Leaky Gut? Leaky Brain!

CHAPTER 1:

INTESTINAL PERMEABILITY

LEAKY GUT/LEAKY BRAIN

This E Book discusses the very important health issue of leaky gut and leaky brain.

You will learn:

● What is the gut, the gut microbiome and the gut – brain axis

● What is leaky gut, its symptoms and why it matters for your long-term health

● What is the problem with chronic inflammation and its link to leaky gut & chronic disease

● About autoimmunity & its triggers

● What are the causes of leaky gut and how do we test for leaky gut

● About the brain, the blood brain barrier and what is leaky brain

● The brain, the gut and inflammation

● The symptoms of leaky brain and the consequences for your long-term health

● What causes leaky brain and can leaky gut cause leaky brain

● Testing for leaky brain

● The comprehensive treatment protocol to resolve leaky gut/ leaky brain

‘All disease begins in the gut’. – Hippocrates, c. 460-370 BC, over 2,000 years ago

WHAT EXACTLY IS THE GUT?

The gut is our digestive system. You may also hear it called the digestive tract, the gastrointestinal or GI tract. The gut extends from the mouth, through the esophagus, stomach, small intestine, pancreas, liver, gallbladder, colon and finally rectum or anus. It includes the parts of the body involved with food intake and output, from start to finish.

The Gut is also called the ‘second brain’. It is sensitive to emotions. We all have a ‘gut feeling’ at times, or butterflies in the stomach when nervous. The gut feels anxiety, sadness, anger and other emotions and the brain can react to these signals from the stomach.

THE GUT MICROBIOME: WHAT IS IT?

The gut contains a microbiome. The microbiome is the collection of trillions of microorganisms (fungi, bacteria and viruses) that live in the gastrointestinal tract. Most of these microbes live in the large intestine. The gut has the largest number and diversity of microbes. The gut bacteria composition changes across the digestive tract. In the stomach and small intestine, there are relatively few species of bacteria.

The colon or large intestine is where most of the microbiome lives. The large intestine has approximately 39 trillion microbial cells that include bacteria, viruses and fungi (Sender R, 2016).1It is estimated that we have 38.2 trillion human cells (Bianconi E, 2013)2. Although hard to measure, research says that a realistic estimate of the number of microbes living in the human body is about 40 trillion, which is close to the number of human cells (Sender R, 2016)1 .

There are a small number of core microbial species shared by most people. Beyond that, populations of microbes can differ quite a lot from person to person. Within one person, the microbial populations stay fairly constant over time. Changes can occur due to changes in lifestyle, diet and age.

The number of bacteria in the large intestine is somewhere from 200 to 1,000 different bacterial species (Yang J, 2020)3. But the majority of bacteria in a person’s gut come from about 30 or 40 species. The microbiome is not just bacteria. It includes fungi, parasites, protozoa, amoebae, archaea and viruses. Less is known about these other microbes.

The microbiome is extremely important for health and well-being. It influences metabolism, nutrition, physiology and immune function. In fact, 70-80% of immune

cells reside in the gut. This means that the health of the immune system depends on the health of the gut.

Even in healthy people, the microbiome has both beneficial and pathogenic gut bacteria. The fungi in the microbiome are also both beneficial and pathogenic. In a balanced gut microbiome, the beneficial bacteria outweigh and keep the harmful bacteria under control. If the harmful pathogenic bacteria become too plentiful, then a condition called dysbiosis results.

Imbalances in the gut microbiome is linked to gastrointestinal (GI) conditions such as inflammatory bowel disease (IBD, irritable bowel syndrome (IBS), dysbiosis, gut infections and many others. The microbiome influences health more widely and plays a role in diseases like obesity, type 2 diabetes, mental health issues, allergies, MS, neurological diseases, skin issues and more.

THE GUT-BRAIN AXIS

The gut and brain are physically connected via the vagus nerve. The vagus nerve is part of the parasympathetic nervous system and connects the brain and the gut. The parasympathetic nervous system controls ‘rest and digest’ functions such as digestion, heart rate and immune system.

Gut flora or bacteria control the signaling and communication that take place between the gut and the brain. This is the chemical connection between the gut and brain that sends chemical messages back and forth. These chemical messages are conducted via neurotransmitters and hormones, like serotonin and others, and are important for mental health.

WHAT IS LEAKY GUT?

Leaky gut is also known as intestinal permeability. It is a condition in which the gut lining becomes permeable or ‘leaky’.

The digestive system breaks down food and absorbs nutrients from the food. It is a barrier which controls what can enter the bloodstream. The mucous lining of the gut is designed to absorb water and nutrients from food that can then pass into the bloodstream. The lining is meant to be protective and non-permeable. This means that nothing extra should pass through, either from the gut into the body or vice versa.

Tight junctions are proteins in the gut lining. They are tiny openings that allow nutrients and water to pass through into circulation in the body. They prevent harmful or toxic substances from entering the bloodstream. In the case of leaky gut,

the tight junctions have loosened, allowing substances that should not pass through the gut lining to do so. This is the permeability of the gut.

Once tight junctions are loose and the gut is permeable, it literally means that there are leaks in the gut lining. Damaging things can leak through like toxins, bacteria and molecules of partially digested food. These things are meant to stay in the gut to be metabolized or else eliminated through stool. If they get into the bloodstream, they can cause problems by triggering inflammation.

