What Should You Eat To Heal a Leaky Gut?
April 5, 2012 in Gut Health
(Created as a guest post for The Paleo Parents)
If you are concerned that you may have, or could develop, a leaky gut, then changing your diet to one that protects the gut is a natural next step for you. If you are already battling health conditions related to having a leaky gut, then you will have to be more strict with your dietary choices and also address other lifestyle factors like getting good quality sleep, managing stress, finding time for low-strain exercise, and getting outside.
The first and most important thing to do to heal a leaky gut is to stop eating foods that damage and inflame the gut lining! It can take six months or more for the gut to fully heal depending on the extent of the damage, the health of the gut microflora and your individual genetics (for people with Small Intestinal Bacterial Overgrowth, recovery can take up to two years!). Until the gut is completely healthy, it is important to abstain from all grains, all legumes, and all dairy products (some people may tolerate ghee and/or butter from grass-fed sources, but I recommend leaving it out for at least a month before trying it). It is also important to avoid additives in processed foods (many of which irritate the gut) and refined sugars (which promote inflammation). Some people will also need to eliminate vegetables from the nightshade family (tomatoes, eggplants, peppers of all kinds, and especially potatoes), eliminate egg whites (I actually rinse my egg yolks before eating them), and limit nut consumption (other than coconut and macadamias). Changing your diet to avoid gut-irritating foods is critical. But, it is also important to include foods that can reduce inflammation and help heal the damaged gut.
Eat foods that reduce inflammation. It’s very important to be mindful of both your omega-6 and your omega-3 polyunsaturatedfatty acid intake. Omega-6 polyunsaturated fats, which are found in large quantities in modern vegetable oils, meat from grain-fed animals, and many nuts and seeds, increase inflammation. Omega-3 fatty acids, which are found in large quantities in wild-caught fish, pastured/free-range eggs, and meat from pastured animals, decrease inflammation. To help reduce overall inflammation and heal the gut, aim for a 1:1 ratio of omega-3 to omega-6 fatty acid intake in your diet. There are several ways of doing this: you can make sure that all of the meat in your diet is exclusively from grass-fed animals (beef, bison, goat or lamb); you can eat plenty of wild-caught seafood; and/or you can supplement with a good quality fish oil.
Vegetables are rich in anti-oxidants, vitamins and minerals which help control inflammation (and help with just about every other normal function of the body!). Eating a variety of differently colored vegetables, a variety of dark green leafy vegetables, and a variety cruciferous vegetables (broccoli, cauliflower, cabbage, turnip greens, kale, Brussels sprouts, etc.) every day will provide all of the essential vitamins and minerals in a way that is easy for the body to absorb (no more need for a multivitamin!). Fruits, especially berries, are also a good source of antioxidants, vitamins and minerals. However, most people will need to exercise some portion control with fruits due to the high sugar content. I recommend eating vegetables at every meal (it can be a bit strange getting used to eating vegetables at breakfast, but it’s amazing what a difference it makes to how you feel for the whole rest of the day!).
It is also important to make sure you are getting enough Vitamin D. You can achieve this by simply spending some time outside in the sun every day, or from eating liver once or twice per week, or from supplementing with Cod Liver Oil
Eat foods that restore gut microflora. If you have a leaky and inflamed gut, chances are very good that your resident good bacteria are having trouble too. To help restore their numbers and their diversity, eat as many different good sources of probiotics as possible. You can do this by taking Probiotic
Eat foods that promote healing: As the body tries to heal itself, it’s important to provide it with plenty of good quality protein (needed to make all those new cells and connective tissues) as well as vitamins, minerals and good fats. In this way, the best way to promote healing is to eat a paleo diet that includes wild-caught fish, meat from grass-fed sources, organ meat (preferably from pastured sources), and plenty of vegetables. There are two other healing foods that are very important to include: coconut and bone broth. Antimicrobial short- and medium-chain saturated fats, like those found in coconut oil and other coconut products, help to reduce overgrowth of bad yeast, fungus and bacteria in the small intestine. Medium chain saturated fats are very gentle on the cells that line the gut since they can be passively absorbed without being broken down by digestive enzymes and used for energy without any modification. This source of easy energy is very helpful for healing the lining of the gut. Broth made from the bones of chicken, turkey, duck, beef, lamb pork and/or fish are anti-microbial, anti-inflammatory, and contain nutrients which help rebuild the integrity of the digestive tract. Most importantly, broth is rich in the amino acids proline and glycine, which help regulate digestion, reduce inflammation, and promote healing in every part of the body.
