How Does Leaky Gut Lead to Autoimmune Disease?

Though the gut is one of the most important parts of the human body, it's something that people typically do not think about until they begin exhibiting symptoms. A condition called leaky gut can occur because of the foods that people eat and because of the environmental toxins and pollutants that surround them every day. As this condition can lead to an individual suffering from an autoimmune disease, it's important that people learn more about the condition and its link to the immune system.

 

The Basics of Leaky Gut

One of the first things that people should consider is the symptoms of leaky gut. The most common symptom is any type of digestive issue. Many sufferers find that they have a difficult time digesting certain types of foods and that when they eat those foods, they experience bloating, diarrhea, constipation, nausea, and other digestive problems. Some people even develop a food intolerance or a food allergy that requires they avoid certain foods or ingredients.

The Basics of Autoimmune Diseases

Autoimmune diseases refer to any conditions that cause the immune system to attack the body. The immune system is important because it wards off infections and helps fight viruses.  Common autoimmune conditions include Type I diabetes and lupus. With diabetes, the body stops regulating and processing the sugars that the person eats. Many patients need to take daily doses of insulin to treat the condition. Other conditions can cause the body to view any abnormality as a threat and attack healthy cells and organs.

Fatigue is a common symptom of autoimmune conditions. Some people feel tired because their bodies do not produce enough hormones, but others feel tired because they keep waking up at night due to their conditions. People should talk with their primary care physician about any unusual symptoms they experience, especially if they have a family history of these autoimmune disease.

The Link Between Autoimmune Disease and the Gut

It's important that people understand the direct link between autoimmune disease and the digestive system. Problems in the gut often occur when the intestinal walls are damaged from spending years unsuccessfully trying to digest saturated fats and complex carbohydrates in combination with other unhealthy lifestyle choices. This leads to undigested food particles moving through the intestines and causing more pathogenic bacteria overgrowth in the colon. As the intestinal wall stretches to accommodate for this distress, undigested food particles are able to leak out of the gut and into the bloodstream and move to other parts of the body. The immune system view undigested food particles as invaders to attack. Over time, because the original food insult is not removed, the immune system starts attacking its own body tissues and organs. This is referred to as an autoimmune condition.

There are many autoimmune condition caused by the same underlying reason. They include:

  • Ulcerative Colitis

  • Crohn's Disease

  • Celiac Disease

  • Hashimoto’s thyroiditis

  • Type 1 and 2 Diabetes Mellitus

  • Rheumatoid Arthritis

  • Juvenile Arthritis

  • Multiple Sclerosis

  • Celiac Disease

  • Lupus

  • Cancer

Ulcerative Colitis

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes ulcers to form in the colon and rectum. Many people find that they have IBD after eating foods that are rich or heavy or after overeating. When you finish a large holiday dinner, for example, you may suffer from stomach cramps and other types of stomach pains that leave you unable to sit or stand. The pain can cause quite a bit of discomfort and leave you feeling miserable. It also presents via blood in the stool. The blood appears in your stool because you have bleeding ulcers and your stool mixes with that blood when moving through the rectum.

IBD patients can also suffer from frequent diarrhea. Other symptoms can include fatigue and anemia because your body cannot replenish blood as quickly as it loses it. Problems with your immune system can lead to the system attacking the colon and rectum, which makes the ulcers even worse.

Crohn's Disease

Crohn's disease is much more common than UC and presents with some of the same symptoms.  Crohn’s disease occurs because your body misidentifies something in the digestive tract as a disease or toxin and fights back against it. Many people with this condition have blood in their stool, feel tired and have problems digesting certain foods.

One of the more harmful effects of Crohn's is that it doesn't impact just one area of the body. It can cause symptoms in your mouth, throat, esophagus and through the entire digestive tract. Those diagnosed with this disease will find that they have a difficult time eating certain foods. They typically cannot eat foods that are spicy or rich because those foods with exacerbate their symptoms.  It is critical to see an integrative medicine physician about your symptoms since the root cause of the disease must be addressed to allow for the disease to go into remission.

Celiac Disease

Another common autoimmune disease is Celiac disease. It is often difficult to diagnosis because the disease affects people differently. The main commonality is that people with Celiac disease cannot properly digest the gluten protein. When they eat gluten, their immune system attacks the small intestine lining, which leads to patients suffering symptoms like stomach cramps, diarrhea, bloating, and vomiting.

