Category: Science

Fixing Leaky Gut

The One Probiotic Supplement You Need to be Taking

Bowel wall permeability, more commonly described these days as “leaky gut,” is now front and center in the news, and is well known as a cause of a large number of common disease entities. The intestinal barrier that separates the luminal contents from the systemic circulation is, incredibly, only one cell thick! This extends from the esophagus to the anus. That means that we are dependent on a one cell layer, as well as the connections between these single cells, to carefully screen what is taken in and what is excluded.

The integrity of the gut lining can be compromised by any number of influences including antibiotics, stress, various medications, including nonsteroidal anti-inflammatory drugs, as well as steroids, harmful bacteria, glycated proteins, and even exposure to gluten. When the permeability of the gut lining is increased, it sets the stage for a dramatic increase in inflammation and compromises our immune system’s ability to determine self versus non-self. The latter is a hallmark of autoimmune diseases including lupus, diabetes type I, psoriasis, rheumatoid arthritis, and so many more of the common maladies of our modern world.

Swedish researchers have recently reviewed the effectiveness of a particular probiotic organism, Lactobacillus plantarum, in terms of its effectiveness in reducing gut wall permeability. Their report summarized not only the animal research done to evaluate the effectiveness of this probiotic organism, in terms of restoring gut wall integrity, but human research as well. While the science is a bit compelling, the take-home message is that non-pharmaceutical approaches, like taking a probiotic, can significantly reduce the permeability of damaged gut lining, and this may have a significant downstream effect in terms of reducing inflammation, the cornerstone of virtually any the degenerative disease you can think of. This is why Lactobacillus plantarum has become one of my most coveted “go to” players when I prescribe probiotics to my patients.

  • fred tully

    so what does Lactobacillus Plantarum feed on? The easyiest way to grow it is to provide it with it’s natural food.

    • Boundless

      > so what does Lactobacillus Plantarum feed on?
      > The easiest way to grow it is to provide it with
      > it’s natural food.

      That might presume that you already have a competitive population of LP (in which case, sure, just feed ’em). They seem to like fermented foods and cheese.

      But for most people, there is a prior problem of having no LP or only a small LP pop, and/or having the LP out-competed by adverse bacteria. Unless you’re sure of your starting situation, a course of probiotics is the best insurance.

  • Greg Smith

    So, is Lactobacillus plantarum only available by prescription? Or can I get it naturally in a fermented food? Yogurt, kimchi, kombucha, etc.

    • David Perlmutter

      Not at all. It’s actually available in my Empowering Probiotic. http://store.drperlmutter.com/collections/individual-supplements/products/empowering-probiotic-new

      • Greg Smith

        But is it in any probiotic foods? Where does this occur naturally?

        • David Perlmutter

          Kefir, kombucha, sauerkraut…the list goes on!

    • Boundless

      Lactobacillus plantarum is also in Sigma-Tau VSL#3, some Garden of Life PBs and at least one RenewLife PB that I checked.

      These PBs are not easy to find in stores (at least two of them need refrigeration). I have no idea how they compare in price to Dr. Permutter’s preparation.

      Most room temperature retail store PBs are worthless, although it is possible to formulate a rom-temp PB with a decent shelf life.

  • Lynn Dell

    When I googled lactobacillus plantarum I kept finding the number 299v after it, which is different than the number on your supplement. Is there a significant difference between the various strains? There was some research paper on the 299v that was interesting to read.

  • Orna Charak

    Does lactobacillus been found in fermented foods?

    • David Perlmutter

      You bet!

  • William

    Does Empowering Probiotic need refrigeration?

    • David Perlmutter

      No, unless you are keeping them in temperatures well above normal for days at a time. The nitrogen purged packaging along with the fact that it is non-dairy product make it stable.

  • Lynn Dell

    I wish I understood the implications of everything: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1563611/

    • Marie

      Now that was some heavy-duty reading! I don’t think it’s possible for anyone to know the implications of everything, but it would be nice if we could. That’s for including the link.

      • Lynn Dell

        I understood bits and pieces of it. That was more of a joke what I said. Someone I know once had a blog called “The Implications of Everything: A Journal of Too Much Contemplation.” I want to figure things out, but a lot of it is above my pay grade.

  • ladyermintrude

    I have been grain and sugar free for 6-7 months now and also cut back on starchy veg and legumes. I felt fantastic, no migraines, no sleepless nights, no brain fog, more energy and concentration, less anxiety. After reading Grain Brain (fab book btw) I cut back carbs to about 30g a day. After a month or so of this I broke out in yeast infections – thrush the worst thing. I have started taking a 20billion probiotic and eating a green banana every day for resistant starch. I have upped my carb level as I think 30g was obviously too low for me. I’m trying to eat more vegetables and higher carb nuts like cashews. Am I doing the right thing?? Is there other stuff I should be doing? And how can I avoid this happening? I love the grain free low carb way of living but don’t want to do it in a way that makes me unwell!!


