A New Option in Infant and Mother Microbiome Testing with Cheryl Sew Hoy of Tiny Health

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons. Today I'll be talking with Cheryl Sue Hoy, who's CEO and founder of Tiny Health, the most comprehensive microbiome platform for precision prenatal and children's health, correcting gut imbalances that may prevent chronic conditions such as eczema, allergies, asthma, and others. And they also now offer adult microbiome and vaginal microbiome tests. As a mother of two, Cheryl started Tiny Health out of her desire to set up her children on a path to better lifelong health. But before our conversation, if you haven't yet followed or subscribed to the show, be sure to do so. And if you wanna get transcripts of the podcast, hop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. They're gonna be much higher quality and have no misspellings or incorrect words like the ones you might get on Apple Podcasts. You'll also get my free ebooklet, Finding Your Root Cause Through Stool and Organic Acids Testing when you sign up. And if you haven't yet done my quiz,, which stool tests will help you get to the root cause. You can find the link in the show notes and take that. Now on to the show.

Welcome to the podcast, Cheryl.

Thank you, Lindsey Parsons. I've been so excited to come on your show. You know why?

Why is that?

Before I started Tiny Health, and this was maybe even before 2020, I think I just kind of searched on Spotify, what are all the stool or gut health podcasts? Out there and I found yours. Mm-hmm. And so I bookmarked your podcast. It's been there for years. And yeah, so it's such an honor to finally come on, on board to your show cuz the, this is literally before I started Tiny Health when I found you.

Awesome. Well, I'm glad to have you here. So what led you to start Tiny Health?

In 2020, I gave birth to my son and that's the year I also started Tiny Health. Well, I started the company a week after he was born.

That's ambitious.

Well, yeah, I incorporated the company and I, I self-funded a study with 8 moms who was pregnant around the same time I was and giving birth the same time I was. So technically I started the study before I started Tiny Health in that my story goes back even before to my daughter, 2 years before my son was born. So in 2018, I gave birth to my daughter by a C-section. And I was really researching the impact of C-section to my, my child. At the time, I didn't know the linkage between C-section and vaginal birth versus gut health. But then since then I've uncovered that your gut health, your gut microbiome, where do you get your gut microbes from? And the answer is from your mom at birth. You first get your, some vaginal microbes from labor and going through the vaginal canal, and then some gut microbes from the fecal fluid during labor. And then through breastfeeding, the mom is continuing to transfer some gut microbes from her gut to baby's gut. So then I was uncovering all this research about how not bypassing the vaginal canal can lead to baby having higher risk of eczema, allergies, and asthma. And so I was alarmed, obviously, for the C-section I couldn't control, and also trying to figure out if I can rebalance my C-section baby's gut and restore her gut, the missing bacteria that wasn't there to prevent her risk of chronic conditions. But obviously I was in that research mode, so I didn't get to see her gut. So when I was pregnant with my son, I was like, this time, you know, if I had to have a second C-section, I really wanted to know sooner than later to course correct earlier on because my daughter did end up getting eczema around 6 months. Food sensitivities. She's dairy, gluten intolerant, so she has a lot of gut issues and skin issues and really wanted to prevent that for my daughter.

Yeah. My son was also C-section and I did give him some probiotics sometime, I think, but it may have been later on, but I was certainly aware of the issue at that point, or at least maybe a year or two after, I think.

Mm-hmm.

Mm-hmm. So why do you recommend that expectant mothers test their microbiome?

Oh yes. So we started Tiny House. So then I, to kind of follow on with my story and I'll come back to your question.

Yeah.

I self-funded a study with 9 moms, including myself, and tested their microbiome throughout the first year of life. And then I learned that I can establish that. And I have sort of gathered scientists and microbiologists who knew much more about this than I did to help me build this thing. And then we finally— so we spent another 2 years of R&D before launching the tests in 2022. And our flagship product was the pregnancy sort of gut test and vaginal tests, and then also the newborn gut tests were basically in the first 3 years, which was a huge gap in the market. There was no stool test meant for babies and moms at the time. And so with my son, I mentioned earlier, then I had that ability to test him with the, the study that I funded, I realized through my pregnancy microbiome that I didn't have the BIFs or the beneficial bacteria that I was supposed to transfer to my son through a vaginal birth and through breastfeeding. So if mom's gut was deficient, then even if she had a vaginal birth and she was breastfeeding, she's not really transferring those microbes. Dr. Martin Blaser is a really well-known scientist or microbiologist. Mm-hmm.

I know him.

I've heard of him. Yeah, he wrote this book called Missing Microbes.

Missing Microbes. Yep. That's what launched my interest in the gut microbiome.

Amazing. Yes. And I, yeah, he's well respected and he, I think there's even a documentary now that he created with his wife. And so he talks about how overuse of antibiotics is really causing a depletion of these essential microbes in our guts, right? And so that was the microbe that was depleted in my gut. I didn't have any bifidobacteria. I had zero. And that is the most essential microbe that a mom should have in a way to transfer to her baby at birth, either through labor and birth or through breast milk. So it's interesting now that we have been in the market for about 2 years, we've seen over 25,000 families. So we have a lot of samples, a lot of infant samples too. In 30% of the cases where the child was vaginally born and breastfed, they didn't have any BiVs. Where we had mom's gut sample, the mom didn't have any DIBS either. So it's really interesting. So I would recommend if I knew what I know now, and if I were to have a third child, not to say I am, I would try to restore that in my gut before trying to conceive because it takes months for an adult gut to change. If you and I were deficient in it, it could take us at least 3 to 6 months, sometimes 9 months to see those bibs recolonize, cuz we're trying to make something that wasn't there, maybe that was being destroyed by antibiotics. And that was what I learned. I had to go through this path of like, why am I not— I don't have any bibs. I asked my mom how I grew up and she said I was formula fed one month on and I had antibiotic exposure as a kid. And bibs are very sensitive to antibiotics in early life, especially in early life. Sometimes it gets wiped out. If you don't take care to restore it, it may be gone forever, right? And so that's kind of why I think everyone should do a stool test to really just see if there's any BIFs. And Akkermansia is the other crucial bacteria that are important for your metabolic health and gut lining. I would check if you're trying to conceive or pregnant, if you have BIFs and Akkermansia in your gut. Because these are two quite important bacteria to pass on to your child.

If you're gonna reestablish it, is it Bifidobacterium infantis in particular that you wanna restore, or is any bifido or just combo bifido? What do you guys recommend in that scenario?

