Is microbiome testing legit?
In short: microbiome tests measure the balance of bacteria in your gut. They can flag imbalance patterns but cannot diagnose conditions on their own; results are most useful interpreted alongside your symptoms and diet history with a qualified practitioner.
A healthy gut microbiome is important to help you support your health, but how do you know if your microbiome is healthy?
If you are eating a diet that is full of plant foods and dietary fibre and you feel great, chances are your healthy gut bacteria are thriving. However, some people have switched to a diet that is healthier for their gut and still experience symptoms.
One common challenge that I see in my clients that have been following a restrictive diet for a while to help them manage symptoms (eg Low FODMAP, Low Chemical, Low Histamine, Ketogenic, Carnivore etc) is that when they try to introduce more ‘gut healthy’ foods into their diet they experience worse gut symptoms.
It is so frustrating when you know that the foods that are good for your gut make you feel worse!
This may be because the restrictive diet that you are following is not feeding some of your beneficial gut bacteria, and so in their place ‘opportunistic’ bacteria increase. I think of it like weeds in your garden, if there are plenty of healthy plants, grasses etc in your garden, the few weeds may not be causing too much of an issue. However if the grasses dies off with the hot dry winds we have had of late, when it rains again the weeds are the first to grow back, taking up space so it is harder for the grass to grow.
But how do you know what bacteria may be affecting your gut symptoms so you can make some changes to help?
What is Microbiome testing?
Microbiome testing is a stool test which measures the bacteria in your gut to give you an indication of specific issues for example
Elevated levels of inflammatory gut bacteria
Low levels of beneficial gut bacteria that are important for gut health, and overall health
Presence of parasites, yeasts (eg Candida)
Many labs also include some additional testing eg level of your digestive enzymes
To do a microbiome test you need to take a sample of your stools (ie your poo!) and send it to a lab for testing
Is microbiome testing essential for a healthy gut?
No. It is not essential to test your microbiome to achieve a healthy gut. We know what types of foods help most people to improve their gut health, and many people improve their gut health by making changes to their everyday eating patterns.
However, Microbiome testing can be a very important tool if you want to improve your gut health. The most common situations that I find Microbiome testing to be an important step to help you achieve gut health are
Your gut symptoms get worse when you try to eat ‘gut friendly’ foods
You are already eating a diet that is ‘gut friendly’ but still have symptoms (not just gut symptoms!!)
You prefer a structured approach to improve your gut microbiome, tailored to address your own individual microbiome issues
You have complex health issues and want a personalized plan so you can make sure that you are addressing the most important issues impacting your health
You want to jump in and make effective changes faster (rather than a more general approach of trial and error)
You want to learn how your gut health may be impacting your overall health
Which Microbiome test is best?
There are many different types of tests available, as technology improves more options become available and some of the older testing techniques are limited on the level of information that they provide
Bacterial culture
Image by freepik
The same technique that you used to grow bacteria in a Petri dish at high school, this technique identifies what bacteria grow from your stools
The downside is that many species of bacteria don’t survive travel to the lab or don’t grow in the Petri dish environment, so we miss some valuable information
This type of test may be useful if you are looking for a specific species causing an infection, but is not very helpful to understand the big picture of what is going on in your gut
May be identified on test results as ‘Bacterial Culture’ or CDSA or CSA
PCR testing
You night be familiar with this technique as the ‘gold standard’ for testing Covid (remember those big long queues of cars lined up, waiting for a nasal swab?)
PCR techniques are very helpful for searching for specific genetic markers for particular bacteria, viruses, parasites etc. PCR uses techniques that search for specific DNA markers, so basically the test is searching for a specific bacteria to see if they exist in your stools. Some tests, known as qPCR (Quantitative PCR) will also give an indication of how much of these bacteria are present
Your GP may used this test to rule out particular pathogenic bacteria (the nasty ones) to understand if they are a cause of your symptoms with this type of test
Some PCR tests will also identify if you have specific beneficial bacteria, and an indication of how much
PCR tests can provide some very useful information, however as they are only looking for specific bacteria to measure there may be other bacteria that are important to your gut health which are missed
This test was one of the earlier gut tests that was readily available and I have used this type of testing with my clients for many years which provided me with information to make decisions to support many clients to reduce their symptoms and improve their overall health. However for some people we could see that there was a mismatch between their symptoms and the test results and it was clear that this test was missing something important
The main downside of this type of testing is that it isn’t able to provide the full ‘big picture view’ of what is going on in your gut
Tests that use PCR include Pathogen tests that your GP orders, GI-Map, Nutripath Complete Microbiome Mapping
Shotgun testing
Shotgun testing is a newer kid on the block and is my current favourite type of testing as it identifies and measures ALL type of bacteria (and yeasts, viruses, parasites etc) using a different measure of DNA.
What I find fascinating is that it is able to identify species that don’t even have a name yet, but the test can tell from the DNA markers what types of byproducts they are likely to produce (eg beneficial or inflammatory etc) so we can understand what impact they are likely to have on your gut
Most importantly Shotgun testing provides a big picture overview of the bacteria in your gut and is able to show the relative abundance of bacteria species and families. I think of it as ‘Holistic Microbiome testing’
This type of testing can show that you have, for example, low levels of bacteria that produce Butyrate, which is an essential compound for gut health, or high levels of Histamine-producing bacteria which may be contributing to your symptoms
I use the Microba (previously known as CoBiome) Microbiome Explorer range of tests (which test I choose depend on your current symptoms and health goals). An added bonus is that this is an Australian company, which analyses all samples from their Brisbane laboratory
How do I order a Microbiome test?
I strongly recommend that you order a test through a gut-focused practitioner so that you know that you are ordering the best test for you. If you want to order a test and you are not currently a client of mine, I recommend booking a free 15minute Discovery Call so we can work out what type of test is best for you and get your test ordered before your first consultation.
There are some Microbiome tests that are available for you to purchase yourself online however I find that (of the ones I have seen so far) these self-ordered tests tend to be using older testing techniques that don’t provide a holistic view of your gut or provide only a simplified overview of results. With less information it means it is harder to understand what is really going on in your gut, which means more guess work to figure out how to improve your microbiome. Sometimes we may need to re-test with a more detailed test to get a clearer picture, so it ends up more costly in the end!
Yes! I’m want to get started with a Microbiome test
Source: Microba.com
If you’re keen to get some more answers about how your gut bacteria is impacting your gut health or any aspect of your overall health I recommend booking a 15minute free Discovery Session where I can establish the best test for you, and show you how to make sense of your report and learn strategies to optimise your microbiome with gut health support with an experienced dietitian.
Once you have decided to go ahead with the test I will get your order started. To make things super-easy for you I have created a package that includes the cost of testing as well as consultations with me where I will review your test results in detail and provide you with a practical plan of what you need to do to improve your microbiome.
