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All tests

Gut · Stool

Zonulin (feces)

A protein linked to the permeability of the bowel wall; not validated and does not demonstrate a "leaky gut".

At a glance

  • Measured in stool
  • In 7 test panels
  • No special preparation

Zonulin (feces)

  • Explanation
  • Result
  • Reliability
  • Who it is for
  • Test panels
  • Sources

Explanation

Zonulin (feces): what is measured?

Zonulin is a protein that can loosen the connections between the cells of the bowel wall, making the wall more permeable. In scientific research it is used to study this permeability, including in celiac disease. The test measures a substance referred to as zonulin in a stool sample. Research has shown that widely used zonulin tests measure not only zonulin but also related proteins.

What can it detect?

  • Permeability of the bowel wall, as studied in scientific research; not a recognized diagnosis

Result

What does the result mean?

Zonulin (feces) too high

A raised value is often explained as a "leaky gut", but that is not a recognized diagnosis and this measurement cannot make such a diagnosis. There is no condition for which zonulin in stool is used to make a diagnosis or choose a treatment. The value can differ greatly between tests and between laboratories. A raised value does not on its own call for a diet, supplements or treatment.

Zonulin (feces) too low

A low value has no known meaning. It does not rule out any bowel condition.

After an abnormal result

With an abnormal result without symptoms, no follow-up is usually needed. With bowel symptoms, the GP can request calprotectin in the stool and blood tests, and refer you to a gastroenterologist if there are signs of a chronic inflammation of the bowel.

Reliability

How reliable is the test?

Zonulin, in blood or in stool, is a measurement from scientific research and is not validated for making a diagnosis. Research showed that widely used zonulin tests also measure other proteins, so it is not certain what the result reflects. A "leaky gut" is not a recognized diagnosis.

What can affect the result?

  • Widely used tests do not measure only zonulin; results from different tests are not comparable.
  • The value differs from day to day and depends on diet and the firmness of the stool.
  • There are no cut-off values established in a guideline or in independent research.

Who it is for

Who is the test useful for?

Useful for

In people without symptoms, an abnormal result says little, because the meaning has not been established and a passing infection or a painkiller can raise the value. With long-lasting diarrhea or abdominal symptoms, the GP uses calprotectin in the stool to rule out a chronic inflammation of the bowel, and a blood test if celiac disease is suspected. With blood in the stool, unintended weight loss, diarrhea at night or new bowel symptoms after age 50, this test is no substitute for a visit to the GP.

How common is it?

Bowel symptoms are common: according to the guideline, irritable bowel syndrome affects about 4 in 100 adults in the Netherlands. Chronic inflammatory bowel diseases such as Crohn's disease and ulcerative colitis are much rarer; the guideline gives no Dutch figure for them. How often an abnormal result for these markers occurs in people without symptoms is not known.

Dutch medical specialists' guideline (FMS) on irritable bowel syndrome (NHG and NVMDL)

Get tested

Zonulin (feces): test panels

Zonulin (feces) is part of these test panels. You order online and have your blood drawn at a collection point or collect the sample at home.

  • 4D Basic Package

    Stool

    4D Basic Package

    Comprehensive basic analysis of intestinal health, including activity measurements and biomarkers.

    € 625,00

  • 4D Specialist package

    Stool

    4D Specialist package

    Comprehensive gut health analysis for patients with complex health problems.

    € 975,00

  • 4D Extended package

    Stool

    4D Extended package

    In-depth investigation of gut health, biodiversity, and biomarkers for persistent complaints.

    € 750,00

  • Basic bowel screening

    Stool

    Basic bowel screening

    Investigation of gut microbiota, digestion, inflammation, Leaky Gut, dysbiosis, and food allergy.

    € 335,00

  • Closed Gut/Leaky Gut screening and mucosal immunity

    Stool

    Closed Gut/Leaky Gut screening and mucosal immunity

    Distinguishes Closed Gut from Leaky Gut. Analyzes mucosal integrity and gut immunity.

    € 285,00

  • Gut therapy screening

    Stool

    Gut therapy screening

    Comprehensive screening of intestinal function and microbiome. Includes 15+ test parameters.

    € 900,00

  • Zonulin

    Stool

    Zonulin

    Measure zonulin in stool. Indication for intestinal wall integrity and leaky gut syndrome.

    € 140,00

Evidence

Sources

This explanation is based on Dutch guidelines and independent information. It is general information, not a diagnosis. Discuss an abnormal result with your GP.

More about risks and results
  • FMS Richtlijnendatabase: Prikkelbaredarmsyndroom, module Gebruik calprotectine-test
  • NHG-Standaard Prikkelbaredarmsyndroom (PDS)
  • NVKC, allesovertesten.nl: Calprotectine
  • Thuisarts.nl: Ik krijg onderzoek om uit te zoeken of ik de ziekte van Crohn heb

More explanations

Other tests: Gut

  • Acetate and propionate production
  • Acetate- and propionate-forming bacteria
  • Acetic acid (feces)
  • Acetic acid, relative (feces)
  • Akkermansia, activity
  • Alpha-1 antitrypsin (feces)
  • Anti-gliadin IgA (feces)
  • Anti-transglutaminase IgA (feces)
  • Aspergillus fumigatus (feces)
  • Aspergillus niger (feces)
  • Bacteroides group, activity
  • Beta-defensin 2 (feces)
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