Ottawa Functional Medicine – Dominick Hussey – Centretown and North Gower
3 Natural Ways Of Preventing and Treating Food Allergies and Sensitivities

3 Natural Ways Of Preventing and Treating Food Allergies and Sensitivities

In this article, I am going to discuss ways of preventing and treating food allergies and sensitivities.

Some people have the perception that food allergies and sensitivities are more prominent than in the past.

For example, when I was a child in the 1970’s, we were never told about the dangers of bringing peanuts to school. Today, I hear from the parents of my child clients that this is commonplace.

However, despite hearing this observation, is the issue increasing or we are merely more aware of it.

Scientific research shows us that the incidence of celiac disease is much higher than when I was a child. Researchers can show this increase by analysing old blood samples and applying the modern day diagnostic criteria.  What they found is that celiac disease is over four times higher today than it was a half-century ago.

So why is the incidence of food allergies and sensitivities increasing?

To answer this question we must first look at why some people develop allergies and intolerances, and some people do not.

Eggs and Liver

Over the past fifty years, we have seen a change away from particular foods including a reduction in the consumption of eggs and liver.

When we remove foods from our diets, this will have a detrimental effect on our nutritional status.

Our immune system requires certain nutrients to work efficiently, and without them, it can become over-reactive, and we can develop allergies and intolerances.

Two essential nutrients for a healthy immune system are retinoic acid and prostaglandin E2.

Retinoic acid is a molecule that we make from retinol. Prostaglandin E2 Is made from arachidonic acid an omega-6 fatty acid that we also find in animal foods.

Retinol is found mainly in liver and cod liver oil with smaller amounts in egg yolks and dairy fat. Arachidonic acid is found primarily in liver and egg yolks. Therefore a reduction in the consumption of liver and egg yolks has probably played a role in the increase in food allergies and food intolerances.

Nonsteroidal Anti-Inflammatory Drugs

Another important consideration is the increased use the over-the-counter nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, acetaminophen, and aspirin. These drugs block the enzyme COX in the body. The enzyme COX converts arachidonic acid into the prostaglandin E2 which we require to ward off allergies and intolerances.

If we are in pain, out of all the NSAIDs from a research point of view, the safest one is aspirin.

How Can We Use This Information?

Regarding food intolerances, I think it is more accessible to prevent them than to fix them. To avoid the development of food intolerances of, we need to introduce both liver and eggs into the diets of our children from an early age. For example, beginning with eating liver once or twice a week and eating egg yolks every day or every other day.

Secondly, avoid the unnecessary use of the NSAIDs. There are many natural and safer alternatives to NSAIDs. I suggest seeking out a local Naturopathic Doctor or Homeopath for advice.

As I mentioned above, there is no easy way to fix food intolerances. The first thing to do is identify which foods you cannot tolerate and cut them out of your diet. My preferred method of determining food intolerances is to carry out a food elimination diet. I also find muscle testing a useful tool.

If you suspect that gluten is an issue, it is essential that you rule out celiac disease. Celiac is a serious medical condition which means you must be very strict with the avoidance.

Similarly, if you are anaphylactic to a food such as peanuts, complete avoidance is imperative. Unlike Celiac disease, it may be possible to treat food allergies even if they cause anaphylaxis. I recommend you look at Natural Allergy Treatment which I have found very effective.

If food intolerances do not induce a medical condition or very uncomfortable effects, it may be possible to reintroduce them over time. I suggest trying to reintroduce foods after say 3-4 months. If there are several foods then introduce them one at a time over a week.

You may also try consuming the foods in a predigested form. For example, if you have a problem with nuts, try soaking them and sprouting them. If you are dealing with grains, try using sourdough grains, long-fermented grains, and so on.


This article is not intended to provide medical advice, diagnosis or treatment.

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Why do not medical doctors understand chronic Lyme Disease - Dominick Hussey

Why do medical doctors not understand chronic Lyme Disease?

