Quick answer: Leaky gut has been associated with symptoms outside the gut, likely because inflammation from a weaker barrier can travel through the body. Research links increased permeability with joint pain, skin conditions, fatigue, thyroid autoimmunity, metabolic disease, headaches and mood changes. These symptoms have many possible causes, so get them checked.
Key takeaways
Increased gut permeability may show up outside the gut, in the skin, joints, mood, energy and brain.
These symptoms have many possible explanations, so they are worth checking with your doctor.
Inflammation that begins in the gut can affect blood vessels, metabolism, the brain and the skin.
Get symptoms checked
These non-digestive symptoms have many explanations. If you have them, see your doctor. Background: leaky gut overview.
Joint pain
Inflammatory cytokines may affect joints, and increased permeability has been linked with the onset of rheumatoid arthritis. See gut and autoimmunity.
Skin issues
Eczema, acne and psoriasis have been linked with the gut microbiome, gut inflammation and nutrient absorption.
Fatigue
Chronic inflammation and dysbiosis can drain energy.
Thyroid dysfunction
Gut changes and inflammation may contribute to thyroid autoimmunity. See TPO antibodies.
Metabolic disease
Fatty liver, type 2 diabetes and heart disease have been linked with gut-derived inflammation and insulin resistance.
Headaches
Inflammation can affect blood vessels and nerves.
Mood
The gut-brain axis links microbes, inflammation and mood. See the gut-brain axis.
Whole-body inflammation and healthy aging
Inflammation that starts in the gut can affect blood vessels, metabolism, the brain and the skin, all areas where aging shows. Supporting the gut is one way to reduce this load.
When to see a naturopathic doctor
It may be time to see a naturopathic doctor if you have ongoing bloating, gas, diarrhea or constipation, or food reactions that seem to be multiplying. The same is true if you have fatigue, skin flares or joint aches alongside gut symptoms, or if you want a personalized gut plan instead of guessing.
See a medical provider promptly for blood in your stool, black stools, unexplained weight loss, persistent vomiting, severe abdominal pain, fever, or trouble swallowing.
What the research shows
Research on whole-body effects of a leaky gut is still early. In a 2008 study by Maes and colleagues, people with major depression had more frequent and higher blood antibodies (IgA and IgM) against components of common gut bacteria than healthy volunteers, suggesting more of these bacterial fragments were crossing the gut wall. Higher antibody levels went along with fatigue, digestive symptoms and a feeling of being unwell. The abstract does not report how many people were studied, and a single blood comparison cannot show which came first.
For joints, a 2020 study by Tajik and colleagues found that people with early autoimmune markers for rheumatoid arthritis had higher levels of zonulin, a protein linked to gut barrier function, and that zonulin helped predict who moved on to joint inflammation. Most of the experiments that tested barrier repair were done in mice, so whether the same approach helps people is not known. Overall, these studies point to a possible gut connection for some systemic symptoms, and the evidence in people is limited.
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Questions to bring to your clinician
These questions can help you get the most out of your next visit.
Could my skin, joint or mood symptoms be connected to my gut health?
Could my skin, joint or mood symptoms be connected to my gut?
Which gut-focused steps might help those symptoms most?
How would we track changes in symptoms outside my gut?
Frequently asked questions
Can leaky gut cause skin problems?
Gut inflammation has been linked with eczema, acne and psoriasis.
Can leaky gut cause anxiety or depression?
Research suggests links through the gut-brain axis, but it’s not a proven cause.
Is leaky gut linked to thyroid problems?
It may contribute to autoimmunity in susceptible people.
Can fatigue come from the gut?
Chronic inflammation and poor absorption can contribute.
Sources
- Maes M, Kubera M, Leunis JC. The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuro Endocrinol Lett 2008. PMID: 18283240. https://pubmed.ncbi.nlm.nih.gov/18283240/
- Tajik N, Frech M, Schulz O, et al. Targeting zonulin and intestinal epithelial barrier function to prevent onset of arthritis. Nat Commun 2020. PMID: 32332732. https://pubmed.ncbi.nlm.nih.gov/32332732/
- Salem I, et al. The Gut Microbiome as a Major Regulator of the Gut-Skin Axis. Front Microbiol 2018. PMID: 30042740. https://pmc.ncbi.nlm.nih.gov/articles/PMC6048199/
- Cayres LCF, et al. Detection of Alterations in the Gut Microbiota and Intestinal Permeability in Patients With Hashimoto Thyroiditis. Front Immunol 2021. PMID: 33746942. https://pmc.ncbi.nlm.nih.gov/articles/PMC7973118/
- Chakaroun RM, Massier L, Kovacs P. Gut Microbiome, Intestinal Permeability, and Tissue Bacteria in Metabolic Disease: Perpetrators or Bystanders? Nutrients 2020. PMID: 32295104. https://pmc.ncbi.nlm.nih.gov/articles/PMC7230435/
- Cryan JF, et al. The Microbiota-Gut-Brain Axis. Physiol Rev 2019. PMID: 31460832. https://pubmed.ncbi.nlm.nih.gov/31460832/
- MedlinePlus: Autoimmune Diseases
- MedlinePlus: Digestive Diseases
This article is for educational purposes only and is not medical advice. It does not replace an individual evaluation. Talk with your healthcare provider before starting supplements or changing medications, especially if you are pregnant, nursing, or managing a health condition.
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