Morning everyone! 

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. Today I am going to talk about Gut Binders.  

Gut binders are medicines (mostly herbal and non-prescription) that cling to the mucosal lining of your GI Tract and grab toxins out of your gut as they pass through. They are essential if you have gut problems.

Let’s dive in. 


It Starts With The Gut


I treat a lot of gut problems in my practice. It is a huge part of functional medicine. Things like autoimmune diseases and chronic fatigue, chronic diarrhea, IBS, constipation, inflammatory bowel disease, food intolerances, etc, all start with the gut. 

Problems like: 

  • IBS (Irritable Bowel Syndrome) 
  • IBS/D (Irritable Bowel Syndrome Diarrhea)
  • SIBO
  • Crohn’s Disease 
  • Ulcerative Colitis   
  • Celiac Disease 

It’s all a spectrum. 


Why We Need Gut Binders


Gut binders can relieve diarrhea, gas, constipation, bloating, and SIBO. These substances bind to toxins and pathogens (things like pathogenic bacteria, fungus, molds, parasites, and even Lyme’s Disease) and sweep them out of your system. It’s detoxing!

Over the years our gut gets damaged due to a lot of different things (i.e., inflammatory substances you get from eating certain foods). This is where binders come in. They take a lot of pressure off of your liver. The longer a toxin stays in your circulation, the more chance it has to trigger a lifelong autoimmune disease. It also decreases your overall energy. These toxins compete with other organs for energy.  

Your liver is actually your main organ for detoxification. It creates bile (a digestive fluid that flows from your liver through your intestines and stored in the gallbladder) and helps break down fats and digest food for absorption. If your body has too many toxins, your liver is compromised (think fatty liver, alcohol liver, and some medicines can even cause problems). Your liver can become overtaxed. 

Not many toxins are fat soluble, so they enter the bile. In a perfect world, these toxins would all be carried out by the bile, but the gut lining is made of delicate tissues and veins that can pick up these toxins and recirculate them. This is called enterohepatic recirculation. Food plays a big part in upsetting that gut lining. There are a lot of people with food intolerances: gluten, dairy, corn, night shades, and soy to name a few. 

Here’s another complicating factor. Many gut pathogens in the body (pathogenic bacteria, fungus, parasites) depend on heavy metals to stay alive. These pathogens use heavy metals to create biofilm, which is like a shelter for them. It’s a house they live in. Biofilm is created from polysaccharides, proteins, DNA, minerals, and heavy metals themselves. If you’re trying to destroy a pathogen with the biofilm still intact, you’re going to have an unpleasant detox reaction. So that’s another reason to eat the right kinds of foods (think the FODMAP diet) and use gentle binders at first. Binders will help that unpleasant die off when you’re detoxing. 


Types of Gut Binders 


There are prescription binders and natural binders. How severe and acute the problem is determines which binders I use. Remember we live in a toxic world. Toxins are a problem for all of us. It’s impossible to avoid them. A lot of people are poor methylators. They have the bad MTHFR mutation like I do. People with MTHFR problems don’t detox well. 

PRESCRIPTION BINDERS: The most potent binder we use is a prescription called Cholestyramine. 

Cholestyramine is a cholesterol lowering medication that is also used as a binder. It is used for conditions like IBS/D and BAM (Bile Acid Malabsorption). Half of the time IBS/D and BAM might be the same disorder, so you want to get to the root of the problem. Cholestyramine binds up bile acids that contain toxins and removes them from the body. It works great for mold as well. One side effect is that it can cause constipation. 

Note: Cholestyramine is a prescription medicine that requires monitoring from your physician. It is for serious gut issues. You don’t want to take this long term unless you are using it for cholesterol lowering. 

NATURAL BINDERS: Sometimes I will start out with milder binders. 

Bentonite and Zeolite clay are two different minerals that work great for soaking up toxins and metals. They also work great for easing you into detox. Note: These two work well together. 

Activated Charcoal is a must have for your home medical kit. It’s better for acute situations versus something long term. Activated charcoal is used for food poisoning, traveler’s diarrhea, acute poisoning and overdoses in the Emergency Room, and excess gas. This is over-the-counter. 

Chlorella is one you should probably add to your daily supplement list. It’s a blue green algae, rich in vitamins, minerals, and amino acids. It’s good for metal detox (i.e., when you remove mercury amalgams from your teeth). 

Pectin comes from fruits. It’s very mild and works well in combination with other binders. 

Humic and fulvic acids come from decomposed plants. They are gentle and you can take them with food. Note: Most of these other binders you should take on an empty stomach. 

Silica is great for metals, especially aluminum (think Alzheimer’s). It’s safe and won’t deplete your minerals. 

Chitosan is a fibrous compound derived from crustacean shellfish. This is in DigestShield, which is the best overall gut supplement I’ve found. 

Aloe Vera is gentle and doesn’t cause constipation. It also contains many vitamins. It’s used in combination with other binders and is safe and effective. 


Final Tips 


  1. Start slow. I really like Chlorella. This is one I’ve added to my rotation, especially since I have the MTHFR mutation. 
  2. Drink a lot of water!
  3. Most of these binders should be taken on an empty stomach. Be sure to read the label. 
  4. Consider taking binders at night. Your body restores and repairs at night. Note: Don’t take your nighttime magnesium close to taking your binder. 
  5. Cholestyramine needs to be taken one hour before or two hours after eating food or taking supplements. 
  6. You may want to cycle your binders. You can periodically change the binders that you take. 
  7. Watch for side effects, i.e., constipation and mineral depletion. This is why you want to increase your water intake and maybe even add an electrolyte solution. Magnesium also helps constipation, just don’t take it with your binder. 

LISTEN TO YOUR GUT. It is important to have normal bowel movements. If you are experiencing a lot of gas, heartburn, and indigestion, these are signs that you have a gut problem. 

If this sounds like you, the first step I would take is to get a stool test called a GI Map for a baseline to find out why. Then I would start taking DigestShield, add Chlorella to my supplement list, and try a low FODMAP diet. 

Hope this helps. Till next week.