The mind-body connection is real.
This once-fringe concept is now being exposed by scientists researching the gut and its direct connection to the brain.
Many experts still consider this research to be in its infancy,
However, one conclusion seems to be clear.. what happens in the brain directly reflects what is happening in the body.
One of the most glaring examples of this is the phenomenon of leaky brain and its relationship to leaky gut.1Mark E. M. Obrenovich. Leaky Gut, Leaky Brain? Microorganisms. 2018
Leaky brain research indicates that it is a serious problem.
In fact, it may be at the heart of many mental health disorders.
However, it is encouraging to know that it is possible to heal a leaky brain by rebuilding the integrity of your gut.
This means that healing your gut could be a promising method to optimize your mind.
In this article, I’ll give an overview of what leaky brain is, how it relates directly to problems with the gut, why I believe it to be so prevalent in our modern culture, and steps you can take to optimize your brain by healing your gut.
Biohack Your Brainpower
What Is Leaky Brain
Leaky brain is the end result of a complex breakdown in the blood-brain barrier commonly referred to as blood-brain barrier permeability.2Souhel Najjar, Daniel M Pearlman, Orrin Devinsky, Amanda Najjar, and David Zagzag. Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence J Neuroinflammation. 2013
A functional blood-brain barrier is essential to maintaining central nervous system homeostasis.
The Blood-Brain Barrier
The blood-brain barrier (BBB) separates the central nervous system (CNS) from the peripheral tissues of your body.
It’s effectively a security checkpoint that keeps harmful toxins and inflammatory mediators that can negatively affect neural function out of your brain.3N Joan Abbott, Lars Rönnbäck, Elisabeth Hansson. Astrocyte-endothelial interactions at the blood-brain barrier Nat Rev Neurosci. 2006
When the blood-brain barrier breaks down, the brain becomes exposed to molecules that may be toxic to vulnerable neurons in the hippocampus and elsewhere in the brain.
Conditions Associated With Leaky Brain
Leaky brain connection has been implicated in a number of psychiatric disorders4Hadar Shalev, Yonatan Serlin, Alon Friedman. Breaching the blood-brain barrier as a gate to psychiatric disorder Cardiovasc Psychiatry Neurol. 2009 including:
- Alzheimer’s Disease5Daniel A Nation, Melanie D Sweeney, Axel Montagne, et al. Blood-brain barrier breakdown is an early biomarker of human cognitive dysfunction Nat Med. 2019
- Depression6Jeremy Appleton. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health Integr Med (Encinitas). 2018 Aug
- Schizophrenia7Javier A Bravo, Paul Forsythe, Marianne V Chew, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve Proc Natl Acad Sci U S A. 2011
- Multiple sclerosis8Emmanuelle Waubant. Biomarkers indicative of blood-brain barrier disruption in multiple sclerosis Dis Markers. 2006
- (MS)
- Autism9Maria Fiorentino, Anna Sapone, Stefania Senger. Blood-brain barrier and intestinal epithelial barrier alterations in autism spectrum disorders Mol Autism. 2016 Nov
- Memory Issues
- Anxiety10Mark Obrenovich, Rudolf Flückiger, Lorraine Sykes, Curtis Donskey. The Co-Metabolism within the Gut-Brain Metabolic Interaction: Potential Targets for Drug Treatment and Design CNS Neurol Disord Drug Targets. 2016
- Obesity
- Cravings
- Parkinson’s11Meng-Fei Sun, Yan-Qin Shen. Dysbiosis of gut microbiota and microbial metabolites in Parkinson’s Disease Ageing Res Rev. 2018
- Brain Fog12Meggan Mackay. Lupus brain fog: a biologic perspective on cognitive impairment, depression, and fatigue in systemic lupus erythematosus Immunol Res. 2015 Dec
Leaky Gut: The Culprit
Of all the potential causes of disruptions in the blood-brain barrier, the most notorious might be leaky gut.13Manuela Pennisi, Alessia Bramanti, Mariagiovanna Cantone, et al. Neurophysiology of the “Celiac Brain”: Disentangling Gut-Brain Connections Front Neurosci. 2017 Sep 5
If you’ve spent any time sifting through wellness articles online than you’ve probably come across this term.
