The Leaky Gut Prescription


Readers Summary:

  1. What is a leaky gut?
  2. What can cause a leaky gut?
  3. What are the leaky gut associated conditions?
  4. How might one consider treating a leaky gut?

 

Well, we have talked about the gut in three other blogs so far. (1) Could It Be the Gut?: An Introduction to the Brain-Gut Axis, (2) Your VAP = Brain Gut Axis Function, and (3) Why Leaky Guts Lead to MS? Click those links or go to my home page under Brain Gut Axis and find each one for a quick review. We have hinted at the leaky gut as a cause of serious human disease in all those posts. Today we get to focus on the “leaky gut” and how we might offer to treat it.

What is a leaky gut syndrome? It is the complex biochemical reactions that occur in the gut appear to be the genesis of where inflammation initially passes in to our body. We need to realize this and avoid eating the things that cause this inflammation. As I have said for close to five years now this means strict avoidance of omega 6′s with a serious addition of DHA from foods, all grains and especially wheat of any kind and very limited fructose (fruit or synthetic sources to lower FODMAPS) The gut associated lymphatic tract (GALT) is the first place where our immune systems interact with the outside world. This occurs right below the intestinal brush border and is our first line of defense. It seems to me that evolution has dictated that this is precisely where the battle between health and disease begin in humans and why our immune system is set up ready on that battle front.

So clearly defense number one is to avoid the dietary sources of inflammation I mentioned above. Many of the low carb diets out there for weight loss completely negate their benefits because they fail to limit omega six fats. A good example of that is the Atkins diet and the current generation of Weight Watchers diet. Both focus their attention on the glycemic index and glycemic load. This is admirable for “fast weight loss” but it completely fails to take leptin resistance due to omega six fats mediated via inflammatory cytokines as I have blogged on often to date. So we must be mindful that low carb does not always mean optimal.

Leaky gut syndrome is found in obesity, autoimmune diseases, over training, adrenal fatigue, fibromyalgia, and inflammatory bowel diseases like Crohn’s disease, ulcerative colitis, eosinophilic espohagitis, and the most common disease of the GI tract today called GERD. GERD = gastro-esophageal reflux disease. GERD is an imbalance of omega 6 to omega in the lower esophageal sphincter which allows molecular oxygen into the gut to simplify the gut flora to lead to disease.  Leaky gut is also a feature of many psychiatric diseases as well. Anorexia and bulimia come to mind. Alzheimer’s and schizophrenia are some others. The data is pointing to autism also being correlated with a leaky gut. The success of the GAPS diet is no surprise to many of us clinicians who have a different insight to the causes of these diseases.

So the question is now that you understand what diseases are correlated with a leaky gut, what can we do to treat this condition? I believe the number one risk factor for the initiation of this syndrome is excessive environmental EMF and artificial light.   You will also begin to accumulate transition metals in your cytosol.  First, you must realize as a patient that many doctors have never even heard the term leaky gut syndrome. If your doctor has worked in an ICU for anytime during they’re training they will be quite familiar with this in relation to severe malnutrition, burn victims, and in long term total parental nutrition cases. The interesting thing is that few doctors seem to realize this disease shows itself far more commonly in our clinics than it does in the ICU. I believe it is the most common syndrome I see in my neurosurgery clinic. I believe it is the main etiology for degenerative vertebral disc disease in the USA today.

Leaky Gut Associations:

A. Foods high in the glycemic index, and most dairy products raw or pasteurized.
B. Foods high in refined flours, processed foods with low fiber contents (Amylose high foods)
C. Foods high in caffeine that are chronically used.
D. Excessive use of alcohol or long term use or abuse of antibiotics.
E. Chronic use of drugs like aspirin or ibuprofen, and all proton pump inhibitors (all NSAID’s too)
F. Strong association with mercury laden foods or mercurial environmental toxins.
G. Any disease that causes an altered consciousness (trauma, delirium, dementia, stroke, SAH)
H. Chronic or severe acute food allergies. Severe food poising can also do this.

How do we treat it? Always consult with your doctor first! Then …

A. Reverse the etiologies in A-H above.

B. Consider use of coconut oil as the main fat in the diet until the syndrome is reversed.

C. Liberal use of probiotics if the patient is conscious. Use fermented carbohydrates in natural foods as the first option before going to live culture additives. Examples are sauerkraut, pickles, Kimchi, kombucha, yogurt, kefir, artichoke and horseradish, rosemary, turmeric, oregano.  these all have high levels of cysteine in them.

D. Consider use of probiotic additives with Lactobacillus acidophilus, Bifido Bacteria, Saccharomyces Boulardi because non of them use transition metals in their life cycle.

E. You might also supplement with Fructo-oligosaccharides (FOS) powders and supplements. These compounds are found naturally in the foods mentioned above in part C, but one can buy (FOS) and use them as well. The FOS helps feed the probiotic bacteria in part D mentioned above and allows them to flourish in our gut flora and replace the species of bacteria that foster inflammation at the brush border.

F. Consider supplementing with L- Glutamine, but I like the use of iodine laden bone broths best. Real food always trumps supplements. Sir Hans Krebs, famous for discovering the Krebs cycle, also found that glutamine improves functioning of the intestinal brush border, and the GALT. Glutamine is critical for immune regulation of intestinal IgA. (Fukatsu et al. 2001) IgA is an antibody that that attacks virus and bacterial pathogens in saliva, tears, and in mucous. Glutamine also normalizes the effect on TH-2 type IgA stimulating cytokines associated with the generation of allergy responses. (Kudsk et al. 2000). /the TH-2 type cells are tied to the endogenous endorphin and endocabinoid systems. They are also tied to MSH levels in the brain which links it directly to leptin.

G. Other supplements you might use to combat this syndrome: Aloe Vera 10 grams 2 tsp three times a day. This is a major natural fiber component. This is NOT to be used in cases with Crohn’s, UC, or intestinal blockages. You might also use N-acetyl-cysteine in combo with vitamin C. You might use 600 mgs of NAC twice a day with 1000 mgs of vitamin C.  For severe prolonged leaky gut or autoimmune conditions IV glutathione treatment hold a lot of promise too.  You would be more wise to add food high in cysteine to your diet because glutathione is difficult to get into cells.  It also requires optimal B12, folate,  and betaine levels when treatment is on going.  Both oral and IV use of NAC or glutathione also uses up zinc as a co factor,  so I usually recommend Zn supplementation when it is used.  NAC is the precursor for glutathione which is the main antioxidant protectant of our body. People with serious skin manifestations of the leaky gut like psoriasis and eosinophilic folliculitis should consider NAC because it directly blocks IL-4 and this in turn is the main factor in producing IgE antibodies. This is a huge issue for vegans.  IgE antibodies are made in hay fever, asthma, anaphylactic shock, and atopic skin diseases. If the asthma is severe, one can measure the amount of nitric oxide directly in the expired air and it will be elevated. This is also true in cases of emphysema, COPD and cystic fibrosis. (Corradi et al. 2001) The NAC will form glutathione and it directly combines with the nitric oxide to create nitrosothiols.  This binding reduces the inflammatory effects of the NO in the body quickly to limit disease. This is also critical within the intestines as well in leaky gut.

H. Magnesium 400-1200 mgs at night, Zinc 25-75 mgs a day and Coenzyme Q10 400-1200 mgs a day (depending upon severity of the disease) are all major cofactors in the stress response and used up quickly in the leaky gut syndrome. They could all be replaced liberally.

I. Consider liberal use of omega three supplements and increase of omega three laden foods.

J. Consider use of licorice root called deglycyrrhizinated licorice root (DGL). The dose here is 500mgs of a 10:1 extract three times a day. This is an adaptogen that normalizes cortisol levels, but this form is extremely helpful in leaky gut because it does not have any of the side effects of using whole licorice such as low potassium, low sodium, edema, high blood pressure and palpitations.

K. For resistant cases one might consider the use of a vagal nerve stimulator to increase the neurologic protection afforded by the tenth cranial nerve by keeping the brain’s main gut “security camera” in the constant on position. This is controversial but the company that makes the stimulators now has clinical trials on going for this indication and for the treatment of obesity due to gut inflammation.

L. For people with resistant leaky gut who can’t afford the stimulator you may want to ask your mom if you were breastfed and for how long? If the answer is no then consider the use of colostrum as a consistent supplement. Body builders have used it for years to allow them to over-train while closing the permeability of their brush border with the colostrum. It is that effective. Many people do not realize that exercise can open your gut to inflammation. It can. The reason why colostrum works so well is because it loaded in proline. Celiac disease permeability is driven by intestinal T cells responsive to proline-rich gluten peptides that often harbor glutamate residues formed by tissue transglutaminase-mediated glutamine conversion.

From previous studies, it is clear that celiac lesion-derived, gluten-reactive T cells predominantly recognize peptides that cluster within the proline (Pro)-rich regions of gluten proteins, and these peptides contain glutamate (Glu) residues formed in vivo through tissue transglutaminase (TG2)-mediated deamidation of glutamine (Gln) residues. The negative charges introduced by this deamidation process generally increase the binding affinity of gluten peptides to DQ2.5.

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Additional Resources

Cites:

0. Sollid, L. M. 2002. Coeliac disease: dissecting a complex inflammatory disorder. Nat. Rev. Immunol. 2: 647-655.

  1. Arentz-Hansen, H., S. N. McAdam, Ø. Molberg, B. Fleckenstein, K. E. Lundin, T. J. Jørgensen, G. Jung, P. Roepstorff, and L. M. Sollid. 2002. Celiac lesion T cells recognize epitopes that cluster in regions of gliadins rich in proline residues. Gastroenterology 123: 803-809.
  2. Arentz-Hansen, H., R. Korner, Ø. Molberg, H. Quarsten, W. Vader, Y. M. C. Kooy, K. E. A. Lundin, F. Koning, P. Roepstorff, L. M. Sollid, and S. N. McAdam. 2000. The intestinal T cell response to

Comments

  1. Adriana G says:

    What is the diagnostic test for leaky gut?

  2. @Adriana. I use a VAP as laid out in my previous blog on that topic and in tougher cases we send then for formal GI testing that uses non absorbable sugars like mannitol and if we find them in the blood system soon after we know for sure they have a persistent leaky gut. This is why eating some sugar alcohols in Atkins and low carb foods cause some GI distress……..if that is you you may have a leaky gut.

    http://online.wsj.com/article/SB10001424052748704…. This article is also very helpful too!

  3. I have heard that commercially produced sauerkraut and pickles do not have the probiotics we are seeking, due to high heat processing.

    Can we get our probiotics with commercial products, or do we have to make our own?

    • @Rebecca. Partially true. Most have them but they are not in great number. I think making your own makes a ton of sense but for those with extra cash and who like convenience look at Bubbies brand of pickles and sauerkraut. They have full born live cultures.

  4. Dan Han says:

    my doctor told me my X-ray shows moderate disc degeneration in my thoracic spine. im 23yrs old. ive been following a paleo/low-carb diet for awhile now. how is it that leaky gut causes DDD? is it thru leptin resistance and the inability to heal, or blood sugar dehydrating the vertebra? can you explain briefly? Thanks.

  5. Christina says:

    Thank you so much for taking on this endeavor. I just spent the last two years researching all this information for my thesis. It was so overwhelming and you seem to have an knack for breaking it down.

    I am currently starting my own psychiatric practice with the base of my work being in the brain gut access. My thesis "The neurological/psychiatric manifestations of celiac/gluten sensitivity" already feels out of date, given your information. There is so much more to understand and thankfully we have people like you to bring it to us.

    Thanks for keeping me thinking!!!

    • you need to read Emily Deans MD. Evolutionary psychiatry. She stays on the brain most of the time while I am trying to weave the entire story of how it all works…….and then hit the diseases I see daily. Once in a while I hit the neurosurgical diseases. Thanks for the kind words.

  6. @Dan. This will be the focus of my book. Moreover, you really can't diagnose DDD from just and xray! You need a MRI to be sure! To say for sure your exact cause with evaluating you would be tough but I will give you the quick overview. The initial insult is porosity via the gut by toxins like high omega six content or from a SAD with tons of whole grains or a high glycemic diet…….they all increase inflammatory cytokines that destroy leptin signaling of the liver which is the main defense in our gut. Reread my blog on VAP and leaky gut to get it. Once your liver is suboptimal cellular stress increases and raises your cortisol simultaneously while your liver is kicking out a lot of sdLDL that easily get oxidized and are deposited in blood vessels. Discs don't have a direct blood supply. They rely on the nutrient vessels to the bone and steal the nutrients. The supply is usually brisk enough to support both, but when one increases their sdLDL over time it reduces the oxygen tension in the disc and the chondrocytes become hypoxic. The first sign that this happens is loss of water content of the disc. We see this on an MRI when the disc goes from bright white on a T2 scan to black. This is called degenerative disc disease by radiologist or spine surgeons but none of them understand why it occurs. If you read our literature it remains a mystery to most. Then the degenerative cascade steepens from there based upon the insult that caused it. The slope of degeneration is proportional to the intensity and duration of the insult. I hope you got it now

  7. Hi Jack,

    Thanks for a terrific post on leaky gut. I have probably had a leaky gut for a long time since I have Hashimotos. Last year I decided to go completely gluten free, but my endo insisted on a gluten challenge first. I wish I was smarter back then and said no, because it caused multiple food intolerances. I have been strict paleo for almost a year, and on the GAPS diet since April. I have seen slight improvement with being able to tolerate some nightshades and some ghee. I have a couple of questions:

    1. The paleo autoimmune diet excludes egg whites and nuts, but GAPS does not. They don't cause problems for me. I try to keep nuts to a minimum due to the O6.

