Demystifying Leaky Gut
- Jessie Hoffman, PhD
- Jan 22
- 4 min read
Leaky gut is a popular buzzword that is used to describe the increased permeability (aka “leakiness”) of the intestinal wall that allows increased amounts of bacteria, toxins, undigested food, and other molecules to pass through the intestinal wall when they shouldn’t normally be able to do so. Currently, this term is not recognized as an official medical condition, but nevertheless, it has become a popular term thrown around on social media. What’s concerning is that there are people, especially those who call themselves natural health/alternative practitioners, out there who test for, “diagnose,” and treat their patients for this condition (that isn’t really a condition yet). So with all of this confusion, let's discuss if leaky gut real and if you should be concerned about it.
Let’s start with some basic anatomy. We have many cells in our gut, but the primary type that makes up our intestinal wall are called intestinal epithelial cells. These cells make up the main component of our intestinal barrier, which is a critical line of defense that protects our body from the outside environment, just like how our skin protects our body. It’s important to note that this barrier is extremely complex, and we have many other factors that play a role in its function including:
Surface mucus—while it may sound gross, this component is essential as it provides protection for the gastrointestinal tract
Immune cells and molecules—a really large portion of our immune system actually resides in our gut. These cells and signaling molecules help initiate our own immune response, which helps us respond quickly and effectively to pathogens or other illness-causing agents.
Junctional complexes that exist between epithelial cells—think like like the mortar between bricks of a house. These components form linkages between the cells (bricks) of the intestine, helping seal them to prevent things from leaking through. These complexes include the tight junction proteins occludin, claudin, and junctional adhesion molecules that are commonly measured in gut microbiota studies and cited in scientific literature.
Commensal microbiota—these are bacteria that inhabit our gut and produce various compounds that initiate our own immune response, which helps keeps pathogens at bay. You can think of them as little soldiers that stand guard and protect against invaders.
When any of these components fail or are not functioning optimally, this can lead to increased intestinal permeability, aka leaky gut. So scientifically, this is a real thing. However, that’s currently where our scientific knowledge stops–we know it exists, but we don’t really have a way to accurately measure the leakiness outside of a research setting, nor do we have evidence that intestinal permeability causes specific symptoms, that can be fixed by eating in a specific manner, or improved by taking a certain supplement.
Knowing that information, let’s break down some of the misleading information that you might see online, and discuss why it’s misleading.
The symptoms of leaky gut you’ll typically see reported online are incredibly broad and common, including brain fog, fatigue, and gastrointestinal pain. These symptoms are conveniently vague, in that it’s easy to convince yourself that you have leaky gut based on just these symptoms. Who hasn’t felt a little foggy, overly tired, or had some gut upset every now and then? What’s important to note, is that while leaky gut, or intestinal permeability, is a real thing that occurs and something we can measure in a research setting, there is no research causatively linking any of these symptoms to prevalence of leaky gut or increased intestinal permeability.
Overwhelmingly, where you will see the use of these faulty symptoms and subsequent diagnoses occur is in the functional/integrative/alternative medicine field. When going to see one of these practitioners with concerns of leaky gut, they may have you do some tests to “diagnose” you. To be clear, there are no definitive clinical diagnostic tests for leaky gut. There are some tests used in research settings, but all have their own limitations and no test has been deemed appropriate for widespread use yet. So in short, anything someone would have you do to treat leaky gut is currently a waste of time and money.
Because we don’t have definitive diagnostic tests, this also means we don’t have definitive and evidence-based treatments for leaky gut. You may see natural health/alternative practitioners attributing leaky gut to things such as a gluten allergy, food sensitivities, intestinal dysbiosis, excess toxins, etc. Treatments are then given to patients that include fad diets and cutting out certain foods, taking supplements or probiotics that are not scientifically backed, reducing other toxins, etc. Again, none of these treatments are backed by scientific evidence. Nonetheless, eating a diet full of whole, nutritious and well-digesting foods, limiting alcohol intake, exercising regularly, and prioritizing sleep may improve your symptoms and support an overall healthy gut. However, there is no evidence that these lifestyle changes have anything to do with fixing a leaky gut.
So bottom line, save your money and don’t buy into the hype. Some of the best things you can do to support gut health are simple. Eat a diet rich in fiber and fruits, vegetables, whole grains, and legumes. Work on stress reduction. And finally, don’t get your advice from a “gut health guru” but from a real medical professional with expertise in gut health. It may not happen overnight but in time, you can find a solution to improve your gut health.
Scientific resources to learn more:
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