As inflammation spikes within the gut, it disrupts the gut bacteria and negatively shifts the health of the microbiome. This creates a vicious cycle that worsens leaky gut, which further affects the microbiome.

This inflammation can trigger the immune system to launch an attack. Once the gut is permeable, these substances pass though frequently, which triggers frequent immune system reactions, which can cause widespread inflammation and an overreaction of the immune system. This inflammation and overactive immune system can become chronic if the leaky gut is not healed.

LEAKY GUT SYMPTOMS:

● A burning feeling in the gut

● Painful indigestion

● Diarrhea

● Gas and bloating from fermentation by overgrown bacteria gut

● Low energy from the reduced ability to draw energy from food

● Sensitivities, intolerances or issues that prevent eating a wide variety of foods

DISEASES LINKED TO LEAKY GUT:

This list is not exhaustive and is not entirely known, but some of the diseases that are rooted in leaky gut include:

● Any Autoimmune disease: we explain further why this is so important later in the E book

● Allergies

● Arthritis

● Asthma

● Autism

● Celiac disease

● Crohn’s disease

● Food allergies, intolerances or sensitivities

● Inflammatory bowel disease

● Irritable bowel syndrome

● Multiple food and chemical sensitivities

● Schizophrenia

● Skin issues: acne, eczema, hives, psoriasis

● Lupus

● Ulcerative colitis

● Type 1 Diabetes

WHAT HAPPENS IF THE GUT IS LEAKY?

Leaky gut may be responsible for many health issues. These can be minor (bloating, cramps, fatigue, food allergies and sensitivities, gas and headaches) to much more serious issues like autoimmune conditions, depression and other mood disorders, diabetes, inflammatory bowel disease and MS.

CHAPTER 2:

CHRONIC INFLAMMATION

Inflammation is the body’s response to eliminate foreign unrecognized substances by the immune system. Successfully clearing pathogens is how inflammation is resolved.

Acute inflammation is when there is a response to a sudden and acute damage to the body, like cutting your finger. To heal the cut, the body sends inflammatory cells to the injury. These cells start the healing process. Once healed, the body stops sending inflammatory cells to the site of the injury.

Unresolved acute inflammation can lead to chronic inflammation. Proinflammatory markers in the body, such as IL-1β, IL-6, TNF-α, C-reactive protein (CRP) or IFN-γ, all increase with chronic inflammation (Mou Y, 2022)4 .

CHRONIC INFLAMMATION LEADS TO CHRONIC DISEASE

Chronic inflammation is closely associated with chronic diseases, cancers and aging (Mou Y, 2022)4. It causes pathogenic changes that happen in various chronic diseases. This includes things like slow tissue remodeling, organ dysfunction, autoimmune responses and cellular senescence. Cellular senescence is when cells age. Senescent cells stop multiplying but don't die off

when they should. They instead remain and continue to release chemicals that can trigger inflammation.

Inflammation of this type that doesn’t resolve itself is called chronic inflammation or systemic inflammation. It can ultimately lead to chronic inflammatory diseases. In chronic inflammation the body continues to send inflammatory cells even when there is no outside danger. The immune system has gone into overdrive and overreacts. Inflammatory cells and substances start to attack tissue and cause inflammation that comes and goes. This c an cause severe damage to tissue.

Chronic inflammation leads to chronic inflammatory diseases. Examples of chronic inflammatory disease include Alzheimer’s, autoimmune diseases, asthma, cancer, heart disease, type 2 diabetes and others. Leaky gut leads to a state of chronic inflammation. In some circles of conventional medicine, leaky gut syndrome is still considered a hypothetical condition and is not necessarily recognized as a medical diagnosis. In Functional Medicine, we know that increased intesti nal

permeability, or leaky gut, can be a significant health problem which plays a role in chronic inflammation, gastrointestinal disease, autoimmunity and other health conditions.

AUTOIMMUNITY

There are now over 100 known autoimmune or AI diseases (Autoimmune Association, 2023)5. Well-known examples include MS, Celiac, Type 1 Diabetes, Lupus, Hashimoto’s, Grave’s, Rheumatoid Arthritis, IBD, Crohn’s and many more.

Leaky gut can be very harmful due to the connection between leaky gut and autoimmunity (or AI). As the gut becomes leaky and more toxins enter into circulation via the loosened tight junctions of the gut, the immune system is activated. It will mark these foreign invaders from the gut as dangerous and attack them. It will be called to do this over and over due to the leaky gut. The immune system will go into overdrive and can then start to be less precise.

Autoimmune disease develops because the immune system gets triggered and goes into overdrive due to the constant perceived attack. This overreaction can eventually become chronic.

Due to molecular mimicry, some of these foreign invaders start to look like the different tissues of the body. For example, the gluten molecule is similar to thyroid tissue. So, the immune system will start to attack ‘self’ or its own tissue. This can happen to any organ of the body. If the immune system attacks the thyroid, then Hashimoto’s or Grave’s diseases can develop. If it attacks the joints, then rheumatoid arthritis can develop, if it attacks the myelin sheaths, then MS is a possibility.

HOW DOES AUTOIMMUNITY DEVELOP?

