Microbiome Madness

It’s truly an exciting time. The information and science surrounding the microbiome is exploding. It seems that a day doesn’t pass without some new, interesting insight emerges on microbiome questions,  providing us with unprecedented insights and strategies to get better control over health, weight management, aging, etc. Look at what we are accomplishing, for example, with our cultivation of L. reuteri and L. crispatus. 

But it also means that misinformation, misinterpretation, and sometimes misrepresentation are becoming more common, leading you to make mistakes that could yield ineffective or even harmful results. 

In this episode of the Defiant Health podcast, let's cut through the misinformation and get a better understanding of what is going on.  

Chapters

• 0:00 Microbiome Science Explosion
• 2:10 Fermented Foods vs. True Probiotics
• 5:40 Dose Response Challenges
• 8:40 Probiotic Gimmicks to Avoid
• 12:10 Intolerance Issues and SIBO
• 14:16 Closing Thoughts and Resources

Transcript

William Davis, MD: 0:06

It's truly an exciting time. The information and science surrounding the microbiome is exploding. It seems that a day doesn't pass without some new interesting insight emerging on microbiome questions, providing us with unprecedented insights and strategies to gain better control over health, weight management, aging, etc. Look at what we're accomplishing, for example, with our cultivation of species like Lactobacillus roteri and Lactobacillus crispatus. But it also means that misinformation, misinterpretation and sometimes misrepresentation are becoming more common, leading you to make mistakes that could yield ineffective or even harmful results. In this episode of the Defiant Health Podcast, let's cut through the misinformation and get a better understanding of what is truly going on. You know it's a really exciting time to be involved in the microbiome. The pace of information coming at us is so fast it's almost overwhelming, it seems. Every day there's some new important insight, piece of information or practice that gives us better power, increased power in better managing our microbiomes, whether it's gastrointestinal or oral, or skin or vagina or others, and you may have gathered that virtually every organ has its own unique microbiome signature. And as this all unfolds, we're getting more and more effective. It is getting more complicated, yes, but it's getting more and more effective. We're getting better strategies for managing the microbiome. Unfortunately, it also means there's plenty of room for misinformation Not intentionally, perhaps, but misinformation, misinterpretation and thereby ineffective or even harmful practices. So let's talk about some of these pitfalls as this wonderful flow of information comes out. What are the things that some are getting wrong? One common mistake is to regard fermented foods Foods like kefir, yogurts, kimchi, fermented pickles, all those kinds of mostly fermented vegetables and other foods, regarding them as probiotics. Now, now let's be clear on this. Probiotics are usually I'm generalizing to some degree but probiotics are microbes that take up residence in the body. It could be, for instance, lactobacillus rhoderi takes up residence in the small intestine, mouth and colon. Or it could be fecalibacterium prosnitzii, a very important microbe because it produces butyric acid. Well, that takes up residence, likewise, in the gastrointestinal tract. Those are probiotic species.

William Davis, MD: 2:56

Fermented foods, as wonderful as they are and don't hear me wrong fermented foods are very important to your overall microbiome rebuilding program. So those foods I listed are important and they provide species like Leuconostoc mesenteroides or Pediococcus pentasaceus or Pediococcus acetylactosci or Wyzella species. Now, the unique thing about that is those species typically do not take up residence in the human body, they just pass through. So if you eat, say, some kimchi. You swallow it, the microbes resident in that kimchi just pass through into the toilet. So it may take a day or two to go all the way through, of course, but they don't take up residence. So what good are they?

William Davis, MD: 3:44

Well, it's not entirely worked out, but it looks as if these fermented food microbes somehow provide a cross-feeding effect, that is, they nourish the probiotic species, the beneficial species, in your gastrointestinal tract and thereby cause their proliferation. So it's an indirect effect you consume something with fermented microbes and it somehow causes the cultivation or bloom of beneficial species, like that fecal bacteria or acromancy or lachnosporaceous species. So there is an important role for fermented foods. I point this out because some people say I take probiotics by eating fermented food. Now, those are two different things. Right, there's a role for fermented foods, there's a role for probiotic species as well, and that's, by the way, one of the reasons why we make such things as lactobacillus roteri yogurt or my recipe for SIBO yogurt. Those are probiotic species that do take up residence, most of them for at least days, weeks or even longer.

