2023 Walk thru of Personal Microbiomes Suggestions

The two videos below are intended as quick introductions to the microbiome prescription site. The site is dynamic with continuous changes of data available and being used.

See also: A series of online meeting on using Microbiome Prescription [Sep 2023] update. Likely a better start point.

16s Samples

This covers sites that provides comprehensive reports on your microbiome. The better reports typically report on over 500 different bacteria from a sample.

Lab/ProcessorLowTypical CountHighSamples Uploaded
AmericanGut7315621318
BiomeSight1157213051635
BiomeSightRdp27957386215
CosmosId643670536
es-xenogene5761522524
Medivere5307219347
Microba5312618621
OmbreLabs/Thryve18567122381241
SequentiaBiotech16631346036
uBiome6249589814
Statistics at the start of January 2023

Older Labs

These are older technology and often are focused on a small number of bacteria. Often the focus was based on what was deemed significant 10 or even 20 years ago.

Lab NameSamples
Viome (No objective measures) 5
All Taxonomies from tests 67
Medivere: Gesundsheitscheck Darm (16s Limited) 15
GI360 Stool (UK) 29
Medivere: Darn Magen Diagnostik (16s Limited) 15
All Bacteria [Family] Reported 25
Smart Gut (ubiome 16s – Limited Taxonomy) 2
GI EcologiX (Invivo) 19
GanzImmun Diagnostics AG Befundbericht 14
DayTwo 8
GanzImmun Diagnostic A6 (cfu/gm) 80
Nordic Laboratories 2
InVitaLab (cfu/gm) 3
Biovis Microbiome Plus (cfu/g) 18
Diagnostic Solution GI-Map (cfu/gm) 498
Metagenomics Stool (De Meirleir) (16s Limited) 4
Genova Parasitology (cfu/g) 4
Verisana (cfu/ml) aka (kbe/ml) 2
Medivere: Darm Mikrobiom Stuhltest (16s limited) 12
Genova Gi Effects (cfu/g) 116
Kyber Kompakt (cfu/g) 2
All Bacteria [Genus] Reported 188
Bioscreen (cfu/gm) 13
NutriPATH 12
Gut Zoomer (vibrant-wellness) 6

New Food Features

This feature was added because many of the suggestions were for flavonoids or other items that may or may not be available as supplements. Most people do not know what is in different foods, especially items you are wishing to avoid. The intent is to allow a more comprehensive and rich diet to be developed by users.

Crohn’s Over Three Years

This is a reader with a diagnosis of Crohn’s diseases with complications (severe histamine and mast cell issues, severe multiple chemical sensitivity). She also have had ongoing hot flashes for a few decase The Crohn’s has been stabled and does not require prescription medications; it has been treated by diet and the use of E.Coli probiotics (Symbioflor-2: SOURCES: https://www.paulsmarteurope.com/ and https://www.naturitas.us/, and Mutaflor). When a flare starts, the E.Coli probiotics have been able to quiet things down quickly.

Using the new Food Suggestions (with consensus)

This is a new feature that is intended to supplement the first class suggestions from microbiome prescription. Almost 8000 different foods are evaluated. The intent is to allow people to fine tune diets for the most impact especially when flavonoids and sugar types are given by name, but not by what food contains them. Some foods may have both good and bad content, the intent is do a deep evaluation of the foods based on their reported nutrients. For more information, see this blog post.

Overview of Samples

The general impression of the samples is reasonable stableness. Some third party criteria improved (Metagnomics, Xenogeme) and other third party criteria (Medivere,MyBioma,Nirvana) got worst, and one with no change(JasonH). The same is seen with the statistical ranges.

Criteria202220212020
Lab Read Quality34.13.8
Bacteria Reported By Lab524584721
Bacteria Over 99%ile596
Bacteria Over 95%ile304436
Bacteria Over 90%ile528284
Bacteria Under 10%ile452526
Bacteria Under 5%ile15104
Bacteria Under 1%ile000
Lab: Thryve
Rarely Seen 1%849
Rarely Seen 5%272951
Pathogens293328
Outside Range from JasonH777
Outside Range from Medivere151514
Outside Range from Metagenomics101012
Outside Range from MyBioma131312
Outside Range from Nirvana/CosmosId232314
Outside Range from XenoGene404049
Outside Lab Range (+/- 1.96SD)312218
Outside Box-Plot-Whiskers138109142
Outside Kaltoft-Moldrup184163205
Condition Est. Over 99%ile000
Condition Est. Over 95%ile121
Condition Est. Over 90%ile121
Enzymes Over 99%ile390
Enzymes Over 95%ile326423
Enzymes Over 90%ile6519471
Enzymes Under 10%ile1364568
Enzymes Under 5%ile422137
Enzymes Under 1%ile040
Compounds Over 99%ile261421
Compounds Over 95%ile1222929
Compounds Over 90%ile3503837
Compounds Under 10%ile1492422
Compounds Under 5%ile311718
Compounds Under 1%ile466

Looking at Special Studies:

  • 2020 – 7%- 21% matched, 38%ile against PubMed Criteria
  • 2021 – 5% – 18% matched, 32%ile against PubMed Criteria
  • 2022 – 5% – 16% matched, 74%ile against PubMed Criteria

The top common ones across the years are:

  • Poor gut motility
  • ME/CFS without IBS
  • Easily irritated
  • Post-exertional malaise
  • Depression

We do not have sufficient samples yet to do a special study for Crohn’s disease.

