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)
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.