria, whereas gram-negative bacteria tend to be more inflammatory. They tend to be more dysbiotic. That's kinda how you can think about grouping them, right? Gram-positive are more like the, quote-unquote, "good bacteria." Gram-negative are, quote-unquote, the "bad bacteria." That is very simplified, but just think of it in that way. When your gut barrier is healthy, LPS stays in the gut, right? Your immune system has these neutralization systems, an enzyme in your glycocalyx. Basically, the enzyme called alkaline phosphatase deactivates it.

[34:13] Becca: Your mucus layer traps it, and your sIgA can bind and neutralize it. So your immune system has those three different neutralization aspects: alkaline phosphatase, which you can measure on labs and is probably, I would say, I would dare to say alkaline phosphatase is one of the most common low lab markers on labs. We see alkaline phosphatase under 60 to 70 on I would say 80% of labs that come into our practice. It is one of the most common things. Your mucus layer, which a lot of people are also struggling with, will trap the LPS and your sIgA or secretory IgA can bind and neutralize it.

[34:50] Becca: Again, on majority of tests that we get back with GI maps, secretory IgA is often low because these people are depleted, right? So when the barrier dysfunction happens, LPS will translocate. It basically crosses into the bloodstream, usually through what we call portal circulation, which then goes straight to your liver, and your body treats this like a five-alarm emergency. But why? Why is it such a big reaction? Because evolutionarily, free LPS in circulation meant one thing. It meant a bacteria infection, sepsis. So your body is wired to treat it like a tsunami of gram-negative bacteria flooding through a broken barrier, so it launches this massive immune response.

[35:33] Becca: And it binds to receptors on your immune cells, activates something called NF-kappa B, which is basically the master regulatory of inflammation, and it floods your systems with cytokines: IL-6, IL-1 beta, TNF alpha. And these are the same cytokines that are linked to metabolic disease, diabetes, autoimmunity, depression, heart disease, and Alzheimer's. A Netherlands study that ran for nine years found that LPS, serum LPS, was the single biggest predictor of anxiety and depression, more than any other marker, which I think is fascinating. The severity of their mental health symptoms tracked directly with LPS.

[36:11] Becca: And people are walking around with this and their doctors are saying their labs look totally fine because guess what? LPS is really hard to test. And I, I went to a presentation at an event a couple weeks ago that Kiran did not speak at. He w- he couldn't make it. There was a flight that happened, a flight delay. He was supposed to speak. And they talked about how endotoxemia, which is what this essentially is, is so much more prevalent than everyone realizes. Because so many people are walking around with SIBO which is essentially endotoxemia, that do never get diagnosed.

[36:44] Becca: They never get diagnosed, they never take a breath test, and it is just rampant in our population because of the poor health… or, I'm sorry, the poor quality of food, the exposure to EMFs and all of the toxins that we have today that we didn't have decades ago, the stress level that people deal with. There's just so many things that essentially make us a weakened host for these things, that LPS and endotoxemia are just… It, it's, like, over 50% of the population. It's insane, to some level, to some degree.

[37:15] Becca: He was saying in his course that this is what you can tie back to all chronic disease. Every single one of them. And there's much more information. I think he was even talking about, it's like, he wrote a chapter somewhere. It was, like, 60 pages long with all of this research to back that up, and it is something that we can see on certain panels that we run. Like, I know the Gut Zoomer has it and different things like that. But this doesn't always show up as, like, elevated HSCRP, for example, right?

[37:45] Becca: Or just your standard C-reactive protein. This goes beyond cytokines, and it directly impairs our mitochondrial function, and it uncouples oxidative- Phosphorylation, meaning your cells can't produce energy efficiently. It blocks dopamine and serotonin receptor sites, so your neurotransmitters are there, but they can't bind properly, AKA you don't really feel them, and it lodges itself in the dorsal vagal complex in your brainstem, which disrupts the gut-brain communication, including your hunger and satiety hormones, leptin and ghrelin. These can completely stop working. I have seen this in individuals where they never feel full.

[38:27] Becca: They're like, "I have eaten, and I just do not feel full." Like, there is no communication and no signaling, and I think there's some basic things that we want to address first, right to assess before this. But it is just something that goes to show you that this is something that needs to be talked about more, and we actually did a full podcast on LPS and endotoxemia. So you can go back and listen to that.

