Which comes first: the leaky gut or the dysfunctional immune system?

September 29, 2014 in Categories: , by

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I was asked by healthline.com to comment on a new study from researchers at Lund University in Sweden that was published earlier this month in the journal PLoS ONE.  The study is entitled “Intestinal Barrier Dysfunction Develops at the Onset of Experimental Autoimmune Encephalomyelitis, and Can Be Induced by Adoptive Transfer of Auto-Reactive T Cells“.  Yep, that’s a mouthful, but hang in there.  This study is absolutely fascinating and is very relevant to everyone battling autoimmune disease.  It’s so interesting that I’m devoting an entire blog post to it!

Lavasani Abstract

The study was performed in a well-established mouse model of multiple sclerosis.  Now, before you get all dismissive because it wasn’t performed in humans, let me assure you that animal models of human disease are extremely powerful tools for understanding the molecular details of disease.  This particular model of multiple sclerosis is called experimental autoimmune encephalomyelitis, or EAE, and it is the same model that was used in the vast majority of basic science research of multiple sclerosis performed to date.  In fact, most of what we know about multiple sclerosis is thanks to this experimental model.

The purpose of the study was to investigate whether or not increased intestinal permeability, or what we more colloquially refer to as a “leaky gut”, is present in EAE (the experimental model of multiple sclerosis) and, if it is, to understand when it develops and what’s causing it.

But, first, let’s take a step backward.

What exactly is a “leaky gut”?

Leaky Gut

Leaky Gut image from The Paleo Approach — Copyright 2013 Sarah Ballantyne

The gut is a barrier between the inside of your body and the outside world. Yes, as unintuitive as it may be, the stuff inside your digestive tract is actually outside your body. But, the gut is a very unique barrier. Its job is to let important nutrients inside the body while keeping everything else out. This makes it a highly selective semi-permeable barrier. Nutrients enter the body through a variety of tightly controlled mechanisms.

What forms this highly selective semi-permeable barrier is a single layer of highly specialized cells called enterocytes. And right on the other side of that barrier is 80% of our body’s immune systems, acting as a sentinel, ready to attack anything that might try to cross the barrier.

A leaky gut, or more technically “increased intestinal permeability”, means things can get across the gut barrier that aren’t supposed to. This happens when either the enterocytes are damaged or the complex structures that glue the enterocytes to each other are damaged. What leaks into the body isn’t big chunks of food, but a variety of small substances—like incompletely digested proteins, bacteria or bacterial fragments, infectious organisms, and waste products—which all stimulate the immune system on the other side. Some substances cause generalized bodywide inflammation (for example, bacterial fragments from those good bacteria that live in our digestive tracts but are supposed to stay there can stimulate inflammation which can then travel throughout the body). Some stimulate targeted attacks by the immune system (for example, a food intolerance or allergy could result from incompletely digested food proteins leaking into the body). The many symptoms and health conditions related to leaky gut are caused by this stimulation of the immune system.

The link between leaky gut and autoimmune disease

A leaky gut is present in every autoimmune disease in which it has been tested, including in people with rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease (Crohn’s and ulcerative colitis), celiac disease, multiple sclerosis, and type 1 diabetes.

It’s intuitive that autoimmune diseases that attack the tissues of the gut, such as inflammatory bowel disease and celiac disease, would go hand-in-hand with a leaky gut.  What’s important is that autoimmune diseases that attack tissues no where near the gut barrier, like the myelin sheaths (a protective covering that surrounds nerves of the central nervous system, i.e., the brain and spinal cord) being attacked in multiple sclerosis or the joint tissue being attacked in rheumatoid arthritis, also go hand-in-hand with a leaky gut.  This implies a more fundamental role for a leaky gut in autoimmune disease.

In fact, many studies have shown that increased intestinal permeability (leaky gut)precedes the development of autoimmune disease (and in some cases can predict an oncoming flare).  Yes, all the current science, including this new paper, show that a leaky gut comes first.