    • David Perlmutter

      I allow for 50-60grams of carbs/day.

    • Needtoknow


      Can you please tell me how you discovered and/or diagnosed the yeast problem? I’ve suspected this for me for a while but don’t know how to be sure. And, is resistant starch the cure? So glad you posted what you did. Always think I’m crazy.

      • ladyermintrude

        Hi there

        I discovered because I had a terrible outbreak of thrush. Also my scalp was itchy, and my ears were too and I had a strange smell from my feet (unlike normal foot odour).

        I think the resistant starch feeds your good gut bacteria which will help rebalance your population of bacteria. I take the probiotic to make sure I have good bacteria. I’m also eating pistachios as they are good for your balance too.

        I’ve been doing this for about a week and I definitely feel better. But I know it takes a while to get back right again.

        My question was really what else should I be doing. I really don’t know enough and I want to keep up with this lifestyle as I have felt so much better. I don’t want my biome out of kilter and I want to make sure I’m at the peak of health.

        I’d welcome any advice!
        Thanks 🙂

        • Elles

          Look into taking both wild oil of oregano and diatomaceous earth. Both are great for yeasts, parasites etc. and keep taking a multiple strain of potent probiotic as well as a low carb diet. A diet free of sugars and low in carb can help starve the yeast.

          • ladyermintrude

            Thanks I’ll keep an eye out for those too 🙂

          • DCU

            You might also look into the book Clean Gut by Dr Alejandro Junger. (not affiliated with him, just letting you know because it helped me.)

          • ladyermintrude

            Thanks. I’ll look out for it 🙂

        • Jenny

          Read Body Ecology by Donna Gates. It has done wonders for my yeast infections:) Best of luck

  • Marie

    I would like to know your opinion of FOS as a prebiotic and whether it’s worth adding to my regimen. Thank you!

  • Janet

    It is difficult to take the many oral supplements I need to take for Parkinsons Disease. Is there a powder that I can add to a smoothie instead of oral pills/capsules? It would be wonderful.. thank you Janet

  • Diana Lee Peery

    I have been a type 1 diabetic for over 33 yrs. My A1C was 9.6 taking 60-70 units of insulin daily, gastroparesis, high cholesterol, hypothyroid, arthritis, fibromyalgia, anxiety, depression, 185 lbs. size 18 pants. That was the old me. The new me on “Plexus” is A1C 6.8 taking 20-25 units of insulin daily, no gastroparesis, cholesterol, arthritis, fibromyalgia, anxiety or depression medications. Thyroid medication lowered 4 times within the last year. 155 lbs. size 10/12 pants. I the new me and Plexus!!!! dianapeery@gmail.com http://www.facebook.com/dianapeery

    • Guest

      Wow. So tacky to promote your products on someone else’s website. Especially when they have nothing to do with the topic at hand.

      • Bebe Bradley

        Actually, it has everything to do with the topic. It’s about leaky gut and probiotics. Maybe she didn’t do it very tactfully, but she’s right. I’m a huge believer in probiotics, the devestation of parasites and a sick gut. Happy for ya, Diana. I’m still learning!

  • Elizabeth Campbell

    I take your Senior Empowerment Supplements daily. Do I need to add anything to that regime or does the probiotic included cover it?

    • David Perlmutter

      The Empowerment Pack includes the Empowering Probiotic,

  • Jan in KW

    I had no idea our intestinal barrier was only one cell layer thick…..it’s no wonder the standard American high fiber diet is so damaging!

    • smartass

      High fiber diet? American? Lol Americans get the least amount of fiber. THIS CAUSES THE PERMEABILITY.

    • Guest

      I’m not sure where Dr. Perlmutter got that info, but it’s simply not correct. The intestinal barrier (bowel wall) is normally 3mm (1/10th of an inch) thick. One cell? That just doesn’t make common sense.


      • Kristin K

        He’s not talking about the bowel wall. He’s referring to the epithelial barrier that is one cell thick.

        • Guest

          Then he should make that clear.

  • Ann

    Interesting – I have celiac disease which has led to multiple food intolerance, etc…..so when I have “issues” and I take VSL#3 which has lactobacillus plantarum I get better so much faster.

  • Jan

    Dr Perlmutter, when do recommend taking the L Plantarum for gut healing? Best with food, without food, at bedtime? Thanks!

    • David Perlmutter

      Best to order these online Jan. Thanks for your interest!

    • David Perlmutter

      Best on an empty stomach, so for most people that’s in the AM.

      • scottie kemp

        what brand would you recommend?

        • ri

          obviously his own! hehe

    • Cindy Remillard

      Did we get a brand that he recommends?

