• Lacy Anderson, MS, MPP, RDN

Everything You Want to Know (or Don't?) About Leaky Gut Syndrome

What the Heck is Leaky Gut Syndrome?

Picture your intestinal lining. If you’ve never gone full Miss Frizzle and taken a deep dive into images of your intestinal structure, try this instead: imagine you’re playing a game of Red Rover. Each kid in the chain represents an intestinal cell that separates the lumen (the tube of your intestines where everything you eat and drink passes) from the bloodstream. With only one row of kids (cells) existing as a barrier to prevent you from getting through, they have to be bound very tightly to each other. In Red Rover, this would be achieved by kids linking arms. In your body, this involves structures called tight junctions.

Leaky gut arises when those cells become damaged and/or the tight junctions between them become weak. When that happens, the intestinal barrier is no longer sound enough to keep the undigested food, bacteria, toxins and viruses in your lumen from slipping into your bloodstream. This sets off your body’s alarm bells. Your immune system kicks into gear to protect you from the new invaders that don’t belong there by initiating an inflammatory response. If you don’t repair your gut, the chronic exposure to foreign invaders wreaks havoc on your immune system.

Leaky gut causes chronic inflammation (a problem deserving of its own blog post) and may cause your immune system to start confusing the actual invaders with your own tissues. This is due to something called molecular mimicry. The molecular structures of some foods look very similar to some of your own tissues, and if your immune system is constantly patrolling for the outsiders that keep assaulting it, it may get a little overzealous and start tagging your own similar-looking tissues for destruction. The antibodies that once targeted the invaders now become auto-antibodies. This is one reason why some suspect leaky gut to be a contributing factor or even a prerequisite for the development of autoimmune disease.

What Causes Leaky Gut Syndrome?

I mentioned that leaky gut is due to damage to your intestinal cells and/or a weakening of the tight junctions that keep them linked together. So what can give rise to either of those conditions? Anything that:

  • Inflames your gut

  • Damages the mucosal lining of your gut

  • Removes the beneficial bacteria that line your gut, or

  • Prevents your body from repairing itself

Unfortunately, most of us lead lifestyles that can be pretty damaging to the gut. The table below provides a summary of some of the major known leaky gut drivers that meet the criteria above:

Do I Have Leaky Gut Syndrome?

Just because you eat, use, or have any (or even all) of the criteria in the table above does not mean that you will develop leaky gut. If you’re a young, healthy individual, your body can probably respond to the assaults on it with no problem. However, a high burden of exposure to gut stressors, especially over a long period of time, may prove too much for even a healthy individual’s system. You should reach out to me or another healthcare provider well-versed in gut health to conduct an assessment if you have any of the symptoms of leaky gut listed below:

  • New food sensitivities or intolerances. Have you taken a food sensitivity test and found that dozens of foods are flagged as triggers? Or maybe you just noticed that you don’t feel well after eating foods that you love? This is a huge sign that you have a leaky gut, that foods are perpetuating damage to your gut lining, and that your immune system might be revved up.

  • New skin problems, unexplained joint pain, and migraines. Acne, eczema, joint pain and swelling, and headaches can all be signs of underlying systemic inflammation driven by leaky gut.

  • Nutrient deficiencies and digestive problems. If your gut lining is damaged, it won’t appropriately break down your food to extract the nutrients. In extreme cases, this can cause severe malabsorption that leads to nutrient deficiencies. In less extreme cases, it can mean you experience digestive discomfort.

  • You feel like you’re always sick and/or tired. Fatigue, brain fog, anxiety, depression, and frequent illness are pretty common changes reported by people with leaky gut. These all relate to increased inflammation, poor nutrient absorption, and higher exposure to pathogens that those with leaky gut experience.

  • You have an autoimmune disease or elevated auto-antibodies. Remember the link between leaky gut and the rise of auto-antibodies? While genetic predisposition is a huge factor, leaky gut could also be a factor that drives the development or worsening of an autoimmune condition.

Can I Heal My Gut?

Yes, with the right approach and guidance. The best way to heal your gut is to follow a 5R Protocol. The way I approach it is represented in the graphic below.

To successfully complete a 5R Protocol, you must proceed through the steps in a particular way. Going too quickly or out of order can have negative side effects or simply waste your time. Here’s what each phase entails:

  • REMOVE what's damaging your gut. Doing the other steps without getting rid of what's causing your gut damage is like trying to put out a forest fire with a garden hose. ⁠⠀

  • REPLACE what your damaged gut may not be producing enough of to aid digestion⁠.⁠ This may include hydrochloric acid and digestive enzymes.

  • REINOCULATE your gut with good microbes by consuming prebiotics and probiotics⁠.⁠ ⠀

  • REPAIR your gut lining by giving it the nutrients it needs to restore its structural integrity, like L-glutamine, Zinc, Vitamin C, Vitamin A, Vitamin D, and collagen⁠.⁠⠀

  • REBALANCE your lifestyle. Your sleep, stress, and physical activity can either help repair or cause damage to your gut (not exaggerating. This piece is make-or-break). Most protocols address this at Step 5, but I think it needs to be a focus through the entire process, hence why I put it as the foundation for the other steps.


If you’re struggling with signs of leaky gut and want to learn the detailed approach for healing, I encourage you to enroll in my Gut Repair Course. You can choose to do it in a group-supported platform or with one-on-one guidance from me. I offer the two options to try to make what is usually a confusing and expensive process more accessible to individuals who want to restore their gut health.


1. Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky gut as a danger signal for autoimmune diseases. Frontiers in Immunology, 8, 598.

2. Myers, Amy. (2015). The autoimmune solution. New York, NY: HarperOne.

3. Foroutan, Robin. (2019). Stopping the leak: leaky gut, leaky brain and beyond. Food and Nutrition, 8(4), 18-21.

4. Wilson, D. (2015). Understanding leaky gut: five steps to wellness. Alternative Medicine, 42–45.

5. Wallace, M., Vazquez-Roque, M., Bojarski, C., & Schulzke, J. (2014). Imaging the leaky gut. Gastroenterology, 147(5), 952–954.

6. Fasano, A. (2012). Leaky gut and autoimmune diseases. Clinical Reviews in Allergy and Immunology, 42, 71–78.

7. Fasano, A. & Shea-Donohue, T. (2005). Mechanisms of disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature Reviews: Gastroenterology and Hepatology, 2(9), 416-422.

8. Lerner, A. & Matthias, T. (2015). Changes in intestinal tight junction permeability associated with industrial food additives explain the rising incidence of autoimmune disease. Autoimmunity Reviews, 14, 479–489.

9. Hollon, J., Puppa, E., Greenwald, B., Goldberg, E., Guerrerio, A., & Fasano, A. (2015). Effect of gliadin on permeability of intestinal biopsy explants from celiac disease patients and patients with non-celiac gluten sensitivity. Nutrients, 7(3), 1565–1576.

10. Samsel, A. & Seneff, S. (2013). Glyphosate’s suppression of cytochrome P450 enzymes and amino acid biosynthesis by the gut microbiome: pathways to modern diseases. Entropy, 15, 1416-1463.

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