“Leaky gut” has become one of the most widely discussed—and misunderstood—concepts in modern health and nutrition. It is blamed for everything from bloating and fatigue to autoimmune disease, skin problems, anxiety, and “brain fog.” At the same time, many healthcare professionals warn that leaky gut syndrome is not a formally recognized diagnosis.

So, who is right?

The most accurate answer is that increased intestinal permeability is a real and measurable biological phenomenon, but the popular idea of “leaky gut syndrome” as a single condition responsible for a long list of unrelated symptoms is not supported by strong clinical evidence.

The intestinal barrier can become impaired in specific diseases and under certain physiological stresses. However, increased permeability may be a cause, a consequence, or simply one component of a more complex disorder. It should not automatically be treated as the explanation for every digestive or systemic symptom. (PMC)

At a Glance

• The intestine is naturally permeable, but this permeability is tightly controlled.
• Abnormally increased intestinal permeability has been documented in conditions such as coeliac disease, inflammatory bowel disease, intestinal infections, and alcohol-related liver disease.
• There is no unique set of symptoms that can diagnose a “leaky gut.”
• Commercial zonulin tests and broad “gut health panels” cannot reliably confirm the condition on their own.
• The most effective strategy is to identify and treat the underlying problem rather than trying to “seal” the gut with supplements.
• A varied, fibre-rich diet, moderate physical activity, sufficient sleep, stress management, and avoiding unnecessary intestinal irritants may help support barrier health.

What Does “Leaky Gut” Actually Mean?

The digestive tract is not simply a tube through which food passes. Its inner surface is a highly active biological interface separating the contents of the intestine from the bloodstream and the rest of the body.

This barrier must perform two seemingly contradictory tasks:

1. It must allow water, electrolytes, amino acids, fatty acids, vitamins, and other nutrients to be absorbed.
2. It must restrict the passage of pathogens, bacterial components, toxins, and incompletely digested substances.

For this reason, a healthy intestine is not completely “sealed.” It is selectively permeable.

The intestinal barrier consists of several interacting layers:

• the mucus covering the intestinal surface;
• a single layer of intestinal epithelial cells;
• tight junction proteins connecting neighbouring cells;
• antimicrobial substances;
• immune cells located beneath the epithelium;
• the intestinal microbiota and the metabolites produced by it.

Understanding how the intestinal barrier responds to diet, microbial activity, and the contents passing through the digestive tract can also provide a useful starting point for exploring how intestinal cleansing may support a healthier gut environment.

Substances can cross the intestinal epithelium through the cells, known as the transcellular route, or between the cells, known as the paracellular route. Tight junctions help regulate the paracellular pathway.

When this regulation is disrupted, larger molecules or microbial products may cross the barrier more easily than they normally would. This is what researchers usually mean by increased intestinal permeability or intestinal hyperpermeability. (PMC)

Is Leaky Gut Real or a Myth?

The answer depends on how the term is being used.

What is scientifically real

Scientists can measure changes in intestinal barrier function. Increased permeability has been observed in human studies involving:

• active coeliac disease;
• Crohn’s disease and ulcerative colitis;
• certain gastrointestinal infections;
• severe illness and sepsis;
• liver disease associated with heavy alcohol consumption;
• intestinal damage caused by some medications;
• some subgroups of people with irritable bowel syndrome.

In these situations, intestinal barrier dysfunction is a legitimate area of medical research.

What remains unproven

The controversial part is the claim that a broadly defined “leaky gut syndrome” can be diagnosed from nonspecific symptoms such as fatigue, bloating, headaches, joint discomfort, food cravings, poor concentration, or skin problems.

These symptoms may be genuine, but they can occur in dozens of conditions. They do not demonstrate that intestinal permeability is abnormal, nor do they establish that permeability is causing the symptoms.

It is also not scientifically justified to assume that increased permeability is the primary cause of every disease with which it has been associated. In many conditions, inflammation or tissue damage may impair the intestinal barrier rather than the barrier defect initiating the disease.

Myth versus fact

Which Conditions Are Most Clearly Associated With Increased Intestinal Permeability?

Coeliac disease

Coeliac disease is one of the best-studied examples of impaired intestinal barrier function. In genetically susceptible individuals, gluten triggers an immune response that damages the small-intestinal mucosa. Changes in tight-junction regulation and increased permeability are involved in the disease process.

