Metagenomic Gut Sequencing with Dr. Robin Rose

Welcome to The Perfect Stool: Understanding and Healing the Gut Microbiome. This is your host, Lindsey Parsons, and today I'm talking with Dr. Robyn Rose, Dr. of Osteopathy, who is founder and CEO of Terrain Health and is a double board certified specialist in gastroenterology and internal medicine specializing in functional medicine. Dr. Rose practices next generation medicine in integrating systems biology with an innovative approach that requires a deep understanding of each person's biochemical, genetic, and lifestyle factors. Her philosophy is deeply rooted in healing her patients from the inside out so they will age less. But before I get started, if you haven't yet followed or subscribed to the show, be sure to do so. And if you want to get transcripts of the podcast, hop over to my website, HighDesertHealthCoaching.com, and sign up for my newsletter. You'll also get my free ebooklet called Finding Your Root Cause Through Stool and Organic Acids Testing when you sign up. Now on to the show. Welcome to the podcast, Dr. Rose.

Thanks, Lindsey. Thanks for having me.

Yeah, it's my pleasure. So my first question is just, since you are a DO or a doctor of osteopathy and not a naturopath like many of my guests, I'm curious what it's like to be amongst your DO and your MD colleagues but focusing on functional medicine. Like, do you encounter a lot of skepticism?

Interesting. It's a good question. My colleagues, yes, I will encounter skepticism. However, from the people in the surrounding area where I'm starting to practice, they really are searching for this type of medicine. You know, I look at it as more of precision healthcare, precision medicine. It's still, it's still driven by science. It's very data-driven. And you know, there's a lot of scientific basis behind it. So it's just as good, if not better, than conventional medicine. And that's what I have to say to my colleagues that don't believe.

Okay. So today we were gonna focus a bit on this Biome FX test. That's one of Microbiome Labs tests, or that's their, it's their gut health test. And I was just wondering why you like this as opposed to the more traditional diagnostic tests, stool tests in the functional medicine realm like the GI Map or the GI Effects.

Yeah, I like that theirs is actually whole genome sequencing of the gut microbiome. I think that they do a little bit of a deeper dive. It's a metagenomic test. And I just like that The Microbiome Labs is so driven by R&D. There's just so much research and development and they put so much money into it. And a lot of their tests and their products are all backed by peer-reviewed studies.

And do they give you the raw data or you just know that they're sequencing the whole microbiome?

Yeah, I know who they use. I know who they— yes, I know the company that they're using and they're really the only one that can do it aside from maybe one other one. And the raw data— we're not given the raw data, but I trust that it's, it's the real deal.

That you're given the relevant data of the raw data, right? Yeah. Because I've seen like Longevity or what's now the Thorn Gut Test raw data, and that was really just straight up Excel chart, everything in the gut. And now apparently they're not giving that anymore.

Well, they're not supposed to, but same with MBL. Like, you know, and yeah, they can't give— they're not really supposed to give the raw data.

Why not?

I don't know.

It's like if people have information, they might do something with it. Well, it's probably the contract that they have with the lab that they use.

I know who they use. And actually, it's the same— you know, Longevity has the same issue, right? And so it's not something that— I don't know if it's proprietary information. I don't know the legalese around it, but I don't think that they should be sharing it based on that.

And do you know what the cost is to— like, the retail cost to the consumer is for this test?

I don't— I pass the charge on to my patient, so we pay $299 and that's what my patient pays.

Okay.

I don't know if like they— if some, some doctors just given, you know, they might retail it for differently, but that's what the cost is and that's what I—

okay, that's pretty reasonable. That's comparable or less than some of the other gut tests. Okay, so I have a biome FX report, and it's going to be on my website for people to pull up. So let me just give them that URL. That's going to be at highdeserthealthcoaching.com/tha-perfect-stool. So if you want to go and pull that up while you listen to us or pause the recording and pull that up, then you will be able to follow along and it'll be at the bottom of the page. So let's start looking at this test and I'll just ask you some questions about it.

Yeah.

So it starts with this summary and gut microbiome index, kind of amorphous. What does that mean, essentially?

So, yeah, so the microbiome index score takes into account 3 factors, and that's your alpha diversity, your beta diversity, and your resistance. So let me explain those. So your alpha diversity is what your species richness is. So when you talk about your gut microbiome and you're looking at microbial diversity, right? So we have like trillions of bacteria, friendly and unfriendly, and then we have about 250 to 300 different species, right? So how many species you have occupying your microbiome. Okay, so that's your alpha diversity. So what is your— it's your individual species richness. Then we look at beta diversity. And beta diversity is basically, OK, so based on that richness, how do you compare— how does that compare to the US adult healthy population or people that are living in your geographic area? And so whatever is there, like maybe your alpha diversity isn't that great, or maybe it is fantastic. But whatever is there, how does that compare to the other people living around you. Okay.

And, and so wait, the, the alpha diversity is compared to what?

Yourself? Well, it's like, it's the nor— it's norms of other people, right? Of like what their richness looks like.

Like worldwide then?

No, it— in the US. In the US.

In the United States.

It could even be North America. I'm not really sure. It, you know, I always, I have to ask, I always mean to ask them that question. I think it's North America. I think it includes Canada as well. I think they did this But it's basically like, so for example, like if I took you and I put you into the Amazon rainforest, okay, you would likely have, you could still have good alpha diversity, but your beta diversity would likely be close to zero because you haven't been living there for long enough to accumulate that same type of microbial diversity that the Amazonians have. So does that make sense? So that's how I explain it to my patients. And I go, that makes sense. OK. And then based on your alpha diversity and your beta diversity, so based on like your species richness and your stability and the stability of your gut microbiome, how prone are you to perturbation? So if you get sick, you know, whether it's the flu or you have a stomach bug or a gastrointestinal virus or you eat something that doesn't agree with you, You know, how well does your gut handle? How resilient is it? Right. How well does it handle those things? And so this person's resistome is really terrible. They're 1.71. Normally they're actually changing the test. It really should be out of 5. Nobody's— I've never even seen any patient above 3.8. So this person, you know, they're struggling. I see most people cluster in the 3s. Maybe I'll see some people under 2, barely ever under 1. And so that's what makes up that index score. So that person's index score is 23.64, right, out of 40. Again, it's a little skewed. I've never seen anybody's over 28. I would say most people cluster between the mid— in the mid-20s like this score, and then some people I will see under 20 as well, but most people cluster in the mid-20s.

And would it be safe to say that the people you're seeing have gut issues?

