
đ Hello Friends,
A few weeks ago, I had one of those clinic days that really stopped me in my tracks.
In a single day, I saw five different patients â different ages, different symptoms, different diagnoses â yet all shared one common root cause: Leaky Gut.
What struck me most wasnât just that they all had confirmed Leaky Gut on stool microbiome testing. It was that their bodies were expressing it in completely different ways!
How do we diagnose leaky gut?
One of the key markers I look at on advanced stool microbiome testing is zonulin.
Zonulin is a protein that regulates the tight junctions between the cells lining your gut. When those junctions loosen, zonulin leaks into the stool, signaling disrupted intestinal permeability â what we commonly refer to as Leaky Gut.
When zonulin is elevated, it tells us something important: the gut barrier is compromised, inflammatory molecules can escape into circulation, the immune system stays on high alert, and systemic inflammation follows.
And that inflammation can show up anywhere in the body.
Let me show you what I mean.
đ©âïž Five Patients. One Root Cause
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Patient 1: Mysterious Dermatitis
A 76-year-old woman came to see me with a strange, itchy rash on her shins and forearms. A dermatologist had biopsied the rash and labeled it simply âdermatitis.â She was prescribed topical steroids, yet the rash persisted.
We dug deeper and ordered a stool microbiome test, which revealed elevated zonulin â a clear marker of leaky gut.
Three months into a gut-healing protocol focused on repairing intestinal permeability, her rash was already significantly improving.
Patient 2: Severe Eczema
A 29-year-old woman struggling with severe eczema affecting her arms and around her eyes. She noticed immediate flares in response to certain foods.
Her stool microbiome test revealed marked leaky gut, with zonulin levels over 600. Identifying the root cause allowed us to immediately focus on repairing her gut barrier and restoring a healthier gut microbiome.
Patient 3: Autoimmune Disease
A 53-year-old woman with a persistent chest rash that had lasted for years. She tested positive for SSA antibodies, was diagnosed with Sjogrenâs syndrome, and was placed on Plaquenil. A prior skin biopsy showed autoimmune-type inflammation.
Her microbiome test revealed leaky gut as well. When the gut barrier breaks down, the immune system can begin reacting to things it was never meant to respond to. Autoimmune disease often begins in the gut long before it appears elsewhere in the body.
Patient 4: Chronic IBS
A 38-year-old woman with chronic IBS-C, bloating, anxiety, and long-standing SIBO. Her symptoms were primarily digestive, yet her testing clearly showed leaky gut.
In her case, chronic bacterial overgrowth and inflammation in the small intestine likely contributed to the breakdown of the gut barrier, making leaky gut both a consequence and a driver of ongoing symptoms.
Patient 5: Allergic Rhinitis
A 16-year-old girl with new-onset nasal allergies and post-nasal drip that seemed out of proportion to her IgE allergy testing. Her stool microbiome test showed leaky gut with a zonulin level of 325, along with dysbiosis and a severely low vitamin D level of 15.
When the gut barrier is compromised, the immune system becomes overly reactive, often leading to histamine intolerance and allergy-type symptoms. In her case, the gutâimmune connection was unmistakable.
How do we Treat Leaky Gut?
Healing leaky gut is not about suppressing symptoms. It is about repairing the gut barrier and restoring balance to the gut ecosystem.
In my practice, this often includes
1) IgG Guard (immunoglobulins) to bind inflammatory triggers and calm immune activationÂ
2) L-Glutamine to nourish and repair the intestinal lining
3) High-dose probiotics like Probiotic 100 Billion to restore microbial balance
4) Herbal antimicrobials such as Berberine Pro and Oregano Oil when dysbiosis is present.
5) Support Digestion: Digestive Enzyme Pro to improve breakdown of food
Equally important is cleaning up the diet â removing gluten, dairy, sugar, alcohol, and seed oils â and practicing meal spacing to support gut motility.



Probiotic 100 Billion



Digestive Enzyme Pro


I have a special treat for you!  As a lifelong chocolate lover, I had to come up with the best recipe for healthy PALEO BROWNIES!  These brownies are so easy to make from scratch and have superfood ingredients like cacao powder, which is loaded with antioxidants and flavonoids. They are gluten-free, dairy-free, and refined sugar-free.Â
Preheat oven to 350 degrees F
Dry Ingredients:
2 cups almond flour
2 tsp baking powderÂ
1/4 tsp salt
1/2 cup cacao powder
Wet Ingredients:
2 eggs
1/2 cup unsweetened almond milk
1/4 cup olive oil
1/2 cup maple syrup
2 tsp vanilla extract
Optional: 1/2 cup chopped walnuts
Mix the dry ingredients and wet ingredients separately in 2 large bowls. Gradually add the dry ingredients to the wet ingredients and mix well. Add in the optional chopped walnuts. Bake for 30-35 minutes.
Enjoy!
Thanks for reading this weekâs newsletter đ§Ą
Leaky gut does not look the same in everyone. But once you know how to identify it â and how to treat it â the patterns become impossible to ignore.
If you have been chasing symptoms without answers, it may be time to look deeper đ
Please feel free to share this with a friend or family member who may need help with their gut health đ€
Wishing you a very Merry Christmas đ and a healthy holiday season,

Rajsree Nambudripad, MD
