20 Aug Top 9 Science-Backed Leaky Gut Tests You Should Ask Your Doctor For
Our modern, hectic lifestyles and varied, polluted environments create havoc for our bodies and dealing with such diverse influences places a huge strain on the inner workings of your system. This is why many of us are actually suffering from a condition that underlies all kinds of problems and diseases we experience in our everyday lives.
It is so critical to our overall health that, when affected, it can be the main cause of all kinds of issues, from internal digestive problems to chronic lifelong illness and even auto-immune diseases.
This is Leaky Gut and these are the Leaky Gut Tests to ask your Dr for.
- Lactulose & Mannitol Test
- Blood Zonulin Test
- Stool or Faecal Matter Test
- Organic Acids Test
- IgG Food Intolerance Test
- The 3 Hour Lactulose Breath Test
- Small Intestine Aspirate
- Functional Medicine Comprehensive Stool Test
- Comprehensive Gut Grader
What is Leaky Gut?
Your gut is the gateway to your inner system health, and this, in turn, promotes your overall health and resilience. This is because, at any given time, between 60-80% of your body’s immune system is present within the gut. In addition, up to 95% of serotonin, the hormone your body secretes to make you feel good, is produced…you’ve guessed it…in your gut.
Your gut is a linked system of tightly bound junctions that sit together. You digest whatever you put in your gut via tiny villi, small nodes that cover the surface and in turn provide a huge surface area over which to absorb substances. The junctions on which the villi sit are semi-permeable, meaning they can open just a little in order to allow macronutrients through for your bodily needs.
These junctions can also be opened at incorrect moments to allow larger unwanted substances through the gut, and this is where problems start to happen. One notable culprit that allows this opening is gluten, as when ingested it sits on the junctions and releases a substance called zonulin, which keeps the gates open, so to speak. This means that larger food particles that were never intended to pass through the gut can do so.
Gluten is an example of an ‘inflammatory food’, meaning the range of substances we can ingest that cause the junctions in the gut to stay open. Depending on your specific tolerances, the casein protein in dairy foods can cause this to happen, or glutens present in grain products, together with nuts, seeds, and many legumes. Alcohol, caffeine, and sugars are all ‘toxic’ to a degree, and overly processed and packaged foods can also play a significant role in causing havoc in the gut, irritating it and disrupting the microbiome to create open junctions.
Additionally, other substances such as infectious bacteria, candida, medications and antibiotics or anti-inflammatories, even stress itself, can contribute to opening up the gates and allowing particles through.
Once these substances pass through, they face only minimal cellular barriers until they can enter directly into the bloodstream, something they never should be able to achieve if the gut junctions were maintained in tight order.
Leaky Gut Symptoms
Because the condition lies at the core of your bodily functions, symptoms that could point to Leaky Gut are diverse. It could be a single symptom or a combination of several while the knock-on effects of Leaky Gut interact to create further problems.
One of the most prominent symptoms is directly at the source of the problem, namely from the gut itself. Digestive issues such as feeling bloated, obvious ‘additional’ gas, and diarrhoea are all indicators of trouble at the gut level or imbalance. Developed further, a persistent condition will reveal itself as irritable bowel syndrome (IBS), with constipation and abdominal pain indicators.
Your general mood may become imbalanced, with heightened periods of abnormal anxiety and lulls of depression. Difficulty focusing and a blurry mind can be commonplace and may increase to full Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) reducing your ability to keep control of your behaviour.
Seasonal allergies that you normally experience may become far more pronounced in their severity, as might food intolerances. Asthma can go through the roof, so normal irritations in slightly polluted environments can become fully fledged reactions.
Visibly, the imbalances attributed to Leaky Gut can result in skin breaking out in acne, rosacea, or eczema, while hormonally, Leaky Gut can wreak havoc, especially in women. Regular hormone patterns such as the menstrual cycle can be dislodged from their expected rhythms, while PMT can increase in severity and even Polycystic Ovary Syndrome (PCOS) may be exacerbated, affecting your fertility and childbearing potential.
Finally, Leaky Gut can result in overall chronic fatigue or the widespread pain associated with fibromyalgia. Additionally, it can hide behind other diagnoses for conditions such as rheumatoid arthritis (RH), lupus, or celiac disease, all masking the fact in some cases that your overall gut health is impaired and Leaky Gut is sending false signals.
Leaky Gut Causes
As mentioned, Leaky Gut can occur due to a wide range of factors. Leaky Gut causes include inflammatory foods in your diet, gut infections such as Small Intestinal Bacterial Overgrowth (SIBO), candida, and other related parasites. Certain medications or foods that contain significant or unusual amounts of toxins, such as mercury and pesticides in unwashed conventionally farmed foods, and BPA found in plastics, can all become causative factors in the development of Leaky Gut.
