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5 benefits of breathwork

Breathwork, by changing our blood’s biochemistry, can influence the function of all body’s organs and systems. As oxygen is essential for aerobic respiration, and all of life’s functions depend on the energy production, it would be no exaggeration to claim that breathwork is a cornerstone of healthy living. The 5 most important benefits, you can expect from a regular breathing practice are:

1 Improve metabolism

Anyone interested in breathing needs to understand that optimal levels of the 3 blood gases: Nitric Oxide, Carbon Dioxide and Oxygen are needed for aerobic respiration from our mitochondria. To that extent dysfunctional breathing contributes to poor mitochondrial function and breathwork can help us restore that.

2 Gain control of Autonomic Nervous System

Of all functions of the ANS, breathing is the one we have most control over. That gives us an opportunity to influence the remaining of the ANS.

3 Improve performance in sports

The way we breathe during physical exercise doesn’t only affect the how well our muscles are oxygenated but also our biomechanics. Breathing well goes hand in hand with high performance in sports.

4 Mediatate

While breathwork is not a prerequisite for meditation, breathing well will make entering meditation easier. Also despite some overlapping effects mediation and breathwork are significantly different, and practicing one will complement the other without making it obsolete.

5 Improve sleeping quality

Sleeping quality is the cornerstone of health and the way we breathe during sleep is a key determinant of sleeping quality. The implications of better sleep are: superior recover, better appetite control and stable energy levels during the day.


While these are the 5 most significant benefits one can get from breathwork, they are not the only ones. Other benefits include: improved posture, balance, digestive health, cognitive function, cardiovascular health (video), lower blood pressure.


What happens to the brain during breathwork?

The source (mouth vs nose), speed and volume of breath will determine which brain regions are activated. Two aspects of breathing that have been well documented to affect the brain in a specific way are:

1 The volume of breath

The most critical and often overlooked factor is the volume of breathing. When the volume is high we will tend towards hyperventilation which will reduce the supply of oxygen (and glucose) to our organs including the brain.

The effect of hyperventilation in the brain

source: Litchfield P M 2003

The reverse will happen during hypoventilation (ie. hypercapnia).

2 Which nostril you breathe through

When breathing through one nostril, there is a small shift in the distribution of hormones in the body with adrenaline having a higher concentration on the side we breathe from. That increases sympathetic activity on that side and parasympathetic activity on the opposite side. Because of that circulation on the right hemisphere of the brain will increase when breathing through the left nostril and the other way around.

Nasal Cycle

source: Werntz et al. 1983


Is it scientifically proven?

There are plenty of studies showing that breathwork as simple as diaphragmatic breathing can benefit both healthy and sick individuals. There are clinical trials conducted among individuals with spinal cord injuries (ref), showing positive results.

What is worth knowing however is that not all scientific studies are of high quality. Some will inflate or twist their findings (video). As a result the claim: “Scientifically proven” has little validity, some times.


How long does it take to see results?

Similar to everything that has value, it takes time and effort to get lasting effects from breathwork. It is not uncommon however, for individuals to see improvements in their concentration levels and quality of sleep within a few weeks and in their physical performance within a few months.


What are the differences between breathwork and meditation?

Breathwork’s goal is to improve respiratory capacity while meditation aims to bring stillness to the mind.


Can breathwork be combined with other forms of training?

For someone to get the most out of breathwork he should be combining it with other forms of exercise.

Breathing plays a key role in posture and core activation. Most healthy individuals will adjust their breathing during exercise naturally. Breathwork can help them get the most out of their training. Running is one of the easiest way to incorporate breathwork in training. However, for different types of exercises different breathing techniques would be appropriate (video).


The pseudoscience of breathwork

Why do people scream during breathwork?

In some breathing practices, participants are encouraged to scream during or after the breathing practice. This is common in techniques that involve hyperventilation and not in breathwork. It would be similar with a cult requesting participants to dance and then scream. Screaming wouldn’t become instantly an essential or relevant aspect of dancing.


Why does breathwork release trauma?

It doesn’t. Claims about trauma release from breathwork diminish the validity of breathwork but given how popular they are I will briefly cover the topic.

Is there trauma at first place?

