At-home gut microbiome testing is trending, offering insight for the curious, empowerment for the chronically ill, and claiming a path to longevity for the health-conscious.
Private companies offer tests that can check the inventory of bacteria in your gut, with costs ranging from $100 to more than $500.
But can microbiome testing actually provide actionable health information?
As more patients visit their doctors with their results in hand, frustrated gastroenterologists want people to know that the test has its limitations.
There’s a world inside your gut, but we still don’t know much about it
In our intestines, an entire ecosystem of bacteria helps us digest food, absorb key vitamins, fight inflammation, and more. Research shows that a healthy gut microbiome plays a role in preventing things like liver disease and diabetes, and can even impact your mental health.
The gut microbiome is incredibly complex, and our understanding of it is “still in its infancy,” says Dr. Mark Benson, a gastroenterologist at the University of Wisconsin-Madison Health System.
“However, there is growing evidence that there are changes in the gut microbiome that are associated with a variety of diseases, including diabetes, liver disease, obesity, and inflammatory bowel disease,” he said.
However, there are important pitfalls. In many cases, it is unclear whether changes in the gut microbiome are the cause or effect of the disease.
This article is part of AP’s Be Well coverage, which focuses on wellness, fitness, diet and mental health. Read more Hope you are well.
Additionally, each person’s gut microbiome is unique, like a fingerprint. Changes can occur even in the intestines of one person.
“Most of the variation between people is not understood,” says Dr. Eamon Quigley, chief of gastroenterology and hepatology at Houston Methodist Hospital. He has spent 30 years studying the gut microbiome and disorders of gut-brain interaction, such as irritable bowel syndrome.
How does a gut microbiome test work?
In most cases, microbiome testing involves collecting a stool sample, usually using a cotton swab or wipe. The sample will be mailed to a laboratory for analysis.
The company then provides a report outlining how that person’s gut bacteria mix compares to the assumed ideal, or where there are imbalances.
These direct-to-consumer tests are not intended for clinical use and are not federally regulated, making it nearly impossible to determine their reliability. Different companies have different testing standards and methods.
This raises many questions for doctors. Is the sample collection consistent and reliable? What is the science behind the benchmarks to which they are comparing the results? Is the best place to take the sample a stool? Should it come from the upper part of the intestine??
What can doctors do about test results?
Your doctor may order a stool test, but they’re usually looking for a specific problem, such as an infection, inflammation from food poisoning or antibiotic use, or cancer.
If a patient brings in their own results from a commercial test, there is little we can do to advise them.
“When you talk to patients, these tests are fascinating. They’re great. These are all data,” says Dr. Sean Spencer, a physician-scientist at Stanford University. What’s frustrating for doctors, he says, is the lack of tools to change the microbiome.
Spencer, Quigley, and Benson all had their patients bring in their microbiome test results. But antibiotics and diet are actually the only proven tools doctors have to change the gut microbiome, Spencer said.
Quigley said the tests can also show measures of intestinal inflammation and pancreatic function, which can be helpful to doctors. But beyond that, “for most people, it’s really a waste of money,” he says.
Doctors said the list of gut bacteria and imbalanced gut bacteria doesn’t equate to medically backed treatments.
“This technology is ahead of clinical applications,” Quigley said. “Just because you can measure something doesn’t mean it’s valuable.”
Some test results are problematic
Companies offering the tests say they do not treat specific conditions. But most of them are around 45% according to one study. Science Policy Forum March 2024 Article — We also sell supplements that we recommend to our customers along with our results.
One of them, Thorne, is a wellness company that sells gut microbiome tests and provides supplement recommendations along with test results along with recommended lifestyle changes.
Chief scientific officer Nathan Price said he didn’t see that as a conflict of interest. He said customers are “not forced” to buy anything, but many are looking for solutions. Thorne’s test allows you to track whether probiotics are changing your results over time.
Probiotics and other supplements are not regulated Although they are recognized as medicines by the Food and Drug Administration, many questions remain about which ones are effective and whether they contain what they claim. Research into the potential of probiotics to treat several chronic health conditions such as atopic dermatitis, high cholesterol, and irritable bowl syndrome. mixed results or limited impact.
Another company, Tiny Health, recommends supplement brands based on its own testing but does not sell them or make money from affiliate marketing. This was an important line for Dr. Elisa Song, the company’s chief medical officer and integrative pediatrician.
“It was clear that Tiny Health should not sell probiotics, because there should be no conflict of interest,” Song said. “We have to keep the science clean.”
No tests needed to improve your gut
health
Gastroenterologists interviewed by The Associated Press agreed that there’s no harm in getting these tests if you’re curious about your gut or want to contribute to a company’s research.
But you can improve your gut health without testing, doctors say.
“I’m not going to drastically change my treatment or start taking a ton of expensive supplements based on these results,” Benson said.
Instead, eat lots of plant-based fiber and protein. Improve your sleep. Let’s move our bodies. See your doctor for serious bowel symptoms, such as blood in your stool, ongoing constipation or diarrhea, or severe pain.
Spencer, medical director of Stanford University’s Division of Microbiome Diagnosis and Treatment, looks forward to the day when doctors can treat the microbiome by tailoring treatments to address imbalances.
He and other gastroenterologists said they understand the frustration of people with complex and difficult-to-treat gastrointestinal diseases. The testing company says it is moving the technology forward.
“I think we need more research. We need evidence,” Song said. “We need evidence to make this the standard of care.”
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. AP is solely responsible for all content.