Yeah, that's a great question. So it depends, right? If you're an adult with no bifs, you know, frankly, any bifs could be beneficial. But if you are planning to have a child, you really are looking for 4 specific BIFs, which is what you mentioned, Infantis. B. infantis is probably the best adapted at digesting mom's breast milk, or specifically the HMOs in mom's breast milk, human milk oligosaccharides. HMOs are the prebiotic fibers that makes up a third of mom's breast milk that the baby cannot digest. It is there for the bacteria, the bifs in the baby's gut to digest. And so B. infantis is the best adapted in digesting the HMOs in mom's breast milk. The second best, maybe in no particular order, the next best are B. bifidum, B. longum, and B. breve. So we really wanna see these 4 specific strains that are very good at digesting mom's breast milk. For the best child health in the first year, we wanna see these at 50 to 90% of the infant's gut, frankly. And then as they grow older, they get more exposed to solids, nature, pets, their guts diversify. And you don't wanna ever see 90% BIFs in a toddler's gut at 2 years old. I was researching in the first 6 months of life, the first year, there's a very specific trajectory of gut maturation that an infant should be following. They're best adapted at training their immune system because the baby doesn't have any gut microbiome in the womb. There was some controversy back then and debate about, oh, maybe there is, there isn't, but the science is pretty settled there in the recent year that the major transfer, the colonization happens at birth. There's some passing through, but it's not really, there's no colonization in, in the womb. So what this means is baby is born pretty much without an immune system and their immune system is being trained by these bacteria, these microbes, right? I always describe the gut like a theater room with only like, say, 10 seats at birth, right? And as the infant grows, these seats in the theater expands. When they start solids, it may expand to 20 at first when they're just nibbling stuff, and then when their solids have been established, it may expand to 50. And then as they grow up past 1 year, it's quickly expanding to 100 seats, 200. You and I now at our age probably have 300 to 500 species, meaning 300 to 500 seats in that theater. So our theater is huge and very complex by now. But an infant's theater is very small and developing. So that's why those early years are so crucial to get the right balance, because this right balance of beneficial versus unfriendly bacteria is there to train their immune system what's friend, what's foe, to recognize if they should react to it. So the reason why eczema, allergies, and asthma is so tied to the gut microbiome in the early days And the, there's a sign of dysbiosis linking to these is because there, it's a sign that their immune system wasn't trained correctly by the right balance of bugs.

That's overreactive.

It's overreactive. Yeah. It's pro-inflammatory. In these babies' guts, often see zero Bifidobacteria. So instead of the BIFs that we just mentioned, the 4 BIFs taking 9 out of 10 seats in the theater, it's the other way. It's maybe zero and then 9 out of 10 are E. coli type bugs. Klebsiella, maybe Streptococcus, Staphylococcus, very common.

All opportunistic bacteria that at higher levels are pathogenic.

Mm-hmm. And babies can tolerate that much. Sometimes parents are shocked, like 90% E. coli, is my baby sick? And the answer is no. Babies again are born without an immune system and they can tolerate really high amounts of unfriendly bacteria. But you do see it in terms of symptoms. You get a colicky baby, a gassy baby, baby who can't sleep very well. And then you get eczema when they start solids at 6 months. So it's kind of that high level of unfriendly bacteria, of opportunistic pathogens is sitting there creating this really inflammatory event in their guts and not training their immune system properly. And so when they finally are met with a dietary allergen or dietary new thing at 6 months, they get triggered and then the eczema happens.

Yeah. And so given that you guys now have sequenced all these infant microbiomes, I'm curious because there are different strains of Bifidoinfontis and some are a lot more expensive than others.

Mm-hmm.

So I'm wondering, is the Bifidoinfontis you are finding in the guts of healthy babies who have the right microbiome the same as any one of those strains they're selling out there as probiotics? Or are there a number of different possible Bifidoinfontises that are good enough?

Yeah, this is a great question. B. infantis, we've seen some native B. infantis from mom and baby, and it's really hard to say. We would have to do a proper study, and we do have the data now to really dive into it. I have to admit we haven't done that yet, but this is what we could do in the future, right? In terms of, is the innate strain better than a supplemented probiotic. Who knows? Probably, right? If the mom, again, if the mom had B. infantis, it's likely superior because her breast milk and her HMOs in the breast milk is probably adapted somewhat to her own B. infantis and to help it colonize in the infant's gut. But again, the problem with our society and modern lifestyle is that most adults are missing BIFs, including myself, right? And a lot of population, it's missing. So then when, when that happens, the infant really needs a supplemented, the infantis that is well studied, clinically backed, and they're not all equal. When you talk about probiotics, you can't just grab a bottle from the shelf and think, oh yeah, I'm taking probiotics or I'm giving my child a probiotic and I'll be fine. No, because different strains have different functions. And even within the strain, like you mentioned, there's so many different strains. And when I, for your audience, when I talk about strain, they are the numbers and letters behind the probiotic. So for example, B. infantis EBC001 is one that we recommend. The brand name is Evivo.

Right.

And it is the most clinically backed B. infantis for infants, but even I would do it for adults too, cuz it's so potent. And if an adult is missing some this, I would take that to help it recolonize in your gut.

I actually just bought some and I'm gonna make the bifido yogurt.

Nice.

With it so I can make it expand.

Now, did you buy the HMO supplement along with it?

I did not buy any HMOs yet, no.

Okay. If you wanted to recolonize, you have to have the food, the prebiotic for the probiotic to colonize. Otherwise you have to keep taking the probiotic, right? Because it is going to give you a transient effect. But again, without the food there, they're not going to stick around. They're just going to pass through and give you that benefit and you have to keep taking it every day. But ideally, exactly. But ideally the goal is to help it recolonize in your gut by, again, I, I think it took me 3 months of pre and probiotic combination and then I sustained it with dietary that supports the sustenance of these probiotics once they've colonized in your gut, right? High fiber diet, polyphenol rich foods, XYZ. So it, takes effort, which is why coming back to the mom question, like, uh, before, if you do wanna conceive in a year, I would start now and start restoring your gut now as it may take you 6 months to, to get there. And then hopefully once you help it recolonize, it's like I had zero and I managed to get it up to 10 and then it became 8% for a long time without any supplementation. Mm-hmm. And now it's kind of back down to zero cuz I moved to Texas from California and I realized my water supply here is terrible. We tested our water and there's arsenic and lead and uranium in my water, that's a different story. But it goes to show you how many factors externally, environmentally, and dietary-wise could influence your gut, which is why we encourage proactive testing twice a year. It's just, you know, as an adult or an older child, so that you catch these things before they turn into symptoms. So now I'm kind of working— I'm trying to work it back up to 8% where I was.

Yeah. I mean, I wonder whether you really can recolonize, whether you do have to essentially supplement with the probiotic or take the prebiotic once you supplement with the probiotic indefinitely in order to keep these strains alive if they haven't naturally settled. 'Cause I know the gut microbiome of an adult is a lot more settled than that of a child. Like it's easier to alter it in a child. So I mean, normally what would you say are the primary differences then between the infant microbiome and then say, when does it start to settle into the adult microbiome?

Yeah, that's a great question. So if you go back to the theater example of it being 10 seats at birth and then it increasing over time as they're licking the floor and you have a pet, even better, then the, the pets are bringing in that diversity from outdoors into indoors, which is why there are studies showing that if you have a dog or a cat at home, your kids are less likely to have food allergies 'cause it's bringing in a lot of diversity that we're missing in a modern lifestyle, right? So the infant gut is malleable in the early years because it's so small, and it's easier if you, if you think about it, oh, you just put in like 9 good guys and 1 bad guy inhabiting the theater room. Or let's just say the flip side, right? 9 bad guys and 1 good guy happen to be in that theater room in the first few months of life. It's easier for you to come in and be like, hey, move away, you know, let me give you a specific strain of probiotic or breastfeed. If mom had the right bacteria in mom's breastfeed, that is very healing. If mom had B. infantis, you just have to breastfeed. You don't even need to supplement with a probiotic. And mom's B. infantis can come in and chase those bad guys out and take those seeds. So it's very easy in an infant gut, frankly, as long as breastfeeding is involved because of the HMO. So the key here is The HMO in a mom's breast milk is the modifier really of dysbiotic gut or very imbalanced gut. So that gut changes over time and with solids and all that. There are some infant guts who have been too much beneficial and no unfriendly, zero E. coli, and that's not healthy either cuz we need some unfriendlies to train the immune system. 1 out of 10 should be unfriendly. In literature, this is what we, we are seeing. And even in clinically because we do a lot of survey data on babies. So we have a lot of data on what makes a healthy infant gut and what isn't because it's so simple. It's so much easier to characterize what is a healthy infant gut and what is an unhealthy infant gut versus for adults, it's much harder to categorize that definitively. And we're not anyway looking for one universal healthy microbiome in adults because everyone has their unique microbiome. But in infants around the world, if you think about it, in the first 6 months of life, their only food is milk, right? So their gut isn't really influenced by different cultural diets and maybe weather or environments yet. It really is consistent. So in the first 6 months, it's very clear what should be there and what shouldn't be there. And as they eat solids, that's where it gets a bit more complex. I think post-1 year, it gets more complex depending on diet and culture and all kinds of things, but still malleable because maybe some kids are still being breastfed at 1 year old. And again, the more there's breastfeeding, the more malleable it is, the easier it is to change the infant gut if there are imbalances. 2 years, you know, in America, I think most people are not breastfeeding anymore. I did breastfeed my son for 2 and a half years.

