‘All disease begins in the gut’ is a quote attributed to Hippocrates of Kos, a famous Greek physician who lived over 2,500 years ago and who is often considered the Father of Medicine. Since the time of this quote, many scientific discoveries and much clinical evidence corroborate the view that dysfunction of the gastrointestinal tract is indeed a major cause of disease.

In particular, the loss of normal permeability of the gut barrier, commonly named ‘leaky gut’ has emerged as a major driver of many diseases including those associated with chronic inflammation and autoimmunity. A recent review suggests that ‘all disease begins in the (leaky) gut’.

This handbook briefly reviews current scientific information on the causes and consequences of a leaky gut/ endotoxemia.

Emphasis is placed on clinical translation of scientific evidence including currently available diagnostic tools as well as natural health products (NHPs) with the strongest evidence base for treatment. A detailed discussion of additional therapies foundational for long term healing such as dietary therapy, support for the parasympathetic nervous system, including maintaining optimal vagus nerve activity, stress management techniques using mind/ body medicine, and acupuncture is not included in this document.

The intent of this publication is to summarize the current evidence base for the treatment of leaky gut/ endotoxemia outside the scope of mainstream medical pharmaceutical drugs. This document functions as a clinical reference tool for health care professionals to use during treatment of patients with leaky gut/ endotoxemia. Interventions should be individualized to each patient’s risk factors, medical history, treatment goals, and current health status.