This is a quote from this new paper:

Recent observations in humans and in a variety of animal models indicate that an increased intestinal permeability (IP), often referred to as a “leaky gut”, is playing a pathogenic role not only in development of gastrointestinal disorders like inflammatory bowel disease (IBD) and celiac disease, but also in systemic autoimmune diseases, like type 1 diabetes (T1D) [1], [2], [3], [4].

This collection of evidence has lead many researchers and medical professionals (including me) to postulate that a leaky gut is a prerequisite for autoimmune disease to develop.  This means that developing a leaky gut is part of the pathogenesis of autoimmune disease.  How would this work?  Because 80% of the immune system is housed in the tissues in and surrounding the gut, the development of a leaky gut stimulates to the immune system to go into overdrive.  When you combine this stimulation with nutrient deficiencies (so the nutrients required for immune regulation aren’t sufficiently available), genetic predisposition (which mean the immune system is more easily stimulated or less easily regulated), and the unfortunate yet common accident of autoantibody formation (antibodies that accidentally target proteins in the human body instead of invading microorganisms), you get autoimmune disease.

What causes this leaky gut to develop?  Well, until now, I and many others have postulated that this leaky gut can come from a variety of causes, from infection, to gut dysbiosis, to diet factors (like alcohol, the presence of grains in the diet, food allergies and sensitivities), to medications (like NSAIDs), to lifestyle factors (like chronic stress, consistently getting inadequate sleep, and over-activity).  The mechanisms of how each of these can cause a leaky gut are well understood (for details, see my first book, The Paleo Approach where each of these are discussed in detail).  But are these what cause the leaky gut in autoimmune disease?  Maybe and maybe not.

New insights from this study

Right from the get-go, this study peaked my interest.  In this experimental model of multiple sclerosis, healthy mice are inoculated with a chemical called myelin oligodendrocyte glycoprotein.  It takes them 2 weeks to fully develop experimental autoimmune encephalomyelitis (EAE) and only about 80% of the mice do develop the disease.  The animals that are going to develop EAE characteristically lose weight, about 10% of their body weight, about 1 week after the inoculation (they typically start to show symptoms about 8-10 days after with full development of the disease at the 2-week mark).

What the researchers did was to select those animals who were developing EAE based on whether or not they lost weight at the 1-week mark.  Then, they measured intestinal permeability (whether or not the gut is leaky) at 1 week (before development of the disease) and at 2 weeks (after the disease had fully developed).  What they found was that a leaky gut was present at 1 week, before the disease fully develops.  A leaky gut comes first.

The researchers further characterized exactly what type of damage was being done to the gut to make it leaky as well as exactly how the immune system was being stimulated in the gut.  The same types of immune system cells known to be culprits in the damage to the myelin sheath in EAE were accumulating in the tissues of the gut and causing damage there too.  And regulatory T-cells, which are supposed to reign in the immune system but are deficient in autoimmune disease, were low in the intestine.  Even more interesting, the protein zonulin, which has been implicated as the protein stimulated by gluten that causes a leaky gut via direct action on the tight junctions in celiac disease, was increased (again, lots more details on the effects of zonulin and the roles of different immune cell types in autoimmune disease can be found in The Paleo Approach).  Taken together, this all looks very much like a gut being attacked by a dysfunctional immune system.

So what’s going on?  This is a model of multiple sclerosis.  How is the gut being attacked if this is a disease in which the immune system targets myelin sheaths?

The researchers did something very clever to begin to answer this question (of course, they were clever up to this point too, but this next experiment is what got me all excited).  They wanted to test if the immune system was what was damaging the gut and causing a leaky gut in advance of the development of EAE.  So, they took immune cells from mice who had developed EAE and put them into healthy mice.  Two weeks after the healthy mice had been injected with these immune cells, they had developed leaky guts with all the same markers of inflammation and with increased zonulin.

Aha!  The immune system is the culprit!  It attacks the tissues of the gut in addition to the targeted attack on other tissues in autoimmune disease!!!

