• Danielle Cheplowitz, CRNP

Step 4: Repair-Why fixing your gut first will cure almost all of your other ailments

Updated: Jan 23

Happy New Year! In my last post, I explained what probiotics and prebiotics are, and how one can enhance their microbiome. Today I will share tips on how to repair the intestinal lining.

Intestinal Permeability

What exactly is intestinal permeability? Our intestines are lined with cells that act as a “barrier”, these are called epithelial cells. Epithelial cells help to transfer food from inside our digestive tract into the blood stream. There are tight junctions in between each epithelial cell to ensure that no undigested food particles, toxins, or unwanted bacteria escape inappropriately. When intestinal permeability occurs, the epithelial cells and their tight junctions weaken, causing undigested food and waste to seep into the blood stream. An influx of foreign particles stimulates the immune response, which if left untreated, can lead to a host of many chronic conditions and autoimmune diseases. This process is also called “leaky gut”.

Causes of Intestinal Permeability

-Nutrient poor diet

-Imbalanced gut bacteria- especially with usage of antibiotics!


-Poor sleep

-Other pharmaceuticals: NSAIDs (ibuprofen), birth control pills, steroids (prednisone), and acid reducing medications (Prilosec)




Reversing Intestinal Permeability

In my previous blog posts, I explained how it is critical to:

1. Remove food allergens or intolerances

2. Replace essential nutrients and digestive factors (enzymes, bile salts, and stomach acid)

3. Repopulate the gut to promote a favorable microbiome

All three of the aforementioned are so key in fixing leaky gut. Once these three steps have been initiated, one can then focus directly on improving the epithelial cell health and strengthen the tight junctions to further halt and reverse leaky gut.

Vitamin D

Vitamin D can help to down-regulate certain immune markers, which can lead to less inflammation. It has also been shown that a deficiency in vitamin D may lead to a compromised mucosal barrier, which further increases the risk for leaky gut. While many people are deficient or insufficient in vitamin D, one should never start taking a supplement without being tested first. Dosages are prescribed based on serum blood levels.

Omega3 Fatty Acids

These have been shown to reduce inflammatory markers. Their safety profile is favorable, and drug interactions are extremely rare with fatty acids. Dosages are based on weight, and generally do not exceed 3 grams per day. It is important to note that the source of omega 3 fatty acids is important, and one should seek a brand that has been third party tested.


This is the preferred fuel for epithelial cells of the small intestine. It helps to increase cell height, stimulates mucosa proliferation, maintains integrity, and prevents intestinal permeability. L-Glutamine can be found in protein-rich food sources, such as beef, chicken, fish and eggs. There are also plant-based sources, which include beans, beets, cabbage, spinach, brussel sprouts, and carrots. L-Glutamine can also be found in supplement form.

Other nutrients important for repair and healing of epithelial cells include:


-Vitamin A

-Vitamin C


-Pantothenic Acid

-Vitamin E


In summary, repairing the intestinal lining and combating leaky gut starts with a temporary elimination diet, replacement of critical factors that play a role in digestion, and supporting the healthy bacteria in the gut. Specific nutrients, such as vitamin D, L-Glutamine, and Omega 3 fatty acids, can further strengthen the enterocytes of the digestive tract, preventing and reversing leaky gut.

Next week we will go into detail on how to rebalance lifestyle in order to promote a healthy digestive tract. See you then!

***This post is for educational purposes only, and is not intended to be used a medical advice. Always speak with your own provider before implementing anything suggested in the post.***


Clarke JO, Mullin GE. A Review of Complementary and Alternative Approaches to Immunomodulation. Nutrition in Clinical Practice. 2008;23(1):49–62.

Kong J, Zhang Z, Musch MW, et al. Novel role of the vitamin D receptor in maintaining the integrity of the intestinal mucosal barrier. Am J Physiol Gastrointest Liver Physiol. 2008;294(1):G208- 16. DOI:10.1152/ajpgi.00398.2007

Levin A, Li YC. Vitamin D and its analogues: Do they protect against cardiovascular disease in patients with kidney disease? Kidney International. 2005;68(5):1973– 1981. DOI:10.1111/j.1523-1755.2005.00651.x

Monograph: L-Glutamine. Alternative Medicine Review. 2001;6(4):406.


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