Nutritional Protocol for the Treatment of Intestinal Permeability Defects and Related Conditions

Under healthy conditions, the intestinal mucosa permits the absorption of vital nutrients from the gut lumen while presenting a barrier against the passage of pathogenic substances into the body. Leaky gut syndrome describes a pathological increase in permeability of the intestinal mucosa that causes increased absorption of intestinally derived endotoxin, antigens, inflammatory mediators, and, in some cases, intact bacteria. These agents can cause local and systemic reactions associated with a broad range of acute and chronic diseases. In some cases, atrophic changes in the mucosal epithelium can lead to the seemingly paradoxical condition of decreased permeability and malabsorption of essential nutrients concurrent with increased permeability and absorption of pathogenic macromolecules.

Research indicates that certain nutritional factors may help to support mucosal health and promote normal intestinal permeability (IP). These factors include antioxidants, mucosal nutrients, digestive enzymes, probiotics, and dietary fiber. Some of these nutrients have also been shown to lead to improvement in diseases associated with leaky gut syndrome. This article outlines evidence of efficacy for a number of these agents. It also includes recommendations for a nutritional protocol to treat IP defects. A number of the recommendations in this article are based on double-blind, placebo-controlled clinical studies that show statistically significant benefit for certain dietary supplements in the treatment of IP defects and related conditions. In most cases, however, the recommendations are based on indirect evidence of efficacy from in vitro human studies or animal research. The nutritional protocol, nutrient forms and dosages presented are the author’s recommendations and have not been studied in controlled clinical trials.