When you study Lyme disease, there are main types. Firstly there is acute Lyme disease, where usually somebody gets bitten by a tick, and they become acutely sick. Acute Lyme disease is not very common. The majority of people do not become significantly ill following a tick bite. Like with myself, it is much later, when their immune system becomes weaker, that they begin exhibiting chronic symptoms.

Chronic symptoms include everything from anxiety to joint pain.  That is very confusing for doctors because they have been trained to diagnose and treat acute illness.

Medical doctors did a fantastic job for me when I broke my arm, or when I recently developed a blood clot in my lung. However, when a person walks into a doctors office with a list of 20 to 30 symptoms and all the lab tests are normal the majority of doctors do not have the time or training to uncover what is happening. Furthermore, when faced with chronic conditions they have a limited and often ineffective number of therapies to help.

For example, with chronic Lyme disease, scientific research shows that current antibiotics do not work very well. Furthermore, the testing for chronic Lyme disease is at best mediocre, especially in Canada.  Often the test results are borderline or equivocal which Canadian doctors do not know how to interpret.

This situation means that many people who have chronic Lyme disease have to figure it out for themselves. People have to search online or read books to unravel the roots of their symptoms.

This approach is something I had to do for myself. I had suffered from chronic anxiety for 17 years without understanding why. Conventional medicine had provided some help through medication but zero for looking at the cause.

If you suspect you have chronic Lyme disease and only have access to a conventional medical doctor, you need to be mindful of their limited knowledge, time and treatment options. When approaching a doctor mention just a couple of the most troublesome symptoms, rather than overwhelming them with a 20 or 30 symptoms. By using this approach, the doctor will be able to give you a better diagnosis and treatment protocol.


This article is not intended to provide medical advice, diagnosis or treatment.

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Does Chronic Lyme Disease Exist? - Dominick Hussey

Does Chronic Lyme Disease Exist?

According to Health Canada, the Centre for Disease Control in the USA and most physicians chronic Lyme does not exist. If this is true, then why are so many people having symptoms that they attribute to the Lyme bacteria?

There are many reasons why mainstream medicine does not recognise chronic Lyme disease including:

  1. The Lyme bacteria is difficult to find once it has been in the body for some time making testing difficult.
  2. Many people with acute Lyme disease do not exhibit symptoms and may get ill months or sometimes years later.
  3. If you do exhibit acute symptoms and you are treated with antibiotics you may or may not get ill again.

Many of the people I see in my clinic who have Lyme disease do not recall getting a tick bite. These people are often chronically ill with a whole spectrum of symptoms, and at some point, they experience some symptom that makes them or their doctor suspect they carry the Lyme infection.

Typically these people also carry other microbes known as Lyme co-infections. So, when looking at somebody with Lyme, it is essential to look for the presence of co-infections.

So, the thing that causes most confusion among doctors is that when they look at microbial illnesses, they expect to treat and cure them with antibiotics. This approach originates from more virulent microbes like the bacteria that would cause pneumonia. In such cases, you would test for the bacterium, treat with antibiotics, test for it again, the infection has gone, and the patient’s symptoms have gone.

The Lyme bacteria, however, are different. The microbes that cause pneumonia, for example, are extracellular bacteria. Extracellular means they reside outside the cells. These bacteria colonise in the lungs or on the skin, and they have an invasive infection.

In contrast, with Lyme disease, the bacteria are intracellular, which is challenging to treat because it does not respond well to antibiotics.

Often people can have a positive test for Lyme in the beginning and later not have one because once they get into the tissue and not in the bloodstream detection is very challenging. So, the infection can be there but not be visible. For this reason, doctors often refer to the Lyme bacteria as a stealth infection.

An older research study took a group of people who had all the symptoms of Lyme, had a negative test in the beginning and was treated with antibiotics for six to nine months. These people were again tested, this time using tiny tissue samples. The results showed that one-third of the people had the presence of Borrelia, the Lyme bacteria.

