How to Heal Your Leaky Gut with the 4R Program

If you have thyroid disease, acne or headaches, the root cause likely isn’t in your thyroid gland, skin or head. Many symptoms stem from a whole-body imbalance, often originating in your gut– even if you don’t have any glaring digestive issues.

With 80% of your immune system located in your gut, it's no wonder it's the foundation of your whole-body health. Without a healthy gut, you can’t have a healthy immune system. No other place in your body interacts with the outside world like your gut. You’re taking in nutrients from food and keeping out bacteria, pathogens, and undigested food. When that barrier (aka: tight junctions) loses its ability to discriminate between the good and the bad, you have a “leaky gut.”

It is well recognized leaky gut is the precursor to food sensitivities, skin conditions, cognitive issues and even autoimmune diseases.

This 4R program is perfect for:

  • Those concerned about leaky gut
  • Trying to maintain a healthy intestinal lining
  • Digestive issues or a disturbed gut microbiome balance (past or current)
  • Those who took a course of antibiotics
  • Supporting a healthy immune response and thyroid function
  • Beating sugar cravings and maintain a healthy weight

There are four steps to promote your gut health and maintain systemic balance – remove, replace, reinoculate and repair.  

4R Program for Leaky Gut

#1: Remove Inflammatory Foods, Stress, Infections & Toxins


Identify and remove the factors that may be contributing to your symptoms, starting with your diet. Certain foods are known to be more allergenic than others and can trigger inflammation in individuals. Remove the common allergy-producing foods including gluten-containing grains and dairy products.

Common Inflammatory Foods Include:
Sugar, alcohol, dairy, eggs, gluten, grains and pseudograins (ie: quinoa), legumes, GMOs, and nightshades (ie: tomatoes, peppers, and potatoes).

When you remove inflammatory foods, you must replace them with foods your gut loves. Your gut will love these five foods, along with these additional foods and lifestyle techniques to support healthy inflammatory levels in the body.

Build your diet around lots of vegetables (other than potatoes), high quality proteins & fats, nuts, nut butters, seeds, fruit and dairy substitutes.


Manage stress because it can impair your digestion and absorption. When you eat under stress, your body is in the opposite state of where you need to be to digest, assimilate nutrients and burn calories.

Neurotransmitters like serotonin are found in your gut. In fact, the greatest concentration of serotonin, which is involved in mood control, depression and suppressing aggression, is found within your intestines–not your brain.

Nourishing your gut flora with good bacteria is extremely important for proper brain function, including psychological well-being and mood control.     

There are many stress-management strategies to help you unwind and address your stress, including:

  • Exercise
  • Restorative Sleep
  • Meditation 
  • Schedule time to eat without rushing


Have your doctor test for and eliminate any pathogens, toxins, and chronic infections of the sinus, oral cavity or intestinal tract. Bacterial and yeast overgrowth, viruses, fungi, parasites and toxic chemicals and toxic metals are common contributors to gut-related symptoms.  

#2: Replace

As you remove the substances that might disrupt the function of your immune system, assess whether you have adequate stomach acid and digestive enzymes, which may be lacking and are required for proper digestion.

Stomach acid is important to kill pathogens that enter our body through the food we eat. Insufficient stomach acid will create an environment for bacteria and candida infections to thrive. Support normal stomach acid with betaine HCL and pepsin. Digestive bitters are another effective way to support normal, healthy levels of stomach acid.

Digestive enzymes are important for fat, protein and carbohydrate digestion. It may be necessary to replace pancreatic enzymes (lipase, protease, amylase) by taking digestive enzymes with each meal. These enzymes also support gall bladder function.

#3: Reinoculate

Once the unfavorable foods, bacteria, yeast and/or parasites are removed, healthy bacteria need to be reintroduced. This can be accomplished with a variety of foods and supplements.


The best way to increase the number of good bacteria in your gut is via probiotics. These live bacteria support normal digestion and promote a healthy gut environment. The body’s “good” versus “bad” bacterial balance is important.

Choose a well-researched and medically documented probiotic (at least 35 billion live organisms CFUs), and eat more fermented foods, which are rich in probiotics.


It’s recommended to take probiotics with a prebiotic supplemen such as inulin, fructooligosaccharides or arabinogalactans. Prebiotics are a type of non-digestible fiber fermented by the beneficial bacteria in the gut and used as a source of fuel to help enhance gut flora health.

During this step, slowly increase the dose of probiotics over a two-week period to allow the intestinal tract to adjust. If the dose of the probiotics and prebiotics are increased too quickly it can result in excessive intestinal gas formation and discomfort.

Here are some of my favorite gut nourishers and a green drink recipe to naturally boost the prebiotics in your diet. 

#4: Repair

After two weeks on the reinoculate probiotics and prebiotics supplement, and in addition to an allergen-free diet, add additional nutrients for continued support of the mucosal lining of the gut and proper function of the gut’s tight junctions.


Omega-3 fatty acids, particularly EPA (1-3 grams per day)

L-Glutamine (6-10 grams per day)

Vitamin B5 - Pantothenic acid (500-1000 mg per day)

Zinc Citrate (10 mg per day)

Vitamin E as mixed tocopherols (400 mg per day)

Glycine (6-10 grams per day)




Vitamin D


Glycophagen GI Wellness (a unique blend of digestive enzymes, probiotics, glutamine, and other gut-nourishing nutrients)

Follow this plan for a total of 12 weeks, evaluating signs and symptoms weekly. The Institute of Functional Medicine has been successfully applying this program for the past 15 years. The evidence is strong: protecting and restoring the intestinal firewall is of primary importance for your health.

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References: Dr. Jeffrey Bland at Personalized Lifestyle Medicine Institute and Dr. Amy Myers at Austin Ultra Health

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