There appears to be a weak indication of worsening — this may be due to not being able to get Mutaflor (E.Coli Nissle 1917) during COVID restrictions. This was remedied shortly after the last sample.

Going Forward

Doing the usual three statistical methods (Standard Lab Ranges (+/- 2 Std Dev),  Box Plot Whisker, Kaltoft-Moltrup Normal Ranges) to get suggestions (including prescription drugs). I included prescription drugs to see if any typical Crohn’s drugs are suggested.

  • risperidone: was the top one, this is used to treat mood disorder (depression and irritability bacteria?)
  • hexestrol:  a nonsteroidal estrogen which was previously used for estrogen replacement therapy (hot flashes)
  • ethopropazine hydrochloride: a drug uses for Parkinson’s disease. A blood family member had Parkinson’s and the person has seen the occasion “shake” in her hands that has raised concerns about that condition
  • The next items were antibiotics and significantly less confidence.

This is not totally surprising that prescription items appear to match conditions. The mechanism of action of these prescription drugs may be partially thru the microbiome.

Returning to the non-prescription world, in terms of priorities:

In one sense, the reader was very pleased with these suggestions being almost entirely supplements. The histamine issues greatly restricts her food choices (she is already gluten free!)

Food Suggestions

I did a walk thru of the food suggestions for this sample. See the video below.

Experimental Food Suggestions

Presentation on What we are doing

This is a short video on the process

Sources of Data

How to Use

Go to Microbiome Prescription, log in and go to [Changing Microbiome]. At the bottom of each section you will see a check box. Make your usual selection and then check this choice and click [Get Suggestions]

You may wish to do a regular suggestion first. It seems that the more bacteria being selected, the finer the suggestions are.

The suggestions are on a subdomain to distribute the load.

Clicking on a food shows the nutrients. Nutrient that are higher than typical have a * . These are the reason for the food being selected. One or more of these nutrients should help your microbiome.

Walkthru of Updated Suggestions — with CONSENSUS

See this post for background of the sample used.

Pending Feature: Synthetic Impact

A reader asked me what is the impact on the microbiome of prunes. My response was simple — I know of no studies reporting the impact on the microbiome. Having a study is first class evidence.

I then pointed out to him that I have prunes on my web site under Foods with Flavonids,

With several listed

Clicking on it shows the contents, data is coming from these open sources:


I suggested that he looks up the main items that have studies and estimate.

Over the weekend, I reflected and realized that it would be more friendly for me to do this mathematically using some simplifying assumptions (i.e. the impact is linearly related to the component for all bacteria). The result is now added to the existing list of modifiers


These are second, perhaps even third class suggestions. We are running off inference.

You can get suggestions using these by selecting this

WARNING

I am refreshing source data from US Dept of Agriculture and the EU equivalent and then need to redo the mapping of the components to appropriate proxies. This is not expected to be done before 2023. Feel free to play around with it — but the results are suspect until the data is updated and re-mapped.

Some lab ranges are Questionable!

People may transcribe data from the tests below to microbiome prescription for suggestions. I just added statistics for how many transcriptions that has been done for each, and I also provided statistics for what they report by bacteria. These latter statistics are very interesting, one lab reports 50% of people have too low lactobacillus, another lab reports 8% only.

Example of the statistics on usage.

From https://www.microbiomeprescription.com/labs/stats


In the video below, I show how you can verified that the ranges they are using are correct, or if the ranges are incorrect — perhaps based on some ideological theory about what makes a healthy microbiome.

What is the best diet in your opinion?

This is a repost with expansion of “What is the best diet in your opinion?” on my CFS Remission blog back in 2018. It consists of the following

  • Basic Logic for this diet
  • How diets have changed in recent years — today’s “normal diet” is radically different than your recent ancestors
  • The manifestation of “keeping up with the Jones” eating habits
  • Finding Your Historic Diet – my own exploration

I have been asked this often. My answer is extremely logical but not what you will get from most health experts (and unfortunately, may not be easy to determine for some, see “mutts” below). It is based on actual science and not idealogy.

The Diet…. it’s Logic

Very simple — the type of diet that your ancestors ate 300+ years ago! Diet changes gene expression, i.e. microbiome AND DNA adapts.