Wow.

And my daughter for 18 months. You know, obviously everyone has their own personal journeys, but around 3 years of age is when the child's gut reaches what we call adult-like maturation, or in the literature, it's kind of— there's a transition phase between 3 to 5 years old. So I would say maybe a 3-year-old's gut is pretty close to adult-like maturity. 5-year-old is a bit more definitive.

Mm-hmm.

Where if we take a FODMAPs gut test and if we have the mom or the dad's stool test, it often maps very similarly. I can tell they're living together, they're in the same family because the child's microbiome tend to look more like the adult microbiome by 5.

Do you think that's because they're sharing saliva essentially, or because they're eating the same foods?

All of the above, 100%. And there has been studies lately being published that the family microbiome is a thing. I can tell, like, because I've seen thousands, tens of thousands of microbiome results now, I can tell if a partner, not husband and a wife, but boyfriend, girlfriend, are they living together or are they not? Because sometimes they do and come in for a consult call and I'm like, you're living together, aren't you? Or you're not living together. Or the partners, the husband's like working elsewhere and eating a different food. So the living environment, The food, the diet, everything influences your gut, right? So the more similar things you do as a family, the more similar your microbiomes will be, which is why we always tell parents— we started with the infant gut and mom because, you know, babies cry and have like symptoms and parents are trying to find a way to help their— to get answers that maybe their pediatricians can't give them because there's a lot of evidence in it. But it is relatively new. It's not really in medical school yet, right? It takes an average of 10 to 15 years for groundbreaking academic research to get into medical practice. And for me, I couldn't wait that long, so I really wanted to start this company to bridge that gap. In kids, we always tell parents, they come to us 'cause they are trying to course correct their infant's gut or rebalance it and make it better, but We're like, you know, what about you? Your child's gut is eventually going to look like yours. So doing a stool test is especially if you— and from a perspective of your, your baby's lifelong health as it relates to immune system training, you can't just course correct in a point of time because this is a lifestyle. It's a repeated thing. You have to have good dietary habits as well. And not everyone needs supplements, but if you do need them, you should know what specifically you need based on your test, whether you do a stool test for your gut health or a blood test or nutrition test. We always believe in testing and not guessing. And then lifestyle changes too, right? A lot of parents were educating on very toxic household cleaning supplies, antibacterial soap. You know, a lot of parents are now from the pandemic, germs and bacteria and viruses is scary to them. And so We're overusing these antibacterial soap that gets into our child's mouths and guts, right? And it's not just killing the bad bacteria, it's killing the good bacteria as well. So we're giving a lot of education on lifestyle changes as well. Like people are not spending enough time in nature and outdoors and all that. And it may sound generic, but it is true. We are deficient in diversity and we used to spend 90% of our time outdoors. And 10% indoors, but now it's the reverse, right? We're spending 90% indoors and 10% outdoors. So a simple thing like open your window once a day for at least 30 minutes, it's going to change the microbiome of your environment and your household to invite some of that outside microbiome in to help your child diversify. So all this is to say, like, you have to think about your family's microbiome Holistically and not just help your child but not care about your own microbiome.

Do you have unspecified gut health issues and haven't gotten tested yet or diagnosed SIBO, IBS, IBD, or Candida? My newest supplement, Serum Bovine Immunoglobulin, or SBI powder, may be the perfect thing to try. In a randomized double-blind placebo-controlled study of adults with IBS-D, GI symptoms including loose stools, hard stools, flatulence, and incomplete evacuation were significantly improved with a 5-gram-a-day dose of SBIs after 6 weeks, and abdominal pain, bloating, and urgency were also significantly decreased after 6 weeks of use at a dose of 10 grams a day of SBI powder. It's basically the immune system of a cow derived from plasma and made into a powder, so it binds and neutralizes a wide array of pathogenic bacteria and fungi and carries them out with your stool, without hurting your beneficial microbes like antibiotics or even strong antimicrobial herbs will. It's also been shown to decrease intestinal permeability, decrease fat in the stool, increase the absorption and utilization of nutrients, and increase lean body mass. So give it a try today at perfectstool.com, where you can also find my supplement Tributrin-Max, which helps solidify stool and slow down motility for people with diarrhea or loose stool. And so you mentioned eczema and asthma and things like that. Are there any other signs you might see to think, oh, my child's microbiome might not be properly developing? Or even if, you know, I, I know if you had a C-section, that's sort of an obvious likely thing, but if you didn't have that.

Mm-hmm. I mean, because the immune system, the lifelong immune system training of the child is so tied to their gut bacteria at birth. Knowing what I know now, again, why wouldn't you test early to get that snapshot of what was there at birth? So the earliest sample you can take is the 7-day sample post-birth, and that will give you a clear idea of what seeded the baby's gut at birth. And then if you wait till maybe 2 or 3 months, start to see if mom was breastfeeding, if mom had B. infantis or Bifidobacteria to be transferring to baby's gut. So by then, if baby had zero Bifidobacteria by 3 months, then we know probably the mom didn't have it. And by the way, if dads had it or older siblings have it, they can pass it on to baby too. So sometimes we do see no BIFs in mom and then the infant has BIFs, but like, where is this from? And when we have an older sibling who maybe went to daycare and had that colonized from daycare friends or dad, we see that passing on to infant. So it's really interesting. If the baby is completely deficient of it, that means nobody in the household likely has it and everyone should be working on that. That thing as well. I think that is quite crucial and C-section is definitely a thing because the baby's being exposed to the antibiotics from the procedure and they're not passing the, the birth canal. However, again, the breastfeeding is the number one modifier if an infant's gut.

Yeah.

So yeah, that is very healing, but there's various things that you can, you can do to restore an infant's gut. In the gut.

Yeah. But are there any other conditions that you might see in your child that would clue you into the fact, say, I'm sure there's people listening who have 1-year-olds and 2-year-olds and 3-year-olds. What might they be seeing in their child that would, yeah, that would let them think, hmm, maybe something went wrong with the microbiome?

I mean, the common things in infants, there is a colicky signature or gassiness. You know, those are very common symptoms. If a baby is crying a lot and maybe not meeting that colic definition specifically, but as a mom, as a dad, you, you have your gut feeling that something is off, right? If they're constipated. By far the most common issues that parents come to us is eczema and allergies. And now there's a lot of cow's milk protein allergy kind of symptoms. But again, colic and sleep issues are also very correlated with infant gut. So almost all the kind of common baby symptoms that you can think of can be linked back to the gut and it can be linked back to Bifidobacteria.

