6

votes

How do you hack a leaky gut?

Answered on August 19, 2014
Created July 22, 2011 at 5:36 PM

I use a VAP and a GI fx test.

@WCCPAUL Here are my detailed thoughts. Jack Kronk's VAP stimulated this response

When most people get a VAP they think heart and lipid study. I do not. I use this test to assess levee 5. Most people in the paleo world associate a leaky gut with a gluten problem. I do not. The VAP test is the best test to use to assess the function of our gut and how leaky it is based upon the fuels we are feeding it now. If you really dissect your VAP you can learn a lot about what you should be eating and you should not be eating based upon your current cellular homeostasis. Most people think a diet is static. I believe a diet must be dynamically altered based upon the testing feedback we receive from our body. As most of you know I use a quarterly lab draw system to assess my own health to make dynamic changes as I see fit. So today lets talk about the uses of a VAP test.

The basis of the brain gut axis is the protective effects of great liver function. I think the real defender of ???leaky gut??? is not the brush border of the intestine but it is the liver. Why? All humans are subject to direct assault of inflammation via our intestines because it is the most common way the environment reacts with our body. This is also why the immune system is ready for defense right behind the brush border. We already know that diseases like celiac destroy this first line immunity. Well, a good liver will protect a leaky gut and the brain. Most endotoxins gain access to our portal circulation but they rarely ever get to our general circulation to cause the real damage because our liver wont allow it to occur based upon its design. In fact, endotoxin binding in the liver is increased by exercise, testosterone, estrogen and even occasional alcohol use. These things all increase our HDL particles too. A high HDL is a sign of good liver function. Remember that HDL particles actually bind inflammatory endotoxin particles to increase our immunity from oxidation from many sources. This is why a high HDL level confers general health and well being across the board. Moreover, VLDL and chylomicrons also protect us from inflammatory damage as well. This biologic process is at the seat of why we see higher cholesterol levels in the face of cellular stress or infection.

Cholesterol production is the bodies natural response to clean up this kind of mess if the brush border is overwhelmed. We also need to be mindful that any stressor can increase the permeability of the gut to endotoxic damage. This includes cortisol, malabsorption, or frank infections. The liver is backed up in its protection by the action of thyroid hormone. If your thyroid is working well, when you get a serious gut insult that causes ???leakage???, your thyroid responds by increasing production of its own hormone to allow the the upregulation of cholesterol turnover. How it does this is by acting as a co factor (thyroid hormone) with vitamin A to allow the conversion of cholesterol to pregnenlone. Remember that pregnenolone is the basic building block of all the steroid hormones that our brain uses to signal our 20 trillion cells of exactly what is going on in our body. You may begin to understand why I believe lowering your cholesterol makes zero sense from a biologic stand point. Its formation is critical to a positive response from our brain to a direct cellular stressor from many different insults.

If this system is not working properly we have a major communication breakdown between the brain and our cells. This is how I globally define LEPTIN RESISTANCE. LR does not allow the brain to understand the current situation as it exists in the periphery or in the liver. In essence, it is blind to the bodies needs. It should be clear now, thyroid hormones help regulate the and control the inflammatory processes in our bodies. When we lose control of our thyroid hormone production ( hypothyroidism by any cause) we effectively lose control of how the brain sends its message to our peripheral cells. We can no longer make steroid hormones effectively from pregnenolone. This is the basis of the pregnenolone steal syndrome. It also helps explain why we see a pandemic in low vitamin D levels and low testosterone and estrogen levels in people clinically today.

So we need to think about the thyroid some more. Its stimulatory protein is TSH and it is released from the brain at the anterior pituitary site. In hypothyroidism, TSH is high because the brain is trying to nudge the thyroid gland to make more active hormone (T4). Remember that T4 has to be converted to the active form of thyroid hormone called T3, guess where? The answer is in the liver! So the liver is critical to how this brain gut axis system works.