We now know the root causes of autoimmunity. Dr. Alessio Fasano is a worldrenowned gut health expert who has done extensive research making the link between leaky gut and AI. The formula for developing any AI condition is:

Autoimmunity = Genetic predisposition + Leaky gut + Environmental trigger

Some people have a genetic susceptibility to developing a certain disease. There may be a family history of a particular disease or autoimmune condition. However, genes alone are not sufficient for an AI condition to develop. If the gut is leaky, the risk for AI is much higher. Add in an environmental trigger of some sort to stimulate the immune system and an AI condition can become present.

The leaky gut + the environmental trigger will cause the immune system to be triggered. If this trigger is not identified and stopped, then the immune system is

repeatedly triggered and will over-react. The over-reaction will eventually cause an autoimmune attack on ‘self’ tissue and an autoimmune condition can develop.

ENVIRONMENTAL TRIGGERS FOR AUTOIMMUNITY

Environmental triggers are many-fold in today’s polluted world. It can come from the diet. Things like gluten, dairy, GMO’s, food additives, pesticides, chemicals used in processed foods and in processing, etc. can be a trigger that over-activates the immune system. Toxins in the food supply can also be a trigger.

According to the World Health Organization, there are now more than 160 million chemicals in use (WHO, 2022)6. They are used in commerce, food production and all manufacturing industries. These include industrial and agricultural products (pesticides, petroleum products, processed metals, plastics, paints, solvents and many other types) (WHO, 2022)6 .

Some estimates suggest we are exposed to more than 700,000 different toxic chemicals on a daily basis as part of normal life. These chemicals come from plastics, synthetic dyes, artificial fibers, solvents, food products, water, personal care products, household cleaning products, pollution and other commercial products.

One huge source of chemicals is personal care products and cosmetics. Personal care products are largely unregulated. The FDA does not require safety testing of ingredients in personal care products before they are used.

According to the Environmental Working Group, the average woman uses 12 personal care products a day and is exposed to 168 chemical ingredients (EWG, 2017)7. The average man uses 6 products and is exposed to 85 chemicals (EWG, 2017)7. These figures have most likely gone up since 2017.

This combination of Genes + Leaky Gut + Environmental Trigger is the formula for

Autoimmunity

We cannot change a person’s genes. But we can heal the gut. We can also seek to identify and avoid the environmental trigger for an individual person.

Once a person has one AI disease, they become highly susceptible to developing a second AI disease. This is because the triad of AI already exists in that person. They already have a leaky gut so another genetic tendency and/ or environmental factor could trigger a second or even third AI condition.

This is why it is CRITICAL to work on healing leaky gut, and ideally, identifying the environmental factors.

3:

Leaky gut syndrome is a silent disorder. You don’t really feel anything in terms of symptoms. So, most people don't know they have it until the intestinal lining is damaged. The symptoms of leaky gut syndrome can be a bit vague and they can vary from person to person. The main symptoms of leaky gut can include:

● A burning feeling like an ulcer in the gut

● Painful indigestion

● Gas and bloating

● Diarrhea and/ or constipation

● Abdominal pain

● Poor immune function due to poor gut health

● Headaches

● Brain fog and/ or memory loss

● Abnormal fatigue due to the reduced ability to draw energy from food

● Nutritional deficiencies, resulting from the reduced ability to draw energy from food

● Skin issues such as rashes, eczema, acne, rosacea

● Strong carbohydrate or sugar cravings

● Joint pain or arthritis

● Mood swings, depression, anxiety, ADD or ADHD

● Autoimmune disease

If you think you may have leaky gut syndrome, it is important to see a Functional Medicine doctor. In our clinic, we regularly work with people on improving gut health and resolving leaky gut.

WHAT ARE THE CAUSES OF LEAKY GUT?

Leaky gut is caused by a combination of potential triggers that cause the gut to become leaky or permeable. These triggers include:

DIET

Diet is one of the biggest factors in leaky gut syndrome. The gut bacteria respond very quickly to changes in diet. An unhealthy diet can begin to damage the microbiome in as little as 24 hours, leading to dysbiosis (David LA, 2014)8. In contrast, diet can be very healing for a gut that has become leaky. Minor damage to the microbiome can be reversed in 2-4 days, by eating a healthy diet (David LA, 2014)8 .

Nutrient deficiencies, particularly in vitamin A, D and zinc, are also a factor and can increase gut permeability.

We will talk about how to heal your gut through diet later in this Ebook, under the section on treating a leaky gut.

The foods to avoid because they cause leaky gut are:

● Processed foods

● Excessive sugar & artificial sweeteners, in particular sucralose

● Dairy

● Excessive alcohol

● Processed seed oils and unhealthy fats

● Legumes

● Soy

● Raw vegetables can be harder to digest with gut issues like leaky gut

● Other toxic/ inflammatory foods: nightshades, eggs or GMOs

● Any food to which a person has an allergy or intolerance is inflammatory

GLUTEN & ZONULIN CONSIDERATIONS:

Grains, and especially gluten, can be inflammatory and lead to leaky gut. This is not just a problem for celiac people or those with a gluten intolerance. Research shows that gluten creates leaky gut in everyone.

This is because the protein called gliadin, found in wheat and gluten, increases another protein, zonulin. Zonulin weakens the tight junctions, causing the tight

junctions of the gut to open. When gluten is consumed regularly, this zonulin-initiated opening of tight junctions is repeated over and over. This eventually causes the gut to become leaky.

Gluten-containing foods are:

● Grains such as wheat, spelt, rye and barley.