However, this does not mean that gluten causes pathological permeability in everyone or that all people with digestive symptoms should follow a gluten-free diet.

Anyone who may have coeliac disease should ideally be tested before eliminating gluten, because removing gluten can make blood tests and intestinal biopsies less reliable.

Inflammatory bowel disease

Crohn’s disease and ulcerative colitis involve chronic inflammation of the digestive tract. Patients may have defects in the mucus layer, epithelial cells, tight junctions, immune regulation, and microbial ecosystem.

Increased permeability may contribute to ongoing inflammation, while inflammation itself further damages the barrier. This creates a potential feedback loop rather than a simple one-way relationship. (PMC)

Irritable bowel syndrome

Irritable bowel syndrome, or IBS, does not produce the same visible intestinal damage as inflammatory bowel disease. Nevertheless, research suggests that barrier function may be altered in certain IBS subgroups, particularly in some patients with diarrhoea-predominant or post-infectious IBS.

The findings are not consistent across all patients. Increased permeability should therefore not be assumed to be the cause of every case of IBS.

Intestinal infections

Bacterial, viral, and parasitic infections may damage epithelial cells, alter tight junctions, disturb the mucus layer, and activate local immune responses.

Barrier function often improves after the infection resolves, but some people develop prolonged digestive symptoms or post-infectious IBS.

Alcohol-related disease

Heavy or prolonged alcohol consumption can disrupt the intestinal microbiota and impair epithelial barrier function. This may allow more bacterial products to reach the portal circulation, which carries blood from the intestine to the liver.

Human studies in alcohol-dependent patients have found relationships between altered permeability, microbial changes, and inflammatory activity. Some barrier abnormalities improved following alcohol withdrawal, although inflammation and symptoms did not always recover at the same rate.

Metabolic, autoimmune, and neurological conditions

Altered intestinal permeability has also been reported in obesity, metabolic disorders, type 1 diabetes, rheumatoid arthritis, neurological disorders, and some psychiatric conditions.

These associations are scientifically interesting, but they must be interpreted carefully. An association does not prove that “leaky gut” caused the disease. Diet, medications, inflammation, stress, sleep, physical activity, and changes in the microbiota may affect both the disease and the intestinal barrier.

What Are the Symptoms of Leaky Gut?

There is no clinically validated symptom pattern specific to increased intestinal permeability.

People who believe they have a leaky gut frequently report:

• abdominal bloating or distension;
• abdominal discomfort or cramping;
• diarrhoea;
• constipation;
• excessive gas;
• nausea;
• food-related discomfort;
• fatigue;
• headaches;
• difficulty concentrating;
• skin symptoms;
• joint or muscle discomfort.

These complaints should not be dismissed, but they should also not automatically be attributed to a damaged intestinal barrier.

The same symptoms may occur with:

• coeliac disease;
• inflammatory bowel disease;
• IBS;
• lactose or fructose malabsorption;
• gastrointestinal infection;
• small intestinal bacterial overgrowth;
• thyroid disorders;
• anaemia;
• medication side effects;
• sleep disorders;
• depression or chronic stress;
• gynaecological conditions;
• inadequate or highly restrictive diets.

The key clinical question is therefore not merely, “Do I have leaky gut?” A more useful question is:

What underlying condition, exposure, dietary pattern, or physiological stress could be producing these symptoms?

For people experiencing recurrent bloating, irregular bowel movements, or a persistent feeling of digestive heaviness, it may also be valuable to learn how the condition of the intestinal environment can influence everyday digestive comfort.

Symptoms That Require Medical Evaluation

Digestive symptoms should be assessed promptly when they are accompanied by:

• blood in the stool or black, tar-like stool;
• unexplained weight loss;
• persistent fever;
• repeated vomiting;
• severe or worsening abdominal pain;
• symptoms that regularly wake a person at night;
• iron-deficiency anaemia;
• dehydration;
• persistent diarrhoea;
• difficulty swallowing;
• a family history of coeliac disease, inflammatory bowel disease, or colorectal cancer;
• new and persistent symptoms beginning later in life.

These signs should not be managed with a commercial “gut repair protocol” without appropriate medical assessment.

What Can Damage the Intestinal Barrier?

1. Active intestinal disease

Coeliac disease, inflammatory bowel disease, infections, and other conditions that directly injure the intestinal lining are among the most important causes of increased permeability.

