Gut leakiness is measurable and linked to fatty liver disease
A tracer that should stay in the gut zipped into the blood of fatty liver patients, but not healthy people.
Huberman Lab · Best Tools for Gut Health & Weight Loss | Dr. Chris ThompsonIncreased gut permeability is 100 percent real, says Chris Thompson, a gastroenterologist. He warns the phrase leaky gut confuses people because it gets blamed for many unrelated conditions.
The gut is sealed by tight junctions, seams between intestinal cells. Researchers grew miniature guts, called organoids, from stem cells. Those from patients with MASH, a fatty liver disease tied to obesity, had disorganized seals and did not make instructions for the seal proteins.
Patients swallowed a tracer, chromium-51 EDTA, that should not pass healthy seals. It zipped into the blood in fatty liver disease, but stayed out without it and in treated celiac disease.
Everything absorbed except fat goes straight to the liver through portal blood; fat uses lymph vessels. Pieces of gut bacteria coats can slip through faulty seals. In a Duke test, injecting those pieces into healthy people drove up inflammation and caused insulin resistance, when the body responds poorly to insulin.
Questions people ask
What is MASH?
MASH stands for metabolic dysfunction-associated steatohepatitis. It is a form of fatty liver disease tied to excess weight and metabolic problems, in which fat buildup triggers liver inflammation and scarring. It can progress to cirrhosis and liver failure.
Can doctors test me for increased gut permeability?
Such tests exist mainly as research tools, using ingested sugars or tracers measured later in blood or urine. They are not standardized for routine checkups, and most care focuses on the underlying liver or metabolic condition. A gastroenterologist can advise whether any testing makes sense for symptoms.
Why do doctors dislike the phrase leaky gut?
Thompson says patients often arrive with a fixed idea that leaky gut explains many different symptoms and illnesses. That makes it hard for a clinician to know what the patient means. He prefers increased gut permeability, which describes a measurable seal problem without claiming it causes everything.