What does the liver have to do with leaky gut?

[38:49] Liz: But the one thing that I wanna call out, and this really gets me, and I said this in the other podcast too, is 85% of lipopolysaccharides that leak through your gut wall go straight to your liver via the portal circulation. This is why I'm so passionate about the gut-liver axis that I'm writing a book on this, right? Because if your liver is already stressed from all the things that we've already talked about, plus you are using sugar and alcohol and other things to cope with your stress, you're not sleeping well enough because those things as well… Take, for example, alcohol.

[39:25] Liz: Like, you guys have seen that I like the Serenity gummies from Cured. I like them because they give me the same kind of feeling of relaxation as wine or, you know, a couple of drinks, but I don't get impaired sleep. Compared to if I have a couple of drinks, my sleep is not on point. My Oura Ring tells me that. It yells at me. But I feel it in terms of, like, I'm tossing and turning a little bit more, I'm waking up a little bit more, especially around the 3:00 AM time, 'cause that's when my liver is kinda working, right?

[39:52] Liz: And so when we look at this and then add all of the things that you don't necessarily mean to get exposed to, but it's just part of being a human in the modern world that we live in in terms of the environmental toxins, the things that are just spraying out of the sky all over our grasses, our produce, our food, or things that they're calling food, injecting into animals, and all this craziness, right? Your personal care products. We've talked about this too. I used to run a Bath & Body Works store- I, I know the sh*t smells good, but it is horrible for you.

[40:24] Liz: Now, if I were to walk around something like that, I'm like, "Oh, I can just smell," I feel like the endocrine disruptors. and so when we think about this, the liver's already stressed. You probably already have some issues going on in your gut that this is only exacerbating it. And we know that fatty liver is at an all-time high. It is an epidemic. Most of our clients have some degree of fatty liver, high triglycerides, elevated enzymes, right? Elevated you know, when we're looking at just, like, the total cholesterol panels and looking at the particle sizes and all of this stuff, like, the body is burdened.

[40:58] Liz: And so with all of this, when the liver is burdened and it's stressed, it can't neutralize LPS. Because what happens, as Becca said before Your body perceives this endotoxemia lipopolysaccharide as like a oh sh*t signal. There is, sound the alarm, right? If it's sepsis, we've got to create inflammation to protect ourselves. So when the im- when the liver creates inflammation to protect itself, what else happens? The function to create bile. Yeah, blood sugars can get dysregulated, but we're not producing as much bile in the right amounts at the right time that we need that trigger a lot of other cascades in terms of even the immune system and all of these things as well.

[41:40] Liz: And yes, that would be part of signaling the islet cells in the pancreas. So this is just really, really important because while over here in conventional medicine, either, A, they're telling you that you have no problems and everything is normal, B, they're telling you you have fatty liver and that meat and eggs are your problem, removing some of the most powerful nutrients to reverse fatty liver and lower your cholesterol. You know that choline is the thing. It's one of the most powerful things that can pull fat out of the liver.

[42:12] Liz: It's also one of the most important things for your brain health. Phospholipids are very, very important, especially when estrogen gets low. So come at me, doctor, and tell me how I'm gonna reverse my fatty liver. They don't know. Trust us. We've heard stories after stories after stories. My liver enzymes are elevated. My blood pressure is elevated. My blood sugar is climbing, and now I'm pre-diabetic, and they wanna give me metformin and a statin. You think that either one of those things are what your God, your creator, designed you to be deficient in?

[42:43] Liz: No. When we go back and we look at all of this at a root, if you skip looking at the gut, because conventional medicine and the GI doctors, most of them at least, don't believe that the liver should be supportive or has anything to do with chronic GI issues. I mean, go back to anatomy and just look at this, through the portal vein. So I know I'm getting off on a tangent here, but the long and short of this is that 85% of lipopolysaccharides, they escape and they go into systemic circulation.

[43:12] Liz: A damaged liver produces less of HDL3, which is a very important thing that your body has as a backup system to neutralize LPS in your bloodstream. So your whole defense system is just collapsing. It is just crumbling. And it's a compounding disaster because every system is failing the next. Remember that your body is all interconnected, and so if you've got one thing that's off, it's going to have a domino effect to other things being off.

