more on the relationship between antibiotics and your microbiome

How badly do ANTIBIOTICS affect your health?  Just click the link and start reading (prepare to be freaked out).  You’ll quickly notice that not only are the various ways that these commonly prescribed drugs affect your health severe, they are nearly endless, with every study being worse than the study before it.   The first couple of pages of the PubMed search engine brought me these gems from the most current issue of the scientific / medical journal they are found in (all of which are cherry-picked due to time / space constraints).

• WHAT IS YOUR MICROBIOME AND WHAT DOES IT DO?   Although I have written about the MICROBIOME in the past, this month’s issue of the World Journal of Gastroenterology (Role of the Normal Gut Microbiota) sheds some more light on this topic.  “Relation between the gut microbiota and human health is being increasingly recognized. It is now well established that a healthy gut flora is largely responsible for overall health of the host. Though the gut microbiota in an infant appears haphazard, it starts resembling the adult flora by the age of 3 years.  The normal gut microbiota imparts specific function in host nutrient metabolism, drug metabolism, maintenance of structural integrity of the gut mucosal barrier [OR NOT], immunomodulation, and protection against pathogens. Several factors play a role in shaping the normal gut microbiota. They include the mode of delivery (vaginal or cesarean); diet during infancy (breast milk or formula feeds) and adulthood (vegan based or meat based); and use of antibiotics or antibiotic like molecules that are derived from the environment or the gut commensal community.”  I can agree with the VAGINAL DELIVERIES / BREAST MILK and ANTIBIOTIC-LIKE DRUGS aspect of this study, but the vegan -vs- meat eater part was addressed HERE. 

• DYSBIOSIS IS RELATED TO GLUTEN SENSITIVITY:   We’ve known for years that DYSBIOSIS is intimately related to GLUTEN SENSITIVITY.  The only question is which one comes first —- does the Dysbiosis cause the Gluten Sensitivity or does the Gluten Sensitivity cause the Dysbiosis?   This month’s issue of the journal Nutrients (Intestinal Microbiota and Celiac Disease: Cause, Consequence or Co-Evolution?) helps shed some light on this topic.  “It is widely recognized that the intestinal microbiota plays a role in the initiation and perpetuation of intestinal inflammation in numerous chronic conditions. Most studies report intestinal dysbiosis in celiac disease (CD) patients, untreated and treated with a gluten-free diet (GFD), compared to healthy controls.  Indeed, some CD genes and/or their altered expression play a role in bacterial colonization and sensing. In turn, intestinal dysbiosis could promote an abnormal response to gluten or other environmental CD-promoting factors (e.g., infections) in predisposed individuals.”  While this is an excellent question to be asking (BTW,they do not definitively answer it in this study); because NON-CELIAC GLUTEN SENSITIVITY is infinitely more common than Celiac Disease, we should be asking the same question of it.  Best guess is that the pathway works either way, and that either one can cause the other.  The discussion in the highlighted paragraph about genes is a great example of EPIGENETICS and the fact that you are less ruled by your genome than you have been led to believe.   Also, the second to the last sentence is one reason that people develop HERXHEIMER REACTIONS as they get healthier.



• STUDYING PREGNANT WOMEN’S MICROBIOME CAN PROVIDE INSIGHT INTO THE HEALTH OF THE BABY:  This month’s Proceedings of the National Academy of Sciences of the United States of America (Temporal and Spatial Variation of the Human Microbiota During Pregnancy) delved into this topic.  Their conclusion after looking at 49 women was that, “these findings have important implications for predicting premature labor, a major global health problem, and for understanding the potential impact of a persistent, altered postpartum microbiota on maternal health, including outcomes of pregnancies…….”  But what about women who have already had their babies?