The increased secretion of TSH from the pituitary has a major effect on out liver too. It is pro inflammatory because it causes the liver to make HS-CRP. HS-CRP is what we used to measure baseline inflammation in patients. It is called an acute phase reactant protein. High CRP levels are known to walk hand and hand with the development of atherosclerosis. The increased CRP produces multitudes or pro inflammatory chemicals body wide, because they activate immune cells like Mast cells. Mast cells and other immune cells, are the factories of pro inflammatory chemicals and they stimulate more inflammation in the plaques of atheromas in blood vessels to rupture and cause disease.

High TSH levels are not good signs. This is why hypothyroidism is correlated with heart disease and many autoimmune conditions. Hashimoto???s thyroiditis is an epidemic in America and in my view is a sign of a constant assault of the intestinal brush border of our gut that eventually overwhelms it and then floods the portal circulation with inflammation. This results in a liver response that over time goes from favorable (particle A LDL size with high HDL) to a very unfavorable particle B size dominated by sdLDL and low HDL and a high HS CRP. This then sets the stage for disease propagation in many sites of the body.

This is how the physiology of the brain gut axis works from a biochemical standpoint. Once the inflammation markers are present in the general circulation they head to the two most prominent organs based upon blood flow . The brain and the heart are those targets. In the brain the first effect is to overwhelm the parts that are not protected by the brain blood barrier. These places are called the circumventricular organs. The most important of these is in hypothalamus where the leptin receptors are. The receptors become over whelmed with these inflammatory cytokines and lead to leptin resistance. Leptin resistance basically makes the brain completely blind to the energy needs and status of our 20 trillion cells. It also no longer allows us to have tight control over how calories are partitioned to our peripheries. Remember also, that the pituitary gland is where TSH is made. The portal circulation of the pituitary also has no brain blood barrier so it too is at the mercy of inflammation from the gut if it is leaky. This is another way your thyroid gland can be shut down and cause a problem allowing the conversion of cholesterol to pregnenolone to help heal the body. This complex disorder results in multitudes of breakdowns of cellular homeostasis in many organs leading to disease development in many organ systems over the years it occurs. You can now begin to see how the brain is totally dependent upon leptin to make hormones that respond in kind based upon cellular homeostasis.

In the heart the HS CRP fosters the development of atheroma generation in the coronary arteries and stiffens the leaflets of our heart valves. Given longer time it also causes huge changes to the hearts electrical system leading to arrhythmia generation. This is why atrial fibrillation is so common in America today. Eventually the atheroma collects oxLDL and grows and when it is matched with a the persistently elevated HS CRP causes a plaque to explode and causes a heart attack or death. The plaque is the ???dynamite??? and the HS-CRP is the ???lit match???. Neither one is dangerous unless they are present together.

The brain gut axis is vitally important to all of us. Understanding how it basically functions is really a study in how our liver protects us. Our liver is the last line of defense before the brain is assaulted. Once the brain is involved , hormonal disruption ensues first with leptin resistance and then cascades to every other hormone in some fashion. Once this occurs the brain loses its control over cellular homeostasis and neolithic diseases become prevalent. We can understand this process dynamically when we look out our VAP profiles. They really don???t measure lipids in my view. It is a test that tells us how good or bad our brain gut axis is functioning to protect the 20 trillion cells in our body from disease propagation.

21fd060d0796fdb8a4a990441e08eae7

(24543)

on July 24, 2011
at 05:08 AM

Damn Matthew, I think you got inherited the super-accuracy gene. I've seen you catch mistakes at least a few times on here.

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 24, 2011
at 02:35 AM

no sweat :)

76f3ead3aa977d876bcf3331d35a36e9

(4620)

on July 24, 2011
at 02:28 AM

Good answer. Ps. thanks for the answer in my "Why did I lose 1 rep point?" question, of which I quickly closed upon realizing I didn't read the FAQ thoroughly. (I think it was you who answered).