Is keto or carnivore bad for leaky gut?

[43:43] Liz: And the biggest thing that I would say here When you look at the studies and you read this, I remember one day I was, like, firing up our chat, you know, about this 'cause I'm like, "Oh my gosh." The worst thing that people can do is do a ketogenic diet to where they are doing very high fat and low fiber because lipopolysaccharide is a fatty molecule. When you eat a lot of fat, especially saturated fat, your body's absorption mechanism piggybacks LPS along for the ride. So research shows a high saturated fat meal can drive a six to seven time s- spike in endotoxins within hours.

[44:26] Liz: Have you ever tried to go on a ketogenic diet and gotten the keto flu? I don't think it's just blood sugar that's, that's, that's messing with your feelings. One study found a single high-fat saturated meal measurably impaired cognitive performance in women, focused reaction time and attention with hours of eating. What happens when you go and you have pizza, a burger, and fries? I get sleepy, personally, unless I'm sharing with Becca 'cause then we're just typically having a little more moderation, right? so we're not saying you can't have these things, but we are saying here is that this is happening to perimenopausal women who are already dealing with brain fog, and they're being told that it's just their hormones.

[45:06] Liz: This is happening to people that are dealing with so much, they're trying to do the right thing, and yet their doctors are completely dismissing giving the test that we should run to look at their gut microbiome. And we see this all the time because, like we said before, it's gonna impact blood sugar, it's gonna cause insulin resistance, it's gonna cause joint pain, brain fog, fatigue, neurological issues. We know, too, when the liver is burdened and we don't have the proper supports for methylation to methylate, to add a methyl group to a toxin, a metabolized hormone, endocrine disruptor, all of these things that we're exposed to, and excrete them from our body and actually poop them out every day, fully evacuate every day, that sh*t backs up.

[45:47] Liz: Your body stinks. Imagine like you didn't take out the diaper pail. You know how bad the diaper pail stinks if you've ever had kids? Oh, it's like you wanna, you know, throw up a little bit. So if you think about this as happening all internally, we have to recognize if we don't stop the leak, we're not gonna resolve this.

What does each layer of the gut barrier need?

[46:06] Liz: So let's get into the nitty-gritty. Let's go nutrient requirements by layer, and this is something that I think most protocols miss completely. And if you're working with a practitioner, feel free to share this with them. If you don't have some of the things that we're talking about in here or you don't have the proper testing, feel free to click the link in the show notes. At FitMom, we do everything comprehensively. We are one of the few practices, that I know of at least, that actually do not offer stool testing without being able to properly support the person through the sequential stages of healing.

[46:37] Liz: Because there is no value in getting a test that you cannot properly address. So let's get into it.

[46:44] Becca: So your glycocalyx, those little finger-like projections Those little finger-like projections that house your brush border enzymes, they need things. They need glutamine, glucosamine, serine, threonine, hyaluronic acid. Your mucus layer needs four specific amino acids, threonine, proline, serine, cysteine, and it needs butyrate. Butyrate from fiber fermentation is the primary fuel for your goblet cells, which are the cells that literally manufacture the mucin, that mucus layer, right? No butyrate, no mucus, no barrier. So your intestinal epithelial cells, those need something different. Those need vitamin A, they need glutamine, they need arginine, vitamin B6.

[47:28] Becca: Your immune layer, they need vitamin D and bol- folate and B12 and polyphenols. So how can you approach this, right? This is why when we start with almost every single one of our clients, they start on a Mediterranean-style eating. Is that always where we stay? Not necessarily. We move them into diet diversity to do different things and test different systems, but the Mediterranean style of eating, generally speaking, reduces LPS significantly. Olive oil showed zero postprandial endotoxemia in studies compared to saturated fat. Omega-3s actually reduce endotoxin levels from baseline.

[48:04] Becca: Increasing the diet diversity increases microbial diversity, which then produces more of these short-chain fatty acids, the butyrate, the propionate, the acetate, which all protect against LPS moving where it shouldn't go. And this is the part that's gonna be controversial for some people. Like Liz was just saying, higher saturated fats actually have been shown to reduce secretory IgA because of the response from LPS. So someone doing carnivore or high-fat keto, they may get short relief because guess what? It will pull inflammation down hard, 1,000%. When you do not eat carbs, you will not store as much water.