Emotional trauma can only exist if we accept events as good and bad. In the absence of this dualistic approach there is no trauma to begin with. There is also a serious implication when accepting the existence of trauma and that is that: your way of seeing the world & values is superior to others. The reason behind that is very straight forward: What you perceived as bad and traumatic is based on your values. Based on someone else’s values the same event is neutral or beneficial. While not always easy to see, all events are neutral. We tend to perceive them as positive or negative depending on whether they support or challenge our values.

Can breathing heal an emotional wound?

Hyperventilation breathing practices make such claims with zero scientific foundation other than participants reporting reduction in perceived stress levels (psl). While this is indeed a positive outcome, psl is a subjective marker. Hyperventilation has not be found to result in improvement of objective markers such as HR, HRV, Blood pressure, and thus no healing can be expected from it long term.


Why do I cry after breathwork?

The chances of crying after breathwork are minimal to non-existent. Instead of breathwork you are probably hyperventilating during which you may partly lose consciousness. Crying due to feeling vulnerable at this stage is a possibility but whatever the reason, there is no reason or benefit that stems out of it.



What are the dangers?

Between the 2 pillars of breathwork: hypercapnia and hypoxia, it is the later, which may cause some adverse effects which is why it is best to build up the practice gradually. The symptoms include: dizziness, drops of blood sugar, headache.

Hypercapnic training needs caution for individuals with severe anxiety.


How can I get started?

If you are new to breathwork, starting with 1-2 exercises is often sufficient. Two breathing exercises accessible to most beginners are the: Soft breathing & Improve your exhalation to inhalation ratio.

Ideally prior to starting you should set a goal and run some basic assessments regarding your current respiratory capacity.


How many types of breathwork are there?

There are many breathing brands and franchises, but there are only 2 types of breathwork: Hypercapnia and Hypoxia.

Both of them when practiced regularly will result in improvements in one’s respiratory capacity. While traditionally only breathing exercises have been classified as breathwork, this approach ignores the importance of breathing biomechanics in respiration.

When considering the effect muscles, fascia and neurones have on breathing, we are likely to accept that yoga, pilates, swimming, cycling, running can also be classify as breathwork.


Is breathwork a spiritual practice?

If you align breathwork with a purpose close to your heart and in line with your values, it will be a spiritual practice. There is nothing spiritual about practicing breathing exercises without connecting the activity with a higher purpose.


Can breathwork cause anxiety?

Hypercapnic exercises can cause anxiety in individuals with low tolerance to CO2.CO2 pH relationshipThe problem in these instances stems from the intensity of the exercise. The link between breathing and anxiety is intricate but should not put individuals that suffer from anxiety off from practicing.


Breathing techniques for running

Breathing Strategies for Running

It is not uncommon for runners to gas out when running. Their lungs will fail them before their legs. While this is more common among beginners breathing strategies for running is often a key component of performance even among elite runners.

In 2022 I run my first two 5k races at 22 mins 22 secs each. During my preparation and the races I deployed a few breathing strategies based on my research which I believe contributed to hitting these times. In this article I will share the 5 most important ones I used on the racing day.

1 Use the max # of red blood cells possible

Preparation: 10mins before the race I performed some gentle breath holds. Ideally, they should have been a lot stronger to get the spleen and EPO effect but even the way I did them was still beneficial in my opinion.

2 Breathe Nasally as much as possible

Race: The easy part of the race – which was not a lot – was done with nose breathing, teeth touching & tongue at the top of the pallet. The reason for that was to stay as much as possible in a parasympathetic state (ie. keep my HR low).

3 Breathe at a steady rhythm

Race: During most of the race I tried to keep a rhythm in my breathing. The rhythm had to change during the race based on my stride. The slower the stride the “lighter” the breathing. Maintaining a rhythm in the breath is a common recommendation for runners. What I found necessary was to modify the rhythm in different sections of the race.

4 Recover half-way when possible

Race: The recovery parts of the race during which I had to “change gears” were by far the most critical “breath-wise”. During some of them, I had to slow down in order to reset my breath.

5 Recover faster by addressing the biomechanics

Post-race: I lay on the grass to recover but soon after I remembered that lying on my belly would help me recover faster (which it did). The reason has to do with the biomechanics of breathing.


Wim Hof Method Benefits

How does the Wim Hof Method improve health?

