By Josh Redd, MS, DABFM, DAAIM, Chiropractic Physician

The term “leaky gut” conjures an unpleasant image. Does stuff really leak out of your gut into your body?

Even though it’s happening on molecular levels, yes, this describes leaky gut. The contents of your small intestine escape through damaged intestinal walls into the sterile environment of the bloodstream.

This is problematic if you have Hashimoto’s hypothyroidism, an autoimmune disease that destroys the thyroid gland can causes more than 90 percent of hypothyroidism cases in the United States. Leaky gut is very inflammatory and exacerbates autoimmune conditions such as Hashimoto’s.

Leaky gut is referred to as intestinal permeability in the scientific research. It means the lining of the small intestine has become inflamed, damaged, and overly porous. This allows undigested foods, bacteria, molds, and other pathogens to enter into the sterile environment of the bloodstream. The immune system attacks these compounds, triggering inflammation that, when constant, turns into chronic health disorders.

In addition to Hashimoto’s hypothyroidism, leaky gut is associated with:

  • Skin problems (eczema, psoriasis, rosacea, acne, etc.)
  • Chronic pain
  • Autoimmune disease
  • Inflammatory bowel disorders
  • Crohn’s
  • Celiac disease
  • Type 1 diabetes
  • Puffiness
  • Fatigue
  • Brain fog
  • Depression
  • Anxiety disorders
  • Poor memory
  • Asthma
  • Food allergies and sensitivities
  • Seasonal allergies
  • Fungal infections
  • Migraines
  • Arthritis
  • PMS and other hormonal issues

Two types of leaky gut

There are two types of leaky gut:

Paracellular: This type of leaky gut happens when a particular food you are sensitive to triggers gut hormones to open up space between cells in the gut wall called the tight junctions. Gluten in particular has been shown to trigger paracellular leaky gut in people with celiac disease and gluten intolerance. Testing in our clinic shows people on strict gluten-free diets also can develop paracellular leaky gut from other foods.

In this type of leaky gut, the best way to manage it is to avoid the foods that trigger it.

Transcellular: This type of leaky gut occurs when constant inflammation in the gut — due to dietary and lifestyle factors — damages the intestinal lining to the point holes open up in the tissue. This allows the contents of the gut can spill into the sterile bloodstream. This type of leaky gut is more common and more difficult to repair. It also paves the way for endotoxemia, a condition in which the body produces toxins that circulate in the bloodstream. Endotoxemia is very inflammatory and linked with many health disorders.

How to repair leaky gut

If you have Hashimoto’s hypothyroidism, addressing leaky gut is vital to improving your health. Likewise, your gut needs sufficient thyroid hormones to be healthy, so when it comes to leaky gut and hypothyroidism, you need to support both.

The bulk of leaky gut repair is done through diet. That’s because the most common causes of leaky gut are processed foods, excess sugars, too little produce and plant fiber, and undiagnosed sensitivities to foods that trigger inflammation, most notably gluten and dairy.

10 causes of leaky gut

Although diet and lifestyle factors are usually the triggers for leaky gut, there are many other possible underlying causes that must be understood in order to have the best chances of repairing it.

Below are 10 common causes of leaky gut:

  1. Inflammatory foodsdamage the intestinal walls, leading to leaky gut. These include junk foods that are damaging to the body in general, but also foods to which you have an undiagnosed sensitivity. If you have an immune reaction to a food, it will cause inflammation every time you eat it. Glutenin particular is associated with leaky gut. Dairy, processed foods, excess sugar, and fast foods are other culprits.
  2. Regular alcohol consumptionis a common cause of leaky gut.
  3. Some medicationscause leaky gut, including corticosteroids, antibiotics, antacids, and some medications for arthritis Also, some drugs have inflammatory fillers such as gluten.
  4. Certain infections, such H. pylori overgrowth (the bacteria that causes ulcers) or small intestinal bacterial overgrowth (SIBO) can cause leaky gut. Yeast, parasites, and viruses are other possibilities.
  5. Chronic stressraises stress hormones, which damages the gut lining over time.
  6. Hormone imbalancescan cause leaky gut. That’s because the intestines depend on sufficient hormone levels for integrity and function. Imbalances in estrogen, progesterone, testosterone, thyroid hormones, and stress hormones all contribute to leaky gut.
  7. Autoimmune conditionscan lead to leaky gut. While leaky gut can play a role in autoimmune diseases such as Hashimoto’s hypothyroidism, rheumatoid arthritis, or psoriasis, sometimes an unmanaged autoimmune disease causes leaky gut. That’s because the constant inflammation of an unmanaged autoimmune disease can inflame and damage the gut. Or autoimmunity in the digestive tract can sabotage gut health. This creates a vicious cycle between leaky gut and autoimmunity, and why it’s so important to manage your autoimmune Hashimoto’s hypothyroidism.
  8. Food processingchanges the structure of foods and makes them inflammatory to the gut. Examples include deamidating wheat to make it water soluble and the high-heat processing (glycation) of sugars. Additives such as gums (xanthan gum, carrageenan, etc.), food colorings, and artificial flavors are inflammatory for some people, too. Meat glues used to hold together things, such as with chicken nuggets, also trigger gut damage in many people.
  9. Our environment inundates us with toxins, some of which have been shown to degrade the gut lining. Regularly taking glutathione, the body’s primary antioxidant, helps protect the body from toxins.
  10. Sufficient vitamin D is vital to protecting the gut lining and a vitamin D deficiencycan make the intestinal lining more vulnerable to damage.