There is a big difference between having a gluten intolerance and Celiac disease. People with a gluten intolerance exhibit far fewer symptoms but may feel tired and suffer from some stomach pains after consuming wheat such as in bread, pasta, and beer.  Most people tend to feel sleepy and lethargic after eating large amount of wheat. It's possible to also exhibit symptoms of gluten intolerance and Celiac disease without actually having the disease.

Hashimoto’s thyroiditis

When the thyroid is repeatedly being attacked by the immune system and no longer able to function properly, normal cell function cannot occur. Symptoms associated with Hashimoto’s include:

  • Weight gain

  • Constipation

  • Depression

  • Fatigue/Feeling sluggish

  • Foggy brain/unable to think clearly

  • Thickening of the skin

  • Thinning of the hair

  • Coldness in the hands/feet

  • Possible goiter

The exponential Rise of Autoimmune Diseases since 1996

Autoimmune conditions have been on the rise with the introduction of genetically-modified crops (GMO) resistant to pesticides, such as glyphosate (RoundUp) in 1996. These crops (i.e., wheat, corn, soy) were introduced into agriculture on a mass scale and heavily used in animal husbandry, to make beer, most processed ready-made food, bread, and other wheat, corn, and soy products. . It has been known throughout that GMO crops and Roundup are carcinogenic since they kill all cell function in both plants, animals, and humans. 

The molecular structure of many GMO crops (especially wheat) and casein (in dairy products) "looks" very similar to the thyroid gland’s protein structure.  In an attempt to prevent you from harm, the immune system neutralizes the threat from these unsafe proteins since they should not be in our bloodstream. In the process of creating antibodies against these unsafe foods and attacking them, the immune system also begins accidentally attacking the thyroid gland since its protein structure appears similar to the foreign protein.  Autoimmunity is now born (aka., your own immune system begins attacking you). 

As the case of "mistaken identity" continues (again, due to consuming the same food that initiated the damage), the immune system becomes destructive in its attack of thyroid tissue.

Intestinal Dysbiosis

An area that is greatly affected by gastrointestinal dysbiosis (also known as microbial imbalance, i.e. an overgrowth of “bad bugs” and insufficient growth of “good bugs” in the gut) is the thyroid gland. Lacking beneficial strains of bacteria or having an overgrowth of harmful ones in the gut has been clearly linked to autoimmune thyroid disease (Kohling et al., 2017). The microbiome of individuals with Hashimoto’s versus healthy controls have bacterial overgrowth (Ishaq et al., 2017). While further research is required, approaching autoimmunity from a different lens can give us an idea about what else is happening in the gut.

Let’s focus on gram negative bacteria. These are considered to be the “Bad Guys” when they grow out of control.

A byproduct of gram negative bacteria is an endotoxin called lipopolysaccharide (LPS). When LPS is released into the bloodstream from intestinal tissue, it causes thyroid mast cell degranulation (Yaglova and Yaglov, 2013). When mast cells degranulate, they release several inflammatory mediators which bombarded the thyroid gland. Inflammation continues to spike when LPS also appears and hence, creates a warzone.  

With Hashimoto's and most autoimmune diseases, I begin by working on the major component of the disease: inflammation. Treatment would be focused on five areas:

  1. Optimizing hydration and allowing the immune system to rest (via intermittent fasting).

  2. Consuming anti-inflammatory alkaline plant-based foods, herbs, and spices such as turmeric and green tea to help reduce inflammatory markers.  Consider licorice root and Ashwagandha to help improve digestive function, hormone levels, and thyroid function.

  3. Ensuring proper rest and relaxation. You NEED sleep to repair and heal.

  4. Shift to a GMO-free diet because many patients with autoimmune disease usually have more than one autoimmune disorder. Because we know cross-reactivity occurs, avoidance of GMO crops (i.e., wheat, corn, soy; animal proteins fed GMO crops, processed pre-packaged ready-made food) and dairy products is paramount. We don't want the body to mistake these foreign proteins for other bodily tissues.

