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Comment by Semirhage | Hacker News Reader

What I want to know is what to do about it by way of probiotic therapy or buffering agents and such. Efficacy of probiotics in practice seems mixed, so what exactly is the takeaway here for the practically minded person who sometimes takes anti-inflammatory medications?

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I suggest reading the current wisdom from Dr. Les Dethlefson, human microbiota researcher at Stanford's Relman lab [0].

In the link he addresses the difference between addressing an acute condition with probiotics versus long-term maintenance of health. Your question seems to land somewhere in the middle. So see what he has to say and please remember, this is far from settled science!

[0] https://humanmicrobiota.weebly.com/prebiotics--probiotics.ht...

I work in the microbiome field, and colleagues and i discussed this paper a few days ago. The overall impression seems to be that this is not for the practically-minded but primarily science for scientists. A lot of microbiome studies have suffered from inadequate exclusion critera because of the lack of this systematic knowledge.

How long until we have a better delivery method for "good" species, and will that solve all microbiome related problems?

There is a lot of work done right now on formulation of defined faeces microbe sets, partly because most people expect that ultimately these treatments will have to be approved by the authorities. This is probably a good idea, as the microbiome consists of both bacteria, virus and eukaryote organisms, and the survey people use for 95% of all microbiome work can only capture the bacterial fraction, so a faeces transplant that look good from the bacterial perspective could potentially include nasty virus or parasites. How long this work will take is difficult to say, but years at the very least.

The second part is that right now it is somewhat unclear what is actually microbiome related problems. Clearly, associations to all kinds of diseases and conditions have been made, but the casuality and dynamics of the interaction with the immune system and host factors is not well-defined for now. It seems obvious that diseases in which we can intervene with a fecal transplant and improve an outcome are microbiome-related, but there isn't actually that many solid cases for this. C.diff infection is well-established. A recent RCT looks really promising for insulin resistance (i saw the senior author talk about it at a conference and i was certainly convinced), but naggingly insulin resistance wasn't actually the registrered primary outcome of the trial

http://www.stephanguyenet.com/microbiota-and-obesity-is-it-a...

I think that the best thing one can do for their microbiome is to stop trying to kill germs in everything around us. Also, when a dog wants to kiss you, accept it. They are good at maintaining theirs.

Look at the ingredients on all the products you use. Unless it's Dr. Bronner's soap or something similar, chances it's harmful to both humans and microbes. Just stop using and stop buying that shit!

Sterility is good for the operating table, but not for everyday life.

A lot more people used to die of disease before we figured out to wash our hands regularly.

Are mortality rates significantly lower in the modern developed world (I am assuming this is true) because people in general wash their hands more? Is that what you're trying to imply?

I don't buy it. I'd attribute the difference more to technologies like vaccines and antibiotics.

Proper sanitation has saved more lives than vaccines and antibiotics. Check for example this well researched Quora answer: https://www.quora.com/How-much-have-sanitation-vaccination-a...

"Proper sanitation" includes much more than just hand washing (e.g. properly disposing of urine and feces rather than throwing them into the street), so you're refuting a statement that I never made.

If you can disentangle hand washing from the effects of modern sanitation in general, I'm interested to hear more.

I agree to a point, but a lot of dogs don't get proper dental care, eat poop and lick buttholes-- sorry, but I don't want any of that on my face, I don't care how magical their saliva is supposed to be.

Not to mention I find dog slobber to be extremely off-putting for reasons other than germs. Just like I would find it extremely off-putting if someone went up to me with a clean wet washcloth and started rubbing it on me.

This is an indicator of your conditioning.

Why would you limit yourself only to probiotics when prebiotics/symbiotics exist? I recently learned about them - bear with me as I have zero experience and lack of terminology in pharma - prebiotics will create a better environment/surface for probiotics to feed on and symbiotics are both pre and pro in a single pill.

It isn't really clear that synbitoics work yet, the evidence for metabolic outcomes at least is sparse as of now http://www.mdpi.com/2073-4425/9/3/167/htm (see figure 6)

You could always opt for a fecal transplant.

Hopefully using this eventually, instead of the real thing: https://microbiomejournal.biomedcentral.com/articles/10.1186...

you can stick that idea up your.... uh.

It is actually a real thing.

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