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LET’S TALK ABOUT ZONULIN

Understanding zonulin’s role on the leaky gut

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By KAYCEE REYES

Last week, we learned about zonulin, the powerful protein that can reverse intestinal permeability or a leaky gut. What’s with a leaky gut, you say? Well, it is associated with lifelong diseases such as celiac disease and type one diabetes. The discovery of zonulin is so important that, knowing how it can be regulated can reverse these diseases, and almost any disease associated with it, from irritable bowel syndrome (IBS), Crohn’s disease, celiac disease, and type one diabetes. While this is all promising, are zonulin levels alone a reliable marker for a leaky gut?

Currently, zonulin is being utilized as a biomarker in detecting intestinal permeability that is an indicator in different autoimmune, metabolic, and degenerative diseases. Aside from those previously mentioned, zonulin has been measured at higher levels in those with depression, autism, type one and type two diabetes, and polycystic ovarian syndrome. Before zonulin testing, the differential sugar test or the lactulose mannitol test has been the standard to identify a leaky gut. This is done via the consumption of lactulose and mannitol after a fast and is then measured via urine the next day.

Since the discovery of zonulin in 2000, the serum zonulin test also became a known option to test for a leaky gut. Some patients prefer this too, as it only requires a simple blood test to determine zonulin levels. There are some questions, however, that arise as, apparently, serum zonulin measurements are not as reliable biomarkers as what was previously considered. Some studies suggest that not all patients with diagnosed diseases as mentioned above display an increased amount of serum zonulin as compared to the control group—a study done among diabetics, and another for those with celiac disease had high zonulin levels detected in only half or even a portion of the group studied.

Moreover, zonulin is quickly targeted by the immune system once it is released into the bloodstream, making the levels unstable even on a daily basis. Errors also arise in detection techniques, and additionally, zonulin results do not coincide with the standard differential sugar test upon comparison. This is not to say that zonulin testing should be disregarded; rather, another alternative such as detecting zonulin antibodies, may be a more reliable measurement as they are more stable and they stay in the body for a longer period of time than zonulin does.

Other antibody testing methods have also been considered and are being researched, such as lipopolysaccharide (sugar) and other tight junction protein (actomyosin and occludin) antibodies. While the discovery of zonulin offers hope and promise to patients and scientists since its discovery, it needs further research and tests if zonulin indeed is a reliable biomarker for intestinal permeability. But another question is, when should you be testing for a leaky gut?

One should understand that while a leaky gut is a factor of having diseases, there are other factors that drive these conditions that may be the real cause—food intolerance, stress, poor diet, bacterial infection, and the list goes on—that must be considered and treated even before testing for a leaky gut. There are a lot of symptoms for a leaky gut and they vary from bloating to skin problems, but if you suspect that you have one, talk to your physician immediately. The most important thing is addressing the cause before it gets worse.

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