      • Anna Belle

        Garden of Life, Dr. Formulated, is the one he helped develop.

  • redhead67

    Fermented foods are the best way to get probiotics. It’s very difficult for your body to use the supplement form.

    • ladyermintrude

      Do you mean like yoghurt? Or something else? I put apple cider vinegar in my green banana smoothie.

      • Tammy Bergeron Poirier

        yogurt is one, along with sauerkraut, kimchi, kombucha, kefir

        • David Perlmutter

          Just make sure it’s plain yogurt. Flavored yogurt frequently has high sugar content.

          • ladyermintrude

            Thanks!! Never touch that stuff. Urgh. Always go for the full fat version too!!

          • Naples Chef

            There is a delicious yogurt called Greek Pastures at Whole Foods. From grass fed, fully pastured cows. Plain yogurt has between 5-9 grams sugar (lactose) naturally. So this one at 11 grams is very low added sugar.

          • Yogurt Girl

            Thanks will try it!

          • Yogurt Girl

            Fresh fruit?

          • meeya

            I had been waiting for a pastured milk Greek yogurt to hit the market. Unfortunately, that company doesn’t have a plain version of their yogurt. The 4 “flavors” they were offering were all loaded with sugar.

          • Guest

            And probably no l. plantarum…

        • earthmom1960

          Homemade ginger ale is fermented and while it’s a multi-step process to make, it’s not a difficult process at all. It’s something anyone can do in the average kitchen. Also, homemade yogurt is something anyone can make with a candy thermometer and a large thermos. However, if I had to choose which is easier, I’d say the ginger ale but it takes longer as in it’s a couple of week process vs an overnight process for the yogurt. But neither is difficult and I’d encourage anyone interested to google a recipe for either or both and give it a try.

      • redhead67

        Home made you yoghurt can be fermented, but Google fermented foods too see the scope of it. Store bought yoghurt does not have any probiotics left after the pasteurization process.

  • Christine Mccormick Burke

    I live in Estero.. do you have these probiotics at your office in Naples?

    • David Perlmutter

      Best to order these online Christine. Thanks for your interest!

  • wp

    I would love to be able to buy the Empowering Probiotics from your website but unfortunately I can’t afford it with four adults in my house the drink them 🙁 Would you recommend any other source that would give us close the to amount your supplement provide? Thank you so much.

  • Lulu

    It’s my understanding that one should rotate different probiotics for the best gut health. How do you feel about this?

  • Katarzyna

    I wish everyone talking about the “leaky gut” would address the issues of parasites! I treated my son “leaky gut” for 4 years with SCD and probiotics of all sorts, before discovering that the reason he had it was a human parasite called Ascaris. The young parasite drills holes in the intestines to get into the bloodstream and travel to lungs to complete its life cycle.

    • Gferraio

      What testing was done to determine that he had the parasite?

      • Katarzyna

        IgM and IgG for this specific parasite, we also saw the larvae in his blood during the live blood analysis test. Stool tests are not reliable- we did the comprehensive tests at Doctor’s Data and Genova which came back negative.

        • Liz

          What lab did the IgM and IgG test and is there a particular panel that you used? Many thanks –

          • Guest

            Try using google.

        • Louisa Tomaio

          Can you tell what lab you used for the IgM & IgG?

        • Louisa Tomaio

          Also, what did you use to eradicate the worms? I found a nematode in my mothers stool sample and treated with pyrantal pamote 2x’s, but i think she is still infected…

    • barry

      What was the treatment recommended for his parasites?

    • Angela Koenigsberg

      Poor kid. Hope he is better now.

    • Ronald S. Kragnes

      What Doctor did you see that finally found that connection?

  • Mel

    I believe L plantarum is the bacteria usually found in traditional sauerkraut and other fermented vegetables. Dr Perlmutter do you have any input on that?

    • foodstuff

      I believe you are correct Mel – as it is typically on vegetables naturally and grows during fermentation

    • Denise Otis

      I believe that is true also. I culture my veggies/veggie juice with Body Ecology’s Veggie Culture starter, which is predominately L. Plantarum. That way I don’t need to take the probiotic capsules–I get plenty in my food/juice. I would like to share with you my recipe for fermented fresh pressed veggie juice; it is posted on this site: http://www.wildfermentation.com/forum/viewtopic.php?f=7&t=3966

      • Karla Ely

        I use Body Ecology’s veggie culture starter as well… I’m going to up my daily dose!

      • earthmom1960

        I make homemade ginger ale which is fermented ginger – my friend who has suffered from life-long eczema since childhood swears this is the only thing that has even remotely brought her relief. There’s is definitely something to ancient knowledge and old world remedies.

  • Marsta

    Dr Perlmutter, why did you choose only the lp-115 strain, out of the 18 strains of lactobacillus plant arum, to include in your probiotic product?