[48:41] Becca: And for some of these people, because they are so reactive otherwise, they… when you do carnivore or keto, you're moving a lot of foods out of your diet. And so the, some of those were probably reactive foods for you. So yes, you will have a short period of time where you will feel better, but the long-term damage… I actually spoke with someone last week. She's been on carnivore for a year And she has a ton of issues outside of with hormones and with GI health. And I was like, "Listen, she-" the one thing that they couldn't figure out is they cannot get her psoriasis to fully go away.

[49:16] Becca: And so I was trying to talk to her about, like, the butyrate aspect that gets missed and the fiber and the microbial diversity and all of these things, and she's experienced a ton of relief from it, obviously. But guess what? There is a point where the immune system will start to build back up issues around other foods, around the foods that you are eating, because we never actually fixed the underlying piece. So fiber is that substrate. Your gut bacteria eat the fiber, and they produce then butyrate.

[49:42] Becca: Butyrate fuels the goblet cells to make the mucin. Mucin becomes the barrier that traps and neutralizes the LPS, and then the intestinal alkaline phosphatase in that barrier deactivates whatever LPS makes it through. It's a cascade of protection that only works when you are feeding it what that system needs.

Why can't you out-supplement a stressed nervous system?

[50:01] Becca: And lifestyle matters more than people give it credit for. Moderate exercise enhances immune surveillance, raises secretory IgA. Not glamorous, not a supplement, something a lot of people don't want to do, but it's one of the most consistent things that we see in the research for supporting mucosal immunity. Stress management, breathwork, vagus nerve work, nervous system dysregulation work directly lowers cortisol, which directly stops the suppression of secretory IgA. You cannot out-supplement your way from chronically dysregulated nervous systems. We see it all day, every day, guys. These people, the people that come in that I fear all the time when they come in they will not see progress are the people that are obsessed.

[50:44] Becca: They are obsessed with every single little detail of their health history, of their food, of tracking, of all of it. Those are the people that tend to not do well because guess what? Their nervous system is a mess. It is a mess. They have been restricted. They have been fear-mongered. They have been pushed into this place where, like, they can't calm down because they have to focus on every symptom they experience. Those people are the people that stay stuck because of this nervous system piece. So if that sounds like you, there are other things that we have to do.

[51:16] Becca: Honestly, a lot of times frequency work, like Solotones is a great app. We'll do PEMF masks. We'll do these different things that kind of force the body into a parasympathetic state, vagus nerve work, you know, deep breathing. but yeah, it is that nervous system piece is no joke. It is something that I for sure see people stay stuck.

Which supplements support gut barrier repair?

[51:36] Becca: And then on the supplement side you have immunoglobulins, SBIs, serum-derived bovine immunoglobulins. Incredible for binding and neutralizing LPS. I see these work really well in histamine cases because in a lot of these histamine cases there's these inflammatory cytokines floatin' around, and immunoglobulins kinda help neutralize that in the gut lumen. Pectins, apple pectin, prebiotic fibers, which feed and produce short-chain fatty acids. Zinc is critical across multiple layers of the barrier. Vitamin A becomes especially important in perimenopause and menopause when production drops. And things like larazotide [corrected, see note].

[52:10] Becca: We love larazotide. Larazotide acetate basically inhibits zonulin, which can help protect the tight junctions while the deeper repair is happening. So nothing wrong with bone broth, all that, but, like, if your whole protocol is restriction of foods and taking in bone broth or L-glutamine, we're not gonna get very far.

[52:27] Liz: And I think as you mentioned before, when you go through these periods of so much restriction, you can create that health anxiety where you're gonna have to do a lot of the reframing of, "This food is safe. I can trust my body." You're also gonna have to recognize that sometimes we heal in flares, and just because you are starting to put something in and you're getting a reaction, a communication from your gut, doesn't necessarily mean that it's wrong. What it can mean-- For example, we take MegaSpore or let's say a tributyrin, a short-chain fatty acid.

[53:02] Liz: Go slower then. Don't give up on it. Maybe take it one every third or fourth day, and then you slowly work your way up. Maybe start with a sprinkle. I have some clients that are so sensitive, we open the capsule, we start with a little bit of a sprinkle, and then we work our way up. Because as you are shifting your microbiome, you are seeding, you are rebalancing and restoring, it's okay. I was sharing with one of my clients, like, as long as we don't have pain, you telling me that you've got a little bit of bloating and a little bit of gas, that's gonna subside as your microbiome shifts.