Having had a child before you go on, having had a child, I, I would say I know that loose stool is a normal thing for a breastfed baby, liquidy sort of yellowish stool, right? Yes. With my son was breastfed, but also bottle fed because I didn't have enough milk. So, so I know that, that they tend to have more solid stool if they're being bottle fed too.

Mm-hmm.

Yeah. I just wanted to bring that up. No, go ahead with the, what were you gonna say with the older?

Oh yeah. The, the range of normal is wide in infancy, right? I get asked a lot, what if they only poo once a week, but they're breastfed and that could be normal, or they poo 5 times a day breastfed and that's normal. It's really hard to say, but I think some stool we are hearing with connected to cow's milk protein allergies, the mucusy type stool, the green stool, your gut tells you something is off and you know about it. And I would say just check in and do a stool test. As the baby gets older and are eating solids, we get more constipation issues cuz then a lot, a lot of kids, toddlers don't eat fiber, right? And so we tend to see fiber digestion or maybe low short-chain fatty acids in those toddlers. And so that's when we offer some strategies to parents of sneaking specific fibers in smoothies more in their diet or encourage their kids to eat more fiber in that sense. So yeah, constipation is a very common thing with older kids. We also see teens who have acne problems, right? Skin issues. So again, there's something called— you've probably heard of the gut-brain axis. There's something called the gut-skin axis, which is the eczema, acne, skin issues kind of thing. There is an association where probably there's too much mucus-degrading bacteria in the gut that's running down the gut lining and that's affecting the skin as well.

So it's creating some leaky gut for the kids. Yeah.

Leaky skin, I would say.

And then leaky skin. Right, right.

Yeah, exactly. Exactly.

Okay.

So there is a connection there and which is why 80% of our immune system is in our gut and that's why it is very essential to take care of it. And when we're eating, we're feeding the microbes in our gut. As much as we're feeding ourselves, right?

Yeah. So have you seen now that you've seen all these gut tests that all of the kids born via C-section have a perturbed microbiome or do some of them, or some, some of 'em are okay? No.

Yeah. It's interesting. 30% of vaginally born breastfed babies don't have a good gut. Right. And I think something like that amount, 30% of C-section born babies have a really good gut. I think that's a fewer, but, but some, yeah, fewer. But again, I think the modifying factor is the breast milk, the length of breast milk and whether mom had the bivs to transfer to baby. And if not, it's okay. It's not the end of the world. Again, this is why we created Tiny Health to be empowering to parents. There's no guilt tripping. It's nobody's fault. My mom couldn't breastfeed me and because it's hard. Low supply too. It's hard, right?

It's hard. Like you really have to be dead set determined on it and willing to suffer all sorts of things. And even still, sometimes you might not succeed. I, I've discovered.

Yeah. And it's also horrible maternal leave policy in America.

Yeah. Yeah.

So sometimes it's a choice and that's fine, but we offer ways to support the baby's gut if you're formula feeding and if you had a C-section, there are certain formulas that are better adapted. At providing support to the gut, infant gut, which really is, it comes down to prebiotics. So I would look for HMO formula added with the HMOs to again, help the BIFs colonize. So it just means that the C-section gut may need some more support and there are means to do it, right? With a lot of the supplements in the market right now. So again, we help, you know, and sometimes we help validate because we had a C-section mom cry when we were on a consult call with her because her baby's gut looked perfect. And she was like, I did all this work and this has validated her work. And we told her to stop the probiotics she was giving infants because she was giving the wrong kind of probiotic. She was giving a lactobacillus-based probiotic which didn't change or impact her infant's gut. And so she got rid of it. It wasn't doing anything anyway. And so for her, it was very validating as well.

So back in the day, when, what, maybe 5, 10 years after Martin Blaser's book came out, there was a lot of talk about the fact that the babies get the microbiome from the vaginal canal and that, you know, you should reseed your baby's microbiome by taking swabs. And then it all came out that most of it's actually coming from the fecal matter that they're encountering as they're born. So I haven't heard as much about the seeding your baby's microbiome by putting fecal matter in their mouth. I'm just curious, what's out there in the world now about that topic.

Yeah, yeah. So Dr. Martin Blaser's wife is Dr. Maria Gloria Dominguez, who is also a well-known researcher in the space in Rutgers University. And she's one of the papers I read when I was researching this. She was the one who came up with the idea of vaginal seating after a C-section. So at the time it was a little bit controversial. In 2018, I would say that was when I had my, my daughter. I did it anyway. So I did the vaginal seeding before it was sort of approved. It's still not approved by ACOG yet, to be frank, but there has since been a few more papers coming out to show that a baby's swap with the gauze that was put in the mom's vagina for an hour before the C-section operations, within 2 minutes after C-section, you would kind of put the gauze in the baby's mouth and face to mimic the passing of the vaginal canal. The few studies that came out in the recent years did show that those babies look more like vaginally born babies than C-section babies. So I would say there is some proof that it works and that they're not taking fecal materials. No, they're not. And there is also kind of, I can explain more here too, what the theory, I think the theory is, but I, I do wanna address that. Now that we have a vaginal test, I would encourage moms, you know, if you're pregnant or trying to conceive, also take a vaginal test so that if you do have Plan B, because you have your perfect Plan A, which is like, you know, vaginal birth, and then you always have to have a Plan B, right? You shouldn't not have a Plan B. I would see if I'm a good candidate for the vaginal swab. So if my vaginal test came back all good, I have high lactobacillus in my vagina canal and I have no weird bugs that I wouldn't want to swap my baby with, then you would know, you would have that option hopefully with your midwife or your OB-GYN to, to do that. So I highly encourage that vaginal test also because if your vaginal microbiome is not in a healthy state, there is risk for preterm labor and other pregnancy complications. So get that checked. And then as far as some studies showing that mostly babies are colonized with the mom's gut bacteria. It is true. However, our scientists at Tiny Health and even within the scientific community, we, we have a theory that there is a role of the vaginal microbiome. So Lactobacillus is what's, what should be dominating the mom's vaginal canal. It should be 98% Lactobacillus and very low diversity. An unhealthy vaginal microbiome is one that's very low Lactobacillus, maybe 10% or maybe none. And again, that's, linked to higher risk of preterm labor and things like that, STIs, STDs. So we think that the baby passing through the vaginal canal, if we get an earlier sample, maybe a 4-day sample, sometimes we don't get it 'cause it's meconium and we don't get bacteria yet. But in some 7-day samples, we do see lactobacillus strains colonizing baby's gut, but it disappears very quickly. It's almost like the lactobacillus are there to prime the baby's gut and prepare for the seeding of BIFs from the mom's gut. So this is the theory. Lactobacillus and Bifidobacteria are two very common probiotics that you'll find in bottles in the supermarket, right? Like the pharmacy and things like that. And we think they go hand in hand, they help each other. So we think the lacto is actually playing an essential role to prime the land. And then if mom had the BIFs to pass on to baby, it would colonize better. So if there was no lacto, then pass-through lacto, then maybe the bibs from mom's gut, maybe it won't colonize as well. So it does sound like a little bit like all the stars have to align for baby's gut to be in the best shape, but it seems like that's how nature intended it to be. However, because we have so many interventions today, modern interventions, the process is being disturbed a little bit, which may explain why we see 1 in 2 kids today having at least one chronic condition. And this is a stat from CDC. So I, I do think we, we are living today in a pediatric chronic condition crisis where if 1 in 2 kids have eczema or asthma, obesity, type 1 diabetes, that is the new norm. But that new norm should not be acceptable. That is just too high.

