Zonulin Why To Test

Zonulin Why To Test

$103.20

Who Should Be Testing Fecal Zonulin levels?

Any person with autoimmune disease or immune-mediated conditions like:

Autoimmune diseases like:

Fatigue, Low Energy
Celiac disease
Leaky Gut
Ankylosing spondylitis
Inflammatory bowel disease (IBS, IBD, SIBO, Chron’s Colitis)
Type 1 diabetes
Rheumatoid arthritis
Systemic lupus erythematous

Neurological diseases

Multiple sclerosis
Chronic inflammatory demyelinating polyneuropathy
Schizophrenia

Cancers:

Brain (gliomas)
Breast
Lung adenocarcinoma
Ovarian, PCOS
Pancreatic

Fecal Zonulin

This stool panel is a comprehensive collection of microbial targets as well as immune and
digestive markers. It screens for pathogenic bacteria, commensal bacteria, opportunistic
pathogens, fungi, viruses, and parasites. It primarily uses multiplex, automated, DNA analysis to
give integrative and functional medicine practitioners a better view into the gastrointestinal
microbiome.
Zonulin is a protein secreted by intestinal cells that regulates intercellular tight junctions (1, 2).
Tight junctions are the connections between epithelial cells that make up the gastrointestinal
lining. Zonulin increases intestinal permeability in the jejunum and ileum (3) and is considered a
biomarker for barrier permeability (1, 2). Tight junctions can be opened or closed, depending
on the physiological need. Zonulin’s role is to open tight junctions in the gut. In the case of
enteric infections, high zonulin can “open the floodgates” and flush out bacteria and toxins (1).
Certain gut bacteria and gliadin (the main staple protein from wheat) can activate the zonulin
system (2, 4).
The intestinal barrier is a critical interface between the lumen of the gut and the internal milieu.
Dysfunction of this barrier is believed to initiate immune dysfunction because it allows
macromolecules from the gut lumen to pass into the bloodstream (5). Intestinal permeability,
also known as “leaky gut,” has been associated with inflammatory bowel disease, celiac
disease, food allergy, irritable bowel syndrome, critical illness, autoimmune diseases (6) and
obesity and metabolic disease (7). In many cases, permeability precedes disease (1).
Zonulin regulates barrier permeability. Serum zonulin correlates with intestinal permeability
and lactulose/mannitol tests for intestinal permeability (3, 8). High serum zonulin has been
associated with celiac disease, type 1 diabetes (8) insulin resistance and type I diabetes (3),
cancers, neurological conditions, and autoimmune diseases (see Table 1) (1).
Zonulin has been used as a biomarker of impaired gut barrier function in
autoimmune, neurodegenerative, and metabolic diseases

References
1. Fasano A. Intestinal permeability and its regulation by zonulin: diagnostic and therapeutic implications. Clinical
gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological
Association. 2012;10(10):1096-1100.
2. Lamprecht M, Bogner S, Schippinger G, et al. Probiotic supplementation affects markers of intestinal barrier,
oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. Journal of the
International Society of Sports Nutrition. 2012;9(1):45.
3. Stenman LK, Lehtinen MJ, Meland N, et al. Probiotic With or Without Fiber Controls Body Fat Mass, Associated
With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial. EBioMedicine. 2016;13:190-200.
4. Fasano A, Sapone A, Zevallos V, Schuppan D. Nonceliac gluten sensitivity. Gastroenterology. 2015;148(6):1195-
1204.
5. Fasano A. Leaky gut and autoimmune diseases. Clinical reviews in allergy & immunology. 2012;42(1):71-78.
6. Fasano A. Physiological, pathological, and therapeutic implications of zonulin-mediated intestinal barrier
modulation: living life on the edge of the wall. The American journal of pathology.2008;173(5):1243-1252.
7. Bischoff SC, Barbara G, Buurman W, et al. Intestinal permeability--a new target for disease prevention and
therapy. BMC gastroenterology. 2014;14:189.
8. Wang L, Llorente C, Hartmann P, Yang AM, Chen P, Schnabl B. Methods to determine intestinal permeability and
bacterial translocation during liver disease. J Immunol Methods.2015;421:44-53.
9. Wang W, Uzzau S, Goldblum SE, Fasano A. Human zonulin, a potential modulator of intestinal tight
junctions. Journal of cell science. 2000;113 Pt 24:4435-4440.

10. Lamprecht M, Bogner S, Steinbauer K, et al. Effects of zeolite supplementation on parameters of intestinal barrier
integrity, inflammation, redoxbiology and performance in aerobically trained subjects. Journal of the International
Society of Sports Nutrition. 2015;12:40.

Collection Instructions

Step 1 – Please write your name and date of birth on the capped vial.
Step 2 – If possible void urine prior to collecting stool. Collect stool by passing stool onto Collection
tray.
Step 3 – Using the spoon attached to the cap of the vial, spoon stool from different areas of the
sample into the vial. Fill vial to the red fill line. Just over half full.
Step 4 – Carefully mix stool and fluid with the spoon. Replace cap tightly and shake vial vigorously
for 30 seconds.
Step 5 – Place cap vial into ziplock specimen bag along with absorbent pad. Seal the bag. Place the
specimen bag with the sample vial into the kit box.
Step 6 – Place Test Request Form into the box with the sample and ship to laboratory. See shipping
instructions below. **
**If you cannot ship the specimen on the day of collection please refrigerate the sample by
placing the box containing the sample into the refrigerator.

Do you need to stop taking any of your medications before you collect your stool sample?

No. Please continue taking all medications as directed by your doctor.

Shipping Instructions

Specimens may be shipped Monday through Friday. The lab receives specimens 5 days a week.
We only require that the specimen be received within 6 days after collection.
Before shipping be sure that the cap vial and the Test Request Form are labeled and completely
filled out. Be sure the sample vial sealed in the ziplock bag and that the Test Request Form are in
the Kit box.

Locate the FedEx Clinical Pak mailer. Fill in your name and address on the shipping label attached
to the outside of mailer.
Place kit box into FedEx Clinical Pak. Remove strip to reveal sticky film and press both sides of
mailer together to seal the pouch.
Call FedEx to schedule a pick-up. Dial 1-800-238-5355. When the automated greeting begins
say “Rep”. When asked if you are shipping a package say “Yes”. A live person will then answer to
help schedule your pickup. Let them know you are shipping using a Billable Stamp.

Can you ship your specimen on Friday?

Yes, it is ok to ship specimens to the lab on Friday. The lab receives specimens 6 days a week. We only require that the specimen be received within 6 days after collection.

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