• INSULIN RESISTANCE, GESTATIONAL DIABETES, AND TYPE II DIABETES:  A study on this very topic (The Stool Microbiota of Insulin Resistant Women with Recent Gestational Diabetes, a High Risk Group for Type 2 Diabetes) was published in this month’s issue of Scientific Reports.  Considering our national prevalence of Insulin Resistance (PRE-DIABETES) and Gestational Diabetes (a type of Diabetes developed by 10% of pregnant women according to the CDC, with incidence skyrocketing), the findings are not a surprise.  “These results suggest that distinctive features of the intestinal microbiota are already present in young adults at risk for Type II Diabetes and that further investigations of a potential pathophysiological role of gut bacteria in early Type II Diabetes development are warranted.”  In other words, because specific types of Dysbiosis lead to specific diseases, it stands to reason that culturing mom’s flora could provide a window into whether or not she is going to develop Type II Diabetes.  By the way, Chris Kresser has a great article on pregnancy and Low Carb Diets (HERE).

• ANTIBIOTICS LEAD TO AUTOIMMUNE DISEASES:  I could write a book on this subject, but considering we just talked about Type II Diabetes, I think it’s only fair to mention Type I Diabetes as well.  The results of a study published in this month’s issue of the ISME Journal (Prolonged Antibiotic Treatment Induces a Diabetogenic Intestinal Microbiome that Accelerates Diabetes in NOD Mice) were not a surprise.  “Accumulating evidence supports that the intestinal microbiome is involved in Type 1 diabetes.  To examine the effect of the intestinal microbiota on T1D onset, we manipulated gut microbes by fecal transplantation between non-obese diabetic (NOD) and resistant (NOR) mice and, the oral antibiotic and probiotic treatment of NOD mice. The gut microbiota from NOD mice harbored more pathobionts and fewer beneficial microbes in comparison with NOR mice. Fecal transplantation of NOD microbes induced insulitis in NOR hosts suggesting that the NOD microbiome is diabetogenic. Moreover, antibiotic exposure accelerated diabetes onset in NOD mice…..    We conclude that NOD mice harbor gut microbes that induce diabetes and that their diabetogenic microbiome can be amplified early in life through antibiotic exposure. Protective microbes like VSL#3 [Probiotics] are insufficient to overcome the effects of a diabetogenic microbiome.”  If you want to understand why this last sentence is true, click HERE.

• ANTIBIOTICS MAKE INFLAMMATORY BOWEL DISEASE WORSE:  This month’s issue of Inflammatory Bowel Disease (Patterns of Antibiotic Exposure and Clinical Disease Activity in Inflammatory Bowel Disease: A 4-year Prospective Study).  We already know that Antibiotics (via Dysbiosis) are one of several causal factors for developing IBD.  If you already have IBD and take Antibiotics, you will make the problem worse.  “Antibiotic-exposed patients were more likely to have Crohn’s disease, require narcotics, receive antidepressants, prednisone, or biological therapy. Antibiotic-exposed patients had higher rates of C-reactive protein elevation, and higher health care utilization compared with nonantibiotic-exposed patients.”    But as miserable as IBD is, it’s small potatoes compared to Cancer.

• ANTIBIOTICS INCREASE RISK OF COLON CANCER:  It’s not news that ANTIBIOTICS CAUSE CANCER.  The real question is what kinds of Cancer do Antibiotics put you at risk for?  This month’s issue of Digestive Diseases and Sciences starts answering this question with a study called (Frequent Use of Antibiotics Is Associated with Colorectal Cancer Risk: Results of a Nested Case-Control Study).  The authors, “found an association between the use of antibiotics, especially when used frequently, and the risk of developing CRC.”  Interestingly enough, they also told us that, “Microbiotical dysbiosis induced by a Western diet seems to be associated with an increased risk of developing colorectal cancer (CRC)“.   When are we going to get it through our heads that a WHOLE FOOD DIET is the single best way we protect ourselves against ill health?