[53:35] Liz: What is happening is that you're crowding out some of those bad guys, so this can kind of even be, like, a little bit of a die-off reaction when these bacteria, right, are fermenting. So I think this is really important that, you know, again, we recommend you work with a provider that can walk you through and know when to introduce some of these things, what's right for you.

Why vitamin A matters after GLP-1s, bariatric surgery or gallbladder removal

[53:54] Liz: I also wanna just add on the side of, like, the vitamin A because there are a lot of people who have been taking GLP-1s, there are a lot of people who've had bariatric surgery or gallbladder removals. And in these three categories, we are at a greater risk of, and you would see this on your labs, and you can look at your vitamin D for this too, not properly breaking down, digesting, and absorbing all these fat-soluble nutrients, antioxidants, and vitamins. and so when we think about vitamin A, it is a fat-soluble vitamin just like E and K and D.

[54:27] Liz: This is important for menopause. and this is really important when we think about, like, the drying effect. This could be, you know, dry skin, dry eyes. It can have a lot of things there, but this can help combat the mucosal dryness and kinda the constipation sometimes that people see. So we don't wanna overdo it. I will just share, you know, if you're doing this on your own, you wanna be mindful of the toler- tolerable upper limit, essentially, which is about 1,500 micrograms or 1.5 milligrams.

[54:56] Liz: I'm gonna tell you as a practitioner, in our protocols when we're in a season for a reason, and I have testing and I can trace this and track it, sometimes it's gonna look more like 2,500. You know, and so just from that standpoint, look and see. Some people are also taking multivitamins that you think you're covered. I'll tell you, I've done a lot of research on this lately because I'm trying to simplify and reduce capsules and supports for many people who are just completely, completely cellular deficient- One of the best products that I've found is actually a multivitamin that is created for bariatric patients because it's providing the actual real doses, especially when we look at vitamin D.

[55:37] Liz: Look at your multivitamin. I challenge you. If you've got a multivitamin and you think it's gonna do anything for you, your vitamin D is less than 50 and you're not taking about 5, 4,000 to 5,000 IUs a day, you're not gonna see that increase 'cause you're also losing some through digestion. And if there's not intrinsic factor, enough stomach acid, you know, fats coming in with this as well. So I just wanted you to be mindful of that, that most of the time people think that they're getting their bases covered and they're not.

[56:04] Liz: And again, we would go higher levels for a period of time, and then obviously when we've gotten back to a place of Feeling better. I, I don't wanna say, like, maintenance, because truly your maintenance is always gonna change with external factors and hormones shifting, 'cause we work with most of these ladies in the time of life where, like, hey, we got the gut issues resolved, and then boom, freaking perimenopause slaps them in the face, and then we gotta go, you know, back through it all again.

Why do so many gut protocols fail?

[56:29] Liz: But if you are in need of help, and you wanna understand this, you wanna know that what you're doing is right for you, you're tired of buying supplements online because somebody, maybe myself, maybe Becca, maybe another creator, practitioner that you saw, was talking about something, and that something can be very valuable, but is it right for you? Then click the link in the show notes. You can always start with a blood work, comprehensive blood work, much more than your doctor is ever gonna run, and do a review with our team.

[56:57] Liz: If you're n- new to functional medicine, and you're like, "I don't know what these girls are talking about, but it sounds like an issue because I've been trying so many things," that is what we do, and we work with women one-on-one, with children as well but around the world. And so everything we do is via telehealth. We love blood work. We love testing. And then being very specific with individualized protocols. So the last thing I'll say is that Becca and I both see a lot of people come to our practice after going through protocols, going through, you know, multiple providers.

[57:29] Liz: And I have a gal right now, I'm not even gonna give you the amount because it's probably over six figures that she spent trying to resolve some of her issues. Not one practitioner provided her a dietary protocol specific customized to her throughout this entire process. That is wrong, and if you're a provider listening to this, we can battle it out because you should be using found- food as a foundation. I have another friend out of Chicago. They're like, "Hey, my friend went to this functional provider, and she just got, like, this whole sheet of supplements." I was like, "Yeah, I know.