Leaky Gut Tests: 9 Tests to Ask Your Dr for if you suspect Leaky Gut
If you are experiencing any of these symptoms or similarly feeling unbalanced compared to what you know is your normal healthy self, then you need to contact your doctor and start looking for the holistic factors that may be causing such change to your overall system. It’s not always the ‘ideal’ of successful Western medicine, i.e. a visible single cause and a nicely balanced treatment. In the case of Leaky Gut, your whole bodily functioning is compromised because of the spreading effects of issues at the source, in your gut wall.
However despairing the situation sounds, the fact that Leaky Gut can present so many widespread symptoms actually provides more options for your doctor to start testing for it. Medical professionals can evaluate various factors, including dietary inputs, evidence of allergies and change in activity, and the hormonal or mood-related symptoms to start cross-linking the evidence and find where Leaky Gut could be the systemic culprit.
Additionally, doctors can also administer direct and indirect tests to detect a range of biochemical signals your body may be sending out that indicate the various bodily imbalances we are looking for, to look for signs of malabsorption in your gut that run counter to the healthy absorption of a happily working gut.
Here are the 9 varied tests your trusted medical professional should be requested to undertake to search for the Leaky Gut causes visible through the Leaky Gut symptoms we have discussed.
1. Lactulose & Mannitol Test
This test is designed to assess the degree of permeability in your gut, so the extent of how open or closed the junctions in your gut wall are. This malabsorption is measured by drinking a pre-measured quantity of a large molecule non-absorbable sugar, lactulose, and the small molecule mannitol, a kind of sugar alcohol that is used as a food sweetener and is poorly absorbed by your intestines.
Over the next 6 hours, your urine is tested and the sugar levels present will indicate the extent of malabsorption. The presence of lactulose means larger molecules can pass through, so Leaky Gut could be in evidence.
Though a logical test to indicate intestinal wall functioning, this test can also be affected by other competing factors within the body that could make the result unclear. Studies have shown that, though simple to take, the test does require more development to pare down the factors that get in the way so that clear results can be measured.
2. Blood Zonulin Test
This is the only blood test that really shows promise to detect Leaky Gut. Zonulin has the effect of ‘persuading’ your gut junctions to open. It regulates intestinal barrier function, and this decides what remains in your gut and what passes through. If you have more Zonulin then the gut wall openings can increase in size. In this way, we call this more permeable or ‘leaky’.
However, Zonulin isn’t the ‘bad guy’. It is the natural ‘gatekeeper’ that regulates gut wall opening to allow healthy macronutrients through in the regular functioning of our intestines. It’s simply a case that too much Zonulin can exacerbate the effects of Leaky Gut.
Testing for Zonulin levels in the blood is, therefore, an effective method to understand the potential for how severe your Leaky Gut could be. Depending on how far above ‘regular’ levels your Zonulin may be, this test can also reveal, together with solid and extensive dietary information, exactly which foods you may be putting in your system that are causing Zonulin levels to increase.
In this way, the Blood Zonulin Test is highly effective in identifying problems with your lifestyle. You may find, for example, that your lifelong love of dairy foods is, in fact, highly inadvisable for your particular system. Or equally, it could determine whether you are gluten intolerant or may have inadvisable levels of candida or other harmful bacteria in your system that could require ‘rebalancing’ in the form of a renewed approach to what you eat or how you prepare your food.
Indirect Testing (tests which do not directly test for Leaky Gut, but assist in diagnosis)
3. Stool or Faecal Matter Test
This is perhaps the test you may not wish to undergo. It’s a little disconcerting to confront yourself with something that normally remains ‘out of sight, out of mind’, but the good old stool sample can be a critical indicator of the state of your gut health. It is, after all, ‘direct from the source’.
To add discomfort to the situation, this test also calls for not one single stool sampling, but two in order to complete the test requirements.
The key is to take both the samples an equal distance apart. Luckily, this syncs with what may be your ‘regular’ movement of approximately one day apart. Anything further than 12 hours apart should provide the testing results required.
This gap in time will show the differences in your samples that can be analysed to show how much your good and bad bacteria levels have changed, if there is a change in the amount of yeast, and the levels of digestive enzymes present that indicate how your gut is reacting to conditions. Also, this test will indicate how well your immune function is doing and if there is inflammation.