The results of this study suggest that our testing is not very accurate. Furthermore, the bacteria can be in the body, not respond to antibiotics and still cause symptoms.

So, yes, I do believe chronic Lyme disease does occur, and an increasing number of holistically minded doctors are beginning to agree. Also, there have been numerous recent studies published with the words “Chronic Lyme Disease” in the title.

Unfortunately, it will take several years for this research to come into the consciousness of mainstream medical doctors.


This article is not intended to provide medical advice, diagnosis or treatment.

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Lyme Disease - Why Antibiotics Often Fail - Dominick Hussey - Ottawa

Lyme Disease – Why Antibiotics Often Fail

The standard medical regimen for Lyme disease is three weeks of antibiotics. However, when those three weeks are over, even if you still have symptoms, your physician is likely to discontinue your treatment thinking three weeks of antibiotics is sufficient to kill eradicate the infection.

Many Lyme literate doctors feel that six weeks of antibiotics is most appropriate for treating Lyme disease since the bacteria are very slow growing.

While most bacteria in your body replicate every twenty minutes, the Lyme bacteria called Borrelia burgdorferi are replicated every one to sixteen days. This replication time is much slower than a bacteria that would cause a sinus infection.

Long-term Effects of Antibiotic Use

Some people end up taking antibiotics for months or even years with little or no improvement. When taking antibiotics, they can kill off a lot of your healthy bacteria, which are essential for having a robust immune system and ability to fight off infection naturally.

Up to 80% of immune function comes from your gut making these healthy bacteria essential for a robust immune system.

Long-term antibiotic use can also cause kidney and liver damage as well as many other harmful side effects.

As a functional medicine practitioner, I have witnessed the long-term effects of using antibiotics including:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal Pain
  • Headaches
  • Fatigue
  • Insomnia

Some of the new research has suggested that the Lyme bacteria have become immune to several of the antibiotics that are usually employed to treat Lyme disease.

Some of these Lyme organisms are called Persister cells, and they have developed ingenious ways to alter hundreds of their genes to survive antibiotics. These Persister cells appear to grow at a slower rate than other Lyme bacteria giving the antibiotics less time to eradicate these bugs.

The Effectiveness of Antibiotics in Treating Lyme Disease

If you have acute Lyme disease then taking antibiotics is an appropriate treatment and eradicate the infection and prevent them from causing long-term damage to your body.

According to the CDC in the US, however, 20% of people with acute Lyme disease will fail antibiotic treatment and go on to develop persistent Lyme disease.

The evidence for treating chronic Lyme disease has not been very encouraging. Some studies have found no advantages of using antibiotics in chronic Lyme disease. Other studies have shown that any benefits were lost shortly after stopping the antibiotics.

Natural Options For Treating Lyme Disease

If you have been on the roller-coaster of antibiotics, then it is time to look at other options.

In his book, The Lyme Solution, Dr Darin Ingels, ND outlines the natural ways he used to treat himself for Lyme disease and thousands of his patients. I use this same approach to help my clients who have Lyme disease which includes:

  • Teaching people how to eat the right foods to help nullify the infection
  • Natural ways to improve the gut health and your immune system
  • Improve detoxification
  • Encourage deeper, restful sleep
  • Employing alternative therapies to help balance your immune system


This article is not intended to provide medical advice, diagnosis or treatment.

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3 Reasons Why Your Normal Thyroid Results May Be Misleading - Dominick Hussey

3 Reasons Why Your Normal Thyroid Results May Be Misleading

When your doctor tells you that your lab results for thyroid function have come back as “normal,” you would assume that your thyroid is functioning well. However, there are three reasons why these results can be misleading. In this article, we discuss the three reasons why standard thyroid testing may be misleading.

