Category: Science


Rebalance the Gut, Rebalance the Immune System

It is very exciting to see the incredible increase in scientific research being released that relates gut issues to various health problems elsewhere in the body. The research that explores this relationship in terms of autoimmune conditions is particularly interesting, not just because it links gut-related problems to changes in immune balance, but in terms of how this new understanding might open the door for new treatments for these challenging conditions.

In a recent issue of the journal Neurotherapeutics, researchers embarked on their study with the accepted premise that intestinal permeability (leakiness of the gut) has been widely evaluated in terms of its relationship to various forms of inflammatory bowel disease, as well as celiac disease, and that imbalances in the gut bacteria are involved in this relationship.

They also described the well-known relationship between an autoimmune, inflammatory condition of the bowel, Crohn’s disease, and multiple sclerosis (MS). Both of these conditions are now characterized by increased permeability, or leakiness, of the gut.

With this understanding as a background, the researchers then move forward and postulated that perhaps some of the effectiveness of various first-line oral medications that have proven useful in MS may actually owe some of their effectiveness to the fact that they help with reducing gut permeability, possibly through changes brought about by the gut bacteria.

I can assure you that only a few years ago, these ideas would not have been anything that mainstream science would have considered. We have certainly come a very long way in appreciating the important role of the gut, and specifically the balance of gut bacteria and regulation of gut permeability, in terms of its role in autoimmunity, and keeping inflammation in a check.

I have no doubt, moving forward, that we will soon see the development of pharmaceutical interventions for MS, as well as other autoimmune conditions, that specifically target rehabilitation of the gut bacteria to bring about reduction in gut permeability and therefore balancing of the immune system. This will be a manifestation of holistic medicine finally entering the mainstream, whereby it becomes commonly accepted that events in one part of the body can clearly affect the health of another area.

Truthfully, this understanding of the interrelationships between seemingly disparate parts of the body has been how medicine has been practiced for centuries. What a blessing that we are finally embracing this understanding once again.

  • Donna Lutsky

    Thanks again Dr. Perlmutter, love how you continue to tie in gut health, to overall health and give the newest research which supports this.

    • David Perlmutter

      Thanks for those kind words Donna. It’s a privilege to be able to share this information with our community.

  • Nigel

    Hi Dr Perlmutter, thanks for all you do for so many!
    I have coeliac disease and MS according to Mainstream labeling. I have been unwell and unable to work for over ten years now and the disability that I have has been a dripping tap progressive form or cascade effect. I had read hundreds of PubMed articles, spoken with many Specialists such as Dr Fasano, Professor Jelinek, Dr Wahls and many other leading edge thinkers regarding diet and the spectrum of auto-immune diseases.
    The insight that all these years has given me is that gut permeability can sometimes be from food or the biome and that the body is reacting to protect us. The change of diet and gut biome seems to be the best possible treatment in all ‘auto-immune’ diseases and the most important detail is to find the triggers in the issue, find the foods or the bacteria type or virus or the environmental trigger(s) as well as look deeply at the life line of general health from birth to now.
    I have struggled with balancing the diet because there have been so many trigger foods and the gut damage has been an issue with mineral, nutrient and vitamin uptakes therefore stopping the cascade has been a huge challenge.
    My reading also indicates that the issue has more than just diet and gut permeability issues, in other words that process has other factors occurring.
    Histamines and histamine intolerances (HIT) and mast cell activation syndrome (MCAS) which seems logically a step of the illness history. This also seems to be a nightmare to test and monitor which is probably why mainstream research hasn’t looked in depth at what I concider the obvious.
    ** Dr Perlmutter have you any insights on the histamine and mast cell activation ‘co-incidences’ in the auto-immune spectrum of diseases?
    It appears there is lots and lots of anecdotal comments and some very good web links from MD’s and well researched people who have HIT and or MCAS.
    I also understand that this issue is potentially a treat to the Food Industry and the Dairy Industry plus Pharma so commitment to research and improving technology for assessment purposes is a risk for a person who operates from integrity rather than greed.

    • David Perlmutter

      Consider looking into the work of Dr. Terry Wahls.

  • Anne Callaway

    Can you recommend a good probiotic? Or prebiotic?

  • Danute

    Dr Perlmutter,
    Thanks for sharing the information!!!! Thank you for opportunity to learn about you and your scientific works.You are my hope.
    I was diagnosed with Lyme disease. Traditionally, I refuse to take antibiotics, but this time I agreed to drink them. I drink Doxyclinum for 20 days. How to restore microbiome? What would you recommend?

    • David Perlmutter

      One thing I suggest doing is cycling your antibiotics and probiotics. If you’re taking an antibiotic in the morning, take your probiotic in the evening, so there is space between them.

  • Colleen Nagi

    Is there a specific brand of probiotic that you could recommend that isn’t ridiculously priced? I have been practicing the Ketogenic way of eating for over a year and need good probiotic. I have severe autoimmune issues, Mixed Connective Tissue Disease and Fibromyalgia. I am experiencing constant digestive issues.

  • Nash

    Hi Dr. Perlmutter, Post recurring UTI I was on heavy dose for antibiotics and was given NSAIDs five years back post which I am down with constipation, acidity, burning in legs, adms, pain and severe form of CFS/Fibro. Can you please please suggest ways to heal gut and get back my health on track. NSAID leads to burning in stomach and pain after evacuation.

  • Laura Burkie


    I know this is specific but if you could offer some direction

    My functional medicine doctor has told me Keto is completly wrong for my leaky gut she has said I have 2 parasites and very little good bacteria she wants me eating legumes and rice and fruit low / no fat and no eggs along with other things – I think she is crazy but could anything she is saying be correct ? I.e will (Wholefoods) Keto help fix my gut and remove parasites or do I need the carbs for this?

    I am also taking a plethora of supplements including probiotics and burberine+GSE etc

    Any advice would be greatly appreciated

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