    I talked to Chris Kresser about this and he said everyone has a different opinion on this — do you think nuts (soaked and dehydrated) and egg whites are OK when trying to heal the gut?

    2. I have not seen my GP since before this all started, is it worth going in to just discuss this? If yes, why — I have not been ill with even a sniffle for almost 3 years.

    • @Gina…..most people would tell you if you feel fine dont worry about it. I will not. Why? Well in a few minutes I will be posting a new blog that you will be very interested in. It ties it all together. In my opinion, I would test you closely for signs of inflammation because you can feel normal but still harbor subclinical issues. The fact that you habve Hashimoto's is enough for me to turn over every stone to ensure optimal health going forward. This is why the quantified self platform is powerful. Its not just about how you feel now. Its about what your cells may decide to do in the face of a chronic low grade cellular stress as you age. This is where the paleo community and I part ways. Paleo is over run with "young bucks" and they are looking at science thru the lens of themselves and not as they age. I look at it from embryo to death. Why……because I am close to death than birth maybe? LOL

  8. My doctor did tell me I had fatty liver, but I have since reversed it thru a low-carb diet. thanks for explaining. is there anything else I can do to prevent DDD from worsening and heal the rest of my body's musculoskeletal system other than following the Paleo Diet? (i assume if I have disc degeneration then the rest of my joints are aging as well)

  9. @Dan. You need to eat a boat load of eggs or offal. If you don't want to do this you can choose option B……less optimal. Buy supplements of choline and inositol and take 500 mgs a day. Make coconut oil your number one diesel and cut pasteurized dairy to nada…….keep vlc paleo too. You'll be cured fast. Make sure your vitamin D level is 50 or above too and supplement 200 mcgs ofmselenium or just eat one brazil nut a day

  10. I take Vit D and use coconut oil on my vegetables. thanks again. I'll look into offal, not too used to eating that stuff yet haha! it grosses me out

  11. Do you think eating organic Omega3 eggs raw is a good idea? Sometimes I just drink a few because it's so fast and efficient, and I figured it's healthier than scrambled. I guess Poached works too

    • I have zero problem with raw eggs as long as your healthy and dont have a leaky gut. As you know raw eggs carry the risk of bacteria disease (Salmonella) so if you are immunocompromised you may think twice before you go this route. I eat at least four raw eggs daily.

  12. Obviously, it depends on the severity of the problem in the first place, but can you give some general, ballpark indications of how reversible leaky gut is and how long it would take to fix the problem?

  13. How much L-glutamine to supplement with?

  14. @Ruth. That is so broad it is not answerable. I have seen people reverse it within two weeks and others it took two years. The people who take the longest do have some things in common. They are resistant to dietary change and they tend to be very overweight or very underweight, have a history of veganism, or those who have been diagnosed with autoimmune disease and remain on steroids. Fibromyalgia patients are another tough group to deal with because they have so many things that need to change all at once. Fibromyalgia is a disease of complete broken metabolism in my view.

  15. HI Jack,

    I know I asked an unanswerable question, but it seems that you managed to answer it. Thanks!

  16. Eric Sosnoff says:

    I noticed that you didn't mention bone broth, which is said to help with leaky gut because it restores the stomach's mucosal lining (wording from Chris Kresser). Bone broth is also the only food included in the first stage of the GAPS diet, and Kresser says he uses it alone for his patients who are in particularly bad shape. This leaves me to believe that bone broth is among the best foods for treating leaky gut. Do you disagree? Did you leave it out of your discussion on purpose?

    • Its good when your adding a ton of cartilage that is connect to the bone to get the glycine. With glycine you can get it from a broth or from a pill. I have no issues with either.

  17. http://youtu.be/5zlJ8CztFO8. Pretty good YouTube video.

  18. @Eric. I think it works well when you also melt coconut oil into it. The key is using grass fed bones with cartilage attached in a crock pot for twenty hours. I used this myself.

  19. Dr.K,

    I'm the person on MDA who had arthroscopic knee surgery and the use of NSAID's, hydrocodone, my Hashimotos, etc. sent me into a massive hive reaction.

    I have auto immune issues…psoriasis, Hashimotos, Gerd, allergies and asthma. My mother had psoriasis, and has AD and auto immune hepatitis.

    So to move forward I am thinking I need to heed your suggestions above in dealing with my auto immune issues.

    For psoriasis do I take NAC 600 mg. 2X a day with 1000 mg of Vitamin C for each dose of NAC, or just 1000 mg Vitamin C 1X a day?

    This is all starting to make sense to me!

  20. didn't finish…I actually take about 3 grams of C a day so my question about how much C to take with the NAC is moot.

  21. @ indigo…..this is why i do what i do. When people get ready to change themselves and their lives then things become congruent. I cant force change. I would suggest 3-5 thousand mgs of C anf 1800 mgs of NAC broken up to three doses per day

  22. Thanks!!

    It's exciting when it clicks!

  23. Do you have any suggestions other than the typical anti-malaria treatments (I have used doxy previously) for travel? I know there is a Chinese medicine that shows promise. Hate to un-do the progress that I've made in healing a leaky gut by using an anti-biotic long-term…

    • @Laurant I have no experience with treating malaria at all. I do have several patients who travel to Africa a lot and they use this stuff. They asked me about it and I told them I knew nothing about it or even if it worked. I would suggest you do your own due diligence. Good Luck. http://www.blueturtlegroup.com/catalog/3

  24. Jaison Metnick says:

    Jack,I have a few questions:

    1. Does a leaky gut always start from a yeast overgrowth that produces rhizoids?

    2. What are your diet recommendations?

    3. Is extra virgin olive oil ok as a salad dressing or does it contain too many Omega 3's?

    4. Is brown rice or brown rice pasta ok to eat? What about turkey sausage?

    5. I want to fully understand whether I really have a leaky gut or if I just developed food intolerances (gluten, corn, and diary to some extent) so do you know of any doctors in the Pittsburgh PA area that could help me with testing?

    6. All I drink is water. Is there anything else I can drink?

    7. I take natural anti-fungals, lots of Glutamine, and Custom Probiotics 6 strain formula. I will start NAC and the fructo-oligosaccharides to help my probiotics. Any other suggestions?

    Thank you

  25. Jack,

    You mention Colostrum… has this supplement proved effective in your practice for leaky gut? I tried it about a year ago for a few months and noticed faster healing speed in things like wounds and such. I seemed to look more "ripped" with it despite not actually have more muscle.

    At what dosage does it actually help Leaky gut? Is the IGF-1 a problem or is a trade off?

  26. indigogirl says:

    Dr. K,

    I had repeated UTI's for years (2-3 a year). At one point about 15 years ago I was put on one Macrodantin a day for a year by my GYN (she also had me eating yogurt daily).

    Currently I take one Trimethoprim (100 mg) post coitally and that has served me well in terms of keeping my UTI's at bay. However, what is this doing to my gut? I do take probiotics.

    I'm afraid to stop the Trimethoprim because I think I'll get a UTI (It's been about a year since my last one).

    Any suggestions?

  27. I have a recipe for leaky gut that I have picked up from various websites…all of which have mentioned the following spices as being good for calming inflammation in the proteins called tight junctions in the gut.

    Those spices are tumeric (which the active ingredient is cucurmin), cinnamon, cumin, black pepper, maca powder and raw cacao nibs…plus coconut oil. I was wondering how and I going to get these things down me. I finally hit upon mixing all into my greek yogurt. I like

    Greek Gods brand plain yogurt. Green Label. Now avail at some WalMarts.

    1/2 cup yogurt

    2 tablespoons tumeric

    1 teaspoon cinnamon

    1/2 teaspoon cumin (careful, it is spicy hot)

    1 teaspoon Maca Powder

    3 tablespoons raw cacao nibs

    1/8 teaspoon fresh ground black pepper

    2 tablespoons melted coconut oil

    If our junctions are not tight, then we allow pathogens to enter our blood circulatory system making us sick.

    All the spices I buy in bulk from my local health food grocery store. Most are about $9 a pound. I get my cacao nibs and maca powder from nutsonline.com

    Bon Appetit

  28. Adriana G says:

    Dexter, is this one portion? If so, i know those 2 tbsp. of coconut oil would give me a leaky gut out the back door!

  29. @Adriana G You have a leaky gut if that happens. I eat at least 5-6 tablespoons of CO a day and Dr K says his family goes through about a gallon of Nutiva a month.

    Yes this is one portion that I incorporate into my Leptin Reset meals…usually with the evening meal that I have around 4:30pm. I have to eat at least 5 hours before bed. It is not a snack.

  30. Adriana G says:

    Dexter,

    Per the Tropical Traditions web site FAQs diarrhea is a common side effect of coconut oil…are you implying that evrybody who reacts this way has leaky gut? I'm OK with smaller quantities, but definitely not 2 tbsp. I've tried to up my intake over the past few months without success.

  31. I put Dexter's greek yoghurt and spice recipe into Fitday and came up with 25 grams of carb in the serving. Ten of those grams are fiber. If the people who need to lose weight need to have 25 grams of carb a day or less on the Leptin Reset protocol, is this something that should be used by those people? Or is it better to not do the protocol until a leaky gut issue is addressed?

    I have low HDL, and have had for sometime no matter how I eat, so hearing that this is a symptom of leaky gut I know I need to do something about it.

    Is it possible to do both at the same time? Are higher carbs worth it to use something like this? Or should the gut problem be addressed first and then go on the LR protocol?

  32. The Leptin Reset protocol will address both the Leaky Gut and and weight loss. When you eat the 50gm of protein within 30 min rising in the am along with sufficient fat, and eat to satiation in the evening with protein (meat and fat) plus a few steamed veggies slathered in grass fed butter you will start to naturally eat less because you feel satisfied. You most likely will be able to make it past lunch…if not then up the protein and fat a little in the AM until you can make it through to 4pm for dinner. If you can make it til the next morning, then too much protein and fat.

    Naturally eating less is not intermittent fasting…which is not recommended on the protocol until after the LS signs come in.

    The timing of eating according to the protocol is critical to success. Use liberal amounts of coconut oil to raise HDL and thus assist in healing the gut.

    See the sunshine post by Doc K about Vit D receptors and how Vit D in amounts considered by CW as excessive can help make the tight junction proteins in the gut tighter so that invading viruses and bacteria do not leak into the blood stream.

    Dr K's entire blog is a fabric woven together to lead us to optimal health. No one magic bullet will cure all our ills.

    The yogurt cocoction is only a very small bullet one can use in the quest for optimal health.

  33. @Jack,

    I'm printing and reading your blog entries when I've time. You emphasize the importance of the O3/O6 ratio in global health, with respect to this, i) what's your take on 'healthy' nuts such as Walnuts, Almonds or Brazilian Nuts (should be roasted and therefore burning the fatty acids or natural), and ii) what's your take with respect to Flaxseed oil which contains a very favorable ration o3/o6. Should this oil be used as a staple oil?.

    Thanks. Santiago

    • @Santiago The only nut I really like a lot is a macadamia nut. It has the best FFA profile. Other nuts are OK (too high O6 to 3 content) but I am not into just OK.

  34. I watched the Cyrex Labs youtube video. I am seeing more and more patients with ideopathic peripheral neuropathy. I have an impossible time convincing them of the Leaky Gut connection. Do you concur that there is a connection?I am having a hard time coming up with good research articles to back this up. Do you know of any? Also we need to find good Labs that test for LGS as well as predictive antibodies that are reasonably priced. Can you recommend any for the Mid Atlantic states?

    • @Rose Most healthcare professionals in medicine do not even learn about leaky gut. Some dont even know what it refers too. That is why it has not picked up any traction. If you go to a medical school physiology book leaky gut is not listed.

  35. Yes, I am aware..I am having a hard time coming up with good research articles to back up gut associated autoimmune peripheral neuropathy. Do you know of any? Also we need to find good Labs that test for LGS as well as predictive antibodies that are reasonably priced. Can you recommend any for the Mid Atlantic states?

    • @Rose. I am sure they are on pubmed but I am on call this week and there is zero chance I can search them Use google scholar and see what you find.

  36. So for someone who has leaky gut and autoimmune disease, what exactly do I get to eat? The more I read, the more confused I get.

    1) no dairy

    2) no night shades

    3) no eggs?

    4) no nuts?

    So, basically meat, coconut oil and a few vegetables. Is it possible to CURE the autoimmune reactions for good? I am 3 days into the reset, thinking this is going to take a while since I am quite sick, but willing to do what it takes. I am just seriously confused on what is the most important aspect to this. I can't afford every single supplement listed on here (lost weight with hCG so looking at that list also), so should I concentrate on the leaky gut first?

    Thanks in advance for any help!

    • @Michele None of those in the 4 listed……for a complete autoimmune version you can buy Robb Wolfs book and read his recs too. They are pretty damn close to mine. I also advocate a lot of MCT in coconut oil and make sure you eat offal!!!! Dont be afraid. If you dont know how to cook it look up Diane Sanfillipo, @Grassfedgirlsf on twitter or Whole9

  37. I am not convinced I even have hashis. I have not had antibodies show up except once a long, long time ago and they weren't even high then (false positive?). I have however had a few ANA titers come back positive, but not recently. Should I still consider myself as having autoimmune diseases and treat accordingly or just do the leptin reset as is (having a hard time wanting to continue with all of the restrictions) and test when done?