Leaky gut, technically referred to as “intestinal permeability” occurs when there is dysfunction in the epithelial lining of the digestive tract.14I Bjarnason, T J Peters, N Veall. A persistent defect in intestinal permeability in coeliac disease demonstrated by a 51Cr-labelled EDTA absorption test Lancet. 1983
The lining of your GI tract is very thin and delicate making it susceptible to damage.
This dysfunction allows for certain proteins, lipopolysaccharide, and antigens to find their way outside of the digestive tract and into the intestinal mucosa where immunoglobulin A (IgA) antibodies are made.15AGerwyn Morris, Michael Berk, André F Carvalho, Javier R Caso, Yolanda Sanz, Michael Maes. The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome Curr Pharm Des. 2016
The immune system identifies these particles from the gut as foreign invaders and mounts a response.
This leads to increased inflammation throughout the body which has been tied to a number of chronic and autoimmune diseases.
How Leaky Gut Leads To Leaky Brain
The pro-inflammatory cytokines triggered by leaky gut eventually attack the tight junctions of the blood-brain barrier.
This results in compromised blood-brain barrier integrity and all the cognitive issues that follow.16Gerwyn Morris, Michael Berk. The Neuro-Immune Pathophysiology of Central and Peripheral Fatigue in Systemic Immune-Inflammatory and Neuro-Immune Diseases Mol Neurobiol. 2016
Leaky gut has been directly implicated in a number of cognitive disorders17Christopher B Forsyth, Kathleen M Shannon, Jeffrey H Kordower, Robin M Voigt, Maliha Shaikh, Jean A Jaglin, Jacob D Estes, Hemraj B Dodiya, Ali Keshavarzian. Increased intestinal permeability correlates with sigmoid mucosa alpha-synuclein staining and endotoxin exposure markers in early Parkinson’s disease PLoS One. 2011 including:
- Alzheimer’s
- Dementia
- Parkinson’s
- Depression
Inflammation is the major disruptor of the BBB. Many diseases and physiological stressors that affect the CNS also alter the functional integrity of the BBB18Michael Maes, Marta Kubera, Jean-Claude Leunis. The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression Neuro Endocrinol Lett. 2008
Causes of Leaky Gut
The lining of the human GI tract is very thin and quite vulnerable to damage.
There are a number of reasons why someone may experience gut permeability including:
- Sugar consumption19Moon Ho Do, Eunjung Lee, Mi-Jin Oh,1 Yoonsook Kim, and Ho-Young Park. High-Glucose or -Fructose Diet Cause Changes of the Gut Microbiota and Metabolic Disorders in Mice without Body Weight Change Nutrients. 2018
- Processed food20Matthew T. Pereira, Mridu Malik, et al. Effect of dietary additives on intestinal permeability in both Drosophila and a human cell co-culture Dis Model Mech. 2018
- Stress21Gen Zheng, Shu-Pei Wu, Yongjun Hu, David E Smith, John W. Wiley,1 and Shuangsong Hong. Corticosterone mediates stress-related increased intestinal permeability in a region-specific manner Neurogastroenterol Motil. 2013
- Drug use22Alexander J. Gill and Dennis L. Kolson. Chronic Inflammation and the Role for Cofactors (Hepatitis C, Drug Abuse, Antiretroviral Drug Toxicity, Aging) in HAND Persistence Curr HIV/AIDS Rep. 2014
- Excessive alcohol consumption23Faraz Bishehsari, M.D., Ph.D., Emmeline Magno, M.D., Garth Swanson, M.D., Vishal Desai, M.D., Robin M. Voigt, Ph.D., Christopher B. Forsyth, Ph.D., and Ali Keshavarzian, M.D. Alcohol and Gut-Derived Inflammation Alcohol Res. 2017
- Environmental chemicals24Pengcheng Tu, Liang Chi, Wanda Bodnar, Zhenfa Zhang, Bei Gao, Xiaoming Bian, Jill Stewart, Rebecca Fry, and Kun Lu. Gut Microbiome Toxicity: Connecting the Environment and Gut Microbiome-Associated Diseases Toxics. 2020
Occasional exposure to one or even a few of these factors may not present such dire consequences.
