Modern people have undergone dramatic changes in the composition of their intestinal microbiomes. To get a sense for how much it has changed, compare modern microbiome composition with the growing list of microbiomes of populations that have not been exposed to all the microbiome-disruptive factors that surround us. Microbiomes of Tanzanian Hadza, Venezuelan Yanomami, Malawi of East Africa, and others, hunter-gatherer populations who hunt wild game, fish, gather roots, tubers, nuts, plants and fruit, and have not been exposed to chlorinated drinking water, emulsifying agents in ice cream or salad dressings, aspartame in diet soda, glyphosate in corn and soy, air pollution (yes: air pollution has been shown to alter bowel flora composition), antibiotics, glyphosate, etc.have markedly different microbiomes compared to us. Remarkably, despite separation by thousands of miles on different continents, the microbiomes of these different populations are similar to each other enriched, for instance, in Prevotella, Spirochetes, and Akkermansia, much reduced in Bifidobacteria.
But it is also becoming clear that your doctor and many of the tools of modern healthcare are also to blame for the dramatic shifts in microbial species in your gastrointestinal tract. Just among pharmaceutical agents, we now know that:
- Statin cholesterol drugs
- Stomach acid-blocking drugs
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Laxatives
- Aspirin
And others all change the composition of the microbiome. This has been appreciated only over the last few years, meaning that the great majority of pharmaceutical agents have never been studied for their effects on the microbiome. But it is highly likely–virtually guaranteed–that most, perhaps all, pharmaceutical agents impact microbiome composition.
And the effects are bi-directional, meaning that, while drugs can alter intestinal microbiome composition, microbes alter drug metabolism, also. To illustrate how profound this relationship can be, it has become clear that response to cancer chemotherapy and immunotherapy is largely dependent on the composition of the microbiome, making the difference between favorable response and no response. Some drugs, such as the NSAIDs, not only change bacterial species, but also cause them to proliferate out-of-check, outmuscle healthy microbial species and ascend up the ileum, jejunum, duodenum, and stomach–SIBO, small intestinal bacterial overgrowth.
Many of the side-effects of these drugs can therefore be explained by their impact on the microbiome. The increase in type 2 diabetes, for example, from taking statin drugs can be explained by the shift in intestinal microbial composition, taking the microbiome composition of a slender, active person and shifting it towards the composition of an obese diabetic. An obese diabetic microbiome pushes YOU towards becoming obese and diabetic.
In the Wheat Belly lifestyle (and, of course, the more advanced concepts we employ in the Undoctored program), we work to get you off all of these drugs, as well as take steps to rebuild a healthy microbiome.
We will look back someday in the not-too-distant future and realize that “modern medicine,” despite being hailed as miraculous and life-saving, is really quite crude and primitive. In the meantime, stay tuned to the Wheat Belly and Undoctored messages to learn how you don’t have to wait for your doctor, whose education from 10, 20, or 30 years ago makes him/her woefully out of touch with emerging evidence, telling you to stop consulting Dr. Google or quit wasting his time and that the drugs he/she prescribes won’t effect your microbiome. You need to know that you have profound control over the composition of your microbiome–but it will likely be without the participation of your doctor.
Dr. Davis has said it’s good to start out with a probiotic supplement to get your intestines in good shape but you shouldn’t stay on them. I believe he said to rely on the fermented foods and L reuteri yogurt. My question is: if you are not at all a fan of yogurt or fermented foods, is it bad to instead stick with the probiotic supplement?
Andrea Hill wrote: «…if you are not at all a fan of yogurt or fermented foods, is it bad to instead stick with the probiotic supplement?»
I don’t recall this arising before, so haven’t seen any official suggestion. My guess would be that, as with prebiotic fiber, an approach might be to engage on a rotation of varied probiotics. There are a growing number of single-strain and blends containing species & strains with decent science behind them.
re: «…if you are not at all a fan…»
Major aspects of being human aren’t necessarily optional. My view of the microbiome situation is that we are creating a modern mimic of the ancestral microbial experience, which included casual hygiene, raw water sources, snout-tail game consumption (including offal), casually cleaned root crops, etc. Modern living is positively sterile compared to that, all at some cost not fully tallied.
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So, using something like NOW’s Probiotic-10 50 Billion alone isn’t sufficient because it only provides 10 probiotic strains? If this isn’t sufficient alone, can you recommend another to use so I can buy that version and alternate using them?
Andrea Hill wrote: «So, using something like NOW’s Probiotic-10 50 Billion alone isn’t sufficient because it only provides 10 probiotic strains?»
Even if that is an effective probiotic (and I don’t know, not having looked into it), chronic use of any single probiotic or blend is apt to not be an effective substitute for a diet that includes diverse and seasonally varying ancestral microbes.
re: «…can you recommend another to use…»
Even if an alternative, what might be required is a rotating list of various probiotic products; single-strain and blends. If I had to avoid fermented food, I might be able to come up with a conjectural probiotic list for myself, but even then, I’d first want to get a sequencing of my intestinal microbiome, to see what over/under/extinct population issues exist. Guessing for anyone else isn’t something I’d attempt.
The Undoctored Inner Circle program is actively exploring the sequencing products available, and there is still no specific service recommendation (other than to utterly ignore any dietary advice that arrives with any of the current reports).
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