Treating the underlying disease is usually more important than taking products marketed as barrier-repair supplements.

2. Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs, or NSAIDs, include commonly used medicines such as ibuprofen, naproxen, and aspirin.

NSAIDs can affect the stomach and small intestine through several mechanisms, including altered prostaglandin production, mitochondrial injury, changes in phospholipid membranes, and increased permeability. Regular use may contribute to intestinal inflammation, erosions, ulcers, bleeding, and protein loss in susceptible individuals. (PubMed)

This does not mean that all NSAID use is unsafe. It means they should be used appropriately, particularly in people requiring frequent or long-term treatment. Prescribed medication should not be stopped without consulting a healthcare professional.

3. Heavy alcohol consumption

Alcohol can affect tight-junction proteins, oxidative balance, microbial composition, and immune signalling. The risk is particularly relevant with heavy, repeated, or binge consumption.

4. Dietary patterns

Diet influences the intestinal barrier both directly and through the microbiota.

Patterns dominated by highly processed foods, low plant diversity, excessive saturated fat, and insufficient fibre may reduce the production of beneficial microbial metabolites and promote an intestinal environment associated with inflammation.

However, individual ingredients should not automatically be labelled as “toxic” based solely on laboratory or animal studies. The overall dietary pattern, dose, frequency, metabolic health, and underlying disease all matter.

5. Psychological and physiological stress

Stress can influence intestinal motility, secretion, pain perception, immune activity, the microbiota, and barrier regulation through communication between the brain and the digestive system.

Human and experimental research suggests that severe or prolonged stress may increase permeability under some circumstances. Nevertheless, stress is difficult to isolate from changes in sleep, diet, medication use, alcohol consumption, and physical activity. It should be considered one contributing factor rather than a universal explanation.

6. Extreme physical exertion

Regular moderate exercise is generally beneficial for metabolic and intestinal health. In contrast, prolonged high-intensity exercise—especially in hot conditions—can temporarily reduce blood flow to the digestive tract and increase intestinal permeability.

This is most relevant to endurance athletes, military personnel, and people performing strenuous exercise in the heat. It should not discourage normal physical activity.

7. Severe illness

Major burns, trauma, sepsis, shock, and critical illness may profoundly impair intestinal blood flow and barrier function. These situations are medically very different from the vague collection of symptoms often marketed as “leaky gut syndrome.”

How Is Intestinal Permeability Tested?

Testing intestinal permeability is more complicated than many commercial advertisements suggest.

Sugar permeability tests

One approach involves drinking a solution containing sugars of different molecular sizes, such as lactulose and mannitol or lactulose and rhamnose. Urine is collected over a defined period, and the ratio of recovered sugars is analysed.

Because the sugars are absorbed differently, the result can provide information about intestinal absorption and paracellular permeability.

However, results can be affected by:

• the type and dose of sugar used;
• the intestinal region being assessed;
• collection time;
• kidney function;
• gastric emptying;
• intestinal transit;
• laboratory methodology;
• medication and dietary factors.

These tests are useful in research and selected clinical situations, but there is no single universally accepted protocol that diagnoses a broad “leaky gut syndrome.”

Zonulin testing

Zonulin is a protein involved in the regulation of tight junctions and has been investigated as a possible marker of intestinal permeability.

The problem is that many commercially available zonulin assays may detect proteins other than the molecule they claim to measure. Results often correlate poorly with functional permeability testing.

A high serum or stool zonulin result should therefore not be treated as definitive proof of intestinal barrier dysfunction, especially when interpreted without medical history, symptoms, and other investigations. (PMC)

Other methods

Researchers may also use:

• intestinal biopsies;
• laboratory analysis of epithelial tissue;
• Ussing chambers;
• confocal laser endomicroscopy;
• bacterial-product markers;
• intestinal fatty acid-binding protein;
• lipopolysaccharide-binding protein;
• combinations of inflammatory and permeability biomarkers.

Each measures a different aspect of barrier function. None independently establishes a universal “leaky gut syndrome.”

How to Support a Healthy Intestinal Barrier

There is no single “gut-sealing” protocol suitable for everyone. Prevention should focus on reducing avoidable injury, supporting microbial and nutritional health, and treating genuine disease.