While these dietary changes may seem overwhelming, it is important to remember that making them will keep you healthy, put many diseases into remission, and prevent dozens of other diseases from developing. For the vast majority of people, using diet to prioritize gut health will mean a lifetime of good health.
Very interesting! Thank you so much for posting this.
Hello, thank you for this post! Do you recommend the 25 billion or the 50 billion in the probiotic? Also, I saw some concerns about refrigeration with the recommended probiotic. Amazon doesn’t ship these refrigerated. Will this make them less effective?
Not all probiotics require refrigeration. For those that do, it shouldn’t matter too much if they are shipped without as long as you keep it in the fridge when you get them. I would recommend going lower dose because you can always ramp up how much you take later if you need to.
This will be my second question on your blog. So first of all I want to thank you for doing all the research for us and sharing your personal experieces. What you are doing is helping lots of people (including me, in the Netherlands). Thank you for all your time and effort!
So up to my second question:
In this post you recommend to restore the gut flora. One of your suggestions is to eat Kefir. However, Kefir is made from milk which crossreacts with gluten. Does Kefir not crossreact with gluten?
Unrelated, but I feel the urge to share my personal succes story:
Before reading anything about paleo I had been of dairy, grains, nuts, legumes, dairy, the deadly nightshades, and most fruits. This helpt my eczema and geographical tongue a lot (actually the geographical tongue was my teacher for most of the things). However my asthma and fatigue didn’t disappear until I completely cut out the grains and crossreactors from my diet last week. I noticed a dramatic increase in mental energy the first day already! I used to be exhausted out of nowhere, while right now I sleep less, wake up energised and stay awake throughout the day.
I do wonder about how and when to reintroduce some of the foods (especially fruit and nuts). Would you recommend to stay on this diet for about six months to let the gut heal and only then start reintroducing the foods? Is there a risk in reintroducing non gut irritating food (which I assume fruits) are sooner than that?
Thanks, Roel
I should be more specific. When I talk about kefir, I really mean coconut milk kefir or water kefir (although some people can tolerate raw grass-fed cow milk kefir or goat milk kefir). Since writing this post though, it seems as though yeast is a common gluten cross-reactor and those with gluten-sensitivity and/or celiac disease are likely not to tolerate kombucha or kefir due to the yeast content.
Six months sounds like a worthy goal, but you might not have to wait that long. Some people are able to start reintroducing as early as one month. I generally recommend that you should wait until you see substantial improvement in your symptoms (which you have already) and then very slowly reintroduce one thing every 4-5 days so you can watch for reactions. The only issue with introducing fruits is that often skin conditions are sensitive to blood sugar fluctuations (basically, when your blood sugar goes high after eating a lot of carbs). If you keep the amount of fruit fairly low to start, that should help. Otherwise, fruits should be fine to reintroduce as soon as you feel ready.
Good luck! And let me know if you want to write up your story for a Real People, Real Paleo guest post on my blog!
Thanks,
Sarah
I’m trying to heal my leaky gut, but I can’t even eat any veggies or fruit. I can eat bone broth, stewed meats and fish, a little avocado, coconut oil. The veggies are not digesting at all. I make my bone broths with veggies, then take the veggies out before I eat it. I had to do this last spring, but then seemed to be able to eat moderate amounts of cooked vegetables and fruits over the summer—even a little bit of raw fruits and veggies—as well as some fermented veggies. But now it’s back to square one, it seems. Have you heard of this? I see how long you say it takes to heal leaky gut, so maybe I just shouldn’t mess around and stick to bone broths with all veggies removed for two years.
There may be a connection to stress, activity or vitamin D that is what meant you were better in the summer. We’re you outside more? More active? Less stressed? Getting better sleep? All of this can tip the balance. So, it might not need to be that you are eating broth and meat for 2 full years, but just until you get the other factors together. Are you taking a vitamin D3 supplement?
I have thought about the vitamin D3 / change in sun exposure connection. I live in Colorado, so I get tons of sun in the summer, and barely any in the winter because we are so north. I still get outside daily, but it’s often in the dark now (early morning, or after work), plus it’s cold so my skin is covered up! I am currently taking 10,000 mg D3, hoping to counter the lack of sun exposure with the seasonal change. Stress, activity, sleep are all about the same, I’d say. Stress management is one of my constant challenges, and a high priority. Since finding your site, I have started the AI protocol (I’ve been paleo for about 10 years), so there were some significant modifications for me: no coffee, alcohol, chocolate, nightshades, yeast (no more fermented veggies or kombucha). Some other things I was thinking of trying: I need to find a good pro-biotic, and I’m thinking of trying a L-glutamine supplement. I have celiac.
