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okay, well, i want to welcome everyone. thisis dr. nik hedberg, and tonight we're talking about how to heal leaky gut syndrome. so,let's get this started. i really enjoy doing these webinars, tryingto get some good information out there to everyone. and leaky gut, it's a big issue.its main connections are going to be with autoimmune diseases and a variety of chronicconditions, which we'll talk about. i'm just going to cover what it is, what causes leakygut, and then some of the things that you can do about it, and then how we manage itin the practice if it's there. the medical term for leaky gut is gastrointestinalhyperpermeability. it is recognized in conventional medicine, but it's really not going to berecognized by your average doctor. they kind

of look down on it or laugh at it, so to speak,but it is definitely something very real. so, let's go ahead and jump right in. gettingto the symptoms, conditions associated, conditions connected with leaky gut syndrome, and asi mentioned, autoimmune diseases are a big one, like hashimoto's thyroiditis, graves'disease, lupus, sjã¶gren's, alopecia, rheumatoid arthritis, et cetera. a lot of the symptoms you'll see are fatigue,brain fog. brain fog is basically inflammation of the brain. because we don't have pain receptorsin the brain, that's basically how the body tells us that the brain is inflamed when there'sfogginess. and there's a really strong connection there between the gut and the brain just in general.

weight gain, depression and anxiety. there'sa lot of literature out there connecting chronic inflammation and inflammation in the gut andpsychological issues like depression and anxiety. different digestive problems, like irritablebowel syndrome, crohn's disease, all sorts of colitis, and then just general symptomslike gas, bloating, cramping, things like that. food allergies, of course. arthritis and jointpain, migraine headaches, adrenal gland imbalances, and then what we call adrenal fatigue, andthen of course asthma and allergies. the gut barrier is called a mucosal barrier,and if there's dysfunction there, there's going to be dysfunction in the other mucosalbarriers like the lungs, for example.

so, what is leaky gut? what you see here onthe left is what we will call a healthy gut lining. these are what we call villi, they'relike fingers, and that's where all of the absorption occurs in between these gaps. thisis also where the immune system is. so the gut barrier protects you from a lot of differentthings. it protects you from infections like viruses, bacteria, fungi, parasites, it protectsyou from absorbing undigested protein, and so it's this mucosal barrier that's very protective. now, leaky gut is when that barrier becomesbroken down, and you can see it's all flat here, all of the villi have been compromised.and so when you have leaky gut, you can also have malabsorption. that might be kind ofdifficult to understand for some people, but

the intestinal barrier is selective, and whenthe immune system becomes compromised, then it can no longer protect you from the varietyof things that we just talked about. malabsorption means that the absorptive capacityof the gut barrier is not what it used to be, so people will start to develop nutrientdeficiencies and they won't be able to absorb protein, carbohydrates and fat. so this isa visual of what we call leaky gut. now, these are some of the main causes. whatyou see here in the pink is a diagram of the intestinal barrier. i want to give creditto dr. aristo vojdani, he is an immunologist for this slide, and dr. vojdani has spokenextensively on leaky gut. so these are some of the main things thatwe see up here. dietary proteins and peptides,

so that's going to be like gluten, dairy andother allergies; other foods that are highly allergenic; antibodies, and that's if there'ssome kind of infection in the intestine; drugs and xenobiotics, so environmental chemicals,environmental toxins; prescription medications, especially birth control pills. women whohave been on birth control pills for many years, like 5, 10, 15 years, they tend todevelop gut issues and leaky gut. you can also throw aspirin in the mix there. there'sa bunch of them that will do that. i would say the biggest one of all thoughis stress, as you can see here, physical, emotional stress. americans, a lot of peopleare under a tremendous amount of stress, or if they're not, they create their own stress.