Well, I mean, here's, here's the thing, Lindsey. We see everybody, okay? And so I— and it's a good— this is a really good point that you're making. So I would say that the majority of people probably have some sort of gut complaint, okay? But there are a lot of my patients that have no gut complaints, but they have autoimmune disease or they have a history of anxiety or depression or migraines or a skin disorder. And so we know that the gut, you know, the gut is the guardian to your health and the gateway to disease. And that, and there is so many connections that fan out from the gut, the gut-skin, the gut-brain, gut-hormone, gut-thyroid. Like I could go on and on and on. Right. So everybody, I feel, unless they live in a bubble and eat plants all day, I think that they have an element of leaky gut and dysbiosis. And I think that's why the vast majority of people have some sort of struggles on— we'll see them struggling somewhere, or if not in many places on this test because of the way we live our lives. I mean, whether it's the standard American diet, obviously, which most of us eat, which is horrible, and that doesn't feed our gut microbiome and that destroys it. From alcohol that we drink on a daily, if not weekly, basis to the tap water we consume, to the nonsteroidal anti-inflammatories we take on a regular basis, the antibiotics we're prescribed, the air pollution that we breathe in. I mean, I can go on and on and on, and that— all of that is going to affect and chip away at the health of your gut microbiome.

Right, right. So, so it may be that the sample you're working with is a less healthy sample that their test is based on a group of healthy people, right? Or some, or some mixture.

But every— yeah, there's a rate— every— there's a range, you know. Nobody's test is the same. I've never seen any— every person is— that's the whole idea, right? We're all uniquely different, right? We all have our own unique biochemical individuality, and this is just another piece to that puzzle when we're trying to figure that out so that we can really create bespoke healthcare plans for people and really treat them for their unique needs.

Yeah. Okay. Well, let's scoot down to the next part of that same page, which is page 2, and look at the pathogens. So, yeah, so the Clostridium difficile is high. So here I'm just throwing this out because you know what the— if this was a patient of yours, what actually was going on. But say this person was not suffering from explosive diarrhea 7 times a day, Yeah. Would you go ahead and treat C. difficile?

Yeah. So the vast majority of people are overgrowing it. They're not, they're not pathogenically colonized with it. And so, and I see a lot of people that have high C. diff. I do not treat them with antibiotics. What I do is, is I, I restore, I repopulate and restore balance to the gut so that that C. diff gets crowded out.

Okay. So you have more using probiotics and foods and such and prebiotics. Yeah.

Yeah. The, the idea is, is that we're all, and this is a summary page. So when you go down, you'll see each one of these things is going to be teased out. But basically that's what we're doing. Like these pathogens, this pathobiome that you're seeing in this patient, the C. diff, the E. coli, and the Bilophila, you will pick this up in many people. And, and even if you don't pick it up, they'll have like a very small amount of this in their gut. It's just when it becomes problematic is when it starts to overgrow and it's outside the reference range and it's too high. That's when you want to deal with it.

Okay. And just by chance, I happen to be thinking about this Bilophylla wadsworthii, and that's one that tends to promote constipation, isn't it?

It's actually consistent with SIBO because it's a small intestine colonizer. And so that's where we want to see Bilophila living. So when we start to see high amounts of it in the colon, that means it's overgrowing the small intestine, spilling over into the colon. There's two main characteristics of Bilophila. It increases secondary bile acids, which are very toxic to the gut lining, and they're also hydrogen sulfide reducers. So anything that you eat with sulfur in it gets reduced to hydrogen sulfide. That's what it wants to eat up. And then when it reduces to hydrogen sulfide, hydrogen sulfide is extremely toxic to the gut lining as well.

So this is like a hydrogen sulfide SIBO.

Yeah.

Bacteria. Okay. That may have been what was sticking in my head.

Yeah. It's really affecting your gut barrier dysfunction when you have bilifila. So we want to definitely deal with that. And a lot of patients will say, yes, I have flatulence that is consistent with a rotten egg smell. They may get bloated a lot more. And although we love our cruciferous vegetables and they're very important for feeding our gut microbiome, while we try to treat and rebalance this person's gut, we might have those people maybe eat those in much lesser quantities and maybe eat the other colors of the rainbow instead while we're trying to heal them. OK. Yeah.

So Let's scooch down since stuff goes into more detail further below.

Yeah.

And okay, let's look at page 4 and the phyla.

Okay, so this is how I— the analogy I make with my patients. You have basically 4 major phyla in the bacterial kingdom. Okay, sort of like If you think of the animal kingdom, I don't know if I can come up with 4, but you know, you have your amphibians, you have your mammals, you have your reptiles, right? So it's the same thing in the bacteria. You have like 4 main, main players. Okay. And you have your Bacteroidetes and your Firmicutes, and they are supposed to balance each other out. And then you have your Proteobacteria and your Actinobacteria, and they are, they are supposed to balance each other out. Okay. And so if you look at the, uh, adult US healthy population, you should have about 64% Bacteroidetes, 27.8% Firmicutes, those should, right? And then you should have about, uh, 2.86% Proteobacteria and 4.21% Actinobacteria. So now let's look at this person. Okay. First of all, they're so dysbiotic in the fact that they've flipped that Firmicutes and Bacteroidetes where, I mean, they have like no— really, they have no— they have such like almost half of what they should in the Bacteroidetes, which is not good. They have a little bit more than what they should in the Firmicutes, and they have so much proteobacteria. And Proteobacteria tend to be much more inflammatory also. Okay, so that's really— and then let's— if you scroll down a little more, you can see the percentage of Actinobacteria that they have. It's on the chart below. It doesn't come up on the pie chart, but if you scroll down a little bit, I can show you right here.

Yeah.

So they have about only 1.82% Actinobacteria. So that's not great. And then if you scroll right back up again, Lindsey, I can show you one other thing on this. On this chart right here, this chart on this bar graph on the right. So as you can see, it has the 4 main phylum there, the Bacteroidetes, Firmicutes, Actinobacteria, and it's showing you the percentages. And then what also is populating here, these are other phylum, but they're just much more rare, and we will pick them up in people. And so like, for example, the Eukaryotes, you know, underneath where it says bacteria of unspecified, the UP, the bacteria UP, They're methane-producing organisms.

Oh, the— okay.

The Synergists are basically bacteria that are normally found populating the oral mucosa. And so if they are populating the colon, that means that there's likely an issue with low HCl or stomach acid or things being broken down above because they're not— it's escaping and it's getting into the colon and colonizing there. The Ascomycotas are associated with fungus and Candida, and the eukaryotes are like protozoas, parasites, and fungi.

Okay.

So those— that's like the main things that you'll see in that. You'll see people growing those out. I've never really seen anyone grow out the Fusobacterium, the Chloroflexii. So not really.

So one thing I'm noticing on here, yeah, is that they do not have unknown listed. And I have seen in the metagenetic data perhaps that there's a whole huge section, something like half of the bacteria.

I think that that's what the, the bacteria UP is. It's bacteria of unknown.

I forgot.

Yeah.

Okay, got it. So what's the highest you've seen of Proteobacteria on someone's report from these?

This This is it.

Okay. Have you ever used BIOM, B-I-O-H-M, their test?

Oh, you mean, uh, no, no.

Okay. Because I did one of theirs and mine was 50% proteobacteria.

There you go.

