Leaky gut tests

Testing For Leaky Gut (and the cause of leaky gut)

Testing For Leaky Gut

“Do I have leaky gut?” and “what testing for leaky gut should I do?” are common questions that I get asked, and this is because there is so much information and research online linking leaky gut to a wide range of health problems.

I will go into a lot more detail about these questions in this article, but the short answer is if you have a lot of digestive symptoms especially combined with other symptoms like fatigue, brain fog, headaches and joint pain then you probably have leaky gut.

So if you can assess leaky gut without a test is there any value in testing for leaky gut? I don’t recommend a specific leaky gut test like the lactulose/ mannitol test which gives you a yes / no answer in regards to leaky gut, because it does not tell us “why” you have leaky gut which I think is a more important question to answer.

Noteworthy:  Testing for leaky gut is important, and testing to find out why you have leaky gut is even more important!

First let’s get clear on exactly what leaky gut is, and what are the symptoms of leaky gut.

What is leaky gut

Leaky gut or leaky gut syndrome is something that many people have heard of but the name sounds quite vague, the official name in all of the research is Intestinal Permeability.

Leaky gut or Intestinal Permeability can bring up images of food particles, toxins and other waste matter from the intestines leaking into the rest of the body, and depending on your imagination this can seem quite dramatic and serious ….. which it can be for your long term health.

From the moment you start chewing your food the digestion processes starts, chewing your food well is important as it makes it easier to digest in the stomach, and even the process of chewing and the activation of saliva sends messages further down the digestive tract to stimulate the release of digestive enzymes.

Once the digested food passes from the stomach to the small intestine it is further broken down into simple sugars, amino acids and fatty acids that are small enough to pass through the intestinal wall and into the bloodstream. These nutrients are the building blocks for cells and provide energy to keep us going through the day.

But for some people this intestinal barrier becomes more permeable, rather than small tight junctions that only let the essential nutrients into the body, larger undigested food molecules are allowed to enter the bloodstream leading to what is known as leaky gut.

The body sees these larger undigested food particles as “foreign” and creates and immune response against them, and this leads to an increase in inflammation and the many symptoms associated with leaky gut.

Leaky gut symptoms

It is this inflammation that is caused by leaky gut that causes the long list of leaky gut symptoms, and why there is now so much research going into testing leaky gut and what causes leaky gut.

20 years ago leaky gut was dismissed by mainstream medicine but now intestinal permeability and the the gut microbiome (bacteria balance) is one of the most researched areas in medicine.

If you look up Pubmed which is the database of published medical literature there is 13,367 research papers on leaky gut.

Here is a List of Leaky Gut Symptoms

  • Food sensitivities and intolerances, especially when it is a food that you did not previously react to, or if you reacted to something like gluten and the list is now getting longer as you seem to tolerate less foods.
  • Brain fog, forgetting words, trouble focusing seem to be totally unrelated to the gut but are often 100% eliminated once you address leaky gut.
  • Autoimmune conditions are associated with leaky gut, Dr Alessio Fasano one of the lead researchers in this field stated that all autoimmune conditions are associated with leaky gut.
  • Skin issues like acne, rosacea, rashes or eczema can have a number of causes and leaky gut is a contributing factor in most cases.
  • Inflammation related symptoms like muscle and joint pain, allergies and even heart disease.
  • GI Symptoms like diarrhea or constipation, bloating and excess gas.
  • Inflammatory Bowel disease which includes Crohn’s and Ulcerative Colitis.
  • Severe nutrient deficiencies, especially B12, iron and zinc.
  • Anxiety, depression and other mood disorders that have been shown to be triggered by inflammation and an imbalance in gut bacteria.

All of these symptoms are common symptoms that people experience everyday, and often take prescription medications to address the symptoms, but not getting to the underlying cause.

Testing For Leaky Gut or Test the Cause of Leaky Gut?

Before we talk about testing for leaking gut I think it is more important to address the cause of leaky gut! There is no point taking gut healing nutrients like glutamine and probiotics to heal a leaky gut if the underlying cause has not been addressed.

The cause of leaky gut can include:

  • 1
    Gluten and casein from dairy are probably the two biggest causes of leaky gut
  • 2
    Lectins are a type of protein found in grains and legumes that enter the bloodstream (if you have leaky gut) undigested lectins can damage the gut wall. This does not mean that you can never eat grains and legumes but they may be a good thing to avoid while you treat a leaky gut, and then have them prepared in the traditional way.
  • 3
    Gut infections include bacteria, parasites and yeast infections, and of these SIBO is one of the biggest causes of leaky gut as it damages the microvilli of the small intestine which increases permeability
  • 4
    Medications including antibiotics which destroy the beneficial bacteria that help protect the intestinal wall, anti-inflammatory medications like NSAID’s and medications that are used to treat reflux are the top 3 medications that can lead to leaky gut
  • 5
    Imbalance in your gut bacteria, also known as dysbiosis Stress which can be physical stress from overtraining or chronic emotional stress, both of these will lead to a rise in your cortisol levels and increase inflammation
  • 6
    Did I mention gluten, I know I did but it is worth repeating as this is the number one trigger, especially if it is combined with the medications or an infection.