● Foods made from wheat include all types of bread (unless labeled ‘glutenfree’), baked goods like cake, cookies, doughnuts, muffins, pies, pancakes and waffles. Pasta, cereal and crackers all have gluten as well.

● Gluten appears in unexpected foods like beer, gravy, soups, some pasta sauces or salad dressings.

Going gluten-free initially requires some education to learn how to avoid all the numerous foods with gluten.

MEDICATIONS:

● Pharmaceutical medications, including NSAIDS (non-steroidal anti-inflammatory drugs) like Ibuprofen, Motrin and Advil, steroids, the birth control pill and acidreducing drugs like PPIs, contribute to leaky gut.

● Chemotherapy and radiation therapies degrade the intestinal mucosa and contribute to leaky gut.

● Antibiotics kill both good and bad bacteria in the gut, which can lead to an imbalance of bacteria and damage the gut lining.

ENVIRONMENTAL TOXINS AND CHEMICALS

Environmental chemicals, personal care products, mercury and other heavy metals, pesticides, fertilizers, BPA, other chemicals from plastics and the other countless toxic substances in our environment can induce leaky gut.

INFLAMMATION

Chronic inflammation is a big contributor to leaky gut, as it loosens the tight junctions. Chronic inflammation can be triggered by poor lifestyle habits:

● Drinking too much alcohol

● Being overweight or obese

● Not exercising or exercising at maximum intensity too frequently

● Being chronically stressed out

● Smoking cigarettes

● Not sleeping enough

We need to find the source of the inflammation and resolve it in order to reduce the problematic inflammation.

GUT ISSUES

● Pathogenic bacteria in the gut can also trigger zonulin, which will loosen the gut lining.

● Gut conditions, like yeast overgrowth, candida, SIBO (small intestinal bacteria overgrowth), gut dysbiosis (when bad or toxic bacteria outnumber the good bacteria in the gut), parasites, other pathogens or other gut issues can all lead to intestinal permeability or a leaky gut.

● Infections, such as H pylori, salmonella and E. coli, can damage the gut lining.

CHRONIC INFECTIONS

Chronic infections can be the stealth cause of many health problems. Infections that are low level or undiagnosed can drain the immune system and allow it to get stuck in the ‘on’ position. If undiscovered, chronic immune activation and low-level inflammation over time damage the gut lining. Infections that can become chronic and are notoriously hard to diagnose include Lyme disease or any Lyme co-infections. Viral infections may be the issue. Viruses remain dormant in the body and can basically be reactivated at any point in time, particularly during times of stress. Shingles is an example, as it is the reactivation of the chicken pox virus. Mold illness, which can develop into CIRS (Chronic Inflammatory Response Syndrome) is another example. It can be hard to diagnose and can become a serious and chronic health

issue. Other infections, like strep throat, can be low level and simply overlooked. The infections and their related toxins are damaging to the gut lining.

STRESS

Stress has a negative and multi-pronged approach to damaging gut permeability (Madison A, 2019)9. Stress raises inflammation and gut barrier permeability. For example, two cytokines involved in immune and inflammatory responses, called IL-1 and IL-6, increase cortisol release (Obrenovich, 2018)10. Cortisol is the main stress hormone and contributes to gut leakiness. Stressed patients often have HPA axis dysregulation, resulting in elevated cortisol levels (Obrenovich, 2018)10 .

A leaky gut allows bacteria to seep into circulation, producing an inflammatory response. This can further increase cortisol and weaken the gut (and other) barriers. Bacteria can leak through the stress-remodeled gut barrier, thereby boosting inflammation (Madison A, 2019)9 .

One study looked at difficult marriages as a chronic stressor (Kiecolt-Glaser JK, 2018)11. The couples in difficult marriages had greater gut permeability than their less hostile counterparts (Kiecolt-Glaser JK, 2018)11. The study concluded that a distressed marriage can promote a pro-inflammatory environment in the body through increased gut permeability. This would then impact the permeability of other barriers and fuel inflammation-related diseases and disorders (Kiecolt-Glaser JK, 2018)11 .

TESTING FOR LEAKY GUT

There is no one perfect test to diagnose leaky gut syndrome. Diagnostic tests are not 100% accurate in confirming leaky gut, but they can give info on gut permeability, immune response or levels of inflammation.

A blood test or stool test can show signs of inflammation or damage to the gut lining. There is a zonulin test. Zonulin regulates the tight junctions of the gut lining and can be measured in the blood or stool. Zonulin antibodies can also be measured.

CHAPTER 4:

THE BRAIN, THE GUT,

INFLAMMATION, & PERMEABILITY

THE BRAIN

The brain is the most complex part of the human body. It controls intelligence, behavior, thought, memory, emotion, touch, motor skills, vision, breathing, temperature, hunger and every process that regulates the body.

The brain weighs about 3 pounds in the average adult (Mou Y, 2022)4. It is made up of about 60% fat. The remaining 40% is a combination of water, protein, carbohydrates and salts (Mou Y, 2022)4 .

The brain contains blood vessels, nerves, neurons and glial cells. The adult brain is composed of 100 billion neurons and 1 trillion glial cells (Mou Y, 2022)4 .

The brain accounts for 2% of body weight and uses up 20% of the body’s energy supply (Mou Y, 2022)4 .

The brain and spinal cord make up the central nervous system (CNS).

