Evidence check: Leaky Gut Test in the context of Wechseljahre

The so-called 'Leaky Gut Test' (intestinal permeability test) is often marketed in the context of menopause because hormonal shifts may affect the gut barrier. However, the scientific evidence for routine use of such tests is weak. Measurements of gut permeability (e.g., lactulose/mannitol test) are used in research, but for clinical practice in menopausal complaints, validated cutoffs and prospective studies are lacking. Many direct-to-consumer tests rely on biomarkers like zonulin, whose specificity is controversial. Zonulin levels can be influenced by diet, medications, and inflammation without necessarily indicating pathological 'leaky gut.' During menopause, digestive issues are common and multifactorial (hormones, stress, diet). A positive test may lead to unnecessary diets or supplements without proven causal benefit. The evidence base is largely mechanistic and marketing-driven. Clinical guidelines do not recommend routine leaky gut diagnostics. Instead, symptoms like bloating or food intolerances should be evaluated specifically. A sensible approach is to support gut health through balanced nutrition, evidence-based probiotics, and stress management, without relying on unvalidated tests.