However, in modern society, many people are exposed to excessive doses of one or more of these elements on a daily basis.
Which may be why diseases tied to leaky gut and leaky brain have become so prevalent.25CDC. Chronic Diseases in America National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
And to make matters worse, the problem may be handed down generationally, leading to increases in childhood disorders and more compounded issues.26Irene Lacal and Rossella Ventura. Epigenetic Inheritance: Concepts, Mechanisms and Perspectives Front. Mol. Neurosci., 28 September 2018
Gut-Brain Tight Junctions and Adherent Junctions
The similar construction of protective barriers in the gut and brain highlights an example of the intricate connection of these 2 organs.
The gut and brain barriers are the ultimate security system, intelligently built to keep tabs on the flow of cellular information.
This is done through selective permeability regulated by tight junctions and adherent junctions that make up the endothelial cells of the barrier lining.27Katherine R. Groschwitz, BS and Simon P. Hogan, PhD. Intestinal Barrier Function: Molecular Regulation and Disease Pathogenesis J Allergy Clin Immunol. 2009
These junctions are joined by a number of specialized transporters, pumps, and receptors which aid in the flow of substances across the linings.28Paula Grammas, Joseph Martinez, Bradley Miller. Cerebral microvascular endothelium and the pathogenesis of neurodegenerative diseases Expert Rev Mol Med. 2011
In the brain, selective transport proteins allow nutrients, oxygen, amino acids, some drugs, and glucose to enter the cerebrospinal fluid for metabolism in the brain.29Chris Greene, Matthew Campbell. Tight junction modulation of the blood brain barrier: CNS delivery of small molecules Tissue Barriers. 2016
In the gut, tight junctions once thought to be static, are in fact dynamic and readily adapt to a variety of developmental, physiological, and pathological circumstances.30Daniel R Clayburgh, Le Shen, Jerrold R Turner. A porous defense: the leaky epithelial barrier in intestinal disease Lab Invest. 2004
When these tight and adherent junctions are working correctly, nutrients are better absorbed by the gut and brain which will optimize the function of both.
When these junctions are not working correctly you experience both leaky gut and leaky brain.
Zonulin
Circulating, serum zonulin is the main marker of gut permeability.31Agnieszka Zak-Gołąb , Piotr Kocełak, Małgorzata Aptekorz, Maria Zientara, Lukasz Juszczyk, Gayane Martirosian, Jerzy Chudek, Magdalena Olszanecka-Glinianowicz. Gut microbiota, microinflammation, metabolic profile, and zonulin concentration in obese and normal weight subjects Int J Endocrinol. 2013
Zonulin is a protein that acts as an endogenous modulator of epithelial tight junctions.
If tight junctions are the security guard, zonulin is the supervisor giving the orders.
It serves a number of functions including regulating the movement of fluid, macromolecules, and leukocytes between the bloodstream and the small intestine, and vice versa.32Alessio Fasano, M.D. Physiological, Pathological, and Therapeutic Implications of Zonulin-Mediated Intestinal Barrier Modulation Am J Pathol. 2008
Zonulin also protects against microorganism colonization of the proximal intestine.33Ramzi El Asmar, Pinaki Panigrahi, Penelope Bamford, Irene Berti, Tarcisio Not, Giovanni V Coppa, Carlo Catassi, Alessio Fasano. Host-dependent zonulin secretion causes the impairment of the small intestine barrier function after bacterial exposure Gastroenterology. 2002
While acute low levels of zonulin are natural in a healthy gut, it seems that prolonged chronic exposure can be problematic.34Zejun Zhou, Chuanxiu Bian, et al. Progesterone decreases gut permeability through upregulating occludin expression in primary human gut tissues and Caco-2 cells Sci Rep. 2019
Prolonged zonulin exposure is one of the main drivers of leaky gut and ultimately all the disorders that follow.