These are some of the factors known to contribute to leaky gut. By understanding the cause of your leaky gut, you will have more success restoring health to your gut and managing your chronic health or autoimmune condition.

If you have Hashimoto’s and leaky gut, you also have to support your liver health. Leaky gut often leads to increased inflammation and poor detoxification in the liver, which can worsen overall inflammation.

How do you know if you have leaky gut?

Many people aren’t aware they have leaky gut as most people with the disorder don’t have gut symptoms. Instead, they suffer from inflammatory based conditions, such as Hashimoto’s or other autoimmune diseases, chronic pain, depression, brain fog, skin issues, and so on.

However, digestive symptoms associated with leaky gut include bloating, gas, constipation or diarrhea, and food sensitivities.

Repairing leaky gut can help manage Hashimoto’s

Repairing leaky gut helps many of our patients manage Hashimoto’s hypothyroidism and even put it into remission. This involves briefly following an anti-inflammatory diet to figure out which foods are triggering inflammation in you, following guidelines to restore or maintain oral tolerance, and including some nutritional compounds to support the healing of your gut lining.

Many nutrients can help support gut healing. Some of these include digestive enzymes and hydrochloric acid with meals, l-glutamine, deglycyrrhizinated licorice root, collagen, and anti-fungal herbs. Glutathione and butyric acid are also two of the best things you can use for leaky gut. In fact, research shows that when these compounds are low — which they commonly are in many people — intestinal permeability more easily occurs. Vitamins A and D are also critical for integrity of the gut wall.

Some of my favorite products to support leaky gut include Clearvite, Repairvite, Trizomal Glutathione, Glutathione Recycler, Enterovite, and vitamins A and D.

It’s also important to support the liver as part of a leaky gut protocol. Nutrients that support liver detoxification include milk thistle, dandelion root, and schizandra.

Clearvite is another product we see good results with for liver support.

Leaky gut is a very comprehensive topic and the repair protocol will be different for everyone based on their unique underlying causes. However, we commonly see patients needing to stabilize blood sugar, manage stress, tame inflammation, and support a healthy balance of gut bacteria. All these factors help repair leaky gut. If you have an autoimmune condition, managing leaky gut can be a lifelong process as autoimmune flares can inflame the gut.

When the brain is a factor causing leaky gut

If you have leaky gut or chronic gut problems, you could have a brain problem. This is especially true if you’ve had a head injury or if you also suffer from worsening memory, brain fog, cognitive decline, or other symptoms of poor brain function.

Chronic digestive complaints — indigestion, acid reflux, constipation, burping, gas, bloating, diarrhea, pain, or irritable bowel disorders — are common among people with brain dysfunction.

That’s because the brain gives orders to the gut through the vagus nerve, a large nerve that runs between the brain and the digestive system. The vagus nerve delivers communication to digest food, repair and regenerate the gut lining, push food through the intestines (motility), and many other functions.

When brain function declines, the brain does not give the gut enough input to the vagus. As a result, constipation, leaky gut, food sensitivities, irritable bowel disorders, and other problems can arise. This is one reason why people with a head injury or dementia have chronic gut complaints.

Fortunately, you can do exercises to activate the vagus nerve on a daily basis to improve gut health.

Vagus nerve exercises

A few simple tests can tell you if your vagus nerve may not be sufficiently active:

  • You don’t have much of a gag reflex. Or when you say, “ahhh,” the uvula (the little punching bag at the back of your throat) does not rise much.
  • If you listen to your abdomen with a stethoscope, you hear virtually no rumbling noises — a healthy gut makes intermittent rumbling noises.

Here are some simple exercises to activate the vagus nerve, taken from Dr. Kharrazian’s site.

Gargle vigorously several times a day. Gargling contracts the back of the throat, which activates the vagus nerve. Gargle each drink of a glass of water several times a day. Gargle vigorously and for a good length of time, ideally until your eyes tear (it may take a while to build up to that.)

Sing loudly. If you are alone at home or in the car, spend some time singing as loudly as you can. This also activates the back of the throat and hence the vagus.

Gag. Using a tongue depressor, which you can buy on Amazon, gently press on the back of your tongue to make yourself gag. Do not poke the back of your throat. Do this several times a day, again, ideally until your eyes tear. Gagging is the most intense form of vagus activation.

Coffee enemas. Please Google instructions for doing a coffee enema or read how on Dr. Kharrazian’s site. Hold the enema solution as long as you can. That, together with compounds in coffee that stimulate nerve receptors, will help activate the vagus nerve.

I hope this article helped you understand what a foundational role leaky gut plays in Hashimoto’s hypothyroidism, and why it’s worth taking action to improve your gut health.

Ask my office for more advice.

To learn more about Hashimoto’s and other factors that can cause hypothyroidism, read my book The Truth About Low Thyroid contact one of our wellness centers for more information.

About Dr. Redd

Josh Redd, MS, DABFM, DAAIM, is a chiropractic physician and author of the Amazon bestselling book The Truth About Low Thyroid. Dr. Redd owns seven functional medicine clinics in the western United States and sees patients from across the country and around the world who are suffering from challenging autoimmune, endocrine and neurological disorders. Dr. Redd also teaches thousands of health care practitioners about functional medicine and immunology, thyroid health, neurology, lab testing, and more.