Um, wait a minute.

Then what gets the immune system all fired up in the first place?

I was asked if this paper confirms what I’ve been saying all along:  that a leaky gut contributes to autoimmune disease.  But, this research shows something altogether more intriguing: that once the immune system develops the ability to attack tissues of the body, the gut is the first victim. The situation is a little bit different than the targeted attack of the immune system on specific tissues (like the myelin sheaths in the case of multiple sclerosis) that happens in autoimmune disease. Instead, the immune system is getting ramped up and, likely because so much of the body’s immune system is housed in the gut, the gut is the first tissue to be harmed by a dysfunctional immune system. Rather than a leaky gut causing the dysfunctional immune system that leads to autoimmune disease, this research shows that it might just be the other way around.

New questions we have to ask

If this research exonerates other factors that can cause a leaky gut in the pathogenesis of autoimmune disease, it then begs the question: if leaky gut isn’t contributing to autoantibody formation and overstimulation of the immune system in autoimmune disease, what is?

Clearly, genetic predisposition is a factor here:  it accounts for one third of your risk for autoimmune disease.  But, autoimmune diseases are not genetic diseases, and our genes don’t take all of the blame.

In The Paleo Approach, I detail the essential role that many nutrients play in the immune system, nutrients that are sorely lacking in the Standard American Diet.  I believe nutrient-deficiency is one of the culprits and there are hundreds of studies pointing to specific nutrient deficiencies in specific autoimmune diseases (many detailed and referenced in The Paleo Approach).

I think the health of our gut microbiome is another clear contender for “thing that can go wrong that can cause immune system dysfunction leading to autoimmune disease”.  We know that the beneficial microorganisms that live in our digestive tracts modulate our immune systems.  We also know that many foods can support the growth of the wrong kinds of microorganism or the wrong numbers or locations (all forms of gut dysbiosis, also known to exist in every autoimmune disease in which it has been investigated), so we lose that important regulation control on the immune system.

We also know that inadequate sleep (which most of us suffer from), sedentary lifestyles, and chronic stress suppress the immune system.  In fact, our modern, Western diets and comfy lifestyles by themselves create the perfect storm of circumstances for immune dysfunction to take place.  And this is without the contribution from toxins and pollutants, which are contributing factors too.

It’s also important to note that this study does not preclude a leaky gut caused by some other factor, leading to a dysfunctional immune system, which then attacks the gut first in the development of autoimmune disease.  I rather suspect that there are so many contributors to the development of autoimmune disease and that sequencing them definitively may prove impossible.

How does this impact the autoimmune protocol?

This is the big question.  The diet and lifestyle recommendations in The Paleo Approach are centered around a few overarching principles:  nutrient-density to support immune system regulation, avoidance of immunes-stimulating compounds in foods, avoidance of foods that are gut irritants or damage the gut barrier, avoidance of foods that feed gut dysbiosis, addition of foods that support a healthy gut microbiome, regulation of important hormones known to be immune regulators (like leptin and insulin), and prioritization of lifestyle factors known to influence the immune system (generally through hormonal effects).

Overall, the recommendations target immune regulation.  These recommendations also support gut health, i.e., the restoration of the integrity of the gut barrier and the normal diversity, numbers, and location of gut microorganisms.  But, the recommendations do not come from the primary goal of fixing a leaky gut.  The primary goal is regulating the immune system.  And what this study now shows is that by regulating the immune system, that’s one more way this protocol can help fix a leaky gut!

This is good news for those of you using the autoimmune protocol and The Paleo Approach to manage autoimmune disease.  This doesn’t change the protocol.  It does however put even more emphasis on nutrient-density (I know you don’t like to hear it, but it really really really is important to eat organ meat, seafood, and tons of veggies as the foundation of your diet), not that there was a shortage of emphasis before this.  It perhaps puts even more focus on lifestyle factors, most notably getting sufficient sleep (at least 8 hours per night, every single night) and reducing stress.  And the good news is, that it means that once we get our immune systems under control, our leaky guts should fix themselves.


hi sarah,

this is so fascinating, and just when we thought we had it all figured out. you are truly on the leading edge here. this might point to why our ancestral lifestyle of being active outdoors, living in small tribes and sourcing the ideal foods that supported their immune systems kept them robust and healthy. your research is invaluable and my family and i are so grateful for your work. i am glad the AIP does not have to change, its just more focused now.