High levels of zonulin have been correlated to elevated inflammatory markers, obesity, metabolic disorders, and advanced cognitive aging.35YanFei Qi, Ruby Goel. Intestinal Permeability Biomarker Zonulin is Elevated in Healthy Aging J Am Med Dir Assoc. 2017
The biggest triggers of excess zonulin production include bacteria and gluten.36Sandro Drago , Ramzi El Asmar, Mariarosaria Di Pierro, et al. Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines Scand J Gastroenterol. 2006
LipoPolySaccharide (LPS)
Lipopolysaccharides are another contributor to inflammation associated with leaky gut.37Sandro Drago, Ramzi El Asmar, Mariarosaria Di Pierro. Lipopolysaccharide-Induced Increase in Intestinal Epithelial Tight Permeability Is Mediated by Toll-Like Receptor 4/Myeloid Differentiation Primary Response 88 (MyD88) Activation of Myosin Light Chain Kinase Expression Scand J Gastroenterol. 2006
Lipopolysaccharides are important outer membrane components of gram-negative bacteria that provide integrity to the bacterial cell and contributes to the interaction of these bacteria to other surfaces.38Aisha Farhana; Yusuf S. Khan.. Biochemistry, Lipopolysaccharide Stat Pearls. 2020
In a healthy gut, LPS concentrations mostly stay put in the gut lumen which houses many trillions of commensal bacteria.39R Benoit, S Rowe, S C Watkins, P Boyle, M Garrett, S Alber, J Wiener, M I Rowe, H R Ford. Pure endotoxin does not pass across the intestinal epithelium in vitro Shock. 1998
In a leaky gut, tight junctions open in the presence of increased zonulin, and LPS is released into the bloodstream.
Once in circulation, LPS elevates inflammatory cytokines and the odds of chronic physical and mental disease.40Perrine André, Fabienne Laugerette, and Catherine Féart. Metabolic Endotoxemia: A Potential Underlying Mechanism of the Relationship between Dietary Fat Intake and Risk for Cognitive Impairments in Humans? Nutrients. 2019
Think of your gut like a tire, LPS like the air, and zonulin like a nail. When your gut tire is pierced by a zonulin nail, the LPS air is let out. The result is a flat tire and a broken-down car.
And much like the broken down car, in the presence of elevated LPS your body also begins to break down.
In fact, studies examining disease-free centenarians show a low presence of LPS and zonulin.41Pedro Carrera-Bastos, Óscar Picazo, Maelán Fontes-Villalba, Helios Pareja-Galeano, Staffan Lindeberg, Manuel Martínez-Selles, Alejandro Lucia, and Enzo Emanuele. Serum Zonulin and Endotoxin Levels in Exceptional Longevity versus Precocious Myocardial Infarction Aging Dis. 2018
How Leaky Gut Helps Toxins Cross The Blood-Brain Barrier
The release of lipopolysaccharide into circulation through a leaky gut produces a cascade of inflammatory cytokines that compromise the integrity of the blood-brain barrier.42Nan Wang, Dan Zhang, Gengyun Sun, Hong Zhang, Qinghai You, Min Shao, Yang Yue. Lipopolysaccharide-induced caveolin-1 phosphorylation-dependent increase in transcellular permeability precedes the increase in paracellular permeability Drug Des Devel Ther. 2015
Lipopolysaccharide itself can also induce blood-brain barrier permeability through phosphorylation of the cellular membrane protein, Cav-1.43Nan Wang, Dan Zhang, Gengyun Sun, Hong Zhang, Qinghai You, Min Shao, and Yang Yue. Lipopolysaccharide-induced caveolin-1 phosphorylation-dependent increase in transcellular permeability precedes the increase in paracellular permeability Drug Des Devel Ther. 2015
This is yet another example of how important reducing LPS-induced Cav-1 phosphorylation is to protecting the integrity of the blood-brain barrier.
The best way to reduce LPS-induced Cav-1 phosphorylation is by lowering circulating LPS through healing gut permeability.
Cav-1 and the Blood-Brain Barrier
Cav-1, a well-established major structural protein of caveolae, has demonstrated an important role in the regulation of multiple cellular processes, including cell growth, differentiation, endocytosis, cholesterol trafficking, and cellular senescence.44Kim Cuc Thi Nguyen, Kyung A Cho. Versatile Functions of Caveolin-1 in Aging-related Diseases Chonnam Med J. 2017
It’s a part of the Caveolae family of integral membrane proteins and expressed mostly in the endothelial cells of the blood-brain barrier.45Anna R Busija, Hemal H Patel, Paul A Insel. Caveolins and cavins in the trafficking, maturation, and degradation of caveolae: implications for cell physiology Am J Physiol Cell Physiol. 2017
Like many other cellular proteins, there seems to be a homeostatic Goldilocks zone of expression. Not too much and not too little.