THE BLOOD BRAIN BARRIER

Because the brain is so critical for life, it is protected by a barrier called the Blood Brain Barrier (BBB). This is a single layer of cells joined together by tight junctions, similar to the gut lining we have talked about.

The role of the BBB is to keep most substances from the bloodstream out of the brain and allow only very few substances into the brain. This is to protect the brain from potentially harmful substances in the bloodstream. Toxins like heavy metals, pesticides, PCBs, other chemicals and damaging proteins can be present in the bloodstream. They are kept out of the brain by the BBB.

The BBB lets substances needed by the brain in, such as oxygen, hormones and nutrients.

WHAT IS LEAKY BRAIN

As we saw in leaky gut, the gut lining is meant to be impermeable to protect the gut. But a number of things can make it leaky. The BBB is meant to be impermeable to protect the brain. But it can become leaky and allow harmful things into the brain and cause health issues.

THE BLOOD BRAIN BARRIER AND INFLAMMATION

The BBB is important for brain health and disease (Mou Y, 2022)4. A compromised BBB can advance into neurodegenerative diseases.

Chronic inflammation is dangerous for the BBB. The BBB is a defense barrier against potentially inflammatory circulating cytokines. A healthy body normally produces inflammatory factors at low but present levels. Excessive production of these inflammatory factors is dangerous. Pro-inflammatory cytokines can dysregulate the tight junctions of the BBB and change its permeability (Mou Y, 2022)4 .

Large inflammatory fluctuations in the brain due to high and frequent levels of inflammatory substances change BBB permeability. This can allow pathogenic substances into the brain.

The resulting chronic inflammation will damage the BBB and increase neuroinflammation, which is a common underlying root cause of brain degeneration (Mou Y, 2022)4 .

THE BRAIN AND THE GUT MICROBIOME

Studies show a strong role of the gut microbiota in brain inflammation/ degeneration and brain aging (Mou Y, 2022)4. Dysregulation of the gut contributes to systemic inflammation. Pathogenic gut issues, repeated dietary irritants and unhealthy lifestyles all cause inflammation.

In lab experiments, when there is chronic inflammation due to gut microbiome issues, pro-inflammatory molecules and zonulin can damage both the gut lining and the BBB. They loosen the tight junctions, making the gut and the BBB leaky (Mou Y, 2022)4 .

Lipopolysaccharides (LPS) are inflammatory toxins made by certain pathogenic gut bacteria. They can cause inflammation if the gut is leaky and pass from the gut into the bloodstream. A compromised BBB allows these inflammatory molecules through the BBB, which results in abnormal emotional activity and temporary memory deficiency (Mou Y, 2022)4 .

As we know, gut issues, bad bacteria producing high LPS and other gut pathogens, antibiotics, stress, microbes and toxins can all lead to inflammation, which may become chronic. Inflammation is a large part of BBB leakiness and chronic disease. Remember, inflammation will trigger the immune response. If the immune system is switched on for too long, it can lead to inflammation and eventually to brain disorders.

WHY BBB PERMEABILITY IS AN ISSUE

Leaky brain is linked to many diseases:

● Neurological diseases: MS, dementia/Alzheimer’s disease, brain trauma, edema, brain cancers, ALS and systemic diseases such as liver failure (Obrenovich, 2018)10 .

● Neurodegenerative disorders: Parkinson’s disease (PD) and even autism.

● Mental health issues: anxiety disorders, panic disorder, obsessive-compulsive disorder, phobias, depression/severe depression, bipolar disorder, eating disorders and schizophrenia (Obrenovich, 2018)10 .

● BBB permeability and disruption is present in Alzheimer’s disease (AD). It may allow peripheral blood, amyloid beta and inflammatory cytokines to enter the brain and contribute to the disease process (Obrenovich, 2018)10 .

● Barrier damage to both the gut and brain through unhealthy gut microbes has been found in schizophrenia patients (Mou Y, 2022)4 .

● Barrier damage is a potential marker for the beginning of and development of chronic disease (Mou Y, 2022)4 .

CHAPTER 5:

LEAKY BRAIN CAUSES AND

SYMPTOMS

SYMPTOMS O

RAIN

How would you know if you had a leaky brain? Neurological and cognitive issues are the main symptoms of leaky brain. They include things like:

● Brain fog or difficulty concentrating

● Chronic fatigue that does not improve with rest or sleep

● Headaches or migraines that come on suddenly and grow worse over the course of the day

● Memory loss or other cognitive decline – this may lead to dementia and Alzheimer’s disease

● Mood disorders; anxiety, depression and schizophrenia

● Peripheral neuropathy

● ADD/ ADHD/ Autism spectrum disorders

● Seizures

A leaky brain is an early indicator of cognitive dysfunction and increases the risk of developing neurological or mental health conditions. A breakdown in the blood brain barrier has been observed in patients with major psychiatric illnesses (Obrenovich, 2018)10. Neuroinflammation and neurodegeneration occur if the brain becomes leaky

(Mou Y, 2022)4. Leaky brain is linked to neurological diseases, such as autism, dementia, Alzheimer’s disease, depression and schizophrenia.

AUTOANTIBODIES AND LEAKY BRAIN

An autoantibody is an antibody that the immune system makes and is directed against the proteins of an individual's own body. Autoantibodies can directly destroy cells that have the specific proteins on them. Or autoantibodies make it easier for other immune cells to destroy those proteins. They are part of the immune system defense. But they are involved in autoimmune disease and autoimmune processes, causing the immune system to mistakenly attack self-tissue. Some autoimmune diseases are caused by autoantibodies.

