Are Your 'Healthy' Habits Causing Leaky Gut? A Doctor Explains

Integrative Medicine Doctor By Aviva Romm, M.D.
Integrative Medicine Doctor
Aviva Romm, M.D. is both a midwife and an Internal Medicine and Board Certified Family Physician with specialties in Integrative Gynecology, Obstetric and Pediatrics, with a focus on women’s endocrinology.
Are Your 'Healthy' Habits Causing Leaky Gut? A Doctor Explains
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A midwife, herbalist, ecologist, mom, writer, and Yale-trained MD, Dr. Aviva Romm has dedicated her life to understanding women’s bodies. This excerpt from new book, The Adrenal Thyroid Revolution: A Proven 4-Week Program To Rescue Your Metabolism, Hormones, Mind & Mood, is all about dysbiosis, or what happens in an unbalanced microbiome. 

Your digestive system is colonized with microorganisms from your mouth to your anus; each region of the gut has its own unique flora, in varying amounts. Dysbiosis is the technical name for disruption in your microbiome. You can have overgrowth of unfriendly species, loss of helpful species, or most commonly, a combination of both. It can occur in any area of the gut; most commonly it occurs in the small and large intestine.

Dysbiosis, like leaky gut, is caused by four main factors.

  • Stress, which changes the milieu of the gut, as well as blood flow to the gut lining, impacting the health of the intestinal lining and the type and quality of gut flora you grow
  • Certain medications, especially antibiotics that can wipe out enormous numbers of gut flora species even with just one dose, antacids that reduce stomach acidity that protects against bacterial overgrowth in the upper small intestine (when this overgrowth occurs, it is called small intestinal bacterial overgrowth), and medications that damage the gut lining (for example, ibuprofen and Tylenol)
  • Deficiencies of gut-protective nutrients (especially vitamin A, zinc, iron, and vitamin D)
  • A diet high in unhealthy carbs, sugars, and bad-quality fats, and low in fiber, fresh fruits, and vegetables, and lacking traditionally fermented foods such as sauerkraut, yogurt, and kimchi

What type of diet hurts the microbiome?

Eating a diet of highly processed foods for just ten to fourteen days can reduce your microbiome diversity by 40 percent, while those who eat a traditional whole-foods diet are up to 40 percent more resilient to stress and mental illness than those who eat a processed foods diet. It’s no wonder then that a shift in the Western diet for the worse in the past few decades has corresponded directly with an increase in chronic and autoimmune diseases and obesity.

Recent research has uncovered a connection between industrial food additives and autoimmune disease. It appears that these additives (discussed in the section on environmental toxins) damage the epithelial lining of your intestines, and this too can create leaky gut, which then activates an autoimmune cascade. Conversely, a diet rich in high-fiber, antioxidant-rich vegetables, slow-burning carbohydrates, good-quality protein, and excellent fats, along with a small amount of naturally fermented foods, provides the “ingredients” needed for a healthy intestinal lining and microbiome.

Some life-saving medications have unintentional (but often fixable!) health consequences.

While medications may sometimes be necessary and even lifesaving, most have unintended consequences, and when it comes to antibiotics, proton pump inhibitors (PPIs), NSAIDs, and acetaminophen, the consequences are damage to your gut ecosystem and infrastructure. More than 70 percent of the antibiotics prescribed in the United States are unnecessary, and on top of this unnecessary insult, 80 percent of all antibiotics produced in the United States end up in our meat as a result of being fed to cattle to make them grow fatter, faster.

Antibiotics destroy the gut flora responsible for about 90 percent of your metabolic activity, hormone detoxification, nutrient synthesis, and protection of your intestinal lining, which is meant to protect against leaky gut.

Even just one course of treatment can irrevocably wipe out entire species of important gut microflora. Many women have had the experience of taking an antibiotic for bronchitis or another infection, only to then spend months battling a vaginal yeast infection. This is because the antibiotic wipes out the Lactobacillus and Bifidobacterium species that keep Candida (yeast) in check.

PPIs (antacid medications such as Prilosec) and NSAIDs induce leaky gut and have been associated with the development of autoimmune disease, while acetaminophen damages the delicate lining of the stomach and can lead to gastrointestinal bleeding and problems with the absorption of nutrients needed for gut health. Small intestinal bacterial overgrowth, or SIBO, a common result of PPI use, has been associated with a number of extraintestinal manifestations including obesity, rosacea, restless leg syndrome, infertility and pregnancy complications, and joint pain.


Healing begins in focusing on gut health.

Because the microbiome is involved in so many aspects of our health, ranging from regulating nutrition and calorie extraction from food, to communicating with our brain about what’s going on in the gut through the production of neurotransmitters and other chemical messengers, a lot can go wrong when the microbiome is disrupted.

Based on excerpts from The Adrenal Thyroid Revolution: A Proven 4-Week Program To Rescue Your Metabolism, Hormones, Mind & Mood by Aviva Romm M.D., with the permission of HarperOne/HarperCollins. Copyright © 2017.

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