In the brain, cav-1 regulates neuronal signaling and promotes dendritic growth and predominantly regulates BBB permeability through transcellular and paracellular routes.46Creed M Stary, Yasuo M Tsutsumi, Piyush M Patel, Brian P Head, Hemal H Patel, David M Roth. Caveolins: targeting pro-survival signaling in the heart and brain Front Physiol. 2012
Changes in cav-1 can sequentially induce a series of alterations in BBB permeability, neuroinflammation, cerebral angiogenesis, apoptosis, and oxidative stress.47Qianyi Huang, Wei Zhong, Zhiping Hu, and Xiangqi Tang. A review of the role of cav-1 in neuropathology and neural recovery after ischemic stroke J Neuroinflammation. 2018
One of Cav-1’s most important jobs is inhibiting matrix metalloproteases (MMPs).
MMP-9 specifically, degrades tight junction proteins and ultimately the blood-brain barrier.48Gary A Rosenberg. Neurological diseases in relation to the blood-brain barrier J Cereb Blood Flow Metab. 2012
MMP-9 production is also highly influenced by inflammatory cytokines and LPS.49Chang-Hoon Woo, Jae-Hyang Lim, Jae-Hong Kime. Lipopolysaccharide induces matrix metalloproteinase-9 expression via a mitochondrial reactive oxygen species-p38 kinase-activator protein-1 pathway in Raw 264.7 cells J Immunol. 2004
All of this underlines how important reducing LPS-induced Cav-1 phosphorylation is to protect the integrity of the blood-brain barrier.
The best way to reduce LPS-induced Cav-1 phosphorylation is by lowering circulating LPS through healing gut permeability.
Leaky Brain, Leaky Gut Functional Tests
Now that you know what a leaky brain is and how it’s connected to a leaky gut, it’s time to find out if this is your problem.
The best way to do this is through functional lab tests that can be ordered by a doctor or health practitioner.
These tests can give you insight into your levels of relevant issues that may be affecting your gut/brain axis. Below are some of the tests that may help you in this assessment.
- Serum zonulin: Indicator of gut permeability
- Serum lipopolysaccharide: Indicator of leaky gut and blood-brain barrier permeability
- Cyrex Labs Array 20 blood-brain barrier permeability: Comprehensive lab test measuring immune system reactions
- Serum Matrix Metalloproteinase-9 (MMP-9): Can tell you if your blood-brain barrier’s tight junctions are under attack.
- Great Plains Labs Organic Acids Testing: Fully comprehensive metabolic marker panel that can indicate harmful gut bacteria and neurotransmitter production
- Great Plains Lab Mycotox/Mold testing : Measure of mold toxicity circulating in your body that may trigger inflammation and ultimately BBB permeability
- Great Plains Lab Environmental Toxin Testing: Measure of environmental chemicals that can cross a leaky blood-brain barrier and cause neurological issues.
The Vagus Nerve: The Real Gut/Brain Axis
Your vagus nerve is the main interface of the gut/brain connection.
It is a mixed nerve with anti-inflammatory properties both through its afferent and efferent fibers and is the principal component of the parasympathetic nervous system.50Bruno Bonaz, Valérie Sinniger, Sonia Pellissier. Anti-inflammatory properties of the vagus nerve: potential therapeutic implications of vagus nerve stimulation J Physiol. 2016
It literally connects your brain to your gut and thus highly influences the bidirectional connection.