And yeah, I don't know if you're familiar with Lucy Meiling, but she questioned their test because she said, I don't think that that's even physiologically possible to have that much proteobacteria.

That's a lot of proteo. Yeah, that's a lot of proteo. Biome is— what's the full name of the company? It's not Biome. It's called— what's the full name?

Biome Health, maybe. Biome Health.

It's the one that you don't need a practitioner. You just order it and they send you. Yeah, I'm very familiar with that company. I've never used the test, though.

Okay.

Yeah.

Anyway, I kind of wonder whether there isn't, like, some grouping of the unknowns into—

right, right.

Into your product. I couldn't tell you if it's real or not, but that's a lot of proteobacteria. And I waited till I felt like I was doing really well. Like I was having a good health, good gut health week. And I thought, now I'm going to nail it. I got rid of those proteobacteria, nothing. So what do you do when someone has this many proteobacteria?

I mean, I would retest, I would retest them 6 months down the road after we've done really some, you know, really cleaned up the terrain, rebuilt the foundation, planted some seeds, sprinkled some fertilizer, you know, and did all those things to really get that person into a much better place. And then I would retest.

Yeah, no, I had done all that stuff.

You should read this. So maybe I can get that, you know, I'll— when you're done with this recording, what I'll do is I'll send it over. I know the owner of the company very well, and I'll give them this. I'm sure they'll send you a test, a complimentary test.

That would be lovely.

I'm sure they will. And then you do the test, and I can— and I'll look at it, and Lindsey, I'll look at it for you, and we'll go over it together.

Thanks.

Okay, so now see this I don't pay too much attention to this.

The families?

Because you want to know, because it's really just the breakdown of what we just saw. So it's showing you the different families, and then it will be broken down into further genea— of like what those four main phyla. So the percentages are going to basically stack up analogous to the percentages we saw of the other four, you know. So I don't, I don't get too crazy about this page. I'm like, uh, you know, okay, there's something crazy jumping out at me, which there's not.

So Okay, so that was the families. We're on page 5, scooting down. Then keep going down.

Keep going, keep going.

Okay, so now we are at page 6.

Yeah, so now these are rarer bacteria that grow out. Okay, and a lot— I, you know, listen, I just had 2. I did the— in the past 2 days, and I had 8 rare species growing out, and someone had 6 rare species. I would say the average I see on most people is anywhere from 2 to 4. Maybe every once in a while someone will have one, but I usually see a couple. And again, that's based on dysbiosis, your gut microbiome balance, and what's going on. And then, you know, maybe some of these rare characters are just sort of rearing their ugly head. Not that it's that ugly, but, you know, just because they got space to, because some of the, a lot of the commensal and keystone organisms aren't there. Right. So I can never— Desulfobryantiae. This guy is also a sulfur-reducing organism, right? So this person's going to have issues with gas, bloating, probably rotten-smelling egg flatulence at times depending on what they eat. And the Eggerthella species, a lot of these rare species, they have some good properties and bad properties. It's neither here nor there. That's why they're not really classified. Classified as pathogens, right? They're just these rare organisms that we're learning more about and that we're seeing, and we're seeing it more of an abundance in some people and more so in some samples than others.

Yeah. No, back in the day when I was getting my first gut tests and you would get one of these, well, your species is, or your sample is particularly enriched for some random bacteria. And I'd curiously search it in all the scientific databases. And at the end of the day, I'd be like, there's really nothing I can do about this. Like, I don't know if it's good or bad. I don't know how to kill it or help it either way.

All right. So it's all about when we're restoring gut health and restoring balance. Like, after we are done with this, really doing that with this person in particular, these species should really go away or we really shouldn't see them as much. Right. That's the whole point. That's why you're seeing it, because there is imbalance right now.

Okay.

That's how I, that's how I look at it.

So let's scoot down to the dysbiosis ratios on page 7.

Okay. So yeah. So first of all, this ratio, the Firmicutes to Bacteroidetes, no surprises within norm. This is falling within range because even though they had a lot less Bacteroidetes, they had some more Firmicutes, but they didn't flip it. It wasn't like they tripled or doubled their Firmicutes and did the same with their Bacteroidetes in the opposite direction. So they sort of still were balancing each other out. So, because again, it's all about balance, right? So this one's okay. But look at the next one.

Okay. Before we do that, let me just say or ask, is there a type of diet that tends to bring Firmicutes into dominance?

I would say probably when you're eating less plants and having more of like an inflammatory type diet. That's what I would say.

And are Lactobacilli and Bifidobacteria under Bacteroidetes?

Lact— I think so. I know Bifido is.

Okay.

I have the answer, but I don't have it memorized. I forget about Lactobacillus.

Okay. So next one is the Proteoactinobacteria. And speaking of which, I have zero Actinobacteria, I think, from my previous samples. And there's like 4 of them.

So this one's like out of control. So this is— so now let me tell you something. When I do these, I want to see everyone's ratio less than 1 because that's, that is associated with like really good healthy metabolism, good cell turnover, stuff like that. So when you see it this— so when, even when I see 1.5, I'm like, yeah, that's not good. You're, you have dysbiosis. This person's at 14.75. So not good. Okay, we gotta fix that.

Yeah, but I mean, is it possible— so just based on my previous samples, I literally think I had zero. Is it possible I've just killed them all off and there's no getting them back?

No, you can get them back. You'll get them back. You got it.

I've got small quantities hiding in my appendix, right?

You'll get them back.

Okay.

All right, so then— and this, this one I don't pay so much to. Everyone's is always around zero.

Prevotella tuberculosa.

Yeah, or 0.0, whatever. Yeah. Unless like every once in a while there'll be somebody that has really high Prevotella and that's when the ratio gets a little wonky. And Prevotella, like high amounts have been— some of the Prevotella species have been implicated in autoimmunity and things like that. But for the most part, I would say most people fall like— and even the vast majority are zero. Like really zero.

So in the US, that's which—

yeah, yeah, yeah.

Okay, so scooting down to page 8, here's our pathogens that we already—

okay, yeah, these are really high. So I mean, the E. coli, 6. I, the high— so the highest actually the other day, someone had 7.2. Again, unless the person is like really, really symptomatic and had some crazy thing like bloody diarrhea, you know, like this isn't giving me like, oh, this is E. coli 0157 or something, right? But there's clearly something going on where they have an overabundance of E. coli. And again, I'm going to go after the C. diff and the Bilophila anyway. And as I do that, I'm assuming the E. coli is going to get crowded out as I get some of those good commensal keystone organisms repopulating the gut. And Yeah.

Will they tell you if there's like a C. diff 0157?

You mean E. coli 0157? I don't think— if you scroll down a little bit, it gives you all of the pathogens here. Just go down to the next page and you'll see. I don't know. No, it just gives you E. coli. You know, it gives you that type of salmonella. That's what it's giving you. Those exact—

Does that mean there's species and genus?

It could be any sort of E. coli.