Last year, researchers discovered that these kinds of environmental genetic changes can be passed down for a whopping 14 generations in an animal – the largest span ever observed in a creature, in this case being a dynasty of C. elegans nematodes (roundworms)…. Usually, environmental changes to genetic expression only last a few generations.
…  studies have shown that both the children and grandchildren of women who survived the Dutch famine of 1944-45 were found to have increased glucose intolerance in adulthood.Scientists Have Observed Epigenetic Memories Being Passed Down For 14 Generations

What is 14 human generations? 300 to 420 years.

Maternal undernutrition during pregnancy (F(0)) programs reduced birth weight, IGT, and obesity in both first- and second-generation offspring. Sex-specific transmission of phenotypes implicates complex mechanisms including alterations in the maternal metabolic environment (transmaternal inheritance of obesity), gene expression mediated by developmental and epigenetic pathways (transpaternal inheritance of LBW), or both (IGT)

Intergenerational transmission of glucose intolerance and obesity by in utero undernutrition in mice [2009]

” Thus, it is possible to construct a chain of events, based on experimentally verified biochemical mechanisms, through which an environmentally induced change in the activity of chromatin-modifying enzymes can lead to a change in DNA sequence.”

Epigenetic responses to environmental change and their evolutionary implications [2009]

A diet based on typical diet of your ancestors 400 – 1400 years ago is likely a better choice than any healthy diet pitched by most people. Your gut bacteria is likely closer to the optimized bacteria your ancestors evolved from eating the same food for a thousand years.

Risk of introducing atypical foods

A new atypical food will have some bacteria/body tolerate it. For others, it may throw the body’s balance off; leading to autoimmune disease, diabetes, gluten sensitivity, autism, ADSD and a host of other conditions that appear to be increasing in western population ‘for no apparent cause’ (… cough, cough, cough). It’s a gamble for you and for your children. Yes, people will adapt and survive — but your offspring may not.

You should avoid the newly introduced foods (for your regions) that were not in use a couple of hundred years ago, for example, potatoes, peanuts (1920’s), and banana (which has been reduced to a single species, Cavendish – because it was the most profitable)The charts below show some of the abnormalities of diet seen recently. You also avoid process foods and modern additives (especially emulsifiers and new preservatives).

Some Drastic Changes seen in Diet

BBC: Which countries eat the most meat?

We can see that Americans have DOUBLED their meat consumption with almost a 10 fold increase of “healthy” chicken.

  • ” In conclusion, consumption of lean red meat (lamb) or lean white meat (chicken) as part of the usual diet is associated with a similar lipid response.” [2011]
  • “Consumption of lean red meat (Pirenaica breed) or lean white meat (chicken) as part of the usual diet is associated with a similar response. ” [2022]
  • “There was no difference in BMI or any other marker of adiposity between consumption of pork, beef and chicken diets. ” [2014]
OPINION
Drivers of U.S. Per Capita Meat Consumption over the Last Century

There are implication that this increase of meat may be a factor in increasing ADHD, Autism rates and autoimmune conditions:

Sugar Consumption in the US Diet between 1822 and 2005

Sugar is added to almost all prepared foods. The reason is simple, it encourages consumption and thus more sales.

And we are eliminating other very tradition foods from our diet, for example legumes and dry beans.

legume consumption remained low in US adults and declined from 2011 to 2014 (mature legumes: 12.8 to 8.3%; dry beans: 10.0 to 6.5%).

Legume Consumption Patterns in US Adults: National Health and Nutrition Examination Survey (NHANES) 2011–2014 and Beans, Lentils, Peas (BLP) 2017 Survey [2020]

Keeping up with the Jones [Health Issues]!

My daughter has seen this in Vancouver, Canada – where almost 50% of the people were born outside of Canada.

Having grown up around such a large amount of immigration, the changes have been really apparent. Interestingly enough, those from India and area tend to keep the traditions at home for eating, so they don’t have such a big impact on their bodies. But those from Asia, they all essentially know that when they come to North America, they are going to gain a lot of weight. Whether it’s food culture or additives in food, it’s a big struggle. They tend to also have problems with both dairy and alcohol. 

Daughter

Keeping up with the Jones often include eating upscale for your own culture group or the population that you are residing in. A food that was once a special occasion food becomes a regular food as a statement of prosperity (and possibly stupidity!)

Evidence of significant impact

  • “Adherence to the ‘ethnic breads, legumes and nuts’ and ‘whole grains, fruit and dairy’ patterns was associated with a lower predicted cardiovascular diseases risk, and an inverse association for the ‘processed food and sugar-sweetened beverages’ pattern in an Asian population. ” [2022]
  • “participants in the highest quintile of the refined-foods pattern had a greater risk of elevated 10-y cardiovascular diseases risk” [2016]
  • “Patterns emphasizing higher consumption of vegetables, legumes, fruit, nuts, whole grains, fish, lean meat or poultry, … were generally associated with decreased risk of all-cause mortality. “
  • Consumption of added sugars has been associated with increased risk of obesity [23,24,25] as well as increased risk factors for cardiovascular disease (CVD) [26], including dyslipidemia [27,28], elevated blood pressure [20,29,30], diabetes [21,31,32], non-alcoholic fatty liver disease [33,34], and even cognitive decline [35] and cancer [36,37].” [2016]
  • “An estimated increase of 10 g/day in total sugar intake (about 2.4 teaspoons) was associated with an increased Alzheimer’s disease  risk  [2022]

Finding Your Historic Diet – my own exploration

From a post that I did seven years ago [2015], I am using myself as an example — you will likely need to do your own research. Beware of revisionist view of traditional diets — research!