A full functioning, highly optimized vagus nerve can
- Lower inflammation51L V Borovikova, S Ivanova, M Zhang, H Yang, G I Botchkina, L R Watkins, H Wang, N Abumrad, J W Eaton, K J Tracey. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin Nature. 2000
- Lower stress
- Improve gut disorders like IBS and IBD52Sonia Pellissier, Cécile Dantzer, et al . Relationship between vagal tone, cortisol, TNF-alpha, epinephrine and negative affects in Crohn’s disease and irritable bowel syndrome PLoS One. 2014
- Deliver neurotransmitters like serotonin, GABA, dopamine, and acetylcholine to the brain
- 53Amar Sarkar, Soili M Lehto, et al. Psychobiotics and the Manipulation of Bacteria-Gut-Brain Signals Trends Neurosci. 2016
How To Heal Leaky Brain
The most effective way to heal a leaky brain is a multi-pronged approach of gut healing, stress reduction, and detoxification.
All 3 will help reduce gut permeability and inflammation while strengthening the integrity of the blood-brain barrier.
Regular movement, exercise, breathing, and mindfulness practices will help lower stress and boost BDNF and neurotransmitter production as well.
Leaky Gut/Leaky Brain Diet
A disciplined approach to diet is of the utmost importance when it comes to healing the gut.
Of course, this is easier said than done.
For many people, diet is what caused the onset of these conditions.
The good news is that many people are able to heal their gut and the associated brain issues with the right diet.
This may take some trial and error, but once you figure out what foods work best for you and which are your problem foods than you are well on your way to success.
Some diets that are known to help leaky gut/leaky brain include:
- Low FODMAPs
- GAPs
- AIP (Autoimmune Paleo)
- Wahl’s Protocol
Foods To Avoid To Heal Leaky Gut/Leaky Brain
To truly heal your gut you must eliminate all the low hanging problem foods that are known gut irritants. These include:
- Gluten54Valentina Melini and Francesca Melini. Gluten-Free Diet: Gaps and Needs for a Healthier Diet Nutrients. 2019
- Fried Foods55Jean Robert Rapin and Nicolas Wiernsperger. Possible Links between Intestinal Permeablity and Food Processing: A Potential Therapeutic Niche for Glutamine Clinics (Sao Paulo). 2010
- High Fructose Corn Syrup
- Soy56Manuel I. Hedrera,Jorge A. Galdames,Maria F. Jimenez-Reyes,Ariel E. Reyes,Ruben Avendaño-Herrera,Jaime Romero,Carmen G. Feijóo . Soybean Meal Induces Intestinal Inflammation in Zebrafish Larvae PLOS ONE. 2013
- Glyphosate (non-organic fruits and vegetables)57Lola Rueda-Ruzafa, Francisco Cruz, Pablo Roman, Diana Cardona. Gut microbiota and neurological effects of glyphosate Neurotoxicology. 2019
Adding in more nutrient-dense whole foods like organic fruits, vegetables, and high-quality animal products will give your body more healing nutrition.
Supplements That Help Leaky Brain/Leaky Gut
- Probiotics58Giorgio La Fata, Peter Weber, and M. Hasan Mohajeri. Probiotics and the Gut Immune System: Indirect Regulation Probiotics Antimicrob Proteins. 2018
- Gut healing herbs like ginger, aloe vera, licorice root, peppermint herb, chamomile59Amanda C. Fifi, Cara Hannah Axelrod, Partha Chakraborty, and Miguel Saps. Herbs and Spices in the Treatment of Functional Gastrointestinal Disorders: A Review of Clinical Trials Nutrients. 2018
- Digestive Enzymes60Gianluca Ianiro, Silvia Pecere, Valentina Giorgio, Antonio Gasbarrini, and Giovanni Cammarota. Digestive Enzyme Supplementation in Gastrointestinal Diseases Curr Drug Metab. 2016
- L-Glutamine61Min-Hyun Kim and Hyeyoung Kim. The Roles of Glutamine in the Intestine and Its Implication in Intestinal Diseases Int J Mol Sci. 2017