Circulating autoantibodies can breach the BBB if it is leaky. Specific autoantibodies could cause severe mental disturbances like anxiety disorders, schizophrenia, bipolar disorders, epilepsy or depression. The symptoms of these diseases might be partially caused by autoantibodies in the brain (Zong S, 2017)13 .

Different autoantibodies may be linked to different diseases. Research in this area is still a work in progress and medical knowledge is still growing (Zong, 2019)13 .

If the BBB is healthy and intact, circulating autoantibodies are unable to enter the brain in high enough amounts to cause pathology.

Various autoantibodies can be found at low levels even in healthy people. They may be present years before any disease onset. They can remain apathogenic, i.e., not cause any health problems, if, very importantly, the BBB is not breached (Meinl E, 2010)14 .

WHAT CAUSES LEAKY BRAIN?

The causes of leaky brain are very similar to those that cause leaky gut. Both linings are anatomically alike with tight junction proteins.

Causes of leaky brain include:

● Poor gut health, especially leaky gut

● Unhealthy diet

● Obesity/ overweight: Being overweight increases oxidative damage and deprives the brain of oxygen. Hypoxia, insufficient oxygen supply, is damaging to the BBB’s tight junctions.

● Food intolerances and food sensitivities

● Gluten/gliadin/zonulin

● Excess alcohol

● Cigarette smoking

● Exposure to toxins (environmental like air pollution or heavy metals, dietary like food additives, etc.)

● Infection, including gut infections: Bacterial infections damage the BBB, allowing bacteria into the brain where they should not be. For example, CIRS (Chronic Inflammatory Response Syndrome, typically from mold illness) and mold toxins raise inflammation levels, increase oxidative damage in the brain and damage the BBB.

● Stress, especially if chronic

● Chronic inflammation

● Medications

● Autoimmune disease

● Head trauma/ concussion

● Disrupted circadian rhythm: Low quality sleep impairs the sleep-wake cycle. This interrupts nutrient uptake and the handling of toxins, increasing inflammation and causing damage to the BBB.

● High blood sugar and diabetes cause extreme changes in blood glucose levels. This can increase oxidative stress and inflammation, causing BBB damage.

● Poor blood flow to the brain

Through the gut-brain axis, the gut bacteria have a significant impact on brain health. The tight junctions of the BBB are like those of the intestinal barrier. They are vulnerable to similar things that can increase permeability. This is the mechanism behind leaky gut / leaky brain syndrome (Obrenovich, 2018)10 .

Permeability can increase via inflammatory processes and direct bacterial involvement. Bacteria and LPS from bacteria are highly inflammatory and the BBB is sensitive to the effects of inflammation (Obrenovich, 2018)10. Once the gut is leaky, pathogens can make it leaky and penetrate the blood brain barrier to reach brain compartments (Obrenovich, 2018)10. These small bacterial components, or toxins, can contribute to disease or worsen health without causing obvious illness or infection (Obrenovich, 2018)10 .

METABOLIC CROSS TALK: THE GUT/BRAIN AXIS

Due to the concept of metabolic cross talk, the gut and brain talk to each other through bacteria, hormones and other signaling substances. This communication between the gut and brain is happening constantly. Any negative microbiome issues will communicate with and travel to the brain via the gut - brain axis cross talk. Other pathogens, like environmental toxins, viruses and fungi, communicate or cross-talk as well, causing inflammation and other potential issues (Obrenovich, 2018)10 .

CHAPTER 6:

TESTING AND TREATMENTS FOR

LEAKY BRAIN

TESTING FOR LEAKY BRAIN

There are two main ways to test for a leaky brain. One is to look at the marker S100B. S100B is a protein that enters the bloodstream when there is disruption of the bloodbrain barrier (BBB). It can be measured via a blood test.

Or we can test for leaky brain by looking at different protein antibodies. Occludin and zonulin are two proteins involved in permeability of the gut lining and BBB. Occludin is involved in the regulation of tight junction integrity. Zonulin induces the breakdown of the tight junctions between intestinal epithelial cells. Elevated antibodies against occludin and zonulin are one way to gauge leaky brain syndrome.

Positive antibodies could indicate a leaky blood brain barrier and high levels of zonulin have been associated with leaky gut as well as leaky brain.

TREATMENT FOR LEAKY GUT & LEAKY BRAIN

In this section, we will cover a multifaceted approach to heal leaky gut and leaky brain. There are many steps to take. The most important include healing the gut through diet, supplements and certain lifestyle habits. It is also critical to reduce inflammation and resolve any infections in the gut or elsewhere in the body.

It is extremely important to Be Consistent with the protocol. Making some changes for a couple of weeks will not do much. It takes time to heal a leaky gut. Leaky gut does not develop overnight, and likewise, curing it will take some time. It is difficult to say how long it will take and every case is different. But you should expect to need anywhere from 4 weeks to 6 months to fully heal the gut. This applies for leaky brain as well as leaky gut.

A Healthy Gut -> A Healthy Brain -> A Healthy You!