    Connections Between the Digestive System and Autoimmune Diseases

    Inflammation is the main connection between autoimmune diseases and the digestive system. When you eat certain poorly digested foods, swelling will develop within your internal organs. Your autoimmune system then views that inflammation as a toxin or a disease that it needs to treat. It attacks that organ to stop the inflammation but actually makes the swelling worse. Red meat, dairy products, wheat, and alcohol are great examples of items that cause inflammation. When you suffer from a common digestive issue and eat a slice of pizza with a glass of wine, your intestines may begin to swell hours later. As the body fights back, the swelling can worsen.

    You can also suffer from any of these conditions because of a lack of good bacteria in your digestive tract. While many people assume that all bacteria is bad bacteria, the human body actually relies on some types of good bacteria in order to absorb essential nutrients and have a strong immune system. A healthy balance of good bugs within your digestive tract keeps your bowel movements regular and helps you healthy.  Taking a laxative or antibiotics can be quite harmful to your digestive system since many good bacteria are eliminated from your body. Your immune system will then send more agents to fight the bad bacteria, which can leave you feeling sick. Even consuming an unhealthy diet can eliminate the good bacteria from your body.

    Wheat, red meat, dairy products, and sugar are far from the only foods that can trigger an immune system attack. Those diagnosed with some of these conditions often have a difficult time processing many high calorie foods.  For example, chocolate, fish, and tomatoes can also trigger an attack.

 

Patient Testimonial

“I did find that healing my gut played a major role in cooling down the autoimmune reaction and inflammation. I did IgG testing and removed eggs, gluten, dairy, and yeast. In reducing the massive amount of inflammation in my system and supplementing with glutamine-containing products, I was able to allow my intestinal permeability to heal. With a modified diet, I am no longer on thyroid medicines and feel great. While the autoimmune portion will always be present with the TPO antibodies that can fluctuate up and down, I know I have control over keeping down inflammation and allowing symptoms to disappear. Amazing how powerful the proper information can be.”  ~ JJ

References

Cindoruk, M., Tuncer, C., Dursun, A., Yetkin, I., Karakan, T., Cakir, N., & Soykan, I. (2002). Increased colonic intraepithelial lymphocytes in patients with Hashimoto's thyroiditis. Journal of Clinical Gastroenterology, 34, 237-239.

Ishaq, H. M., Mohammad, I. S., Guo, H., Shahzad, M., Hou, Y. J., Ma, C., ... Xu, J. (2017). Molecular estimation of alteration in intestinal microbial composition in Hashimoto's thyroiditis patients. Biomedicine & Pharmacotherapy, 95, 865-874.

Köhling, H. L., Plummer, S. F., Marchesi, J. R., Davidge, K. S., & Ludgate, M. (2017). The microbiota and autoimmunity: Their role in thyroid autoimmune diseases. Clinical Immunology183, 63-74. 

Xu, M., Iwasaki, T., Shimokawa, N., Sajdel-Sulkowska, E. M., & Koibuchi, N. (2013). The effect of low dose lipopolysaccharide on thyroid hormone-regulated actin cytoskeleton modulation and type 2 iodothyronine deiodinase activity in astrocytes. Endocrine journal60(11), 1221-1230. 

Virili, C., Bassostti, G., Santaguida, M. G., Iuorio, R., Del Duca, S. C., Mercuri, V., ... Centanni, M. (2012, January 11). Atypical celiac disease as cause of increased need for thyroxine: a systematic study. Journal of Clinical Endocrinology and Metabolism, 97, E419-422.

Yaglova, N. V., & Yaglov, V. V. (2013). Ultrastructural characteristics of molecular release of secretory products from thyroid mast cells induced by lipopolysaccharide. Bulletin of experimental biology and medicine155(2), 260.

AUTHOR

Dr. Payal Bhandari M.D. is one of U.S.'s top leading integrative functional medical physicians and the founder of SF Advanced Health. She combines the best in Eastern and Western Medicine to understand the root causes of diseases and provide patients with personalized treatment plans that quickly deliver effective results. Dr. Bhandari specializes in cell function to understand how the whole body works. Dr. Bhandari received her Bachelor of Arts degree in biology in 1997 and Doctor of Medicine degree in 2001 from West Virginia University. She the completed her Family Medicine residency in 2004 from the University of Massachusetts and joined a family medicine practice in 2005 which was eventually nationally recognized as San Francisco’s 1st patient-centered medical home. To learn more, go to www.sfadvancedhealth.com.