For the patient whose reaction list keeps growing. Barrier support led by L-glutamine, the primary fuel for the cells that hold the intestinal lining together — dosed per meal, not as a flat daily total.
A reaction list that keeps growing points at the barrier rather than at each new food. The intestinal lining decides what crosses into circulation; when it becomes more permeable, more food proteins meet the immune system. Total Leaky Gut supplies L-glutamine, the primary fuel for the cells that maintain that lining.
When the list keeps growing, the question is not what changed about the food. It is what changed about the barrier.
The standard answers are real and worth knowing. Adult-onset allergy, where the immune system begins treating a familiar protein as a threat. Cross-reactivity, where a new pollen allergy makes the body confuse similar proteins in raw fruit or vegetables. Declining enzyme output with age, which is how adult lactose intolerance arrives. Microbiome shifts after antibiotics or a change in diet.
Each of those explains a reaction to a food. None of them explains the pattern Dr. Frazier sees most often at Absolute Health, which is a reaction list that keeps getting longer — new foods added every few months, no single allergen ever identified, elimination diets that work for a while and then stop working as the next food joins the list.
The intestinal lining is one cell thick. Those cells — enterocytes — are among the fastest-dividing in the body, and they are joined by protein structures called tight junctions that decide what passes into circulation and what does not. Nutrients cross. Larger intact food proteins are not supposed to.
When that barrier is compromised, larger fragments reach an immune system that was never meant to meet them. The recognized contributors are cumulative rather than sudden: a significant course of antibiotics, sustained NSAID use, a gastrointestinal infection, diagnosed inflammatory bowel disease. A growing reaction list is classic for a compromised barrier letting more triggers through over time.
Here is where this page will part company with most of what you will read, in both directions.
The biochemistry is well established. Tight junction proteins are characterized in detail, and barrier disruption is documented in celiac disease and inflammatory bowel disease. That is not fringe science and it is not in dispute.
The clinical significance is genuinely debated. What is not settled is how often subclinical permeability changes in an otherwise healthy-seeming patient explain the wide range of symptoms sometimes attributed to them. Dr. Frazier's position is stated exactly that way in his clinical reference: mechanism established, clinical significance debated.
Which means the honest reading sits between the two loudest camps. Anyone telling you this explains everything is overstating it. Anyone telling you it does not exist is ignoring characterized biochemistry. The reason to take the barrier seriously in a specific patient is the pattern — an expanding list rather than a fixed reaction.
| Component | Role |
|---|---|
| L-Glutamine first by weight | Primary metabolic fuel for enterocytes, among the fastest-dividing cells in the body. Availability is directly tied to how well cell turnover and barrier integrity are maintained. Reasonably well supported, with research in critical illness, post-surgical recovery and specific IBD contexts. |
| N-Acetyl Glucosamine | A documented component of the intestinal mucin layer sitting above the epithelial cells — the same ingredient that connects gut repair to joint repair, working the gut side here. |
| Slippery Elm · DGL Licorice | Slippery elm mucilage coats and soothes irritated tissue. DGL has the glycyrrhizin removed — the compound responsible for licorice's blood pressure effect — retaining gastric soothing without that concern. |
| Jerusalem Artichoke | A significant inulin source. Prebiotic benefit for most patients, and a genuine FODMAP caution for SIBO or IBS-sensitive patients. See the honest cautions below. |
| Cat's Claw · Alpha Lipoic Acid | Cat's claw carries traditional anti-inflammatory digestive use, present in a small amount, and is the reason for the pregnancy caution. Alpha lipoic acid addresses the oxidative contribution to tight junction breakdown; disclosed as racemic 50/50. |
| Ginkgo Biloba two forms | Proposed to support microcirculation to the gut lining. Carries the contested bleeding-risk profile discussed below. |
| Probiotics · Vitamin C · Zinc | Lactobacillus acidophilus and Bifidobacterium bifidum support flora balance and barrier function from the microbial side — strain-specific rather than a uniform class effect. Vitamin C supports connective tissue collagen. Zinc is required for enterocyte function and has its own permeability-specific research base. |
It is a significant source of inulin, a fructan that is high-FODMAP at any typical serving. In SIBO or FODMAP-sensitive IBS patients — exactly the population most likely to reach for a product like this — it can feed already-overgrown bacteria and increase bloating in the first days. Start at the lowest tier and watch the response. Where SIBO is documented or strongly suspected, a dedicated protocol may need to run ahead of this one.
