Tired All the Time? Try Healing Leaky Gut Syndrome for Fatigue Relief

Scientific studies confirm the fatigue-leaky gut syndrome connection. Try this short-term diet, along with key supplements, to find relief.

Leaky gut syndrome can wreak havoc on your energy and mood, causing you to be tired all the time, depressed, and more. Fortunately, this disorder can be healed through specific, temporary dietary modification and targeted nutritional supplements.

First, however, you need to know what leaky gut syndrome is. That is found in Part 1 of this series. You also need to learn how to identify and test for leaky gut as described in Part 2. Here in part 3, I discuss how to heal leaky gut syndrome. By combining a restricted dietary program with nutritional supplements that have been shown in the literature to reduce intestinal inflammation and repair the intestinal lining, you can break the vicious cycle of a leaky gut and finally bring a lasting end to that “tired all the time” feeling.

Healing Leaky Gut Syndrome: The Leaky Gut Diet and 4R Program

The key to treating leaky gut syndrome is four-pronged and has been become commonly known as the 4R Program among many integrative medicine practitioners. The 4R program was developed by Jeffrey Bland, Ph.D., and his associates at the Functional Medicine Institute to promote gastrointestinal health. It is an extremely effective way to address and treat leaky gut syndrome.

The 4R program simplifies the complex interactions in gastrointestinal health by asking four questions:

  1. What needs to be REMOVED?
  2. What needs to be REPLACED?
  3. Does one need to RE-INOCULATE with probiotics?
  4. Does the intestinal lining need to be REPAIRED?

Step 1 for Healing Leaky Gut Syndrome: Remove. To lower toxic load and reduce inflammation, a special short-term diet in which common allergenic, irritating, and inflammatory foods are temporarily removed is absolutely essential. If you’ve had recent food allergy testing, strict elimination of all your allergic foods is essential for allowing the gut lining to heal. If you have not food allergy testing, that’s okay. Avoidance of foods that commonly inflame and/or cause allergic reactions or food sensitivities (sugars, refined foods, alcohol, additives/preservatives, wheat and all gluten, dairy, eggs, soy, citrus, and corn) will typically do the trick.

This is by no means easy, but it’s doable for a short period of time, and you’ll be amazed at how good you feel after a week or two off these foods. That tired all the time feeling will gradually begin to lift. However, if you continue to eat these food culprits during this short-term elimination period, no matter how much you heal your gut otherwise, it will continue to suffer damage. Keep in mind that you don’t have to deprive yourself of your favorite foods forever; you just have to avoid them long enough to allow proper healing to occur (typically one to two months). The goal is to restore the normal intestinal barrier so that you are able to eat these foods again.

Step 2 for Healing Leaky Gut Syndrome: Replace. In step 2 for healing leaky gut syndrome, you replace digestive secretions by adding back things like digestive enzymes and hydrochloric acid that are required for proper digestion and that may be compromised by diet, drugs, diseases, aging, or other factors. This helps to make sure foods are more thoroughly digested before reaching the lower intestinal tract. A typical supplement product contains the pancreatic enzymes lipase, protease, and amylase along with betaine HCl to enhance stomach acid. The recommended dose is usually 1-2 capsules with meals.

Step 3 for Healing Leaky Gut Syndrome: Re-inoculate. Step 3, Re-inoculate, provides your gut with beneficial bacteria to reestablish a healthy balance of microflora. The best way to increase the amount good bacteria that live in the gut is by taking a probiotic containing lactobacillus and bifidobacteria. Probiotics have been shown to provide protection against increased permeability by enhancing your immune defenses. Be aware that probiotic supplements are very susceptible to contamination or loss of potency. For this reason, it’s extra important to seek out a good company that maintains very high standards. Good manufacturers of probiotics include Pharmax, Metagenics, and Xymogen. Take at least 35 billion organisms a day for four weeks and then reduce to 10 billion organisms a day for another month.