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 23, 2011
at 06:22 PM

Oh boy. More hypothesizing stated as fact.

0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on July 23, 2011
at 02:26 PM

An example, Metametrix incorrectly list Escherichia coli as an Obligate aerobe when it is a Facultative anaerobe. That is a rather worrying mistake for a company claiming to specialise in stool analysis. http://www.metametrix.com/test-menu/profiles/gastrointestinal-function/dna-stool-analysis-gi-effects?t=clinicianInfo

0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on July 23, 2011
at 02:15 PM

Is it not better to accept a state of unknowing than for what you know to be incorrect?

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 02:00 PM

Ok Matthew. So avoid them. So what do you do if anything?

D1c02d4fc5125a670cf419dbb3e18ba7

on July 23, 2011
at 01:55 PM

@Dr Q - I am onboard with the "dose makes the poison" line of thinking. Context here is "in moderation". I distinguish white rice from gltuen grains, which I feel even at low levels are harmful and should be avoided.

345c1755efe005edd162b770dc6fb821

(8767)

on July 23, 2011
at 01:22 PM

@Quilt, wishing your were my Dr!! I'd love to let you have a crack at my system!

0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on July 23, 2011
at 12:55 PM

Metametrix GI tests don't look very reliable to me.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:50 AM

agreed.........plus one

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

plus on Stabby.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

plus one.......thanks.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

i think Aravind when you use the term "safe" you need to qualify it and give it context. nothing in our diet is safe without context.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:47 AM

@Micheal it is a test from metametrix that I use for patients I suspect with a leaky gut from their initial VAP or NMR. @WCCPAUL not sure what I can expand upon. I just wanted to know how others think about hacking this topic. My views are based in clinical medicine when I think many others are based upon alternative or complementary approaches. I want to know how people look at this issue.

Ef4c5b09fdccf73be575d3a0c267fdd9

(2539)

on July 23, 2011
at 04:53 AM

agreed. Raw milk really helped my digestion 100%. Since I dropped it the past 3 months as an experiment my body as really missed it. Will take it up again in the fall for sure. Especially kefir.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 23, 2011
at 01:39 AM

You know, I have no issues with pure white rice - basmati, jasmine, sushi whatever. I sometimes hostess a sushi party and happily partake with no ill effects.

D1c02d4fc5125a670cf419dbb3e18ba7

on July 23, 2011
at 01:12 AM

What do you think about white rice as a safe starch ala PHD?

47a42b6be94caf700fce9509e38bb6a4

(9647)

on July 22, 2011
at 09:51 PM

Quilt, would you mind editing and expanding a little bit? E.g., Do you mean diagnosis or treatment? And can you educate us a little about those tests, maybe give a link or something? If it causes you some stress you can just work it off surfing in LA in a couple of weeks. Anyhow I for one am quite a bit interested in leaky gut and what exactly it is -- diagnosis being one important part of that. Thanks, P.

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 22, 2011
at 07:02 PM

http://paleohacks.com/questions/41359/hack-i-am-totally-confused/41367#41367

Medium avatar

(19469)

on July 22, 2011
at 06:47 PM

Perhaps a definition of the word "hack" is in order. Quilt seems to be using it as a simile for "diagnose" whilst grenadine considers it to mean "resolve".

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 22, 2011
at 06:32 PM

those sound like tests, not solutions.

0bc6cbb653cdc5e82400f6da920f11eb

(19235)

on July 22, 2011
at 06:16 PM

What is the GI fx test?

  • Ed71ab1c75c6a9bd217a599db0a3e117

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7 Answers

4
2d4ff23c8ce7fb00708fa88ceffd4087

(408)

on July 22, 2011
at 11:46 PM

I know this might seem a bit controversial but adding goat milk into my diet has helped a lot. I am not recommending it to anyone, it's just what has worked for me.