This is certainly intriguing, and thank you for this very informative post about the new study. Do you think this could work as a sort of vicious circle, whereby the immune system attacks the gut, which then leads to further immune disregulation, which then further damages the gut, which then leads to the further-away attacks (on the thyroid, myelin, joints), etc.? Because so many people have experienced such dramatic results from the dietary changes you advocate (I have), it seems like diet must play a major role in healing, not the secondary role that this study implies. I know the other fundamentals are important too (that’s why they are fundamentals!), but just from reading about peoples’ experiences with AIP, the healing seems to start immediately with the dietary changes.

This was a very interesting study and thanks for sharing it with us. However, can one study provide definitive information? Should we wait to see if the study can be replicated? It definitely raises some interesting points and does help reinforce your calls for a nutrient-dense diet. Thanks to you and Stacy Toth, that is my main goal in life for me and my family. And getting sleep and exercise of course.

I too felt that this question was left unanswered. Having loved this website and visited daily for about 5 months now (and being very strict paleo for as long) my understanding was that we were “healing” our guts in order to “fix” the immune system. However my understanding of this research is that leaky gut is just a symptom and not a cause. So although I will be sticking with my new lifestyle I can only expect it to alleviate my symptoms but not to in fact regulate my autoimmune system?

Yes. I am exceptionally curious of the answer to this too.

I would like to throw the idea out there that perhaps vaccination has something to do with it.

Now to clearly set the record straight, I am NOT in any way, shape, or fashion, supporting an alarmist stance against vaccination. I think they are highly valuable and prevent wide-spread disease and devastation. But I think the topic deserves an educated, non-alarmist discussion, especially with the context of ‘which came first’.

Is anyone aware of any data on the prevalence of leaky-gut in countries without a defined vaccination schedule? That data may give some valuable insight. Perhaps there’s an issue with the schedule, or timing of vaccination, that proves especially detrimental to the development of the immune system. Or perhaps there is a problems with the vaccination adjuvants themselves. Who knows, but I’m very interested in such a discussion taking place, albeit may prove to be difficult without attracting almarst, non-sensical attention, unfortunately:(

Ahhh… perhaps! That is a very good point! Do you by chance have any ideas on what mechanisms antibiotics would cause this?? I’m very curious.

I have had what seems like HUNDREDS of dental procedures in my life. I spent a solid chunk of my childhood in the dental chair and each time I was given a prescription for antibiotics which translated into me being on them nearly everyday for years.

It makes me sick to my stomach to even begin to imagine the sheer amount of damage they may have caused… Is it redeemable? So far the research I have come across says no – once you bomb your gut microbiota, it never recovers (on a side note, what sort of evolutionary purpose do you suppose a fragile gut microbiome serves? I mean its documented that a single case of food poisoning can forever change your flora, but WHY are our guys so sensitive?).

Anyways, RIP prior gut flora. Oh how I am beginning to fully realize how much I miss you 🙁

Wow, great post and fascinating article. Thank you for the link. Great leaky gut graphic too. First time visiting your site, and I feel lucky. But maybe all your posts are this interesting. I will subscribe.

Truly fantastic post Sarah! This blog, along with Robb Wolf’s and Chris Kresser’s, are my most valued sources of information next to the primary literature itself.

It seems as of lately that all the molecular mechanisms discussed in regards to the Paleo Diet are funneling down to a single explanation: the immune system.