  • Veronica Hippensteel

    What brand has this in it?


    I have been taking VSL #3 for over 5 years. Are you familiar with this? Highly recommended in the GI community.

  • Davina

    Thank you Dr. Perlmutter. I live in Australia, what’s the best way to purchase these probiotics? Thanks

    • David Perlmutter

      Unfortunately, we aren’t shipping to Australia yet, but are working on that. Thanks for your interest Davina.

    • Lisa Edwards

      Davina, We have an awesome probiotic with Youngevity and we have a division in Australia. Do a search for Youngevity and find a rep near you. We have “root beer belly” and “Nightly essence” both excellent.

  • Jill

    Hi Dr Perlmutter, which probiotic do you use with the ingredient that is mentioned, and how do we purchase it, thx 🙂

  • Momof3

    Hi there, have you heard of Deglycyrrhizinated licorice (delicorice)? My daughter was on this for a while as it is supposed to help rebuild the stomach lining…

    • Jessica Nelson

      Quick tip: I started the gut healing protocol at http://www.LeakyGutCure.info and I’ve never felt better. I’ve always had gut issues and I’ve never felt so good for this long. This program helped my mood, energy, and overall feeling of well-being. Before using this, I was plagued with daily stomach and GI pain that would only subside with my prescription, Protonix. After using this guide, I am off my Protonix and my pain is pretty much gone. Best of luck to you… this changed my life!

  • foodstuff

    why do you suggest on an empty stomach? I have also heard with food because that is when acidity is lower. What are your thoughts?

    • Lisa Edwards

      Always on an empty stomach.

  • Nancy

    How long do you recommend taking the probiotics or is ongoing use best?

    • David Perlmutter

      Ongoing use would be ideal.

  • Nancee

    What is the difference between a leaky gut and IBS?? I have not been diagnosed, my doctor tested for celiac, but that came back negative. I am taking a probiotic 3 billion SBC and have eliminated all grain, dairy, legume, alcohol but still have gut issues. What do I ask my doctor to look into next?

    • Trisha

      I had a similar experience…….after years of continuing problems I learned my problem was fructose malabsorption! My GI had me complete a breath test for diagnosis. Good luck.

      • Nancee

        Thanks Trisha….is that the 4. Cortisol level saliva test? I have been reading that it could be thyroid related too with low energy. If you remember what your Dr. called the test that would be greatly appreciated.

  • Marnie Britcher

    Do fish oils, probiotics and digestive enzymes need to be changed quarterly and/or suspended periodically, as I was told by 2 holistic nutritionists? Thanks for all your wonderful sharing of health information. You are a God-send!

  • Maria Vergara

    Soy de Chile, me han diagnosticado lipolinfedema, he comprado su libro cerebro de pan, pero no se si puedo comer tanta proteína, todos los días, quisiera saber qué puedo hacer y cómo seguir su dieta.

  • Judy williams

    Not related. I need to let you know I nearly choked on pork rinds.

  • Guest

    Thank you for revealing to me the efficacy of LP for leaky gut. I have been taking Ther-Biotic Complete by Klaire labs for the past several years. It has 24.0 billion of lactobacillus plantarum per serving. I am wondering if this is enough for leaky gut, or if I should switch to a different formula?

    • heat4life

      If your leaky gut hasn’t resolved in years of treating it, I’d look into getting lab work done for GI infections

  • What about L-Glutamine? 1-5grams a day? Howcome I never really hear about it? I believe it is THE reason my symptoms (IBS with constipation, mucus, blood) are GONE. I eat gluten and dairy and corn now and anything else normal people who need a variety of natural foods to survive can eat. L-Glutamine, and yes a good probiotic (but it was the L-Glutamine that really made all my symptoms finally be gone), is what helped me for sure.

    • meeya

      I have read several sources stating this fact as well. I will start taking it as well. Thanks for the reminder!

    • Sean

      I realize this is an old post, but was hoping you could respond. Did you take L-Glutamine with food or on an empty stomach? Thanks.

      • I took it on an empty stomach in between meals. And I used NOW brand powder which has 5g of L-Glutamine per teaspoon. So, I took one teaspoon twice a day (10grams) and that’s what helped me personally. I think you really have to take at least that much, or at least I did. Some people might need to take more.

        • Sean

          Thanks a bunch!

  • John

    Dr. Perlmutter, bowel wall permeability could be the cause of plaque psoriasis?

    • Lisa Edwards

      Our skin is like a billboard for our intestinal health. Many skin conditions clear when digestive health is corrected.

  • Pam Mann

    Hello Dr. Perlmutter.. my daughter has churg strouss syndrome. . What do you recommend for her.