infections, we'll talk a little bit aboutthat. parasites, bacteria, fungus, et cetera. cytokines are basically mobilized, they goto areas where there's inflammation, and then neurotransmitters, and then enzymes. so these are kind of the main causes of leakygut. we'll talk about a few of those in more detail. so these begin to break down the gut barrier.you're probably all familiar with ulcers. ulcers occur when the stomach – basicallya hole is eaten away in the stomach and someone develops an ulcer. that can happen at a muchsort of lower grade further down in the intestine where the gut barrier begins to break down,as you can see here.

so the immune system weakens, permeabilityincreases, meaning almost anything can get in, and then you develop intestinal barrierdysfunction. the first thing you'll notice is food allergiesand intolerances. you might start having indigestion when you eat certain foods, you might startreacting to foods that you didn't normally react to, like gluten or dairy or pretty muchanything. 70% of the immune system is in the gut, soas the gut barrier breaks down, there's going to be a significant decline in immune systemfunction. when the immune system just gets stressed and it can no longer really repairthe body on a daily basis, you develop autoimmunity. every day, your body goes through a certainamount of wear and tear, and it's up to your

immune system to repair everything. autoimmunityoccurs when the immune system can no longer keep up with all the daily wear and tear,so the body starts attacking itself. it can happen pretty much to any tissue or organin the body. some people will develop autoimmune thyroid disease and the body starts attackingthe thyroid, some people will develop lupus and the body may start attacking the kidney,et cetera. then further on down the line is the blood/brainbarrier, so you start getting brain fog and anxiety, depression, and then what we callneurodegenerative disorders like alzheimer's, and then even autoimmunity like multiple sclerosis. so that's kind of how it happens and whathappens to your body when you start to develop

leaky gut. now, let's talk about what we can do. i'lljust kind of take you step-by-step with what we do. the first thing that we do first andforemost is to identify, and we have the patient avoid food sensitivities. this is an easyblood test, just a finger stick. the blood is dropped on to a card, and 96 foods aretested for immune system reactivity. this way we know exactly what the immune systemis reacting to. so if you have a food sensitivity and you'reeating it all the time, this contributes to leaky gut because it creates inflammationin the intestine. the thing to understand about this is that there was a time when wecould only eat foods seasonally, and now because

of technology and agriculture, people caneat pretty much any food they want 365 days a year, and our immune systems and our intestinesare just not designed for that. we're supposed to give them a break, whether it's a seasonalbreak or on rotation, just eating it once a week, you should do that no matter what.you should not be eating the same things every day. it doesn't matter if something is considereda healthy food. even something like celery, you wouldn't want to eat that every day becauseover time you could develop a food sensitivity. a lot of these major ones that you see herelike gluten, dairy, corn, eggs and soy, the main reason why these are such big offendersis because people eat them all the time. americans, you know, when you're a kid, you grew up eatinggluten-containing cereal and milk, and then

people have eggs every morning for breakfastand grits, so people start to develop these food sensitivities because they're eatingthe same foods all the time. now, it's true gluten is more difficult to digest for a lotof people, but it's not difficult for everyone. so these are sort of what we call the bigfive: gluten, dairy, corn, eggs and soy. and now we're to the point where all of the soyin america is genetically modified. corn is i think up around 98%, 99%. we don't reallyknow the long-term effects of the genetically-modified foods, we'll have to see, so i'm erring onthe side of caution and not eating genetically modified crops. so that's kind of the first thing we do, andwhatever we find as a reactant, depending

on the severity of the reaction, we avoidit for about three to six months and that allows the immune system to calm down andfor the gut to begin to heal. it doesn't really matter what you do like what supplement youtake or if you reduce your stress levels, if you're eating foods that you're sensitiveto, it will really set you back and prevent you from making progress. the second thing we talk about is improvingdigestive function. this isn't anything high tech, but sometimes low tech things, practicalthings, are going to go the longest way. the first would be talking about chewing foodvery slowly until it's liquefied. eating in a calm, quiet and relaxing space. don't eaton the run. we've all seen the people eating