Absolutely. Yeah. So if you can start intervening at the, at birth with the proper probiotics if necessary, that really could make a big difference for their long-term health. So speaking of crises, I've heard numbers now for autism, like 1 in 26 kids or boys, I'm not sure which, was diagnosed with autism. And I'm, I'm curious, are you taking conditions when you take in these microbiome kits and have you seen any kind of a signature associated, microbiome signature associated with autism or with ADHD or anything like that?

Yeah, we, we haven't done the work. Oh, well, we have done some work, but we haven't added that signature into our platform, we do have predictive signatures for microbiome signatures for eczema, asthma, constipation, things like that, colic, but not yet autism and ADHD, just because the research there is, is quite new and we're still untangling because for things like autism and ADHD, more likely than not, it's bidirectional. So is it the imbalanced gut that's causing the autism or behavioral issues, or is it the behavioral issues that's causing a bad gut, the answer is probably both of them, right? Kind of has a bidirectional effect, which makes it more complex and harder to untangle what we want to show. But there's definitely studies that show that if you modify the gut, it leads to behavioral issues. So there is definitely a gut-brain axis connection for sure. And in some studies, I think because we, we do like more kid and infant studies, we found a study where it has shown that an imbalanced gut in babies as young as 6 months old could be predictive of ADHD later in childhood. But again, that's just one paper. So it's a lot to untangle and our science team is very rigorous in the way that we wanna see multiple papers supporting the same notion, the same taxa, the same microbial signatures before we put it forth. But it's emerging research, right? So we're continuing to track it. We know that the gut bacteria produce metabolites, which can, can travel to the brain via the blood. So crossing the blood-brain barrier and influence brain functions and affecting mood, cognitive functions, and neurological health for both kids and adults. So we know there is a linkage, but yeah, we're, we're in pretty early days on, on that work.

Okay. So I did the Tiny Health Gut Test. And mine was a pro test, but I don't know that I saw that offering on your website. Is that a new offering or something you have to go through a practitioner for? How does that work?

Yes, it is something that is practitioner only available, and I ordered that for you cuz we're probably familiar with the more conventional PCR tests like GI Map, GI Flux.

Right, right.

And so the pro test that we offer has to be ordered by a licensed practitioner to help you interpret it. And the only difference between our regular test and the pro test is that it adds on the stool chemistry markers, right? Which are the calprotectin, secretory IgA, and all those markers. So we do have it actually, if you go to tinyhealth.com, I think slash store, if you scroll down a little bit, you'll see the pro test. If you click through it, it'll bring you to the practitioner website. So we now do actually have a new partnership practitioner website called poweredbytiny.com. That's a bit more practitioner-focused because we realized in the 2 years that we launched, a lot of patients or users are taking the results to their doctors and that's how we're getting— we have hundreds of doctors in our network now because they want to learn more about how to interpret our tests. And a lot of them have— a lot of them are functionally trained, they're integrative or holistic health practitioners and they want to steal chemistries. So we created the Pro-Test for them to have additional measurements to host immune response.

So does that mean that people can go to your website and order the Pro-Test and you, you provide the practitioner for that?

They have to order it through their practitioners.

Okay. They have to know the practitioner themselves. Okay.

Correct.

Yeah.

Because they need someone to walk them through. Okay. In the future, we may, we do have our own health coaches. I think it's just a matter of we, we walk folks through our shotgun sequencing results, the microbial part, cuz we are experts in it. And the stool chemistries, we feel like we need the right practitioners who know those markers really well. So I think maybe in due time we, we will offer that, but right now they have to order it through their own practitioner.

Okay. Hey, this is Lindsey here, just letting you know that if you're tired of dealing with digestive issues, like bloating, indigestion, soft stool, diarrhea, constipation, reflux, IBS, IBD, or the numerous health conditions that come about when your gut is off, like brain fog, weight gain, UTIs, fatigue, mental health issues, or complex conditions like fibromyalgia and ME/CFS. That's my specialty. With my 3 or 5 session gut health coaching packages, we'll discuss different stool and functional medicine tests to find out the root cause of your symptoms. I'll interpret the results and provide clear explanations, empowering you to make informed choices for your gut and overall health. And together we'll develop a customized action plan based on your test results so you can find relief and regain your health and vitality. I come from a functional medicine perspective, trying to incorporate the latest peer-reviewed research and educating you on protocols used by functional medicine practitioners, but devoting lots of time and support to my clients the way a doctor simply can't. If you're interested in a 3 or 5 session Coaching package, you can sign up for complimentary 30-minute breakthrough session, or if you can only afford one appointment at a time, you can book an initial 60-minute consultation. Links for those are in the show notes. Now back to the show. So for the microbiome test, the, the metagenomic sequencing, right?

Yep.

That was called Shotgun Metagenomic Sequencing. Shotgun.

Yeah. So you only asked for a tiny bit of stool, like the Q-tip wiping of it. So I'm just curious, how can you be sure that that properly and in proper proportions represents what's in the colon versus an entire vial of stool that are used for diagnostic tests like the GI-MAP or the GI-FX?

Oh, I'm so glad you asked this question. We get asked this so much. And by the way, GI-MAP and GI-FX are not diagnostic tests. They're qPCR-based, but at best you can call them a screening test, but it's not diagnostic because to really properly categorize it as diagnostic, you do have to go through an FDA approval, which there isn't such a thing right now in microbiome. Like, the FDA doesn't have the proper regulation for the microbiome, for microbiome testing, stool testing, which is part of the criticism in a way in our industry, in the stool testing world. I mean, I wish there was more oversight, and in due time I think they will come up with that. But for now, it's not— it's a screen. But anyway, the PCR test, some companies have a culturing component, which I know is less reliable. And for culturing, you do have to scoop a bunch of stool. And if you're doing multiple cultures, basically the way you've used cultures for decades, right? Scientists would take a small amount of stool and put it in a Petri dish and grow it under the lab conditions, right? So the reason why we don't use culture anymore is because we're like, you know, at least we, we don't think it's reliable. It's because it is biased towards what you're trying to look for. It favors rapidly growing oxygen-loving microbes, whereas most of the microbes in the human gut are anaerobic, so oxygen-intolerant bacteria. So that means like E. coli is usually oxygen-loving, so it grows more quickly in a Petri dish than say, Arkemisia or Bifidobacteria. So the problem with culture is that it's gonna give you biased results that really is overblown. I wouldn't trust clinically, I wouldn't trust any culture.

Yeah, I don't, I don't pay any attention to the culture if, if the test I'm looking at has it.