One other thing: since my leaky gut problem developed, my cholesterol levels have gone up. The break down is: LDL 151, HDL 91, TRT 37. Total 249. I think this is my liver trying to deal with leaky gut, and the inflammation.
By TRT, I assume you mean triglycerides? If so, I look at those numbers and think they look really good! Triglycerides of 37 is outstanding and is the most important of those three numbers to look at. HDL of 91 is also outstanding. LDL is high compared to what a doctor wants to see, but there are two types of LDL. Large, fluffy LDL are beneficial. Small dense LDL are the bad ones. If you are eating a lot of coconut or palm oil, you likely have more large fluffy LDL which is making your number look higher but is actually a good thing. Actually, your numbers don’t look that different from mine (my LDL is 121, HDL is 98, TG 41). There’s also some evidence in the literature that higher cholesterol (especially with low triglycerides) is associated with a lower risk of cancer in women.
L-glutamine would be very good to try. I buy the straight powder and just mix it with some water. General guidelines are 3-5g per day on an empty stomach (ideally in 2-3 doses). I’m playing around with a soil-based probiotic right now and I quite like it (I’m taking prescript assist). Have you had your D3 levels checked? I take 10-12,000 D3 per day and it works fairly well for me. I tried taking 50,000 every 5 days and didn’t like doing that. And I hear you on the stress. That may be the biggest piece to your puzzle. Have you tried mindful meditation? You commit 5 minutes every day to sit somewhere quiet and comfortable and just focus on your breath. If thoughts come, acknowledge them and let them go, and just focus on breathing (you can do a complicated breathing pattern to help, like in for 3 counts out for 5). I do alot of breathing practices through my yoga classes and I really do find them helpful for reducing stress.
Agreed about my cholesterol numbers! I did a bunch of research after these results came back and my doctor said she wanted me to go on statins. I said no way! Luckily she’s very open and read the information I found and backed off from that recommendation. Plus I have absolutely no risk factors. My D3 levels were good (can’t remember the number), but she thought I could stand to supplement over the winter. You are so quick and responsive. Thank you. Yesterday I bought some L-glutamine, and an allergy-free pro-biotic from Jarrow. Next time I’ll try the prescript assist, since it’s good to switch. Mindful meditation is a good idea. I get strenuous exercise every day, and I also do a nice slow nature walk every day. I know stress is a big part of the puzzle, because I regularly get acupuncture (and take some chinese herbs—who knows what they are but my chinese doctor knows his stuff—and he’s always talking to me about stress management), and my digestion is dramatically better afterwards, with a gradual decline until my next appointment. Oh and I do eat a ton of coconut oil, but have not tried palm oil. Do you recommend palm oil?
Red palm oil has even more antioxidants and vitamins that coconut oil, with a similar fat profile. It’s a very distinct flavor so it takes some getting used to. I do recommend it.
I have just discovered your site and am so glad that I did!
I have had chronic gastrointestinal issues for 2 years. I had no food intolerances 2 years ago, but now I have discovered that I have 26! My doctor said that the food intolerances weren’t a medical issue. I found a different doctor who ran tests that determined I had a massive intestinal yeast overgrowth. (My score was as high as the test would go.) I went on an anti-yeast diet of just healthy meats and vegetables, and my symptoms improved dramatically.
The only problem that I still have is that I often feel like my throat is blocked or closing up. I seem to feel this for 2 days straight, and then it gets better for 2 days. I have an endoscopy scheduled for next week.
Here is my question–should I follow the paleo diet without nuts and the other irritants for two years to heal my leaky gut? I am willing to do this, but I am concerned that eating so much meat will give me high cholesterol.
Also, after my leaky gut is healed, should my food intolerances improve? I have some basic ones such as banana, garlic, and black pepper, and avoiding those things is difficult. Also, I worry that while I am healing, I will develop more food intolerances to the foods that I am eating more frequently now.