Some nuggets that I found in a Christmas Present…

My wife gave me “Danish Cookbooks” by Carol Gold. This is NOT a cook book, but rather an academic study of cookbooks published in Denmark.  I’m 100% Danish and very interested in history.

I have always been inclined towards going for ancestral diet patterns, and did Paleo for a while. My problem with Paleo is that it is more ideological based than actual (scientific-evidence) archeologically based. It is also trying to jump the diet back thousands of years which effectively ignores how our bacteria evolved to meet our changes of diet.

In this book, I found two gems from the historical records:

  • We have decreased the use of spice considerably — in 1600, the common spices were:
    • cumin, anise, coriander, dill, fennel, lavender, sage, rosemary, mint, bay leaves, cloves, pepper, saffron, thyme, marjoram, nutmeg, cardamon, ginger, cinnamon, hyssop, wormwood, lemon balm, angelica-root.
    • “The issue here is … the use of seasonings in general slackens” p.47
    • Many of these spices (like wormwood and ginger) have strong antibacterial characteristics which would have kept some gut bacteria families in control well.
  • “Their most common food was meat” p. 122
  • White (wheat) bread was very uncommon, expensive, and typically seen only in upper class homes on special occasions(not as part of the regular menus) —Note this is in Northern Europe. It appears that most of the carbohydrates came from Rye Bread.

I am sure that some readers who favor a diet that is vegan or vegetarian on ideological grounds would object to these suggestions.  My response is simple, if your ancestors were vegetarians for centuries or millenniums (as some friends who were born in India can validly claim), then that is the right diet without any doubts.

Evidence shows that gut bacteria is inherited through generations — hence it is good to know what your ancestors ate because your gut bacteria have likely adapted to that diet. Given my heritage (which likely applies to people from the UK, Poland, northern France and Germany etc), this boils down to:

  • Rye Bread without any wheat flour
  • Meat and Fish (especially since the family seemed to always been within 5 miles of the coast back to 1500..)
  • Often goat milk and goat cheese (Gjetost) were the norm and not cow milk.
  • Vegetables:

No potatoes — they really did not enter my ancestor dies until the early 1800’s – after one of my great-grandfathers was born. Little or no sugar (“Worldwide through the end of the medieval period, sugar was very expensive[1] and was considered a “fine spice“,[2] but from about the year 1500, technological improvements and New World sources began turning it into a much cheaper bulk commodity.” – Wikipedia)

Dropping back earlier in my ancestry, the Vikings. We have an excellent summary here “Viking Diet: Why you should eat like the Vikings did!” which cites historic text describing the food with archeological findings.
“Vikings farmed cold-hardy vegetables like cabbage, carrots, leeks, turnips, parsnips, garlic, onions, and other root vegetables to add vitamins and variety to their diets. They ate peas, beans, and other legumes. They were fond of apples and cherries from wild or cultivated trees and collected berries and nuts when they were in season.

There is an excellent interview with a specialist: Nordic food culture – A historical perspective by Henry Notake. He cites “the practice of soaking fish in lye is not an original Norwegian tradition, even though the actual raw material of dry fish is. I have found recipes for lutefisk in German cookbooks, Swedish documents from the 16th century, and Spanish and Polish cookbooks from the 17th century. ” He is also the author of Printed Cookbooks in Europe, 1470-1700

Frumenty for Breakfast?

Some foods that are common now were not the case in the past and vice versa.

A Dollop of History, describes this and how to make it. It used  Furmente wt Porpays (Frumenty with Porpoise) from the 14th century English manuscript, The Forme of Cury. This food and similar recipes dates back to Roman Times. It uses saffron. If you can’t get porpoise, oogruk (bearded seal) is a good substitute (a unique taste according to my wife from her own experience). For other recipes see: Medieval Recipes and Ancient Recipes on the same site.

One item to keep in mind, often surviving recipe books were written to the upper class and not your ancestors! Many recipes on the internet are modern adaptions of old recipes to suit contemporary tastes — so be warned!

Project Gutenberg does have some historic cook books available (besides The Forme of Cury cited above)

A list of 13-16th century cook books is on Old Cook with a list of recipes in English. Compare to this, a modern omelet is rather plain!

Ingredients (1 tsp = 1 teaspoon)
6 leaves of tansy
1 rue leaf
4 leaves of Apium (wild celery)
4 mint leaves
4 sage leaves
6 leaves of marjoram or oregano
handful of fennel (aromatic foliage)
large handful of parsley
2 handfuls of the mixture: violet leaves, spinach, lettuce, green chard
16 eggs
1tsp of ginger
salt.

