Balance and Robustness Walkthrough - Tiny Health Gut Health Test

Hi, my name is Emily Cerda. I'm a microbiome specialist here with Tiny Health. Um, today we're going to talk about the balance and robustness section, um, in your patient results. So here on the main patient, uh, results page, I'm going to go to see all metrics, and I'm going to click the checkbox to just look at balance and robustness. So this section of our test I like to say that it gives the 1,000-foot view of what's happening in the gut. Um, it kind of gives us an idea of who's in there, um, what their percentages are, what really makes up this environment. The first couple metrics that we'll see relate to microbiome diversity. So we, here we have Shannon diversity and species richness. Species richness is looking at the number of individuals in the gut. So this individual has 462 species. In the gut. And if you've watched the overview of the entire test, you'll know that the species richness you can see in the microbiome breakdown of this section, and we will actually list all 462 of those species so you can go in and check them out. Diversity— the Shannon diversity looks at diversity in a little bit different way. So where species richness are the individuals in the gut, Shannon diversity says how robust are those individual populations? So this, I think of this, my brain thinks of this more in like a 3D way of thinking about diversity. So how robust are the populations in this individual's gut? And you can see we want this to be on the higher end. We know that the correlation to good health throughout the lifespan is linked to good Shannon diversity. Okay, um, going back in to balance and robustness, the next section that we see, um, in this individual's report is an overabundant species. Now, these overabundant species, um, they're actually marked a little bit further down the common microbiome members.. And it's important that these are distinguished from the disruptive pathogens in our gut. So common microbiome members, here is that Ruminococcus navis. It, they should be there. If I click on this overgrown species, you'll notice that yes, it's marked high, but there is a gray portion to this bar where we actually want Ruminococcus navis to be, can be beneficial to us at those lower levels. So you can think of these as commensals. Um, they're helpful for us at lower levels, but they can become opportunistic if the population gets too large and they can drive inflammation. This particular individual can make some, um, hydrogen sulfide, and it can also damage that mucus layer in the gut. Now, that doesn't mean we don't want it to be there. Like I said, it needs to be there in small levels. So when you see something that is overabundant, this section of the test, we're really taking a crowding out, um, approach instead of using an antimicrobial to knock it down. So on the actions here, you can see polyphenol-rich foods are listed, and that's because those polyphenols really feed things like Faecalibacterium and Bifidobacterium, which are beneficial bacteria that can in turn crowd this population back down to where it should be. And obviously, variety, building diversity in the gut, making sure those individuals are very robust, taking up a lot of space, that also will have a crowding out effect. So overabundant species, know that they are in this balance and robustness section, and that does differ from the disruptive microbes section, which I talk about in another video where we're talking about pathogens. In the gut. So we're taking a crowding out approach here. Now, the next, the next metric down is gut resilience. Gut resilience is a very cool metric. It's one of our newer metrics. This is taken from our resample data. So if somebody took a test and they went off and life happened, say they got sick, they needed antibiotics, they traveled internationally, um, maybe they got told they had to work swing shift for a week, right? All of these things are things that could derail our gut health. And, um, what we then see is that the population took a second test. And so in that resample data, we're finding that some people had that event and it's like nothing ever happened. Their gut health just really remained the same and they were very, very resilient. And for other individuals, whenever that event happened that might be disruptive to the gut, their gut health really took a dive. And so we see in their resample data that their gut health is really— it's taken a hit. It's a lot worse than it was in that first test. And so, you know, in this, in these metrics, we can click in and we can read in the About section about how these things are, how we're measuring these things. And so our science team created a machine learning algorithm that looked at what are the metrics in the test that really set somebody up to have great resilience? What was different in that population versus the population where their gut health really fell off? So you can see some of those listed here. But in a nutshell, as a practitioner, what you need to know about this is that if your patient is testing, like say they test here like this individual, and they're on this lower end of normal. If they were to have any of those events happen, if they were to have something where they needed antibiotics, they would probably need a decent amount of support around that event so that their gut doesn't take a really big slide. Their gut health doesn't take a slide. Um, and the opposite is if they have great resilience, then maybe they'll need a little bit less support. They should be able to maintain their gut health. Their gut health is going to bounce right back from something like that. So that can be helpful too. If, if you have somebody who's down here in the red and they're really trying to shift their gut health, it can also take a bigger push. It can take a bigger effort to get yourself from the red up into the green. But a lot of the metrics, the other steps that we have in balancing out the test balancing those beneficials, really creating an environment where those things want to thrive and the disruptive pathogens do not, shoring up digestive sufficiency. All of these things are going to create that microbial environment that will lend itself towards good gut resilience. Okay, back into Balance and Robustness. The next section we have here are oral microbes. Now, you know, we're only testing stool. So these are oral microbes in the gut. We're really talking about the translocation of microbes commonly found in the oral microbiome who have made their way down to the large intestine. Now, there's a couple ways I look at this. First, if you think about it, an oral microbe should not have a straight shot to the large intestine without encountering stomach acid and knocking down the population significantly or killing it outright. So if this is really high, I am functionally thinking about, does my patient present with some issues around stomach acid, digestive sufficiency? The other thing that we're finding with these is that that translocation of certain microbes is being related to some neurodegenerative disease. In the literature. So I think Porphyromonas gingivalis is one that comes to mind, and I know that it's been implicated in some, some Alzheimer's and maybe Parkinson's. So there, there are some correlations. I think we're kind of on the cutting edge of this research and finding out about these microbes and what they're doing in the large intestine when they really shouldn't be there. So that's what we're looking at here. This individual doesn't have any, but if they did, it would say species in the sample and it would list what those are. And if it said Porphyromonas, for example, you can go out into the microbiome breakdown section and you can search Porphyromonas and it will give you a list of the specific species. So you can see, is it, is it something that's harmless or is it something that's more like a gingivalis that we need to keep an eye on? Okay, next in the balance and robustness section, we have bacterial phyla are listed here. Now, honestly, I don't use this a ton because the phyla Bacteriodota, Firmicutes, Actinobacteriota, those are all made up of some of the microbes that we've already talked about earlier in the test. And I like to drill into the details because there can be good individual, like really beneficial individuals in these families. And also, there can be individuals that we need to keep an eye on in the same family. So giving the phyla percentage doesn't give me as much information as drilling in, in the other parts of the test. At the same time, I do pay attention if these are out of range. Common microbiome members, we already talked about. So these are those commensals that we want at lower levels, but not at higher levels. You will notice, like the Ruminococcus navis that was listed as overabundant in this section, you see it's up here. It's not listed red twice because we don't want you to think there's two different things going on. That would be confusing. Um, we'll only list it once. And it— you will notice that that species is called out against the Ruminococcus genus. So the reason it's called out is because it can be opportunistic and, like I said, make hydrogen sulfide damage that gut lining. You'll notice the same thing for Bacteroides fragilis. It's called out against Bacteroides because this is a pernicious one that we want to keep an eye on. This is a great level here. We still need it, we just don't want it to get too big. Um, so keep an eye on these. Uh, and then we also have gut ratios here, which again, these are comparing those genus, phyla to each other. And again, I don't— I would love to hear if you do find utility in these. I do not find so much utility because again, there's good and bad in the Firmicutes. There's good and bad in the Bacteriodota. And so giving me the ratio doesn't tell me, well, is it the good ones? Is it the bad ones? Like, who's carrying the weight of that phyla? So I drill into the, the details in other parts of the test. I hope this is helpful. 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