1. Investigate persistent symptoms

Long-lasting digestive problems deserve proper evaluation. Depending on the symptoms, this may include testing for:

• coeliac disease;
• inflammatory bowel disease;
• infection;
• anaemia;
• thyroid dysfunction;
• lactose or fructose malabsorption;
• medication-related effects;
• other gastrointestinal or systemic conditions.

A diagnosis should guide treatment. Beginning a highly restrictive diet before appropriate testing may hide useful diagnostic clues.

2. Eat a varied, fibre-rich diet

Dietary fibres are fermented by intestinal microorganisms into short-chain fatty acids, including butyrate, propionate, and acetate.

Butyrate is an important energy source for cells lining the colon and participates in the regulation of immune responses, mucus production, and epithelial integrity.

Useful fibre sources include:

• vegetables;
• fruit;
• legumes;
• minimally processed whole grains;
• nuts;
• seeds;
• resistant-starch-containing foods.

A carefully formulated combination of different plant fibres and seeds can offer a practical way to increase dietary fibre intake and support regular intestinal elimination.

A Mediterranean-style dietary pattern naturally combines many fibre-rich foods with olive oil, herbs, nuts, legumes, and fish. In a randomized dietary trial, improved adherence to a Mediterranean diet was associated with changes in short-chain fatty acids and biomarkers related to barrier function. The results are promising, although they do not prove that one dietary pattern will correct permeability in every patient. (PubMed)

People with active inflammatory bowel disease, intestinal strictures, severe diarrhoea, or other specific conditions may require individually adjusted fibre intake.

3. Increase fibre gradually

A sudden large increase in fermentable fibre can cause gas, bloating, discomfort, and changes in bowel movements.

This does not necessarily mean that fibre is damaging the intestinal barrier. It may reflect rapid fermentation or poor tolerance of a particular fibre source.

Gradual introduction, adequate fluid intake, and dietary variety are often more practical than adding a large dose of a single isolated fibre.

Products that combine several complementary sources of soluble and insoluble fibre may provide a more balanced approach than relying on one isolated ingredient, especially when they are introduced gradually as part of a consistent digestive routine.

4. Avoid unnecessary dietary restriction

Eliminating gluten, dairy products, grains, legumes, nightshade vegetables, fruit, or multiple other food groups without a clear reason may reduce nutrient intake and microbial diversity.

Temporary elimination diets can sometimes be useful when professionally supervised, but they should include a structured plan for reintroduction.

The goal should be the widest nutritious diet that the individual can comfortably tolerate, not the greatest possible number of exclusions.

5. Limit heavy and binge alcohol consumption

Reducing alcohol exposure removes a well-established source of intestinal and liver stress.

People who find it difficult to reduce their alcohol intake should seek professional support rather than relying on supplements to offset its effects.

6. Use NSAIDs responsibly

People who require frequent ibuprofen, naproxen, aspirin, or similar medication should discuss gastrointestinal risk with a doctor or pharmacist.

The appropriate strategy depends on the reason for treatment, dose, duration, age, other medications, and medical history.

7. Exercise regularly—but recover properly

Moderate physical activity may support metabolic health, microbial diversity, and intestinal function.

People performing prolonged endurance exercise should also pay attention to:

• hydration;
• heat exposure;
• adequate recovery;
• pre-exercise meal timing;
• sudden increases in training volume;
• gastrointestinal symptoms during exercise.

More exercise is not always better for the intestinal barrier.

8. Protect sleep and manage chronic stress

Sleep deprivation and chronic stress can alter food choices, pain perception, immune activity, intestinal motility, and microbiota-related signalling.

Stress reduction should not be presented as a cure for intestinal disease. Nevertheless, regular sleep, relaxation practices, social support, and appropriate psychological care can be valuable components of a comprehensive digestive-health plan.

9. Do not smoke

Smoking affects circulation, immune function, oxidative stress, and the gastrointestinal tract. Its effects vary between digestive diseases, but it should not be used as a strategy to manipulate symptoms or inflammation.

Can Probiotics, Prebiotics, or Supplements Repair a Leaky Gut?

Possibly in selected situations—but there is no universal supplement protocol.

Probiotics

Probiotics are not interchangeable. Their effects depend on:

• the precise strain;
• the dose;
• treatment duration;
• the condition being treated;
• the person’s existing microbiota;
• concurrent diet and medication.