Step 4 for Healing Leaky Gut Syndrome: Repair. The fourth step, Repair, is extremely important for healing leaky gut syndrome. In order to repair the intestinal lining and support the immune functioning of the gut, you need to provide nutrients that have been studied and shown to help heal the cells of the gut mucosal layer and repair the leaky tight junctions. For nutritional support to help heal the mucosa lining the intestinal wall, a single amino acid, L-glutamine has been shown to both prevent and reverse intestinal mucosal damage from various insults. The recommended dose is at least 1000 mg three times per day between meals. Butyric acid is another natural compound that has been shown to help repair and regenerate of damaged intestinal cells. Butyric acid is a fatty acid normally made in the lower intestines when bacteria ferment fiber. The recommended dose is 600-1200 mg three times daily with meals. Lastly, the omega-3 essential fatty acids EPA and DHA are recommended at a dose of 1-2 grams three times per day to reduce inflammation and promote healthy cell membranes.

Following the 4R program for leaky gut syndrome can address the true underlying reason for feeling tired all the time, chronic depression symptoms, irritable bowel, autoimmune diseases, and more. That underlying cause is a leaky gut. Excessive permeability of your intestinal barrier can underlie chronic fatigue and several other chronic health problems. When you devote time to improving the health of your gastrointestinal tract by removing, replacing, re-inoculating, and repairing, you’re doing your whole body a favor. The 4R program can lead to dramatic improvement in fatigue and other symptoms, and sometimes even complete resolution of the problem.

Besides leaky gut syndrome, your “tired all the time” feeling could be due to something as simple as a nutritional deficiency, dehydration, or a statin drug side effect. To learn about other possible answers to the question, “Why am I tired all the time?”  take advantage of our fatigue resources here.

[1] Neurogastroenterol Motil. 2012 Jun;24(6):503-12.

[2] Physiol Rev. 2011 Jan;91(1):151-75.

[3] J Int Soc Sports Nutr. 2012 Sep 20;9(1):45.

[4] Altern Med Rev. 1999 Aug;4(4):239-48.

[5] J Nutr. 2009 Sep;139(9):1619-25.


This article was originally published in 2012 and has been updated

Posted in Fatigue, Lack of Energy, Natural Health 101.

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  1. ResearchingLeakyGut says

    I’m trying to figure out how long it takes to heal a leaky gut. I’ve been on a regime similar to what you mentioned above for 7 weeks now and am feeling significantly worse than when I started (e.g. had no real noticeable symptoms when i started other than sore joints and now I’m cramping badly each day)? No one seems to have a definitive answer and I can’t find any real research.

  2. Helen says

    are the 4 stages done in succession or at the same time? and what timescales are these done for?

    To the comment above me I have done some reading and the time varies between cases. Generally the older you are, the worse your initial conditions etc the longer it takes. Children respond in ~2/3 weeks, adults can take much longer. If you feel worse you may be having a ‘herxheimer reaction’ that will pass with time

  3. sue davis says

    What can one eat?!!!!!!!!

  4. restorationgirl says

    To Sue Davis above – eat veggies fresh preferably, non GMO and organic, wild caught salmon…. and I guess since they don’t say stay away from meat then red meat and pork is fine… local organic pasture raised would be best – you don’t want to avoid corn and grains and then have your meat be eating grains you’re trying to stay away from! Go to Eat Wild website to find local farms near you that will have quality meat. I’d probably stay away from all grains if possible – maybe rice would be okay since rice does not have gluten in it. Might want to look into True Roots Organic Germinated Brown Rice (GABA) They test their products to make sure they are NON-GMO. You don’t want anything that is GMO if you can help it. Stay away from any food now and in the future that has carrageenan in it – highly inflammatory to the digestive system – look it up online. Go to Cornucopia Institute for info on a partial list of products that contain carrageenan. Labs give carrageenan to animals to inflame their guts to test pharmaceuticals on them. Any peach or orange food like cheeses and yogurt and ice cream and frozen pies, etc – have annatto in them – stay away from that. And stay away from MSG and hidden MSG – it’s a excitotoxin and kills brain cells. MSG, Annatto, and Carrageenan are ALL natural substances so don’t trust the grocery store OR the health food store to protect you – get familiar with ingredients you don’t want to consume and refuse to buy foods that have those ingredients in them. Once your gut is healed up you can probably slowly start reintroducing the foods on the forbidden list one at a time in small quantities until you can handle them.

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