• LOOKING AT THE INTESTINAL MICRIBIOTA CAN HELP DIAGNOSE CANCER:  A certain type of tumor (adenoma) that occurs in the colon has been shown to be detectable according to what kinds of bacteria are living in the lower GI system — great news considering CT Scans (the most popular way to diagnose Cancer) are themselves a major cause of Cancer (HERE).  The April, 2015 issue of EBioMedicine (Fecal Microbiota Characteristics of Patients with Colorectal Adenoma Detected by Screening: A Population-based Study) determined that, “Phylum-level fecal community composition differed significantly between colorectal adenoma (CRA) and normal patients.  Screening for colorectal cancer (CRC) and precancerous colorectal adenoma (CRA) can detect curable disease. However, participation in colonoscopy and sensitivity of fecal heme for CRA are low.  Note what they are saying here.  Not only that we can tell whether or not a person has a certain kind of tumor simply by doing a stool sample, but that the current methods of detection (Fecal Blood and Colonoscopy) — tests we have been told we must have in order to be healthy — don’t work as well as we’ve been led to believe.  This is more true than you ever imagined (HERE).

• AT LEAST THINK ABOUT TREATING YOUR HEALTH PROBLEMS WITH FMT:  FMT (FECAL MICROBIOTA TRANSPLANT) is the new frontier in the war against AUTOIMMUNITY and CHRONIC INFLAMMATORY DEGENERATIVE DISEASES.  The latest edition of PLoS One (Low Level Engraftment and Improvement following a Single Colonoscopic Administration of Fecal Microbiota to Patients with Ulcerative Colitis) would likely agree.  This study showed that, “Fecal microbiota transplantation (FMT) is an investigational treatment for diseases thought to involve alterations in the intestinal microbiota including ulcerative colitis (UC). Case reports have described therapeutic benefit of FMT in patients with UC, possibly due to changes in the microbiota. We measured the degree to which the transplanted microbiota engraft following FMT in patients with UC using a donor similarity index (DSI)”.  And even though, “no patients remained in remission at 3 months after FMT, following a single colonoscopic fecal transplant, a DSI of 40-50% is achieved in about two-thirds of recipients.”    All this really tells me that you may need more than one round of FMT — something that experts are already well aware of.  It also tells me that unless you change your diet and feed these critters properly, it won’t work nearly as well. 

• THE VAST MAJORITY OF YOUR IMMUNE SYSTEM IS MADE UP OF BACTERIA:  It’s not like this is new information either.  We learned nearly 20 years ago via peer-review that 80% of your body’s Immune System is found in the Gut (HERE).  This is why GUT HEALTH is so critical for overall health.  It’s also an indictment against our medical community for continuing to ignore the HYGIENE HYPOTHESIS.  A study from this month’s issue of Chinese Medical Journal (Commensal Microbiome Promotes Resistance to Local and Systemic Infections) plainly concludes that, “Diverse microorganisms colonize human environmentally exposed surfaces such as skin, respiratory tract, and gastrointestinal tract.   These microbes [have] extensive and diverse impacts on multiple aspects of host biological functions. The commensal microbiome promotes resistance to local and systemic infections, respectively. To protect against the local infections, the microbiome functions contain the following: the competing for sites of colonization, direct production of inhibition molecules or depletion of nutrients needed for pathogens, and priming immune defenses against pathogen insult. At the same time, with the purpose to maintain homeostasis, the commensal bacteria can program systemic signals toward not only local tissue but also distal tissue to modify their function for infections accordingly.  Commensal bacteria [your good bacteria] play an essential role in protecting against infections, shaping and regulating immune responses, and maintaining host immune homeostasis [balance].“

Here’s the thing; I could do a blog post 10 times this long, each month of the year, year round, and only begin to scratch the surface of what is being published in the peer-reviewed literature (notice that I did not even talk about ANTIBIOTIC RESISTANCE today).  And although there is a (slowly) growing public awareness of this problem, I see very little change in my neck of the woods.  Antibiotics are still one of the easiest-to-get drugs on the market.