Omelette with herbs, from Arboulaste , Ménagier de Paris, 1393.

This Wikipedia article may be a helpful start for many.

The last item needs to be taken with a touch of salt and sung: “A spoonful of soil helps the microbiome recover!” We have become hyper-hygienic. See the Hygiene hypothesis. This comes from a post in 2016:

“The Amish and Hutterites are U.S. agricultural populations whose lifestyles are remarkably similar in many respects but whose farming practices, in particular, are distinct; the former follow traditional farming practices whereas the latter use industrialized farming practices….Despite the similar genetic ancestries and lifestyles of Amish and Hutterite children, the prevalence of asthma and allergic sensitization was 4 and 6 times as low in the Amish” – i.e. industrialized farming practices resulted in six times (600%) the rate of asthma and allergies. See Innate Immunity and Asthma Risk in Amish and Hutterite Farm Children(2016). This is also echoed in their farm products!!! Amish and Hutterite Environmental Farm Products Have Opposite Effects on Experimental Models of Asthma [2016]. Given a choice of buying groceries from a Hutterite farm or a Amish farm, buy the Amish (non industrialized) groceries!!!!

So I advocate not a Paleo diet, but a regional medieval-food diet (partially modified for modern nutritional needs). No prepared foods (talk about being extremely unnatural!), so food prepared from scratch — ideally organic with heritage seeds. Orange carrots are unnatural! Carrots should be white! The food should also be seasonal! The rotation of food with the seasons is a significant factor. Having fresh strawberries at Christmas is so very wrong.

Are you a Mutt?

The term mutt or “Heinz 57″means mixed ancestry – for example, Asian with African, Icelander with Italian. If you are not sure, a DNA test is suggested.

If you are a mutt, look for commonality of historic foods from the dominant ancestors.

Are what you have been told is healthy wrong?

Chances are that it is corrected relative to the typical common western diet. That is the base line that most studies are done against. If you change the base line, the answer may change…

Note the “compared with other high carb foods

One other factor?

There is evidence that a combination of blood type and being a secretor  or non-secretor impacts the body and the microbiome. There is a nice blood type table by country listed here. Iceland and Ireland are very similar (partially because both had major Viking settlements 1200 years ago). One could propose a model that traditional regional diet influenced the survival rate of different blood type which would be reflected in their blood type distribution. Compare the Scandinavian (meat eaters) to India/Sri Lanka (Vegetarians) below for aNeg,bPos and oNeg.

countryoPosaPosbPosabPosoNegaNegbNegabNeg
Denmark3537846721
Norway33.241.66.83.457.41.20.6
Sweden32371056721
Iceland46.827.29284.81.60.4
Sri Lanka43.422125.785.1321.041.250.26
India32.5321.832.17.721.3620.48
United Kingdom4428829621
United States37.435.78.53.466.31.50.6
Ireland4726928521


Bottom Line

Showing off prosperity by what you eat, trying to assimilate into local or trendy eating habits and convenient “get-healthy” diets are excellent ways to cripple your microbiome (and likely future generations). One simple example is going gluten-free. For some medical conditions it is necessary — but for a person without those conditions, available studies suggests that it is a poor choice advocated by naïve people

Food taste is acquired — cutting sugar and salt from the diet can be hard for many people. Eating turnips and rutabaga may be unfamiliar tastes. Eating 100% rye bread with goat cheese is definitely a different taste. It will take time and may present extra challenges if you have kids or other in the family that want to stick to contemporary eating habits.

My daughter states “There’s a reason why old recipes don’t always work, because ingredients are either no longer available, or they have changed over the years, or techniques have changed (see this post)”

So that is my logic and my reasoning and my evidence…

Comments from Social Media

Possible help for the root of all evil in the microbiome?

Using my last post, The root of all evil in the Microbiome?, I tried identifying items that address many of the evils. The process is simple, I use Microbiome Prescription existing database with 2,099.126 interactions between gut modifiers and bacteria. I then select items that only increase the top N items. Starting with 2 items and then working up.

Two Items: Prevotella, Veillonella

Produced following items

  • Amino Acid and similar
    • acetic acid
    • l-citrulline
      • propionate
  • Antibiotics, Antivirals etc
    • rifaximin (antibiotic)s
  • Diet Style
    • ketogenic diet
  • Food (excluding seasonings)
    • blackcurrant
    • cranberry bean flour
    • Far infrared Sauna
    • fasting
    • lupin seeds (anaphylaxis risk, toxic if not prepared properly)
    • Miso
    • pea (fiber, protein)
    • Pulses
    • red wine
    • wheat bran
  • Herb or Spice
    • Bofutsushosan
    • chinensis (Chinese goldthread)
    • isobutyric acid
    • isovaleric acid(fatty acid)
    • smoking
  • Prebiotics and similar
    • arabinoxylan oligosaccharides (prebiotic)
    • galacto-oligosaccharides (prebiotic)
    • xylan (prebiotic)
  • Probiotics
    • Lentilactobacillus buchneri
  • Sugar and similar
    • non-starch polysaccharides
    • saccharin
  • Vitamins, Minerals and similar
    • vitamin d

Three Items: Prevotella, Veillonella, Clostridium

We are done to just one item: Amino Acid and similar l-citrulline

This is not unexpected, in building the suggestions algorithms, I often encountering items that helps one and hurts another; also a lack of studies.