Testing for Leaky Gut

There are a number of different tests for leaky gut, but as I mentioned earlier it is more important to identify the actual cause of the leaky gut.

A lot of people with chronic digestion problems have a colonoscopy and/ or gastroscopy and while these can be valuable tests to rule out cancer, ulcerative colitis or ulcers they are not going to identify leaky gut or many other gut pathologies. That is why so many people with digestive issues who have a colonoscopy get the all clear, and are told there is “nothing wrong” even though they have many different digestion symptoms.

Let’s look at some of the testing options for leaky gut and then I will give you my number one recommendation.

Mannitol/Lactulose test for leaky gut

This is the most common test performed for leaky gut, but it will not identify the cause which is why I do not use it. Two liquids, lactulose and mannitol, are drank. Depending on the results of which one is better absorbed, intestinal permeability and malabsorption can be evaluated. If both liquids are elevated in the body, this signifies leaky gut. If mannitol is low, this signifies poor absorption of small molecules.

Zonulin blood test for leaky gut

Zonulin controls the size of the openings between your gut lining and your bloodstream, this was only discovered in the last 10 years by Dr Alessio Fasano. Even in healthy people, small openings are needed between the two to transport nutrients back and forth, but abnormally high levels of zonulin can cause these openings to become too large leading to intestinal permeability or leaky gut.
The zonulin blood test is a good test option but it is not cheap, and if you are going to spend the money on testing you want to invest in a test that will measure Zonulin and the cause of leaky gut.

G.I Map testing for leaky gut

The Best Test for Leaky Gut (aka intestinal permeability)

My favourite test for leaky gut is the G.I Map test, this is a stool test that measures Zonulin levels which is a specific marker of leaky gut.

High zonulin causes leaky gut

Plus the G.I Map test will help to assess the cause of leaky gut as it gives you a detailed analysis of bacteria, parasite, viral and yeast infections. All of these can be the underlying cause of leaky gut and need to be addressed first before you begin a treatment plan for leaky gut.

It makes sense that if a candida infection or bacterial infection can be the underlying cause of the damage to the intestinal microvilli (which leads to leaky gut) then removing this infection is essential before any treatment plan can begin.

The G.I Map test also assesses your levels of beneficial bacteria and this is important in addressing the underlying cause of leaky gut. Low beneficial bacteria levels may be caused by an infection, or it can be related to diet, antibiotics or other medications and even if you don’t have a gut infection this may be the main cause of leaky gut as it leaves the intestinal wall vulnerable to damage.

The G.I Map test also measures your digestive enzyme levels, in particular pancreatic elastase and low levels can be caused by leaky gut, and also be the cause of leaky gut as you have difficulty digesting the food you are eating.

The G.I Map test will assess inflammation and immune markers like calprotectin and Secretory Immunoglobulin A (SIgA), plus beta-glucuronidase a marker of phase 2 liver detoxification and high levels are associated with high estrogen levels.

Leaky gut and bacteria infections

Other Tests for Leaky Gut Include

Organic Acids test

The Organic Acids Test (OAT) is one of my favourite tests because it looks at so many different metabolic processes in the body from energy production, fat metabolism, gut infections, nutrient deficiencies and neurotransmitter levels.

The OAT is not as specific for leaky gut and the exact cause of leaky gut which is why I recommend the G.I map test, but this is a good test to do in addition to the G.I Map test especially if you have symptoms like chronic fatigue, fibromyalgia or a lot of neurological or mood issues.

Food Intolerance Testing for Leaky Gut

The IgG food intolerance testing can not only give you an indicator of the foods that you are sensitive too, but if it shows up that you are sensitive to a wide range of foods then this is most likely leaky gut. If you fix the leaky gut then the food intolerances will go away.

I don’t normally do this test as it is not cheap and the money is better spent doing the G.I Map test, but for some people who need extra motivation to cut out foods like gluten and dairy a positive test result can give them that motivation.

The Next Step

If you are looking at doing a test for leaky gut and identifying the underlying cause of leaky gut then I highly recommend the G.I Map test.

The cost of the G.I Map test includes a 45 minute consultation to help explain the results, and more importantly give you an action plan to get your gut health and overall health back on track.

If you are on a budget and want to just trial diet changes and specific gut healing nutrients that is an option too, just remember if you don’t get results that may mean that the underlying cause has not been addressed.

I recommend a gluten and dairy free low FODMAP diet for around 8 weeks while you take the gut healing nutrients. Also include plenty of bone broth or collagen powder to help provide the nutrients to heal the gut.

There are a lot of nutrients that can help with gut healing and I don’t recommend them all, and the specific formula can vary from person to person.

Below are Some of the Key Nutrients.

  • Glutamine - is the number one nutrient for healing leaky gut, there is a lot of research to support the use of glutamine in healing the damage caused by intestinal permeability.
  • Pancreatic enzymes - are often depleted with leaky gut, this will show up in the G.I Map test, and short term supplementation for a few months will speed up recovery.
  • Probiotics - help to protect the mucous membrane of the digestive tract, reduce inflammation and aid in the recovery from leaky gut. I personally use and recommend Seed Probiotic - use this link for 20% discount seed.com/planetnaturopath #ad
  • Epicor - has a number of studies showing it's effectiveness in improving immune function, reducing inflammation and it also acts as a prebiotic
  • Fulvic /Humic Minerals - provide easily absorbable colloidal minerals to help heal gut function, and provide essential minerals to the body which maybe currently missing due to poor absorption.

