Chronic digestive health

Leaky Gut — intestinal permeability and the condition at the root of many chronic diseases

Intestinal permeability — commonly called leaky gut — is a real, well-studied physiological process backed by a substantial and growing body of research. Scientists have identified the mechanisms involved, including the tight junctions that regulate what passes from the gut into the bloodstream, and ongoing research continues to map its connections to food sensitivities, chronic inflammation, and a range of systemic symptoms.

If you have ongoing symptoms that haven't been fully explained — food sensitivities, skin issues, brain fog, or persistent inflammation — intestinal permeability may be necessary to explore.

I help identify what's driving your gut barrier issues and rebuild it through nutrition — restoring tight junction integrity rather than treating symptoms in isolation.

Book a free 15-minute call

The science

The gut lining — and what happens when it fails

The gut lining is a single cell layer thick one of the most remarkable barriers in human biology. Its job is to allow nutrients to pass into the bloodstream while keeping bacteria, toxins, undigested food particles, and inflammatory compounds out. This function depends on tight junctions protein structures that seal the gaps between gut lining cells. When tight junctions become dysfunctional, those gaps widen allowing substances to pass through that should not. This is intestinal permeability.

Zonulin — the gatekeeper protein

Zonulin is a protein that regulates the opening and closing of tight junctions in the gut lining. Discovered by Dr. Alessio Fasano, it is the first identified and validated biomarker of intestinal permeability. Elevated Zonulin indicates that tight junctions are being held open allowing larger molecules into the bloodstream than should be crossing. Zonulin testing provides an objective measure of gut barrier function that a standard GP blood panel does not include.

LPS — the inflammatory signal from bacterial cell walls

Lipopolysaccharides (LPS) are components of the outer membrane of gram-negative bacteria in the gut. In a healthy gut, LPS stays within the intestinal lumen. When the gut barrier is compromised, LPS enters the bloodstream a state called endotoxemia triggering a systemic inflammatory response. Elevated LPS is associated with metabolic syndrome, insulin resistance, non-alcoholic fatty liver disease, neuroinflammation, and depression.

Causes + consequences

What opens the gates — and what passes through when they do

Root causes

Gluten and gliadin — potent Zonulin triggers in all humans
Gut microbiome dysbiosis — imbalanced microbial communities weaken the barrier
Chronic stress and cortisol — directly disrupt tight junction integrity
NSAIDs and certain medications — damage the gut mucosa with repeated use
Alcohol and ultra-processed foods — alter gut bacteria and barrier function
Chronic low-grade or viral infections — drive persistent gut inflammation

Downstream consequences

Food sensitivities — IgG immune reactivity to foods crossing the barrier
Immune system activity — an active area of research into gut permeability and immune reactivity patterns
Systemic inflammation — LPS endotoxemia contributing to whole-body inflammatory burden
Metabolic health markers — research links gut permeability with insulin resistance and related metabolic patterns
Skin conditions — eczema, rosacea, psoriasis via the gut-skin axis
Neurological symptoms — brain fog, anxiety, low mood via the gut-brain axis

Gut-skin axis

Eczema · Rosacea · Psoriasis

Gut-brain axis

Brain fog · Anxiety · Depression

Gut-immune axis

Autoimmune · Food sensitivities

Leaky brain — the gut-brain barrier connection

Leaky brain the gut-brain barrier connection The blood-brain barrier (BBB) is the brain's equivalent of the gut's tight junction system a selective barrier regulating what enters the brain from circulation. Emerging research indicates that intestinal permeability and blood-brain barrier dysfunction are closely linked through shared tight junction proteins, systemic LPS-driven neuroinflammation, and the gut-brain axis. Symptoms including persistent brain fog, anxiety, depression, and cognitive changes in people with gut issues may reflect this connection. This is an area of active research and an important reason why gut healing extends far beyond digestive symptom relief.