Alternative Approach

I am going to pick the top dozen (12) genus, and then select the items by the number of genus positively impacted. As you see, the best that we get is impacting 50% of the genus picked.

Remember: we are doing items with absolutely positive impact only. We exclude all items that has a negative impact on any of the genus reported in any study. For clarity, if a substance increases a genus in some studies and decreases in other studies, it is excluded. This is the most conservative approach.

Caution: this assumes undergrowth for all 12 genus. It may make an overgrowth worse.

ModifierTypeModifier2Cnt
Prescription – Otherproton-pump inhibitors (prescription)6
Sugar and similarnon-starch polysaccharides5
Amino Acid and similaracetic acid3
Amino Acid and similarConjugated Linoleic Acid3
Amino Acid and similarl-citrulline3
Amino Acid and similarproline (amino acid)3
Diet Styleanimal-based diet3
Food (excluding seasonings)blackcurrant3
Food (excluding seasonings)fasting3
Food (excluding seasonings)lupin seeds (anaphylaxis risk, toxic if not prepared properly)3
Food (excluding seasonings)Pulses3
Food (excluding seasonings)safflower oil3
Food (excluding seasonings)wheat bran3
Miscellaneous, food additives, and other odd itemsisobutyric acid3
Miscellaneous, food additives, and other odd itemsisovaleric acid(fatty acid)3
Prebiotics and similararabinoxylan oligosaccharides (prebiotic)3
Sugar and similarsaccharin3
Amino Acid and similarpropionate2
Diet Stylefibre-rich macrobiotic ma-pi 2 diet2
Food (excluding seasonings)barley,oat2
Food (excluding seasonings)cranberry bean flour2
Food (excluding seasonings)Miso2
Food (excluding seasonings)navy bean2
Food (excluding seasonings)pectin2
Food (excluding seasonings)red alga Laurencia tristicha2
Herb or SpiceBofutsushosan2
Herb or Spicecoptis chinensis (Chinese goldthread)2
Herb or Spiceplantago asiatica l.2
Herb or Spiceschisandra chinensis(magnolia berry or five-flavor-fruit)2
Miscellaneous, food additives, and other odd itemsTributyrin2
Prebiotics and similarcarboxymethyl cellulose (prebiotic)2
Prebiotics and similaroligofructose (prebiotic)2
Prebiotics and similarresistant maltodextrin2
Prescription – Otherepicor2
Probioticsbacillus subtilis natto (probiotics)2
Probioticssaccharomyces boulardii (probiotics)2
Sugar and similarglucose (sugar)2
Sugar and similarlevan2
Vitamins, Minerals and similarFerric citrate2

Bottom Line

The above is a generic list that should “do no harm” for most people and will likely help. Better results are likely to occur using a 16s microbiome report (OmbreLabs [US only] and Biomesight [World wide] are the most used) and using the Artificial Intelligence on Microbiome Prescription that factors in the 2 million facts that it has available (see this example). That would produce a targeted list for your needs.

The root of all evil in the Microbiome?

From Special Studies, I extracted the genus who are associated with various symptoms/conditions and then aggregated into a single table below. See Special Studies Updated and A new specialized selection of suggestions links for background.
UPDATE: Just added Possible help for the root of all evil in the microbiome?

Conceptually, these are the ones that will lead to a variety of symptoms and conditions. Two of the more significant ones are available as probiotics:

  • Clostridium (i.e. miyarisan (jp) / miyarisan)
  • Bifidobacterium (many brands, I tend to favor Custom Probiotics offerings with HMO)
  • Prevotella may be available as a retail probiotic soon (see Prevotella copri as Next Generation Probiotics). There is also a US Patent for  Prevotella histocola which implies work on producing it.
  • Veillonella probiotics appear to be available in a mixture (ULTRA-VEILLONELLA) however, I have reservations about the seller (site is new – 2022, no species information, no safety or other studies (legally required in the USA), no information about the company, etc. in other words has an unpleasant smell)
  • Note that Lactobacillus is far down this list.

