Clinical Pearls: Zonulin

This week's topic: Zonulin

Starting with a quiz:

• How does zonulin increase gut permeability?
• What are the 2 primary triggers of zonulin?
• What does an elevated stool zonulin indicate?

All but one of the above is answered below!

Overview of today's email:

1. Quick review of zonulin
2. Clinical tips

1. Quick review of zonulin

Zonulin is an extracellular protein that is released by the liver and intestinal cells, and is the only known physiologic modulator of intestinal permeability.

It increases intestinal permeability by disassembling ZO-1 (a scaffolding protein, responsible for keeping intercellular tight junctions "tight").

The two primary triggers of zonulin release are bacterial overgrowth and gliadin.

Although we know a lot about zonulin, and there's even a treatment to block its actions, zonulin testing is not a valid way to evaluate for leaky gut (I cover the 4 reasons for this in the upcoming course on leaky gut and metabolic endotoxemia).

2. Clinical Tip

Avoid zonulin testing in those who are obese, metabolically unhealthy, or who have a history of Celiac.

I hope this was clinically useful!

Did you know I made a course? It took 6 months of research, but it's finally done and I'm so excited to share it with this community! I know it will be helpful for anyone who watches it!

Why did I choose to create a course on the topic of leaky gut and metabolic endotoxemia? It started after I found out that elevated TPO antibodies and low free T3 could be tied to metabolic endotoxemia, and I wanted to learn more (and see what the human literature says).

If you've been reading my newsletters, you know how much I focus on practical, evidence-informed functional medicine. And my course is just like my emails - but with a lot more details (and videos). This first launch also includes:

• A 2-page clinical resource
• My "protocol" that I developed as a result of my research findings
• A live Q&A on September 1st

First module goes out on August 10th, but registration to join the course ends August 14th.

​Click this link to learn more and join!

Meg

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