  38. Let me say also Dr. Kruse, that I thank you from the bottom of my heart. For the first time in years I feel like there may be light at the end of the tunnel.

  39. Hi Dr. K, I am a fan of yours from the paleohacks site. my 8 year old son has Eosiniphilic Esophagitus, and leaky gut. He has battled the chronic stomach aches for years. He does not have any testing that shows food allergies, but he has severe environmental allergies. His nose is always plugged, allergy medicine doesn't help. Paleo eating does seem to slightly help his symptoms. We recently did a saliva test, and his SIGA was severely depressed. Any advice for my little guy? I am desperate to heal him and the drs say EE in incurable and all I can do is give him the dreaded steroids as a bandaid.

    • @amanda. EE is a new diagnosis that few GI docs seem to know what causes it. In my experience (limited) most have come back with terrible )6/3 ratios and are severe hypomethylators with terrible B vitamin status. I have a real good friend who bailed on his GI doc took my advice to get tested. His B12 was horrible, his hs crp and vitamin D terrible and his 06/3 ration was 32 to 1. He started betaine, went ketogenic paleo with massive offal and fish intake, B12 injections and a supplement grouping for him and it was gone in three months. There are some things to think about

  40. Thanks for the info Dr…. I've had his D levels tested and he is good there, wouldn't be surprised if he is low in B's as I, his mom, am severely deficient myself. I give him digestive enzymes a lot, never tried betaine though. How much Betaine would you say a 50 pound 8 year old should take? I just wanna make sure I don't overdose him…

  41. Drl Kruse,

    I have read this blog on leaky gut several times trying to figure out what to do first. I am eating pickles daily, and have already cut out most carbs, and especially wheat. Don't use caffiene, alcohol, or ibuprofen. I also get about 2 tablespoons of coconut oil a day in chicken bullion. I have ordered some l-glutamine supplement and hope to start this week. What else can I do from here? Really want to get my gut straight so I can continue to reach for optimal. You had responded to me earlier in another blog because I had trouble taking mag malaate since it caused bloating and constipation.

    Thanks for all you do.

  42. berger6696 says:

    Sounds like I've got a lot of reading to do here Doc! Thanks again for all your help!!

  43. What's the best & safest way to ensure one always has sufficient Vitamin A – especially when one is taking Vitamin D supplement – I am taking approx 6,000IU D3 daily – along with 200 micrograms Vit K2 MK7 – and magnesium most days?

    Thank you

  44. So I started with the Leptin Reset back in September, I've been overweight as far back as I can remember, with an unending appetite and it just made sense to me to eat a huge breakfast, did I mention my appetite? I have been working on different versions of low carb since 2000, but never able to drop all the weight, this leads to frustration and doubts that I'm doing things correctly. Self doubt + overweight = not a happy camper!

    Leptin Reset worked wonders with my appetite and relationship with food in general, thank you Dr. Kruse. One thing it did not help with was my ezcema, but I will admit I was still eating nightshades, did not realize I was supposed to cut them out until 3 weeks ago, which is when I also came across this blog and decided to give it a go. So 3 weeks no nightshades, no dairy, no wheat, no nuts, no eggs and most of the supplements listed and I feel I am healing from the inside out. There is definite improvement in my patches of ezcema, which I am taking as a sign of healing. They no longer itch and the skin is starting to feel much softer. How do I know when I have healed my gut? Is there a time when I can introduce some the the foods I've been avoiding, not the wheat of course, but I'm really missing my eggs in the morning. Do I continue with the supplements or is there a time I can discontinue usage on some of them?

  45. Ouch! Tough Love! Thanks, I needed that.

    Merry Christmas to you and yours!

  46. Dr. K,

    I am finally getting around to reading the comments on a second pass of the blog posts. That brought up a peripheral neuropathy question. The peripheral neuropathy is secondary to CHOP-R for 4th stage non-Hodgkins lymphoma (M.D. Anderson / Levy (Stanford Univ) given to my husband in 2002. He has been declared a molecular cure, but the vincristine was terrible on his gut. He has had residual numbness in his fingertips and we just got to wondering, can vincristine caused gut damage be repaired, and would the neuro changes repair as well?

    We did the Leptin reset together since I needed it. He has seen some love handles disappear that he has had for as long as I have known him and all his wired skin issues are gone. Hair not oily, skin not dry, and is seeing some subcutaneous fat return to his face. He is still chasing a waking up early problem. It got brought on by prednisone and is the only other sequalae of the cancer.

    After listening to Mat Lalonde he has added back Yukon gold organic potatoes, peeled, boiled and never baked as a safe starch replacement for days with heavy working like moving 5 yards of organic topsoil to our garden today. Most desk days he stays clear of the potatoes. No other nightshades right now. Totally grain, sugar, sugar subs and dairy free except cream in coffee and ghee for cooking.

    Not taking anything but a multi, O3, melatonin, C, and Natural Calm at h.s.

    Thanks for all you do. We appreciate it greatly. And my nod of understanding vis a vis posting via an iPad. Pain in ass to not make typos. So if I made any I apologize in advance.

    • @LIANE I have never been asked this question and really do not know the answer but I do know that several Cancer patients have had great luck with PN and vincristine so I see no reason it would not help the gut. I would tell you to get a grass fed bone broth mix recipe too and add that to his list of recovery things as this would be additive. Please let me know how this goes. I could learn a lot from it and so could others.

  47. I did a search for oncovin / vincristine + PN and read here
    http://www.lymphomation.org/side-effect-neuropath
    that it is myelin sheath damage. So it stands to reason any MS healing protocols would work. Not a lot in paleo sphere on healing PN. But there is a lot on MS.

    Will order some bones in my next meat share.

  48. Hey Dr. Kruse, I have a quick question. You mention Asthma in G. and I was wondering what your take is on it. My daughter is continuing to struggle. She is on advair, and albuterol. The pulmonologist ran tests and said that he could see no reason why she should need it. Her breathing tests and her allergy panel came back clear except a few minor obvious things- shrubs, trees, mold. Ha! We live in western Oregon so we are surrounded by them all.

    Anyway she is continuing to have more and more attacks and I am wondering if you have any advice. She has cut out all wheat and eats minimal GF foods. We don't eat any processed junk. I am just not sure what to do with her!

    Any ideas??? (other than moving to Arizona)

    BTW- I am doing the reset day 46 and now have acne like a 17 year old boy… what's that about and how long will it last?

    Thank you for all you do!

  49. Dr. Kruse,

    Thank you for posting your insightful thoughts. My two kids (age 6 & 3) are on GAPS diet for leaky gut. Their main symptom when they eat offending food is horrible eczema.

    I would greatly appreciate if you shared your opinion on the following questions:

    (1) will eating foods that show up positive on IgG test panel worsen the leaky gut?

    (2) will using raw liquid colostrum (not pills) help with leaky gut treatment?

    (3) will drinking fresh green vegetable juices(with a little bit of apple juice) help in improving leaky gut or worsen it?

    Thanks,

    Sujatha

  50. Any thoughts on children supplementing with L-Glutamine? I'm struggling to find info on appropriate dosages. My sons (3 & 4 years) are low IgA.

    • @Tim I will tell you how I did it with my kids…….I just made a special brew of my bone broth and gave them a cup to drink three times a week. The bones are all made from grass fed beef. For kids you really want them to get their nutrients from food versus supplements because you want the gut to work they way it was designed because it is still in the process of learning how to work best.

  51. Re: your answer on #59 – Raine eliminated all the autoimmune foods, including eggs, but doesn't have specific evidence that eggs are harming him. Once healed, he wants to know if he can bring back eggs. Not "crap," just eggs. I have the same question. Pastured eggs have been an enormous part of my healing BED, cavities, and more – without butter, I especially feel the need for them. Is the general idea to add in one food at a time once recovered, and stop immediately if a problem crops up?

  52. @NuttmegsThe Hashimoto’s thing……it makes up 95% of all hypothyroid human cases today and it treated by medicine with CW. Most who have it have leaky guts and low levels of intracellular glutathione. Glutathione is a very important antioxidant that plays an important role in maintaining the correct oxidation-reduction potential inside cells. It scavenges oxidising free radicals, detoxifies heavy metals, pesticides, tylenol and leukotrienes. It stores and transports amino acids, regulates the cell cycle, protein synthesis and gene expression, and protects thyroid cells from self-generated hydrogen peroxide. Glutathione is quite important for patients with Hashimoto’s. Glutathione protects the body in an extraordinary number of ways, but the fact that it protects the thyroid against hydrogen peroxide is particularly significant for the thyroid. In untreated Hashimoto’s, the body’s levels of T4 (thyroxine) begin to fall, and TSH (thyroid stimulating hormone) levels generally start to climb. In order to stimulate the thyroid to make more T4, the TSH activates the thyroid cells to make hydrogen peroxide. If the TSH levels remain high, the thyroid cells continue to produce more and more hydrogen peroxide, and this can lead to increased inflammation, scarring, and ultimately the destruction of thyroid cells. If the hydrogen peroxide manages to gain entry to the cell, the damage becomes far worse.

    Hydrogen peroxide is thought to play a significant role in the development and progression of Hashimoto’s disease, despite the fact that the thyroid gland actually requires hydrogen peroxide for thyroid hormone formation. Hydrogen peroxide is normally produced during the oxidation of the iodine ions. It is an essential part of the thyroid function. But the critical factor is the protection of the thyroid cells (glutathione level), and the place in which the iodine ions are oxidized. If oxidation occurs inside the cells, the hydrogen peroxide is produced inside the cells, and the cells sustain damage.

    A study found that if hydrogen peroxide is allowed to enter thyroid cells, it attacks and cleaves thyroglobulin (protein within the thyroid), producing fragments that are able to diffuse into other cells – and these fragments were recognized by autoantibodies taken from people with Hashimoto’s disease. This suggests that hydrogen peroxide entry into thyroid cells may actually be the cause of Hashimoto’s disease!!!! SO if you have Hashimoto’s your glutathione levels maybe a proxy of how bad your disease really is. It can be a measure of really how leaky your gut is too.

    The predominant infiltrating cells in autoimmune diseases such as Hashimoto’s thyroiditis are phagocytic macrophages, neutrophils and various T-cells; the macrophages and neutrophils damage the tissues by releasing inflammatory cytokines and proteins, including hydrogen peroxide making things worse because this further depletes glutathione inside the cells. This is complicated by co-morbid B12 and folate deficiencies in the diet because of the leaky gut. Glutathione requires both to be on hand to work well!

    The body’s stores of glutathione can become depleted through any stressor. For example, alcoholism, HIV infection, cirrhosis, diabetes, surgical trauma, fasting, environmental toxins, overuse of acetaminophen, chronic stress, inadequate diet, elevated adrenaline release, extensive strenuous exercise, or infection. It is also associated with cigarette smoking, as smoking increases the rate at which the body uses glutathione.

    Glutathione is not easily absorbed through oral supplementation, but is synthesized in the body from amino acids, and body levels can be increased through oral administration of glutathione precursors such as N-acetylcysteine (NAC), S-adenosyl-L-methionine (SAMe) and L-gluatmine. Getting it into cells is even tougher and requires IV infusions using lipid soluble mediums. For serious autoimmune diseases it is often a great treatment. Oral administration of NAC of doses up to 8,000 mg/day was not found to cause clinically significant adverse reactions, although doses of 600mg/day were enough to significantly improve symptoms of chronic lung disease like COPD. I have used over 3000 mgs a day when my HS-CRP was around 3.0. When I have falls in Vitamin D levels I also reach for NAC or sometimesWHEY protein. Whey also breaks down into glutathione and reduces inflammation. This is why Whey use can augment weight loss in people with high CRP’s

    Intake of NAC does increase zinc loss through urine, so zinc supplementation would be advisable for anyone supplementing NAC over an extended period. This can deplete your sex steroid hormones if you do not eat a lot of foods with zinc. Me personally when I take a ton I always make my oysters rockerfeller recipe.

    Glutathione can also be up-regulated by vitamins C and E, and alpha lipoic acid, PQQ, spinach, offal, yeast extract, and broccoli. N-acetylcysteine is considered to be the most effective, fastest route to raising levels of glutathione. It also increases levels of glutathione only when there is an actual need, and it seems to concentrate only in tissues where glutathione is required. This need corresponds to high MMP9 levels in cells.

    The fact that NAC is able to restore glutathione levels and thereby protect the thyroid is particularly interesting given its ability to crack open bacteria such as chlamydia pneumonia, which hide inside the body’s own cells during one part of their life cycle, using the host cell’s machinery to replicate. Chlamydia pneumoniae has been implicated in autoimmune diseases such as multiple sclerosis, and N-acetylcysteine is considered an important part of treatment. I do not consider these diseases as part of AI’s. I consider finding titers of these in patients to be patho-mneumonic that glutathione levels are very very low in these people.

  53. @Rob here is the link between Colostrum and working out and gut permeability.

    I think many might not know excessive exercise increases gut permeability across the board. So in the leaky gut Rx we have the same recommendation for exercise. Small amounts are OK but nothing aggressive. I really like just heavy lifting during your home based cures.