Here’s my story in short (followed by a quick question that I would LOVE for you to help me understand):

I am a 25-year-old female college student diagnosed with narcolepsy at 17. At the time of my diagnosis, I weighed 189lbs (5’5″ tall). I was overweight, but not obese. After starting drug therapy for my narcolepsy (e.g., stimulant medication), I quickly lost 30-lbs in 3 months putting me at 159lbs. My weight-loss spurred an interest in diet/exercise and I stumbled onto a Ketogenic diet. I decided that I would be an ideal candidate for a ketogenic diet being that narcolepsy is commonly considered ‘neurological disease’ (actually an autoimmune disease, but I didn’t know that at the time) so I tried it.

I saw a remarkable improvement in my symptoms almost immediately: I had more energy, I was in a better mood, my blood sugar was stable, my appetite controlled itself, my skin was glowing without a trace of acne, my vision improved, I lost an additional 15 pounds, and my hair grew 6 inches in 4 months. I was elated.

I dove into the research and studied the mechanisms behind a ketogenic diet for months – all of which solidified my belief in a ketogenic diet being the ideal diet, not just for neurological conditions, but for every eukaryotic organism on the planet.

I would occasionally browse discussions of ketogenic diets and would read several anecdotal stories describing a decline in health after switching to the diet, I’m sure you’ve heard them all;

• “My Thyroid started malfunctioning.”
• “Ketogenic diets raise cortisol.”
• “My hair started falling out.”
• “My energy tanked.”
• “My workouts have gone to s***.”
• etc.

Each time I came across one of these stories I would think to myself, ‘You’re just doing it wrong, you probably are misinterpreting what a ketogenic diet really is…’or ‘You are clearly so emotionally attached to your carbohydrates that you are fishing for any and every reason to incorporate them in your diet again…’ I was convinced that dietary carbohydrate was the real culprit behind all human malaise, but then seemingly overnight, everything changed after approximately 8-years on a low-carbohydrate diet, the last 3-years of which were strictly ketogenic (5-years of low-carbohydrate by virtue of low-calorie due to my medication and 3-years of deliberate ketosis).

Without any change in my diet, exercise, or environment, my hair started falling out handfuls at a time, which was distressing, not because I was attached to my hair, but because I knew it was an indicator of something being very wrong. In the following weeks I developed an EXTREME intolerance to temperature changes and Raynaud’s phenomenon. I became irritable, miserable, cold, bitter – my personality completely changed. My workouts were maybe 30% of what they were just a few weeks prior and I gained 17 pounds over exactly 4 months, 3 weeks, and 2 days even though I was eating isocalorically (as measured via weighing/measuring food intake and activity monitoring activity levels via FitBit, self-quantification nerd right here). Oh, and I lost my period.

Everything, and I mean EVERYTHING, seemingly took a turn for the worst – I was complaining of exactly what the others I criticized about were complaining of. I was forced to ‘eat my thoughts’ and reconsider my original paradigm of a ketogenic diet.

Starting in June this past summer I started eating a strict moderate carbohydrate paleo diet. By the Fourth of July, all of my issues reversed and my period returned. In addition, my low-grade gingivitis that I have battled since childhood has COMPLETELY disappeared, a benefit that I didn’t experience eating ketogenic, which I find counterintuitive (you would assume that by eating ketogenic I would see an improvement in my oral health due to the nature of eating very little carbohydrate). My hair has stopped falling out and I can see little ‘baby hairs’ sprouting all over my skull. I’ve lost 19 pounds – yes, 19 pounds – all while eating a sweet potato at every meal, something my previously ketogenic-obsessed brain could not of fathomed a few months earlier. I feel better right now eating a moderate-carbohydrate, moderate/low-fat paleo diet then I ever did following a ketogenic protocol.

My diet has been isocaloric (from the inputs I have control) since I started eating ketogenic. From the best of my knowledge there is very little, if any, chance of error in my calculations during this entire period. My diet was a ‘well formulated’ ketogenic diet (>30g/day TOTAL carbohydrate (all carbohydrate coming from vegetables), ZERO vegetable oils, moderate protein intake from grass-fed animals and sea food, sodium/trace minerals and 1/4 of a multivitamin supplemented daily, etc.), sleep and exercise in check.

