Leaky Gut: What It Is, What Causes It, and How to Heal It
By Joana Amram, Registered Nutritional Therapist & Naturopath (ANP) Published on ammarhealth.com · Lisbon, Portugal
By Joana Amram — Registered Nutritional Therapist (ANP/APENB), CNM London
Gut health & digestion · Lisbon & online · joana-amram.com
"Leaky gut" is one of those terms that gets dismissed by some as unscientific and over-hyped by others as the cause of everything. The reality sits in between. The clinical name — intestinal permeability — is well established in the research. What's debated is its significance and how much weight to give it. In practice, I see it as a meaningful contributor in a large share of the chronic gut and whole-body complaints I work with.
What "leaky gut" actually means
Your gut lining is a single layer of cells held together by tight junctions, designed to be selective: it lets nutrients through and keeps everything else out. When those junctions loosen, the barrier becomes more permeable — allowing larger particles and bacterial compounds to cross into circulation that normally wouldn't [1]. That's intestinal permeability. It's not a gut that's literally full of holes; it's a barrier that's become less discerning.
Why it matters beyond the gut
When the barrier is compromised, the immune system meets things it isn't meant to, and the result is low-grade inflammation that can show up far from the gut — in the skin, the brain, the joints, and energy levels. This is part of why gut issues so often travel with skin flares and brain fog.
What drives increased permeability
Common contributors include an imbalanced microbiome, chronic stress, bacterial overgrowth (SIBO), certain medications, a previous gut infection, and ongoing inflammation. Often it's several of these together — which is why it rarely resolves by fixating on a single food or supplement.
The supplement-fixation trap
"Leaky gut" has spawned a whole industry of powders and protocols promising to "seal" the gut. Some supportive nutrients do have a place. But pouring gut-repair supplements onto an unaddressed driver — an untreated overgrowth, unmanaged stress, ongoing inflammation — is like patching a wall while the leak behind it continues. The barrier is supported best when the reason it became permeable is addressed.
How the gut lining is supported
The gut lining renews itself constantly, which means it responds well when conditions improve. That usually involves removing what's driving the permeability, supporting the microbiome, calming inflammation, and supporting the nervous system — tailored to your specific picture, and alongside your doctor. It's gradual work, not a 7-day fix, and that's normal.
If you suspect your symptoms trace back to your gut barrier, let's look at it properly. No cost, no obligation.
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You can read more about how I work with gut-related symptoms on my services page.
This article is for educational purposes and is not medical advice. Always work with your doctor for diagnosis and before making changes to your care.
Frequently asked questions
Is leaky gut a real condition?
Intestinal permeability — the clinical term — is a real, well-studied mechanism. What's debated is how significant it is and how aggressively to address it, not whether it exists.
What are the signs of increased intestinal permeability?
There's no single symptom. It's often associated with bloating, food reactions, skin flares, brain fog and fatigue, especially when several appear together.
Can supplements alone fix leaky gut?
Usually not. Supportive nutrients can help, but if the underlying driver isn't addressed, the barrier tends to stay compromised. The cause matters more than the powder.
Can I work with you online if I'm not in Lisbon?
Yes. I support clients online in English, Portuguese, Spanish and French, as well as in person in Lisbon and Estoril.
Related reading
– The Gut-Skin Connection
– Brain Fog & Fatigue After Eating
References
Gut-skin axis: emerging insights — a narrative review (on intestinal permeability and systemic inflammation). PMC, 2025. pmc.ncbi.nlm.nih.gov/articles/PMC12476645