Leaky Gut & Hashimoto’s - How are They Connected?

A Healthy Gut

The digestive tract is basically one long, loopy tube that runs from the mouth to the anus. The digestive system is made up of this tube as well as various organs that help breakdown food and absorb nutrients that the body needs to function. The digestive tract also serves as a barrier separating the internal and external environments, the major site of the body’s immune system protecting against foreign invaders, the communication hub linking the gut and brain (gut-brain axis), and the home of the infamous microbiome supporting a symbiotic relationship between humans and beneficial bacteria. A healthy digestive system and a flourishing microbiome is essential for promoting health and preventing disease throughout our lives. Hippocrates (aka the father of medicine) once said, “all disease begins in the gut.” The digestive system plays such a vital role in overall health, naturopathic and functional doctors practice by the saying “when in doubt, treat the gut.”

If we were to catch a ride on the roller coaster that food takes – we’d enter the mouth, slide down the esophagus, roll around inside the stomach, squeeze through the small and then large intestine, and finally exit, well you know where. The digestive “tube” and the digested food contents within it get inside the body only after crossing the digestive lining. This lining is made up of multiple layers and covers more than 4000 square feet of surface area! The innermost layer, that directly contacts food consumed, is called the mucosa. The integrity of the mucosa’s barrier function depends on tight junctions that hold its cells close together to let in what’s beneficial for us and keep out what’s harmful to us. In a healthy state, this barrier function works like a well-oiled machine, despite being bombarded by heavy loads of food, toxins, and microbes on a daily basis.

A Leaky Gut & Hashimoto’s

When the mucosal lining loses the integrity of its barrier function, its tight junctions become loose (‘leaky’ or ‘permeable’), letting foreign contents into the body that would not otherwise be allowed passage. These foreign contents can include undigested food particles (e.g. larger proteins that are unrecognizable because they have not been broken down into smaller amino acids), toxins (e.g. bacterial byproducts called lipopolysaccharides, or LPS, that can lead to toxic effects if they enter the bloodstream), and microbes (e.g. bacteria that can be pathogenic, or disease-causing). This condition is known commonly as leaky gut and scientifically known as intestinal permeability (IP). Leaky gut can have consequences both locally inside the gut (leading to digestive disorders and food sensitivities/allergies) and systemically throughout the entire body (leading to autoimmune, metabolic, and mood disorders). For the purposes of this blog, we’ll focus on its systemic consequences.

Leaky gut is well-known for firing up the immune system – the foreign contents leaking into the body create fires (i.e. problems) that set off the fire alarm (i.e.activate the immune system) and call in the firefighters (i.e. immune cells). Immune cells try to put these fires out by creating antibodies against the foreign contents to attack and destroy them. However, this process creates an overactive immune system and an inflammatory state, which overtime can trigger autoimmunity and the development of autoimmune disease, such as Hashimoto’s thyroiditis (aka Hashimoto’s disease or Hashimoto’s). Autoimmunity occurs when the body’s immune system mistakenly attacks and destroys its own healthy tissues or organs. In the case of Hashimoto’s, the body makes thyroid antibodies that attack and destroy the thyroid gland. Common symptoms of hashimoto’s include fatigue, brain fog, depression, weight gain, infertility, irregular menstrual cycles, hair loss, cold sensitivity, constipation, and joint pain. Click here to learn more about Hypothyroidism.

Causes of Leaky Gut & Autoimmunity

What is the spark that starts and fuels the fire that is leaky gut? Pretty much anything that creates damage, inflammation, or dysbiosis (imbalanced gut bacteria) inside of the digestive tract. Just as there are many associated symptoms and conditions of leaky gut, there are also many potential causes – impaired digestion, poor nutrition, alcohol or drug/antibiotic use, toxin exposures, chronic stress, intestinal infections, abdominal surgeries, certain medications/diseases – to name a few.

Autoimmune diseases have increased dramatically worldwide within the past century and are among the most common diseases in the US with more than 80 different ones existing! Most people with autoimmune diseases are female and these diseases are in the top 10 leading causes of death for females of all age groups. It’s safe to say that having a leaky gut is a risk factor for developing autoimmunity. It’s also safe to assume that if you have a leaky gut, you might also have autoimmunity, and if you have autoimmunity, you likely also have a leaky gut.

***Note, leaky gut has been found to be associated with several autoimmune diseases including Crohn’s disease, ulcerative colitis, celiac disease, type I diabetes, systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, multiple sclerosis, and autoimmune hepatitis.***

Healing a Leaky Gut

In naturopathic and functional medicine, healing a leaky gut is arguably the most important place to start when treating Hashimoto’s, and now you understand why. The main therapeutic goal is to heal the (leaky) gut; to normalize immune function and decrease inflammation; to stop the progression of autoimmunity; to restore thyroid health. Treatment interventions may vary, especially depending on the severity of leaky gut and autoimmunity, but it typically involves lab testing and a 5R gut protocol, which should be individualized to each person. Leaky gut and Hashimoto’s can be completely healed and reversed.

Lab Testing - common lab tests used for evaluation of leaky gut/Hashimoto’s

Comprehensive blood work: this is a blood test used to assess overall health status, and in particular, the health status of the thyroid
Comprehensive stool analysis (CSA): this is a stool test used to assess all aspects of gut health, and in particular, the presence of a leaky gut
- Zonulin is a protein made in the gut in response to certain triggers that opens up tight junctions in the gut lining and is therefore is considered a biomarker of leaky gut
Food sensitivity testing: this is a blood test used to assess what foods the body is sensitive/reactive to, and in particular, can indicate the presence of leaky gut

5R Gut Protocol - common model used for treatment of leaky gut/Hashimoto’s

Remove: removing insults to the gut
Replace: replacing digestive function
Reinoculate: rebalancing the microbiome
Repair: repairing the gut lining
Rebalance: rebalancing nutrition/lifestyle

Leaky gut is associated with many health conditions, including Hashimoto’s, which has far-reaching effects on overall health and quality of life. It can be evaluated simply with a consultation and lab testing and it can be treated successfully with non-invasive interventions that target the underlying causes. ANAMARIA Natural Medicine is a functional and naturopathic clinic dedicated to helping women blossom into abundant health by addressing health and hormone imbalances at their root using natural, evidence-based, and wholistic approaches. For personalized care, get started by scheduling a free discovery call.

Written by Dr. Jordan Valdez, ND, RD

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