Q&A: leaky gut; zapping belly fat; menopause supplements and HRT substitutes; & testosterone for women

You ask the best questions!! Keep 'em coming!

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Disclaimer: The views expressed here are entirely my own. They do not reflect those of my employer, nor are they a substitute for advice from your personal physician.

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The following subscriber questions have been lightly edited for length and clarity.

QUESTION #1: LEAKY GUT SYNDROME

I was told I have leaky gut syndrome. Eek!! What is it? I Googled it and I freaked out.

- Kate

Dear Kate,

Great question. Here’s what we know: The lining of our intestines is permeable. The delicate membranes from our mouth to our rear ends are designed to absorb water and essential nutrients—and to prevent toxins and other substances from “leaking” into the bloodstream. Intestinal permeability is a recognized feature of several inflammatory and autoimmune diseases affecting the digestive system, including inflammatory bowel disease and celiac disease. 

Here’s where things get murky: Leaky gut syndrome is a condition that some people believe exists, but it is not a recognized medical diagnosis by most medical professionals. The concept of a “leaky gut” is that, for some people, the intestinal lining is overly permeable, allowing toxins and potentially harmful substances into the bloodstream, which can cause inflammation and other health problems. 

In the case of various inflammatory gut problems (such as Crohn’s disease, Ulcerative Colitis, or celiac disease), scientists generally consider increased membrane permeability to be a symptom, not a cause. In other words, currently there is not enough evidence to support the concept of leaky gut syndrome as a standalone diagnosis. 

In practice, my patients who have been told they have a “leaky gut” diagnosis usually are patients who experience gas, bloating, and irregular bowel movements for the same reasons I discuss here. Whether or not we call these symptoms “leaky gut” or irritable bowel is often immaterial. What matters most is trying to identify the root cause of the patient’s symptoms; connecting the dots between their genetics, lifestyle, laboratory data, diet, and social-emotional factors; targeting treatment to the underlying cause; and managing symptoms with a hefty dose of humility and patience.

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QUESTION #2: REDUCING BELLY FAT

How does a woman in her midlife reduce her belly fat? I would like to zap it away but it seems impossible.

- Cathryn

Hi Cathryn,

I hear this question—and frustration—a lot!