Previously my explanation would be that I simply wasn’t eating enough calories, but I am nearly 100% positive that wasn’t my issue. As of now, my thinking has evolved to believe that a ‘leaky gut’ was the issue behind both my ketogenic diet success AND failure.

My reasoning currently is this;

The reason why I saw such benefits from a ketogenic diet initially was because I eliminated a large proportion of my gut flora via carbohydrate restriction – essentially I starved them out. I still had a ‘leaky gut’, but the sheer QUANTITY of gut bacteria was drastically reduced, therefore the QUANTITY of bacteria seeping into my bloodstream was reduced as well. This decreased amount of low-grade sepsis allowed my neuroregulation of appetite, hormones, neuronal function, and my immune system to fix itself, therefore leading to the benefits that I experienced.

But by the very same token, the decreased amount of gut bacteria meant that I was absorbing less nutrients from my food and over the course of 3-years I slowly became nutrient deficient. Regardless of whether or not I was eating a nutrient-dense ketogenic diet, I wasn’t absorbing any of the nutrients because the microflora whose job is to assimilate those micronutrients just weren’t there, at least not in the titer required. Once I started eating more carbohydrate I encouraged the growth of the bacteria I needed to assimilate nutrients to return therefore reversing my symptoms.

To put it into a one-liner; The very ketogenic diet that saved my life turned around and caused my demise.

Am I following the right train of thought here? Right now I’m observing that if I get a little too crazy with the saturated fat my gums immediately become inflamed and will stay that way for approximately 5-hours before calming back down. Being that saturated fat causes intestinal permeability, this aligns with my reasoning. Which leads me to my question (finally, I know, I’m sorry for being so long winded);

What are your thoughts of this study that found that coconut oil increases intestinal permeability?: http://www.nutritionandmetabolism.com/content/10/1/6

Should those who are wary of developing a ‘leaky-guy’ be mindful of their coconut oil use along with all that’s required to follow a nutrient-dense paleo diet?

I plan on experimenting with coconut oil here soon and will be back with my results. In the mean time can I get your take on things?

Thank you so much for all that you do, and again, great post and I apologize for this being such a long post. I truly appreciate your time!

– Cat

I skimmed over the article Cat has linked to above and am now also wondering about saturated fats causing problems. I hadn’t read anything about that until now. Most of what I read about eating a Paleo diet and AIP, encourage including saturated fat back into our diet via cocnut oil, grass-fed butter and ghee, lard, tallow, etc. now I am totally confused.

I wonder if you could be sensitive to coconut, I am quite badly. I know that doesn’t answer about the article, but it could answer for your gums [my whole esophagus feels like it’s on fire for days if I eat any coconut oil or coconut yogurt.] Just a thought.

And probably — in many more cases even than those we’ve already demonstrated to be linked — by vaccines, which are inherently *designed* to alter the immune system from its natural course.

But nobody wants to look into that on a large scale because Merck and Pfizer and the like have too much money in the game. 🙁

Fabulous article, thank you so much Sarah for sharing your findings with us. I have gastric Crohns disease and Ankylosing Spondylitis and I am actually recovering from a severe flare, using diet, lifestyle and a big bunch of supplements … No drugs ! . The process is slow and I have to be disciplined. The reward is that pain is going away , every day a bit more. It feels like a victory. Your post is truly encouraging. I will keep eating nutrient-dense foods (liver !) , enjoy the sun and move gently my body.