Meet Mary

Mary lives in Russell, Ontario. She came to see me complaining of a goitre. A goitre is an increase in volume, often visible, of the thyroid gland. The goitre became apparent five years previously. On blood tests, she had a TSH of 4 and thyroid antibodies were within the normal range. These results were perplexing to Mary as she had every sign and symptom of hypothyroidism including fatigue, constipation, hair loss, dry skin, depression and, goitre. The most disturbing aspect for Mary was how much the size of her goitre would vary on a day to day basis. When she was overtired or particularly under any emotional kind of stress or caught a cold or the flu, her thyroid would swell, and become inflamed, tender and red. When I asked Mary why she had decided to see me, she said that she lost confidence in her doctors and appeared incapable of looking past the so-called normal thyroid results.

Unfortunately, Mary’s story is the norm (pun intended!) and not an exception. Many clients report thyroid symptoms and have normal test results. Why does this keep happening? In the next section, we discuss the main reasons why thyroid test results are misleading.

1. Conventional Medicine Blood Testing Does Not Give You A Complete Picture

When testing thyroid function, most Canadian family doctors will only check the thyroid-stimulating hormone (TSH). The pituitary gland produces TSH. As the name suggests, TSH tells the thyroid gland how much thyroid hormone to produce. TSH is an excellent overall indicator for assessing thyroid function. However, TSH does not on its own give you a complete picture of what is happening with the thyroid gland. In other words, if all that is being tested is TSH, you certainly cannot rule out problems with thyroid function by that result alone.

Total vs Free Thyroid Hormone Testing

Some family doctors might also test total T4 in addition to TSH. T4 is the primary form of thyroid hormone that is produced in the thyroid gland. Approximately 93 per cent of the hormone produced by the thyroid gland is T4. The remaining is T3. T4 is a good indicator of how well the thyroid gland is functioning. However as we will discuss later in this article, T4 alone, does not give a complete picture because it is not the metabolically active form of thyroid hormone. The metabolically active form of thyroid hormone is T3. Thus, even if there is sufficient T4, if T4 is not getting converted into T3, then a person can still suffer from hypothyroid symptoms. This pattern is prevalent among people with thyroid dysfunction.

The two most common thyroid blood tests a family physician will run are TSH and total T4. Some doctors might also measure total T3, which is a better measure than TSH and total T4, as mentioned above, as it provides some idea about the conversion of T4 into T3. However testing TSH, total T4, and total T3 is also insufficient because they are forms of thyroid hormone that are bound to a protein carrier.

All hormones are fat soluble, meaning they are not water soluble, and the composition of the blood is mostly water. Consequently, for the blood to transport hormones around the body, they have to be attached to a protein carrier. The principal protein carrier for thyroid hormones is thyroid-binding globulin. So total T4 and total T3 are measurements of how much of thyroid hormone is bound to a protein carrier. These measurements are valuable as it shows, in the case of total T4, how well the thyroid gland is functioning. However, the problem with only looking at total thyroid hormones, the protein-bound thyroid hormones, is that it does not show metabolically active thyroid hormones.

Free thyroid hormones, or free T4 and T3, have been separated from the protein carrier. Free T4 and T3 assess the amount of metabolically active thyroid hormone in the blood. Such information is useful because it is not uncommon to have adequate amounts of total T4 and T3 and have low values of free T4 and T3. In such a case there is an excessive amount of the protein carrier of thyroid-binding globulin, which leads to a lower-than-optimal amount of the free thyroid hormone. And as we will discuss later, that can be caused by excess estrogen.

Antibodies and thyroid hypofunction

The most probable cause of thyroid hypofunction in the developed world is Hashimoto’s Disease. Hashimoto’s is an autoimmune disease that affects the thyroid gland, where the body’s immune system attacks the thyroid gland and eventually decreases its ability to produce thyroid hormone. Unfortunately, conventional doctors, rarely test for thyroid antibodies, because if the antibody test is positive, it will not change their treatment. In traditional medicine, the therapy for hypothyroidism is to prescribe thyroid hormone regardless of the cause.