fast food in their car while they're driving,wolfing it down on their lunch break. you're not going to heal your gut doing that. whenyou eat, don't read or watch tv or text on your phone. we're so caught up now in technology,we're not really present with what we're doing anymore, there's so much going on. and thatdoes affect digestion. so just focus on your meal. one of the things that can help improve digestionis drinking ginger tea with your meal, possibly with some lemon in it. if your digestion isreally sluggish, like you're getting a lot of burping and gas and things just feel kindof backed up, one of the old-school ways is using herbal bitters. it's also known as swedishbitters. you can get them at pretty much almost

any health food store. have a little bit ofthose before you eat, and those will stimulate digestion. they’ll actually stimulate hydrochloricacid, which is what i'm mentioning here. if it's really bad, we'll use betaine hclcapsules with meals. if there's a lot of gas and bloating and burping after meals, thatwill really help to digest food, especially if someone is severely hypothyroid. if youhave hypothyroidism, you'll also have low hydrochloric acid levels and that will affectdigestion. then sometimes we'll use just straight-up digestive enzymes. a lot of these are pancreaticenzymes like lipase, amylase, protease, all the things that break down protein, carbsand fats. so these strategies will usually go a long way in improving digestive functionand healing the gut.

the third thing that we'll talk about is makingsure there aren't any infections in the intestine. if there is an infection, it's very difficultto heal the leaky gut because the infection causes continuous inflammation and it reallybreaks down the immune system. so what we do is a stool analysis, and thestool analysis identifies any types of infections that may be in the intestine. we're lookingfor parasites like worms, amoebas, things like that. it will also tell us if there areany bacterial infections. it will tell you specifically what they are, like if it's h.pylori or if it's e. coli, et cetera, and it'll also look at the fungi. so you'll seecandida albicans or black mold, various types of different fungi that show up in the intestine.

if somebody has one of these, it's cool becausethe lab does a sensitivity on the infection, it will test a bunch of different herbal medicinesto see what actually kills the infection, and you'll get a printout of what works andwhat doesn't. for some people it might say oil of oregano, some people it might say wormwoodor black walnut or caprylic acid or goldenseal, you just never know what will come back. sothen we'll know exactly what to use to wipe out the infection. if there is a yeast, sometimes we'll use what'scalled saccharomyces boulardii, and saccharomyces boulardii is actually a beneficial yeast.it lines the gut barrier and it strengthens the immune system, and it actually will crowdout bad yeast. it's cool because sometimes

a lot of people will just go after the yeasttrying to kill it, but saccharomyces is a little bit more delicate, a less aggressiveapproach that works by strengthening the immune system and just kind of pushing out the badyeast, and sometimes that works really well for certain people. all of these have been shown to directly healthe intestinal barrier, and the real big one that we're talking about is glutamine. glutamineis an amino acid and it's the main fuel source for the cells that line the gut. we use allthe way up to 20 to 30 grams a day. what we'll do is we'll have the patient mix the powderand water and sip on it all day so it's kind of bathing the intestine the whole day, orwe'll have them mix it with a protein shake

if they have a protein deficiency. now, we're not going to get into a lot ofdetail about that, but protein deficiency, the gut barrier needs good protein to heal,and that's a whole other thing that we focus on. i do have a video, i think it's called‘protein power’ on youtube where you can learn all about that. dgl is deglycyrrhizinated licorice, it worksreally well for ulcers and gut healing. aloe, also known as aloe vera, very soothing, veryreparative. good probiotics, a good lactobacillus and bifido [bacter 19:14], these are importantfor a healthy gut immune system. zinc, we do a zinc taste test in the office.what you do is you put a little bit of liquid