CLICK ON THE BACTERIA BELOW TO SEE WHAT INCREASES OR DECREASES EACH

Bacteria RankShiftedConditionsSum Of Conditions
PrevotellaLow22145
VeillonellaLow21113
ClostridiumLow21102
BifidobacteriumLow20151
AnaerococcusLow1779
PhocaeicolaLow1778
StreptococcusLow15118
BacteroidesLow1472
PeptoniphilusLow1469
BlautiaLow1464
LactobacillusLow1451
MegasphaeraLow1351
ErysipelatoclostridiumLow1351
SchaaliaLow1342
LactiplantibacillusLow1339
EscherichiaLow1236
PorphyromonasLow1146
CorynebacteriumLow839
FusobacteriumLow831
SlackiaLow827
CampylobacterLow723
SuccinivibrioLow622
CollinsellaLow622
RoseburiaLow517
ActinobacillusLow517
MediterraneibacterLow516
MegamonasLow515
HungatellaLow515
CatenibacteriumLow420
DesulfovibrioLow419
HaemophilusLow418
The Genus associated most with health issues

Special Studies Updated

With this being the Thanksgiving Weekend, I had time to work on my backlog. One of the items was special studies. I have done the following changes:

  • Executed the analysis for both uBiome and Thryve/Ombre samples. So more samples will have the option of using special studies.
  • Implemented Consensus/Monte Carlo between the bacteria, casting the species (which are not reported consistently between labs) to their genus. These are shown on the [Key Bacteria] link below.

Last, I have added per  Peripheral neuropathy to the symptom list.

REMEMBER TO ANNOTATED YOU SAMPLES WITH YOUR SYMPTOMS

This is what Special Studies use.

Common Bacteria across labs is now available for each.
https://microbiomeprescription.com/Library/CitizenScience

Example: for Chronic Fatigue Syndrome

The page below shows a distinct pattern for ME/CFS with Bifidobacterium being the greatest significance. For this bacteria, my first suggestion is simple:  Human milk oligosaccharides (HMOs) and Bifidobacerium infantis probiotics.

https://microbiomeprescription.com/sample/specialDetails?study=Chronic%20Fatigue%20Syndrome%20(CFS/ME)

It is interesting to note that Lactobacillus does not appear as significant.

Bottom Line

Special Studies are still a “work-in-progress”. Using them “as is” have not produced superior results to those from the standard triplet (Outside Lab Range, Box-Plot-WhiskersKaltoft-Moldrup) — see this post for an example. How do I determine which is better? For ME/CFS, we should have the top suggested items being cross validated with clinical studies. Feel free to explore the results.

I will continue working on getting superior results from special studies — stay tune!

An ME/CFS Journey using their Microbiome

Back Story

I go this email from someone who just moved to Spain from the U.S. She has being using Microbiome Prescription to try improving her ME/CFS. She had the testing done by Ombre Labs, and then transfer the data to BiomeSight. This allows her to keep consistent analysis on her journey of recovery.

I’m doing pretty well with bacillus coagulans and pretty bad with some other recommendations so I’m looking for some extra clarity. When I hit a great herbal antibiotic and a great probiotic life gets so much better, but oftentimes it’s harder than that. Sometimes I don’t get enough  herbal antibiotic recommendations. Some of the probiotics I may need, like e-coli or bifidus, cannot sustain me the way coagulans does -keeping my local infections at bay. So I try to combine them  or if it’s not clear if they are compatible, I tend to not take them, which is a shame. So I’m considering prescription medicine to see if I can get a bit more help.

I’m also figuring out where to buy supplements etc. Life is really an adventure!

Comparison Between Samples And Lab Interpretations

For those not familiar with the issue of Lab Interpretation of the identical data see The taxonomy nightmare before Christmas…[2019]. Ombre typically reports on 25-30% more bacteria types than BiomeSight. The quality improved, but the number of bacteria identified are very similar. I give observations below:

OmbreLabResultsBiomeSight LabResults
Criteria6-Jul19-Aug10-Oct6-Jul19-Aug10-Oct
Lab Read Quality2.15.47.12.15.47.1
Bacteria Reported By Lab365628625280497490
Bacteria Over 99%ile560271
Bacteria Over 95%ile27241193111
Bacteria Over 90%ile49511375824
Bacteria Under 10%ile18604854562224
Bacteria Under 5%ile10284112830175
Bacteria Under 1%ile17317113135
Lab: Thryve
Rarely Seen 1%091042
Rarely Seen 5%8402741817
Pathogens192825152616
Outside Range from Medivere16165444
Outside Range from Metagenomics7719171716
Outside Range from MyBioma14148777
Outside Range from Nirvana/CosmosId23238997
Outside Range from XenoGene333325222219
Outside Lab Range (+/- 1.96SD)101442282822
Outside Box-Plot-Whiskers6461126137
Outside Kaltoft-Moldrup11218231708464
Condition Est. Over 99%ile0054270113175
Condition Est. Over 95%ile000010
Condition Est. Over 90%ile2210040
Enzymes Over 99%ile131517060
Enzymes Over 95%ile698200100
Enzymes Over 90%ile155411022320
Enzymes Under 10%ile551382455121
Enzymes Under 5%ile22671593308219212
Enzymes Under 1%ile521320187132146
Compounds Over 99%ile104126641124767
Compounds Over 95%ile385397430719
Compounds Over 90%ile5335486011276138
Compounds Under 10%ile183248103342313323
Compounds Under 5%ile109127359180125224
Compounds Under 1%ile1617303376473
Compounds Under 1%ile1721224172140
Comparison Table

The following are apparent, between the last two samples, the reader was trying to follow the suggestions.