About the Author Michael

Michael is head consultant at Planet Naturopath - Functional Medicine and Nutrition Solutions. He is a registered naturopath with the Australian Natural Therapists Association (ANTA) and works with clients from all over the world via video or phone consultations. He is a degree qualified naturopath from the Endeavour College of Natural Medicine in Australia with 18 years of experience. He uses advanced testing methods, nutritional medicine, herbal medicine, and lifestyle advice to help you stay healthy. He is a Kalish Method-trained practitioner that keeps updating his education with Chris Kresser. Michael completed Dr. Terry Wahls practitioner training program, a 12-month program with ongoing training that helps understand the underlying cause and treatment of MS and autoimmune conditions. He keeps up to date with the latest research into health and natural medicine through the Metabolic Fitness Pro course with Dr. Bryan Walsh.

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Leave a Comment:

Judy Martin says January 21, 2021

I copied all of this, just wanted you to know I just discovered all of it did not copy so I wrote it in. It looks like after words, order this now, the material below is not copying. I was told last Jan. 2020 that she thought I had leaky gut and developed Hashimotos by blood work & peridase antibodies. My allergist didn’t approve of the 3 supplements & gave me a paper showing fermented foods so I went off the 3 supplements and started drinking the Kombucha tea & the Kefir water, so 3 mts. later, my thyroid labs had all improved but not optimal yet and the antibodies had reduced 61 pts. I had started using the selenium 2 wks before after reading it can reduce antibodies. Allergist has a master’s in autoimmunity so he seems to know what to do next. I had lost 12-13 lbs. last december, then after diagnosis they put me on the whole 30 diet and anyone would have lost 10 more lbs.. I have lost 29 lbs altogether but not gaining any back so the allergist said for me to try the nutrient powder with water & I did but gained no weight so he rec. I see a GI dr. so she has me schedule for a sibo TEST on 1-26-21 then an endoscopy on 2-15-21. she seems to think that the sibo test if positive or negative will tell if I still have leaky gut or do not from what she read on internet. I only read that the sibo can include 10 things and leaky gut & Hashimotos are in the 10. I had read the lactulose/mannitol is std. test for leaky gut plus there is stool, blood & urine tests also. So I don’t know what she read but I believe I should have the test to show if my leaky gut is healed or not. also,
my symptoms of HASHIMOTOS, some gone away, last 2 wks, having insomnia again like at beginning, I had constant light headed in beginning but it is alot less now and barely there. fatigue is also gone so diet or something has helped me for symptoms to be leaving. Hoarseness at night seems to be gone also. She also wanted me to do the COLORGUARD stool test and have it now to do. she also did blood work for celiac disease and genetic test for it. Nurse is supposed to call me today and give me results. So after hearing all this, do you know which test would be the best for me to have? I’ve been on the diet since last January, one year. I feel the diet & what the allergist has me doing has helped, its just the weight now thats the problem. I’ve also drank bone broth but probably need to drank more, haven’t taken any collagen. any advice you can give me, I’d appreciate. the gi dr. told me, 1st sentence, you do realize with weight loss we start looking for cancers. Next morning I was scared to death & bad stress. I feel she should not have said this before any testing was done. someone told me a dr. has to tell you why tests are being done but if so, she should have done it more gracefully. but I feel dont say this, wait until after tests are done. also sibo is not cancer and lactulose test is not for cancer, to my knowledge but i know cologuard cks. for cancer. anyway, any advice will be appreciated. the person who ordered the peridase antibody test thinks for sure the reason for my leaky gut that caused hashimots was from stress, I was under chronic stress for 10 yrs., trial and last 4 yrs, stress was horrible, I had adrenal fatigue 2 times and then 2nd round of adrenal fatigure was after court for divorce and his lawyer was nothing but evil and had no mercy or feelings for anyone and I got bronchitis 2 wks later, had it 3 times, dr. couldn’t get me better then third time seemed to be getting better then had an asthma attack at home & almost died, ready to call 911 but I used the 2nd. serum in nebulizer, Xopenex and it slowly opened me up. so, i feel woman is correct that stress started the leaky gut. the test you recommend to find cause sounds very good but after all i typed, can you tell me what test I should have. thank you, Judy Martin

    Michael says January 22, 2021

    Hello Judy – I have emailed you directly

Judy Martin says February 9, 2021

I never did get the free health guide in my email, judmar276@outlook.com.
I did it more than once. You said you sent me an email besides this but it did not answer my questions, it was just telling about hormones, etc. thanks, Judy Martin I’m going to dr. tomorrow, I’m going to show him about the GI TEST that you recommend.

    Michael says February 9, 2021

    Hi Judy – I have just emailed you again, maybe check junk mail in case the outlook filters are sending emails there. Let me know if you don’t get it.

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