Almanac A1C

The Guide to Gut Repair and Microbiome Restoration

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A1C Medical Writer 2

Table of Contents
Keywords: , , , , , , , , , , , ,
SupplementPropertiesIndicationsDosageContraindicationSide EffectsSynergistic Combinations
L-GlutamineL-glutamine is a conditionally essential amino acid that acts as a major fuel source for cells lining the gut and is crucial for maintaining the integrity of the intestinal barrier and as fuel for enterocytes [1,2].Leaky gut, IBD, gut repair, stress gut [1,2]5-15g daily, divided doses [2,3]Cirrhosis, epilepsy, hepatic , encephalopathy, some cancers, pregnancy/breastfeeding-avoid high dose [3]Safe within dose; high dose: GI upset, altered amino acid balance, ammonia build-up [3,4]Vitamin C, zinc, omega-3, collagen [2]
Multi-Strain ProbioticRestore microbiota, inhibit pathogens, modulate immune [5].
A multi-strain probiotic supplement is a blend of several beneficial bacterial strains designed to enhance gut health by restoring microbial balance, supporting digestion, inhibiting harmful pathogens, and boost immune function.		Dysbiosis, IBS, IBD, antibiotic, diarrhea [5,6]Strain specific, often 10-30bn CFU daily [6]Immunocompromised host: risk of infection: severe illness caution [5]Bloating, gas; rare: infection in high-risk patientsPrebiotics (e.g., inulin), zinc, synbiotics [5]
Saccharomyces boulardiiProbiotic yeast supplements that helps restore and balance gut microbiota, reduce the risk and duration of diarrhea, and anti- pathogenic, supports flora [7,8]Antibiotic-associated diarrhea, C.diff, IBD [7,8]250-500mg, 1-2x daily (about 5–20 billion CFU total per day) [8]Immunocompromised (fungemia risk), critical illness [7]Very safe; rare cases: yeast infection in severely illCombines well with other probiotics [7]
Zinc CarnosineZinc carnosine is a chelated compound of zinc and L-carnosine that helps stabilize and repair the stomach and intestinal lining, promoting healing of gastric ulcer and reduction of gastrointestinal inflammation through antioxidant and mucosal-protective actions  [9,10].Gastritis, ulcers, mucosal damage [9,10]37.5 mg twice daily (as PepZinGI) [10]Wilson’s disease/ other zinc excess disorders; excess zinc can interfere with copper [10]Nausea at high doses, copper deficiency long-term [10]Synergistic with probiotics, glutamine [9]
DGL (Deglycyrrhizinated Licoirice)DGL is a specially processed form of licorice root that soothes and protects the digestive tract, promotes healing of ulcers and mucosal tissue, helps reduce symptoms of acid reflux and indigestion by enhancing the natural mucus lining without the blood pressure-raising effects of natural licorice [11,12].GERD, functional dyspepsia, mucosal healing [11,12]380 mg tabs before meals, up to 3x daily [12]Avoid non-deglycyrrhizinated if hypertension/kidney/heart issues (mineralocorticoid effect in raw licorice); DGL is safer [11,12]DGL: generally safe. Raw: sodium retention, hypertension not seen with DGL [11]DGL and glutamine for ulcers, probiotics for gut repair
Butyrate (Na/Ca/Mg)SCFA that help nourish the cell lining the colon, strengthen the gut barrier, reduce inflammation, enhance microbiome diversity and support overall digestive and immune health [13,14].IBS, IBD, microbiome support, leaky gut [13,14]300-1,200mg (NaB) daily; varies by form [14]No major reported; may aggravate certain conditions when used with chemotherapeutics [13,14]GI upset, rare allergySynbiotics, probiotics [13]
Slippery ElmMucilage forms barrier, demulcent, mild anti-inflammation [15,16]GERD, IBS, mild gut discomfort [15,16]Powder: 1-2g/day in water, 1-3x/day [16]None reported, but may interfere with absorption of meds-space dosing by at least 1 hr [16]Rare: nausea, allergy; safe for most [15,16]Marshmallow root, DGL, probiotics
Marshmallow RootHerbal supplement rich in mucilage that soothes and protects irritated tissues in the digestive tract, helping to relieve symptoms of indigestion, acid reflux, constipation, and inflammatory bowel conditions by forming a protective, anti-inflammatory barrier along the gut lining [17,18].Gastritis, ulcers, cough, sore throat [18]2-5g dried root/day, or as tea [17,`8]May increase bleeding risk, caution pre-surgery, allergy; pregnancy/breastfeeding- insufficient data [18]Usually safe; allergy, low risk of adverse effects [18]Slippery elm, DGL, Glutamine
Digestive EnzymesContain natural or synthetic enzymes that help break down proteins, carbohydrates, and fats in food, supporting nutrient absorption and relieving symptoms like bloating, gas, and indigestion, especially in people with enzyme deficiencies or certain digestive disorders.Maldigestion, pancreatic insufficiency, bloatingAccording to product, varies by formulaAllergy to components (e.g., fungal, animal, plant origin); GI ulcers-cautionGI upset, sometimes allergic reactionBetaine HCL, probiotics
Betaine HCLIncreases stomach acid (HCL), improving the breakdown and absorption of nutrients-especially proteins-in people with low stomach acid, thereby relieving symptoms like bloating, indigestion, and nutrient deficiencies.Low stomach acid, indigestion, SIBO325-650mg before meals, titrate by needUlcers, gastritis, GERD: risk of irritation; not for children or those with normal/high stomach acidHeartburn, GI discomfortDigestive enzymes, pepsin

