Our ancestors had a symbiotic relationship with their microbes that evolved over millions of years and served them well. They were benevolent hosts to a dense jungle of microscopic creatures, including worms and other parasites that actually contributed to their health. Large predators and the absence of food were their main threats, not the hundreds of diseases that afflict us today. The irony is that as we’ve “unwilded” our bodies and our environment in an effort to become healthier, we’ve actually become a lot sicker in some important ways.
Urbanization and modern medicine have undoubtedly improved our lives, but they’ve also introduced practices—overuse of antibiotics, chlorination of the water supply, processed foods full of chemicals and hormones, microbe-depleting pesticides, increasing rates of Cesarean sections—that have ravaged our microbiome, diminishing the total number of organisms as well as the diversity of species. The result is an increase in a wide range of modern plagues, including asthma, allergies, autoimmune diseases, diabetes, obesity, cancer, irritable bowel syndrome, anxiety, and heart disease. The rise of these diseases is inextricably intertwined with the full-on assault on our microbiome resulting from our super-sanitized lifestyle.
A decade ago, who knew that every antibiotic dispensed during cold and flu season was potentially bringing us one step closer to a diagnosis of Crohn’s disease, or making us fatter? None of us doing the prescribing realized that we might be paving the way to real illness in our well-meaning attempts to cure the sniffles. The prevailing wisdom was—and to some extent still is—that germs are bad and we should get rid of them, and antibiotics are good and we should use them. And use them we have: the average American child will receive more than a dozen courses of antibiotics before reaching college, primarily for minor illnesses that require no treatment at all. Despite the tremendous amount of research in the last few years connecting the dots, many physicians and their patients remain in the dark, blaming each manifestation of microbial discord on bad luck or bad genes, never questioning or understanding the root cause.
Rehab for Your Gut Microbiome
Every day in my gastroenterology practice I see patients with the telltale signs of a disordered microbiome: bloating, leaky gut, irritable bowel, gluten intolerance, Crohn’s disease, ulcerative colitis, eczema, thyroid disorders, weight problems, fatigue, and brain fog. It’s a veritable epidemic of “missing microbes.” The symptoms vary, but the history doesn’t: overzealous use of antibiotics, often accompanied by a highly processed Western diet low in indigestible plant fiber—the preferred food of gut bacteria.
Repopulating the microbiome can be a challenging process, but the good news is that most people do get better. Your microbes are constantly changing and evolving, and even if they’ve been severely damaged by medications, infection, or diet, paying attention to what you put in and on your body can yield huge improvements. The microbiome you have today isn’t the one you were born with, nor is it the one you’ll have next year or even next week. It’s highly dynamic, constantly changing and adjusting in response to your internal and external environment.
In medical school, I was taught how to eradicate people’s germs. A quarter-century later, I’m teaching my patients how to restore theirs: which foods to eat, how to care for their bodies and their homes without stripping away their microbes, what questions to ask when their doctor recommends an antibiotic, and whether a probiotic or even a stool transplant might be of benefit. These, I believe, are the new and essential survival skills for thriving in our super-clean era.