Those practicing the Wim Hof Method will benefit primarily from the progressive exposure to cold. The regular cold showers the method advocates will:
• up regulate the immune system
• improve cardiovascular health and
• help regulate the circadian rhythm if practiced at the same time every day.

While these 3 benefits can have a knock on a positive effect on other functions in the body, including: mood, metabolism, energy levels, cold exposure is still a stress for the body and thus should be practiced progressively and always reflecting one’s health status at the time.

The Wim Hof Breathing (WH Breathing) can also benefit those who struggle to switch off their brain, or experience low levels of energy and need an adrenaline boost.

In this article I will be answering some popular question on what one can expect from WHM. If you have a question which is not answered here, drop me a message through the contact page.


Can the WHM help with Anxiety or Depression?

While breathwork can provide relief for those with high stress, the Wim Hof Breathing will be safe and beneficial only for mild forms of anxiety and otherwise healthy individuals. Those suffering with depression on the other hand are more likely to benefit from the breathing due to the increase of adrenaline, shown to last for 2 hours.

Individuals with neurological conditions, including depression and anxiety are likely to benefit from cold exposure through its effects on the cardiovascular system, hormonal and metabolic function. Cold exposure will benefit other forms of mental health and when practiced progressively it will result to higher levels of energy and a more positive outlook on life.

Cold exposure and the Wim Hof breathing have very different effects on our body’s biochemistry. As a result while someone may benefit from one may not from the other.


How long does it take to see results?

Those practicing the WH Breathing if they are going to experience any positive results, are likely to notice them instantly. The change in the blood gases will happen after the first round and will build up over consecutive ones.

The cold exposure will have an effect on the long run on the cardiovascular, metabolic and hormonal system. While one will get a boost of increased energy (from the adrenaline) straight after the physiological adaptations will take months – years to materialise.


Is it suitable for beginners?

The WH Breathing is accessible to beginners. It requires practitioners to breathe heavy on the first part and hold their breath to the max of their ability in the second. Very shallow breathers, usually elder or those with severe asthma, may still not be able to perform the exercise in which case improving their lung capacity first will be appropriate.

Whether it is suitable or not depends on one’s goals. Due to the exaggerated hype around the benefits it is worth being clear on what you expect from the WH Breathing.

You don’t need any skill or prerequisites to practice cold exposure either. Those with poor circulation, who are likely to benefit from it the most, are the ones that will struggle a lot initially. Cold exposure requires extra caution for those with cardiovascular complications, type 1 diabetes and pregnant women.


Are there any risks associated with the Wim Hof Method?

There are risks associated with it so it’s best to build up your practice gradually and stop in the presence of any adverse symptoms.


Can it be combined with other forms of exercise or training?

The WHM can definitely be combined with exercise. This is especially true for the cold exposure which can serve as a pre-training booster. The WH Breathing has less of a synergistic effect with exercise.


Can breathwork help with anxiety?

Breathwork is one of the most powerful tools in dealing with stress and anxiety. Scientific research and clinical evidence have proven that 4-6 weeks of practice is likely to result in lower the occurrence of panic attacks & improve one’s ability to recover from one faster if needed. At the same time not all breathing techniques will have such effects and some can even be harmful.


How does breathwork help with anxiety?

Breathwork consists of breathing and physical exercises that improve one’s respiratory capacity. Due to breath’s intimate link with the nervous system, breathwork is one of the fastest ways to help someone feel safe and restore regular brain function.

Based on the above definition, there are 2 pillars of breathwork: hypercapnia and hypoxia. The former can help the prevention of a panic attack and the later the recovery from one.

Individuals with anxiety tend to have low tolerance to CO2, which can cause hyperventilation and sequentially the feeling of stress.

Regular breath training can improve ones tolerance to CO2, and its negative consequences. Breathing techniques that include hyperventilation (ie: Wim Hof Breathing) result in hypocapnia and thus would be counter indicated for someone with anxiety.


Can breathwork also help with physical symptoms of anxiety?

The physical symptoms of anxiety, such as racing heart and shortness of breath, are the result of the neurological and chemical imbalances. Breathwork allows us to alter both our blood’s biochemistry and the way our nervous system is firing. To that extent breathwork is the best way to deal with such symptoms without medical intervention.


Can it be used in conjunction with other therapies?