    Colostrum seems to help leaky guts not only in infants but in adults with leaky guts. This is why so many body builders use colostrum when they are overtraining. Here is a study linking the good effects of colostrum.

    http://www.ingentaconnect.com/content/adis/smd/20

    This is why those with leaky guts should consider backing off exercise just like I recommend in the Leptin Rx for the same reason. It drives up IL-6 while increasing the cortisol to DHEA level and will hurt metabolism and sleep.

  54. Jack,

    I have symptoms of a leaky gut (small joint pain after eating nightshades, dairy, corn, and gluten). I thought I had Hashimotos, but had antibodies tested 3 times over 2 years and all antibodies were undetectable. I have HS-CRP = 0.3 and HDL = 72.

    I eat lots of bone broth, fermented foods and followed the GAPS/paleo diet strictly for 8 months with little to no improvement.

    I tried implementing some of the Leaky Gut protocol, but had problems with the l-glutamine and DGL. I started the DGL, followed 7-10 days later with l-glutamine. During that time I had terrible insomnia (previously slept well), night sweats, and hot flashes. Within 3 days of stopping both supplements it all went away. I don't know which caused the problem, but guessed DGL. I tried 500 mg glutamine once and got night sweats within 48 hours. I guess I will proceed without these 2 supplements. How important are they to recovery?

    I found that adding a bit of sweet potato to the mix has improved by symptoms. This is not supposed to happen according the GAPS protocol, so I am intrigued.

    Here is the main question. I have still have not solved by thyroid problem (low T3 and taking 60 mg Armour) — should I focus on healing leaky gut and leptin RX at the same time or focus on one at a time.

    Many thanks for the generous donation of your time and knowledge.

    • @Regina you might be one of the people who need IV glutathione therapy or colostrum therapy. I listed colostrum on the Leaky gut Rx but the Iv glutathione I saved for the book. I also posted recently about it in the last 15 pages of the monster MDA thread if you want to read about it. Since yout got better with the sweet potato keep it up but I would go heavy one the bone broth, coconut oil and consider the other two mentioned earlier.

  55. As you know, I have major leaky gut, but I have no joint pain at all. HDL is 80, hsCRP is .77, stool lactoferrin (signifying gut inflammation) is .7 (range=<3.1). But ANA homog & speckled = 1:160 & antigliadin sIgA is just over positive.

    My question: are nightshades out? I've never had any pain from them, and have no problem avoiding potatoes, tomatoes, eggplant, & bell peppers while fixing my gut. But my breakfast staple is sausage from pastured pigs, full of … cayenne pepper. All my homemade seasoning blends have cayenne. I can remake all with black pepper, but it's a huge work load for someone with chronic fatigue – but I'll do it if needed.

    Do you think cayenne will hold me back or delay optimal?

  56. I have fructmal, so am doing lower carb paleo. I am 36yrs old,(128lbs) I have a really lean and defined upperbody (visual ribs and abs), but my lower body has always been flabby and no definition at all, and I train 4 days a week with med-heavy weights. I only do warm-up cardio(10min). Will your leptin rx help with estrogen dominance? I get huge stomach flares from anything broccolli or it's derivitive (ie; DIM). I have never slept well my whole life, I can count on my hands how many times I have slept an entire night without getting up. I have no problem falling asleep,but 2 hrs later the wakefullness starts. So my question is will this rx help with estro dominance and sleep and fructmal( fructose malapsorption). Thanks so much for your help.

    • @Angela yes it will……but I have some news for you you might like. When a woman complains of the their lower half being flabby its a sure sign there is a major leptin problem with LPL. If you google this hormone you will see that it is directly tied to your estrogen/progesterone ratio……..my bet is your progesterone and pregnenolone levels are probably terrible because you are likely in deep peri-menopause due to excessive inflammation coming from your gut. If I am right you can easily check this out……go to any lab and get your pregnenolone, progesterone and highly sensitive estrogen levels done on Day 3-4 of your cycle. Add DHEA level for shits and giggles…….I bet you find your problem. When you do you need a good anti aging doc to balance your Prog to Estrogen level while eating the Leptin Rx and a strict paleo diet……..cut all dairy except for eggs. If you want more reading on the fat disposition enzymes I believe Gary Taubes covered these in both his books…….if my memory serves me.

  57. Thank-you so much for your reply. I live in Canada and anti-aging docs are very expensive, but that will be on my wish list. My GP says my hormones are all fine, I know he is talking out his wazoo! Would you be able to recommend any herbal progesterone/pregnenolone/dhea boosters. Something that I could get a hold of on my own? I have just started to eat 3 Big meals and make most of it lean meat with fish oils,and ghee and coconut oil. Greens and a little squash. I finally am feeling full after a meal, that has been an issue most of my life. Always being hungry! You are so generous, thank-you and have a blessed day.

    • @Angela You can probably buy bioidentical prometrium somewhere on the net but you might need a Rx from you doc. I would suggest you need that doc to help you apply this correctly. Hormones are great when you know what your doing with them.

  58. Thanks again, I will look into that. Have a fabulous day!

  59. Hi Dr. Kruse,

    Thanks for posting the LeakyGut Rx.

    Where I live, I can get glutathione injections from a naturopathic doctor. Are the injections as effective as glutathione IVs?

    Thank you

  60. Dr K – would you be willing to recap what tests a person with AI issues and gut dysbiosis should consider having done and how often? I have tons of tests but they don't seem to line up will with the ones you blog about. I'm trying to halt my RA progression (if that is really what I have) and heal leaky gut issues. Some progress has been made, but not enough IMHO. FWIW – I have been doing everything that the Leaky Gut Rx outlines for quite a while. I'm sorry if this crosses the line. Any suggestions are appreciated. Thank you

  61. Cú Chul says:

    can the leaky gut prescription be done at the same time as the leptin Rx?

  62. Fascinating post. The article you referenced above was really interesting to me–esp. the part on brain deposits in ataxic pts. My family has a link of spino-cerebellar ataxia and Hashi's and whole maternal line with thyroidectomies. The men seem to get the worst ataxia sx, and the women have no thyroids left! WOW, and more reasons for me to continue off on the wheat since I have +anti TPO abs. Thank you for your help and advice, I am heading to Austin in March for Paleo Fx.

  63. Hi Doc,

    question about CO and leaky gut. I know you like context so a bit: about 4 years ago diagnosed with non-celiac gluten sensitivity and I am hyper sensitive (ie 1 tbsp grain based vinegar in 16 c casserole set me off).

    that same year came off about 1500 mg daily of naproxen for damaged suprasprinitus muscles, ran out of the Rx and took non-rx generic and eventually advil end result was severe lower leg edema ankles went from 9 in to about 12-13inch diameter in less than an hour or so and persisted all day. I questioned the naproxen and was told this was highly unlikely. Since this episode have only been able to keep edema at bay with a combo of at least 115g protein per day and recently Rx 10% progesterone cream cycled days 12-26 (I'm mid 40s.

    because of hyper sensitivity to gluten decided to try a CO fast to clear system (single exposure to gluten, even cross contamination, causes instant inflammation and weight creep, even while on LR.

    Arrogantly assumed I did not have Candida as have never had any yeast infections etc and was proven wrong (never argue with your body)

    Day 1 did 213g CO (Nutivia), had nausea, headache and diarreah, knew this was a possibility was fine with it but noticed at 2 am I went from nausea to almost puking, acid only, cool water stopped the vomit urge.

    Day 2 backed off to 176g of CO, similar symptoms to the day before, albeit less bowel movement, but at midnight on the dot began puking which lasted 15 minutes and brought up pretty much everything ingested between 3-6 (stopped eating after 6)

    sorry for the novel but context is important :) questions:

    I'm working with the assumption I have leaky gut, hdl reading is lowish and I have inflammation shown by high ferritin, low iron and higher crp, as per your previous suggestion using curcumin etc.

    given absorption issues because of leaky gut and gluten sensitivity is there a theoretical upper limit on CO in this circumstance?

    is it possible the puking is simply a detox symptom or a side effect of absorbption issues?

    not looking for a diagnosis just the benefit of your education as this is not something CW could even begin to approach.

  64. Hello Dr. I am desperate in need of some advice from a knowledgeable medical practitioner like yourself. I recently got laid off from my job and don't have medical insurance so going to a doctor at this time is just not feasible. I just don't know what direction or ailment to try to heal first so I thought I'd get your opinion.

    Quick background: I am a 29 year old male. 5'11 155 lbs with probably 10-12% bf. I had been practicing intermittent fasting where I would eat for 6 hours each day followed by a 18 hour fast. I did this for 3 years or so and maintained sub 10% bodyfat while working out 3 days and week and was feeling fantastic with lots of energy everyday. I would eat HC, LF on my 3 workout days (Mon, Wed, Fri) and then low carb, medium fat on the other 4 days of the week. Protein was kept high (200 grams) every day.

    Well I had a few consecutive traumatic incidences in my life in the past year and have done some major damage to myself. I first got down to about 140 lbs. and didn't have an appetite at all. Then for the past year my appetite became out of control. I started binge eating close to 10,000 calories per day in a 3 or 4 hour period. I became addicted to almonds and would eat 3 lbs of natural or roasted almonds in one setting. That's close to 7,000 calories just in nuts in one setting. I would mainly binge on nuts and peanut butter and not a bunch of chips or donuts or anything like that. Then I would fast for the entire next day and the taste of rotten nuts would linger in my breath for the next 36 hours. Obviously the nuts weren't fully digesting and just sitting in my digestive tract. The taste I would burp up in my mouth the following day was just foul. Then I would eat more normal the rest of the week, but I would basically eat one day then fast the next day. I would then start off the next week with another almond binge like the one I mentioned above. I followed this for an entire year.

    Needless to say, I had some underlying problems causing me to binge. But I would eat 10,000 calories in that one setting and still not be full. I'd just force myself to stop. I have stopped that habit and have went back to eating strictly paleo (no nuts, no dairy, very little fruit-just meat and veggies mainly) for the past 2 months. I still intermittent fast everyday for 18 hours with a 6 hour feeding window. I eat close to 2,200 calories a day now, and have not once had the desire to binge again since then.

    The past few weeks I have been following absolutely awful. I have nearly every single symptom of adrenal fatigue listed:

    -I have absolutely no energy during the day, except at night. I wake up every morning at 6:00, but sleep on and off until about 10:00 because I am sooo tired.

    -I take 3 mg melatonin to put me to sleep every night. If I don't take it, I can't sleep despite feeling like a zombie.

    -I get a head rush every time I get up quickly

    -I have absolutely no libido or sex drive at all

    Aside from this, I also have serious digestion problems now, I'm assuming due to the damage I did with the binging on 3 lbs of almonds per day 4 or 5 times each month. I haven't pooped solid for almost 2 months, and even when I have small meals, I burp the food back up into my mouth hours after I have eaten it.

    So I just need some advice on what I should do? What should I try and fix first? I can't seek medical advice right now, but I would be willing to try and start the long road back to recovery any way that I can. I am desperate and any advice you could give me would be so greatly appreciated you have no idea. I have been extremely healthy my entire life outside of that past year episode, it's so strange that happened. Would you recommend a leptin reset first? Address my adrenal fatigue first? Or try and fix my obvious serious digestion problems first? I have so little energy each day, and would like to do whatever I can to try and get back to my old self as soon as I can. Thank you so much from the bottom of my heart

    • @Ben You need to realize your problem is not your diet it is in how you think. I would strongly suggest you get into Meditation. Start with the Healing Code book and move to transcendental meditation. That is my best advice. I'd also tell you to read my blog post called Primal Sense. Its free and you need to bath your thoughts in something to soothe them.

  65. Just wanted to add one quick note to my last post Dr. I know it's already too long I just needed to add this.

    When I say I'm not, well "digesting" my food well, I mean I'm only going like 2 or 3 times a week max, and each time is just a few small pebbles despite eating close to 10 servings a day of veggies (mainly broccoli, cauliflower, spinach and carrots). No solid stools at all for the past 2 months since making the switch back. Also, for the last 3 months of my almond binging episode, I was taking laxatives to try and stimulate a stool and try and get rid of the back up of rotten nuts that were sitting in my stomach and throat the next day. I was taking 10 to 15 laxative pills when the maximum recommended dosage was 3 pills for 24 hours. Like I said, I did a lot of really dumb stuff. I'm thinking taking all those laxatives may say a lot as to why I can't seem to have any solid digestion now. Once again thank you so much for any advice or direction you can point me in to try and turn my health back around

  66. Thanks for your input Jack. I actually have gotten into meditation in the past few months. I have started a program called Quantum Mind Power. It gives one all the results of meditation by listening to different sounds. I will look into the site you mentioned as well.

    In the meantime, do you suggest trying to fix my digestion problems first or my adrenal fatigue? I have read on a few blogs that a lot of times digestion problems can be the overlying factor in many other complications, so fixing my digestion might lessen the powerful symptoms (extremely low energy all day except at night) the adrenal fatigue are having over me.

    One last question. Every time after I eat I have tons of small bumps (like a combination of a white head and a black head) that cover my face. They reside usually two hours or so after eating, but a few will remain and turn into zits. I have had worse than usual acne the past few months, assuming due to the detoxifying effect my diet is having on my body and face. Any idea what is causing this? As always thank you so much Dr. Kruse

    • @Ben work on the gut……its a biggie. The adrenal gland will bounce back if you fix the main issue. The skin issue surely points to the gut too. Most skin diseases are tied to the gut. When I had skin breakouts like this 6 yrs ago I would put coconut oil directly on my face. Made a huge difference

  67. @Grizz thanks for the link for patients on LDN.