[58:03] Liz: I've been there." That was my experience with my functional provider. And if they are not discussing … I don't want it to be somebody, you know, that just go see this nutritionist over here because that nutritionist may not have read all of your labs. They may not understand everything that's happening supplementally for you. They need to be working together. If they work together, amazing. Teams are what make the dream work. But my point here is that if you have gone through protocols, and you've not addressed your foundations with your hydration and your diet that's very specific to you, and you understand why, and it's solving problems for you with your inflammation, and your blood sugar, and metabolic health, and then supported because supplements should be supportive to supplement, right?

[58:45] Liz: You're missing a big piece. And that is very similar to how when people are throwing things at the wall, they keep spinning their wheels. They don't solve the problem that we just went through and talked about because they're not thinking about all of the assassins coming in at the same time. It's like you're trying to detox while you're continuously re-toxing. You will just spin your wheels. So links in the show notes, and with that, we hope that you have a fantastic day wherever you are listening.

[59:09] Liz: Don't forget to rate, review, subscribe, and share the show

Frequently asked questions

Why won't my leaky gut heal even after taking L-glutamine?

Because L-glutamine targets the last stage of the problem. FitMom practitioner Becca Chilczenkowski explains that leaky gut starts with dysbiosis and an immune system that loses oral tolerance, which thins the protective mucus layer before tight junctions ever open. Glutamine can support the lining, but it cannot correct the bacterial imbalance driving the damage, and in some women it can worsen anxiety or insomnia.

Can I have leaky gut if my labs are normal?

Yes. Standard workups rarely look for it. A doctor may run calprotectin, see it isn't high enough to diagnose IBD, and send you home. FitMom's Liz Roman notes you don't need your entire gut to be leaky to feel the effects, so fatigue, brain fog, joint pain, skin issues and new food reactions can show up long before any test flags disease.

Why am I suddenly sensitive to foods I used to eat with no problem?

New food reactions usually come from the immune system, not the food. When gut bacteria fall out of balance, oral tolerance breaks down and the immune system starts treating ordinary food proteins as threats. FitMom practitioners see this most often with healthy foods. Cutting more foods shrinks diet diversity, which starves the microbiome further, so repairing tolerance matters more than building a longer avoid list.

Are IgG food sensitivity tests accurate?

Not for deciding what to stop eating. IgG antibodies largely reflect which foods you eat often, so a dysregulated immune system can make nearly everything light up. Becca Chilczenkowski says many women arrive living on three foods because of an IgG panel. FitMom uses an MRT panel only in highly reactive cases, as a temporary guide, aiming to reintroduce most foods within six to nine months.

What is LPS and how is it connected to leaky gut?

LPS, or lipopolysaccharide, is an endotoxin from the outer wall of gram-negative gut bacteria. A healthy barrier contains it using mucus, secretory IgA and intestinal alkaline phosphatase. When the barrier weakens, LPS crosses into the portal circulation and reaches the liver, which reacts as if facing a serious infection. FitMom's practitioners link the resulting inflammation to fatigue, brain fog, blood sugar problems and mood symptoms.

Is a keto or carnivore diet good for leaky gut?

Usually only short term. FitMom practitioners see quick relief on keto or carnivore, partly because reactive foods disappear. But very high-fat, low-fiber eating starves the bacteria that make butyrate, the main fuel for the cells that build your mucus layer. Saturated fat also helps LPS cross the gut wall: a 2007 study found a high-fat meal raised blood endotoxin about 50 percent within hours.

How does stress cause leaky gut?

Chronic stress lowers secretory IgA, the gut's first line of immune defense. With it suppressed, the body loses control over which microbes grow and where, and opportunistic bacteria take advantage. FitMom's Liz Roman adds that unresolved trauma works through the same cortisol pathway but doesn't switch off when the stressor ends, so a woman can do everything right with diet and supplements and still stall.

What nutrients does the gut lining need to repair?

Each layer needs different inputs. FitMom's Becca Chilczenkowski breaks it down: the mucus layer needs threonine, proline, serine, cysteine and butyrate from fiber fermentation. The epithelial cells need vitamin A, glutamine, arginine and vitamin B6. The immune layer needs vitamin D, folate, B12 and polyphenols. Zinc supports several layers. No butyrate means no mucus, and no mucus means no barrier.

