Microbiome Prescription computes items that are likely to cause positive shifts in the microbiome. These positive shifts are expected to reduce symptoms and symptom severity. This is only part of a treatment plan. How much to take? When to take it? Interactions between suggestions are clinical issues that are usually based on clinical experience. We do not have that wisdom.

We can provide some guidance from the literature:

• List of dosages used in clinical studies for many items are available here 📏🍽️ Dosages for Supplements. Our general suggestion is to use the highest dosage by starting at a low dosages and slowly increasing.
• We provide information about interactions of various items with probiotics. Our general suggestion is not to take items together that conflicts. For example, taking an antibiotics or herbal oil/extract that reduces a type of probiotic with that probiotic. Wait until the course of antibiotics or herbal oil/extract ends, then take it (to help restore the lost population).

Our thinking has been greatly influenced by the work of Cécile Jadin, MD – who is a surgeon. She applied models from her father’s time at Pasteur Institute of Tropical Medicine when he worked with a Nobel Prize Winner. She has had over 25+ years treating difficult conditions: ME/CFS, Chronic Lyme Disease, Chronic Q-Fever and Rickettsia infections. See Dr. Jadin’s Current Protocol for ME/CFS

Our general interpretation of her model gives us some general rules to follow are:

• Pairs of antibiotics for 7 days and then 21 days off and then different ones for the next month
  • Antibiotic means prescription antibiotics AND Herbal antibiotics.
  • Typically two dosages a day, 12 hours apart
    • See Jadin’s notes for her suggestions of things not to do with certain antibiotics
• Probiotics should be viewed as antibiotics (many produce natural antibiotics)
  • There are good and bad probiotics. You do not want to play Russian roulette with a mixture of both good and bad.
  • Caution: for me, some probiotics at bed time will cause deep sleep (with night sweats on some) while others will make getting to sleep hard. Adjust the time to your response.

A 4 week cycle may look like this:

• 1st week on a pair of antibiotics,
• 2nd week on a herbal oil or extract
• 3rd week on a probiotic — ideally a single species probiotics at desired dosage
• 4th week rest

At the end of the 4th week, take another microbiome sample. We want to have some natural stabilization of the microbiome before the next course correction.

If no antibiotics are involved, then do a different herb or spice instead. My personal preferences are two from the following list (make sure they are positive for you):

• Wormwood
• Olive Leaf Extract
• Neem
• Triphala
• Tulsi

Amino acids and vitamins can usually be taken continuously.

Pre- and post- biotics should be started with the probiotic AFTER verifying that it increases the probiotics selected (see tool above). Example for Human milk oligosaccharides is shown below.

Picking items on Suggestions

We are walking thru a vast desert devoid of good studies with a few oasis. We compensate by using fuzzy logic. In keeping with increasing odds, my usual advice is to look at the highest priority item number and divide by two. Those over half (50%) of this should be your main focus. Similarly, look at the most negative item and those more negative than half of that are items to reduce or eliminate. For example:

• Highest Priority: 800, look at items between 400 and 800
• Lowest Priority: -450, look at reducing items between -225 and -450.

Review with your Medical Professional

At least, inform them of what you are going to do (by email, message or letter) and ask “Do you see any problems?”. 99% of the time the response will be silence, or a “I don’t see an issue”. If something goes wrong, you have a defense against a blame game….

Finding a knowledgably experienced medical professional is a challenge. Often the reality is that you have to educate your medical professional which is a slow process. My usual strategy is to bring in 1-2 summaries or papers printed from the US National Library of Medicine each time after finding a medical professional that is interested in learning more (i.e. no burn out, patient exhaustion, etc.).