  • Denise Otis

    My recipe for fermented fresh pressed veggie juice made with Body Ecology’s Veggie Culture starter, rich in L Plantarum:


  • My little guy cannot swallow capsules yet, is it ok to put your brand of probiotics in his applesauce?? Thank you!
    Peace & Raw Health,

    • David Perlmutter

      Watch the sugar and ingredients, but that could be an option.

      • Mary

        Mott’s Natural Applesauce does not contain added sugars. Regular Mott’s & Cinnamon has HFCS rather than sugar, Yuk!

  • Beeb

    Good Morning! I’m trying to wrap my brain around gluten-intolerant leaky gut and celiac leaky gut. Do gluten-intolerant sufferers have a leaky gut the same way as celiac sufferers? OR does leaky gut only happen in celiac sufferers?Can they be healed the same way (i.e. removing gluten, probiotics?). 🙂

    • heat4life

      Anyone can get leaky gut. Treatment is more than just gluten removal and probiotcs. Look for underlying causes such as yeast overgrowth, bacteria, parasitic infections, activated viruses, and other GI infections. There are many factors that contribute to leaky gut, like, nsaids, soy, antibiotics, chronic stress, steroids, etc…

      Increase fat intake, specifically omega 3 fats

      • Mary

        I think I read that PPI’s can increase leaky gut because they further reduce acid in the stomach and contribute to not being able to digest properly or absorb nutrients. I know B12 is one that can be really reduced when taking them.

  • HighlandHoney

    How can you reduce elevated RCB, Hct and Hgb? Can this be related to small bowel obstructions? Is it be dangerous to have surgery to remove section of small bowel with these three red blood counts elevated?

  • HighlandHoney

    What is the difference between your probiotic and VSL#3?

  • Terri Anne Hargis Meyer

    Hi Dr. Perlmutter. Thank you so much for the wonderful information! My daughter is 5 years old. We have had several challenges and your information has been extremely valuable. Thank you. Is there a pro-biotic that you would suggest for her? Can she take yours? Thank you so much!

    • David Perlmutter

      Empowering probiotic is certainly an option.

      • What would the dosage be for her? She is 5 years and 42 lbs. Thank you! We look forward to trying your products!

  • Suzy Fauria

    Is any Lactobacillus okay? My shake has Lactobacillus Sporogenes, not plantarum. Thank you for all the helpful information! So much to share 🙂

  • kaitangata

    There is lots of info on how to lose weight – but none on how to put it on. I’m of slim build & just slightly below BMI 18.5 – not on any medication – still firing on all four – very active – 82 years old. Could do with a bit more flesh on my bones.
    any advice?.

  • cary

    Dr Perlmutter, I wanted to get your thoughts on learning disabilities and nutrition? My 9 year old daughter has learning issues and loves all carbs. Waffles with syrup for breakfast….wheat bread for lunch and pasta with butter ..sooooooo picky …she has sensory issues and food textures are a huge issue. any advice

  • Margo

    Hi all – I just finished the book Grain Brain – Amazing I have been off Gluten due to sensitivity for a while now. My sister, an osteopathe has been on this topic for years! Glad to see there is more awareness on the topic. One thing I don’t understand is Why are seeds (ie sunflower) OK but oils and butters from these seeds not considered good? Is it the refinement/milling that makes the oils and butters not so good? Dr. Perlmutter can you explain this?

    • Becky

      I think it has a lot to do with the oils going rancid. If you were to make them fresh from freshly hulled raw sunflower seeds and consume the seed butters before they had a chance to go rancid, it might be better?

  • Beth M

    I regularly ferment vegetables and was wondering if Lactobacillus plantarum is something that would develop during the fermentation process.

  • Beth M

    I just looked it up and apparently between days 2-16 it is present.

  • Rachael

    Hi I want to buy this probiotic but it contains magnesium sterate. Isn’t that bad for you? Thanks

  • Rachael
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  • Elly

    I’m 51 years old and am at my wit’s end with my health. I had my gallbladder removed at age 18 (stones) and was diagnosed with a duodenal ulcer at age 20. I’ve never smoked, and rarely taken any medications besides those prescribed for allergies/sinus or stomach problems (I believe I’ve taken every ‘stomach’ medicine from Aciphex to Zantac). In 2000 I had an endoscopic procedure that showed 1) I had a duodenal ulcer and 2) I had small lesions all over my stomach, which were referred to as a bunch of small individual peptic ulcers. I was given a prescription for Aciphex. A few months ago, I had an endoscopic procedure done to remove 7 small stones from my bile duct (no way to tell if they were residual from the gallbladder removal or if they formed in the meantime). The scope showed that 1) I had a duodenal ulcer and 2) I had small lesions all over my stomach. I was prescribed Nexium, with no other treatment options offered to me. I have seasonal allergies, terrible sinus problems with frequent infections, am about 15 pounds overweight, have no energy at all, and experience brain fog on a daily basis. I try to work out 2-3 days a week and always fit in a brisk walk wherever possible. I recently read Grain Brain and am almost finished reading Your Personal Paleo Code (Chris Kresser). I want to try a Paleo approach because everything I’m reading makes so much sense to me — I’ve followed the American Heart Association’s approach, increasing carbs and limiting meat, eggs, etc., and I feel like I’m 81 instead of 51. My husband, who is always under stress at work, rarely exercises, and was prescribed Androgel for low testosterone, wants to try it with me both for support and to see if a diet/lifestyle change will help him as well. I would love to hear from anyone who has similar issues to find out what you’ve done to help yourselves out of sickness and back into health.

