When I have the chance to listen to a full orchestra, I appreciate the fact that there are so many musicians playing different instruments, bringing out particular notes at the right tempo, with precise rhythm and intensity, each doing their part to create a full, rich and multi-layered sound. I think about the human microbiome similarly. On an even grander scale, the microbiome is made up of trillions of bacteria, viruses, and fungi along with genetic materials, working together in a multi-layered way to promote health and well-being.

An optimally functioning microbiome supports effective digestion, sustains a responsive immune system, informs the maintenance of hormonal balance, impacts fertility for both men and women, and supports clear thinking and an even-tempered mood. The more it is studied, the more we understand that a well-orchestrated microbiome plays a substantial role in the prevention of both acute and chronic illness, and in fostering sound physical, cognitive and emotional health.

Many parts of the body have been studied to reveal their own specific microbiome such as that found in the digestive system which is most essential, the vaginal tract, the eyes, the urinary tract, the lungs, the respiratory tract and more. In other words, the microbiome is at work throughout our human physiology communicating and helping conduct essential roles. While we are each made up of trillions of cells, we are also made up of trillions of organisms that define the microbiome. For example, a thriving microbiome is essential for digestion, absorption, and elimination. We also know that the microbiome that is not working in concert with circadian rhythms, has a negative impact on fat metabolism and weight gain. The gut microbiome has an effect on how you metabolize nutrients and how you use your calories. There has been much discussion about the role of the microbiome in optimizing immunity and keeping our ability for fighting infection alert and responsive.

What happens when the microbiome is disturbed? This state is called dysbiosis and is associated with a myriad of human complaints from inflammatory bowel disease, metabolic disorder, obesity, depression and other human complaints.  What works against a healthy microbiome? There is a growing body of evidence that highlights the impact of processed food, over-prescription of antibiotics and other pharmaceuticals, industrial farming, and other elements of modern times, that has a grave impact on the extent and diversity of the human microbiome.

By way of example, research has shown that early-in-life use of antibiotics, which can disturb the microbiome, is associated with the development of asthma in children, and that in general, antibiotic use is one causative factor for autoimmune ailments.

More broadly, the Standard American Diet (SAD) interferes with a balanced microbiome. SAD is defined by highly processed foods, refined carbohydrates and added sugars, hydrogenated fats, high fat dairy products, and overeating red meat. Though many people know this would not make up a healthy diet, change can be difficult due to developed tastes, cultural factors, finances, and access to healthy foods. Naturopathic doctors have extensive training in therapeutic nutrition and can help you get on the right track with regard to diet in general and with improving your microbiome in particular.

Excessive drinking influences many aspects of physiology, including causing negative repercussions on the microbiome. Infectious disease can impact the function of the microbiome in its own ways. So, while the infectious disease might be helped by an antibiotic, the microbiome will also be further disturbed by antibiotics.

Increasingly, the role of stress and the stress response and its impact on the microbiome are being examined, and not surprisingly, intense or ongoing stress has a negative impact on the health and balance of the microbiome. There are many approaches to reduce overall stress and to include daily habits and strategies for stress management.

Being mindful of your microbiome and working to create a robust and diverse internal environment is an area well worth your time and effort. We each have the capacity to improve our microbiome, which in turn can help prevent and treat chronic ailments and improve overall immune function to help us side-step more acute ailments, and to promote healing of all kinds.

Here are some ideas to consider:

Right from the start, the microbiome both influences and is influenced by pre-conception time for each parent,  pregnancy, delivery and postpartum care. Choices in lifestyle, food and pertinent supplementation are very important to establish and maintain both short and long term maternal and baby health. Maternal diet, method of delivery, nursing or feeding, medications prescribed, and bathing approaches all influence the microbiome, which in turn can optimize physical and emotional health in mother and baby and encourage healthy development of the child.

Beyond that time, for both children and adults, choosing an anti-inflammatory diet, like for many elements of good health, is central. When available and affordable, choose organic food helps. Side-step foods that you are allergic or sensitive to. If you drink alcohol, do so only in moderation.