There's E. coli Nissle and then there's E. coli 0157, right?

Well, you're assuming unless the person is like definitely, you know, if they're really ill and extremely traumatic, then it's just, again, this overcrowding, this dysbiosis imbalance, right? The pathogens are really overwinning the commensals.

Yeah. It just, it sort of bugs me that when they don't give you the strain and they don't give you the raw data, then you're kind of like, yeah, they don't help me out here.

It's hard to do that though, I think, because I mean, because also like not everyone's a physician looking at this. And then I just, I think it's Unless it's a pathologic issue, then at that point you, or if you think it's a really pathological, then you should just do a conventional stool test and see what you're growing out. Yeah.

Yeah. No, it's just hard to know. Like, I mean, these numbers, what, what number would it have to say, or would it be more be symptomatic?

I want to say that they did. I did have a case where the C. diff was like really high. And I feel like they said if it was greater than 5 or something with the C. diff, which I've never seen, you had to like treat with antibiotics.

Okay.

But again, I would maybe then do a standard stool test and check it out.

Yeah.

Backup. You should go to the last page because the way I look at this, I would go last and I'll tell you why. I like to look at first who's taking up real estate. Like I want to, before I get to structure and function, I want to say who's there. Who's taking up real estate, what good guys are there and what bad guys are there because I feel like it sets up the story much better.

This page here?

Yeah, I told them to move this up. I think it should be up above. So yeah, this is pretty bad. So this person really lacks a lot of good stuff. So Akkermansia is like one of your big, big keystone species, huge for like short-chain fatty acid production and metabolism. They have none.

Yeah, that would be me.

Faecobacterium prausnitzii, again, like none. You want to have a good amount. That's protective against colon cancer. Ruminococcus bromii, Ruminococcus flavifaciens, these are both cellulose degraders. So anything that's like coming down through the upper part of the GI tract, middle part of the GI tract, that's not really broken down very well, especially like fibrous foods. These guys are there to really get them to a place where the bacteria can utilize their energy, use them as energy resources, and that's not happening. So you, you're going to need some help above. So this person, I would definitely put on enzymes for sure. Roseburia, another one not detected. Let's see what else we got here. No Eubacterium, no Bifidobacterium, no Lactobacillus. They have like nothing basically.

What else?

And very little Bacteroidetes. So what do they have? Do they have anything? Hold on, go back up. I don't think they have anything. Yeah, they're lacking like pretty much in all of their commensals. So the issue here is that's why they probably have so much proteobacteria because they just are so crowded out and have no good keystone commensal organisms.

So looking at this, you might think, oh, this is a person who must have a terrible, like, standard American diet and who knows what else. But I had a report that probably wasn't a heck of a lot different than this, except I had tons of the Faecalibacterium prausnitzii.

And you feel like you eat pretty good. And I eat—

yes, I mean, I, you know, like gluten, dairy-free, healthy, you know, really high in fruits and vegetables. I mean, I eat meat and stuff, but not excessive quantities. So, you know, once you've sort of gotten into this situation and diet is not— doesn't seem to be turning it around.

Yeah.

And you've— and you've killed everything off and you've replaced it, you've killed everything off and you replaced it. Like, well, I know the answer in my own case because I've got sort of recurrent SIBO, but what do you do?

Well, let— well, first I always ask these patients, especially if they're like, well, I've been eating really good, and they tell me like No, I'm like, all right, so what ha— what's happened though in the last few years, right? Like, have you had extensive antibiotic use for something? Were you in the hospital? Did you have surgery? Did you— like, I'll ask them all these questions that could really have really affected the health of their microbiome significantly. I always ask that because I want to know what has happened, right? Because it's so important. We always want to understand, you know, where the person has been, where they are, and then where they're going with their health in the context of their life so that we can interpret these a little bit better, you know? And so that's important. A lot of people will give me an answer, like, and I'll be like, oh my God. And so that person, because they had like a major surgery, were on antibiotics, or, you know, or they— or something else happened, whatever, they're really, really, really behind the 8 ball. And so they're going to need a lot more help getting across that finish line. And especially, I can't say— I mean, you're probably a lot more diligent than most people, but most people just aren't going to eat like a cow. And really just eating like a cow and eating plants all day long is really going to get your gut microbiome to where it is. And then even it might not. And that can take like a long time, like a year or more.

Mm-hmm.

So I, I always support the patients, especially Americans. We're really impatient anyway. But I always support the patient and I want to give them really good, you know, I want to lay the foundation. I want to start getting rid of the bad stuff, reinoculating it with the good stuff, and then giving them the fertilizer and the things that they need to get that all growing back and sticking. And it can be hard. It's not always the easiest thing.

Okay, so I've pulled this up to page 10, but if you want to go somewhere else, I can do that.

No, no, you're in the right spot. So now, okay, so now we've established, let's think about this patient for a second, right? So we know that they're severely dysbiotic, right? They have severe dysbiosis. They have an imbalance, definitely, of all the phylum that they should have, plus now that they have good significant amount of pathogens, right? And as a result, those pathogens and the lack of the good commensal organisms are going to affect structure and function. So we know for a fact they have leaky gut, like screaming leaky gut, actually. So that gut barrier is significantly impaired. Okay. They appear— they definitely have gut barrier dysfunction. And now we're going to look at the metabolic function, right? And let's see, and let's see how that's probably destroyed to some degree because we already see who's taking up real estate there and it's not a good, it's not a good situation. Right. So now we're going to look at metabolic functioning. And so we're, so the bacteria are going to, there's two different sources of fuel that they utilize and it's through either breaking down and eating carbohydrates, resistant starches, or high-fibrous foods. Right. And that's their preferred energy source. Okay. This is the saccharolytic fermentation is what they want. Proteolytic fermentation is like a backup that was evolutionary. It was evolutionarily developed by these organisms because I guess I think really when there was feast or famine, right, because we were We were walking along, eating the plants, picking this, and I guess if there was a drought of some sort and nothing was really growing, then they had a game for food, right? So this proteolytic fermentation is a backup, but the problem is it doesn't prefer it. It doesn't want it, and a lot of the byproducts of this fermentation process are toxic to the gut lining, as you could— the amines, phenols, sulfides, and they do other things in your body that aren't great. When we are seeing these things, it's okay if we see them in a certain amount. It's like that Goldilocks theory, because some of them, the amines and the indoles in particular, they do some good things for us, but it has to be just the right amount, right? So let's see what this person's doing with their saccharolytic fermentation. So the major byproduct of saccharolytic fermentation is short-chain fatty acid production, right? So let's look and see what happened here. So it looks like they're doing pretty good, which is sort of interesting. Let's see. So there's 3 short-chain fatty acids they're going to make.

Okay. You want me to go down to the—

Yeah.

Butyrate here. Okay.

Which— wow.

Page 11.

