So, you’ve got leaky gut. Now what do you do?
The first thing you need to do to heal yourself? Get yourself a good dietitian.
Yep. That’s right…even though I am about to go into detail into my practice strategies, this is not a DIY situation because leaky gut doesn’t happen on its own. Some of my clients struggle with getting their gut back on track for years before they come to see me. And even then, it takes some time…so you really need individualized advice. I offer this blog as a means of moving forward so you can be better informed to be an active participant in your care.
How long does it take to heal leaky gut?
When researching this article, I couldn’t help but have a look at what other blogs are saying…and I couldn’t believe all the ‘fix leaky gut in five simple steps’ posts I found. Easy??? Nope, this stuff ain’t easy. I so wish it was. I have had gut issues since I had my first child almost eight years ago. What I’ve learned over the years allows me to live 70-80% of the time like nothing is wrong. But when I have an (almost always) stress-induced flare, I’ve got to roll up my sleeves and get to healing.
I typically find that it takes a minimum of three months to start really healing leaky gut…but 6-12 months isn’t uncommon if there is a lot going on in the body. So no time to waste. Let’s start talking concrete steps for healing leaky gut.
Is there a leaky gut diet?
We talked a lot in part one and two about how it is pretty impossible to deny the existence of intestinal permeability. But treatment? Here is where the science of intestinal permeability gets shaky. Because there is scarce human trial evidence to back up a ‘leaky gut’ protocol. We have all this evidence to observe what is going on in the human body but much, much less to guide how to treat it. What scarce evidence we do have tends to be focused on critical illness, not subacute manifestations of the issue. Which is probably why it’s still easy for health professionals to dismiss; however, if you’re unwell, we’ve got to try and fix it, yes??
Yes. Of course we do. And we can use our knowledge of the physiological effects of certain nutrients on the gut tissues to guide our nutritional approach. It may not be backed by gold-standard evidence yet…truth be told, nutrition isn’t filled with gold standard strategies. But there is plenty of cell, animal and physiological evidence to support the following strategies I outline here. And where the suggestion is based on my practice-level experience alone, I am disclosing that.
Leaky gut treatment starts with food elimination…but it’s not as crazy as you think.
The Basic: If you’re not there already, your first step is to 100% whole food. Zero hyper-processed foods like snack cakes or coffee frapps, and zero added sugars. Zero alcohol. Scale waaay back on your caffeine. Ditch inflammatory fats like refined vegetable oils high in omega 6 fatty acids. If you have a standard North American diet, don’t think you need to eliminate everything but kale and air. This first ‘elimination’, which is really just cleaning up your diet, will likely work wonders.
Next Level: If a whole food diet doesn’t get you where you need to go, keep a food journal and observe how the food you eat makes you feel. Work with your dietitian to eliminate suspected culprits for a limited time, systematically, to observe the effects. If you have irritable bowel syndrome or similar symptoms, consider a low FODMAP diet. For my autoimmune patients, I absolutely recommend getting screened for celiac disease and then trialling a gluten elimination to see if it helps. There isn’t a ton of evidence to support eliminating gluten in autoimmunity but some to suggest that celiac disease is a common co-morbidity. And for those without celiac, I do find that going gluten free makes some clients feel better.
In my heaviest gut flares, going 100% grain free (yes, even quinoa) really helps me snap back to health faster. I have yet to find good evidence showing similar results in gut health but it works for me and has worked for some of my clients.
Foods to Nourish Yourself When You Have Leaky Gut
Healing is never just about elimination…it’s about providing your body with extra healing foods. Your body is built to heal; it just needs the tools.
I recommend that you consume plenty of high fibre plant foods. Aim for at least a cup of vegetables at each meal, if not two. The phyto-chemicals they contain are critical for managing your inflammatory response; in addition, polyphenols are thought to help boost the growth of beneficial microbes and improve gut barrier function.
If they agree with you (and you’re not going the low FODMAP route), eat legumes daily. Their fibre is critical to support beneficial bacteria that produce butyrate, a key short chain fatty acid for gut barrier function.
Eating chia, flax and hemp seeds will help you increase your intake of vital minerals for better healing and omega 3 fatty acids, to support appropriate inflammatory response. In addition, eating fermented plant foods like sauerkraut and kimchi should become a daily part of your routine. While not concentrated enough to be therapeutic, eating foods with small amounts of beneficial microbes is a good idea to keep your own gut flora in balance.