    • Becky

      Elly, I can soooo identify with your comment, “I feel 81 instead of 51”! I, too, had stomach troubles, a duodenal ulcer and GERD. This led me to take a lot of antacids to try and quell the burning/stabbing feelings that ensued after consuming just about any meal or liquid. I suffered brain fog and just general malaise. Even worse was that I could no longer eat anything acidic (marinara sauces were the worst for my symptoms, but spaghetti was one of my favorite foods) or spicy (flavorful, spicy Asian foods were some of my favorite things to cook). This went on for well over a year as I prayerfully searched to find something to get to the bottom of my health troubles. During this time I was on Prilosec at my doctor’s recommendation, which in my opinion made things worse over time, as my digestion became very sluggish. My already very slow metabolism practically stopped, and I began to feel ‘stopped up’ all the time, which had never been a problem before. A medicinal tea that I found around that time (Stomach Ease) seemed to help soothe the irritated lining of my stomach in a pinch, making it at least possible to dine out with friends, but most of the time after meals at home, I’d be in bed with a hot water bottle on my stomach sucking on antacids. The tea was easy to have with me and I felt no yucky side effects. Then I found super Papaya enzymes which I found worked better than antacids. They became my best friend after meals. This freed me up quite a bit to be able to go places without being miserable after meals, but still, the stabbing pains just above my stomach persisted after meals. I finally came across something in a book about raw young thai coconuts being very good for soothing the stomach lining, healing ulcers and being very healing to the gut. They were a pain-in-the-behind to open so often, but the recommendation was to eat them on an empty stomach every morning for a week, the liquid and the pulp of the young coconut. The pulp scoops out of the shell with a spoon quite easily. (The trick is cracking those babies open, though you can find helpful tutorials online). I pureed the liquid and pulp from one coconut together in my Vitamix and drank it that way every morning as my breakfast (having meals that I’d found to be my ‘go-to’ meals that didn’t seem to affect me quite so much (proteins and steamed veggies) the rest of the day. I noticed an almost immediate soothing to my inflamed stomach. Three days in to the coconut thing, my husband brought home spicy thai food for his meal one night, and it smelled divine. I was able to eat several bites without ‘paying for it’ later due to discomfort and digestive upset. I couldn’t believe it! I’d not eaten spicy foods in over a year. I kept the coconut thing up for the full week, and the difference was night and day. The stabbing sensation was gone, and I honestly felt like the ulcer was healed. Coconuts have anti-fungal and anti-bacterial properties (h-pylori bacteria are prevalent with ulcers), and I think they sort of had a one-two punch in killing the bacteria and then soothing the lining. Every so often in the weeks and months following, I would feel a little twinge of stomach irritation, and would get a couple of coconuts and repeat the process on an empty stomach for a couple of days. That was a few years ago now, but I totally credit coconut as healing the ulcer in just a couple of weeks time. I’ve not had trouble with ulcers or GERD since. Since then, however, I have had trouble with kidney stones which I believe were directly tied to my heavy dependence upon antacids during that year or two with the ulcer. I have been taking probiotics for quite some time (Kefir products) to help with leaky-gut related issues. I’ve also done some juicing using greens and veggies (trying to get the acid/alkaline balance under control, as being overly acidic has caused all kinds of inflammation that I never used to feel…which has made me feel elderly at times even though I’m in my early 40’s. Anyway, those were some things that really helped me, and I hope you might find some success with them as well. I would add that the leaky gut issue, and the connection with the acid/alkaline balance (lightening the acidic load in the body) have both been very important in my own health journey. The standard American diet is very acidic and not at all conducive to a healthy gut. Hope that helps!

  • smd1133

    Dr. Perlmutter, How does VSL#3 compare to your probiotic? It contains 112.5 billion live strains: Bifidobacterium breve
    Bifidobacterium longum
    Bifidobacterium infantis
    Lactobacillus acidophilus
    Lactobacillus plantarum
    Lactobacillus paracasei
    Lactobacillus bulgaricus
    Streptococcus thermophilus
    I wondered if all these strains are necessary to someone like me who has leaky gut lots of inflammation and allergies to lots of foods.

