Are Lectins Bad for You—and Are They Bad for Dry Eye Disease? A 2026 Evidence Review

As a fellow surgeon, I do respect Dr. Steven Gundry and his anti‑lectin diet. I know a number of physicians and surgeons who trust his guidance, largely because he was a cardiothoracic surgeon. As the daughter of a cardiothoracic surgeon, I know how hard that life is, and I know he has been studying this area for years.

I generally follow all his rules, but I wanted to do an updated review to see what has actually been proven about the lectin theory in 2026. It remains controversial, as there are still no randomized, double‑blinded, controlled trials on lectins. As you know, such studies would be extremely difficult and expensive to conduct. It will likely take years before we have “hard science” proving whether lectins are truly inflammatory. Still, I do believe he is right, and I personally avoid lectins for myself and my family.

Below is a summary of what the current medical literature does—and does not—show about lectins, inflammation, and dry eye disease.

What Are Lectins?

Lectins are carbohydrate‑binding proteins found in many plant foods. They have a dual nature:

• Some lectins may trigger inflammatory responses.

• Others appear to have immunomodulatory or even beneficial effects.

A 2024 review highlights this complexity:

• Phytohemagglutinin (found in raw or undercooked beans) has been associated with inflammatory responses and possible autoimmune links.[1]

• Lectins from butterfly peas and pink bauhinia show immunomodulatory properties that may support immune function.[1]

• Wheat lectin may actually improve nutrient absorption.[1]

• Mushroom lectins are generally nontoxic and may support immune regulation.[1]

Bottom line:

The medical literature does not support the idea that lectins are universally harmful. Nor does it identify specific foods or medications that meaningfully “reduce lectin levels” for disease treatment.

Do Lectins Affect Dry Eye Disease?

This is the key question many patients ask.

Current evidence shows no link between lectins and dry eye disease or Meibomian gland dysfunction (MGD).

The established pathways of dry eye include:[2][3][4]

• Tear film instability

• Hyperosmolarity

• Ocular surface inflammation

• Meibomian gland obstruction

• Neuropathic components in some patients

Lectins are not identified as contributors in any of these mechanisms.

So while lectins may influence systemic inflammation in some individuals, there is no evidence that they worsen dry eye disease or MGD.

Inflammation in Meibomian Gland Dysfunction

MGD is well‑documented as an inflammatory condition. Studies have identified elevated levels of inflammatory markers such as:

• Matrix metalloproteinases (e.g., MMP‑9)[9]

• Cytokines

• Transglutaminase 2[9]

These inflammatory pathways are well‑established, but none of them involve lectins.

Evidence‑Based Treatments for MGD

Here is what the literature does support for managing Meibomian gland dysfunction:

Pharmaceutical Treatments

• Topical cyclosporine – reduces T‑cell activation and cytokine production[5][6] aka Restasis, Vevye, Cequa

• Lifitegrast – an integrin antagonist approved for dry eye disease[7][5] aka Xiidra

• Corticosteroids – short‑term use for severe inflammation (e.g., loteprednol)[8][9]

• Oral antibiotics – doxycycline and azithromycin for anti‑inflammatory effects[8][10][11]

• Topical azithromycin – improves lid flora and reduces inflammation[8][10]

• Omega‑3 fatty acids – may help, though evidence is mixed and continues to evolve[8][12][13][6]

Non‑Pharmaceutical Treatments

• Warm compresses

• Lid hygiene

• Tea tree oil for Demodex

• In‑office procedures (thermal pulsation, IPL, probing)[8][10][11]

-PRP eye drops, Autologous serum eye drops, Amniotic membrane, 

What is NOT supported

There are no medications or treatments shown to reduce “lectin effects” on the eye, because lectins are not established contributors to dry eye or MGD.

So—Should You Avoid Lectins for Eye Health?

From a dry eye perspective, there is no evidence that lectins worsen symptoms or contribute to disease pathways.

From a whole‑body perspective, lectins remain an area of active debate. Some individuals feel better avoiding them, and some lectins clearly have inflammatory potential. Others appear beneficial.

Given the lack of definitive trials, it is reasonable for patients to experiment with dietary lectin reduction if they feel it helps—but not as a treatment for dry eye disease, because the evidence simply isn’t there.

Do I generally stay away from lectin rich foods? Yes I generally do and I try to avoid feeding it to my children until more research is available.

References

1. From Inflammation to Immune Regulation: The Dual Nature of Dietary Lectins in Health and Disease. Konozy EHE, Osman MEM. Heliyon. 2024;10(20):e39471.

2. Messmer EM. Pathophysiology of Dry Eye Disease and Novel Therapeutic Targets. Experimental Eye Research. 2022;217:108944.

3. Baudouin C, Messmer EM, Aragona P, et al. Revisiting the Vicious Circle of Dry Eye Disease. Br J Ophthalmol. 2016;100(3):300‑6.

4. Chhadva P, Goldhardt R, Galor A. Meibomian Gland Disease. Ophthalmology. 2017;124(11S):S20‑S26.

5. Pflugfelder SC, de Paiva CS. The Pathophysiology of Dry Eye Disease. Ophthalmology. 2017;124(11S):S4‑S13.

6. Perez VL, Mah FS, Willcox M, Pflugfelder S. Anti‑Inflammatories in Dry Eye Disease. J Ocul Pharmacol Ther. 2023;39(2):89‑101.

7. FDA Orange Book.

8. Thode AR, Latkany RA. Therapeutic Strategies for MGD. Drugs. 2015;75(11):1177‑85.

9. Aragona P, Aguennouz M, Rania L, et al. MMP‑9 and TG2 in Dry Eye. Ophthalmology. 2015;122(1):62‑71.

10. Sabeti S, Kheirkhah A, Yin J, Dana R. Management of MGD. Surv Ophthalmol. 2020;65(2):205‑217.

11. Villani E, Marelli L, Dellavalle A, et al. Latest Evidence on MGD. Ocular Surface. 2020;18(4):871‑892.

12. Eom Y, Jun I, Jeon HS, et al. Omega‑3 Trial in MGD. JAMA Ophthalmology. 2024;142(7):617‑624.

13. Clayton JA. Dry Eye. NEJM. 2018;378(23):2212‑2223.