William Davis, MD: 4:49

Now, that highlights an important issue here, and that is, we yet don't know how to cause probiotic species to take up permanent residence as they would had your mom given them to you at birth. So, for instance, when you were born and if you were delivered vaginally and your mom breastfed you, she should have given you lactobacillus reuteri. Well problems, mom probably got antibiotics, you probably got antibiotics. Maybe you weren't delivered vaginally but by C-section, maybe you weren't breastfed. So there's all kinds of reasons that people either never got or killed their lactobacillus roteri and of course most of us have taken multiple courses of antibiotics and there was more than enough opportunity to wipe out your roteri. So, putting that aside, in an ideal world probiotic species would take up permanent residence, but they so far we've not figured out how to do that. But they take up at least temporary residence as compared to just a pass-through function of fermented food microbes.

William Davis, MD: 5:50

Another tripping point that I don't have a full answer to, and that is the lack of knowledge we have in what's called dose response, that is, how many microbes of a specific beneficial species are necessary for full effect. Here's one study to illustrate. There's a study of lactobacillus gasseri, the BNR17 strain, and the measure looked at was waist circumference. So people given placebo low dose 1 billion and what they called high dose 10 billion. I think those of you following my conversation know that we would regard 10 billion as a teensy, weensy dose. Nonetheless, in this study, placebo 1 billion, 10 billion, and then measured waist circumference. So placebo, no surprise, no significant change. 1 billion, no meaningful change either. 10 billion, 5 centimeters reduction in waist circumference pretty significant.

William Davis, MD: 6:49

Well, if 10 billion worked, what would 50 billion have done? Or 100 billion, or 500 billion? So, because of the lack of funding a lot of us have, we don't have the kind of pharmaceutical budgets that the drug industry has. We have limited capacity for multiple arms, dosing arms. So we lack a lot of dose response data and that, by the way, is one of the great advantages in what we're doing, using my recipes for prolonged fermentation. So Roteri, for instance, recall lactobacillus Roteri doubles about every three hours, give or take at human body temperature. So we're going to let it double 12 times over 36 hours and we get something towards 300 billion counts per half cup or 120 milliliter serving. So we get this really huge numbers.

William Davis, MD: 7:40

Now, is that really necessary? Could we get better? Could we get important effects, say at 50 billion, 40 billion, 25 billion? Probably, but we don't know that for a fact. We'll learn this over time, as our experience grows, as our ways to manipulate microbes and their numbers expands. But for now, know that we just don't know. So people will ask me things like was 10 billion enough? Maybe I don't know. So also look for your own feedback effects. So, for instance, I know I get better sleep out of lactobacillus roteri, but it takes probably upwards of about $40-50 billion for me to experience that. So you can use your own kind of feedback tools to track whether you think the dose you're getting, by whatever means, is sufficient.

William Davis, MD: 8:28

Another tripping point is watch out for gimmicks in the world of probiotics. Admittedly, most commercial probiotics are created haphazardly, that is, there's really no rhyme or reason. So someone formulating a probiotic, for instance, might say well, I think Lactococcus lactis is a good microbe, let's throw it in. I think that Lactobacillus acidophilus is pretty good, let's throw that in. I think that lactobacillus acidophilus is pretty good, let's throw that in. I think that streptococcus thermophilus is a good microbe, let's throw that in. In other words, they're haphazard, slapdash concoctions of microbes with no thought to collaborative effects among different species, cross-feeding effects, ph effects, all different things. Many factors are simply not factored into creating a probiotic. So that's one problem with commercial probiotics. It will improve over time.