- D-Ribose62Yan Liu, Tong-Ruei R Li, Cong Xu, and Tian Xu. Ribose Accelerates Gut Motility and Suppresses Mouse Body Weight Gaining Int J Biol Sci. 2016
- CBD63Hollis C Karoly, Raeghan L Mueller, L Cinnamon Bidwell, Kent E Hutchison. Cannabinoids and the Microbiota-Gut-Brain Axis: Emerging Effects of Cannabidiol and Potential Applications to Alcohol Use Disorders Alcohol Clin Exp Res. 2020
- Turmeric/Curcumin64Bagher Farhood, Keywan Mortezaee, Nasser Hashemi Goradel, Neda Khanlarkhani, Ensieh Salehi, Maryam Shabani Nashtaei, Masoud Najafi, Amirhossein Sahebkar. Curcumin as an anti-inflammatory agent: Implications to radiotherapy and chemotherapy J Cell Physiol. 2019
- Butyric acid65Andrea Bedford and Joshua Gong. Implications of butyrate and its derivatives for gut health and animal production Anim Nutr. 2018
- Dandelion Root66Pamela Ovadje, Saleem Ammar, Jose-Antonio Guerrero, John Thor Arnason, and Siyaram Pandey. Dandelion root extract affects colorectal cancer proliferation and survival through the activation of multiple death signalling pathways Oncotarget. 2016
- Methylsulfonylmethane (MSM)67Matthew Butawan, Rodney L. Benjamin, and Richard J. Bloomer. Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement Nutrients. 2017
- Okra68Tingxu Yan, Tingting Nian, et al. Antidepressant effects of a polysaccharide from okra (Abelmoschus esculentus (L) Moench) by anti-inflammation and rebalancing the gut microbiota JInt J Biol Macromol. 2020
- Collagen peptides69Qianru Chen, Oliver Chen, et al. Collagen peptides ameliorate intestinal epithelial barrier dysfunction in immunostimulatory Caco-2 cell monolayers via enhancing tight junctions Food Funct. 2017
- L-carnitine70Junichiro IRIE, Yoshihiko KANNO, et al. L-Carnitine improves gastrointestinal disorders and altered the intestinal microbiota in hemodialysis patients Biosci Microbiota Food Health. 2017
- CoQ1071Rajiv Saini. Coenzyme Q10: The essential nutrient J Pharm Bioallied Sci. 2011
- 1Mark E. M. Obrenovich. Leaky Gut, Leaky Brain? Microorganisms. 2018
- 2Souhel Najjar, Daniel M Pearlman, Orrin Devinsky, Amanda Najjar, and David Zagzag. Neurovascular unit dysfunction with blood-brain barrier hyperpermeability contributes to major depressive disorder: a review of clinical and experimental evidence J Neuroinflammation. 2013
- 3N Joan Abbott, Lars Rönnbäck, Elisabeth Hansson. Astrocyte-endothelial interactions at the blood-brain barrier Nat Rev Neurosci. 2006
- 4Hadar Shalev, Yonatan Serlin, Alon Friedman. Breaching the blood-brain barrier as a gate to psychiatric disorder Cardiovasc Psychiatry Neurol. 2009
- 5Daniel A Nation, Melanie D Sweeney, Axel Montagne, et al. Blood-brain barrier breakdown is an early biomarker of human cognitive dysfunction Nat Med. 2019
- 6Jeremy Appleton. The Gut-Brain Axis: Influence of Microbiota on Mood and Mental Health Integr Med (Encinitas). 2018 Aug
- 7Javier A Bravo, Paul Forsythe, Marianne V Chew, et al. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve Proc Natl Acad Sci U S A. 2011
- 8Emmanuelle Waubant. Biomarkers indicative of blood-brain barrier disruption in multiple sclerosis Dis Markers. 2006
- 9Maria Fiorentino, Anna Sapone, Stefania Senger. Blood-brain barrier and intestinal epithelial barrier alterations in autism spectrum disorders Mol Autism. 2016 Nov
- 10Mark Obrenovich, Rudolf Flückiger, Lorraine Sykes, Curtis Donskey. The Co-Metabolism within the Gut-Brain Metabolic Interaction: Potential Targets for Drug Treatment and Design CNS Neurol Disord Drug Targets. 2016
- 11Meng-Fei Sun, Yan-Qin Shen. Dysbiosis of gut microbiota and microbial metabolites in Parkinson’s Disease Ageing Res Rev. 2018
