Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
Understanding the Role of Probiotics in Healing Leaky Gut Syndrome
Probiotics are a key approach to healing leaky gut and can repair the gut lining, reduce inflammation, and restore the gut microbiome.
Probiotic supplements help reduce symptoms associated with leaky gut syndrome, including bloating, abdominal pain, stool changes, fatigue, and brain fog.
It may only take a few weeks to see the beneficial effects of probiotics for leaky gut.
Multi-strain probiotics are preferred and should be used alongside an anti-inflammatory diet for best results.
Thinking about trying probiotics for leaky gut? These beneficial bacteria are likely a good place to start, as they work fast to help repair the lining of the gut, can reduce symptoms associated with leaky gut, and will get you back on the road to better health.
Research shows that probiotics decrease intestinal permeability (leaky gut), which is linked to many chronic health conditions, like obesity, chronic fatigue syndrome, autoimmunity, and irritable bowel syndrome (IBS).
They can help fix an imbalance of gut bacteria, reduce an overzealous immune response, and put a halt to inflammation — all of which are thought to contribute to leaky gut syndrome. Probiotic supplements are also effective at improving many non-specific health symptoms associated with leaky gut, such as bloating, brain fog, fatigue, and joint pain.
Though many people see relief from their leaky gut symptoms in just a few weeks after starting probiotics, remember that they’re only one piece of the treatment puzzle and work best when implemented with a healthy diet and lifestyle. Let’s take a look at what the research says about probiotics and gut permeability.
What Is Leaky Gut?
Leaky gut syndrome — otherwise called intestinal permeability — occurs when an unhealthy gut environment breaks down the mucosa lining the small intestine. This disruption in the intestinal barrier allows food particles and bacterial toxins to slip through the tight junctions (spaces between the cells) lining the digestive tract .
Once these unwelcome intruders get into the bloodstream, the immune system sees them as foreign and initiates an inflammatory response. This inflammation can target many areas of the body and may cause a wide range of symptoms, including digestive complaints, joint pain, fatigue, food sensitivities, and brain fog after meals.
Who Has Leaky Gut and What Causes It?
While digestive issues like gas, bloating, constipation, and diarrhea are certainly common in those with leaky gut syndrome, it isn’t exclusively associated with gastrointestinal symptoms or conditions. The immune dysfunction seen in leaky gut is linked to numerous chronic health conditions, including [2, 3, 4]:
Metabolic syndrome, insulin resistance, and diabetes
Elevated cholesterol and triglycerides
Inflammatory bowel disease (IBD), like Crohn’s disease and ulcerative colitis
Irritable bowel syndrome (IBS)
Polycystic ovary syndrome (PCOS)
Chronic fatigue syndrome
Non-alcoholic fatty liver disease (NAFLD)
Autism and ADHD
Leaky gut isn’t a generally recognized diagnosis, but intestinal permeability is widely recognized in the scientific literature. If you have any of these conditions, you may very well have a leaky gut too.
Below is a summary of symptoms and chronic health problems that may be tied to leaky gut syndrome. Keep in mind that some people may have multiple symptoms that affect several body systems, while others’ symptoms may be limited to just one body system (like the skin).
As there are many factors that can contribute to developing a leaky gut, it’s important to take a holistic approach when healing your digestive tract. One of the most beneficial things you can do to kick-start your gut-healing journey is to start taking probiotic bacteria.
How Probiotics for Leaky Gut Work
Probiotics are a key part of reversing leaky gut and improving digestive health. They simultaneously work to heal the lining of the gut and help eliminate the cause of leaky gut by reducing intestinal inflammation and restoring healthy bacteria in the gut [50, 51, 52, 53, 54].
Research shows that all three categories of probiotics (see below) are successful at reducing the signs of leaky gut. They’re also effective at treating conditions and symptoms linked to increased intestinal permeability, such as:
Probiotics may provide relief for non-digestive symptoms associated with leaky gut as well, like brain fog (which often comes on after meals), joint pain, and fatigue [69, 70, 71, 72, 73, 74].