Where you  grow up and where you live has an effect on your microbiome. Being in contact with the outdoors, with nature, and with dirt help diversify your microbiome. Even just spending time in green spaces and outside, can positively impact the microbiome. Having an over-emphasis on cleanliness may in fact not be working in our favor. Encouraging your child play outdoors when and where feasible and safe, and getting dirty, alas, is good for the microbiome.

Toxic exposures in the environment cause many issues, including adding to the degradation of the microbiome, so working to decrease toxic exposures as much as possible in your food, in your home and in your personal care products is a good idea.

Taking a probiotic may well worthwhile. One of the most common products in the food and supplements area, probiotics are defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host.” Generally recognized as safe, some studies reveal probiotic content, consistency and safety is not guaranteed. There is some evidence of potential harm from probiotics, especially for those who are immune compromised from chronic ailments, AIDS, or chemotherapy. So be sure to work with your naturopathic physician to determine if probiotics are right for you.

Many foods contain probiotic organisms like fermented dairy as in yogurt and kefir, soy products like miso and tempeh, honey, fermented drinks like kombucha, and fermented vegetables like sauerkraut and the vast variety of Korean condiments known as kimchi. You do not need to eat enormous quantities of these items, but rather include each day as part of your regular diet.

Your naturopathic doctor can apply knowledge about how specific strains of probiotics confer specific actions. Different strains are labeled by including genus, species, subspecies (when applicable), and an alphanumeric describer. Lactibacillus GG was one of the first strains used in OTC commercial product for the treatment of diarrhea and further research on Lactobacillus Rhamnosis R0011 suggests that this strain helps modulate immune activity.  The seven most common genera of are Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, Escherichia, and Bacillus. Ongoing research has clarified which strains of probiotics are effective for which illnesses.

A licensed naturopathic doctor can help you identify which if any probiotic strains will be best for you. There are guidelines for the industry with regard to labeling and content for probiotics, an important step toward ensuring safety and efficacy. Probiotics have been shown to have impact on many common symptoms and illnesses from bowel diseases, to high cholesterol to addressing skin and dental issues.  There is also a growing appreciation of the gut-brain connection and how probiotics, as part of a whole person medical approach, have a positive impact on anxiety and depression.

Prebiotics provide the nourishment for, and are broken down by the microbiome in the digestive system. They are a key area to consider when you are trying to improve your microbiome and research on prebiotics is burgeoning. The products of that the breakdown process include short-chain fatty acids which are important for providing energy to our colon cells and have broad impact across human physiology related to immune function, prevention of cancer and more. Prebiotics are just as important as probiotics, though most people are able to ingest foods that provide adequate prebiotics. Eating a diet high in fiber will go a long way to providing the prebiotics your body needs. Foods with the best kind of fiber include vegetables, fruit, whole grains, and legumes.

Studies show us that taking probiotics and prebiotics may well influence hormonal production and secretion, as well as neurotransmitters which among other roles, impact hunger, appetite, satiety and weight gain and loss. There are many causes of weight gain and difficulty with losing weight, building a beneficial microbiome is one among many natural medicine approaches to consider if you are trying to reach a healthy-for-you weight.

You may have heard of the concept of fecal microbiota transfer (FMT), which is when the microbiota, in the form of specially prepared stool of a healthy person is placed in another person for therapeutic effect. Beyond the “ick” factor, this approach is FDA approved for the treatment of Clostridium difficile (C. diff.) the often difficult-to-treat diarrheal disease most often contracted in the hospital or nursing home setting or after a course of antibiotics. There is a growing body of research which suggests that FMT may well be useful in the treatment of numerous other physical as well as psychological ailments. Time and further research will tell, but the fact that FMT is being researched underscores how very much the role of the microbiome and its impact on health and disease is valued.

The denigration of the microbiome has both individual and public health implications.  It is entirely possible that studying population-scale microbiome may influence our understanding of public health, as well as environmental health.

As the microbiome is developed, maintained and influenced over the course of a lifetime, it is working in an orchestrated and broad acting way. Knowing it exists, avoiding things that impair its function, and tending to its health by improving its diversity and robustness, are all well worth the time and effort and may well have a far-reaching impact on your health and vitality.

Photo by kian zhang on Unsplash