Zonulin + Intestinal Permeability
I recently had the opportunity to listen to Dr. Alessio Fasano speak at the 2018 IFM Annual International Conference - Solving the Puzzle of Autoimmunity: The Interplay of Gut, Genes, and Environment. It was a fascinating several days filled with physicians, researchers and functional medicine experts like Mark Hyman, M.D., Alessio Fasano, M.D., Jeffrey Bland, Ph.D., Steven Gundry, M.D., Terry Wahls, M.D., Thomas O'Bryan, Ph.D., and Yehuda Schoenfeld, M.D.
Until now, there has been too little attention focusing on determine the causes of autoimmunity. The conference was centered around learning applications that can prevent and treat the various triggers and mediators of autoimmune disease.
Function of the Intestinal Tract
An important function of the intestinal tract (the "gut") is to monitor and regulate molecules that can cross through the barrier of the intestines.
I think visuals help. Imagine that your gut is lined with rugby players standing shoulder to shoulder. These rugby players in your gut are there to control what leaves your intestinal barrier and what has to stay in. When we have "leaky gut", we have gaps in the spaces between the rugby players and molecules from the food we eat, gets out of our intestinal tract and into our bloodstream. Our body reacts thinking these food particles are foreign invaders and sends out an immune response - INFLAMMATION!
Zonulin and Tight Junctions
So we want to have "tight junctions" in our intestines, like a lineup of strong rugby players who don't let anything pass through that isn't supposed to pass through.
Let's introduce zonulin.
Zonulin is a protein that is synthesized in intestinal cells and liver cells. It is a key biomarker for intestinal permeability and is the only regulator of intestinal permeability that is reversible. Zonulin opens up the spaces between the cells of the intestinal lining. In our example, Zonulin is able to muscle spaces between our strong rugby players.
Zonulin has an important role because it allows nutrients to get in and out of the intestinal tract. However when there is intestinal permeability, larger protein molecules also get into the bloodstream and your body mounts an immune response. Your body becomes inflamed, and in genetically susceptible individuals, autoimmune can occur.
Gluten + Bacteria
What causes zonulin to make gaps in our intestinal cell structure? Dr. Fasano says its two things - gluten and bacteria. Gluten contains gliadin (a protein) which increases zonulin. This occurs with individuals who have celiac disease and (pay attention) - those who don't!
So zonulin is pretty important. Too much is a disaster for our health. Conditions like Small Intestinal Bacterial Overgrowth (SIBO), gut dysbiosis, bacterial/viral/parasitic infections both can cause an increase in zonulin.
Gluten and grains can cause an increase in zonulin.
Increased intestinal permeability can be caused by food allergies and sensitivities, stress, infections and low stomach acid, among other causes. Elevated levels of zonulin are associated with Celiac Disease, Autoimmune disease, and Multiple Sclerosis, in addition other chronic illnesses. In a healthy gut, there are healthy cell junctions and good nutrient absorption. In a leaky gut, however, the Villi are damaged, there is poor absorption and the cell junctions are loose. This means that bacteria and unwanted items can pass through the gut.
Measuring zonulin is one way to diagnose a leaky gut. Zonulin Testing is a good way to measure if food elimination is working to improve intestinal permeability. It is estimated that anywhere between 50 and 100 percent of food intolerance sufferers have increased intestinal permeability. For some of my clients, I offer the KBMO Fit Test with Zonulin. I recently had one done myself and I learned that my zonulin levels were really good and I did not have signs of intestinal permeability. This provides reinforcement and encouragement to keep working hard at eating healthy foods which my body likes.
Eliminating Reactive Foods
There is a growing body of evidence to support the clinical benefits of eliminating IgG reactive foods from the diet. IgG food sensitivities have been implicated in weight gain, arthritis, eczema, migraine headaches, irritable bowel syndrome, bloating and indigestion, fatigue, chronic post nasal drip, autoimmune diseases and more. Discovering what your food sensitivities are is an important step towards achieving optimal health. The KBMO FIT Test is different than every other IgG test out there as it looks for a special protein called "complement" which helps avoid false positives and limits the number of foods that need to be taken out of your diet. KBMO measures 132 foods and food additives (including Candida), for IgG 1-4 and C3d compliment (measuring 2 inflammatory pathways instead of just IgG dramatically reduces false positives compared to traditional IgG testing). Zonulin testing measures the protein that binds the cell walls in the intestines (which is associated with intestinal hyper-permeability). You can schedule food sensitivity and zonulin test here.
If you are interested in Dr. Fasano's work, here is one of his articles on intestinal permeability and the role of zonulin. Enjoy and share your thoughts below!