Let’s take a look at the research on probiotics for leaky gut syndrome.
Probiotics May Decrease Intestinal Permeability
Several clinical studies have shown improvements in intestinal permeability from the use of probiotics.
In one study, a marker of intestinal permeability (zonulin) was significantly lower in the group who received a 14-week course of a multi-species probiotic .
In another clinical trial, oral spore-based probiotic species reduced markers of intestinal permeability compared with placebo .
In a randomized controlled trial, a seven-day trial of Lactobacillus rhamnosus showed biopsy-confirmed beneficial effects on the genes that regulate intestinal permeability .
One small study found that probiotics helped to promote intestinal repair in the human gut .
Another trial found positive effects of probiotics when used to treat intestinal impairment after a GI infection .
Probiotics Help Rebalance the Gut Microbiome
Dysbiosis refers to an imbalance in gut bacteria and is likely correlated with a leaky gut. The makeup of the gut microbiome is closely connected to gut barrier integrity [29, 43, 44, 45]. It’s likely that introducing healthy bacteria into the digestive tract through probiotic supplements can help heal intestinal permeability.
The following research supports the beneficial effects of probiotics on the gut microbiome:
A meta-analysis (the highest quality of science) summarizing 18 clinical trials concluded that probiotics are an effective treatment for small intestinal bacterial overgrowth (SIBO) .
In a study of 181 infants, probiotics were as effective as nystatin (a standard antifungal medication) in reducing fungal infection and improving food intolerances .
Two studies show that probiotics can be more effective than standard antiparasitic drug treatment in Blastocystis hominis and Giardia infections [78, 79].
In summary, we have good science to show that probiotics for leaky gut work well. Even better, probiotics can do this safely and without side effects [80, 81, 82, 83].
Using Probiotics for Leaky Gut
Now that you know how probiotics heal your digestive tract, we can get into the details on what using probiotics for leaky gut actually looks like, including how soon you can expect to see results and which type of probiotic you should use.
Probiotics Can Give Fast Relief
If you think you may have a dysfunctional gut barrier, probiotics for leaky gut can work quickly to get you back on track. I often see in the clinic that patients have less reactivity to foods and more regular stools within one to two weeks of starting probiotic use.
These results are backed by current research that suggests that probiotics work within one to four weeks to improve leaky gut symptoms and laboratory markers of intestinal permeability [52, 68, 84, 85].
Though probiotics are highly effective in treating gut conditions and symptoms associated with leaky gut syndrome , keep in mind that improvements in symptoms after leaky gut treatment aren’t always reflected on laboratory markers [86, 87, 88, 89].
This serves as a reminder that lab findings aren’t the end-all-be-all when it comes to recovering from a leaky gut (or any health condition), and the focus should be on how you feel. If you feel better after taking probiotics for leaky gut, chances are you are better.
What Kind of Probiotic Should You Take for Leaky Gut?
To get the most benefit out of your probiotics for leaky gut, we recommend using one from each category of probiotics:
Category 1: Bifidobacterium and Lactobacillus strains
A 2020 systematic review and meta-analysis found that category 1 probiotics can improve blood markers of leaky gut when used with category 3 probiotics .
Research also shows that Bifidobacterium and Lactobacillus probiotic strains improve leaky gut in those with IBS, in elderly populations, and in endurance athletes [50, 67, 68, 84, 91].
Category 2: Saccharomyces boulardii
This healthy fungus can restore barrier function and has anti-inflammatory effects in the digestive tract .
Studies show that it improves leaky gut in those with Crohn’s disease, and is beneficial in treating numerous gut conditions and combating gut pathogens [93, 94].
These spore-formers can decrease leaky gut and significantly reduce the amount of bacterial toxins in the bloodstream [52, 85, 95].
Using one type is good for gut health, but using all three together is often best for maximum benefit. Multi-strain probiotics are likely more effective than single-strain bacteria in treating certain gut conditions, like IBS and constipation, which are commonly associated with leaky gut syndrome [62, 96, 97].