William Davis, MD: 9:23

Another problem are the gimmicks some companies are coming out with. So one thing I would regard as a gimmick is double encapsulation, that is, putting the probiotic microbes in one capsule and then putting that capsule in another capsule. Double encapsulation, why would they do that? To delay release into the colon, so it doesn't dissolve in the stomach or the duodenum or the jejunum or the ileum. Well, why would they do that? Well, they presume that most of the problems in the microbiome, the gastrointestinal microbiome, are unique to the colon. Well, those of you following my conversations know no, the problems in the microbiome, yes, they're in the colon, but they're also in the small bowel, starting as high as the stomach, maybe even higher. So you don't want release into the colon, you want release into the stomach and small intestine.

William Davis, MD: 10:15

Some would say well, those microbes, many of them, don't survive stomach acid or bile acids. That's not true. There's a degradation count of some species, but species like Lactobacillus roteri, lactobacillus gasseri. They're very acid resistant. They have genes to make them acid resistant and bile acid resistant and they survive in very high numbers despite the harsh conditions of the stomach and the duodenum. So there's no need for the gimmick of double encapsulation.

William Davis, MD: 10:48

There's a lot of other gimmicks also, such as trying to pack as many species. There's one product I came across, for instance, that has 100 species. Well, that means 100. That means each species is present at very low numbers and probably too little to really have any kind of effect. Another gimmick is putting in microbes that had not been tested in humans. That's a violation by the way of FDA guidelines. The FDA does specify you can only put microbes that have been tested for safety in humans and have been around for years. So you just can't grab a microbe and shove it into your probiotic. But there have been companies who've done that and they shouldn't do that, at least not without going through the FDA and having some kind of scrutiny provided, because, for all they know, they're providing pathogens, microbes that are not safe, and there's actually a number of products out there that have those kinds of unsafe, untested, unscrutinized species in them. So don't fall for the gimmicks, but accept that the current crop of probiotics you can only expect so much from because they have not been tested, concocted, have not been created with all those factors in mind, like collaborative effects, cross-feeding effects. It will happen over time, it's going to happen in the next few years.

William Davis, MD: 12:09

Another tripping point is intolerance. People say things like I took a probiotic and it made me sick. I had diarrhea, I had mental fog, I had a skin rash. Likewise with fibers prebiotic fibers, that is, fibers that are meant to nourish microbes and similar kinds of things diarrhea, bloating, gas, etc. Well, does that mean the probiotic is flawed or the prebiotic fiber is no good for you? No, what it means is that you have SIBO.

William Davis, MD: 12:40

You have fecal microbes that have colonized the small intestine where they don't belong. Now you know this, especially if those effects occur within 90 minutes or so of consuming either of those things a probiotic or prebiotic fiber. So let's say you had some legumes or maybe some England powder in your coffee and within 30, 45 minutes you've got gas, bloating, diarrhea, anxiety, panic, depression, all those things. That means you've got microbes living in the small intestine where they don't belong, fecal microbial species like E coli and Klebsiella and Pseudomonas and Proteus and Campylobacter and Citrobacter. These are all fecal species that should have stayed in the colon but for a variety of reasons have been permitted to ascend into the 24 feet of small intestine and that is the cause of those intolerances.

William Davis, MD: 13:36

So the solution is not to just say, well, prebiotics are not for me or probiotics are terrible for you. No, it's to address the SIBO. Because if you just accept those intolerances and just avoid the prebiotics and the probiotics, you're setting yourself up for long-term health complications. It could be something minor, like a skin rash. It could be something very serious like colon cancer, ulcerative colitis and other health problems, weight gain, type 2 diabetes, heart disease, etc. So don't accept, don't stop at avoiding something like a probiotic or prebiotic. If you prove intolerant, address the root cause. Now. These kinds of conversations are valuable to you. If you learn something, I invite you to see my other videos on my YouTube channel, to see my Defiant Health podcast, to look at the thousands of blog posts I have in my williamdavismdcom. Or if you want some guidance or support in doing these kinds of things, I invite you to join my innercircledrdavisinfinitehealthcom.