Hmmm, while not an expert on the immune system, I’m not convinced. T-cells can proliferate and make memory T-cells which mount immune responses in the future. Don’t you think that the addition of these T-cells, which were already programmed to attack the gut, just acted like they would in the original host’s body by replicating themselves and propagating the immune response? They way I see it is that these cells were programmed to attack something – that something is the gut. Just because it is a “healthy” gut to start, doesn’t mean that these cells will act differently. They’ve essentially found a system which propagates itself in a loop, and then inserted elements from the loop to recreate the loop in a new environment. That being said, one could argue that once present, you could never fully heal from an autoimmune disease, by diet or otherwise, which is probably true. But by reducing total inflammation and the initiating disease process, which I think is more likely to be an initiating permeability to the gut leading to the immune response, you decrease the total level of disease to something that is tolerable, or even better, not noticeable. I’m not convinced by this article at all, and PLOS One is kind of going down the tubes right now, which questions the integrity of its “peer reviewers.”

Well, I think you got this wrong. To keep this simple: They transferred MOG-reactive T-cells (MOG is a protein in myelin, only present around nerves in the central nervous system) from an ill mouse to a healthy mouse to prove that when this mouse also gets ill (gets Multiple Sclerosis, but the animal kind) from these autoreactive T-cells attacking the brain, an increase of a leaky gut can be seen too = there is a corelation between MS and a leaky gut.

They do not transfer any T cells that are reactive to the gut itself, thus these T cells do not attack the gut but only the CNS.

Also, yes, it is not known if the leaky gut comes because of the disease (after onset), or is perhaps a trigger of disease (a leaky gut could be due to some genetics faults i.e.).

You should read the article before dismissing it as unconvincing, as your comment made it very clear you hadn’t really read it at all.

Gee Martina,
Way to make this personal…..
Actually, my comment supports the paleo mom’s original ideas about leaky gut and the link between autoimmune disease, which I actually think is correct. I have every right to not buy into this one publication, and the fall of this journal is well documented.
I did read the article. AND just because an immune response in the form of an antibody in the body is initially created against one target (say a protein, like MOG), it doesn’t mean that it won’t also react with other proteins in the body, because the antigen on the protein is not specific to the protein itself, but just a portion of the protein.
Maybe check your facts, because all I did was ask a question, and certainly was soliciting a “tongue lashing” from you. I guess this blog isn’t really a friendly place to talk about science…. good to know.

Meg, I am very sorry if you thought my comment was personal and rude, I read it over again and it sure does not sound as I intended it to sound, and I didn’t mean anything in a personal way, sorry again and I hope that you accept my apology!

Anyhow, I will try this again without it sounding wrong:

Of course you have the right to not believe in this one publication, it needs to be replicated many more times before we know “the truth”. I am just saying that if you immunize the mice with MOG -peptide (they are using only a small portion of the MOG-protein, I think only a few aminoacids long), the immune system will not mount a response against other proteins in the body, just the MOG-peptide sequence= the immune system does not attack the gut after immunization. This is why vaccines are safe, as you immunize the person only with small fragments from the virus you are protecting the person from, which will mount the immune respons only against this peptide (and not others as this could have detrimental effects).

Maybe you got different information reading the article than I did, and that’s why our opinions differ. Hope you understand me better now and that I wrote in a nicer way, I clearly need to practice on my comment-writing skills.

Hi Sarah,

Do we as future moms pass the immune cells responsible for damaging the gut and Hashi’s to our children? I have a 4 year old girl, I’ve had Hashi’s for almost 20 years. Can we say for sure that moms pass on the auto immune cells to their children? I breastfed her for a year.
I would love more kids but on some days I feel sad putting them through what I experience which is constant low energy and brain fog. I love life and there is so much I want to accomplish, but I feel trapped in my body and brain, as if they can’t keep up.


According to Sarah, colostrum can reduce the intestinal permeability caused by NSAIDs but significantly increases intestinal permeability caused by endurance exercise, so it’s kind of a gray area. – Christina, Sarah’s assistant

How would I know if I need to do AIP, or just follow Paleo? I’ve recently been diagnosed with Crohn’s, discovered because of iron deficiency anemia, & am otherwise asymptomatic. After the diagnosis, & lots of reading, decided to go gluten free (but am really shooting for all paleo). Again, wasn’t sure if I need to go further with AIP? I’ve not had any specufic food allergy testing, but feel fine eating anything. Thank you in advance! Love your blog!

