I think the causal nature of this relationship is way overestimated.
Gut microbe linked to depression in large health study
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Re: Gut microbe linked to depression in large health study
#62Gut microbiome researcher here - not involved in this study but happy to answer questions or dig in with anyone interested!
In your opinion, what is the best study that shows direct evidence that changes in gut flora can change health outcomes (preferably something that is a randomized control study). The only area I feel comfortable that good data exists is in the setting of fecal transplants for refractory clostridioides difficile infection. Thanks.
I think you hit it on the head - the C. diff stuff is good and will meet FDA criteria soon (the phase III data from ECOSPOR was good: https://www.clinicaltrials.gov/ct2/show/NCT03183128).
In general we only have mouse or other animal data for other indications.
There are retrospective analyses of patient cohorts receiving anti-PD1 or anti-CTLA4 therapies which have identified certain microbiome states as supportive of those therapies. I believe that these are probably real effects, though I don't think the particular microbes matter - instead I think it's the metabolites they produce and how those influence resting immune state (https://www.science.org/doi/10.1126/science.abf3363 - but you can find many more).
A paper I really like shows that a specific protein from a common gut microbe (Akkermansia muciniphila) confers resistance to diet induced weight gain, insulin insensitivity, etc. (https://www.nature.com/articles/nm.4236).
In general, I think the majority of microbiome work has been associational and demonstrative of the kind of hypothesis-free science that is prone to all sorts of statistical artifacts and misaligend incentives between truth-finding and paper publishing (garden of forking paths, file-drawer effect, etc. etc.)
Re: Gut microbe linked to depression in large health study
#63Earlier quoted context omitted.
As a fellow comment says - its all over the place and kind of hard to say, see [1] saying they are useless but lots of studies saying they are useful . Personally as someone with IBS, I have tried many probiotics over the years and have mixed results - most of them were useless but for some time I found one or 2 that worked but I couldnt say for sure if they worked due to other factors (for e.g generally healthier fo…
Not sure if you have heard of the low FODMAP diet? Its now the standard treatment for IBS. The theory is certain bacteria ferment FODMAPS into gas and water which leads to the symptoms. They don't know which bacteria yet but going low fodmap is now a well researched and accepted treatment. Everyone is different but personally, I'm able to tolerate everything except Fructans (one of several types of FODMAPS). So no ga…
I was skeptical of this when I first heard of it several years ago. It sounded just like every other popular diet does: “Just (don’t) eat this certain food, and you will feel amazing!”
But I have several family members on it right now, and they all report feeling WAY better. And this is after years of dealing with IBS type problems too.
Re: Gut microbe linked to depression in large health study
#64I think the causal nature of this relationship is way overestimated.
I’m curious, why do you think that?
Re: Gut microbe linked to depression in large health study
#65Great to see the gut brain axis becoming more well known in medicine. Less than 10 years ago it was considered near pseudoscience to consider that the gut could actually influence the brain. https://www.hopkinsmedicine.org/health/wellness-and-preventi... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/#:~:tex... . https://en.wikipedia.org/wiki/Gut%E2%80%93brain_axis
I went down that rabbit hole to have a more informed opinion and I found that accepted science would converge on some of the same goals naturopaths and other alternative medicine practitioners eventually.
Basically, they both want personalized medicine. As in, remedies that are custom tailored to the internal state of the individual, instead of “personalized” by listening to an individual describe a current ongoing affliction.
Alternative medicine lacks any method for peer review or repeatability and practitioners themselves procedurally generate the remedies, which makes it incapable of being accepted science except by mere coincidence of some practices eventually being peer reviewed if reviewable at all. This is by a design that is comical to the scientific community, where “everybody is different”.
At the same time, the scientific method and peer review itself is too rigid to evaluate all ailments, without associated advances in technology. This is also by design as it was necessary to distinguish the sciences from arbitrarily religious or arbitrarily heretical practices at one point in some areas.
Now we are on the cusp of convergence of the ideals, by being able to analyze and sequence the symbiotic relationships within our bodies. How little control we have in many cases, or at least potentially redefining the sense of self.