In many cases of hypothyroidism, the root cause of the problem does not come from within the thyroid gland. An underactive thyroid gland is a symptom of the real issue which is immune dysfunction or autoimmunity. It would, therefore, be useful to know if antibodies are being produced against the thyroid, because if there are, then the primary focus would not be on the thyroid. Instead, the aim would be on balancing and regulating the immune system to prevent it from attacking the thyroid gland. This is why thyroid antibodies, should be a part of blood testing for anybody who is suffering from hypothyroid symptoms.

Conventional Lab Ranges

The traditional lab ranges are, typically, based on a sample of people that have undergone those tests. There have been issues using this approach. For example, initial calculations to determine the normal range for TSH were based on data from the Nurses’ Health Study. When choosing which data to include steps where taken to exclude people that had already had a diagnosis of hypothyroidism, had abnormal TSH and thyroid antibodies. However, the nurses did not undergo a thyroid ultrasound of their thyroids or other kinds of evaluations to screen for people who did have hypothyroidism. It is a well-known fact that the number of people with hypothyroidism that don’t know that they have it is significantly higher than the number of people that have a definite diagnosis. Those initial calculations studies led to a TSH range of around 0.5 to 4.5, which is now the standard conventional range. Mary had a TSH of 4 which according to the traditional range would be deemed as normal.

There have been many studies written over the last 20 years that have been critical of those initial calculations. The study authors have said that there were likely many people included in those initial calculations that did have hypothyroidism. Their inclusion would have skewed the “normal” range of TSH to be too high. In the subsequent studies, researchers did a much better job of eliminating participants with hypothyroidism. As a result, a normal TSH range was more like 0.5 to maybe 2 or 2.5, dependent on the study. That is a much narrower range than 0.5 to 4.5. So if you go to your doctor and your TSH is 4, they will tell you that four is within the normal range while most of the evidence now suggests that that is not the case. A TSH of 4 in the case of Mary is indicative of perhaps a mild hypothyroid state.

2. Goitres Are A Clinical Sign Of Thyroid Disease

When considering Mary, the next relevant question is, what does a goitre typically indicate? We know from the research that in the developed world, the number one cause of goitre is Hashimoto’s Disease, the autoimmune condition I mentioned above wherever the body attacks the thyroid gland. In the developing world, the number one cause of goitre is iodine deficiency.

One of the ways to look for Hashimoto’s Disease is to test for thyroid antibodies. Mary’s antibodies were in the normal range.  However, about 20 to 30 per cent of people patients with Hashimoto’s, according to the studies, never test positive for thyroid antibodies. In such cases, a goitre that is visible on ultrasound may be the only sign that they have Hashimoto’s. This scenario is well documented in the scientific literature, and it is not understood why people with goitre do not test positive for antibodies. In some cases, they may have a compromised immune system, so they are not very good at producing antibodies, period. A compromised immune system can be assessed by testing total immunoglobulin levels IgG, IgA, IgM and IgE.

To summarise, if like Mary you a goitre is present it is extremely likely that there is a thyroid problem regardless of what the labs are saying. And statistically speaking, you likely have either Hashimoto’s Disease.

3. Thyroid Disease May Not Show Up On Standard Conventional Blood Tests

Is it possible that the thyroid is not functioning correctly, even if the lab results are all normal? In other words, is thyroid disease possible even if TSH, total T4 and T3, free T4 and free T3, thyroid antibodies results are all normal? The short answer here is yes. There are five main reasons why thyroid dysfunction may be present despite normal blood test results.

1. Pituitary Dysfunction.

The pituitary gland produces thyroid stimulating hormone (TSH). A problem in the pituitary may affect the production of TSH. TSH tells the thyroid to produce more thyroid hormone. Pituitary dysfunction may lead to a low-normal TSH, T4 or T3 but the patient can still be suffering from hypothyroid symptoms.