Evidence supporting one strain for one condition cannot automatically be applied to another strain or another disease.

Prebiotics

Prebiotics can stimulate the growth or activity of selected microorganisms and may increase the production of beneficial metabolites.

However, a 2024 systematic review found limited support for a simple, direct conclusion that prebiotic supplementation reliably reduces intestinal permeability across different populations and testing methods.

Prebiotic foods may still be valuable as part of a varied diet, but the evidence does not justify presenting every prebiotic supplement as a proven “gut-sealing” treatment.

Glutamine

Glutamine is an important fuel for intestinal and immune cells. Supplementation has been studied in critically ill patients, athletes, people receiving certain medical treatments, and selected gastrointestinal conditions.

Results cannot be generalized to every person with bloating or fatigue. Appropriate dose, treatment duration, medical condition, and kidney or liver health must be considered.

Zinc, vitamin D, polyphenols, and omega-3 fatty acids

These nutrients participate in immune regulation and epithelial biology. Correcting a genuine deficiency may support general and intestinal health.

This is different from assuming that high-dose supplementation will repair the intestinal barrier in a person who is not deficient.

“Gut repair” mixtures

Products combining probiotics, glutamine, herbs, enzymes, collagen, vitamins, and fibre may contain useful ingredients, but the mixture itself may not have been clinically tested.

Improvement after using such a product also does not prove that the person previously had abnormal intestinal permeability. Symptoms may change because of fibre intake, altered bowel movements, dietary changes, placebo effects, reduced alcohol consumption, or natural symptom variation.

Can a Leaky Gut Be Healed?

Barrier function can improve when the underlying trigger is removed or treated.

Examples include:

• treating active coeliac disease with a medically appropriate gluten-free diet;
• controlling inflammation in Crohn’s disease or ulcerative colitis;
• recovering from an intestinal infection;
• reducing or stopping heavy alcohol consumption;
• modifying medication under medical supervision;
• correcting severe nutritional deficiencies;
• recovering from extreme physical or physiological stress.

However, the time required and degree of recovery depend on the underlying condition.

It is more scientifically accurate to talk about restoring or supporting intestinal barrier function than promising to “seal” the intestine permanently.

Frequently Asked Questions

Is leaky gut a real medical condition?

Increased intestinal permeability is real. “Leaky gut syndrome,” when used as a broad diagnosis for many nonspecific symptoms, is not currently supported by standardized diagnostic criteria.

Can leaky gut cause autoimmune disease?

Barrier dysfunction may participate in some autoimmune processes, particularly in genetically susceptible people. However, autoimmune diseases result from complex interactions involving genetics, immune regulation, environmental exposures, infections, hormones, and other factors. Increased permeability alone is not a sufficient explanation.

Does bloating mean that the gut is leaking?

No. Bloating is commonly related to fermentation, constipation, altered motility, visceral sensitivity, meal size, swallowed air, or specific carbohydrate intolerances. It does not prove that large molecules are crossing the intestinal barrier.

Should everyone avoid gluten?

No. Gluten must be avoided in coeliac disease and may require restriction in certain other medically evaluated conditions. Removing it without testing can make coeliac disease more difficult to diagnose.

Is a zonulin test enough to diagnose leaky gut?

No. Current commercial zonulin tests have methodological limitations and should not be interpreted as stand-alone proof of increased intestinal permeability.

What is the best diet for intestinal barrier health?

No single diet is best for everyone. The strongest general approach is a nutritionally adequate pattern containing varied plant foods, appropriate fibre, minimally processed foods, and limited heavy alcohol consumption—adjusted for individual tolerance and medical conditions.

The Bottom Line

“Leaky gut” is neither a complete myth nor the universal explanation it is sometimes claimed to be.

Intestinal barrier dysfunction is a genuine biological process that can be measured and is relevant to several gastrointestinal and systemic diseases. At the same time, there is no validated symptom checklist, blood test, stool test, or supplement protocol that can diagnose and treat a broad “leaky gut syndrome” in everyone.

The most responsible approach is to:

1. take persistent symptoms seriously;
2. investigate established medical causes;
3. treat the underlying condition;
4. support the intestinal barrier through a varied diet and sustainable lifestyle;
5. avoid unnecessary restriction and unvalidated testing;
6. remain cautious of products promising to “seal the gut” or cure numerous unrelated diseases.