Ayurvedic perspective

How Ayurveda understood leaky gut — thousands of years before Zonulin

Agni, Ama, and Srotas — the Ayurvedic model of gut barrier failure

Ayurveda described intestinal permeability in precise functional terms thousands of years before the discovery of Zonulin. When Agni (digestive fire) is weakened, food is incompletely transformed, and Ama (toxic, undigested residue) accumulates in the gut. This Ama damages the Srotas the channels and membranes that govern what is absorbed and what is kept out. The result is a permeable gut membrane that allows substances into the bloodstream that should have been contained a concept that maps with striking precision onto the modern understanding of leaky gut. The Ayurvedic approach to healing this is not primarily about supplements. It is about restoring Agni making digestion strong enough that food is fully transformed and Ama no longer accumulates. This requires the right food for your constitutional type, appropriate digestive spices, meal timing, stress management, and removing foods and habits that are suppressing Agni. Pitta-type presentations characterised by inflammation, loose stools, and burning require a cooling, anti-inflammatory approach. Kapha-type presentations bloating, heaviness, sluggish motility require a lighter, more kinetic approach.

The healing framework

The 5R protocol — a staged approach to gut barrier repair

The 5R protocol is the gold-standard framework in functional and integrative medicine for repairing the gut barrier. Each R is applied in sequence because the order matters. Skipping steps or applying them simultaneously is less effective and often counterproductive. The fifth R — Rejuvenate — is Manjiri's clinical addition to the standard 4R framework, integrating Ayurvedic Rasayana principles and Agni restoration into the healing process.

01

Remove

Identify and remove triggers reactive foods, inflammatory inputs, infections, dysbiotic bacteria

02

Replace

Restore digestive capacity digestive enzymes, stomach acid support, bile function

03

Reinoculate

Rebuild the microbiome beneficial bacteria, prebiotic fibres, fermented foods

04

Repair

Heal the gut lining L-glutamine, zinc carnosine, collagen, anti-inflammatory nutrients

05

Rejuvenate

Restore whole-body vitality — Ayurvedic Rasayana, Agni restoration, systemic recovery

My integrative approach

What working together looks like

Identifying whether intestinal permeability is a factor

A comprehensive symptom assessment often reveals the pattern — food sensitivities, autoimmune conditions, skin conditions alongside digestive symptoms, brain fog, and chronic inflammation are all indicators. Where clinically indicated, Zonulin testing through a validated laboratory provides an objective measure of gut barrier function.

Identifying and removing the root cause drivers

The Remove step is not just about food elimination. It includes identifying reactive foods, addressing dysbiosis, and assessing the contribution of stress, medications, and lifestyle factors to gut barrier disruption.

The 5R protocol — staged and personalised

The 5R framework is applied in sequence and tailored to your individual picture. The fifth R — Rejuvenate — integrates Ayurvedic Rasayana principles and Agni restoration into the healing process, addressing the constitutional dimension that functional medicine alone often misses.

Addressing the systemic consequences

Supporting the gut barrier is one part of a bigger picture. The plan also considers related patterns — food sensitivities, immune activity, neuroinflammation, and metabolic health — as part of your overall nutritional support, alongside any medical care you're receiving for diagnosed conditions.

Is leaky gut at the root of your symptoms?

Book a free 15-minute call a conversation about your gut picture and what a root-cause approach might offer.

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The entire contents of this website are based upon the opinions of Manjiri Nadkarni (Manjiri Nadkarni Consulting) and is meant for educational purposes only and does not constitute medical/ psychological advice . Please note that Manjiri Nadkarni is not a dietitian, physician or other licensed healthcare professional in Canada. She is a Doctor of Ayurvedic Medicine - MD (Ayurveda) (licensed and regulated in India but not Canada), Registered Holistic Nutritionist as well as Oncology Nutrition Consultant.

The content on this website is not intended to diagnose or treat any diseases. The information on this website is NOT intended as medical or psychological nor is it intended to replace the care of a qualified health care professional. Always consult with your primary care physician or licensed healthcare provider for all diagnosis and treatment of any diseases or conditions, for medications or medical advice as well as before changing your health care regimen.