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Stress and Leaky Gut: Implications and Solutions


October 18, 2012 | Published by

leaky pipeStress has many negative effects on gastrointestinal function, including increased intestinal permeability—otherwise known as “leaky gut.” When a person experiences stress, the brain releases a chemical called corticotrophin releasing factor (CRF). CRF triggers a cascade of other chemicals which eventually cause the release of the stress hormone, cortisol, from the adrenal glands, but CRF receptors are also found located in the gut itself. This means that the release of CRF impacts the digestive system directly. Through the effects of CRF on the gut, stress can result in changes in intestinal motility, sensitivity, and inflammation which may be experienced as constipation, pain, or gastrointestinal upset. Stress can also alter intestinal permeability—how easily the intestines allow various substances to pass through their walls.

The entire digestive tract is a continuous tube that runs from the mouth to the anus and separates materials inside the lumen of the tube (which is technically outside the body) from the rest of the body by a single layer of cells. The role of the digestive system is to extract nutrients from food and to provide protection against toxins or pathogens. Adjacent cells of the intestinal epithelium (that layer of cells lining the tube) adhere tightly to one another so that the passage of fluids and other substances can be carefully regulated and controlled. Some substances such as chloride and potassium diffuse freely without any assistance. Others like glucose and amino acids are actively transported across by proteins. If the integrity of this barrier is compromised, substances that should not ordinarily be allowed to pass—bacteria or large proteins from food—may slip through the wall.

When this happens, the immune system tags the substances as “antigens” and mounts an immune response against them, increasing inflammation via the use of chemical messengers and creating antibodies against the antigens. Some of these antibodies may cross-react with the body’s own tissues (i.e. attack them), leading to an autoimmune reaction, while increased inflammation contributes to the etiology or progression of other disorders such as depression.

In fact, many varied symptoms and conditions are associated with increased intestinal permeability including abdominal bloating, indigestion, joint pain, food allergies, fuzzy thinking, rashes, mood swings, fatigue, and hay fever. To test for leaky gut, a person drinks a liquid with two substances dissolved in solution: mannitol, a small molecule easily absorbed through the intestines, and lactulose, a larger molecule not well absorbed by a healthy intestinal lining. Urine is then collected and the amount of each molecule measured. In a healthy individual, levels of mannitol will be high while levels of lactulose will be low. If intestinal permeability is compromised, levels of both molecules will be high, reflecting increased absorption of both.

If you have leaky gut, there are many things you can do to help heal your intestinal epithelium. First, identify and eliminate any foods that may be contributing to the problem. (See my earlier blogs on making sense of food allergies, identifying food allergies, and eliminating food allergies and sensitivities for more on problematic foods). Then, utilize nutrients that can support repair of the tissue. Glutamine is the primary fuel for intestinal cells. It preserves intestinal structure and maintains healthy permeability. Quercetin, a flavonoid, also supports intestinal barrier function. Both L-glycine and phosphatidylcholine help to support normal levels of inflammation. Nutrients such as vitamin A, vitamin C, and zinc enhance intestinal repair and function.

Stress impacts many different conditions through its damaging effects on the gut; by supporting your gut, you may be able to improve your health in a multitude of areas as well.

About the Author

Dr. Lise NaugleDr. Lise Naugle is an associate of Dr. James L. Wilson. She assists healthcare professionals with clinical assessment and treatment protocols related to adrenal dysfunction and stress, and questions regarding the use of Doctor Wilson’s Original Formulations supplements. With eleven years in private practice and a focus on stress, adrenals, hormonal balance and mind-body connection, she offers both clinical astuteness and a wealth of practical knowledge. Dr. Naugle also maintains updated information about the latest scientific research on the hypothalamic-pituitary-adrenal axis function, endocrine balance and nutritional support for stress and develops educational materials about stress and health for clinicians and their patients.

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  • Monica Oanta says:

    Hello Dr. Naugle,
    I have a question. I have Addison’ disease and on hydrocortizone for almost 2 years. I want to know if there is a way to get rid of the medication? I live in Canada and I don’t know anybody willing to help me do that.
    Thank you,

  • Dalia says:

    People who have Addison can they use other treatment than hydrocortisone? Can you please give an example and tips?
    Thank you

    • Hi Dalia,

      We can’t advise on the treatment of someone with Addison’s, which is a quite serious condition. We suggest working with a healthcare practitioner for treatment options. Thanks for your question, and all the best.

      Dr. Wilson’s Adrenal Fatigue Team

  • teri mccurry says:

    I have been diagnosed with leaky gut, adrenal fatigue and low thyroid. I am on different supplements and strict diet and seem to do well for a week or two then I suffer the same symptoms for about a week or so. Usually the symptoms return the week before I start my period. I haven’t had my progesterone or estrogen tested yet but I’m thinking I’m having pre-menopause. Does this make sense?

  • Sean Walton says:

    Hello doctor

    I have been suffering from insomnia and constipation (what was diharea for 7 months first but turned to constipation after i had a candida treatment) i also got the helico bacter pylori wich was treated. I got all of this after stopping diazepam en abilify that i took daily 5 years ago. I keep waking up in the middle of the night since. The doctors are not taking me serious at all. Never in my life did i ever have insomnia. I have lost allot of weight in my face and have huge bags under my eyes. I also have a sore stomach all the time. After doing loads of stool tests my zonuline is high, i am sensitive for gluten, i am casseine intolerant and my histamine is high which could be shortage of diamine oxidase so the test sayes. I recon i have Adrenal fatigue after doing the torch test on my iris which made my iris open and close constantly. I live in the Netherlands and after spending thousands of euro’s and getting no where all i can do is look on the internet. My problems all started after i started waking up in the middle of the night. I have had a anxiety disorder for 15 years now and i used to be a heavy drinker to hold my anxiety back while taking allot off medications at the same time. Its been 5 years now since i have this problem and i cant get any answers. Everybody sayes stress but the test sayes hight zonuline and maybe glutenintolerant. I know for a fact that it is either leaky gut and adrenal fatigue or one of the two alone or maybe hypoglycemia because im always exausted as specialy after meals or in the late afternoon or maybe it could be my liver.I have changed my diet loads of time yo yo ing in weight but i noticed that i am calmer without milk and gluten but something is still missing. I keep asking myself all day every day and checking the internet. Is it stress or is it diet that i must do or both? Its very hard because i am a thin person and my cheeks look hollowed allready and if i stop gluten dairy and sugar i look really bad. I have done so many tests and thing i really am desperate and dont know what to do or where to start anymore. Could you please give me some advise? It would really help.

    Kind regards

    • Adrenal Fatigue Team says:

      Hi Sean,

      Thank you for writing. Based on your questions and concerns, you would be best helped by a healthcare professional. We do not have anyone in the Netherlands in our practitioner database, but work with some who do online consultations. One of those is Dr. Eric Bakker, who is based in New Zealand. You can find information on him and how to book a consultation here on his website:
      All the best!

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