    About LDN

    With MANY thanks to Jansz for posting information about LDN enough times for it to sink into my thick skull. I've accumulated this information from many posts & sources over the weeks. This is the message I sent out to everyone on my list. I hope this helps.

    =====================

    "The most important drug discovery since Penicillin"

    Generic Name: Naltrexone Hcl

    AKA:Naltima

    US Brand : Revia 50 mg

    Manufacturer : Intas Pharmaceuticals India

    Package : 10 Pills

    Price : $16.80

    Strength : 50 mg ( must be cut down to 4 mg daily )

    Available without prescription here:
    https://www.alldaychemist.com/311__Naltrexone-Hcl

    Dosage: Just 4 mg daily, cost $1 a day, causes a big boost in the immune system for multiple diseases. How to cut dosage:
    http://www.marksdailyapple.com/forum…tml#post68…

    Bernard Bihari, MD, as well as other physicians and researchers, have described beneficial effects of LDN on a variety of diseases.

    LDN Web Site:

    Links

    Cancers & Other Diseases:

    Bladder Cancer

    Breast Cancer

    Carcinoid

    Colon & Rectal Cancer

    Glioblastoma

    Liver Cancer

    Lung Cancer (Non-Small Cell)

    Lymphocytic Leukemia (chronic)

    Lymphoma (Hodgkin's and Non-Hodgkin's)

    Malignant Melanoma

    Multiple Myeloma

    Neuroblastoma

    Ovarian Cancer

    Pancreatic Cancer

    Prostate Cancer (untreated)

    Renal Cell Carcinoma

    Throat Cancer

    Uterine Cancer

    ALS (Lou Gehrig's Disease)

    Alzheimer's Disease

    Ankylosing Spondylitis

    Autism Spectrum Disorders

    Behcet's Disease

    Celiac Disease

    Chronic Fatigue Syndrome

    CREST syndrome

    Crohn's Disease

    Emphysema (COPD)

    Endometriosis

    Fibromyalgia

    HIV/AIDS

    Irritable Bowel Syndrome (IBS)

    Multiple Sclerosis (MS)

    Parkinson's Disease

    Pemphigoid

    Primary Lateral Sclerosis (PLS)

    Psoriasis

    Rheumatoid Arthritis

    Sarcoidosis

    Scleroderma

    Stiff Person Syndrome (SPS)

    Systemic Lupus (SLE)

    Transverse Myelitis

    Ulcerative Colitis

    Wegener's Granulomatosis

    LDN is available as a Generic Drug (Naltima) without a prescription here:
    https://www.alldaychemist.com/415-naltima-50mg-.h

    Instructions for cutting it down here:

    I know that some fill a 50mL medicine bottle (w/dropper) with distilled water, then dissolve the 50mg Naltrexone Hcl to make LDN. Shake gently each time before taking, and work up to 5 drops. ( 1 mg per drop )

    I have not done the dosage calculations lately, but one can make as low a dose as desired with a dropper.

    You may suspect that most doctors likely have never heard of LDN.

    Rob
    http://www.marksdailyapple.com/forum…tml#post68…

    Dr. Kruse (Digital Surgeon) said he will be talking about LDN in his 1st book, scheduled the end of this year.
    http://www.marksdailyapple.com/forum…tml#post68…

  68. That's interesting, my doc was just talking about putting me on LDN because my Hashimotos antibodies numbers keep creeping up.

  69. Souldanzer says:

    Is powdered colostrum fine or does it need to be fresh/raw?

    Should I be taking colostrum at all if all dairy gives me bad acne?

    Can a Leaky Gut cause heart palpitations?

  70. How do you know when your leaky gut has been healed?

  71. Dr. K, is pernicious anemia the result of a leaky gut? Besides your Gut RX, is there anything else that can (or should) be used as a treatment?

    • @Lab lover a B12 deficiency is a big clue to a gut issue. You need to get it fixed and hacked. Most CW docs can handle this hack

  72. Hi Dr. K, thank you for all of the great information! Do you use combination supplements like Repairvite in your practice or do you prefer to use individual ones for help in healing leaky gut? I have been researching leaky gut as it pertains to MS and this is the first reference that I have found that explains it in a way that makes sense to me for autoimmune diseases. I wish other doctors and neurologists, that I have encountered anyway, would at least be open to exploring this concept.

  73. Grammasmitty says:

    I keep reading that dairy is bad, that it spikes blood glucose, which of course is bad for insulin. Then I read that homemade yogurt (i make it from raw milk) is good because of the probiotics. Can I use my yogurt while on the leptin reset for healing leaky gut?

    Also, about eggs. I am full of inflammation (HS CRP = 4.4). I read where eggs are inflammatory, then I read that they are such a good food for the reset. Would you please clarify for me?

    • @Grammasmitty…….Dairy is bad. i have never been an advocate for it. I myself only eat raw heavy cream, Ghee, pastured butter and pastured eggs. Everything else I am out of for dairy. I do not buy the WAP methods for dairy but I respect their position and think they have some great minds who work for them.

  74. Grammasmitty says:

    Also, am I correct that as long as I am overweight, I need to eat as though I still have a leaky gut?

    • @Grammasmitty…….on the whole its true…….but I have to say you can be over weight or even skinny fat and not have a leaky gut because the disease processes are on a continuum. As one trends to healthy the gut remarkably improves. As one trends to the SAD or a vegan diet it goes the other way. This is like a lutron light switch vs a regular light switch…….with a lutron switch it gradually gets light or dark depending upon which buttons you push over a time interval…….as opposed to all on or off. People generally think in concrete all on or off and they should not when it comes to health.

  75. Grammasmitty says:

    Thank you!

    So if I just concentrate on strict paleo, as much omega 3 as I can get, some vinegar free fermented foods and good supplements, any leaky gut issues I have are going to heal?

  76. "So we must be mindful that low carb does not always mean optimal."

    The people here need you like crazy today: http://www.cheeseslave.com/why-i-ditched-low-carb

    So many people with miserable health on low carb, upped the carbs (even adding grains for some) and felt human again. There's so much wrong with them and I can't help but feel they've just put a temporary patch on some of the symptoms (and left the others unaddressed) instead of getting to the root.

  77. Is fermented cod liver oil a good source for omega 3s?

  78. I don't care much for eating fish, but there are so many different kinds of omega 3 supplements on the market – some with added O6s and 9s and other ingredients, that it's difficult to know what to take. Can you please recommend a good source or what guidelines should be followed when selecting one? Thanks!

    • @Deb Supplements never equal food. Destroy that myth. You need to get real food sources of high quality omega sixes. If you can not adapt than I would tell you you wont sniff optimal. Find some seafood that you like and begin to pound it.

  79. Dr. K – I do think I have some digestive issues going on and probably leaky gut though I've had two stool tests and neither show any major problems – just a lack of good flora.

    I'm trying to follow the leaky gut protocol as best I can, but can't do all parts for the following reasons. Any alternatives or can I still heal without these additions??

    – Coconut oil causes severe constipation (I'm already dealing with it mildly, but it gets much worse with just 1/2 tsp CO)

    – Can't tolerate bone broths due to histamine reactions. I'm going to try L-Glutamine powder soon.

    – Can't do high vitamin C supplementation due to oxalate issues

    – Don't tolerate oral Magnesium for some reason. Not sure why, but it gives me black stools and causes kidney pain.

    So, any chance I can still heal without incorporating the above or do you have any alternatives to try? Any other suggestions for testing to figure out gut problems if a stool test comes back ok? Thanks so much Dr. K!

  80. Thank you so much for donating your time trying to help us. I'm amazed at what the primal/paleo way of eating has done for my health. I'm about to start following the leaky gut prescription and have a question.

    In comment #45 to Michelle you wrote no dairy. Does this include grass fed butter? I know butter is high in K2 so I'm reluctant to give it up, but if it will interfere with healing my gut I will definitely give it up.

    • @Johnlyn If you have AI disease……no dairy period. If you do not the only dairy I am ok with initially is pastured butter raw cream and eggs. If pastured butter is an issue then move to Ghee.

  81. If you are unaware of having an AI disease and continue to consume dairy will it just slow the reset or prevent it? I have yet to be officially diagnosed with an AI disorder, but I'm concerned I may have recently developed Raynaud's.

    I eat a lot of pastured butter and homemade goat milk yogurt.

  82. Thanks!

    One more question (I've searched several posts, but can't find the answer).

    Recently I started taking N-acetyl-cysteine and vitamin C. My eyes get incredibly dry when I take these two supplements. Is this a normal side effect?

    • @johnlyn No its not but you maybe suffering from an AI like xero opthalmia and not know it. When one adds these and glutathione production spikes it can lead to the opposite clinical effect as you adapt to the dose.

  83. Interesting…goes hand in hand with what I've been reading about my night vision issues and my creaky knees when I walk up the stairs.

    I bought some liver today for the first time so I'm hoping that will help.

    Thanks again!

  84. Can the colostrum be bovine or must it be banked human?

  85. Has anyone found a good source of colostrum? I'd like to try it, but all I can find is bovine. It's good, grass-fed colostrum, but if Dr. K is saying we need banked human – I have no idea where to get it.

    Also, Dr. K – you say to avoid dairy for AI issues. You're saying colostrum is ok for AI though, right?

  86. http://scdlifestyle.com/2011/08/how-to-tell-if-yo

    Great podcast on SIBO/leaky gut issues for you all to listen to.

  87. Thanks Dr. K. I know you said to eliminate eggs and dairy, but what about raw pastured egg yolks? They provide so much nutrition and I thought they digest very easily.

    • @Jean I think the yolks are a better choice than the whites but you must see how you do with them…….you need to consider a F/U lactulose 3 hr breath test when you embark on that kind of testing to make sure you are doing the correct thing. Go to SIBOINO.org to find out more.

  88. Hi Jack. I was rereading this post and picked up a few more tips to try to clear up my husband's psoriasis. He's been off all dairy, eggs, grains, nightshades and alcohol for about 3 weeks now. (Minimal pastured butter occasionally has been his only cheat) Vit D3 level was 41. D2 <4. Supplementing 4000IU D3 daily, Fish oil 2 gm daily, Milk Thistle 175 mg daily, Turmeric and Bromelain 450mg/150mg, just changed to Mag Glycinate 400 mg, and Probiotics. Also eating something bone broth based a few times per week and getting in coconut oil daily.

    He was treating the lesions with jojoba oil or coconut oil. Saw only a small improvement (less scales, still red and still quite itchy) in the past 3-4 weeks. He just went back to a new dermatologist who was supportive of his diet etc. but she Rx'd a 10 day course of Keflex, Taclonex ointment and Olux foam. You're fb post today of, "Dont just treat the symptom of things…….reach for the cause." really struck a chord. I know dermatology is not your specialty but I KNOW you know FAR more that can help him treat CAUSE. Any other advice/links to offer? Thanks!!

    Janel

    • D level 41 is really low. You need to consider doing something about that like stat. 4K of D3? I am healthy as an ox andI take 10K a day. My ten yr old daughter takes 10K a day with 5 mgs of K2 and she eats a strict paleo template…….go get your spouse an artificial sunlight bulb too…….he needs it. Keflex? Can you say you just made the gut leakier than Obama's budget? If it struck a chord…….it certainly did not register with that advice he got. Read my Vitamin D post…….it has a section in it all about your hubby's issues. You need to step up your personal game because your doc is in the paleolithic time zone on advice. Read the last 5 comments in that blog too……..eye opening studies.

  89. Sweetners? My DD can't eat most of the alcohol sugars and isn't too fond of stevia. I have been having her stay away from sugar and just found out that she has been using agave nectar. How about honey or maple syrup? I am talking about maybe 2T a day in her yogurt.

    Thanks!

  90. I kicked dairy & gluten 100% 1/1/12. On 2/1 I started GAPS again, and the autoimmune protocol. After nearly a month of 4C broth, gobs of CO, insane amounts of organs, etc., my leptin resistance signs are nearly gone, but there has been no change in leaky gut signs. (E.g., there has been zero decrease in bloating despite removing all dairy & nightshades & eggs & produce except for non-starchy veggies.) I plan to keep on keepin' on, and move to the IV glutathione, but first I wanted to ask:

    – My teeth have started to hurt some. This always happens when I remove pastured eggs & butter, but I held it off a lot longer this time with daily raw liver, fish roe, & fCLO. Still, it has begun. Will ghee or butter oil compromise my goals? Normally, I'd just test and see, but since I've seen no decrease in leaky gut signs, I don't know what I'd look for! (As a reminder, my hsCRP, HDL, vit D, etc., are good, but fecal antigliadin sIgA & ANAs are just over the "positive" mark.)

    • @MomaGrok i think Ghee and butter oil rock to replace the K2. If its just over I think its a problem……..considering your history. I think IV glutathione…..is a good option but you need to really cut all starches, rice, and grains. Beware of cross contamination. It is the easiest way to get a constant reaction. BBQ grills and pots and pans etc…..

  91. Thanks for your great information. Is bone broth equivelent to glutamine? glutamine causing nausea in 18 year old young man with fibromyalgia.