Thanks, that bothered me too in an otherwise excellently-spelled article. There was also this:

“And regulatory T-cells, which are supposed to reign in the immune system…”

That should be *rein* in.

I wondered if there was a way to check the mice’s stomach’s before doing anything to them – to see if any had a stomach problem to begin with & then check the ones that didn’t get sick to see if their stomach was still healthy. Just to see if they maybe had extra healthy stomachs, and maybe the others were weaker in that area, thus more vulnerable.

I have a special place in my heart for people who fundamentally understand the science and break it down in an objective way for everyone else! Nicely done. Since I rarely have the time to do such awesome work these days, I was happy to share this post on the facebook page for my site. I hope you don’t mind :). I’m sure to be checking in to see what you’re up to next…

IF autoimmune disease attacks the pancreas and / or liver, the same protocol is followed ?
There are variations from fats or carbohydrates ?
and if there is severe malnutrition ? You can add rice or buckwheat previously soaked and boiled in coconut oil ? I need help please . Thanks !

The answer is both, depending on the pathophysiology.

Consider the following completely different case:
1) CFS -> immune dysfunction -> candida -> leaky gut -> inflammation -> immune dysfunction
2) Salmonella infection -> leaky gut -> inflammation -> immune dysfunction

I think this points to helminthic therapy as a very important addition to any autoimmune treatment. Helminths regulate the immune system and increase the number ot t regs. It also shows why fecal microbiota transplant is often unsuccesfull in autoimmune disease, even though leaky gut and sybiosis very clearly present. In CDiff infection FMT treats the cause, but in autoimmune disease FMT usually just treats the symptom not the cause.

I’ve been diagnosed with UC for 12 years now but was recently made aware that the Army base I received my Basic & AIT school were shut down due to toxic levels of PCBs (heard of Monasato & Agent Orange). According to studies, many soldiers have been diagnosed with Autoimmune Diseases and cancers, so I was offering that as an origin ‘trail’ – I read the comments where some thought vaccinations or antibiotics could have contributed, so just thought I would throw that out there.

My 4 yr old son was diagnosed with type 1 diabetes 2 days after finishing a course of macrolide antibiotics. He also had a course when he was 1 week old plus several other courses. Macrolides antibiotics combine with bile acid. I think the successive rounds of antibiotics may have caused gut dysbiosis and perhaps leaky gut as a contributor to the autoimmune response. Still trying to figure out what happened.

“A leaky gut is present in every autoimmune disease in which it has been tested, including in people with rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel disease (Crohn’s and ulcerative colitis), celiac disease, multiple sclerosis, and type 1 diabetes.”

Has it been tested on Polymyositis?

I know there are only a few and scarse scientific papers on this, but please do not overlook the impact of increased exposure to electromagnetic fields, more specifically in the microwave band, on the immune system. The are no minimal tresholds in that specific range (ie. no safety level), and the effects have shown to be cummulative. The first reaction of the cell is to contract which stops all normal processes.

Is there any information as to how this applies to a auto- immune illness of multi -focal neuropathy?
known as mnms.

a very rare disease that attacked the nerves.
Very few people have it.
any info would be great from someone who knows about this.

@jim gallagher

“Is there any information as to how this applies to a auto- immune illness of multi -focal neuropathy?
known as mnms.

a very rare disease that attacked the nerves.
Very few people have it.
any info would be great from someone who knows about this.”

Do you mean Multifocal Motor Neuropathy, or MMN? I have that, and have been very interested in diet, both as a possible cause and for treatment to ameliorate symptoms. You can read more about it on the MMN Forum (mmnforum.com/forum). Click on “diet” and “low carb” in the tag cloud. Disclaimer: I run the forum.

May I ask where you see in the bespoken study a direct link to the kind of food a sick person eats? The study is indeed interesting, but the outcome should be in my opinion vice versa to support your hypothesis.

Best regards,


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