When twenty-six year old Jen first visited Narayani Wellness Medical 8 months ago she felt constantly fatigued and unwell. Most mornings she would rise feeling like she hadn’t slept a wink, despite sleeping a solid 7-8 hours each night. She would wake with what she described as “brain fog” - a mild headache alongside difficulty concentrating, finding words and performing basic mental tasks. Jen likened many of her symptoms to a hang over, recalling a gradual worsening since high school.
Tiny, itchy, fluid-filled blisters had begun to appear on her hands and the skin on her face was flushed and dry. She has always had sensitive skin, though these skin issues only arose in the last few years. She also complained of terrible hay fever in spring and autumn, which she experienced every year for as long as she could remember.
Jen couldn’t understand why she got these debilitating symptoms despite her healthy diet and adequate sleep. She had been to see a couple of GPs who ran some tests, all of which came back normal (besides a mild deficiency in iron). Jen was given a script for an iron supplement, anti-histamines for the hay fever and a steroid cream for the blisters on her hands. Despite these interventions, Jen’s symptoms did not improve.
By this stage, Jen had begun feeling very despondent about her health, questioning whether she would be able to finish her university course and start full time work feeling this way. After reading a blog on gut health that was sent to her by a friend, Jen came to the clinic to learn how her symptoms might relate to her gut i.e. her small and large intestine.
What could be affecting Jen?
After some thorough questioning, we suspected that Jen’s issues related to non-coeliac gluten sensitivity. We performed an intestinal permeability test on Jen – a urine test that uses two sugars, lactulose and mannitol, to determine if the gut is “leaky”. Her result was positive, indicating that her gut lining was allowing trigger compounds (e.g. food proteins and toxins from bacteria) to slip through into her bloodstream. Resultantly, her immune system was hyperactive, accounting for her inflammatory skin issues and lack of mental clarity.
We also screened her for intestinal parasites, small intestinal bacterial overgrowth (SIBO) and low stomach acid, some of the most common contributing factors to leaky gut. Her nutritional status was assessed, finding that in addition to iron, she was also low in zinc, vitamin D and omega-3.
We spoke to Jen about her relationship with stress, discovering that she had perfectionist tendencies. She often put a lot of pressure on herself to have all the answers, blaming herself for her poor health. She also liked to perform to a high standard, making even small tasks stressful. Jen didn’t recognise that her day-to-day stressors were affecting her; yet it was having a direct effect on intestinal permeability via her enteric nervous system (the part of the nervous system that intertwines the intestines).
What was suggested to Jen?
We suggested Jen completely remove gluten from her diet for a period of time and recommended some supplements to heal her gut lining – zinc, glutamine, probiotics, prebiotics and good fats. We worked with Jen to reduce her stress levels by combining psychological interventions, breathing techniques, meditation, exercise and all-round better self-care.
We explained that you aren’t necessarily what you eat, but what you absorb. Our goal was to improve her intestinal function first by addressing the underlying issues (in her case; gluten, stress and zinc deficiency) and then to ensure her nutritional status was optimised and maintained with supplementation and diet.
Jen’s mental clarity and energy levels had improved so much within 1 month of removing gluten that she decided to continue eating this way indefinitely. After 2 months of treatments her skin started to settle, and after 6 months her skin was better than it had ever been. The next spring she didn’t need to use anti-histamines at all. Jen is now much better at recognising when she is stressed, so she can manage it before it interferes with her health.
With a few simple changes in Jen’s day-to-day diet and lifestyle, she has seen massive improvements to her health. Jen’s story is a fairly common one, however treatment for leaky gut is not one-size fits all. Each case requires tailored treatments that address the underlying factors unique to the individual.
By Lucy Mason, Naturopath