Breathing exercises are often used by therapists, counselors and healthcare professionals alongside other treatments. This allows for a more holistic approach and quicker results. At the same time breathwork should not be confused with nonsense, such as:
• Take a breath in from the nose, out from the mouth or sigh – to release stress.

• Breathe diaphragmatically at all times.

• Always be aware of your breath.


Are there any studies that support the use of breathwork for anxiety management?

Scientific literature is inundated with papers that prove the beneficial use of breathwork for anxiety and mental health. Those interested in research however need to aware that there is good, bad and ugly papers published.

The intricate relationship between anxiety and breathing is discussed in the paper bellow which also highlights how breath can also be a contributing factor to anxiety.

An important area that research often fails to distinguish is this between breathing exercises that have a short term effect and those that have a long term effect. The ones that have a long term effect will have an impact on markers such as: resting heart rate, HRV, blood pressure, while those with a short term effect will improve only perceived stress.

Unfortunately a few papers like the one reviewed below, muddle up information calling sighing, breathwork and making unsupported claims in the abstract.


How can you learn breathing techniques to manage your anxiety?

How often and for how long should I practice?

Daily. As you are trying to re-wire your nervous system that is firing all the time you need to practice many times a day. The sessions can be 5-20mins long.


Can breathwork be used in acute anxiety situations, such as panic attacks?

Breathwork can be extremely useful in instances of panic attacks. Practicing the techniques when you are feeling well however, is ideal so that you become familiar with them. The “Easy Breath Holds” exercise is one example.


How to integrate breathwork into your daily routine?

If you dealing with anxiety, here are 5 ways breathwork can help you:

1 Regulate your circadian rhythm. You can practice breathwork before going to bed and as soon as you wake up.

2 Improve digestion. Nutrition plays a big role on how our Nervous System works. There is an intimate link between digestion, appetite and breathing.

3 Practice meditation. Breathing exercises can help you enter meditation.

4 Use your physical workouts as breath training. You can get even more out of your workouts if you modify your breathing accordingly.

5 Improve your posture. Breathwork and good posture go hand in hand.


To get the most out of breathwork you can follow the 3Cs rule:


2 Practice exercises that COUNT. – There are many exercises that will make no impact on your respiratory capacity.

3 COMBINE breathing exercises with meditation, physical exercise, sleeping hygiene, relaxation techniques, rebalancing exercises.


What are the different types of breathwork practices that can help with anxiety?

When it comes to dealing with acute episodes of anxiety the options are many and it really depends on the individual’s experience and predisposition. In order however for someone to avoid panic attacks and deal with chronic anxiety the only breathing practice he/she can benefit from is hypercapnic training.


Is breathwork safe for everyone to practice?

Breathwork is 100% safe when practiced progressively and in cases of neurological, cardiovascular and blood sugar problems with supervision. Pregnant women need also to be careful when practicing breathwork. Breathing techniques that include hyperventilation however, neither do they qualify for breathwork nor are safe.


Does Buteyko breathing really work?

Does Buteyko breathing really work?

Developed by Russian doctor Konstantin Buteyko in the 1950s the Buteyko Method is a system aiming to restore the levels of healthy CO2 in the body through breathing exercises. It has been found beneficial among individuals with cancer, high blood pressure, anxiety, asthma, allergies, snoring and sleep apnea.

I got certified as a Buteyko instructor in 2017 and in this article I answer some of the most frequently asked questions on the Buteyko Method (BM).


The Benefits

What are the benefits of practicing the BM?

By restoring optimal levels of CO2 in the body the BM promotes healthy function in our cells, tissue, organs and systems.

Our body’s organs depend on sufficient supply of oxygen to function. Due to the Bohr effect this can only be achieved through healthy levels of CO2 – as CO2 & O2 work synergistically. To that extent optimal organ function relies on healthy levels of CO2.

Knowing that, it may come as no surprise that K. Buteyko noticed early in his career as a doctor, a lot of chronically ill patients breathing poorly.


How does the BM improve breathing?

The way we breathe depends on our posture and our respiratory biochemistry. The Buteyko Method focuses on the later, through exercises that aim to restore optimal levels in the 3 blood gases: Nitric Oxide, Carbon Dioxide and Oxygen.