Wow. They're making butyrate and that's good because this person is suffering in so many other areas. So whatever few commensals they have or whatever is there, they're really doing a good job spewing out and making some butyrate. Okay, okay. And then propionate— and propionate is really good for T cell regulation and not terrible. I mean, it could be worse. I mean, it's a little low, but it could be way worse. So that's not so bad. And then acetate, your third short-chain fatty acid. And when you have acetate— so if you have some of these species, if you have enough of them, like Roseburian and the Faecalibacterium prausnitzii, they can actually— what they do is they then they convert the acetate into butyrate. Okay. So if you have enough of acetate, that's maybe why they get— maybe this is why this person has some butyrate too, because they have enough of the acetate that's converting it to butyrate. All right. And we know why butyrate is so good. It's great for everything like oxidative stress, metabolism, your immune system, you know, all those wonderful things that we need it for and obviously to help with that gut barrier dysfunction. Right. And keeping our gut lining intact.

So do you supplement with butyrate for people who are deficient?

You know, no, not if people really have none. I do like one or two supplements that can give you back butyrate and/or propionate. There's a lot of stuff circulating about that and how good it really is, but I feel like people just need a— like, I'll do it for just a short period of time while I'm sort of, again, like planting those seeds, right, and getting those good commensals to start growing back. So that then they can start making the butyrate. Right. But I'll do it for just a limited amount of time if people are really that depleted and that deficient.

Okay.

And then this person's lactate, I find that the lactate will be on the higher side. And to me, this is like, I don't want, I don't like to see people's lactate really more than 40%. Again, this makes sense because there's probably, this person has a lot more lactate producers. And then they have a lower abundance of the lactate utilizers. And lactate utilizers tend to be the short-chain fatty acid producers, which are those key stone commensal organisms. So, you know, you don't want to have too much lactic acid production, which is just like how we hear it being toxic to our muscles. It also is toxic to the gut lining. Okay, okay. Here's our proteolytic. So this is now using protein as their source of energy. And these are the byproducts include amines. So you can go down and we'll look at these guys. So there's 3 different polyamines. There's putrescine, spermidine, and cadaverine. Now putrescine and spermidine are good. Cadaverine can be sort of a bad guy, but these guys are important overall for helping us stabilize RNA and DNA. And so you wanna have some of it. This person's on the lower side. It's okay. I'd rather them be lower than higher, but maybe if they had a little bit more, it'd be fine. This person has like a high amount of phenols, which is not good. Phenols is extremely, extremely toxic to the gut lining. It impairs the intestinal barrier function and p-cresol, which is the main byproduct. It can be very toxic to our your skin. Like, so a lot of people that have really elevated levels of phenols or p-cresols, they'll have a lot of inflammatory skin conditions too.

So phenols are not the same then as polyphenols. Now the name could confuse people.

Good distinction, Lindsey. Good to see.

And then p-cresol, is that not a marker on the organic acids test?

P-cresol, I feel like There is a P something. You're right. Yes, I think it is. I think it is. I think it is.

Yeah. Okay.

Yes, on the oat. I think it is on the oat. I wish I had a note in front of me. I could tell you right now, but I don't.

I could, I could pull one up real quick, but then I'm gonna throw the screen off, so I better not.

Okay. So now look at this. So now we're looking, okay, ammonia production is sky high in this person, likely because of the really high C. diff, you know, although there's a bunch of other organisms that also produce ammonia. This person should definitely not go on glutamine. That's going to push even more ammonia production. So we'll leave that person alone with the glutamine for now.

Interesting. Okay, so that gives you a good marker. But whether that should be a supplement for them, hydrogen sulfide production, that's—

they're having a little issue with their vendor that does all the raw data for them. And the hydrogen sulfide hasn't really been positive in people that it should. Like, it's been negative. But this person definitely, I can promise you, is producing hydrogen sulfide based on their high level of Bilophila and also that they have that other rarer bacteria, the Desulfovobryantia. So I'm sure this person— and again, hydrogen sulfide, so toxic again to that intestinal lining. And again, people that have high protein, low fiber diets and sulfate reducing or bacteria are going to eat up that stuff.

So, so you basically don't trust their hydrogen sulfide marker at this point?

Yeah, they gotta work on— they, they are working on it. I don't know why. Okay, no methane didn't surprise me. They didn't have any methanogen-producing organisms, so that's good.

Okay, other than Methanobrevibacter smithii, what, uh, what might be the other ones you'd be looking for?

Oh, there's a lot of methanogens. I can't— I don't have them committed to memory. They fall all under the Euryarchaeota. There's a lot of different species.

Okay.

Okay. Psychobiome.

So, okay, so we're on page 14 for the listeners.

So now we're looking at like neurotransmitter hormone production. So GABA, we know, is like a really important neurotransmitter. Like a vast majority of it is made in the gut. And there's definitely certain, you know, they're using it as a psychobiotic, actually.

Yeah. Yeah.

They use certain strains rather, excuse me, as a psychobiotic. Like, I know, like, Lactobacillus rhamnosus is one, and I can't really name the other species, but they potentiate GABA production. We know that GABA is the calming hormone, the hormone that helps us sleep, and it balances out glutamate. And glutamate's the excitatory neurotransmitter, right? And so it's really important to have a lot of this around. Some people see that they have none, and— but that doesn't necessarily mean that correlates with the GABA levels that are found in their brain, right? We know that there is this bidirectional communication between the gut and the brain where even the gut is communicating, I think, even 4 times more with the brain than the brain is with the gut. But still, we don't know. We're still teasing out all that information, right? So, but having a healthy gut is going to help us have a healthy brain.

So I, I'm assuming that you must see low levels of GABA in people with ADHD.

So the thing is, it doesn't always correlate, right?

Not, not on this test, but I mean, in general, that there, that there would be.

Yeah, probably. Absolutely. Yeah.

Like, I give it to my son to help him calm down.

Yeah. Does it help him?

Yeah. Yeah. But he doesn't, he doesn't want to take it much. I mean, I give him, I also give him phosphatidylserine. Uh-huh. But he doesn't want to take the GABA. He seems to think that that kind of makes him not be him.

Oh, okay.

And it's funny. So when I was, I had sciatica last year and I was so desperate to fall asleep that I was taking literally everything in the kitchen cabinet that I could find to make myself go to sleep. Uh-huh. Since I would have excruciating muscle spasms. And I was taking GABA for a bit. Like, I'm like, okay, we'll do the GABA, we'll do the melatonin, we'll do the ibuprofen PM. Well, I mean, it was everything anyway. I found that after some time I was beginning to feel kind of depressed, like I was sort of like not taking a lot of pleasure in life. And I'm like, I think that GABA's kind of too much. GABA dialed me down a hair. Like, that's not, you know, I— that was not something that was out of whack for me.

Yeah. The other thing too, that for the listeners to know the difference, GABA— so basically melatonin is what is going to help you go to sleep. Like, so there's different people, different types of insomnia, right? You have people that have trouble falling asleep, people that have trouble staying asleep, and then— or a combination of both, right? Melatonin is what helps you fall asleep. It doesn't help you necessarily stay asleep, although there's some extended release version, but I don't know how, how good that is.