In short, testing your stool is normally a reasonable method to get a ‘snapshot’ of your gut health, what it’s doing, and how well the engine is running, so to speak. However, despite timing the two tests apart to give a baseline and more information to determine real gut functioning, this test still isn’t a 100% complete indicator of what’s going on inside your intestine. The reason is that many bacteria and diseases will not appear in your stool. Instead, they are designed to remain within the gut lining. This means that we have an incomplete overview of your gut health with a stool test, as it can only show some of the symptoms and generally not everything we need to form a truly comprehensive picture.
Your stool certainly will tell you a lot, but the specific villains in your own personal Leaky Gut story may be missing, and that means your doctor will be hard pressed to arrive at a firm (no pun intended) conclusion.
4. Organic Acids Test
This test works to assess methylation, the chemical process that is an essential metabolic function of your body. Methylation pathways accompany the formation of proteins, amino acids, and other biochemistry. They are essentially the uncountable on/off switches that control everything from how your body makes its energy from the food you eat, how you detoxify unwanted substances, your inflammation response to stress, and how you fight off infection and viruses via your immune system response.
Methyl groups control all these processes and are comprised of organic acids. Interrupting the methylation cycle and reducing your body’s potential to switch all those essential processes on or off means you are opening yourself to sickness, especially in people with susceptibility to autoimmune conditions. Methylation is super important in the production and reuse of your body’s master antioxidant, glutathione, the substance that plays a critical role in neutralising free radicals from sun exposure, reducing inflammation during illness and stress, and in helping your body make the best use of other antioxidants such as vitamins C and E, and lipoic acid. Vitamin B is also an important player in bodily defence, and its levels are tested with the Organic Acids Test.
Basically, glutathione contains chemical compounds that ‘stick’ to unwanted heavy metal toxins and escort them, like a bouncer, right out of your body. Gut microbes are constantly busy producing an array of chemicals for varying purposes, and in certain cases, these can also adversely affect your methylation pathways by spilling through the gut wall into your bloodstream, where they then transport around your body and interfere with certain processes.
However, in ‘regular’ healthy gut circumstances this should not occur. It depends on whether your gut bacteria are in healthy balance or being driven into a state of overpopulation and activity due to other issues in the gut.
Testing for organic acids can be undertaken via simple urine sampling. It looks for ‘biomarkers’ that reveal what the state of chemical play is in your gut, and therefore the degree to which your methylation pathways may have been compromised. It shows how your gut can be interfering, and therefore illuminates the problems that may require treatment through ‘rebalancing’ measures to start returning your gut to functional balanced health.
Depending on how many factors your doctor wants to look for, this is a simple, cost-effective, and comprehensive test that is sensitive enough to outline the issues that may not be found in the stool test.
5. IgG Food Intolerance Test
Food intolerances are critical to address in good time. If there are substances you can understand are regularly going to be harmful to the effective working health of your body, then you need to find out what they are and take steps to limit their inclusion in your regular diet and lifestyle. It may not be ‘half the battle’, but certainly, a great deal of harm can be avoided through a solid familiarity with how your body reacts to certain foods. Particles that reach the bloodstream due to Leaky Gut kick your immune system into overdrive, so looking for this kind of response is the first step in tackling intolerances.
Prevention, via understanding, is always the best first measure to take.
A food allergy is an adverse reaction to a given food. A food intolerance is somewhat more serious as it underlines substances your body simply should not be ingesting. Testing can be difficult, simply because there are hundreds of potentially harmful culprits out there that could upset the working balance of your particular system. Food intolerance testing involves screening you against a list of foods you have provided that you find issue with. It can involve a significant amount of introspection and evaluation to start with to determine which foods, yes foods plural, sorry, may actually be doing you harm. Many people are reluctant to point a finger at their favourite snack, even when it’s clearly something the body doesn’t want.
Immunoglobulin G, or IgG, is the body’s most common antibody that represents 75% of your total. Testing for its presence via a simple finger prick blood sampling can provide the information needed to identify specific immune system-based food intolerances, based on the IgG levels measured. You ingest a certain food and, if you have a native intolerance, your body will react with an inflammatory response. IgG levels jump and therefore indicate how sensitive you are to that given food.
The blood test helps form a picture that can be adapted to a personalised regimen of vitamin and supplement recommendations, thereby moving you toward a state of optimal, or at least more balanced, nutrition for your particular needs.
Testing for Other Forgotten Conditions Which Cause Leaky Gut
6. The 3 Hour Lactulose Breath Test (Testing for SIBO)
It’s tough to really work out what is happening in the small intestine. It’s a long, long environment that means poking an endoscope only goes so far, while more drastic measures such as a colonoscopy only analyse the end portion of the intestine.