  92. Jack, I just don't know what to do anymore. My DD, who is 15, has eliminated fruit, except strawberries and raspberries, all grains/legumes, all dairy, except FF GY, all nightshades, eggs, sugars and artificial sugars. She does have one minute muffin a week as her only "treat". She has coconut oil every day as her only oil. She is taking Align, Dycyclomine and Omeprizole.

    This week has been bad and is getting worse. Her stomach aches are getting more frequent again and more painful. To the point where she is couch bound crying. Today on the way to school she told me that her kidneys are hurting. We have been to the GI- 3 ultrasounds of all organs, endoscopy of stomach/esophagus lining, stool test, allergy testing, sugar allergy testing. I just don't know what to do to help her.

    • @April you need to get her to a doc who can fully treat her gut……probiotics, IV glutathione, even consideration of a fecal transplant should not be eliminated if all else fails. There are trials being done on fecal transplantation for leaky gut. In fact fecal transplantation is now the treatment of choice in humans with refractory c -dif diarrhea! Many people and docs do not even know that. Do not give up

  93. I guess I don't know what to look for? Who do I take her to? It breaks my heart to see her in such agony.

    • @April go to a functional medicine practitioner to get this done who specializes in this. You can go to their organizations site to get info.

  94. Thank you!

  95. Thanks for the info. Already increased Vit D to 10000iu and started your leaky gut Rx supplements. Any MD friends from your residency days in Nola that keep up with your blog? Would LOVE to find a doc here that has a clue. Have not met one yet that is even remotely familiar with or knowledgeable of paleo. Frustrating…

  96. I am considering IV glutathione for my leaky gut. How often per week and how long do you recommend it?

    Thank you.

  97. hi Dr Kruse, I`ve been following the leaky gut rx since October no grains, no legumes, no nightshades, precious little fruit and things are mostly better. but I keep running in cross contamination with gluten. I`m the only gluten intolerant in the house and while we are slowly getting everyone into primal eating there are instances of little bits of contamination that wreak havoc with me. even the use of an improperly cleaned utensil causes 2-5lbs of inflammation overnight, constipation, aches etc. beyond the obvious of not having any gluten is there anything you can suggest that will help speed healing?

    things were good for 8 weeks but 2x this week I`ve had this problem and I am just about in tears. it takes me 5 days to rid my body of the inflammation by doing 80% of my food from coconut oil but I can only do that 2 days in a row (I think Quelson is doing something like this?)

    I follow your thread at MDA and was thinking about the Seacure powder that Hazyjane mentioned, would that be worth a try? I`m doing 2800 mg NAC, 2000 NAG, tumeric and MSM and added in CT this week (hubby thinks I am nuts :) )

    any suggestions would be greatly appreciated

    • @ColleenM all are good but cold is what will help most. You need to think about the protocol and really dive into my cold thermogenesis series. It is a critical piece

  98. Thanks Dr K. cold bath here I come (again)

  99. berger6696 says:

    Or does this strengthen the case for viral infection, as you and others suggested?

  100. Does high igA mean you have leaky gut?

  101. berger6696 says:

    Hi Jack,

    Just listened to your Paleo Summit webcast. Well Done! Anyway, I asked a question a few (5) months ago on PaleoHacks to which you responded, thinking I had leaky gut (and Apoe4, which I am 2/4 )http://paleohacks.com/questions/68443/had-a-heart-attack-need-suggestions#axzz1naRUvb1Q. Well I began doing some of the things suggested here to heal the gut and about a month ago developed a severe lactose intolerance, which has still not gone away. Do you think this is a problem or could it be a sign the my gut is finally healing?

  102. Hi Dr. Kruse,

    Interesting stuff; I believe I have a leaky gut. My question is about coconut oil being the main fat source until the situation is reversed. Does this including the fat I'm getting from animal sources? Meaning, should I be eating lower fat meats and compensating with liberal amounts of coconut oil, or should coconut oil be the main supplemental fat I use to cook with, etc? Thanks.

  103. Thank you Doctor. And one more question, if you don't mind. Would a dairy based or rice based probiotic be better as a second option to a natural one?

  104. Hello Dr. Kruse,

    Was linked over here from 'crohnsdad.com'. I am wondering if you could expand on or point me to a deeper discussion about how exercise can affect the gut lining.

    Thanks in advance, MGH

    • @MGH Its quite simple……if you have Crohns' and you eat a diet that cause gut inflammation at all you are depleting the telomere in the GI cells and they age faster and work less well. Exercise induces higher levels of cortisol which is liek throwing more logs on the fire for inflammation to burn…….you need cold thermogenesis to stop the process and you need a strict ketogenic paleo diet to stop this process. Moreover the more inflammation that passes into the portal circulation, oxidizes your plasma and this means your HS CRP rises……your LDL rises, your HDL falls and you develop neolithic diseases faster and your telomeres really get short…….and your organ functions decline faster…….and you spend more time in the doctors office and your die sooner. That is how it goes.

  105. Definitely a believer in everything you mention. Just wondering how much exercise I can sustain and be healthy, or if there are rules to follow regarding exercise (time before or after meals, etc.). I can't believe it would be recommended to cut out exercise absolutely?

  106. What about vagal stimulation in the form of gargling water, gagging,and humming. I understand all of these to have pronto medullary effects. Oh and also vestibular activation such as head rotation or caloric stimulation

    • @Chase I have not talked about head submerging and wont……that has some other issues in play. Stick to what I have told you.

  107. Get Healthy says:

    Jack — Thank you for creating & maintaining such an informative website! I have Celiac disease, Hashimoto's, and a couple other autoimmune diseases. I've been gluten free for 6 months now, and also been on a low oxalates diet for 3 months. I have a leaky gut and started the low oxalates diet to reverse my lichen sclerosus – which is working!!! My question is a low oxalates diet is different than the suggested "leaky gut prescription". My thinking was to stay on the low oxalates diet until the LS clears up, and then switch over to a leaky guy prescription/diet. What's your opinion or suggestions? It's difficult to find a doctor that understands all of this.. And challenging to maintain 3 restrictive diets all at once. Thank you in advance.

    • @Get healthy its pretty comparable……..A functional medicine doc that specializes in leaky gut. Functionalmedicine.org maybe? On the Paleo Summit they had a Dr Siebecker. Her talk was spot on to me.

  108. I have low testosterone and on androgel. I looking for the underlying casuse vs lifelong TRT.

    A naturopathic doctor diagnosed me with candida dysbiosis in my gut and leaky gut. He suspects that could be connected with my low hormone issue.

    I had ENT infections all the time as a kid and sore throats as an adult. Tonsils and/or adenoids removed as a child.

    But apparently the tonsils either grew back or were only partially removed because they are chronically inflamed and enormous. The tounge/back of throat is always white and I often get sore throats.

    Couple Q's:

    1) My CRP is only .1 but clearly I have underlying chronic inflamation as evident by my throat and tounge. Any tests/supplements you would recommend?

    2) Traditional medicine doesn't seem to see gut dysbiosis and leaky gut as a clinical issue. Any thoughts on using combination nystatin/diflucan vs "natural" supplements to treat the candida?

    I also gather you would recommend doing leaky gut rx before leptin rx so we can absorb nutrients during leptin Rx.

    • @Jedeye if you have a leaky gut it must be dealt with aggressively. I think seeing a functional medicine doc/practitioner makes sense.

  109. Mamagrok says:

    Since removing FODMAPs, my bloating has gone down a good bit. Since starting CT, my belly & thigh fat have started receding. I lost 6lb over two weeks. So far, so good, right?!

    Yesterday, I GAINED 6lb in one day. Never had anything like that happen before. Calf, thigh, wrist measurements up, although mostly down today (most of the weight is still there, though). I think it's either the trace amount of cayenne in my sausage (nightshade) or the fact that I ran out of HCl in the morning and didn't take any the rest of the day.

    Which is more likely to cause such a crazy amount of all-over … water retention? This is clearly linked to my gut. I'm buying more HCl today!!

  110. Bridgette says:

    Dr. Kruse – Can you give me more info on how to use my VAP results to determine if I have a leaky gut? I thought for sure I did previously, but I was never officially diagnosed and I seem to be doing much better.

    I'm trying to figure out if I need to follow this rx or not.

  111. Hi Dr. Kruse,
    I have celiac disease and terrible inflammation lately with bloating and skin rashes. I have been grain free for a year and mostly paleo with the addition of fermented milk products. My biggest complaint is my inability to lose weight. I have been on armour thyroid for 10 years and recently switched to t3, but haven’t noticed any change. My doctor most recently found candida in my gut which I will begin cleansing soon. My leptin level was 14 six months ago and is now down to 10. Would the leptin reset be a good idea for me? I’m also wondering what you think of taking my sustained release t3 at night instead of in the morning?

    • @melissa I have no earthly idea why your eating any dairy period fermented or not…….it will cause inflmamtion. Bad move and likely why your failing. Moreover, this is why you have candida and a leaky gut. You need a strict I paleo template, the leaky gut Rx, with the Leptin Rx and CT protocol……..this is one of the hardest things to reverse but those things all will help you. go to MDA monster thread and ask all the girls there if what I told them all 8 months ago about this same situation is true or not……..they are all fixing them selves with what I just suggested to you.

  112. That is so helpful, thank you. Sounds like I have a fun challenge ahead of me!

  113. Hi Jack,

    Thanks for posting this. I’ve had both acne and IBS issues for around 15 years. Recently, I’ve switched to a low-carb, paleo like diet, though I certainly cheat a fair amount.

    My IBS has gone from about an 8/10 to a 5/10, but my acne is still as bad as ever.

    A few questions:

    1. I know you are generally against dairy. How bad is whey protein? I’m a pretty skinny guy, and have been trying to eat more and gain muscle. I’m finding it difficult to get enough calories without using whey.

    2. Assuming I’ve cut out 90% of wheat, sugar, and carbs, what foods would you try to test removing next? Dairy? Nuts? I don’t eat much dairy outside of whey and cheese, but I do eat a ton of almonds to keep my calorie counts up.

    Any other tips for addressing skin issues effectively?

    Thanks,
    N

    • @Neil Dairy is a no no……for acne whey should also be a no no. You must cut out 100% of wheat, dairy, grains and legumes to have a shot at clearing the acne…….90% wont cut it.

  114. Bridgette says:

    Dr. Kruse,

    1. I don’t mean to play devil’s advocate, really, just trying to make sense of this. I struggled for years to raise my vitamin D, ferritin and B12 levels even with supplementation. After starting to consume organic, grass fed raw butter and homemade SCD goat yogurt my levels finally increased. I believe I have leaky gut and have been off the dairy now for 4 weeks, but I worry that perhaps the dairy was in fact good for me. Thoughts on this?

    2. As mentioned in a previous post, my hormones are all low. I got Thierry’s book yesterday and devoured it in 2 hours. This seems to indicate I’d be adding in BHRT for pretty much everything! True or is it best to go back to the “top of the chain” and look at just adding in pregnenolone?

    3. I will be seeing a new hormonal/anti-aging doctor shortly. Do you do consults with other doctors or just discuss your protocol with them if they are willing/interested?

    Thanks so much!

    • @Bridgette 1. no thoughts on it……I know dairy is no good for us as a species. You have to conquer your own beliefs I can not do that for you.
      2.If your hormones are all low, then why dont you question what you asked in question one? Makes too much sense? You need to explain to yourself how did all your hormones get trashed in the first place……..short answer……your doing a lot wrong. Therefore you need to begin to question everything…….sound familiar. You need to go to the MDA site and meet my friends. You need to wake up to this reality. I cant fix that thinking.
      3. Other docs are not so open to discussing this with other docs unless it is a meeting and they know the guy doing the talking knows more than they do……This is the modern doctor paradox. Crazy but it is in fact how my profession acts.

  115. @ bridgette I do have leaky gut, I have known this for a long time, I guess I was very fortunate, to find dr Langer about 20yrs ago. He was a head of his time I guess, that being said he told me ,I must heal my gut Cause any supplements I take where of limited value, the first thing he took me off is DAIRY.

    It took along time for me to notice anything but dairy was the key ,after awhile I went back to SAD diet and now have the same problems as before ,My CFS has come back also my yeast over growth has returned(Dr Langer found that too he said they do not have a scale for how bad my gut was) bridgette you have to understand your intestines right now is a sieve, your body is going to attack anything that LEAKs out as a enemy using up precious resources your body NEEDS to heal its self, Sooo the more you cut the junk dairy out of your life the better your body can heal.

    This will take time it all comes down to the choices you make, I made some really poor ones I am paying for it.I am so glad to find Dr kruse because he GETS it ,and has put me on the right track again.

    Please do not go from DR to DR looking for a answer you want to hear sometimes it is right under your nose.

    Happy healing (I am going to get off my soap box now)

  116. Bridgette says:

    I was obviously at least starting to do something right since my vitamin D, B12 and ferritin levels finally shot up after years. I have no doubt the hormone levels have been trashed for years. I’m trying to isolate what WAS going right more recently so I make sure to continue it.

  117. Yes that is wonderful, spend as much time outside to get that good sunshine, it is good stuff.

    I am trying CT (cold therapy) it has helped with my hormones.

    I hope things go well with you the MDA website is a gold mine go there too.I must leave bye!