The intestinal barrier is not a wall that should be completely closed. It is a living, adaptive interface that must continually decide what to absorb, what to tolerate, and what to keep out.

Supporting this system requires more than a single supplement. It requires appropriate nutrition, microbial balance, immune regulation, healthy circulation, recovery, and—when necessary—proper medical treatment.

Bibliography

1. Lacy BE, Wise JL, Cangemi DJ. Leaky Gut Syndrome: Myths and Management. Gastroenterology & Hepatology. 2024;20(5):264–272. (PubMed)
2. Camilleri M. The Leaky Gut: Mechanisms, Measurement and Clinical Implications in Humans. Gut. 2019;68(8):1516–1526. doi:10.1136/gutjnl-2019-318427. (PMC)
3. Vanuytsel T, Tack J, Farré R. The Role of Intestinal Permeability in Gastrointestinal Disorders and Current Methods of Evaluation. Frontiers in Nutrition. 2021;8:717925. doi:10.3389/fnut.2021.717925. (PMC)
4. Di Vincenzo F, Del Gaudio A, Petito V, Lopetuso LR, Scaldaferri F. Gut Microbiota, Intestinal Permeability, and Systemic Inflammation: A Narrative Review. Internal and Emergency Medicine. 2024;19:275–293. doi:10.1007/s11739-023-03374-w. (PMC)
5. Macura B, Kiecka A, Szczepanik M. Intestinal Permeability Disturbances: Causes, Diseases and Therapy. Clinical and Experimental Medicine. 2024;24:232. doi:10.1007/s10238-024-01496-9. (PMC)
6. Dmytriv TR, Storey KB, Lushchak VI. Intestinal Barrier Permeability: The Influence of Gut Microbiota, Nutrition, and Exercise. Frontiers in Physiology. 2024;15:1380713. doi:10.3389/fphys.2024.1380713. (PMC)
7. Khoshbin K, Camilleri M. Effects of Dietary Components on Intestinal Permeability in Health and Disease. American Journal of Physiology—Gastrointestinal and Liver Physiology. 2020;319:G589–G608. doi:10.1152/ajpgi.00245.2020. (PMC)
8. Massier L, Chakaroun R, Kovacs P, Heiker JT. Blurring the Picture in Leaky Gut Research: How Shortcomings of Zonulin as a Biomarker Mislead the Field of Intestinal Permeability. Gut. 2021;70:1801–1802. doi:10.1136/gutjnl-2020-323026. (PMC)
9. Michielan A, D’Incà R. Intestinal Permeability in Inflammatory Bowel Disease: Pathogenesis, Clinical Evaluation, and Therapy of Leaky Gut. Mediators of Inflammation. 2015;2015:628157. doi:10.1155/2015/628157. (PMC)
10. Bjarnason I, Scarpignato C, Holmgren E, Olszewski M, Rainsford KD, Lanas A. Mechanisms of Damage to the Gastrointestinal Tract From Nonsteroidal Anti-Inflammatory Drugs. Gastroenterology. 2018;154(3):500–514. doi:10.1053/j.gastro.2017.10.049. (PubMed)
11. Leclercq S, Cani PD, Neyrinck AM, et al. Role of Intestinal Permeability and Inflammation in the Biological and Behavioral Control of Alcohol-Dependent Subjects. Brain, Behavior, and Immunity. 2012;26(6):911–918. doi:10.1016/j.bbi.2012.04.001. (PubMed)
12. Seethaler B, Nguyen NK, Basrai M, et al. Short-Chain Fatty Acids Are Key Mediators of the Favorable Effects of the Mediterranean Diet on Intestinal Barrier Integrity: Data From the Randomized Controlled LIBRE Trial. American Journal of Clinical Nutrition. 2022;116(4):928–942. doi:10.1093/ajcn/nqac175. (PubMed)
13. Acharya B, Tofthagen M, Maciej-Hulme ML, Suissa MR, Karlsson NG. Limited Support for a Direct Connection Between Prebiotics and Intestinal Permeability—A Systematic Review. Glycoconjugate Journal. 2024;41:323–342. doi:10.1007/s10719-024-10165-8. (PMC)

This article is intended for educational purposes and does not replace medical diagnosis or individualized treatment. Persistent, severe, or unexplained symptoms should be discussed with a qualified healthcare professional.