Fortunately, gaining a picture of the levels of bacterial activity in your small intestine and the potential for SIBO is possible via a less drastic, non-invasive test. Since the human body cannot digest or absorb lactulose, as it lacks the bacteria required to do so, taking it into your system will result in gas created as a byproduct of your gut bacteria trying to feed off the lactulose carbohydrates. This produces different levels of either Hydrogen (H) or Methane (M) in the lungs and therefore in your breath, and these levels tell the story of which bacteria are doing what, and in turn, whether there is overgrowth (SIBO).
The test can be taken at home or in the lab. You fast for 12 hours first after a special diet for the prior 2 days to prepare the gut conditions for accurate testing. This means taking out fermenting foods that can interfere with the bacteria and develop false results. First, you breathe into a tube to create a baseline level of H and M, then drink the lactulose solution. By simply breathing again into the tube every twenty minutes, you test how the H and M levels change. There is a positive SIBO result if H and/or M elevate after taking the lactulose.
You must test for both H and M. This is because although both are produced from the gut, in many people the H levels are too low to detect. Therefore, we rely on M levels as well to develop reliable results. Although this test will diagnose SIBO at the end of the small intestine, it may not be quite as comprehensive as a similar glucose test that tells us what is happening in the earlier portions of the intestine. However, as it is so simple to undertake and the results are even more reliable the longer you take the test, the Lactulose Breath Test is considered the accurate option for understanding SIBO.
Read the overview of the testing procedure to see if this is something you feel fits your needs.
7. Small Intestine Aspirate (SIFO)
Small Intestine Fungal Overgrowth (SIFO) is also now identified as a common cause of IBS, as well as SIBO. Candida is a major culprit, and, though naturally present in the gut, it can become truly problematic when overgrowth occurs due to imbalance. This is when candida releases toxins such as uric acid and acetaldehyde that enter the bloodstream and cause problems such as brain fog.
It’s somewhat more difficult to test but can help to understand the state of your intestinal health when SIBO results and follow up treatment don’t work effectively.
Since fungus doesn’t ferment and give off detectable gases like bacteria, we need to instead take fluid from the small intestine by aspirating it, or pulling it out via negative suction. The main drawback versus the other options listed here is that aspirating fluid is cumbersome for the doctor and the most invasive procedure for the patient. Until there is another option, this is probably the best method to use as it doesn’t lead to the ‘false positives’ found in stool testing. Aspirating involves performing an esophagogastroduodenoscopy (EGD), so it’s up to you as the patient if you wish to undergo discomfort in return for solid results.
8. Functional Medicine Comprehensive Stool Test (Intestinal Parasites)
This process tests for levels of ‘good bacteria’, the beneficial soldiers of the body, in your gut. It also determines if there are any infections via ‘bad bacteria’, certain yeasts, or intestinal parasites. It can tell you how well your gut it actually performing in terms of breaking down fibre and fats, immune system levels, and reactivity to certain inputs, such as gluten. All these indicators may reveal the presence of parasitic activity, wreaking havoc on the balance of gut interactions.
Parasites are not an abnormal occurrence. They can be contracted through improperly prepared or undercooked foods such as meats, or via contaminated water or unwashed produce. They can reveal themselves through constipation, diarrhoea, IBS, gas, or many of the other symptoms associated with Leaky Gut. By attaching themselves to the intestinal wall, parasites can injure its structure and increase its permeability, causing Leaky Gut.
The best way to know for sure is via a Functional Medicine Comprehensive Stool Test, which goes beyond regular stool tests by adopting a Polymerase Chain Reaction (PRC) to ‘amplify’ the DNA signature of any detected parasite, whether that parasite is living or dead. This test shows the parasite’s genetic material present in your gut, and as such is very reliable in identifying exactly which parasites are present, allowing your doctor to formulate the correct treatment response to help remove those parasites from your system.
If you can deal with the light trauma of another stool sampling, then opting to use genetic medicine is a wholly sensible way to understand exactly what has invaded your gut and is causing exactly which specific issues. And naturally, testing more will result in more comprehensive results. Ask for a triple faecal test or a purges sample (using laxatives that sweep the gut for all parasites) to make it truly comprehensive.
9. Comprehensive Gut Grader
Finally, if you suspect that you may have Leaky Gut, or simply wish to take the sensible approach of finding out about your overall gut health for preventative understanding, then you can take this free and comprehensive Gut Grade Assessment. It has been formulated to assess your intestinal health based on the Four Pillars of Health, which include your Diet, Lifestyle, Signs and Symptoms, and the Mind.
This may be the most pragmatic first step that you can take yourself to gain a better understanding of what is happening with your body. You can then start making informed decisions on how to address the potential you have Leaky Gut by working on a plan of attack with your doctor.