  118. @Melissa – it’s the dairy. I just reviewed two years’ worth of my food journals, and I cannot believe I didn’t notice it before – every time I saw a big weight and/or bloating drop, it was b/c I had taken out dairy for a while. Every time I added it back in, I stalled. Somehow I missed it over and over again, and constantly said, “Well, when I add it back, I see no changes,” but the journal review spelled it all out.

    Since removing the dairy for good in January, my gut symptoms have slowly, but absolutely surely, gotten better, for the first time since they went downhill years ago. (BTW, the dairy I was using was 24hr yogurt made at home from pastured raw milk & grassfed butter.)

    Heal the gut, heal the body – thyroid & adrenals follow.

  119. Mamagrok says:

    @Bridgette – it’s probably the K2 benefiting you. I need K2 bad; every time I go off dairy my teeth hurt. But dairy isn’t the only source. I know I need to get off dairy, so I just made up my mind to find a way I could eat lots of the other sources – pastured egg yolks (dang, I’m off eggs, too, for autoimmune reasons), pastured liver, fermented cod liver oil, fish eggs.

    It’s working – my teeth aren’t hurting even though I’m off dairy right now. Every morning I hold my breath and swallow an ounce of liver (I do it raw) that I’ve chopped up somewhat. I don’t taste it at all. Every evening, I have 1/2t or so of Blue Ice fCLO. Every Friday (when I don’t eat meat), I hold my breath and have a tablespoon of fish eggs (can’t taste anything but the salt).

    I never thought I could tolerate these foods, but I’m determined, so I found a way.

    In your shoes, there’s no doubt I’d do K2 in non-dairy foods (a LOT), do the leptin reset if it applies, do the leaky gut RX (so someday down the road you can tolerate that dairy again), supplement pregnenolone (most likely), do the CT, do the circadian rhythm things (like sleep in darkness, lights down at night, etc.) Dr. K mentions for cortisol, and do the CT. Then wait for the rest to correct itself – it will. There are a lot of stories at MDA where exactly that has happened!

  120. Bridgette says:

    Thanks MamaGrok. This is exactly the kind of info I was looking for. I knew there must be something I was getting out of the dairy that I needed, but just wasn’t sure exactly what it was and how else to get it.

    I do eat a ton of liver and have recently started salmon roe. Believe it or not, I love both of them, so yea – I’m a bit weird! I’ve also been doing the reset, the CT, using the blue-light blocking glasses, sleeping in darkness, etc and following the leaky gut rx which is why I did cut out dairy for the last 4 weeks.

    Your post was extremely helpful and exactly what I was looking for. Thank you.

    BTW – any suggestions on where I can get more info about supplementing with pregnenolone? Thanks again!

  121. Mamagrok says:

    @Neil – with any kind of gut thing, the dairy & wheat have got to go 100%, ESPECIALLY the wheat. I was fooling myself into thinking I could have a tiny bit every other week or so. Then I got my test results back – severe fat malabsorption, positive antigliadin sIgA, positive ANA (autoimmune disease markers) … YIKES!

    Going 100% has made a huge difference in my health & especially my gut symptoms. Just do it!

    @DrK: credit to the teacher!

  122. @ Bridgette, I second what Mamagrok says about K2, dairy and liver. I craved dairy ALL the time (and believed I felt better when I ate it… though it was a neolithic feeling pattern). Now I eat high quality liverwurst every day and the dairy cravings are gone and the results are healing the gut. I am not helpful when it comes to particular things like pregnenolone and other specifics (though the MDA thread has experts there), but I can tell you that my experience is that when you tinker with one bit, others get effected (and sometimes out of whack). For me what is working is following the Leaky Gut RX faithfully, eating a seasonal keto paleo diet faithfully and doing CT faithfully. And then trust in the process… don’t engage your old brain to build your new one!

  123. Thanks for the inspiration mamagrok! This has been a long journey for me and I feel like I’m finally getting down to the core issues. Is dripped whey from raw milk going to be a problem? I use that whey to lacto-ferment my vegetables and mayo.

  124. Mama2Groklets says:

    @ Melissa- I prefer to ferment using Celtic sea salt or a probiotic powder starter.

  125. Mamagrok says:

    Ditto – Nourishing Traditions (sounds like you’re using that) gives two options for most ferments. Either use 1T salt & 1/4C whey per quart of veggies, or 2T salt. I do the latter now. Unfortunately, I don’t know what that means for mayonnaise. I LOVED my NT mayonnaise! I even switched to baconnaise, but still would need the whey to make it ferments … alas!

    At any rate, I’m just staying away from dairy. I think even butter affects me, even ghee (no whey, casein, or lactose), so definitely no whey for me, for now. :(

  126. Dr. Kruse,

    Are you familiar with oxalate issues? I ask because I suffer from them and medical researcher Susan Owens who specializes in oxalate issues says vitamin C is converted to oxalate in the body, so one should not have it in excess (> 150 g/day) when they have oxalate problems.

    How necessary is the NAC/Vit C combo for treating leaky gut? Are there any substitutes for those with oxalate issues?

  127. Thank you. I think there is a local research clinic that offers IV glutathione. I’ll check into it. Are there any side effects that you’re aware of? I seem to be sensitive to many supplements, even those without nasty fillers.

  128. My new obsession:

    http://www.shop.cocokefir.com/Tulas-CocoYo-CYO.htm

    “hCocoYoâ„¢ is a powerful live probiotic coconut yogurt-like food made from cultured raw young coconut meat and other natural ingredients. It is dairy and gluten free, soy free, naturally low in sugar and contains over 80 billion cfu live probiotics per 4oz. serving!

    Ingredients: Raw young coconut meat, raw young coconut water, alcohol free vanilla, probiotic cultures, stevia (0.4% by volume).”

    Freakin’ delicious…and only 3g of carbs in 1/4 c. Found it today in a natural food store in manhattan, and now I’m hooked (especially since I’m basically cutting out coconut oil/manna for CT.)

    Yum!! My gut is happy today.

    • Krusing_to_Optimal_in_CA says:

      I dont see any problems in those ingredients based on what I’ve read all over this blog.  but.  Do you know the ingredients in the cocokefir also listed on their website?  Also the only thing I am not sure about is the sweet taste.  I *am* obese so trying to stay away from sweet-tasting things that will be insulemic for me.

  129. Is this CocoYo ok for leaky gut?!?!

  130. I sincerely hope so…

  131. Doc – thoughts on the cocoyo product posted above?

  132. Dr. Kruse, I’ve been doing your Leaky Gut Rx and your Leptin Reset since January. It’s coming along but I noticed I am peeing a lot during the day. Also, after going to bed, in the first hour, I usually have to get up 1-3x to pee and then 1x in the night. Does this mean my body is getting rid of toxins or is something else going on? I thought you mentioned before that this has something do with the liver not being able to keep up…? Thank you

  133. drjackebner says:

    lindsey, why did you cut out CO for CT?

  134. @drjackebner: for a few reasons, as highlighted by Dr. Kruse.

    1) It is not in season, and therefore not optimal to consume until the weather is warmer.

    One of Dr. Kruse’s responses in reference to this:

    “@Sharpman coconut fine all the time except winter.”

    2) MCTs, like coconut oil, do not aid in cell fluidity. As a result, they’re not great to use while doing CT.

    Dr. Kruse writes re: MCTs:

    “Eating MCT, in winter is probably not the best choice for a cold adapted mammal, because they do not help fluidity of cell membranes. This is why we see so many problems in the literature with saturated fats in humans. The results did not make sense and researchers attributed them to disease generation. They did not make sense because they were studying animals at different stages of their mammalian biochemistry. These fats also can make a cold adapted mammal gain weight when eaten off season because of this mismatch. This is a reverse analogy to the one I used in the Paleo Summit with the banana in Canada. If you want to see proof of this fat reversal ask any person who uses the HCG diet how coconut oil or palm oil work for them on protocol. In short it sucks. Why? those oils protect warm adapted mammals eating tons of carbs. This is why CO and Palm oil are tropical oils and not found in our polar regions. When you ask a human who uses HCG for dieting, you will find they do not do well with MCT’s during their HCG protocol use for this reason. In winter, mammals prefer animal fats like ghee, tallow, lard, bacon grease, and pastured butter as the best choices. This is wired into our brain by the CD 36 receptor and the floor of the fourth ventricle in humans too. Seafood is always a good choice no matter what season we are in.”

    3) I am not obese (though I could stand to lose 10-15 lbs), so it is not necessary, or even particularly helpful, if I consume CO for my primary fat source. If I WERE obese, the benefits of eating the CO might possibly trump the former two reasons…but I’m not sure about that. You’d have to ask Dr. Kruse. Also, I know it’s key in the leaky gut prescription, but there are plenty of other good fats and ways to eat for the leaky gut without inhibiting cell fluidity while doing CT.

    Here are a couple comments Dr. Kruse has made in his blog re: CO with CT:

    “@Adam your doing it right…..back off coconut oil unless your obese and use animal fats.”

    “@Heather if your cold adapting I would limit MCT and CO…..use animal fats and lots of seafood and nuts in your paleo template……you will notice that your appetite gets crushed as you do this.”

    Soo, yeah, haha. Hope that answers your question! I think you just have to figure out if using coconut oil for your leaky gut is right for you while doing CT and considering these other factors.

  135. drjackebner says:

    Lindsey, Jack said, “Eating MCT, in winter is probably not the best choice for a cold adapted mammal” Are you already cold adapted?

    Thank you for your dialog about this…VERY HELPFUL!

  136. No worries! I don’t think I’m cold adapted yet, but I’ve been working on it for a couple of weeks now with cold baths at 50-55 degrees for 30-45 minutes. I’ve done them 3 times a week for the last couple of weeks, and on the days that I don’t do them, I try to spot ice for a few hours. I started with the face dunks and then went from there.

    I haven’t really noticed much of a physical difference yet with regard to my tolerance for cold/strength/muscle tone/etc as some other people on this site have noted – but I have noticed my sleep and sense of well-being are better, which has been HUGE for me. I don’t know if this is because of the reset (been doing that for about a month), or because of CT, or both – but I’m excited to see what happens, either way. I HAVE gained 4 pounds since going on the reset, but I’ve read that gaining a few pounds at first is normal. (Probably won’t get too worried about that unless it continues to go up significantly in the next couple weeks.)

  137. Drjackebner says:

    Jack, So, for us with a leaky gut and not cold adapted, CO is still
    therapeutic?

    BTW, love you new format here.

  138. Get Healthy says:

    I’ve been on Paleo diet now for 3 weeks, but having some reactions to adding Kefir into my diet. Kefir gives me alot of gurling stomach noises and some discomfort. I know it’s important to add to my current diet to heal my leaky gut. It was suggested to start slow on Kefir and only add a small amount into my diet until my stomach can handle it, and increase more each day. What do you agree with this thinking? Appreciate your thoughts.

    • @Get healthy Kefir for me is non paleo……..I don’t do dairy. Only dairy I eat…..is eggs (not dairy really) raw cream, and pastured butter. Sometimes in winter I will cook with raw mild dairy cheese from France. That is it.

  139. Get Healthy says:

    Okay thanks. I was following your info “how to treat leaky gut” from this post “Use fermented carbohydrates in natural foods…” which included adding Kefir. Sounds like I should nix that.. Conflicting info or did I misunderstand? Planning to start bone broth to see if that helps?

    • @Get healthy Some people will use kefir……to me there are a lot better options…….dairy is just sub standard food choice for humans. We can get by with it……but it is not the top of the list and the name of my site is optimal life……not sub optimal life.

  140. Get Healthy says:

    Yes I heard you. I just want to heal my leaky gut. I have no problem removing Kefir. Thought it would help it, but clearly my stomach is not tolerating it. I’ll up my probiotics with vitamin supp then. Thxs.

  141. Hi Dr. Kruse, Thanks for all of your good information. How does one go about finding a doctor who is helpful with all of this? I have premature ovarian dysfunction and my ANA has tested high in the past (320) but all of my other tests were fine (or so the doctor said). But it has been very very hard to find a doctor who can help me get my hormones straight or who even believes in something like Adrenal Fatigue. I thought I found one who was touted in the media as being a great combo of traditional and alternative medicine. After spending thousands of dollars with him(of course he didn’t take insurance), he proceeded to tell me how I was so fertile because my estradiol was high (over 300)and my FSH was low (below 10)! WTH? A simple Google search will tell you that an estradiol level that high is bad and masks a high FSH. I live in Los Angeles if you have any good recommendations. Thanks.

  142. Mamagrok says:

    I know you love KeVita, and I found one today I can love – the coconut flavor (the fruity ones get my cravings going). Coconut flavor has just 10 calories per bottle, none from sweeteners, so I feel more comfortable about it not conflicting with my no-fruit goals. Anyway … I drank two whole bottles today, so…

    Questions: Any possibility this is a bad idea for someone with a binge history? And can I drink this between meals, or is it too many calories and will get insulin going?

    • @Mamagrok I drink mine at meal times. And no I dont think this is a big risk. My favorite is the coconut plain. It is great for the gut.