Yeah. So maybe some companies are still using that and culturing some, and I wouldn't trust that at all. So when shotgun sequencing came up, this is basically the next-gen sequencing method that sequences your entire gut. We sequence all the bacteria, viruses, parasites, fungi, or yeast, archaea, everything in your gut. Versus the way PCR tests work is that you need to know what you're probing for. You need primers for specific microbes that you're looking for. So typically in a GI Map or GI Effects, you get 30+ microbes you're looking for, but you may be missing the full pictures of what's in your gut, right? So did the 35 microbes in that PCR test, does that represent maybe just 5% of your gut or did that represent 95% of your gut? It makes a huge difference. I think PCR tests are great when you're looking for specific things, like if you have presence of Candida or not, but beyond that, it's less useful for helping you understand overall gut health and do you have enough fiber digestion functions, short-chain fatty acids and things like that. Then knowing technology, the way shotgun sequencing works is that it chops up all the bacteria and all the microbes in your gut and we, we assemble genomes to establish that you have 1% of E. coli strain D, 2% of Bifidobacteria infantis XYZ. There's been a few papers published that shows that with next-gen sequencing, just taking a swab versus a stool sample, Yields the same results and it represents your gut because where the, just the shotgun technology is able to chop up fragments, millions and millions of fragments in your gut. And it's pretty even. There are, there has been tests showing that sticking the swab into different parts of the stool versus just one part, we get the same results because again, that tiny little fragment of fecal matter it's very well mixed. So it represents the whole— yeah, large intestine quite well. We know that because the scientists that work at Tiny Health, and they come from different universities, from Washington University or Iowa and like UCSF and things like that, each lab usually does their own validation because even the lab, the scientists want to know if the swabs, how does that compare to the stool, the whole stool. So a lot of them are unpublished and I wish these labs publish more of these papers, but I often hear them saying, we've done the test and it's so consistent that we switch from stool samples to swabs. And then also at Tiny Health, we have some families or some users just wanting to test how reliable and reproducible our tests are. They buy 2 swabs and sample it one day apart and oftentimes we come back because we have a very good QC process. We're like, this is the same person. Did they submit two swaps? And then so we email them to ask because we would know it's the same person. It's so identical. Maybe the top species, maybe the 5 top species might swap places just a little bit, but I can tell looking at stool sample that this is your gut versus someone else's gut.

Okay, great. Well, so I'm gonna pull up my sample results and we can look at them together and you can tell me what you see and what, what's interesting in them and such.

Mm-hmm. Yeah.

Yeah.

So I'll send you the PDF just so you have, cuz I just pulled your file.

You can go to the show notes website to pull up this report so you can kind of look along with us if you're listening to the podcast.

You did the ProGut Health Test, which includes the stool chemistry markers as we talked about, and this is a good snapshot. That overall your gut test looks pretty decent. You do have 7 things that need support, so I would focus on these areas and then 6 things that can, uh, have optional support. So I would, in terms of priority, work on these first. And so the way we kind of categorize our tests is through different categories. 'Cause again, I think sometimes stool tests focus too much on pathogenic or opportunistic pathogens and not enough on the balance of beneficial bacteria, protective bacteria. So we always start with like, do you even have those beneficial bacteria? And it seems like you do, you are lacking some of them here. And we also tell you what probiotic species we detect in your gut if we do detect them. And then do you have a lot of disruptive microbes that are opportunistic pathogens or parasites and infectious microbes and things like that? I'm just walking you through each category that we show. And so the third category is gut inflammation markers. So this is what you might commonly hear of leaky gut. I would come here to see if you have a leaky gut. But again, based on these test results, you don't really have a leaky gut, which is nice. But what you're lacking here seems to be beneficial bacteria and maybe, maybe some borderline high levels of pathogens here, no parasites, which is nice. Kind of going down, short-chain fatty acids are essential for your gut lining, and the most important one for adults are butyrate. So you do wanna see good butyrate levels. For kids and infants, acetate is the most important. So because you did the PROTEST, we are measuring not just the microbial production capacity. Do you have the microbial gene function to produce butyrate, acetate, and propionate? We also measured the actual concentration. So it seems in this results, your actual concentration for the most part is okay. It is a little bit low and that's driven by your acetate being a little bit low. So that's kind of what it means. And microbial functions is not performing so well. So there are action items that you can take from dietary perspective in your tinyhealth results portal. You, you're also gonna see from a dietary perspective what kinds of maybe specific fiber foods that will help with these metrics and also supplements. I know there are butyrate supplements.

Um, I, I sell one.

You sell one? Oh, you do?

Yeah. I have a product called Tributrin Max, which I take almost daily. But since I've changed my diet since these test results, I'm needing it less and less with all the fiber I'm getting.

Okay. Okay. Well, it seems your butyrate is, is okay. I'll need to dive into the butyrate producing capacity here. But yeah, seems like acetate and then I'm gonna attempt to pronounce this beta glucuronidase. I can never pronounce it well.

That was, that was the most alarming one that I saw.

Yeah, that one is the high amounts and you're not so high. You know, you can kind of go down to the detail level on the bottom to see exactly how off you are, but we can come back to that. I think you're just borderline high, which is usually linked to estrogen dominance, right? If it's too high, it's typically linked to premenopausal state. It may cause issues in women's hormonal health. So this one is very important for women's health, especially as we get, get into those older ages.

To look out for.

And then digestion absorption markers seem to have more fiber digestion, complex sugar digestion issues. And we also have some dietary recommendations there on how to improve these markers because it may mean that eating specific fiber— and we'll have to see what kind of fiber is triggered in you— that you may feel a little bit discomfort in eating that. So This is also a question we get asked a lot. It's like, oh, if my gut isn't adapted to digest these fibers and eating them causes me discomfort, then why should I eat them? Right? Ideally, the human gut can handle a large variety of foods. So if you eat certain foods and you don't feel good, it may mean that you may need to eat more of that to encourage more bugs that can digest that. Then that enables you to eat a variety of foods. Foods in the future. Ultimately, that's what we'd like to work towards. Some other stool tests tell you not to eat certain foods and eliminate it from your diet entirely. We don't do that because we believe that sometimes eliminating certain foods, group, food groups out of your diet may lower diversity and cause more issues. Again, it depends on what your conditions you have. You have some people are on a FODMAP diet for a good reason if they have certain digestive issues, right? But if you're a healthy gut, if you have a relatively— and you don't have these conditions, then we would really encourage a large diversity of foods. And then yeah, like some of these other balance and robustness, you don't really have an overabundance of one or two microbes. Some people have that, which makes diversity very low. And then we have a population chart here. That compares you with everyone who's taken Tiny Health Tests. So at this point, maybe we're closer to 30,000 samples. So definitely there are things you can work on. And I think you mentioned that you have had some conditions, right? And you were bloated when you were taking this test.

Yeah. I, I mean, I have autoimmune SIBO, so I, I always have that and I have been letting myself get sort of out of hand in preparation for a stool test or a breath test by my doctor to get ahold of some antibiotics.

So, mm-hmm. Mm-hmm. The SIBO bacteria that we— it's connected to the methane.

Yeah. No, I don't have that one. Yeah.

That's, you don't have it.

That's not my problem.

That's not your problem. And the breath test and all that is, there's no good diagnostic test for SIBO right now cuz it is trying to measure what's in the small intestines, right? And overgrowth of bacteria in the small intestines. So right now there is no known test to measure what's in your small intestines. All the stool tests that you find in the market are only measuring the large intestines. Even the breath test, which is the gold standard, is not perfect. It's very sensitive. But certainly if you have the symptoms, then there could be other things that are triggering the symptoms. So if you go down to page 5, this is where you go down to the detailed level. And all those things that would trigger it, like you are low in Bifidobacteria, but you do have Infantis. So this is your native strain, which is nice. So maybe with a little bit of HMO and the right high fiber diet and maybe some probiotic help, you can boost these amounts to a higher level. And Arkemisia, at least you have some. So Arkemisia is really important for your gut lining and metabolic health.