No matter how good your posture is if you breathe like an asthmatic armadillo you will suffer the consequences.

The benefits of the Buteyko training can be amplified however when combined with yoga.


Can the BM help with asthma or other respiratory issues?

The Buteyko Breathing has been found in research to benefit adults (ref1, ref2) and children (ref) with asthma as well as those with Obstructive Sleep Apnea (ref). These findings however, do not pay justice to the numerous cases of individuals that have benefited from the practice.

Once someone understands the logic behind the Buteyko Method he will not seek further proof to believe in its importance.


The Criticism

How long does it take to see results from practicing the BM?

Positive results from the Buteyko practice in most cases are evident within 2-3 weeks. In my experience there are 3 reasons this is not always the case:

1 Breathing is not compromised at first place.

There are instances when the symptoms of other imbalances overlap with those of dysfunctional breathing. If you implement a breathing protocol without any breathing issues chances are you will see little to no benefit in your symptoms. For that purpose an initial assessment is important.

2 The exercises practiced are not appropriate.

For any protocol to have an effect, it needs to provide the appropriate stimuli. If you follow a Buteyko exercise which is too easy for you, chances are you will not see much effect from it.

3 Compliance is poor.

Sometimes 90% (or even 99%) is not enough. While some individuals will see results by adopting 50% of the recommendations others will need to be 100% compliant.


Are there any risks or side effects associated?

NO. The reason is very simple. The cornerstone of BM is to incrementally increase the exposure of an individual to CO2 so he becomes more tolerant to it over time. Our body is very sensitive to CO2 and thus will resist its build up way before it reaches moderate levels (used in lab experiments), let alone dangerous levels. Anyone that argues otherwise has not done any breathwork and speaks theoretically.


Is it a complete breathwork system?

The Buteyko Method has 2 primary weakness as a breathing system:

1 Not addressing sufficiently breathing biomechanics.

2 Not incorporating enough exercises at a high Heart Rate.

That is due to the fact that K. Buteyko worked primarily with sick individuals. Oxygen Advantage includes some breathing exercises relevant for athletes.


Are there any scientific studies or research supporting the effectiveness of the BM?

Research on asthma (ref) and Eustachian tube dysfunction (ref) has indicated that the Buteyko Method and the Control Pause are beneficial for patients with compromised breathing.


The Application

Can it be combined with other forms of exercises or training?

Absolutely. I will argue that, for best results the Buteyko Method HAS TO be combined with one or more physical exercises. Which one depends on one’s status of physical health and the goals. Good candidates are: yoga, pilates and cardiovascular training.


How can I get started?

The best way to get started with the Buteyko Method is understand the principles and adopt a 10-20 mins protocol appropriate for your level of respiratory capacity and goals. If the exercises you adopt don’t meet the above 2 critical you are unlikely to see any benefits.


My opinion in a nutshell


Leaky Gut fix

How do you permanently heal leaky gut?

Leaky gut is the result of structural damage in the intestines. With the gut permeability been compromised, most individuals experience a series of symptoms, not solely digestive. To heal leaky gut permanently a structured multidisciplinary approach is needed.

Leaky gut: is a digestive track with a compromised permeability (like a hose with holes).


The Intestinal Immune System

The reason why leaky gut symptoms are not exclusively digestive are due to gut’s double role:

• digest and absorb nutrients

• host part of the immune system

The immune system in the gut has the delicate role of balancing between: Tolerating or Reacting to the foods it comes in contact with. The evolutionary benefit of this role is the following:

Foods we consume may be degraded or containing toxins and thus be poisonous to the body. In these cases the activation of the immune system can kill the pathogenic substances and protect us.  This process is mediated through a series of steps leading to the increase of intestinal permeability.

Unfortunately in certain people the same reaction is triggered not only by toxins but also by regular foods. In these cases after the consumption of the “trigger food” the individual experiences a reaction such as: foggy brain, bloatedness, diarrhea, stomach cramps, increased heart rate, running nose, anxiety, irritability. Reducing gut permeability (i.e. healing leaky gut) can make previous “trigger foods” tolerable again.


Our gut wall consists of just one cell thick epithelial tissue (Sturgeon, C. and Fasano, A., 2016). The space between each epithelial cell is called tight junction. The following tests can be used to identify leaky gut.