In a nutshell, the treatment plan needs to focus on gut healing and reducing chronic inflammation. It should incorporate:

● Diet

● Supplements

● Lifestyle factors

The diet to heal leaky gut/brain must be anti-inflammatory. A healthy diet rich in fiber and probiotics can help to heal the gut lining. Research shows that a gluten-free Mediterranean diet lowers inflammation. The Paleo diet is another good option to

follow. Or just simply avoid inflammatory foods and focus on anti-inflammatory, gut healing foods. THE ANTI-I

● Eat a diet of whole and unprocessed foods. Processed foods contain all sorts of undesirable ingredients such as excess sugar, food additives & chemicals, GMO ingredients, gluten, processed soy etc. etc. Processed foods and artificial sweeteners (aspartame, sucralose and saccharin) all reduce gut diversity and increase inflammation.

● Eat high fiber foods which includes all vegetables and fruits. The soluble fiber found in vegetables, legumes, and fruit feed and support the good gut bacteria. Focus on low sugar fruits like berries. Aim for a minimum 25g of fiber per day. You can use apps like Cronometer, Myfitnesspal, etc. to track macro and micro nutrients.

● Eat the widest variety of fruit & vegetables possible. Aim to eat 30 plants per week. People who eat a more diverse plant diet have more diversity in their gut microbiome. A diverse gut microbiome is healthier. Plants, in this case, include vegetables, fruits, nuts, seeds and even coffee and dark, sugar-free chocolate.

● Most people living in the West eat less than 50 plant or animal species in their diet. In contrast to this, the average Hadza person eats around 600 species of plants and animals in a year with huge seasonal variation. The Hadza are a modern hunter-gatherer tribe of people living in Tanzania. The Hadza people

have a gut microbiome diversity that is one of the richest on the planet. The Hazda have very little of the common Western diseases of obesity, allergies, heart disease and cancer.

● Increase your polyphenol intake. These are antioxidants which protect against oxidative stress and inflammation. Polyphenols are found in strongly-colored vegetables & fruits, nuts, seeds, berries, cocoa, olive oil, coffee, tea and green tea.

● Eat prebiotic foods, such as oats, flaxseeds, onion, garlic, apple, leek, dandelion greens, green bananas, and asparagus. These feed the good gut bacteria.

● Resistant starch is a type of prebiotic that feeds good gut bacteria. A great source is white potatoes that have been cooked, then cooled for 24 hours. Eat these at room temperature. Reheating them will kill the resistant starch. Or you can buy potato starch powder and take a tsp in a glass of water, daily.

● Eat fermented foods for additional probiotics to replenish the good gut bacteria. Fermented foods increase gut microbiome diversity. They also reduce inflammatory microbes in the gut and thus gut inflammation. This can happen in as little as 10 weeks. We recommend eating fermented food every day. Try things like sauerkraut, kimchi, kombucha, yogurt, raw milk or cheese, miso soup.

● Eat dark green leafy vegetables like spinach, arugula, bok choy, collard greens and kale. These contain micronutrients and have been found to be an important part of a diet that supports brain health and prevents dementia.

● Bone broth is anti-inflammatory and very healing to the gut lining.

● Eat clean organic protein like grass fed beef, wild fish and other pesticide and GMO-free animal products.

● Eat good fats. Essential fatty acids are vital for brain health. Include avocado, coconut oil, flaxseed, hemp seed, oily fish, pumpkin seeds, walnuts, olive oil, ghee, etc.

● Eat anti-inflammatory oily fish. Think SMASH = sardines, mackerel, anchovies, herring and (wild not farmed) salmon. These contain Omega 3 fatty acids, which reduce inflammation and support brain health.

Note: It is always good to work with a Functional Medicine practitioner about your own unique situation. Some of these recommended foods can be an irritant to certain conditions. For example, bone broth and berries are high in histamine and may irritate a histamine intolerance issue. Probiotic fermented foods will irritate a case of SIBO. Raw vegetables can be difficult to digest in the case of poor gut health. These, and any other potential, gut issues need to be resolved before enjoying these super foods.

● Limit sugar and refined carbohydrates in the diet. Too much sugar negatively affects the gut and overall health.

● Eliminate gluten because gluten contains zonulin which makes the gut and brain leaky.

● Remove all foods that you don’t tolerate well. Avoid common triggers like gluten, dairy, sugar and processed foods.

● Don’t drink alcohol while healing your gut and brain.

● Don’t use inflammatory vegetable oils like canola, corn oil, sunflower, safflower oils. They are high in Omega 6 fats, extremely processed and promote inflammation.

● Stop grazing and leave time between meals to give your digestive system a rest.

SUPPLEMENTS TO HEAL LEAKY GUT & LEAKY BRAIN

Certain vitamins (vitamin A, vitamin C, vitamin D) and minerals reduce inflammation and enhance repair. Zinc carnosine, collagen and L-glutamine, in particular, are very healing for the gut lining. Omega 3 fats found in fish oil are anti-inflammatory. Use spices with anti-inflammatory properties, such as turmeric, ginger or garlic.

Probiotics are live bacteria that are similar to the good bacteria that naturally live in the gut. Probiotics help to restore the balance of bacteria in the gut and improve gut health. They increase microbial diversity and promote the growth of good bacteria in the gut. Probiotics can prevent or repair leaky gut and reduce zonulin.

Research finds that spore-based probiotic supplements are most effective. Sporebased probiotics are highly resistant to stomach acid, stable at room temperature and deliver a much greater quantity of bacteria than traditional probiotic supplements.