Ginkgolide B inhibits platelet-activating factor, a real mechanism, and case reports describe bleeding events temporally linked to ginkgo. Controlled trials of the standardized extract found no measurable effect on coagulation or platelet aggregation. The prudent default regardless of which side is correct: stop two weeks before any scheduled surgery, and coordinate with the prescriber for anyone on warfarin or an antiplatelet agent. Ginkgo has also been studied specifically in seizure disorder, with the decision belonging to the treating neurologist rather than this page.
Because the barrier is challenged at the meal, not on a schedule. The label figure is one tablet daily. The working range at Absolute Health starts at one tablet per meal and moves to two per meal across two to three meals as the standard therapeutic tier, with three per meal for extended work and up to four per meal for active presentations. Once the acute picture stabilizes, maintenance drops to two in the morning and two in the evening.
Those tiers sit meaningfully above the label and belong under a provider's direction rather than being self-escalated. One note worth flagging for a growing group of patients: GLP-1 medications such as semaglutide and tirzepatide slow gastric and intestinal motility by design. The working tier there is two to three tablets morning and evening, generally paired with a digestive enzyme.
Blood in the stool, unintended weight loss, nocturnal symptoms, or a change in bowel pattern in an older patient warrant workup rather than nutritional management — these are refer-out criteria, not judgment calls. This supports barrier integrity; it does not replace obtaining a diagnosis for a condition that needs one. Cat's claw carries a manufacturer-declared pregnancy caution. Glutamine converts to glutamate in the body, so anyone under specific physician direction to limit glutamate intake should review this with their prescriber. Alpha lipoic acid improves insulin sensitivity and stacks with glucose-lowering medication — worth flagging for anyone on that class of drug.
Because the barrier and its repair machinery have specific segmental supply, not a single generic "nerve to the gut."
| Level | Organ Supported |
|---|---|
| C1 to C2 | Vagal outflow to the entire gut. The vagus carries constant two-way gut-brain traffic and drives the cholinergic anti-inflammatory pathway acting on the barrier directly. |
| T5 to T9 | Stomach and liver via greater splanchnic. Gastric acid is itself the first line of the barrier system, before anything reaches the intestinal lining. |
| T6 to T10 | Pancreas and duodenum. Enzyme delivery and the proximal small intestine. |
| T9 to T12 | Jejunum, ileum, and Peyer's patches via lesser splanchnic. Where the barrier and roughly 70 to 80 percent of the immune system sit together. |
| L1 to L3 | Colon via lumbar splanchnics and the inferior mesenteric plexus. Where the probiotic strains and inulin substrate in this formula act. |
| S2 to S4 | Distal colon and rectum via pelvic splanchnics. Parasympathetic supply to the hindgut. |
Supplementation supplies the material. Restoring normal segmental motion at each of these levels addresses the nervous-system signaling governing whether the body spends that material on repair.