2. Poor Conversion Of T4 To T3

Remember that T4 is not metabolically active and is the primary thyroid hormone produced by the thyroid gland. T4 is converted to T3 which is metabolically active. Conversion happens in the gut and the liver and other tissues around the body, and it can be inhibited by inflammation, gut issues, and also nutrient deficiencies.

3. Elevated Thyroid-Binding Globulin Protein

Thyroid-binding globulin protein, as I described earlier, carries the thyroid hormone around the blood. Some states like high estrogen, which could be related to taking birth control or hormone replacement therapy, can elevate thyroid-binding globulin. Elevated thyroid-binding globulin can lead to low levels of free T4 or T3, even if total T4 and total T3 are normal.

4. Non-Thyroidal Illness Syndrome

Non-thyroidal illness syndrome (NTIS) is sometimes referred to as central hypothyroidism. NTIS is the result of low levels of TRH, or thyrotropin-releasing hormone, which is secreted by the hypothalamus to tell the pituitary how much TSH to produce. The causes of NTIS include leptin resistance, insulin resistance, inflammation, and other non-thyroid-related causes, hence the name.

5. Thyroid Resistance

Thyroid resistance is similar to insulin resistance or leptin resistance. Thyroid resistance is when both the thyroid and the pituitary glands are functioning normally, but the thyroid hormone is not entering the cells. The cellular receptors for thyroid hormone have become resistant to thyroid hormone, in the same way, that way that the cells for insulin can become resistant to insulin. Thyroid resistance can be caused by things like high cortisol levels, inflammation, elevated homocysteine, and other factors.

New Thyroid Function Testing

At this point, I should mention that some new tests may help identify thyroid dysfunction earlier than the current blood markers. One of them measures the ratio of free cortisol to total or metabolised cortisol.  This information is obtained from the Dutch test, offered by Precision Analytical. Thyroid hormone is required to metabolise cortisol. People with a high free cortisol low total cortisol ratio is, therefore, an indication of low thyroid hormones.

What next?

If you have a similar story to Mary and have been experiencing thyroid signs and symptoms, what should you do?

If it all possible, you should attempt to find a holistic health practitioner to work with who is familiar with thyroid physiology and proper assessment of these issues and is willing to treat you perhaps. A holistic practitioner may include a functional medicine practitioner, an integrative medical doctor, or naturopathic doctor. If you are not able to see a practitioner there are some steps you can take yourself:

  1. Under the presumption that your thyroid issues may be autoimmune you could try the autoimmune paleo diet (AIP). Follow the diet for a month and if your symptoms resolve then try reintroducing foods to identify the triggers.
  2. Optimize vitamin D and glutathione status, which can help balance and regulate the immune system.
  3. Take curcumin is an anti-inflammatory that has an immunoregulatory effect.



This article is not intended to provide medical advice, diagnosis or treatment.

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2 Best Leaky Gut Tests - Dominick Hussey - Functional Medicine

2 Best Leaky Gut Tests

Susan was experiencing severe bloating, gas and diarrhea. She had been to see her GP, 3 Gastroenterologists. All her tests were normal including bloodwork, an endoscopy and a colonoscopy. No one could explain her symptoms. Like most people in her position, Susan began to look for answers on the internet. Eventually, she came across an article on a condition known as leaky gut. Her symptoms appeared to match those of leaky gut. Her question was what were best leaky gut tests.

In this article, we will cover the fundamentals basics of leaky gut, is testing for leaky gut a good idea, and the two best leaky gut tests.

The Fundamentals of Leaky Gut

A leaky gut is a popular term that describes a condition where the lining of the intestines is not functioning correctly. The correct medical term for leaky gut is increased intestinal permeability.