zinc in the mouth and you swish it aroundfor about 30 seconds and if you taste like a metallic taste in the mouth, then you probablydon't have a zinc deficiency. if you don't taste anything, if it just tastes like water,then that's a good sign that you have a zinc deficiency, so we'll use zinc for 30 to 60days and that really helps the immune system and the gut. slippery elm is more of an anti-inflammatorysoothing herb, same thing as marshmallow root. marshmallow and slippery elm, these are whatwe call mucilaginous herbs, meaning that they have mucus-like properties that soothe thegut lining. msm, methylsulfonylmethane, msm and glucosamineare used for cartilage repair and healthy

joints, but it also works really well forthe gut barrier. anyone who's had okra knows that okra is a little slimy, but that's actuallyreally good for the gut barrier. quercetin is a great antioxidant. it's actuallyalso antiviral, it helps to heal the gut. quercetin works really well for allergiesor if there's a lot of histamine in your system. it also works for chronic pain. quercetinis one of my favorite antioxidants. so, there are products that contain all ofthese in one or most of them in one, or sometimes we’ll just use the glutamine by itself withprobiotics. the most important thing, probably just asimportant as the food sensitivities, is managing stress. a lot of people have leaky gut becausetheir stress levels are out of control. cortisol

is a stress hormone made by the adrenal gland,and cortisol eats away at the intestinal barrier. if someone has high cortisol levels it's goingto be virtually impossible to heal the leaky gut, so you've got to get stress under control.adrenal adaptogens can help with cortisol imbalances, like ashwagandha or rhodiola andeleuthero. these help your body respond to stress. another product that works well iscalled seriphos, which is phosphorylated serine, and that basically prevents too much cortisolproduction in the body. so that can be useful as well. don't multitask. we talked about what to dowhen you're eating. make sure you’re taking enough time off from work, plenty of vacations.i have a lot of patients who go on vacation

and almost all of their symptoms just disappear,so that's an important thing to think about. eat protein at every meal. meditation canbe very beneficial, not only for your mood, but for your immune system. it doesn't takea lot, maybe 15, 20 minutes a day. and exercise, as long as you're not overdoing it. exercisewill help your body deal with stress and it's also good for your immune system. so these are really key points, and all ofthese things have to be in place for true healing to occur. if we miss one thing, likeif we miss an infection or we miss a food sensitivity or if there's too much stress,then it's going to be very difficult to heal the leaky gut. so all pieces have to be inplay.

i've got on this link, drhedberg.com, patientresources, some good ebooks, downloadable documents and things like that that you canread, talking about the alkaline diet. there's a good podcast on there from my good friend,suzannah tebbe davis, who will help you manage stress. and then i have a free ecourse, ‘7steps to burn fat & boost energy’, on the bottom of the homepage. in that course wetalk about the best way to eat to burn fat and get your energy levels up, and some ofthat will tie in with healing the leaky gut. so, we're about 30 minutes in which is perfect,that's usually what we're shooting for, i know everyone's really busy. as far as questionsgo, all you have to do is type your question into the chat box. if you have any questionsabout any of the material that we covered,

i'd be happy to answer that in the chat box.if you type that in and press ‘send’, that should queue up here in just a minute. so, i love doing these webinars. we do themabout once a month, and we've covered a lot of different topics. i'm not sure what we'llbe doing next month, but it will definitely be something with some information that youcan use to help you get better. no questions coming in so far. we'll giveit just a few more seconds here and see if any questions come in. this presentation is being recorded. the videowill be up on youtube and on my website sometime later in the week.