I’m not sure what would be making you throat feel that way. Maybe a new food sensitivity? or inflammation from acid reflux? Hopefully the endoscopy will show something (and that something is easy to fix!). Yes, I think paleo without nuts and other irritants (like hot peppers) for an extended period of time (might not have to be 2 years, but I’d bet on at least 6 months to a year) is a very good idea. Don’t worry about your cholesterol. Contrary to popular belief, eating saturated fats and cholesterol doesn’t increase your blood cholesterol. Sugar does. And since you’re going to be eating so few sugars and starches following this plan, your cholesterol is very likely to improve dramatically. I think the best paleo book for describing cholesterol is Sweet Potato Power, but you also might enjoy checking out Dr. Attia’s website http://eatingacademy.com/ .I think he has something like a 10-part series explaining cholesterol. Yes, after your gut has healed, many if not all of your food intolerances should improve if not disappear completely. It is possible that you will develop more food inolerances while you are healing. To avoid this, you can rotate your foods (1 week on 2 weeks off) which can be challenging when following such a limited diet, but doable (the easiest way to do this is to have three separate lists of foods and do each one for a week). Also, it might be worthwhile getting a food sensitivity test done every few months just to check (I know that adds up, but even doing it once in about 6 months will probably be worth it). I hope this helps!
Thanks so much for your reply. Do you recommend the one week on two weeks off for my meat and fish consumption too, like pork one week, then beef the next, then bison the next, etc? I would think that might be a challenge.
If you’re really worried about food sensitivities, that is the standard recommendation. You could do pairings to give more variety. Like pork, beef, and whitefish one week. Oily fish, bison, and chicken the next week. Lamb, turkey and shellfish the next week. You could even stagger so that you don’t always have the same three pairings. Actually, I would try and have some kind of oily fish all the time. Salmon, sardines, trout, mackerel, albacore tuna, herring, etc. By the time you start thinking about seafood being each a separate species, it starts to sound like some great variety.
Hello Sarah
you mentioned macadamias. Are they less irritant than other nuts ? Should we soak them a little to make them easier to digest?
They are less irritant than other nuts. They have very little polyunsaturated fat and about a quarter the phytic acid of almonds. They would be even easier to digest soaked.
Butter is not only healthy fat but also can contribute to curing leaky gut syndrome as it contains butyrate which decreases intestinal permeability and improves gut flora. If not tolerating look for lactose free butter or use ghee ( if prepared correctly contains minimal amounts of lactose and casein) which can be used as cooking fat too.
I have a strong yeast intolerance, which makes it difficult to find a good probiotic or to eat things like sauerkraut or other fermented veggies. I also have a milk intolerance which makes milk a no go. What would you recommend for me to improve my gut flora? Thanks!
I take Kirkman Biogold which is yeast free. Other good sources of probiotics are food you grow organically yourself and skimp on the washing.
I also have a candida/yeast issue like Melissa and appreciate your recommendation of Kirkman Biogold.
I have osteoporosis as well and wondered if the Paleo diet will be helpful for this? Is the acid in the proteins (meats, seafood, eggs) reduced to alkaline by all the veggies so calcium is not pulled from the bones? Thank you so much.
Yes, it will. I also recommend taking fermented cod liver oil and including homemade bone broth daily.
I have had skin condiditons since I hit puberty, but my diet was lacking nutrients and very SAD then, I managed to clear most of my back acne since senior year, but am sure my body is messed up from antibiotics I took when I was 15. I’m now 19 and have been trying to heal myself naturally for years!!! I am an athlete, and I have taken so many antifungals and probiotics, and eat healthy. I don’t even know if I have a leaky gut or candida, or what is causing my skin issues anymore. I feel as if I took too much vitamin D, and then I just went to the Caribbean. My face skin has little bumps all over it, and I have my keratosis pilaris like usual. I want to be able to eat some rice and not freak out if it causes my skin to flare up. I just don’t know how to get enough calories, heal my gut, and not spend on all my money on my college budget. Thank You! I always take some probiotic, i’m taking culturella right now, and was going to do a coconut oil enema.