The intestinal lining covers a surface area of about 400 metres squared and requires about 40 per cent of the body’s energy expenditure.  That is pretty extraordinary when you think that the brain needs only 20 per cent of the body’s energy expenditure.

This fact tells us that the intestinal lining is essential to our health.

The gut is a hollow tube that connects the mouth to the anus.  So, everything that is inside of the gut is technically outside of the body. Therefore everything that is inside of the gut is not technically inside of the body.

Therefore anything that is in the gut to move into the body has to cross that intestinal lining. A fundamental function of the intestinal lining is to let in things that should get in and keep out things that should not stay out.

When certain conditions are present, the intestinal lining’s capability of doing that task breaks down, and then all kinds of problems can happen.

Many factors can interfere with the function of the intestinal lining including:

  • A western-type inflammatory diet, lacking in fermentable carbohydrates and fermented foods
  • Bacterial, viral, parasitic infections
  • Fungal overgrowth
  • Heavy metals
  • Mold
  • Certain medications like proton pump inhibitors, antibiotics, or NSAIDs
  • Lifestyle factors like chronic stress or sleep deprivation or inappropriate physical activity, like too little or too much
  • Inadequate immune stimulation during our developmental period. Insufficient immune stimulation is known as the hygiene hypothesis. Better hygiene has done a lot to reduce acute infections, but these overly sterilised environments may have contributed to immune dysregulation because our immune systems aren’t adequately stimulated.

There are other factors which we call endogenous factors. Endogenous means they are factors that occur inside of the body that can contribute to leaky gut.

Endogenous factors include chronic inflammation, SIBO, or gut-brain axis problems

Is testing for leaky gut a good idea?

In my opinion, a leaky gut is almost always a symptom of a deep-seated underlying issue, meaning that the underlying problem comes before a leaky gut.

Causes of a leaky gut may include any of above factors that interfere with the function of the intestinal lining.

One of the critical principles of functional medicine is that we want to get to the bottom of what is causing symptoms or even manifestations of a disease. We want to remove or address those causes or triggers before we try to do anything about the symptom or the sign. The more we can get to the root of the problem, the more effective the intervention will be.

In other words, by suppressing symptoms, it is going to be less effective, and will not last for as long because we have not addressed the underlying cause.

So with intestinal permeability, if we remove the triggers that are causing leaky gut in many cases, you will not need to address intestinal permeability because it will take care of itself.

One of the astonishing things about the cells in the gut is they regenerate every two to three days. Therefore if you remove the triggers that are causing the problem, the cells will revive and the tight junctions can restore themselves, and the intestinal permeability will disappear.

Hence typically in my practice clinic, before looking at a leaky gut, I will test and treat the triggers such as food sensitivities, gut infections and stress. If the patient is still having problems that we could associate with leaky gut, at that point, I will consider testing for intestinal permeability.

Testing options for intestinal permeability

If you look at the research, many different leaky gut tests have been used to define or identify intestinal permeability. Some of these are more common than others, but I am just going to mention a few different ones, and then I will tell you what I use in my practice and what I recommend.

The first is the lactulose/mannitol permeability assay. This test uses molecules, sugars, long-chain sugars called oligosaccharides, and I will explain a little bit more about that in a later.

The second test is an antigenic permeability screen. This test looks at antibodies to particular antigens like lipopolysaccharides and then also antibodies to endogenous molecules like actomyosin, occludin and zonulin. These are proteins that the body produces in the gut that help to regulate tight junction permeability, the structure of the gut and determine whether the gut is permeable or not.

The next marker that researchers sometimes use in studies is an organic acid called D-lactate or D-lactic acid. D-lactate is different from lactic acid that you may have heard about that can be high after exercise. This organic acid is a product of bacterial metabolism which is produced in the gut. Some studies have shown a correlation between high D-lactate and increased intestinal permeability.

Butyrate, which is a short-chain fatty acid, has been investigated as a potential marker for intestinal permeability. Low butyrate is a sign of leaky gut.

