Place a large skillet over medium heat.
Add the sausage and cook, using a spoon or spatula to break it into small crumbles, until it is completely browned and cooked through, about 8-10 minutes.
Do not drain the grease.
Reduce the heat to low.
Sprinkle the xanthan gum evenly over the sausage, then pour in the heavy cream and water.
Whisk everything together immediately to prevent the xanthan gum from clumping.
Continue to cook, stirring frequently, for about 10 minutes as the gravy simmers and thickens to your desired consistency. If the gravy becomes too thick, stir in a tablespoon of water at a time to thin it out.
Season generously with salt and black pepper to taste.
Serve immediately over warm biscuits or scrambled eggs.