Re: Gut microbe linked to depression in large health study
#66Earlier quoted context omitted.
That is as may be, however, this study shows that removing that bacteria helps with mood disorder. And, there is no evidence that diet gives you this bacteria. Nor that it can help remove this one, either. That is, discussion of diet is a bit of a non sequitur. Not wrong, but also not necessarily relevant.
The paper is titled “ Combined effects of host genetics *and diet* on human gut microbiota and incident disease…” (emphasis mine). Dairy (and the way some people process it, because of genetics) was shown to influence levels of certain bacteria. The study also does not show that removing Morganella resolved depression; the study did not attempt to remove it, and a researcher is quoted as saying it’s not clear how one…
Ah, fair. I was going with what I saw as an implication that removing it would help. My apologies.
Clearly, I had not made it through the article to the underlying studies. My reading was that they were looking for lactose related bacteria, but landed on this other one. And that they did not find a way to control it's presence.
Re: Gut microbe linked to depression in large health study
#67Tangential: Is there any evidence that pro biotic foods or supplements can increase gut health? Given the evident importance of gut health, I wonder whether it's worth using something like this, to grab a random example: https://www.amazon.co.uk/Restored-Bio-Cultures/dp/B082SZXBF2...
Another anecdata point: I used be lethargic, couldn't get myself to do anything but be on the sofa. I would get horrible migraine headaches if drinking alcohol or even alcohol free beer or eat certain foods. I self-diagnosed histamine intolerance through trial and error. I tried multiple pro-biotic combinations. An easy one I tried in the beginning was simply some Danone Actimel the family had in the fridge anyway. I…
Really interesting indeed! I just found this paper on B. subtilis from November: https://pubmed.ncbi.nlm.nih.gov/34630666/
Reducing intestinal permeability is a highly desirable effect.
Re: Gut microbe linked to depression in large health study
#68or depression causes this bacteria to proliferate more easily? I see nothing in that research showing causation. It doesn't invalidate their correlation though.
That's my thinking as well. Depression leads to lifestyle changes which includes dietary changes which can cause certain bacteria to grow faster, as your gut bacterial makeup changes constantly based on what kind of food you consume and which microorganisms are specialized for it.
I think there will be some breakthroughs by studying the human microbiome, for example there could be reasons that a moderately harmful microorganism or strain becomes dominant in your gut for whatever reason and causes problems, but from my personal anecdotal experience with gut health and diet, I believe most issues will still be solved with dietary changes and perhaps some targeted antibiotics or antimicrobial treatments in general.
I'm also willing to bet we'll discover a lot of immune involvement in the regulation of various bacterial population in the gut. There must be an adaptive system that minimizes or eliminates most harmful organisms in the gut, otherwise we'd all be dead.
Re: Gut microbe linked to depression in large health study
#69> Thus, the newest study seems to be “further proof” that inflammation caused by gut microbes can influence mood
Of course it bloody can - if you have IBS or any number of other gut-related problems, believe me you are very likely to be depressed, because the symptoms of these are very nasty and humiliating. This does not mean that the bacteria are directly affecting the CNS.
Also:
> Kiebdiella
It's Klebsiella
Re: Gut microbe linked to depression in large health study
#70Earlier quoted context omitted.
At the current pace of research and studies, when do you think we could expect to see something come to 'market' that could be used - first as a diagnosis and then as a treatment/medication/technique. As someone with IBS - right now I feel like there is no clear 'problem' defined for it. You are just categorized by the doctor (Rome 3 or whatever) and people go through various tests, medications, non-fda approved stuf…
There are a variety of strategies being pursued to make pharmaceutical products out of microbiome research. Broadly those are: 1: "bugs as drugs" - genetically engineered microbes that perform some function. The idea here is that having the microbe in situ performing some function will be a much better way to administer a particular compound (or set of compounds), or remove a compound, than a traditional pharmaceutic…
Thank you, appreciate the breakdown. With so much focus on the gut research recently I feel like we are on the cusp of bringing together lots of things and new understandings and that hopefully happens soon