Think of it this way — each category of probiotics works as one leg of a three-legged stool. Without the other two legs, the stool can’t remain standing.
How to Take Probiotics for Leaky Gut
Try taking a probiotic from each category for three to four weeks, while monitoring your symptoms. If you see improvements, stay on them for a month or two until your symptoms completely resolve or begin to plateau.
Once you’ve seen sustained improvement, you can begin to slowly reduce your dose until you find the minimum effective dose for you.
Be sure to select a high-quality probiotic from a manufacturer that stands behind its label claims. For more on how to use probiotics, see our Probiotics Starter Guide.
More Leaky Gut Support
Probiotics are just one part of a leaky gut-healing strategy. It’s especially important to pay attention to lifestyle changes like improving your diet and getting enough sleep. Certain supplements can help too.
Eating an anti-inflammatory diet that’s right for your body is a key strategy to improve leaky gut symptoms. An anti-inflammatory diet, such as the Paleo diet, also helps maintain a healthy gut microbiome and intestinal wall. Your main leaky gut diet goal is to reduce gut inflammation by eating healthy, whole foods and to avoid the processed foods that cause gut inflammation. Include clean protein, healthy fatty acids, and fruits, veggies, nuts, and seeds as a source of carbs. Foods like bone broth and curcumin are especially healing for the gut.
Pay attention to the foods your body tolerates and doesn’t tolerate. Everyone is unique in this respect and there’s no one right diet for everyone.
Probiotic Foods for Leaky Gut
While probiotic foods, such as kimchi and kefir, provide general gut health benefits, probiotic foods generally do not have enough colony-forming units (CFUs) to provide a clinical effect on leaky gut or other digestive system disorders.
You can include fermented foods in your diet, but also consider taking a quality probiotic supplement with CFUs in the billions.
Prebiotics for Leaky Gut
Prebiotics are starchy fibers that feed the bacteria in your gut so they can produce important gut-healing compounds, like butyrate. Prebiotics can be included as a supplement, but the best source of prebiotics is a diet rich in fiber.
Including fruits and vegetables, whole grains and legumes (if tolerated), and nuts and seeds should provide plenty of food for your good bacteria. However, prebiotics should be used with caution, as they can flare digestive symptoms for some. If you want to try a prebiotic supplement, your best bet is to start with a very small dose and increase slowly to tolerance.
Other Key Leaky Gut Supplements
Digestive supports like digestive enzymes and stomach acid support can help encourage gut healing. Several other supplements can also be helpful for resolving leaky gut.
L-glutamine: Supplementation with L-glutamine, an amino acid, can help speed the repair of the intestinal lining, decrease intestinal permeability, and reduce inflammation .
Vitamin D: Some studies indicate that low vitamin D is associated with greater gut lining permeability and worse outcomes for people with IBD, while increasing vitamin D reduced irritable bowel syndrome (IBS) symptoms [99, 100, 101].
Deglycyrrhizinated licorice (DGL): Soothing herbs like deglycyrrhizinated licorice (DGL) can help coat and soothe an irritated gut lining . DGL combined with L-glutamine can super-charge your gut-healing protocol.
If changing up your diet and adding in probiotics don’t seem to completely resolve your symptoms, it may be time to add in one of the above gut-healing supplements.
Healing Leaky Gut With Probiotics: The Bottom Line
Probiotics are a key approach to healing leaky gut. They help rebalance your gut flora, restore your intestinal wall, and decrease intestinal inflammation.
These healthy bacteria can work in just a few weeks to give relief for leaky gut symptoms like abdominal pain, brain fog, and stool changes. For the most benefit, you’ll probably want to take a multi-strain probiotic that uses strains from each probiotic category.
If you have a chronic condition that you suspect may be a result of a leaky gut, feel free to reach out to our functional medicine clinic for help with your journey toward better health. You can also find out more on the huge impact that a healthy gut has on your overall health in my book, Healthy Gut, Healthy You.
The Ruscio Institute has developed a range of high-quality formulations, including a variety of probiotic supplements, to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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