Yeah, yeah.

GABA is what helps you stay asleep. So That's the difference. So it's good to always have that distinction or know that distinction, rather.

Okay. That's good to know.

So now we're on glutathione and this person has a massive amount of this too, which is great. I mean, it's the most powerful antioxidant in the human body and it also acts as a hormone. It can potentiate the release of GABA and dopamine. And, you know, it does a lot of other amazing things in our body, like obviously scavenging up free radicals, helping with oxidative stress, all those things. So this person has a lot of that, which is good. Not terrible.

Okay.

I'm not going to be like, that sucks. It's good. So at least they have a few good things. Not many, but where else we go next?

Okay. So we'll go to page 16.

Yeah. So indoles again, it's the goldilocks. So we don't want too much of this. I would say this person might have a little bit too much. I'd want them more in the green again. The production of indoles, it's through the degradation of tryptophan, which is what we find in usually meats, especially turkey. You guys all know it's like the sleepy hormone, right? So basically we want this guy because he helps increase the expression of the enzymes that help break down xenobiotics or toxins in our body. So you want— you definitely want to have, like, again, that Goldilocks rule, like just the right amount of this is important. Okay.

Okay.

So this is a good estrobolome in this person. I like to see a lot of my females, I find, hug around this 20%, which I think is good just from my experience. You know, my females that are premenopausal, you know, I'll see some people go up into the 30s. I think once you get it up into the 40s and you're dealing with estrogen dominance, that could be an issue. And then probably women that start to fall below like 15 13%, that's like, you're probably getting more postmenopausal and stuff, or perimenopausal maybe.

Okay.

At that point, you might want to do a metabolomic test, like look at a Dutch or something to look at hormones.

Okay.

Yeah. Okay.

So we're on page 17 now. Vitamin biosynthesis.

Right. So now we want to see how well are your gut bacteria synthesizing vitamins or making vitamins. So it's different. There's a distinction between making the vitamins and having vitamins. Right. So you could supplement. Right. But that doesn't mean you're synthesizing them well. It's two different— this is really showing us how well they're being made in the gut. OK, so let's look and let's see. So let's look and see how each vitamin is doing here. So B1 looks, you know, it's decent. It's not terrible. You know, it could be way worse. You know, I like it into the green area, like 40, 50, 60%. But that's fine. B2 is good. They have a lot of riboflavin, so that's great.

And if it's not totally clear, the important part is that the gut bacteria are producing these.

That's right. So this is another snapshot of metabolic function, right? And because of who's there and who's not there and the imbalance of the current gut microbiome state that this person has. So again, B5, which is pantothenic acid, they don't really have any of that.

Yeah. So they're probably fatigued, I'm guessing.

Yeah.

Because you need that to produce energy.

Uh-huh. B1 too, bentify me. I mean, B1 is very important for energy as well. They had some of that. B6 looks pretty decent. I'm happy with that. Let's see, B7. They have a lot of B7. That's good. Let's see what else we got here.

Page 19.

B9, not bad. Folate and B12, not bad. I mean, I'd like to scooch it up a little higher, but not terrible. And K2, not as good. You know, again, K2, not only for helping us put the calcium in the right places, like in our teeth and bones, and not make— making sure that they don't get deposited in our soft tissue and our vessels, but also very important for VO2 max, cardiac output, energy, things like that. So, you know, this person's doing well here too.

Can you explain VO2 max?

Cardiac output. So, okay, you can— yeah, I'm sorry. So it's really cardiac output, like how— I guess how powerful is the— is your heart? How well is your heart working, right? How well is your heart pumping the blood to your extremities and to your tissues and your nerves and cells and all those things? And so when you give K2 to people. There's different forms of K2. The most commercially used is K2-7, although the jury's out on that. I've spoken to people that think we should be using the 4M4. But that being said, they've done studies where— and I know Kieran at Microbiome Labs has a product that they've done studies on— and they increased VO2 max when they gave them the K2-7 at the dosage that was, was in the supplement. By like, I feel like it was up to 20%, but I could, it was like 15 to 20% maybe, but it was pretty, it was pretty big number.

And isn't VO2 max like, like you can measure when you're exercising?

Yeah.

Something. So how do you do that?

Measure it? I think that there's a device you can wear that calculates it, but that's how they do it in the studies. I don't know. I don't know.

You might know, cause I listened to another podcast that talks about VO2 max all the time and it's an equation.

It's like VO2 equals blah, blah, blah, or something. I, I, yeah, I don't know.

I thought it had to do with like the, the max heart rate.

Yeah, I can see it, right? I can see it in my head, but I'm like, wait, what's the calculation? Now I don't know what to look it up.

Okay, so now we've looked over this entire, yeah, report and you're seeing this. So what's, what do you, what do you do with this person?

So I'm gonna go after the, the C. diff first because that's going to have a lot of die-off. There'll be a lot of toxins released. So I'm going to put this person on binders, bind up whatever's going to die off, and I'm going to give probably a more specific, maybe supplements that, like a spore former that is good at basically cleaning up C. diff.

Like a spore-based probiotic.

Yeah. Like HU58. He has, it's really good.

Oh, right, right, right. So that's a Microbiome Labs product.

HU58. Yeah. That's B. subtilis. I like that product. I like Another one I really like is Cleanzyme by US Enzymes. It's shown that there's activity against C. diff and it's, it's ozonated magnesium. It's really giving your whole gut a nice cleaning. Has built-in binder as well.

You're not, you're not giving antimicrobials though.

And so I find that when I have people that tend to constipate, the IgG 2000, that's the binder that I'll use for Microbiome Labs. I need to balance it out. And the Cleanzyme does the trick because it— because if you titrate it up, you can titrate up to like whatever, whether it's 2 doses or 2 caps or 4 caps a day, but it will help. You can titrate it to having a good complete bowel movement. It will balance out the binder, the constipation, a side effect from binders sometimes. So I like using them in combination and they're both sort of cleaning up the house a little bit.

Okay. No, wait, did you, did you say the Mega? You use the Mega IgG as the binder?

The Mega IgG 2000.

Yeah, right, right, right. Which is like a derivative of colostrum.

Yes. And then I'll use that in combination with the cleanse. I'm—

yeah, with the cleanse.

I'm like, at the same time, a lot of patients, I will, unless the patient has like significant diarrhea, then I'll just leave them alone with the IgG 2000. But a lot of people are— have the opposite issue. And then I find that they get even more constipated. So I like the Cleanzyme because it helps you poop and it also helps with C. diff. So I'll use that.

Yeah.

So I'll use that with HU58.

Okay.

And then, yeah.

So the Omega IgG 2000, I've always thought of that as sort of, you know, if you've got low secretory IgA.

I think you're thinking more than Mega Mucosa. Are you thinking the Mega Mucosa has all the different immunoglobulins in it, and the IgG 2000 is like just more specific and it acts as a binder.

