The Leaky Gut?

Over an year ago, I was introduced to a mind-twisting concept to auto-immune disorders. The Clinical Reviews in Allergy and Immunology journal published an article in Feb 2012 that was titled “Leaky gut and Auto-immune diseases“. The more I explored the leaky gut syndrome, it started becoming clear to me the link between various degenerative diseases of the lifestyle and the lifestyle itself. Interestingly, when we talk to the doctors, most of them refer to these diseases as lifestyle diseases but cannot pin point exactly “what lifestyle changes” cause these or can avert such diseases. With that, I am referring to all the auto-immune diseases such as thyroid conditions, rheumatoid arthritis, eczema, multiple sclerosis, Alzheimer’s and over 80 other conditions that have been categorized as auto-immune. Most of the doctors as well as the government health websites also state that the cause of auto-immune disorders is not known, whereas all this time, it is staring in the face with loads of medical research to back it up.

The concept is a bit different from the conventional model of medicine where we try to disassociate all the body parts and look at them in isolation. Which is probably why it took me several months to wrap my head around this concept and understand how exactly it impacts the individual diseases. I am going to make the best effort here to simplify the workings.

The human body has various barrier mechanisms that help protect our internal organs from external invaders. So what are some of the common barriers you may ask? The obvious ones – Skin. A bit less obvious – Lungs that act as a barrier for external air and does not let it directly interact with the organs and blood till its purified and deemed safe for use. The other less commonly thought of barrier is the small intestine, which we’ve been referring to as the gut. If you really think about this, the entire passage of food – starting from the mouth right till the anus, is actually just a long tube. Everything that happens in that tube is “outside” of the body.  Its this tube that processes food and makes it ready for your body to absorb. The food that is ready to be absorbed is pushed outside of this tube on its way out. Whatever cannot be processed falls out the next morning.

The small intestine has a mucosal lining that absorbs the digested food molecules. Imagine the lining of the small intestine as a sieve – albeit a very fine sieve that only allows extremely finely  digested particles. Infact, in the ideal scenario, the only things that would be able to pass this sieve are completely digested molecules that are small enough to be immediately assimilated into the blood stream.

But then as we know, none of our bodies are in the “ideal” condition today. Frequent stress, chemicals in the food supply, lack of sleep, parasite infections and similar stressors take a toll on this intestinal sieve starting to break it apart. So in effect, instead of a fine mesh, the intestine starts experiencing bigger “holes” or tears in the mesh that allows bigger molecules (not completely digested) in the bloodstream. This leakiness of the gut is also known as “intestinal permeability” in the  medical lingo.

Once the undigested particles start escaping in the blood stream, that’s where the immune system kicks-in. It now sees the bigger undigested molecules as invaders since they are not supposed to be there in the blood stream. The immune system starts to generate anti-bodies to kick these molecules out of the blood-stream. At this point, by freak of nature or with a explained process called “molecular mimicry”, some of the undigested molecules have similar chemical signatures as some of the tissues in the body. Once the anti-bodies for the specific chemical signature are generated, their sole objective is to kill everything that matches that specific chemical signature. In a normal circumstance, this behavior is useful when the body uses it for fighting with virus invasions. However, due to this behavior and the “virtue” of the molecular mimicry, the body now starts attacking its own tissue. For instance, it will start attacking the thyroid hormone to cause hypothyroidism. Or it will start attacking the joints to trigger a rheumatoid arthritis. Again, in usual circumstances, the body has a regulatory mechanism built-in to control such auto-immune attacks (called regulatory T-cells) . However, certain polymorphisms (or mutations) in the genes can cause this regulatory mechanism to not work as expected against some tissues. For someone who has auto-immune thyroid disorders, their immune system is not regulating the auto-immune attack on thyroid. The regulatory t-cells think of that attack as normal due to the genetic mutation.

Some of the very recent studies are discussing if this genetic mutation is actually “epi-genetic“. Epigenetics is basically part of the gene expression that can be changed or influenced by lifestyle factors during the lifespan of a person. Contrary to the belief that the genetics are cast in stone at birth, the field of epigenetics is actually showing us that the gene expressions can change throughout your lifetime based on your lifestyle choices and events.

This is a very high level view of how the auto-immune diseases trigger. There are obviously much deeper mechanisms playing hand here which I have not discussed here. But my hope is that will provide at least a basic understanding of auto-immunity mechanisms without overwhelming. This mechanism is also the basic underlying mechanism for almost all the auto-immune diseases. So it would not be very wrong for us to say that the gut is the birth-place of all (or most of the) lifestyle diseases today.

If this information interests your geeky mind, you might want to use the below articles for your night time reading –

Molecular Mimicry: Its Evolution from Concept to mechanism as a cause of Autoimmune diseases

Leaky gut in Type 1 Diabetes

–  Intestinal Permeability: An Overview – Do note however that this article is over 20 years old now. Although its good to understand the concepts, some of the inconclusive points that it talks about are proven with a lot of modern research.

According to the US Department of Health and Human Services, auto-immune diseases affect over 23.5 million Americans and are a leading cause of death and disability. The numbers in most of the other countries are almost the same.

Do you know someone with any auto-immune conditions? ( such as Type 1 Diabetes, Thyroid disorders, multiple sclerosis, Lupus, Rheumatoid arthritis, eczema, etc.)  Send this information over to them. This might just be the information they need to get towards a better life.



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