Lactulose/Mannitol test

The test that has been used the longest for detecting leaky gut is the lactulose/mannitol urine test. The test is simple: after an overnight (12 hour) fast you collect the urine then have a solution of lactulose & mannitol and 6 hours later you collect the urine again.

Mannitol enters the body through the epithelial cell membrane, while lactulose goes through the tight junctions (FlemIng, S.C. et al., 1990)

The loss of absorptive areas ➛ ↓ the absorption of mannitol.

The loss of mucosal integrity ➛ ↑ lactulose absorption.


An elevated lactulose: mannitol ratio indicates the presence of leaky gut. The test is available from many labs including Genova Diagnostics. The results can be affected by the use of  NSAIDS, alcohol and according to Dr. Alesio Fasano the results are very sensitive to the collection process and thus may not be reliable when done outside a lab.


3 stool markers of leaky gut (α1-Antitrypsin – sIgA – calprotectin)


is a protein of the liver. When detected in stool (sourced from the intestines) it indicates a severe case of intestinal permeability and thus is not a sensitive enough marker of leaky gut (Biancone, L. et al., 2003)


is part of the immune system and functions as a tag for substances that need to be excreted.


is a protein linked with intestinal inflammation. It is used to distinguish between IBD & IBS (Leblhuber, F., et al., 2015).


3 blood markers of leaky gut (Zonulin – LPS – DAO)


Zolulin is a protein responsible for the modulation of tight junctions (Sturgeon, C. and Fasano, A., 2016).

↑ levels of Zonulin ➛ Opening of tight junctions ➛ influx of dietary & microbial antigens in the blood

The 2 main triggers of Zonulin release have been found to be:

  1. Bacteria: including Eschericha coli, lab E. coli, virulent E. coli, and Salmonella typhi (El Asmar et al. 2002)
  2. Gliadin: a protein found in gluten (Clemente, M et al., 2003)

Elevated levels of Zonulin have been linked in the literature (Sturgeon, C. and Fasano, A., 2016) to:

  1. autoimmune conditions such as Type 1 Diabetes, Celiac Disease, Multiple Sclerosis, Intestinal Bowel Diseases
  2. metabolic disorders such as: Obesity & PCOS
  3. Asthma
  4. Coronary Heart Disease
  5. Systemic infections
  6. Gluten Sensitivity
  7. Necrotizing Enterocolitis
  8. Brain cancer (Skardelly, M et al., 2009) by altering the integrity of the Blood Brain Barrier.


Lipopolysaccharide Bacterial Endotoxin

Lipopolysaccharide (LPS) is a component of the wall of gram-negative bacteria (Trent, M.S et al., 2006) responsible for the activation of the innate immune system. LPS has 3 regions. Lab tests measure the lipid A region which is also known as endotoxin. Germ-negative bacteria live in the lumen of the gut but should not be found in the blood. Detection of LPS endotoxins in the blood is a sign of leaky gut.



Dunwoody Labs measures the levels of DAO enzyme in their intestinal permeability test. DAO is responsible for the break down of histamine. Histamine while necessary for good gut health when elevated can cause problems. Low levels of DAO thus is also a sign of leaky gut. Genetic polymorphisms in the AOC1 gene (which encodes the DAO enzyme) can impair the body’s ability to produce the DAO. Those with low levels can check their genetic burden using the table below.

source: Opus23


The future of leaky gut testing

While not currently available for the general public I-FABP is a marker of gut permeability used in laboratories. Intestinal fatty acid binding protein (I-FABP), is a marker of early enterocyte cell death (Derikx, J.P. et al., 2010)


How to support a leaky gut?

When it comes to supporting leaky gut I like to split the nutrients in 2 categories:

  1. the ones affecting the mechanisms that cause the problem (these are the ones that ultimately will heal the intestines)
  2. the ones that suppress the symptoms – commonly referred to as anti-inflammatory (these are the ones that should help ameliorate the symptoms)


Avoid trigger foods

While I consider elimination diets not a good idea long-term in the short run it is important to remove any trigger foods to control inflammation. IgG food intolerance tests can be very useful for that matter.