Okay, because it essentially pulls out any toxins.

Yes, exactly.

Yeah, you got it.

So I'm talking about that, that I'll give later. I'll give the Mega Mikosa a little later after I've cleaned it up, you know, just to keep their, their gut lining intact, you know what I mean, and, and keep that gut barrier function optimal. Okay, so I'll do that up front for that person. Let's see what else. So then I sort of want to clean up that bilifila too. So there's a product by Master Supplements, also called, uh, TruFlora, and it really shows it does a lot. It has a lot of activity in the small intestine and helps with SIBO and reversing SIBO and stuff. So I, I'll use that. For like 8 weeks or so after I get them off the H258 and the person's like feeling okay and I'll get them off the binder. I'll keep them on the Cleanzyme. I'll put them on the True Flora. At the same time, while I'm doing this, I'm usually trying to give them some sort of prebiotic also, right? I'm trying to feed the good bacteria that's being established now so that they keep thriving and growing.

So do you use the MegaPre?

Yeah, I'll use the MegaPre. I use that. I use another product called Sun Spectrum. Which has the ingredient in that is very— it's excellent. There's so many studies that show it increases butyrate production and those butyrate-producing organisms.

That's not SunFiber, is it?

Yeah, it's SunFiber. SunFiber in the sun. Yes, you got it. Yes.

Do you find that that's better for people who are constipated, though, than people who have, you know, soft stool?

I haven't found a difference, really, to be honest with you. And I have a lot of both. The one I've noticed, the main thing is with the IgG 2000 with my constipated patients. But what I do with the Sun Spectrum is, you know, the only complaint I will get is they'll get really bloated if they use too much too fast. Same with the Megapre though too. So what I do is I have them like, they'll put in a protein shake or something and they'll do like a quarter of a scoop for 3, 4 days and if they feel fine, Then they'll go to half a scoop for 3, then they'll go to 3. You know, they just titrate, go, go, go low, go slow. And then you get them there and they're fine. I literally barely ever get a complaint if I do it that way. Now, the ones that go off on their own and they didn't listen to us and I'm like, oh, you didn't titrate it up, did you? They're like, no. So I'm like, all right, start over. Yeah. But yeah, I don't— it's funny, I haven't noticed. Why had you noticed a difference? I'm so curious.

Yeah, no, just I personally felt like—

Yeah.

Well, because I was thinking about the— So I know that the SunFibre is partially hydrolyzed guar, right? Guar gum. Yeah. And so I know that that's an adjunct for Rifaximin for SIBO.

And so I got some, but you feel like it's going to make you more constipated, right? Is that what you're going to say or no?

No, no, the opposite.

Really?

Well, in my personal experience, it made— it felt like it kind of just went right through me and sort of sped up the bowel movements or increased them. And I, and I thought, that's not what I want.

I haven't had that. Did you, did you, do you think you just used it too quickly? Like, do you think—

I'm trying to think, did I start with a— I probably started with a full pack.

Yeah, go slow, go lower. I don't—

I wasn't, I wasn't using Sun Spectrum brand. I don't think I'm going to— they were in individual packets.

I love Sun Spectrum, and Sun Spectrum has other products in it that are really healthy and help the gut lining. Yeah, I think it has curcumin. Does it have vitamin E? No, it has curcumin. I can't remember the other main thing. And it's like curcumin. I can't— I don't know why I'm blanking.

I don't know. I'm the worst patient for myself, though. I never follow the kind of advice. Why does that—

Try the Sun Spectrum and try to just do a little, like, just a little bit of, you know, or try the Megapre. Either one, you know, either one.

I've never done the Megapre.

So yeah, try the Megapre. Like, just do like, start with again, like a quarter for like a few days and do, you know, and just like go slow and you'll be fine.

So I kind of struggle though with like philosophically the idea of giving somebody a prebiotic powder. I sort of feel like they could and should be getting that from their diet, from their food. Right. And that I should be adding it for my food.

You're 1,000% right. But the problem is, is I just don't— I even think so. Like, I really try to be plant-based, right? Like, I even think about myself, right? Let's, let's, let's look at myself. So I, I do time-restricted eating. Okay. So I, I eat like, do a 16:8 usually. That's how— that's just my life pretty much, you know, except maybe like on one of the weekend days or whatever. But I'll tell you, I just don't even have time to get enough of the plants in.

Oh yeah.

You know what I mean? Like, I'm not getting enough of those. Like, if we're really being practical here, I'm just not getting enough of the servings in, I feel like, to really help my microbiome to the best I can. Yeah. So I feel like I agree with you 1,000%, and everything we do in practice is getting people to understand, like, why it's so important to be more plant-centric, right? And I'm like, okay, I believe in moderation, everything. I am not really one of those people that demonize any one macronutrient even, right? But, and so when you think about, you know, if you're a vegan or this, and I don't judge anybody, if that's what they prefer, that's fine. But I would say for the most of my patients, I'm like, listen, get like your plate to be at least 60% right? When you look at your plate, like 60, or if it's 70, awesome, like to be the plants, right? To be like all those beautiful vegetables, different colors, your salad with all these different colorful, colorful vegetables in it too. I'm like, and then the smaller portion of your plate can be like a piece of wild salmon or an organic piece of chicken or a ground, you know, organic ground turkey meatball, or, you know what I mean? I don't know, like I guess, and God, if once in a while or once every 2 weeks you want a piece of a beautiful piece of ground, like a small piece of ground grass-fed, grass-finished beef, it's okay. As long as you're talking about regenerative farmed animals and then you're putting not crap into your body. Right. And so I just think it's like, it's like creating balance, you know? And I, I think once the people get used to having the plants as most of their plate, That I feel like you've done such an amazing job, right? Because it's so hard to get so many people to get there.

So, and, and yeah, where do grains fit into that?

Yeah. So I'm fine with grains. I'm not against grains. I am in certain instances when I'm trying to heal a patient and they have something going on, maybe with like some autoimmunity or something like that. Right. But, but I'm fine with like a little thing, you know, a little portion of your plate to be a little bit of like quinoa, right? Or like maybe a little bit of brown rice or a little bit of, you know, like my kids even like, you know, we don't eat conventional pasta anymore, right? I don't know how I did it, but I did it.

And you must have had— you must either be single or have a spouse who is compliant, right?

No, he— well, he—

does he make his own pasta?

You know, it was so hard to do. And listen, they're all full of like, any of the pastas, they all have like so much carbohydrate in them, you know, actually. But the sugars aren't so bad, right? Which is good, which I look at even more, right? But I mean, I found this great brand that does a brown rice pasta.

Yeah.

And we don't really eat pasta that much. But when I serve it, it happens to be delicious. Right?

Yeah.

And so we make it with like a really good homemade tomato sauce. And, you know, we put— or we make with olive oil or whatever, and garlic and blah, blah, blah. And we mix it with like a bunch of vegetables. And it's great.