Spore based probiotics actually reached the gut alive and were 53% more effective in one study (McFarlin BK, 2017)15 . They also reduce symptoms of leaky gut syndrome (McFarlin BK, 2017)15. Spore-based probiotics reduced bloodstream toxins associated with leaky gut by 42% in one study (McFarlin BK, 2017)15. No other probiotic was found to be as effective.

Short Chain Fatty Acids (SCFAs) produced by probiotics can enhance the integrity of the gut and the BBB (Mou Y, 2022). They also decrease the risk of neuroinflammation and neurodegeneration (Mou Y, 2022)4. Tight junctions can be improved after probiotics colonize the digestive tract with short chain fatty acid-producing bacteria (Obrenovich, 2018)10. The probiotics prevent leaky gut and increase resistance to the species contributing to gut permeability.

The short chain fatty acid propionate had protective effects on the BBB by inhibiting microbial infections. This suppression of the inflammatory signaling protects the BBB from oxidative stress, which damages BBB barrier integrity (Obrenovich, 2018)10 .

THE PEPTIDE BP-157

Peptides are short chains of amino acids, the building blocks of proteins. They can be taken as a supplement. Collagen is a well-known peptide. BPC-157 is a peptide that is very effective in gut healing. It restores damaged tissue, speeds up wound healing and improves gut health. In the case of a leaky gut, it triggers repair of the gut lining.

● Be consistent with the protocol to prevent & reduce chronic inflammation. It takes time to heal and to reduce the chronic systemic inflammation, which will ultimately decrease your disease risk (McFarlin BK, 2017)15. Expect it to take from 4 weeks to 6 months to fully heal the leaky gut/leaky brain.

● Make time to be in nature. People living in rural areas have better microbes than those in cities. Get out into the garden or do other outdoor activities that help both mental health and the microbiome.

● Spend time with animals. People living with dogs have more microbial diversity.

● Don’t overdo the hygiene. Obsessive washing and overusing antibacterial sprays are not good for the gut.

● Practice Intermittent Fasting. It gives the digestive system a break from constant grazing and digesting. Fasting triggers hormones that boost the body’s ability to repair itself. This can improve the integrity of the gut and blood brain barrier. Fasting lowers the risk of cognitive decline, dementia and other neurological problems. Start off by fasting for 12 hours at a time per day. Eat dinner around 6:00, don’t eat anything else before bed and then eat breakfast the next day.

● Reduce stress levels. Gut bacteria can be harmed by chronic stress, which can damage the gut lining. Find ways to manage stress, such as yoga, meditation, breathing exercises, tai chi, spend time in nature, spend time with people you love, exercise, try journaling or chanting/singing. Do whatever it takes to reduce your psychological and emotional stress.

● Get to and maintain a healthy weight.

● Quit smoking. Tobacco smoke may increase digestive tract inflammation and is a risk factor for a number of bowel conditions. Get help with a smoking cessation program if you need support.

● Exercise 3-5 times per week at least, although daily exercise/movement is best. But do not exercise at maximum intensity too frequently because this is inflammatory. Equally, not exercising enough is also inflammatory and not advised. Exercise, at the right amount, reduces oxidative stress and is anti-

inflammatory. Regular exercise maintains the integrity of the BBB by preserving tight junctions and re-establishes the expression of tight junction proteins such as occludin (Małkiewicz MA, 2019)16 .

● Reduce alcohol consumption. Drinking too much alcohol increases intestinal permeability. Get support if you need help to limit your alcohol intake.

● Avoid medication of any kind if you can. Antibiotics destroy good and bad microbes so it is advised not to take them unless you really need to. Common medications like paracetamol and antacids interfere with gut bacteria. Reduce the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, because they all increase intestinal permeability. PPI drugs for acid reflux are also particularly damaging to gut health.

● Get treatment for bacterial and viral infections. Any unresolved infections, like Lyme disease, a Lyme co-infection, mold illness, any virus, bacteria or other infection are all pro-inflammatory. The increase in inflammation contributes to gut problems

● Reduce exposure to all types of toxins in air, water, food, cleaning products, furniture, clothing, personal care products, etc.

● Use the Environmental Working Group’s website 7 to check and rate your cosmetics and personal care products for toxin content. Switch to less toxic products.

● Do an occasional detox to clear your body of pesticides, heavy metals and the multitude of other toxins we are exposed to on a daily basis.

● Use a sauna to help the detoxification process.

● Making quality sleep a top priority. Get help if you don’t sleep well.

● Support and prioritize your mental health, well-being and happiness. Positive emotions boost healing. Take time for yourself. Try to prevent getting overwhelmed by obligations. Practice gratitude.

● Find Joy and build it into your daily life. Do things that make You happy. Prioritize things that bring you joy and happiness, like curling up with a good book, getting out in nature, sharing a cup of tea with your best friend or climbing that mountain. Whatever it is that makes you happy, do it!

CONCLUSIONS

The body has a remarkable ability to heal itself. This goes for the gut microbiome and the blood brain barrier as well. In as little as a few days to a few weeks, improvements will start to happen. You’ll likely need to follow this protocol longer, for 6 months, to fully heal. But the good news is that healing can happen. Contact us at the Medicine with Heart Functional Medicine clinic for more support and a personalized approach unique to your body.

END NOTES:

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