I would suggest starting the reading (or listening to the podcasts) everything Chris Kresser has written about gut-brain-skin axis (his blog is chriskresser.com). You could definitely be taking a more powerful probiotic, maybe add a soil-based probiotic. How is your digestion? You could look into digestive support supplements (like digestive enzymes). Great sources of carbs for atheles include sweet potatoes, parsnips, plantains, taro root, lotus root, yucca, and squash. Of course, if you have candida, those dense starches will make things worse, and then it would be better to stick with fruits as your carb source. Eating coconut oil will help dramatically with energy too and reduce your need for carbs. You might also check out Prof. Loren Cordain’s books
http://www.amazon.com/gp/product/160961917X?ie=UTF8&tag=wwwthepaleomo-20
and
http://www.amazon.com/gp/product/0978510917?ie=UTF8&tag=wwwthepaleomo-20
Thank You! I find I do so much better off mostly carbs, and some meat. I can even go a day or two without meat sometimes. I’m afraid I have so many deficiencies from puberty and not eating right, and imbalances from getting too much of one, like Vitamin D over A and Zinc. I don’t know if I have candida, I have some skin problems…so I am assuming I do…, maybe I just have leaky gut? I never get vaginal yeast infections, just white discharge, and I am waiting to see after my period if I have gotten rid of it once and for all. I also incorporate a lot of coconut products into my diet…even some pure coconut milk ice-cream, which still has anti-fungal properties, so I don’t think it would harm my healing. I’m trying to eat a little bit of brown rice twice a day, I dunno if this is also detramental. I just don’t really know what I can eat on leaky gut, and candida healing, and how I will know when to stop thissss. Cause It would be silly to eat all those lovely carbs, like yams, and not even have candida and heal, but not to cause I just don’t know. I’m also worried about white potatoes and insulin spikes until my body heals? I should probably just test them when I do decide to eat them. I mean some green apples with cinnamon, stevia, and goat milk kefir sounds so good!
I was also wondering YOUR take on nuts and phytic acid and antinutrients. Why would we eat them or crave them if they have anti-nutrients? Like I crave chocolate a lot, but I’m afraid to eat it, just like rice and such cause of these antinutrients.
Candida is a possibility and so are bacterial overgrowths, each of which cause a leaky gut. I recommend eating a variety of meats, fish, fruits and vegetables–variety is key to getting everything you need. If you want to eat rice as a carb source, polished white rice has fewer anti-nutrients. I think nuts are fine in lower quantities. Phytic acid stops you from absorbing the minerals from your food but doesn’t leach them from your body. Excessive phytic acid can be a gut irritant though and nuts are fairly high in omega-6 fats, so think about limiting to 1-2 ounces per day. Chocolate is also high in phytic acid but also high in antioxidants so go ahead and have a little (1 oz or less) of very dark chocolate (80% or higher). Chocolate cravings are often due to magnesium deficiency, so upping your green veggies or taking a magnesium supplement will help too. You could be having food cravings for a variety of reasons, but a common one is not eating enough fat or mineral deficiencies from not eating enough vegetables. It sounds like you need to eat more proteins too… how about fish?
Yeah, I feel like I am so deficient! I started taking a zinc supplement, my right eye keeps twitching. I should eat more meat, organic if available! Thanks!!
What do you think about long-fermented yogurt and aged cheese (like allowed in the GAPS protocol)?
I think that many, many people dealing with leaky guts have dairy intolerances. If you happen to know that you tolerate it well, then I think it’s fine. But, I think the number of people (with gut health issues especially) who tolerate it well will be in the minority.
I wd like to cur emy allergy, cur emy leaky gut bu ti dont know to eat bananas.. I weight 62kg i am slim but do i have to avoid carbs beacuse i have leaky gut? It suck beacuse i dont weight much… I heard that fruits are bad when you cure leaky gut? beacuse …
Hi there, I love your blog because it explains things so very simply and understandably. I have a question. I think my case is very similar to Crystal Ivy, skin issues on face but I do have many other symptoms like low white blood cell count. I want to do the autoimmune paleo protocol but coconut oil, many green vegetables, broth, sauerkraut are all out because one of the results of my leaky gut is salicylate sensitivity (that’s what my naturopath said). And I really feel better on a low salicylate diet. But I have been reduced to eating just fish, lamb and rice (yes not allowed on paleo but I don’t feel good eating so much meat to get the calories as my liver is weak). How can I get more good fats and probiotics into my diet to heal my leaky gut???(I can’t do any dairy as well and many brands of probiotics seem to cause a skin flare!)
There are plenty of low salycilate vegetables that you can eat, including those usually used to make kraut. This is a great resource: http://salicylatesensitivity.com/about/food-guide/vegetables/ and I would also more recommend checking out my post on salicylate sensitivity (under Paleo modifications). What about animal fats? Lamb tallow? And you’re getting great fats from the fish you are eating. He do you handle winter squashes for your carbs instead of rice?