Yeah, I take, I take a Pendulum product, the, uh, Metabolic Daily, so I, I have done that in the past and I'm doing it now. And, but I, of course I paused for a couple weeks to take the test, but something's still there. So I was glad to see that.

So it's good because I have zero and I have not— it did colonize temporarily when I was taking Pendulum too, and as soon as I stopped, it disappeared. And this one, if you don't have any, it's harder to engraft. It's just really hard. The fact that you have some is a really good sign. So again, if you have some, I think continue on the Pendulum and the polyphenol-rich foods and maybe an HMO and checking again, because you don't want this to be too high too, right? Because Akkermansia is kind of a bacteria that replaces the mucus of the gut lining. So if you have too much, it's too— it's degrading the mucus too quickly and it could be linked to eczema and skin issues as well. So you don't want that too high. We also see it shooting really high as an inflammatory event. Your immune system may be reacting to some, some pro-inflammatory events. So, but it's very temporary. When we see spikes to like 14%, something happened and it comes back down.

Okay.

Yeah, it's very mysterious. Arkemisia is a very mysterious bug, but you, we know that it, it is quite important and you do want it in few percentage points would be just nice. And Faecalibacterium is, it's an anti-inflammatory marker. This is important again through a lot of dietary actions. You can help improve this bacteria. But let me just like, instead of going one by one, 'cause this is a lot to go through, are there any specific areas that you wanna double-click into? We see a little bit of C. diff here, which is why it's yellow, and this pops up with prior antibiotic use. So I would ask if you've had prior antibiotic exposure.

It's been a long time.

Long time.

But I take antimicrobials, herbs on a relatively regular basis. As soon as the SIBO starts acting up, I'll, I'll dose myself with herbs again.

So, mm-hmm. Mm-hmm.

Yeah.

So we see some, not, not a whole lot, 0.05%. Just say, keep an eye on it. I mean, this is where if you do need antibiotics, I would be more careful because we know this tends to bloom with antibiotic. It's antibiotic resistant. Yeah.

Well, I can take some of my other product, my serum bovine immunoglobulins with it. So.

I love SBIs. I do that when I travel. I do that when I have high pathogenic bacteria, gut inflammation, signs of gut inflammation, that works wonders to bind these. Toxins. So maybe, maybe it was higher before and it, you've worked it down. Um, because again, I, yeah, your gut doesn't look that bad.

I was pretty pleased with, with what I saw overall, except for the high beta glucuronidase. That was what bothered me because I know that that predisposes you to breast cancer and to colon cancer. So I made a quick turnabout in my diet and have reduced meat drastically and have kicked up fiber and beans and lentils drastically.

Yeah, beans and lentils can really help. Again, looking at the range here on page 9, you're just barely above, right? So I wouldn't be too alarmed. It is borderline. I think what you're doing right now should help. You know, hopefully if you retest in a couple of months, I would say maybe retest in 3 months. Hopefully that gets back into the, the green range. We've seen some people up into like the right, like they have a lot of health issues, hormonal health issues.

Yeah, I've always been a bit estrogen dominant, but I'm in menopause now, so I can't imagine there's a lot of estrogen circulating in my system other than that that's coming from the patch I've, I'm wearing.

Mm-hmm.

Mm-hmm. Yeah, yeah, for sure. So it's good to keep it in check for, for sure at this age. We were wondering what the fiber digestion thing that was flagged. So resistant starch was flagged and this, if you eat rice or potatoes, I would say cool it down first. I used to eat, you know, as I was an Asian, like, oh, hot rice and, you know, hot potatoes. We would just eat it hot. But now, knowing what we know about resistant starch, you know, we now wait for rice to cool down. And even bananas, which I love bananas, I'm trying to buy more green bananas because they retain more resistant starch. So if you're low in that, in our, again, our action plan, we do offer some of these tips on how to increase that.

Yeah, no, I, I make these grape leaves and part of 'em is rice and part is lentils on the inside and then a dressing and it's got oregano in it and they're just like the perfect resistant starch food and fiber food and I just am addicted to them.

Yeah, that's great. So yeah, more of that perhaps, or different variety of them, like maybe add some green bananas or like something to your smoothies. Yeah. And then this one, you have zero RPKM for this one. I am a little bit less familiar with, so I'll have to go back into the web portal to figure out.

Iso-malto-oligosaccharide. So it basically, you're saying that I don't have the bacteria to digest those. Is that what it, it's essentially saying?

Correct.

Not just the bacteria, but the gene function to digest these complex sugars. So I think maybe it's correlated to your low BIFs perhaps. So increasing the BIFs should help with this.

Mm-hmm.

It can be found in fermented foods. How much fermented foods do you do?

I make my own sauerkraut and I eat it every morning. That's pretty much it. Occasionally used to eat yogurts, but I, every time I ate it, I felt sick. If I eat the entire container, I feel sick. I feel nauseous. And I don't know, interesting.

Maybe it's related to this.

Yeah. Maybe I'm, I'm missing what, what one needs, but, or maybe it's the strains of bacteria and they're starting to ferment in my stomach. I'm not sure what, but mm-hmm. I'm gonna try the bifido yogurt with the, with the Evivo and see if that helps things.

Yeah. Yeah. And, and if possible, add an HMO.

Add the HMOs.

Yeah.

Yeah.

I'll let you know.

I'll get the HMOs too.

Yeah. And if you can tolerate, you know, adding some sauerkraut like bit by bit, or kimchi and some of these fermented kefir, maybe like bit by bit will help you hopefully gather some functions here. I have been eating sourdough bread, but sometimes it's like if you've been doing one thing over and over again and it's not showing the results, maybe it's a lot of times it's the variety or the kinds of, you know, maybe like one thing is just not working and you're, you're, you know, your gut needs a different thing. And oftentimes it's a variety of, of things, right?

Mm-hmm.

So yeah, we could try that. But let me see everything else. Your vitamin production is perfect. Not everyone has all this in green. So I would say this is very good. No histamine.

And that's all pulling from the bacteria that I have or the amount of vitamins that are found in my stool.

Oh yeah. This is a good clarification. No, this is the, again, the gene function. Of the bacteria. So not the bacteria directly, but your bacteria has the capacity to produce these vitamins. And like, if you have low amounts of them, it just may mean that you have to eat more of some certain foods that give you more of that kind of vitamin. But it doesn't measure the vitamins in your gut. It just tells you that the other essential role of your gut bacteria is to produce vitamins. I think this is not a very well-known fact, but your bacteria gives you vitamins, which is amazing, right?

Yeah.

So it doesn't mean you're deficient. It just means that the contribution of your gut bacteria to this vitamin is either sufficient or lacking. Yeah. If that makes sense. Yeah. And then you would have to fill that more with dietary means. People are often very low in B12. Then you may need to supplement with a B12 supplement or eat more B12-rich foods.

I was really glad to see that I had a normal level of proteobacteria and not an elevated level because the last stool test that I did of this nature, which was a 16S, I think 50% of my microbiome was proteobacteria. Oh, and I have since been supplementing with butyrate, which has clearly turned that whole picture around.

Hmm. Yeah.

Yeah.

16S is one of those earlier next-gen sequencing methods. To give you the full picture of your gut bacteria, which was a huge innovation. But I would say now today, 16S is a very outdated technology, and because it can only detect bacteria, not fungi or parasites or viruses, it's also missing a lot of pictures. The way I compare 16S with a shotgun is that you may take a photograph of your family members and 16S gives you a blurry picture. So you don't know if that's Uncle, like, you know, extended family, that's Uncle Tom or Uncle Tim or Auntie Laura or Auntie Kim. Whereas shotgun sequencing gives you a very sharp, high-resolution picture of who, and you can see Uncle Tom smiling and Uncle Tim frowning. It gives you that specific—

The strain.