You know, so that's great that they'll do it because they love it.

It's delicious.

Lindsey, I can't pass that stuff off on my family. I mean, it's like complete mutiny, starting with my husband. Started with my husband, then my older son, the whole, the whole place would be in mutiny.

So wait, I got all 3 of my kids to eat, and my husband, they all love it now. It is such a good brand.

Which one is it?

It's Ancient. I'm gonna send it to you. It is so good. It's Jovial. Jovial.

Okay, I've seen that in the store.

So good. Listen, my kids know when it's chickpea. They know when it's, they know when it's chickpea. They know when it's Well, but when I give them the brown rice, they gobble it up. Gobble it up.

I've just given up. I just have— we have two pots.

No, you've got to do the brown rice. Promise you. I got everyone in my family. We don't have any more conventional pasta in the house. It's brown and it looks like regular pasta. It's like it has the same— it's really good. And like they make a penne, they make a farfalle, they make elbow macaronis. I'm telling you, Lindsey.

Yeah, no, one time— no, you see, here's the thing about my family is even if you don't tell them and you try and just fool them, somebody is going to begin to sniff something out because they know I'm gluten-free. And if I'm eating it and they're eating it, there's a problem. And so even if it tastes perfectly fine, like somewhere in the meal, somebody's going to be like, wait a second, you're eating this too. Something's wrong. You fed us. And then I'm going to get reminded of the time when I tried to pass off turnip fries as French fries, and then it all goes south.

Oh my God. No, I really honestly, I'm telling you, there is no way. You cook it for like 8 minutes. I'm telling you, they will all like it. Put a yummy marinara sauce on it. I'm telling you.

Okay.

There's no way. You have to let me know. You have to try it because I've lived and I give it to all their friends. All of their friends eat it. Nobody doesn't eat it.

Okay. Okay. I'll trust you on this one. We'll give it a try. Okay, so I've kept you much longer than I should have.

I'm sorry.

How should we, how should we wrap this up?

How should I— don't know.

Is there any, any final thoughts on, on how you might help this person?

Yeah, so I— so basically I'm gonna, after I'm done with the C. diff, I'm gonna go, go after the bilifila like I just said with that TruFlora. I'll probably keep them on the Cleanse, keep them on a prebiotic, keep them on digestive enzymes. And I'll probably retest them in 6 months, you know.

Okay, but nowhere in here did I hear any antimicrobials. You're just, you're just using probiotics, prebiotics, enzymes?

I'm not, I'm not.

Okay.

No.

Is that for most people or just this particular profile?

The vast majority. I don't use any antimicrobial unless like, unless I see some weird pathogen.

Okay, so you're, yeah, you're using the spore-based probiotics to colon shape the microbiome?

A combination of those, or maybe some other type of pro— depending on what the situation is. Yeah.

Interesting. Okay. Wow. So I will link to Microbiome Labs stool tests, this, the Biome FX, and, and products. So people want to use that. And, and through my— through my—

yeah, they have great products.

I have an affiliate account so they can get a 20% discount using my affiliate account.

So nice.

Yeah.

And it's a great— they have great products. Yeah.

I give Megaspore Biotic to a lot of clients.

Yeah, it works great. It works great. I would say, like I said, everyone's different. I had a person the other day that I did a consult on this through Microbiome Labs, and he was like, it just doesn't work for me. The Megaspore Biotic doesn't work. So I'm like, okay, we're going to try something different. Again, everyone's so different, right? So not everything's going to work the same for everybody. So we have a lot of tools. In our toolkit and we'll just try something different for that person, you know? And that's okay.

Yeah. I think, you know, a round of it for— I give almost everybody at least a month of it, but they're so expensive and all of the good brands are expensive.

And so all of them are everything. Yeah.

On top of everything else, I feel like it's just a lot to ask of people sometimes.

Yeah. Yeah. But listen, so when you get— when you're— when this is done, you got to give it to me. I'll get it to Quran.

Okay.

I'll get you a stool test. And then we end up—

okay, this sounds great.

We'll see what those probiotics look like.

That would be interesting because I, you know, I never knew if I could trust it or not. And I'll have to, I'll have to make sure my SIBO's not acting up when I do that.

You should get rid of your SIBO.

Oh, I keep trying. I, I just did the IBS Smart Test and found out that I do have autoimmune IBS, essentially.

So wait, what did you do? You said you did— why you broke—

I do. It was positive for the anti-vinculin.

Oh, you did it. Oh yeah. What did you— I didn't hear what you read. Is that the Vibrant test?

No, the IBS-Smart.

Yeah. Vibrant has the same thing.

Oh, do they?

Okay. Anti-vinicular antibody. I think I have anti-vinicular antibody too.

I just did it like a week ago. I mean, I got the results a week ago.

Well, did you— you know, it usually— that usually results if you've had like an infectious— an infection.

Right. And I did have a couple nasty incidents of food poisoning.

Yeah, neat. So years ago, yeah. And I, I was— funny that we were talking about before, I was, I was hospitalized for E. coli 0157 when I was in medical school.

Wow. And yeah, no, I had never had anything that had me hospitalized, but I, I lived in Costa Rica a couple different times.

And oh, there you go.

Once I got one, some weird thing, I don't know what it was, but I had to take some strange antibiotic for it. And then the other time was a full-on just food poisoning because I left mayonnaise sitting for 2 days and then made like tuna salad.

What are you going to do with your anti-veniculin antibody?

I'm, I'm, I'm sort of working on the prokinetic question right now.

Okay.

Yeah, I'm playing with Iberogast, but I'm thinking I want to see if I can get somebody to prescribe me something.

Okay, got it.

Yeah, so we'll see. I'm, I'm launching into a study on prokinetics now.

Okay, that's awesome. Let me know how that goes though. It's really—

yeah. Thank you so much for coming on and all this great information about this test. Nobody's talked about this or worked on it before, so, so this is an interesting new approach.

Yeah, thank you. It was a pleasure. Thanks so much for having me. I really, really appreciate it.

If you'd like to connect with Dr. Rose, I'll link to her practice, Terrain Health, in the show notes. And I've also got a link to Microbiome Labs who make the Biome FX test and most of the products she mentioned, like the HU58 probiotic MegaSporeBiotic, MegaPre, Mega IgG 2000, and MegaMucosa. And you can get a 20% discount on the test and those products using my link. And I'll also put a link to my Wellabay dispensary, which carries the other products she mentioned, like the Cleanzyme and TruFlora. And you can get all of the Microbiome Labs products from my Fullscript dispensary as well, so I'll link to that too. And of course, if you use my links, you're supporting the show, so thank you for that. And if you'd like to connect with me online, you can follow my High Desert Health Facebook page or join my Gut Healing Facebook group, or join my newsletter list at highdeserthealthcoaching.com. And you'll find links for all that in the show notes. Thanks for joining me today, and here's wishing you all the perfect stool.