No one would argue that healthcare and medicine are ever-growing, as they should be: with advancing research, comes change. Most of this change is built upon itself; research begets more research, thus advancing information about how our body works and how we can help heal it. Who would believe in this day and age that discoveries could still be made about the function of the human body that are so profound they could change our understanding of how the body functions, perhaps eventually changing nearly every facet of medicine? Believe it or not, this shift might not be too far off, as more and more research is focusing not on the human body itself, but the human body as an ecosystem, or microbiome, and how the coordination of all of the bacteria and microorganisms (our flora) that we host affect our systems, immunity, and everyday function.

Studying the microbiome — a term originally used to describe the DNA of bacteria that we host, but is now commonly used to encompass the study of the DNA and bacteria themselves — has become a hot research topic, and with good reason. It is estimated that our digestive tract alone hosts trillions of bacteria of about 1,000 different species. Considering that each has its own DNA, it is thought that the DNA of the bacteria we harbor outnumbers our own by as much as 5 to 1.

So do all of these functioning organisms within our system affect our health? Probably. Current studies from around the world suggest that a healthy microbiome can decrease incidence of diseases like irritable bowel syndrome, inflammatory bowel disease, diabetes, Parkinson’s, Alzheimer’s, autism, depression, cardiovascular disease, colon cancer, and more. Take Alzheimer’s research for example. Researchers have found that certain bacteria produce chemicals which look identical to human transmitters (messaging systems in the body). It is proposed that understanding this production, which good bacteria are producing these neurotransmitters, and assuring people have appropriate levels in their bodies, could change the rate of loss leading to dementia. Similar studies could change the need for anti-depressants and other mood-supporting agents. And this is just one system of the body. We also know that good bacteria help us to digest, extract nutrients from our food, manage our appetite, kill bad bacteria, improve immunity, and control inflammation attributable to heart disease. The list goes on and on. Until recently, much of medicine has focused on killing bacteria and other microorganisms, not determining whether we should support them. This is not to say this was completely in error. Antibiotics have been and continue to be a necessary and successful treatment to control infectious diseases, but they are non-specific and also kill much of our good flora along with the bad. Until this research emerged, we had not thought to replace this flora or had much concern for depleting it. We either categorized bacteria as infectious or non-harmful, but not as helpful.

Consider that most children are given an average of 15- 20 antibiotics before they are grown, greatly altering good flora; we now know that this could be setting them up for bowel disease, impaired immunity, depression, cardiovascular disease and other diseases prominent in our culture during adulthood. Could we prevent these diseases with more controlled use of antimicrobials and antibiotics? Could we decrease them with proper good flora replacement? This is why a complete shift of human health and medicine may be looming.

But, and this is a big but, so far none of it is conclusive and much of it is highly speculative. This is exciting research and we should all be watching the results, but other than trying to cultivate a generally healthy flora, we don’t know much beyond that for now.

There are now tests available for measuring the components of your microbiome. However, there are questions about reproducibility (whether you would get the same results on any particular sample multiple times). It is also thought that your bacteria likely change with time, diet, and environmental exposures. Some postulate your flora could be different from day to day. And remember those 1,000 species? It is an understatement to say that we are scratching the surface of understanding what these are, where they are, and what they might do. So should you order a test? Maybe, but only if you are contributing to science — the more microbiomes scientists can study, the better. But don’t expect a read-out with particular warning signs or a list of probiotics to take. Not yet anyway, and don’t let anyone jumping on the micro-flora bandwagon tell you differently.

What you can do at this point is foster a healthy flora. Our flora begins at birth with exposure and collection of bacteria from your mother (this tidbit is putting into question whether increased cesarean rates might also affect long-term health). Our collection of good flora during early development and beyond continues with exposure to breast milk, illness, pets, food, other people, and the environment. We can help our flora thrive by limiting use of antibiotics to only when necessary. Not surprisingly, it has been shown that people with healthy diets, high in vegetables, fruit, and fiber, and low in processed foods, fats, and meat, generally have better flora.

Finally, it is a good idea to re-inoculate your good flora, especially if you have been on antibiotics, have a poor diet or digestion, or low immunity. There are many bacterial species that we just don’t know much about yet, but we do know a few predominant species and have seen them improve outcomes in studies. Look for a probiotic that contains various Bifidobacteria and Lactobacillus, both of which are predominant strains and have proven effective in study. According to research, it is not necessarily the number of probiotics in a supplement that is most important, but rather that it contains a good variety of strains. Lactobacillus acidophilus will often be included because it colonizes the walls of the small intestine, supports nutrient absorption and aids in the digestion of dairy foods. Other common Lactobacilli include rhamnosus and fermentum. Bifidobacteria also regularly inhabit the small intestine, help with digestion, and are thought to decline with age. Common Bifidobacterium are longum and bifidum. Some combination of these should be the basis of your probiotic.

PREbiotics are nutritive for flora, and are often in the form of fructooligosaccharides (FOS). FOS is often included in a good probiotic supplement. Your dosage for your probiotic should probably be around 1 billion of mixed species; higher dosages aren’t necessarily more effective. Good food sources of pro- and prebiotics include naturally fermented foods such as sauerkraut, pickles, miso, certain types of yogurt, and kefir.

The exciting news is that we are microbiomes and the ecosystem that we host most definitely affects our health and function. This could be a turning point in all of medicine. For now, however, simply take measures to cultivate a healthy ecosystem for yourself, and watch as the fascinating research unfolds.

Stay healthy & be well!

– Amy Whittington, NMD

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