The strain, exactly. What they're doing, what they're functioning, right? Are they happy? Are they not? Whereas 16S may have high false positives. In that it may be mixing up, it may be confusing, you know, an E. coli bacteria with something else that's not E. coli. And so you may see higher levels of something that, you know, maybe is, is something different. So again, maybe 6 years ago, 8 years ago, that, that would be the technology, but we've really moved on from that since. Yeah. So this is good. I think it's, again, a very stable DNA sequencing is very stable. If you were to do this stool test a day apart, we'd probably get the same results.

Yeah.

It's very consistent.

And what's Shannon diversity?

Shannon diversity is comparing the diversity of your microbes, right? So the evenness, meaning you don't have really high overabundant bacteria on top and then the rest are kind of little and you have a lot of— I mentioned our grown-up adult microbiome has maybe 300 to 500 seeds.

Seats.

So the more seats, the more species we find in the gut, the more robust and healthier your gut is. And you have a decent amount. It can be higher. So if we go down to your species breakdown, your microbiome breakdown, here we're on page 11, which is the last part of the PDF report. And if, if you go to the app, you can actually expand each species to look at them. And there are like citations you can link out to PubMed articles to look at how why we categorize these as bearable bacteria. So you have 18% unknown bacteria, which just means that scientists haven't been able to categorize if these are friendly or unfriendly bacteria. It's just less studied. I can't count, but if you were to count the number of species you have in the gut, because you're in the gray, you may have maybe closer to 300 than 500, right? If you were in the gray. Green, maybe you have 600 species and the higher the better, right? Typically when I look at shotgun sequencing results, I want to see the top 10 species. What is really making up your— the bulk of your gut? And I want that to have more greens than yellow, right? Because then you have 12% of the top species, 10% and 4%, which is not bad. What we don't want to see is this being 18% or 20%, which is like one bacteria dominating the gut. So the evenness, the Shannon diversity index is also linked to evenness. So if you have a higher Shannon diversity index, then this could be like more like 7, 7, or like 8, 7, 7, 6, you know, it's more uniform throughout your gut, at least the first 5 to 10 species. So typically we want to ideally see some of these Blautia, which is linked to, I think, butyrate function and things like that, being higher on top. And because you have your top 3 species as variable, too high of these amounts of bacteria are linked to certain kind of conditions. Again, they're not terribly high right now, so I wouldn't be alarmed by these, but it's just very interesting to note, right? Like if you do have a family history of certain, like type, I see type 1 diabetes here and Crohn's disease. Species here. Again, so your top 3 species are kind of— not to freak you out on any or anything like that, but it's just something interesting that is connected to what's out there in literature and did detect it in your gut. Something to look out for perhaps.

Yeah. Fortunately we don't have any of that in me or my family.

So, hmm, interesting. Yeah. So again, it may not be anything, right? Again, it's when, when you see these conditions, it's connected to higher levels in people who do have these conditions than other people who don't have the conditions. But like the, the Dory for example is 4%, it's, it's pretty low. So I wouldn't be concerned about that.

So we gotta be wrapping this up. Uh, we've gone a bit over time. So let me just ask you, can people access their raw data when they do Tiny Health?

We don't automatically offer that, but we do have practitioners who write in asking for the C, CSV files if they're raw data taxonomy files. And we do, we do custom, we manually produce them for people.

Okay. So it's possible, could a person do that for themselves or it's just a practitioner?

I'm just curious why you want that file. Like, you know, are you running your own analysis?

Oh, some people, some people like to upload those to websites like BiomeSite. Some people track. If all the strains are listed in that report, which I assume they are, then that's good. Because I was, there was a couple strains I was worried about that are they're not good for your oral microbiome. And I had seen them in a prior metagenomic sequencing and have been using an oral rinse to try and clear them out. And sure enough, they were not on this report. I was really happy to see that this was the Porphyromonas gingivalis and the Fusobacterium nucleatum, which together, the combo puts you at risk of pancreatic cancer and other stuff. So I was really kind of worried that I had had both of those in the previous report.

Oh wow.

Oh yeah, you don't wanna see any oral bacteria in your gut for sure.

It's, it's not a good sign usually. But yeah, we're glad we didn't see any of that. Yeah, we can, we can definitely share the taxonomy files with you.

So I know that you offer like a membership option. Can you just tell, tell people a little bit about what offerings you have now on the site so they know, and then we'll, then we'll wrap it up.

Yeah, for sure. Thank you. So we do have a membership program called TinyPlus where you do get 2 kits up front. And a consult call with our microbiome specialist. It's a 30-minute call to walk you through a report. The membership is $399, and I believe you, you may have a coupon code, right, to share with your, your audience. If not, we will get you one.

I know I got a link, and it may be that the coupon applies on the link. I'll, I'll put it all in the show notes.

Okay, sounds great. Yes, so we did have that option because again, we think that this shouldn't be a, a single time point. Whenever we have two data points of the same gut, we see the trajectory of change. And especially as it relates to early life, we wanna see if it's trending and maturing in the right direction. And as for an adult gut or an older kid, it's proactive. Updating your baseline every 6 months is a good idea cuz you never know when you need medication, when the diet change, when you move or get sick with the stomach bug. Or need antibiotics. So then having that baseline is really helpful to help you recover and restore the missing bugs. So I would say like for those reasons, the membership is really good as a proactive step for your overall wellbeing and health, especially if you're, you have an infant, if you're trying to conceive and pregnant, I would even do 3, 3, 4 times a year to sample the infant. We also have targeted programs, what we call targeted programs for people who are dealing with a chronic condition. So for kids, again, commonly it's, it's a lot of these symptoms we talked about earlier, like eczema, allergies, constipation, even sleep issues. Older kids have different sets of issues, mostly constipation. And then for women who are experiencing fertility issues, we do have a women's health program that could be a combination of a vaginal and a stool test, or just vaginal tests. So we have that too. For adults, we, we actually are coming up with a few digestive health programs to help you tackle some of these conditions as well. We also have a single kit where you can buy for $249. It comes with a consult call and you can figure out if you wanna commit to a membership after that or a targeted program.

Okay. And I did find the discount code, it's called THEPERFECTSTOOL for $20 off, all caps.

Perfect.

Anything else you would like to share with us before we sign off?

You can find us at tinyhealth.com. And if you're a practitioner, do have a practitioner program to support you in consulting your clients. We train you for free and you can find out about that through heartbytiny.com/practitioners. And then you can also reach me at hello@tinyhealth.com. I always do read a lot of the, the emails coming in and at on Instagram and @tiny.health.

Okay.

Awesome.

Well, thank you so much.

Thank you.

Well, that was some great information for potential moms and dads and people with young kids. So I would definitely encourage you to check out their website. If you'd like to support the podcast in other ways, you can buy supplements at a discount from my Fullscript dispensary, order tests at a discount from my Rupa Health Lab Store. Or use my affiliate links to iHerb, which is available worldwide, Bulk Supplements, or Amazon. If you'd like to connect with me online, you can follow my High Desert Health Facebook page, join my gut healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com, as well as follow me on X, Instagram, TikTok, and Pinterest. Links for those are in the show notes.

Thanks for joining me today. Here's wishing you all the perfect stool.