Can you heal leaky gut with supplements alone?

No. FitMom's practitioners say you cannot out-supplement a chronically dysregulated nervous system. The women least likely to progress are often the ones tracking every food and symptom, because constant vigilance keeps cortisol high and secretory IgA suppressed. Moderate exercise, breathwork and vagus nerve work support mucosal immunity, and food should be the foundation, with supplements supporting it rather than replacing it.

What diet helps heal leaky gut?

FitMom starts almost every client on a Mediterranean-style diet, then expands variety from there. Swapping much of the saturated fat for olive oil and omega-3 fats lowers the post-meal endotoxin load, and a more diverse diet builds a more diverse microbiome that produces butyrate, propionate and acetate, the short-chain fatty acids that protect the barrier. Diversity, not restriction, is the goal.

Key terms

Leaky gut (intestinal permeability)

A gut barrier that lets bacterial fragments, toxins and undigested food cross into circulation. In FitMom's model it is the late stage of a breakdown that starts with dysbiosis.

Dysbiosis

An imbalance in gut bacteria: too many opportunistic species, too few beneficial ones, or microbes growing in the wrong place.

Oral tolerance

The immune system's ability to see food and normal bacteria passing through the gut and let them pass. When it fails, food sensitivities appear.

Secretory IgA (sIgA)

The gut's first-line immune antibody. Low levels suggest an exhausted immune response; chronic stress suppresses it.

Calprotectin

A stool marker of intestinal inflammation driven by neutrophils. Useful for screening IBD, but not a direct measure of permeability.

Mucus layer, goblet cells and mucin

Goblet cells make mucin, the material of the mucus layer. The inner mucus is meant to be sterile and acts like a moat around the gut lining.

Glycocalyx and brush border enzymes

Finger-like projections on the gut lining that house the digestive enzymes of the brush border.

Tight junctions, adherens junctions, desmosomes

The three types of gates that hold gut lining cells together and control what crosses.

GALT

Gut-associated lymphoid tissue, the immune tissue beneath the gut lining.

LPS (lipopolysaccharide)

An endotoxin from the outer wall of gram-negative bacteria. In the bloodstream it triggers a strong inflammatory response.

Endotoxemia

LPS circulating in the blood. Low-grade endotoxemia is linked to chronic inflammation.

Intestinal alkaline phosphatase

An enzyme in the gut barrier that deactivates LPS. Alkaline phosphatase also appears on routine blood panels.

Butyrate

A short-chain fatty acid made when gut bacteria ferment fiber. It is the primary fuel for the goblet cells that build the mucus layer.

Zonulin and larazotide acetate

Zonulin is a protein that opens tight junctions. Larazotide acetate is an investigational zonulin antagonist, not FDA-approved.

MRT (Mediator Release Test)

A food sensitivity blood test FitMom uses in highly reactive cases as a temporary guide, not a permanent avoid list.

Gut-liver axis

The direct link between gut and liver through the portal vein, which carries LPS that crosses the gut wall straight to the liver.

Sources

• Vogelzangs N, et al. Cytokine production capacity in depression and anxiety. Transl Psychiatry, 2016 (NESDA). doi.org/10.1038/tp.2016.92
• van Eeden WA, et al. Basal and LPS-stimulated inflammatory markers and the course of individual symptoms of depression. Transl Psychiatry, 2020 (NESDA). doi.org/10.1038/s41398-020-00920-4
• van Eeden WA, et al. Basal and LPS-stimulated inflammatory markers and the course of anxiety symptoms. Brain Behav Immun, 2021 (NESDA). doi.org/10.1016/j.bbi.2021.09.001
• Erridge C, et al. A high-fat meal induces low-grade endotoxemia. Am J Clin Nutr, 2007. doi.org/10.1093/ajcn/86.5.1286
• Jernberg C, et al. Long-term ecological impacts of antibiotic administration on the human intestinal microbiota. ISME J, 2007. doi.org/10.1038/ismej.2007.3
• Helander HF, Fändriks L. Surface area of the digestive tract, revisited. Scand J Gastroenterol, 2014. doi.org/10.3109/00365521.2014.898326
• Microbiologist Kiran Krishnan, previous guest of The Health Revival Show, whose framework this episode builds on.