    • Devan

      I know this post was a while ago, but did you ever try VSL3 for your leaky gut? If so, how did it work? I have leaky gut and I’m thinking about trying it out.


  • pammypim

    Re the statement – “Empowering Probiotic provides four researched strains of beneficial bacteria, including the extensively studied HN019 strain of Bifidobacterium lactis”- I’d like to know what all the bacterial strains are.

  • disqus_VrnxMOXw0t

    I am thankful that I have come across Dr. Perlmutter. So many of my lifelong illnesses are finally understood. I’ve been diagnosed as being gluten intolerant and I have problems with nutrition. It seems strange, but even though I have been diagnosed as being morbidly obese, I’ve also been diagnosed as being malnourished. My immune system is virtually non-existant. If there is a cold or flu I end up getting sick and 9 out of 10 times it goes into Bronchitis or Pneumonia. Since going off gluten I’m feeling better. I still feel awefully fatigued and I recently did a 24 hour fecal fat test because my feces never look normal and lately have started to be flat, float, and greasy. I’ll find out soon about that result. I also was tested again for celiac’s.

    I just wish there were more regulation on labeling. You can spend a ton of money on gluten free products only to have a week of bombastic bowel and feeling like crap because you ate something unknowingly that has gluten as a filler or thickening agent. I was eating some delicious snack bars that appeared to be gluten free because they were made with whey curd and no wheat products, only to find out it has some sort of filler or binder that has gluten in it and you wind up feeling awful for 2 weeks. Why hasn’t there been more done for labeling requirements. Probably the same reason the government has cowtowed to Monsanto about franken food labeling.

  • pammypim

    I had CDIFF for about 10 months in 2007/08. I still take Florajen3 & Florastor daily but have heard that Lactobacillus Rhamnosus is a probiotic that works in the gut. Should I add that to my regimen? My GI tract has never been the same since Cdiff – sometimes I think I have IBS-D but I don’t really know. I just want to be normal again. Thoughts?

  • pammypim

    I posted this earlier but it never showed up. I had a 10 month bout with CDIFF about 7 years ago & since then my GI tract has never been the same. I have continued to take FLorajen3 & Florator but I am wondering about Lactobacillus Rhamnosus, which I understand is gut bacteria. Would it be a good idea to add this?

  • pammypim

    I have posted the same thing twice today but when I come back to the group later, it’s gone. Am I doing something wrong?

  • jond95

    everyone find a functional medicine doctor near you to help you, i got cured of an “incurable illness” they didnt even have a name for my illness,hives and wrinkles all over face and neck, thank god im ok


  • Karen Fultz-Smith

    I am wondering your thoughts about takin Betaine HCL with pepsin. I have Hypochlorhydria and am dealing with stomach issues. What are your suggestions on healing my gut.. I have lost twenty pounds in two months dealing with this problem. Am I on the right track? I just recently went and had breath test for H pylori. I am following
    your grain Brain diet.

  • Martha

    I have a friend who has psoriasis and has had it for a while. I will send this to him. But could you include an article on your new letter. Trying to get him thinking and be willing to get your book. Maybe he would subscribe to your news letter. He is in the medical field, they don’t listen so good. Lol! TKS!

  • Marilyn Peters

    Please suggest specific prebiotics and probiotics. GG

  • Debbie Christensen

    What dosage of lactobaccillus plantarum should we take? I have seen 10 billion. Is that ok?

  • sapphiresea

    I am lactose intollerant. Since the lactobacillus plantanum has “lacto” in it, does that mean it has dairy products in it? Thanks. If I can’t take this, what would you recommend as a substitute for this probiotic. Also is there a prebiotic that helps heal a very painful leaky gut? Ten minutes or even immediately after eating some foods it feels like my intestines are on fire and this pain lasts 3 – 5 minutes. I am gluten sensitive – getting congested sinus and headaches after eating it. Thank you so much for sharing your time and expertise with me.

    • Katie @decoratemylife

      Hello sapphiresea!
      I noticed no one suggested a product to you! Have you tried Arbonne before? It is a certified vegan and gluten free. Look up our Digestion Plus. It has both probiotic-prebiotic-11 digestive enzymes. You can email me if you have questions. Happy to help find a good fit for you.
      katie@decoratemylife.com katiesurly.arbonne.com

      • sapphiresea

        Thanks.  I’ll check it out.

        From: Disqus
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        Sent: Saturday, August 29, 2015 12:15 PM
        Subject: Re: Comment on The One Probiotic Supplement You Need to be Taking
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        Katie @decoratemylife
        Hello sapphiresea!
        I noticed no one suggested a product to you! Have you tried Arbonne before? It is a certified vegan and gluten free. Look up our Digestion Plus. It has both probiotic-prebiotic-11 digestive enzymes. You can email me if you have questions. Happy to help find a good fit for you. katie@decoratemylife.com katiesurly.arbonne.com 3:15 p.m., Saturday Aug. 29 | Other comments by Katie @decoratemylife |   |
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  • hollyarmstrong

    I have lymphocytic colitis. What probiotic is best for me? What is a reliable source for the probiotic (so many OTCs have misleading labels)?