Ef4c5b09fdccf73be575d3a0c267fdd9

(2539)

on July 23, 2011
at 04:53 AM

agreed. Raw milk really helped my digestion 100%. Since I dropped it the past 3 months as an experiment my body as really missed it. Will take it up again in the fall for sure. Especially kefir.

2
559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 23, 2011
at 07:28 PM

"Permeability is measured by the differential absorption of lactulose and mannitol in clinical studies, the intestinal permeability test (IPT) discriminates between paracellular (lactulose) and transcellular (mannitol) pathways.[11] It is a useful test in clinical studies, giving information on the overall status of the digestive tract (villous atrophy, inflammation)."

http://www.nleducation.co.uk/resources/reviews/leaky-gut-food-reactivity-whats-the-mechanism

76f3ead3aa977d876bcf3331d35a36e9

(4620)

on July 24, 2011
at 02:28 AM

Good answer. Ps. thanks for the answer in my "Why did I lose 1 rep point?" question, of which I quickly closed upon realizing I didn't read the FAQ thoroughly. (I think it was you who answered).

559aa134ff5e6c8bcd608ba8dc505628

(3631)

on July 24, 2011
at 02:35 AM

no sweat :)

2
0dbd7154d909b97fe774d1655754f195

(16131)

on July 23, 2011
at 01:09 AM

My thought is that the act of rejecting or reacting to something is the body's protective mechanism working to guard against that material. I do not have any machinery and I do not have the funds to "hack" myself at labs all the live long day. Instead, I notice how I react to certain foods. If I bloat up - is that leaky gut? Then I avoid the things that cause that. Also, I have read that grains and legumes are quite dangerous when it comes to this. So I avoid them.

0dbd7154d909b97fe774d1655754f195

(16131)

on July 23, 2011
at 01:39 AM

You know, I have no issues with pure white rice - basmati, jasmine, sushi whatever. I sometimes hostess a sushi party and happily partake with no ill effects.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

i think Aravind when you use the term "safe" you need to qualify it and give it context. nothing in our diet is safe without context.

D1c02d4fc5125a670cf419dbb3e18ba7

on July 23, 2011
at 01:12 AM

What do you think about white rice as a safe starch ala PHD?

D1c02d4fc5125a670cf419dbb3e18ba7

on July 23, 2011
at 01:55 PM

@Dr Q - I am onboard with the "dose makes the poison" line of thinking. Context here is "in moderation". I distinguish white rice from gltuen grains, which I feel even at low levels are harmful and should be avoided.

2
Be1dbd31e4a3fccd4394494aa5db256d

(17969)

on July 22, 2011
at 08:08 PM

Reduce inflammation, sensitize leptin receptors, provide a lot of glycine and glutamine and other nutrients, eliminate anything gut-irritating. I have heard good things about colostrum although it doesn't always work for everyone. Perhaps because it needs to be combined with the amino acids. I'm pretty sure that butyrate heals the gut but I don't know if fermentable fiber is always a good idea for people with leaky gut. Some probiotics seems to help.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

plus on Stabby.

2
B58511bcd1ecc0dd4ad8130859513c81

on July 22, 2011
at 08:04 PM

My son has leaky gut. We are having good results with a home made type cleanse right now. First thing in the morning, 3-4 digestive enzymes. Also drink 1 tablespoon of coconut oil. Sip on 2 oz colloidal silver (high quality) throughout the day. No grains, or fructose filled fruits (he has a small amount of berries though). ENd the day with 3-4 more enzymes and a good quality probiotic.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:49 AM

plus one.......thanks.

1
B3aa5369cae632a191ceb779897839d9

(30)

on July 22, 2011
at 10:05 PM

GAPS diet and Specific Carbohydrate diet, both excellent books.

Ed71ab1c75c6a9bd217a599db0a3e117

(25477)

on July 23, 2011
at 10:50 AM

agreed.........plus one

0
Medium avatar

(4878)

on July 22, 2011
at 10:41 PM

G.A.R.D. Diet - Thanks Dogtor J

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