- 12Meggan Mackay. Lupus brain fog: a biologic perspective on cognitive impairment, depression, and fatigue in systemic lupus erythematosus Immunol Res. 2015 Dec
- 13Manuela Pennisi, Alessia Bramanti, Mariagiovanna Cantone, et al. Neurophysiology of the “Celiac Brain”: Disentangling Gut-Brain Connections Front Neurosci. 2017 Sep 5
- 14I Bjarnason, T J Peters, N Veall. A persistent defect in intestinal permeability in coeliac disease demonstrated by a 51Cr-labelled EDTA absorption test Lancet. 1983
- 15AGerwyn Morris, Michael Berk, André F Carvalho, Javier R Caso, Yolanda Sanz, Michael Maes. The Role of Microbiota and Intestinal Permeability in the Pathophysiology of Autoimmune and Neuroimmune Processes with an Emphasis on Inflammatory Bowel Disease Type 1 Diabetes and Chronic Fatigue Syndrome Curr Pharm Des. 2016
- 16Gerwyn Morris, Michael Berk. The Neuro-Immune Pathophysiology of Central and Peripheral Fatigue in Systemic Immune-Inflammatory and Neuro-Immune Diseases Mol Neurobiol. 2016
- 17Christopher B Forsyth, Kathleen M Shannon, Jeffrey H Kordower, Robin M Voigt, Maliha Shaikh, Jean A Jaglin, Jacob D Estes, Hemraj B Dodiya, Ali Keshavarzian. Increased intestinal permeability correlates with sigmoid mucosa alpha-synuclein staining and endotoxin exposure markers in early Parkinson’s disease PLoS One. 2011
- 18Michael Maes, Marta Kubera, Jean-Claude Leunis. The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression Neuro Endocrinol Lett. 2008
- 19Moon Ho Do, Eunjung Lee, Mi-Jin Oh,1 Yoonsook Kim, and Ho-Young Park. High-Glucose or -Fructose Diet Cause Changes of the Gut Microbiota and Metabolic Disorders in Mice without Body Weight Change Nutrients. 2018
- 20Matthew T. Pereira, Mridu Malik, et al. Effect of dietary additives on intestinal permeability in both Drosophila and a human cell co-culture Dis Model Mech. 2018
- 21Gen Zheng, Shu-Pei Wu, Yongjun Hu, David E Smith, John W. Wiley,1 and Shuangsong Hong. Corticosterone mediates stress-related increased intestinal permeability in a region-specific manner Neurogastroenterol Motil. 2013
- 22Alexander J. Gill and Dennis L. Kolson. Chronic Inflammation and the Role for Cofactors (Hepatitis C, Drug Abuse, Antiretroviral Drug Toxicity, Aging) in HAND Persistence Curr HIV/AIDS Rep. 2014
- 23Faraz Bishehsari, M.D., Ph.D., Emmeline Magno, M.D., Garth Swanson, M.D., Vishal Desai, M.D., Robin M. Voigt, Ph.D., Christopher B. Forsyth, Ph.D., and Ali Keshavarzian, M.D. Alcohol and Gut-Derived Inflammation Alcohol Res. 2017
- 24Pengcheng Tu, Liang Chi, Wanda Bodnar, Zhenfa Zhang, Bei Gao, Xiaoming Bian, Jill Stewart, Rebecca Fry, and Kun Lu. Gut Microbiome Toxicity: Connecting the Environment and Gut Microbiome-Associated Diseases Toxics. 2020
- 25CDC. Chronic Diseases in America National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP)
- 26Irene Lacal and Rossella Ventura. Epigenetic Inheritance: Concepts, Mechanisms and Perspectives Front. Mol. Neurosci., 28 September 2018
- 27Katherine R. Groschwitz, BS and Simon P. Hogan, PhD. Intestinal Barrier Function: Molecular Regulation and Disease Pathogenesis J Allergy Clin Immunol. 2009
- 28Paula Grammas, Joseph Martinez, Bradley Miller. Cerebral microvascular endothelium and the pathogenesis of neurodegenerative diseases Expert Rev Mol Med. 2011
- 29Chris Greene, Matthew Campbell. Tight junction modulation of the blood brain barrier: CNS delivery of small molecules Tissue Barriers. 2016
- 30Daniel R Clayburgh, Le Shen, Jerrold R Turner. A porous defense: the leaky epithelial barrier in intestinal disease Lab Invest. 2004
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