  • Danielle

    I am trying to find a broad-based supplement or powder for leaky gut which does not contain licorice. This is contraindicated for me due to high blood pressure. Any suggestions as to what supplements might be most important for treating leaky gut?

  • Samantha

    My daughter had gangrenous appendicitis and had been taking
    Doxycycline. She had a portion of her intestine and bowel removed. She started having swelling throughout her body including her face.
    She was tested and it was concluded that she has Leaky Gut. She has been on a Gluten Free diet and taking Florastor twice a day and continues to have swelling. She swells frequently when she is hot. What else can you recommend to help heal her intestinal lining?

  • julie

    Hi there, this might seem crazy, but every time I start probiotics, I start having very loose stools. Is this common? If so, then why is it happening?

  • Love your work and this is great-amazing how many people don’t know they have to take care of their GI tract.I hope you are still answering comments. I am an A4M boarded doc, and wouldn’t you know “brain health” is one of my “arenas”. Well I am wondering if I can get a phone consult (I’ll pay!) with you? Not complicated knowing what you know about GI tracts and brains. I don’t want to post my contact info but if you would be so kind,you can contact me via the contact form on my website and I really would appreciate it if you would-I’m a huge fan! https://www.drkimsagewellsolutions.com

  • peter clayton

    if the gut is only half or one cell thick how come the intestine’s of Pigs etc can be used to make Sausages the wall must be thicker than one cell ??

  • peter clayton

    and what about haggis ? hardly a cell thick ?

  • shumee

    It’s complicated for people with Histamine Intolerance. Have you heard it is one of the histamine-producting strains, as opposed to Bifido infantis or longum?

    • Rebecca

      Please tell more about whether you have discovered that this probiotic (L. plantarum) is histamine producing, as I have an intolerance.

      • lynnie

        Plantarum is NOT histamine producing, according to Bulletproof:

        Histamine producing bacteria: Lactobacillus casei, Lactobacillus reuteri, and Lactobacillus bulgaricus (Found in most yogurts and fermented foods).

        Neutral bacteria: Streptococcus thermophiles (also in yogurt) and Lactobacillus rhamnosus (shown to down regulate histamine receptors and up-regulate anti-inflammatory agents)

        Histamine degrading bacteria: Bifidobacterium infantis (found in breast milk), Bifidobacterium longum, Lactobacillus plantarum, and some soil-based organisms.


  • Sarah

    I have my husband taking L plantarum to treat possible histamine intolerance. But he is getting crazy coloured stool. First, pale while, then yellow, green, brown/black, etc. Is this normal?

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  • Mike Harper

    You should take a look at the strains of bacteria available in the
    supplement. There are a large number of friendly bacteria present in probiotic products, and also many various strains – http://pronutrics.net/probiotic-supplements/

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  • kiran patel

    Respected Doctor David,

    I am listening your audible book as well as reading ebook, It’s really life-changing recommendation to stay healthy.I bought your Probiotic supplement but one question baffled me is how to take it. I checked online but everyone saying different thing.

    Can you please advice in brief how to take it and for how long should I have to continue?
    Moreover one question arouse is if I will take for couple of months then my natural bacteria will stop producing or it will not make any difference?

    Thanks in advance to reading my post.


  • Holly Fox

    I have been on an organic diet for about 8 months to deal with Candida. I have been taking a Garden of Life probiotic also. I still have had sleep issues and my scalp has been oily and itchy. and my hair has been thinning. any suggestions?

  • Rebecca Callaha

    My dad was diagnosed of Emphysema (COPD) in 2014 and we have tried all possible means to get cured, we even visited pulmonologist but all to no avail, until i saw a post in a health forum about a herbal doctor from joburg who prepare herbal medicine to cure all kind of diseases including Emphysema, at first i doubted if it was real but we decided to give it a try, when i contacted this herbal doctor via his email he sent me the Emphysema herbal medicine through courier service, when i received this herbal medicine, he gave us step by instructions on how to apply it, three weeks later my dad went back for test and he was informed that he was free from this deadly disease.
    Here are the information to contact this doctor abumereherbalcentre @ gmail. com OR http: // abumereherbalcentre . com

  • lisajh

    And there is no specifying of the strain, you know that’s important. Because one strain can have different effects than another. There is a reference to two strains, one Lactobacillus plantarum 299v and the other I’ve never heard of before. The second one is Lactobacillus plantarum WCSF1. The question is what companies have either of these strains?

  • Jason T

    Does L Plantarum produce D lactate?

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