I consider the use of probiotics the most potent yet the most tricky in implementation among all interventions. Certain probiotic strains have been found to induce cell proliferation in gut cells:

Bifidobacterium breve R0070 & Lactococcus lactis R1058, when taken together, seem to have synergistic effects and both can be found in the Jarrow-Dophilus EPS. (Grimoud, J. et al., 2010 *)

Some others that were shown to suppress inflammation induced by LPS levels are:

  1. Bifidobacterium longum subsp. Infantis, Bifidobacterium longum, Bifidobacterium bifidum, Lactobacillus rhamnosus – in the order mentioned (Laetitia, R. et al., 2013)
  2. Lactobacillus reuteri strain, ATCC PTA 6475 – available from Biogaia. (Thomas, C.M. and Versalovic, J., 2010)
  3. Bifidobacterium infantis 35624 (Groeger, D. et al., 2013)


* The French study by Julien Grimoud is a goldmine of information.



Edible & medicinal mushrooms have been shown to activate & modulate the  immune system in the gut acting this way as anti-inflammatory in LPS toxicity.  A. bisporus, C. cibarius and L. deliciosus (Saffron Milkcap mushroom) are mushroom extracts available in supplemental form (Moro, C. et al., 2012).


Berberine is an alkaloid found in some plants shown to inhibit the inflammatory effects of LPS (Mo, C. et al., 2014Wu, Y.H., et al., 2012). Berberine has been shown to interact with 57 genes, so cross-checking polymorphisms related to other symptoms is worth doing.


Other agents

Quercetin & CoQ10 were also shown to have anti-inflammatory effects in  LPS toxicity (Abd el-gawad, H.M. and Khalifa, A.E., 2001). Fish Oils were shown to restore intestinal integrity by increasing DAO enzyme concentration in the gut (Liu, Y. et al., 2012).



L-glutamine acts as fuel for intestinal cells (Larson, S.D, et al., 2007), and to that extent supplementation can benefit a leaky gut. Gradually building the dosage from as little as 2.5 gr per day to 20 gr should be a safe way to avoid adverse reactions. I have not seen any studies demonstrating the benefits of L-glutamine supplementation for leaky gut however it does support overall intestinal health.


Larazotide acetate

Larazotide acetate is a protein shown to inhibit Zonulin production without any adverse effects (Paterson, B.M et al., 2007). Alba Therapeutics an Indian pharmaceutical company is in the process of developing a drug with this protein.


Frequently Asked Questions

Many individuals suffering from leaky gut, experience food sensitivities. The easiest way to deal with food sensitivities is to adopt an elimination diet. While this initially is a good idea as inflammation goes down, long term they cause problems.


That’s why in my opinion:

  1. While elimination diets (i.e. FODMAP, low oxalate, low histamine diets) remove foods that cause reactions, the reason why the reaction was there are 1st place stays. The same foods that
  2. Most chronically ill patients have restricted diets: the body is not able to renew the epithelial tissue in the gut leading to poor gut integrity ➛ increased gut permeability  ➛ food sensitivities.
  3. Diversity in gut flora is positively associated with health: A diverse gut flora supports gut integrity.


Can Candida cause Leaky Gut?

Candida can cause intestinal imbalances and sequentially leaky gut. As candida symptoms overlap with other GI tract issues it is worth testing for candida prior to following a protocol.




Abd el-gawad, H.M. and Khalifa, A.E., 2001. Quercetin, coenzyme Q 10, and l-canavanine as protective agents against lipid peroxidation and nitric oxide generation in endotoxin-induced shock in rat brain. Pharmacological research, 43(3), pp.257-263.


Biancone, L., Fantini, M., Tosti, C., Bozzi, R., Vavassori, P. and Pallone, F., 2003. Fecal α1-antitrypsin clearance as a marker of clinical relapse in patients with Crohn’s disease of the distal ileum. European journal of gastroenterology & hepatology, 15(3), pp.261-266.


Clemente, M.G., De Virgiliis, S., Kang, J.S., Macatagney, R., Musu, M.P., Di Pierro, M.R., Drago, S., Congia, M. and Fasano, A., 2003. Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function. Gut, 52(2), pp.218-223.


Derikx, J.P., Luyer, M.D., Heineman, E. and Buurman, W.A., 2010. Non-invasive markers of gut wall integrity in health and. World J Gastroenterol, 16(42), pp.5272-5279.


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