okay, great, so here's our first question.what would you recommend to clean the blood for blood disorders? that question is not really specific enough,joanne. can you reword that? that can be a very detailed, kind of long-winded question,so to speak, because so many things can affect the blood. leaky gut will definitely contributeto issues with the liver and the blood. those three kind of are connected in their own sortof ecosystem, the digestive system, the liver and the blood. but if you’d clarify thata little bit more, i might be able to answer you better. okay, here's another good question. how longshould someone be on supplements for leaky

gut? is there a timeframe for gut healing? that's a great question. it really dependson the individual. the gut can heal in a relatively short period of time, just a matter of a coupleweeks if everything is done right. it depends on the individual. sometimes a few weeks,sometimes a few months, sometimes a year, year and a half. so, it really depends onthe person. okay, a lot of great questions coming in.how do you work with people who are down to a few foods? bone broth, green veggies, salmon,raw milk? so that's an extremely restricted diet. thekey with that is figuring out what has been missed up to this point, and it usually meansthat something has been overlooked, whether

it be a gut infection or something going onin the patient's life. a lot of endocrine issues, like adrenal problems, blood sugar,hypothyroidism, et cetera, often go undiagnosed and overlooked, so usually we're able to pinpointthe one or two things that's really driving the person's health problems, and that's reallywhat we're focused on. whenever you see something like leaky gut, it's not something that youjust directly automatically go after because it's there for a reason, and that's why wehave to do the detective work to find out why. okay, next question. what length of time isappropriate to supplement with adaptogens? i just stay on them almost all the time, becausewe all have stress. adaptogens are a part

of different cultures on a regular basis,like in china, ginseng is consumed virtually every day just as a regular part of the daybecause adaptogens have so many benefits. if you watch my webinar on youtube called‘herbal medicines for fatigue’, i go into detail on all the adaptogens as far as howmuch to take and for how long. next question, do you also advocate doinga detox at the same time? no, i don't do detoxification. that's sortof a misnomer, it's sort of an antiquated way of looking at the body. it's very popularin the alternative medicine world, so-called detoxes and cleanses, and that's really alack of understanding of how the body does detoxify. the main reason why people feelbetter on so-called detoxes or cleanses, number

one, they remove all the most common foodallergens. so right off the bat, they're going to start feeling better because they eliminategluten, dairy, sugar, all the bad foods, and they start eating better. the second reasonthey feel better on detoxes and cleanses is because they're eating more protein, and theprotein powders that are used, all the detox powders that are out there, have really goodprotein in them. your body is able to detox very efficiently, and it's detoxing rightnow. i'm detoxifying right now, you're detoxifying right now, and when you get the body healthy,it will remove what doesn't need to be there. so, no, we don't do detoxes or cleanses. so, next question, the immune system is inthe gut, what would you recommend to strengthen

the immune system for leukemia? i have no experience with leukemia. that'ssomething that you would want to discuss with your oncologist. next question, do you see a connection betweenthe timeframe that gmo foods have been out, the rise in vitamin d deficiency, and leakygut? no, that's not a connection that i've everlooked into. the rise in vitamin d deficiency however, that is published in the literature.the first is the more body fat you have, the greater the chances of a vitamin d deficiency.and of course, americans are getting fatter and fatter, so obesity, weight gain, thatcauses a vitamin d deficiency. that's really

the main reason. the second reason is inflammation.if there's inflammation anywhere in the body, then that will also contribute to a vitamind deficiency. next question, does leaky gut contribute tofructose malabsorption? it seems like every third person has this condition. do you havean opinion why? fructose malabsorption is going to tie inwith pretty much any malabsorptive syndrome, and we're talking about fat malabsorption,cholesterol malabsorption, pretty much any kind of malabsorption. leaky gut, when youask does it contribute, that's kind of the chicken or the egg. again, you're trying tofigure out what caused the leaky gut, and malabsorption can be turned around relativelyquickly with the high doses of l-glutamine

that i talked about before as well as workingon all these other things. so the blood/brain barrier, that can completelyheal in about two weeks. so can the gut. usually the gut takes a little bit longer, but thatis something to be aware of. a lot of great questions. if you have anymore questions, type them into the chat window, and i'll do my best to answer them. okay. well, that's it for tonight. thanks,everyone, for joining us. again, this is recorded. it will be up on youtube and on my blog verysoon. thanks, everyone, for joining, and i'll see you at our next webinar. take care.