  • The number of high bacteria (> 90%ile, > 95%ile, > 99%ile) show significant decline
  • Rarely Seen bacteria show significant decline
  • The number of low bacteria (< 10%ile, < 5%ile, < 1%ile) show significant increases – suggesting more diversity
  • The Outside Range is a little mixed, with either both labs showing a decline, OR one showing a decline and one an increase. None showed increase on both.
  • High Enzymes show decline. Low Enzymes had inconsistent results.
  • Compounds and Conditions had inconsistent results

Enzymes, Compounds and Conditions are best effort estimates (and experimental) and be taken with a grain of salt (50 mg). By conventional thinking, the microbiome has improved (less extreme high levels), less pathogenic bacteria types.

Going Forward

Consensus approach (also known as Monte Carlo Simulation) remains the safest choice. To simplify the analysis, I will use the standard triplet (Outside Lab Range, Box-Plot-Whiskers, Kaltoft-Moldrup) on both latest samples processed through Ombre and Biomesight data processing. Given the report that some did not work subjectively, I decided to proceed down the most restrictive approach. I used the new quick suggestions (best choice for someone with brain fog).

Probiotics

The #1 and #2 choices are lactobacillus paracasei and bacillus subtilis. Kegg choices are Escherichia coli, Bacillus subtilis (with Biomesight numbers being much less than Ombres).

ThryveBiomesight
Microbiome ModifierSuggestionsClinical DosageEst ConfidenceSuggestionsEst Confidence
bacillus subtilisTake10 BCFU/day340.4Take223.6
bacillus lichenformisTake279.1Take20.9
enterococcus faeciumTake1 BCFU/day13.2Take8
bifidobacterium longumTake10 BCFU/day516.2Take182.5
lactobacillus paracaseiTake40 BCFU/day58.7Take397.5
pediococcus acidilacticiTake157.7Take215.4
Items with Agreement

For other items, there were a surprisingly few in agreement.

Microbiome ModifierSuggestionsClinical DosageEst ConfidenceSuggestionsClinical DosageEst Confidence
galactooligosaccharides (GOS)Take10 gm/day15Take10 gm/day139.1
CalciumTake500 mg/day129.2Take500 mg/day36.2
MagnesiumTake500 mg/day189.7Take500 mg/day119.2
D-RiboseTake10 gm/day80.6Take10 gm/day23.6
GlycineTake15 gm/day409.2Take15 gm/day258.5
Omega-3 fatty acidsTake4 gm/day166.8Take4 gm/day289.4

Using the Consensus across Multiple Samples

This gives a lot more information, but at the cost of more complexities.

The approach is similar to the above, except for suggestions we change to Every thing. I have extracted the items > 100 that are 5 or 6 Take Count with 0 or 1 Avoid Count to the table below in decreasing order

Prescription Drugs Analysis

The approach is similar to the above, except for suggestions we change to Every thing.

And then use the option on the Multiple Samples tab,

Remember to empty the old baskets.

The items that came up (as discussed above) are:

So every item at the top of the list (from over a possible choice of 3000 different prescription drugs), are cross-validated against the literature with the exception of proton-pump-inhibitor. This person can show their medical professional that the microbiome model suggests it and clinical studies confirm that they are reasonable.

I favor Dr. Cecile Jadin protocol of rotating antibiotics typically a course (7-10 days), then a break of 1-2 weeks, and then proceed to the next one.

Feedback from Reader

I love Dr. AI [Artificial Intelligence], which other doctor asks you to eat as much 100% chocolate I can??? And I tolerate it, luckily. And there are so many yummy brands in Spain, I don’t remember having that much choice when I left! 

Thanks for all the info, very helpful, very encouraging to see progress “on paper”, and to have clear things to share with my new doctor. I’m confident I’ll find a microbiome helper here in Barcelona.

The greatest challenge in treating ME/CFS is that there is no clear test to see if something is helping. Using repeated microbiome samples with systematic trials of suggestions, provides objective evidence — even when the subjective evidence is not pronounced. ME/CFS patients have a real challenge on doing subjective evaluation — they often cannot recall how they were two weeks ago!

Postscript – and Reminder

I am not a licensed medical professional and there are strict laws where I live about “appearing to practice medicine”.  I am safe when it is “academic models” and I keep to the language of science, especially statistics. I am not safe when the explanations have possible overtones of advising a patient instead of presenting data to be evaluated by a medical professional before implementing.

I cannot tell people what they should take or not take. I can inform people items that have better odds of improving their microbiome as a results on numeric calculations. I am a trained experienced statistician with appropriate degrees and professional memberships. All suggestions should be reviewed by your medical professional before starting.

The answers above describe my logic and thinking and is not intended to give advice to this person or any one. Always review with your knowledgeable medical professional.