When your gut is going crazy, eating a healthy diet may not be easy…which is why you have a dietitian on your side. Sometimes, you need to start with a low fibre, bland diet to help your gut calm down and slowly work your way up to a healthy whole plant diet, as tolerated. Some strategies I love: using blended foods like smoothies, dips and soups to assist in ‘pre-digesting’ food for easier absorption and less gut distress.
Intermittent Fasting for Leaky Gut
I also like using a simple intermittent fasting window of 12-14 hours to give the gut a break from digesting – this is not based on evidence, but personal and practice-based results. Likewise, I’ve found that avoidance of constant snacking also tends to ease gut distress. Think of it this way: if your gut is ‘leaking’, every time you eat, you are exposing your immune system to substances it may react to as well as substrates that will be fermented by your gut bacteria. Doing this 3-4 times a day will likely help you feel better than eating 5-6 times a day.
Add Supplements That Support Healing Leaky Gut
L-glutamine is an amino acid that fuels the gut cell and has a beneficial effect on the gut barrier. In animal and human clinical trials, the effect of l-glutamine has been tested on everything from Crohn’s Disease to intense exercise to alcohol ingestion with mixed results (here, here and here) but the combination of physiological pathways and current evidence is strong enough that I recommend it. Typically, I recommend starting with 5 grams of powdered l-glutamine, 2.5g in the morning and 2.5g at night.
You’re probably tired of hearing me talk about vitamin D…but you may be really surprised to learn that there is evidence for improved gut barrier function with adequate vitamin D levels. In one human trial, it only took 2000IU of vitamin D3 a day to improve things. Depending on the client, I may recommend double that (still within the safe upper limit). I don’t recommend higher unless the client is working with their physician to test their levels.
BTW…I keep hearing people talk about ‘getting their vitamin D’ every time the sun shines. Word to the wise: at Northern latitudes like Canada and half of the US, the sun’s rays are not strong enough to trigger vitamin D production in skin for two thirds of the year. Here in Vancouver, we’re talking like October – April. So supplement!!!
Zinc is a critical mineral for both gut cell metabolism and immune function. Zinc carnosine is the typical form I recommend for gut health but it is difficult to find on its own in Canada. This is a good supplement option here. Taking high doses of zinc can throw off copper balance, so ensure you are getting adequate copper in your diet if you are taking zinc.
Replenish Good Bacteria
It almost goes without saying, but when the gut is off…the bacteria probably are too. And in fact, we know from a physiological perspective that dysbiosis can be the source of gut barrier dysfunction. However, research is still in its early stages and results are mixed so we don’t have gold standard evidence to guide us.
So I do recommend that you use an evidence-based probiotic, such as Bio-K+ or VSL#3, daily at full strength for at least 12 weeks. I typically recommend this at night, if there is any evidence of slow motility or small intestinal bacterial overgrowth (SIBO).
How to fix leaky gut and get on a path to better digestive health
So there you have it, the basics of how I approach leaky gut and supporting overall health and healing. This is by no means an exhaustive list of possible strategies (just writing these ones took hours!) but these are the strategies that I feel form the foundation for many of my clients.
I also feel like I need to mention the role of stress in wellbeing. Most of my clients greatly underestimate the real, physiological impact of stress in their daily lives. I will repeat: 95% of the digestive health flare ups I experience can be attributed to stress. I am at the point where my self-care doesn’t really change when I am stressed; I still eat well and exercise but the stress is enough to mess things up. So seek out strategies for mitigating its impact on your life. Time in nature, meditation, adaptogens like ashwangandha and hot baths are my go-tos.
This is a lengthy post; if you’re still with me, it’s probably because you’re not feeling well right now. I wish there was a way to write a blog post that addresses your individual needs and responses to dietary therapy. This is why working one-on-one with a dietitian is key. We are here to help, when you are ready to commit to better digestive health, so get in touch!
PS…please do not undergo any of the strategies listed here without first clearing it with a health professional, especially the supplements!
And a disclosure: I am a paid spokesperson for Bio-K+ probiotics but this blog post was not solicited nor approved by them and there are zero affiliate links. These recommendations are my true and trusted sources.