Finally, zonulin is a protein that regulates the tight junctions in the gut has been investigated as a marker for intestinal permeability.

What Are The Best Leaky Gut Tests?

In terms of clinical practice and what is readily available and has been most validated by the scientific research, the lactulose/mannitol test and the antigenic permeability screen are the two best leaky gut tests.

The Lactulose/Mannitol Test

The lactulose/mannitol test involves measuring levels of two sugars in the urine after the patient consumes those sugars. By looking at the ratio of the two sugars in the urine you can tell you whether the gut is permeable.

The lactulose/mannitol test is available through Genova Diagnostics.

There are some shortcomings of lactulose/mannitol testing.

One of the issues is that the transport of lactulose or mannitol through the gut barrier is not actually or not necessarily an indicator of a malfunction of the intestinal tight junctions. In other words, a positive result doesn’t necessarily mean that there is intestinal permeability present.

There are a lot of variables that can influence the uptake of the sugars, like GI motility, use of medication like NSAIDs, the surface area of the intestine, gastric emptying, and mucosal blood flow so these variations can affect the result.

Another issue is that some studies have shown that only large molecules (over 5,000 daltons) can change the permeability of intestinal epithelial cells and then result in an inflammatory response in the body.

Lactulose and mannitol are below 500 daltons, which suggests that they may not be appropriate as challenge molecules for an intestinal permeability test.

There are ways to increase lactulose/mannitol testing accuracy including:

  1. Avoiding foods containing lactulose 24 hours before the test. Lactulose is found in heat-processed dairy and non-dairy beverages such as soy milk and some yoghurts.
  2. Avoid mannitol for 24 hours before the test. Mannitol is found in brown seaweed, celery, carrot, coconut, cauliflower, cabbage, pineapple, lettuce, watermelon, pumpkin, squash, cassava, pea, asparagus, coffee, olives and berries, and chewing gum.
  3. Avoid dairy products for 24 hours before the test.
  4. On the day of the test avoid drinking too much water.

The Antigenic Permeability Screen

The second test for leaky gut is called the antigenic permeability screen.  This test was developed by Doctor Aristo Vojdani at Cyrex Labs.

In large part, Dr Vojdani developed the test because of the shortcomings of the lactulose/mannitol test.

Doctor Vojdani wanted to create a test that would better reflect pathological permeability of the gut. So instead of using larger sugars, he decided to screen for antibodies to proteins and bacterial endotoxins, since those are the primary concern when it comes to immunoreactivity.

We know that the uptake of antigens, proteins and bacterial endotoxins, plays a significant role in the pathogenesis of a gastrointestinal and autoimmune disease.

Many studies are showing that the inappropriate transfer of proteins and endotoxins from the gut into the bloodstream initiates an inflammatory response and can contribute to autoimmune disease. This understanding explains the connection between leaky gut and autoimmune disease. Less than 10 per cent of subjects with a genetic susceptibility to autoimmune disease progress to having a clinical autoimmune disease in their lifetime. This fact suggests that environmental triggers like toxic chemicals and infections and dietary proteins are probably involved in the development of autoimmune disease.

The Antigenic Permeability Screen is a blood test. This test is only offered by one lab, Cyrex Labs, and is called Cyrex Array 2.

This test needs to be ordered by a healthcare practitioner who is registered with the Cyrex.

The test involves drawing a blood sample and then testing for antibodies to lipopolysaccharide, IgM, IgG and IgA antibodies,


In practice, for the reasons I explained above I do not check for intestinal permeability very often. Typically I tend to look at the underlying cause of intestinal permeability and address that first. So although the mannitol/lactulose and antigenic permeability screen are the best leaky gut tests, If I do a sound job with addressing the root, in most cases, the intestinal permeability will resolve on its own.

When I do test for permeability, I use the Cyrex test.



This article is not intended to provide medical advice, diagnosis or treatment.

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