Modern Health and the Gut Microbiome

There is an increasing interest in the gut microbiome and how it relates to wellness. While integrative physicians have acknowledged the importance of the gut microbiome for quite some time, its importance in wellness is now starting to be recognized with allopathic physicians and researchers.There is an amounting number of illnesses that are being recognized as having a gut microbiome connection. These range from gastrointestinal issues, mental health issues to some cancers. Immunotherapies for cancer may also be rendered more effective through a healthier gut microbiome.

A microbiome is an internal ecosystem of organisms including yeasts, fungi, viruses, protozoans and bacteria. The gut microbiome is a complex, dynamic ecosystem of a vast number of  greater than 500 bacterial species, which are in a equilibrium with their host, the human body. This microbiome can exert both local and distant effects. Aberrations and disruption of this equilibrium can lead to disease. The composition of the gut microbiome is influenced by genetics, nutrition, alcohol intake, environmental exposures, and medications, in particular antibiotics.The gut microbiome is functional and influences hormonal intermediates, metabolism, immunologic responses, carcinogenesis, and inflammation. Multiple studies have shown that the richer the diversity of an individual’s microbiome, the lower the risk of disease.

The role of the gut microbiome in women’s health has not been well evaluated at the scientific level. Problems with the accurate study of the gut microbiome include: the amount of information to process is large, 1 g stool contains 100 billion microbes; the information also is dynamic, the microbiome profile changes with diet, medical interventions and other undefined impactors. Interpreting results of microbiome testing and determining the clinical significance can be challenging and difficult,  due to a lack of standards and reference data for comparison. The gut microbiome may influence hormone levels and production in the body. For example declining estrogen levels at menopause, or endocrine disruptors from the environment may lead to a change in the gut microbiome which can in turn affect metabolism, energy levels  and other wellness issues.

Through its role in estrogen metabolism, the gut microbiome can also influence estrogen levels as the gut microbiome includes an estrobolome. The estrobolome is defined as “the aggregate of enteric bacterial genes whose products are capable of metabolizing estrogens”. In the liver, estrogens and are metabolized and  excreted in bile, urine, and the gut. Approximately 10% to 15% of estradiol, estrone, and estriol are found in metabolized form in the gut, and a biologically significant proportion of estrogens are reabsorbed in the circulation. The gut bacteria of the estrobolome participate in this metabolism of estrogens. The estrobolome, through its effect on estrogen metabolism can alter cardiac health, glucose metabolism, bone health, and cancer.  Abdominal weight gain can be a symptom of dysbiosis, or an imbalance of the gut microbiome leading to altered estrogen metabolism. Research has demonstrated that consuming phytoestrogens (plant estrogens) can help with weight gain. In addition to estrogen, the gut microbiome also affects other hormones and neurotransmitters such as thyroid hormones, serotonin, dopamine, and melatonin.

In order to maintain a healthy gut microbiome, eat a variety of natural whole foods and avoid processed foods and sugars. A variety of fruits and vegetables should form a foundation, along with healthy fats and lean protein. A variety of probiotics and prebiotics should be included. Probiotics are foods or supplements that have live bacteria in them, and are thought to benefit the gut. Prebiotics are foods that help boost existing gut bacteria and encourage a diverse culture of microbes. Prebiotics include fiber rich foods,  and probiotics are fermented and help healthy bacteria to grow. Prebiotics include kefir, kimchi, miso and fermented vegetables. Healthy management of stress, sleep, exercise, limiting alcohol is also important to a healthy gut microbiome. Adding poylphenols through broccoli, blueberries, green tea, cocoa, red wine and almonds can be beneficial. The goal should be to increase diversity of plant consumption and eat in moderation meat, poultry and fish. Adding fiber is important. Spices such as: turmeric, chilli, cumin, cinnamon and paprika may help with inflammation. This allows your bacteria to grow and develop, and therefore keeps your microbiome in better balance.