| Product | Dose | Why |
|---|---|---|
| Total JT Plus | 2 twice daily to 3 three times daily | The reverse pairing for the gut-joint bridge — N-acetyl glucosamine feeds the mucin layer here and the joint matrix there. Contains shellfish (green lipped mussel) and bovine trachea. Not vegetarian. |
| Total Enzymes | Equal number per meal | Routinely paired with a GLP-1 protocol. Supports digestion directly rather than only the barrier. |
| Hypo-D | 1 to 2 per meal | Where low stomach acid is part of the picture — adequate gastric acid is itself part of the barrier system. Swallow whole. Ulcer caution. |
| Complete Paleo | 1 scoop daily to booster | Glycine, glutamic acid and threonine feed the barrier and its mucin layer directly. Bovine collagen. Not vegetarian. |
| Total Probiotic | Per label | Flora rebuilding beyond the two strains already in this formula. |
| Total FLM | Per protocol | Multi-pathway anti-inflammatory support, including quercetin for tight junction upregulation, where systemic inflammation is also driving the picture. |
Products not yet linked will become live pages as they clear the clinical and schema review gate.
Two minutes on what the intestinal barrier does and why an expanding list points there. Narrated from Dr. Troy Delane Frazier’s own clinical writing on this formula — his reasoning, his words.
Narrated summary of Dr. Frazier’s clinical rationale. Nothing plays until you click — no tracking loads on page view.
A true food allergy is a different thing entirely, and it is dangerous to treat it as a barrier issue. Allergy involves the immune system and produces hives, swelling, itching or difficulty breathing, usually within minutes to two hours. That needs a board-certified allergist and specific testing, not a supplement.
Unexplained weight loss, blood in the stool, persistent severe pain, or symptoms suggesting inflammatory bowel disease also need medical evaluation first. Barrier support does not substitute for a diagnosis, and delay is the real risk in those cases.
What this is for is the accumulating picture — a list that keeps growing, no single allergen identified, elimination rounds that stop working as the next food joins the list. That is a different group of people.
The term has been badly overused, which is why serious institutions push back on it. But the underlying biochemistry is characterized in detail and barrier disruption is documented in celiac disease and inflammatory bowel disease. The honest position is the narrow one: mechanism established, clinical significance debated. This page will not tell you it explains your symptoms. It will tell you the pattern that makes it worth considering, and what would rule it out.
Testimonials reflect individual experiences and are not a guarantee of any clinical outcome.
| Each Tablet Contains | Amount |
|---|---|
| Vitamin C (sago palm) | 25 mg |
| Zinc (chelate) | 0.5 mg |
| Proprietary blend — L-Glutamine, Slippery Elm (bark), N-Acetyl Glucosamine, Ginkgo Biloba (leaf), Deglycyrrhizinated Licorice (root), Jerusalem Artichoke (root), Cat’s Claw (inner bark), Alpha Lipoic Acid, Ginkgo Biloba Extract (leaf), Lactobacillus acidophilus, Bifidobacterium bifidum | 469 mg |
Other ingredients: Microcrystalline cellulose, vegetable stearine, vegetable magnesium stearate, vegetable stearic acid.
Suggested use: 1 tablet daily, or as directed by your provider. · Vegetarian: Yes · Gluten free: Yes · Declared allergens: None
Contraindications: Use caution in pregnancy — the formula contains a small amount of cat’s claw. Coordinate with the prescriber if you take warfarin or an antiplatelet agent, and stop two weeks before scheduled surgery, on account of the ginkgo content.
Supervision note: If you are pregnant, nursing, taking prescription medication, or under care for a diagnosed digestive condition, review this label with your physician before starting. Keep out of reach of children.
Four stages. Each one builds on what the last one found — you paste the AI’s answer back in and the next prompt is written around it. You end with a document you can take to a doctor. This is education, not diagnosis.
Before anything else — what is actually happening underneath the symptom. This stage translates what you feel into the biological systems involved.
Your prompt will appear here.
Now the specifics of your case, written against what stage one found.
Complete stage 01 to unlock
Your prompt will appear here.
A visual of your own picture — the pathway involved and where this formula enters it. Paste into an image-capable AI.
Complete stage 02 to unlock
Your prompt will appear here.
Image generators garble dense text. Proof the rendered image before showing it to anyone.
Everything above, assembled into a document you can actually read and understand — what may be happening underneath, how this formula applies to you, and the questions to ask before you book.