  143. Dr kruse what do you think about intramuscular glutathione vs IV?

  144. Jack, Please can you reference any information you may have found relating leaky gut to OCD anxiety. Would be very much appreciated. Regards and thanks. Lisa

    • @Lisa I dont see a lot of OCD but I do have a personal friend who has this to a degree who just agreed to CTing so I let you know how it goes for him over time. He just began Monday

  145. Many thanks Jack. I developed it after my third child out of nowhere – happy life, no financial worries etc. I’m convinced it’s leaky gut and toxins etc. But cutting out the carbs is making it worse but could just be die-off – I’m trying to find someone who can advise. I know it’s serotonin deficiency as anti-Ds make it lots less to disappear but don’t want this for life. Now off a/ds and has returned – I am determined to find a non-medicated solution but unless you live with OCD it’s extremely hard to express just how difficult it is. Not just a case of “will power” or not desperate enough to change as may be the case with many clients you see. I want to know how to make serotonin without carbs basically! I’ll appreciate any update and many thanks again you have a very positive evergy.
    Kindest regards, Lisa

    • @Lisa Lots of serotonin in some proteins that are common in the paleolithic diet. Cordain’s work show that.

  146. Melissa says:

    Hi Dr. Kruse,
    I wrote about about a month ago and have been following your advice to do the leptin reset with leaky gut rx and paleo template. I am still very bloated with rashes. I found I react to eggs, nuts and coconut so I’ve been off those for weeks. I am only eating veggies, bone broth and meats and yet the scale is not budging and I am still inflammed and I’m frustrated. My doctor recommended a metagenics medical food fast using a product called ultra clear sustain for leaky gut. Do you have any thoughts on this?

    • @Melissa I agree with the testing but do not do a thing else until the result are known. Make sure you get test not only for absorption issues but also to see if you have a real leaky gut with the sugar alcohol serum test. Usually you will eat a non absorbable sugar like mannitol or sorbitol and they will look for it in you blood serum. If they find it in high enough quantities they knwo your brush border is a problem.

  147. Jack just for you to file away somewhere in your brain if you ever come to reasearch OCD – I can not tolerate Glutumate in GAPS broths – sends OCD thoughts through roof and takes days to recover. Because it’s an excitory neurotransmitter? I have tested this a few times with same results and it’s almost immediate – which makes healing gut a harder job. Re serotonin in protein – I know tryptophan is high in turkey, meats, chicken eggs etc but the other amino acids in these I thought won the battle to cross the brain blood barrier. To my amateur research only the tryptophan produced from food crosses the BBB and when taken just as protein it’s a loosing battle. Only 2% of body’s serotnonin stored in brain – the 90% in gut doesn’t get used in brain functions as can not cross BBB. I believe you have to absorb the tryptophan from meats etc first with a complex carbohydrate – all not allowed on GAPS and SCD and paleo. I will try B6 as it helps convert the tryptophan etc. Only mentioning all of this as I know you said you have a personal friend who has OCD and it may be of some assistance? Again, I’m just trying to piece it all together on we-based research and personal experience so not scientific. Have seen 5 MDs with holistic leanings and naturopaths and none have any experience – all very kind and talk about leaky gut but none with ideas beyond using GAPS etc. Kind regards,

    • @Lisa his OCD is improving dramatically…..but he is using a ketoversion of the diet and I have made him a special batch recipe of the broth…….its a bit different. His real problem seemed to stem from processed carbs and artificial sweeteners.

  148. DrJack
    Am suffring from severe constipation bloating and cronic zystic acne I been to a hand full of doctors they can’t help have done hundreds of test all they see is gas reflux till I tried doing some research online and have found out I have leaky gutt..my. Acne is so sever that my self confidence is gone ..I really need your help

    • @vivian its all right here. Eat a paleo diet and follow this blog. Its not that hard to do. Buy Robb Wolf’s book called The Paleo Solution.

  149. Hi Dr jack…can I buy the Robb wolf book has an ebook?

    • @Vivian you can go to my site under recommended products it is there. It will take you to amazon and you can buy the kindle version. It is an awesome book.

  150. Thanks a million Dr. Jack I just bought the e book and have gone thru it and have learnt a lot already..I have spent 5 years suffring with bad acne and low self esteem serious bloating and very bad constipation have spent over 10 thousand dollars buying over the counter medication and flying around to visit doctors am so glad I found you..

  151. Toni Coleman says:

    @Lisa with OCD issues; in my home we have found that “Gaba-Plus” supp by Twinlab which has niacinamide, inositol and gaba, has helped my son quite a bit. Inositol by itself is said to help. Google OCD and Inositol. Some people use IP6 form and some the other(s?)

    • @Toni that is good but getting a neurotransmitter assay (urine or saliva) will make it less of a shot gun approach. Not all OCD cases are caused by the same NT issues. In OCD, low inositol is a very common finding however.

  152. Hi Dr K,
    I am 43 year old male, at 28 I had L3/L4 microdiscectomy due to bulging disc, last 6.5 years have had chronic wrist/hand pain (computer overuse/stress/rsi/fibromyalgia). I have been Paleo for last 18 months with dairy (ice cream, greek yoghurt, goats milk), occasional gluten free grains, no legumes. Recently had some tests and have concerns around thyroid, sex hormones, cortisol and not impacting the fibromyalgia.
    —Bad—
    Thyroid TPO Antibodies 70 (0-34) IU/mL (Hashimoto’s)
    Homocysteine 11.6 (<7)
    Cortisol Morning 72.70 (6.0-42.0) nmol/L
    Cortisol Daily Total 95.00 (11.0-76.0) nmol/L
    DHEAS/Cortisol AM Ratio 0.08 (0.20-0.60) Ratio
    Progesterone (P4) 1593.00 (<159) pmol/L
    Estradiol (E2) 40.00 (<6) pmol/L
    Estrone (E1) 50.00 (9.6-20.0) pg/mL
    Calcium 168.00 (22-97)
    Potasium 1.00 (2-24)
    Ferritin 66.00 (30-500)

    —Good/Normal—
    TSH 1.08 mU/L, Free T3 5.6 Free T4 17.0
    HSCRP 0.33 (<5)

    Degenerative disc, Fibromyalgia, Hashimoto, adrenal fatigue! Do I have progressive leaky gut related conditions? Should I be adopting a more strict autoimmune protocol + CT? Advise much appreciated as currently I can’t see the woods for the trees.

    • @Paul strong rec to cut the dairy with your history and your labs. Read the Paleo Answer. You need to heed its word.

  153. Mamagrok says:

    Alright, lost 3 more pounds since my last post on this thread, and am finally seeing a long, gradual increase in energy.

    Question du jour:

    [b]What would prevent someone from making enough HCl?[/b]

    It made sense that I was depleted after 15 years of low-fat, low-meat diet. I supp’d it last year until my body said it had enough, then decreased it till I couldn’t tolerate even a tiny bit. That was Dec ’11. That’s supposed to me that I was now making enough on my own.

    In Feb ’12 I tried it again. I was able to take gobs and not get any signs of excess. I have been taking it full strength for two months since … I cannot figure out why I got to the point of making it on my own, but then lost that again. I’ve never heard of that happening to anyone who supp’d with betaine HCl the way I did. And I can’t find any info on the mechanisms of making it.

    I know having enough stomach acid is crucial to fixing this leaky gut … I just can’t figure out what parts of the body are upstream from HCl.

    • @Mamagrok if that is true that means you should be below your goal weight is this correct?

    • @Momagrok Low HCL is usually a sign of poor methylation in the body. It can also due to a MTHFR defect that one can check on with a 23andme.com test.

  154. Mamagrok says:

    2lb away … when I’m not suddenly bloating 5lb in a day mysteriously! (usually some vegetable I didn’t know was a FODMAP)

  155. Jack: looking for a test lab that measures mannitol in the blood, but all that I found measures the mannitol in the urine. Cyrex Labs does blood measuring for

    Actomyosin IgA
    Occludin/Zonulin IgG
    Occludin/Zonulin IgA
    Occludin/Zonulin IgM
    Lipopolysaccharides (LPS) IgG
    Lipopolysaccharides (LPS) IgA
    Lipopolysaccharides (LPS) IgM

    but I don’t know what the challenge mechanism is. Can you recommend a specific lab that measures the mannitol in the blood so I can get my doc to order the test? Thanks Ron

  156. Jack: my apologies up front as I wasn’t clear in my previous question. I am looking to diagnose leaky gut, and as you stated in comment #2, mannitol or some other sugar alcohol can be used as a challenge and then measured in the blood for confirmation. Do you know of any labs that offer this test? Sorry for not being clear in the earlier question. Thanks Ron

    • Labs? You can have your doc draw it….you eat the stuff and the doc draws the blood at 30, 60, and 90 min…….

  157. Dr K,

    Is undigested food particles in stool a definite sign of leaky gut? What are options for remedying that? I’ve tried digestive enzymes in the past, but I have terrible reactions from them – usually just feel extremely irritable and angry.

    I believe it’s all vegetable fibers that I’m not digesting – leafy greens mostly and sometimes I’ll even see bits of sauerkraut that hasn’t been digested.

  158. Dennis Walla says:

    Hey all…

    About a year ago I did the “Food Safe” allergy test(Meridian Labs)thru Life Extension due to some skin problems. The results came back positive for gluten, dairy, eggs, nuts, and pineapple. At the time I wasn’t aware of “leaky gut.”

    A few months ago I read Robb Wolf and his explanations about leaky gut and why it is important to avoid “grains, dairy, and legumes.” I concluded that this is a good test for a leaky gut.

  159. Doc,

    Thanks to your Optimal Labs posting I had my ANA panel done and found I have 1:160 titer, ANA Pattern = homogeneous and speckled. Any clues what that points to and what tests I should take?

    My internist says it is probably “because of my IBS” but I think he may have it backwards and the leaky gut is causing autoimmune and IBS.

    Sounds like a clear case of leaky gut and I need to go hardcore GAPS diet huh?

    Could this autoimmune condition be the cause of my fatigue/ low testosterone (273 total free, 9% free). I am a 29 year old male.

    Any suggestions you may have are greatly appreciated. Thanks!

  160. Dr. Kruse, how exactly does the licorice root/deglycyrrhizinated licorice root help with leaky gut? I’ve read before that it is healing, but I can’t remember what it is supposed to do exactly.

    • @Yvonne I use licorice root in a tea form as the herb as they do in Chinese medicine. It reduces the amount of hydrocortisone broken down in the liver thereby increasing the liver’s endotoxin clearance in the portal circulation while decreasing the total load of the adrenal glands to produce cortisone. This helps to also protect the intestinal brush border from damage of high cortisol levels too.

  161. Dr. K ~

    You list “mercury laden foods” in with the Leaky Gut Associations. What foods specifically are you talking about here?

    • @BJK77 Processed foods like those with insidious amount so wheat. Wheat is loaded with Hg from pesticide runoff for example.

  162. Dannielle Thatcher says:

    Hi Dr. K. I had some labs done and my homeopath said that my CRP,cardio came back high and is indicative of inflammation. When I asked her where the inflammation was, she replied, “most likely in your gut because you are not absorbing minerals and nutrients.” Do I ask her to do a more specific test , even tho my guy (no pun intended) tells me that this is indeed correct. I take supplements galore, eat paleo,cut out all the crap and am still sick and hypothyroid with adrenal fatigue. BTW. my CRP, CARDIO WAS 2.8 ranges were:
    low risk. 3
    so is the GALT diet the way to go? any thoughts are always appreciated.. thanks so much

  163. Dannielle Thatcher says:

    the ranges did not stay… let me repost here…….CRP, cardio low risk 3 dont know what happened to the previous numbers.

    • @Dannielle I would tell you to send them to me via email……That does not surprise me at all. Your gut flora is the biggie in the room. I have not hit that yet in the Brain Gut series…….but it is coming very soon.

  164. Larry P. says:

    Awesome info…Best available online.

    Trying to learn about DDD and causes. I’m 32 and have a thinning L5 disc that’s been spreading pain into soft tissues & sacrum area but no obvious symptoms of leaky gut. Iridologists tell me my lymph is clogged; my colon has pockets and extra mucous; and stomach digestion is not the best. No signs of GERD, but I do have a throat clearing issue in the windpipe that began 8 years ago; I suspect PND, but maybe LRD, or yeast?

    Non-smoker/drinker/caffeiner, not overweight, but vegan since age 20. Medium carb intake levels; almost no refined/processed foods; doing water kefir, plantain tea, skin brush & rebounding on trampoline; switching to coconut oil; and will try the DGL licorice root.

    Do you have any other suggestions on the link between the thinning disc/sacrum pain and colon/lymph/liver relationship? Or how the throat clearing might tie in? Thank you!!!

  165. Sandy Koshure says:

    Helo Jack,

    Can you tell me about the best diet and suppliments that address osteoporosis, high cholesterol and hypothyroid that exist in the body at the same time? There is some controvery regarding a paleo diet and high cholesterol. Thankyou

  166. Zorica Vuletic says:

    @ Larry, I strongly think the colostrum would be a good addition to your protocol. And your doc says you don’t have leaky gut? Pfft…sounds like it to me!

    There are good sources of bovine colostrum, but my second time buying colostrum, I will look for goat colostrum.

    Good luck.

    Did you book a consult with Dr. K? Make sure you have labs before you do…otherwise it might be not worthwhile…

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  1. [...] every autoimmune disease our species faces in my humble opinion.  It is also why I think having a Leaky Gut Rx is a critical part of any physicians armamentarium to help people treat themselves at home to see if [...]

  2. [...] how about my buddy Dr. Jack Kruse?  He has lots of opinions about Leaky Gut, and he seems to be right about a lot of things.  If I had unlimited time to do all my own [...]

  3. [...] why would a human have a leaky gut by [...]

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