Notes

  • Dosages are general and may vary by product/individual needs; always check individual manufacturer instructions or seek clinical guidance
  • Synergies often come from protocols in “gut healing,” e.g., glutamine with zinc, or DGL with mucilaginous herbs like slippery elm
  • Do not substitute this information for medical advice; review with a healthcare provider if you have chronic health issues or are taking medication

References

  1. L-Glutamine [Internet]. go.drugbank.com. Available from: https://go.drugbank.com/drugs/DB00130
  2. L-Glutamine for Skin Health: Benefits, Dosage & Gut Support [Internet]. Kaya.in. 2025 [cited 2025 Aug 5]. Available from: https://www.kaya.in/blog/l-glutamine-skin-health-benefits-dosage
  3. Cleveland Clinic. What Is Glutamine? [Internet]. Cleveland Clinic. 2024. Available from: https://my.clevelandclinic.org/health/articles/glutamine
  4. Holecek M. Side Effects of Long-Term Glutamine Supplementation. Journal of Parenteral and Enteral Nutrition. 2012 Sep 18;37(5):607–16.
  5. Kwoji ID, Aiyegoro OA, Okpeku M, Adeleke MA. Multi-Strain Probiotics: Synergy among Isolates Enhances Biological Activities. Biology [Internet]. 2021 Apr 1;10(4):322. Available from: https://www.mdpi.com/2079-7737/10/4/322/htm
  6. Ibrahim A, Ali RAR, Manaf MRA, Ahmad N, Tajurruddin FW, Qin WZ, et al. Multi-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial. PLOS ONE [Internet]. 2020 Dec 31 [cited 2021 May 11];15(12):e0244680. Available from: https://pubmed.ncbi.nlm.nih.gov/33382780/
  7. Kelesidis T, Pothoulakis C. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders. Therapeutic Advances in Gastroenterology [Internet]. 2012 Mar 1;5(2):111–25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296087/
  8. Saccharomyces Boulardii: Uses, Side Effects, Interactions, Dosage, and Warning [Internet]. www.webmd.com. Available from: https://www.webmd.com/vitamins/ai/ingredientmono-332/saccharomyces-boulardii
  9. Hewlings S, Kalman D. A Review of Zinc-L-Carnosine and Its Positive Effects on Oral Mucositis, Taste Disorders, and Gastrointestinal Disorders. Nutrients. 2020 Feb 29;12(3):665.
  10. Mahmood A, FitzGerald AJ, Marchbank T, Ntatsaki E, Murray D, Ghosh S, et al. Zinc carnosine, a health food supplement that stabilises small bowel integrity and stimulates gut repair processes. Gut [Internet]. 2007 Feb 1;56(2):168–75. Available from: https://pubmed.ncbi.nlm.nih.gov/16777920/
  11. Yeh A, Golianu B. Integrative Treatment of Reflux and Functional Dyspepsia in Children. Children. 2014 Aug 18;1(2):119–33.
  12. Wahab S, Annadurai S, Abullais SS, Das G, Ahmad W, Ahmad MF, et al. Glycyrrhiza glabra (Licorice): A Comprehensive Review on Its Phytochemistry, Biological Activities, Clinical Evidence and Toxicology. Plants [Internet]. 2021 Dec 14;10(12):2751. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8703329/
  13. Eladwy RA, Alsherbiny MA, Chang D, Fares M, Li CG, Bhuyan DJ. The postbiotic sodium butyrate synergizes the antiproliferative effects of dexamethasone against the AGS gastric adenocarcinoma cells. Frontiers in Nutrition. 2024 Mar 12;11.
  14. Cao S, Budina E, Raczy MM, Solanki A, Nguyen M, Beckman TN, et al. A serine-conjugated butyrate prodrug with high oral bioavailability suppresses autoimmune arthritis and neuroinflammation in mice. Nature biomedical engineering. 2024 Apr 1;
  15. Griffin RM. Slippery Elm: Uses and Risks [Internet]. WebMD. Available from: https://www.webmd.com/vitamins-and-supplements/slippery-elm-uses-and-risks
  16. What Slippery Elm Can Help You With [Internet]. Verywell Health. Available from: https://www.verywellhealth.com/the-benefits-of-slippery-elm-89585
  17. Marshmallow Root: Benefits, Side Effects, and More [Internet]. Healthline. 2017. Available from: https://www.healthline.com/health/food-nutrition/marshmallow-root
  18. Marshmallow: Uses, Side Effects, Interactions, Dosage, and Warning [Internet]. Webmd.com. 2019. Available from: https://www.webmd.com/vitamins/ai/ingredientmono-774/marshmallow