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Blog: Four microbiome myths we still hear in clinic

Four microbiome myths we still hear in clinic

Microbiome testing has moved quickly from research into routine clinical practice, and with that pace comes a fair amount of received wisdom that no longer holds up. Some of it is outdated, some of it was never quite right to begin with. Either way, it shapes how testing is offered, interpreted and explained to patients.

Here are four myths we still hear in clinic, and what the evidence actually says.

Myth 1: Microbiome testing is only relevant for patients presenting with GI symptoms

It is easy to file the microbiome under gut health and leave it there. But microbiome disruption is linked to metabolic, immune, neurological and skin health, and testing can offer additional clinical context well beyond GI symptoms.

For patients whose presentation does not point neatly at the gut, that wider lens is often where the value sits.

Myth 2: A short dietary intervention can meaningfully shift the microbiome

Diet does change the gut microbiome, but meaningful, sustained change takes time, and a brief intervention rarely delivers it.

Set realistic expectations with patients – a week of fermented foods will not remodel an ecosystem, and framing it that way with patients sets up a fairer view of what their efforts can achieve.

Myth 3: A healthy microbiome profile looks the same across patients

There is no single ‘ideal’ microbiome. Diversity, keystone species and functional capacity all vary between individuals, which means a result that looks unremarkable for one patient may be meaningful for another.

This is why personalised interpretation matters. Reading a profile against the person in front of you, rather than against a fixed template, is what turns data into clinical insight.

Myth 4: qPCR panels give you the full clinical picture

qPCR panels are useful, but they target a narrow set of predefined organisms. They tell you about the things they were designed to look for, and nothing about the rest of the community.

Whole-microbiome profiling captures the full community – bacteria, archaea fungi – giving you the resolution to see what targeted panels miss.


A note for your next patient conversation

If any of these myths sound familiar, they are worth revisiting. Whole-microbiome profiling gives you a fuller view of the ecosystem you are working with, and a stronger basis for the conversations that follow.

References

Asadi A, et al. Obesity and gut-microbiota-brain axis: a narrative review. J Clin Lab Anal. 2022;36(5):e24420. https://doi.org/10.1002/jcla.24420
Chen L, et al. Influence of the microbiome, diet and genetics on inter-individual variation in the human plasma metabolome. Nat Med. 2022;28(11):2333--2343. https://doi.org/10.1038/s41591-022-02014-8
David LA, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014;505(7484):559--563. https://doi.org/10.1038/nature12820
Ruze R, et al. Obesity and type 2 diabetes mellitus: connections in epidemiology, pathogenesis, and treatments. Front Endocrinol. 2023;14:1161521. https://doi.org/10.3389/fendo.2023.1161521
Schirmer M, et al. Linking the human gut microbiome to inflammatory cytokine production capacity. Cell. 2016;167(4):1125--1136.e8. https://doi.org/10.1016/j.cell.2016.10.020
Sinha S, Lin G, Ferenczi K. The skin microbiome and the gut-skin axis. Clin Dermatol. 2021;39(5):829--839. https://doi.org/10.1016/j.clindermatol.2021.08.021
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