Introduction to Gut Microbiome Tests
At-home gut microbiome tests are trending, selling insights to the curious, empowerment to the chronically ill and a claimed path to longevity to the wellness-conscious. Private companies are offering tests, costing $100 to $500 or more, that promise a bacterial inventory of your intestines. But can microbiome tests actually provide actionable health information? As more patients arrive at doctors appointments with results in hand, frustrated gastroenterologists want people to know the tests have limits.
The Complexity of the Gut Microbiome
Inside our intestines, entire ecosystems of bacteria help us digest our food, absorb key vitamins, combat inflammation and much more. Research shows a healthy gut microbiome may play a role in preventing things like liver disease and diabetes and could even influence mental health. The gut microbiome is incredibly complex and our understanding of it “is in its infancy,” said Dr. Mark Benson, a gastroenterologist for the University of Wisconsin-Madison’s health system. “But there’s growing evidence that there are changes in the gut microbiome that are associated with different diseases, including diabetes, liver disease, obesity and inflammatory bowel disease,” he said. There’s a key catch, though: In many cases, it’s unclear if the gut microbiome change is the cause — or an effect — of the disease. On top of that, each person’s gut microbiome is unique, like a fingerprint. It can even vary within one person’s gut.
How Gut Microbiome Tests Work
In most cases, a microbiome test involves taking a stool sample, usually using a swab or a wipe for collection. The samples are mailed to a lab for analysis. The companies then provide a report of how the person’s mix of gut microbes compares with a supposed ideal, or outlines where things are imbalanced. These direct-to-consumer tests are not meant for clinical use and are not federally regulated, so it’s nearly impossible to say how reliable they are. Different companies can set different standards and methods for their tests. That raises many questions for doctors: Is the sample collection consistent and reliable? What is the science behind the benchmarks they are comparing results to? Is the stool the best place from which to take a sample, or should it come from higher up in the gut?
Limitations of Gut Microbiome Tests
Physicians sometimes order stool tests, but they typically are looking for specific problems: infections, inflammation from foodborne illnesses or antibiotic use, or cancer. When patients come in with their own results from an over-the-counter test, there is little advice to give. “If you talk to patients, these tests are appealing. They’re cool. They’re all this data,” said Dr. Sean Spencer, a physician scientist at Stanford University. The frustration for doctors, he said, is with the lack the tools to change the microbiome. Spencer, Quigley and Benson have all had patients bring them the results of microbiome tests. But antibiotics and diet are really the only proven tools doctors have to change the gut microbiome, Spencer said.
Test Results and Recommendations
Occasionally, the tests show a measure of inflammation in the gut or pancreatic function that can be useful to doctors, Quigley said. But beyond that, “for most people, they’re actually wasting their money,” he said. The list of gut bugs and purported imbalances don’t align with any medically backed treatments, the doctors said. “The technology is jumping ahead of the clinical application,” said Quigley. “Just because you can measure something doesn’t mean to say it’s worthwhile.” The companies offering tests say they are not treating any specific conditions. But many of them — some 45%, according to a March 2024 article in Science Policy Forum — also sell supplements that they recommend to customers alongside their results.
Alternative Ways to Improve Gut Health
The gastroenterologists who spoke to The Associated Press agreed that there is no harm in taking one of these tests if you’re curious about your gut or want to contribute to a company’s research. But you can improve your gut health without the tests, the doctors said. “I would not significantly change therapy or take a bunch of expensive supplements based on these results,” Benson said. Instead, eat lots of plant-based fiber and protein. Improve your sleep. Move your body. See a doctor for serious gut symptoms, such as bloody stool, ongoing constipation and diarrhea or severe pain.
Conclusion
Gut microbiome tests may be trending, but their limitations and potential conflicts of interest should be considered. While they may provide interesting insights, they are not a substitute for medically backed treatments. Improving gut health can be achieved through simple lifestyle changes, and patients should be cautious of companies selling supplements alongside their test results. As research continues to evolve, it is essential to prioritize evidence-based approaches to gut health.
FAQs
Q: What is a gut microbiome test?
A: A gut microbiome test is a direct-to-consumer test that analyzes the bacteria in a person’s gut and provides a report on the balance of different microbes.
Q: Are gut microbiome tests reliable?
A: The reliability of gut microbiome tests is unclear, as they are not federally regulated and different companies may have different standards and methods.
Q: Can gut microbiome tests provide actionable health information?
A: While gut microbiome tests may provide some useful information, they are not a substitute for medically backed treatments, and their results should be interpreted with caution.
Q: How can I improve my gut health without taking a test?
A: Improving gut health can be achieved through simple lifestyle changes, such as eating a plant-based diet, improving sleep, and exercising regularly.
Q: Should I take a gut microbiome test?
A: If you are curious about your gut or want to contribute to a company’s research, taking a gut microbiome test may be harmless. However, it is essential to prioritize evidence-based approaches to gut health and be cautious of companies selling supplements alongside their test results.
