As a self-proclaimed gut geek and registered dietitian, I spend my days preoccupied with what goes into…and what comes out of…that gut of yours.

But it’s not just a professional pursuit. I have a vested personal interest in gut health nutrition, because mine gets pretty messed up from time to time.

Until very recently, the gut was probably the most underappreciated system in entire human body. Its most basic – if you can call it basic – function is to break down everything you consume into absorbable components which are then absorbed into the bloodstream to build, repair and run your body. Like it’s no damn thing…until it becomes a thing.

You see, your gut inhabits some pretty interesting landscape. Namely, that it is essentially like an inner fence, defending your body from anything that might have hitched a ride from the outside world. This is where things get weird. Because we can’t see it, we assume the gut is inside our body but in reality…the gut is continuous with the outside world. So you can think of your gut as kind of like an inner skin, but much more delicate (and squishy!).

As I write in my recent cookbook, Good For Your Gut, the function of this gut barrier is complex and essential to life. This barrier function gets vastly oversimplified on the internet because the reality doesn’t fit neatly into a 500-word blog post (hence the book!).

Defending the Border Line

In its infinite evolutionary wisdom, your immune system places 80% of its cellular activity along and within the gut space. If the gut barrier system falters (a.k.a. ‘leaky gut’), your immune system goes berserk. This is where inflammation enters the picture.

But what cause the gut barrier to falter? This is the million-dollar question. Drugs, alcohol, poor diet, disease such as HIV or liver disease, stress and infection have documented impact. And while this concept of ‘leaky gut’ has been around for a long time…and there is plenty of research focusing on the impact of gut barrier dysfunction in disease…there is still some question as to what is going on and the true impact.

In addition to the wild and wacky world of gut-associated immunity and inflammation, you also have the trillions of bacteria living in your nether regions to contend with. These critters can drive pro- or anti-inflammatory pathways; they can compete with pathogens or be pathogens. They can alter production of neurotransmitters like serotonin or emit endotoxins like lipopolysaccharides.

Your Gut is Not Vegas

What does this have to do with the rest of you? Well, for starters, chronic inflammation ain’t that good for you. It can have origins other than the gut; for example, a high glycemic diet or poor quality fats but even when all of those things have been taken care of, inflammation can rage on (I speak from experience!). Thanks, gut.

You see, while we have been studying the systems of the body in silos – like your brain and your gut have nothing to do with one another – it doesn’t reflect physiological reality. Your gut is not Vegas. What happens there doesn’t stay there…it gets communicated via the nervous, immune and endocrine systems. Have an inflamed gut? That inflammation doesn’t recognize invisible borders created by human logic. And that inflammation is not so kind to your skin – or your brain.

The Gut-Brain-Microbiome-Skin-Everything Else Axis

At this point, it is no longer news that the bidirectional communication between the brain and gut influence the operation of both nervous systems, with implications for the immune system and it’s fave thug, inflammation. And the connection between gut health and mental wellbeing is gaining ground.

What is less explored is the effect on the skin. Eczema, psoriasis and acne are all associated with inflammatory states. Skin issues have been associated with poor quality of life, depression and anxiety and early research suggests significant overlapping of mental health, gut and skin concerns. However, little direct research is looking at the influence of the gut on skin health. The link between eczema and the gut microbiota is the best studied; for example, low diversity in the gut microbiota has been associated with eczema in early life. There is a bit of research suggesting that dairy elimination, or a lower glycemic diet may improve acne. Both of these moves would improve inflammation and support a healthier gut microbiota.

So what’s a gut-skin geek to do? You could rush head on into the arms of Dr Google. But what you will find there is not so evidence-based and totally contradictory. And I would totally understand if you go that route…because I have been known to dive down the rabbit hole looking for answers.

The best course of action is one that embraces a long-term view of optimal health.

Start with the basics.

Choose a plant-rich, anti-inflammatory diet.

Take your probiotics and get plenty of fibre to support a healthy gut flora.

Try to manage stress and stay mindful.

Even if these approaches don’t totally clear up your skin or fix your gut, they are good for you. If you make it that far and still need further help, get individualized advice from a trusted health professional. Perhaps ditching dairy, or going lower carb…or to yoga daily…will be your thing. Between where the evidence leaves off, and where the healing begins…well, sometimes you just have to trust your gut.