Complete stage 03 to unlock
Your prompt will appear here.
Not every practice works at this level, and there is no fault in that — it is a different training. Ask these on the phone before you pay for a visit. If the answers are no, you have saved yourself an appointment.
If your provider referred you here, take the dossier to them — it is built to make that visit better. If you don’t have a provider working in this lane, Dr. Troy Delane Frazier, DC sees patients by telehealth and this is exactly the conversation he has been having since 1998.
Call to Schedule · (801) 221-1151Telehealth availability varies by state. Absolute Health, Orem, Utah.
The usual answers are adult-onset allergy, cross-reactivity with pollen, and declining enzyme output — all real. There is a fourth possibility that rarely gets named: the intestinal barrier itself. When the barrier that decides what crosses into circulation becomes more permeable, larger food proteins reach the immune system that would not normally meet it. Dr. Frazier's clinical observation is that a growing reaction list, rather than a reaction to one new food, is the pattern that points there.
Several things. Low stomach acid, which leaves protein incompletely broken down before it ever reaches the intestine. Bacterial overgrowth in the small intestine, where the reaction tracks with fermentable carbohydrate rather than with a specific food. Insufficient digestive enzyme output. Bile insufficiency, where fat is the common thread. And barrier permeability, where the list keeps expanding rather than staying fixed. These need different answers, which is why a reaction diary that records timing and pattern is worth more than another elimination round.
It can appear suddenly from the patient's side while having developed gradually underneath. The recognized contributors to barrier compromise are cumulative: a significant antibiotic course, sustained NSAID use, a gastrointestinal infection, or diagnosed inflammatory bowel disease. Barrier and flora both take time to recover after any of those. What feels like a sudden onset is often a threshold being crossed.
Yes, and the mechanism differs by type. True allergy involves the immune system and produces hives, swelling or breathing difficulty. Intolerance is digestive and produces gas, bloating and cramping without an immune response. Those are distinguished by a board-certified allergist with specific testing, and that distinction matters — it changes what to do next. Nutritional barrier support is relevant to the third category, where reactions accumulate over time and no single allergen explains them.
This deserves a straight answer rather than either of the loud ones. The biochemistry is well established — tight junction proteins are characterized in detail, and barrier disruption is documented in celiac disease and inflammatory bowel disease. What is genuinely debated is how often subclinical permeability changes in an otherwise healthy-seeming patient explain the wide range of symptoms sometimes attributed to them. Dr. Frazier's position: mechanism established, clinical significance debated. Anyone telling you it explains everything is overstating it, and anyone telling you it does not exist is ignoring characterized biochemistry.
Because of the Jerusalem artichoke content, and this is not contested. It is a significant source of inulin, a fructan that is high-FODMAP at any typical serving. In patients with SIBO or FODMAP-sensitive IBS — exactly the people most likely to reach for this product — it can feed already-overgrown bacteria and increase bloating in the first days. Start at the lowest tier and watch the response. Where SIBO is documented or strongly suspected, a dedicated SIBO protocol may need to run ahead of this one.
Honestly contested. Ginkgolide B inhibits platelet-activating factor, which is a real mechanism, and case reports describe bleeding events temporally linked to ginkgo. Controlled trials of the standardized extract found no measurable effect on coagulation or platelet aggregation. The prudent default regardless of which side is right: stop two weeks before any scheduled surgery, and coordinate with the prescriber for anyone on warfarin or an antiplatelet agent. Ginkgo has also been specifically studied in seizure disorder with mixed findings, worth knowing with any seizure history.
No. Total Leaky Gut is dispensed by Dr. Troy Delane Frazier, DC at Absolute Health, 560 South State Street, Suite H-1, Orem, Utah 84058, and ships nationwide. If your own provider referred you, enter their Referring Provider ID at checkout so the order is credited to them. Questions: (801) 221-1151.
120 tablets · 469 mg proprietary blend
Vegetarian · Gluten-free · No declared allergens · Ships nationwide
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