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Sourced from: Dr. Davis Infinite Health Blog, authored by Dr. Davis, original posting date there: 2023-04-04 PCM forum Index of Infinite Health Blog articles.
In collaboration with the Primal Health Coach Institute, I’ve put together a comprehensive educational course on the microbiome called The Human Microbiome in Health and Disease. The course is designed for health coaches to empower them in advising clients and patients on issues microbiome. It is, I believe, the most comprehensive and complete course of its kind. While designed for health coaches, it can also provide deep education on all microbiome issues for other health professionals, physicians, or the well-informed citizen scientist or anyone with a deep interest in these important issues.
Because the science exploring the human microbiome is emerging so rapidly, most people in healthcare have become helplessly out-of-date. Yet insights into the microbiome are proving to be one of the most important revolutions in health to emerge in many years. It is changing almost everything we thought we knew about health and disease, re-defining health conditions as common as type 2 diabetes, obesity, hypertension, heart disease, colon cancer, and cognitive impairment.
The course is delivered over nine modules, each starting with a video overview, includes graphics and diagrams, health coaching tips, and selected references for further exploration. Note that Members of my DrDavisInfiniteHealth.com Inner Circle will also be provided access to a similar, expanded course near-future.
Here is the general layout of the course:
Module 1: Overview Basic gastrointestinal (GI) anatomy and physiology from a microbiome perspective Microbiome in health—locations, concentrations, species: bacteria, archaea, fungi, viruses, phages Microbiome in disease—primary, secondary; causative or exacerbating roles; metabolites Methods of assessment—stool microbiome assessment; breath testing; empiric methods Why the science has progressed rapidly just over the past decade—culture methods, 16s rRNA sequencing, shotgun metagenomics Human Microbiome Project, Meta-HIT Why study the microbiome, what health advantages are possible?
Module 2: Basic microbiology Bacteria, fungi, archaea, bacteriophages Gram positive, Gram negative Asexual reproduction, fermentation Lipopolysaccharide, lipoteichoic acid, beta glucan Introduction to endotoxemia and translocation
Module 3: Human GI anatomy and physiology from a microbiome perspective Mouth, teeth, oropharynx—salivary components; reservoir of microbes in normal vs. decay/gingivitis/periodontitis Esophagus—propulsive action, esophageal sphincter Stomach—Role of stomach acid, parietal cells, H pylori, intrinsic factor Duodenum—common bile duct, cholecystokinin, alkalization, bile, pancreatic enzymes; susceptibility to microbial disruption Jejunum, ileum—mucus barrier, intestinal immune system, myenteric nervous system, vagus nerve; unique microbial environment; migrating motor complex—is this a real issue? Colon—cecum, appendix, ascending, transverse, descending, sigmoid
Module 4: Gastrointestinal microbiome in health Is there such a thing as a “healthy microbiome”? Judgements based on assessments of indigenous hunter-gatherer populations—Do they represent the optimal situation or adaptations to local environments? Healthy modern microbial populations—GI locations, concentrations, and functions of bacteria, fungi, archaea Functions—intestinal mucus stimulation, competition with pathogens, food processing, participation in intestinal immune function Short-chain fatty acid metabolites Vitamin metabolites—B vitamins, K2 Bile acid metabolites—role of taurine, glycine; bile salt hydrolase Concept of keystone species and role in maintaining a healthy microbiome Evolution of the microbiome from birth, to infancy, to early childhood, to adulthood, to elderly Changes associated with pregnancy and lactation Basics of gastrointestinal mucus
Module 5: The disrupted microbiome and its role in human disease Core microbiota; relative populations of Bacteroidetes, Firmicutes, Actinobacteria, Proteobacteria, and Verrucomicrobia; changes in species composition Overgrowth of bacteria, fungi, archaea Key markers—Bacteroidetes/firmicutes ratio; percentage Verrucomicrobia/Akkermansia; percentage Faecalibacterium prausnitzii; Fusobacterium nucleatum; Ruminococcaceae, Lachnospiraceae, Clostridia; Proteobacteria—E. coli, Klebsiella, Enterobacter, etc.; Gram positives—Staphylococcus, Streptococcus, Enterococcus Factors that disrupt microbiome composition—antibiotics, other prescription drugs, food additives (emulsifiers, preservatives) herbicides/pesticides, glyphosate, chlorinated drinking water, synthetic sweeteners, stress, electromagnetic frequencies? Consequences of lack of prebiotic fibers and other microbial nutrients Changes in species location—colon vs small bowel, bacterial translocation Disrupted microbial composition, disrupted intestinal mucus barrier, intestinal permeability, serum LPS, serum zonulin Metabolic endotoxemia and its broad consequences Meaning of food intolerances—histamine containing foods, nightshades, FODMAPs, fructose, legumes, nuts
Module 6: The microbiome in various disease states Hypochlorhydria Gallstones and bacterial infestation Pancreatic exocrine insufficiency Gingivitis, periodontitis—including the colon connection via Fusobacterium nucleatum as a cause of colon cancer Irritable bowel syndrome (IBD) Inflammatory bowel disease Celiac disease, “non-celiac gluten sensitivity” Type 2 diabetes, overweight/obesity Autoimmune diseases Neurodegenerative diseases Cardiovascular disease Cancers Disorders of pregnancy and lactation Bariatric procedures including gastric bypass
Module 7: Methods of microbiome assessment Symptom assessment Stool analysis—reliability, methods (16S rRNA vs. shotgun metagenomics), microbial analyses, physiologic markers. We review several real world examples across different testing platforms—e.g., Genova, Ombre, Viome, Gut Zoomer. Breath testing—hydrogen, methane, hydrogen sulfide, AIRE device, Trio-Smart
Module 8: Focus on forms of overgrowth Small intestinal bacterial overgrowth (SIBO)—symptoms; endotoxemia, systemic disease implications; assessment; eradication; prevention of recurrences Small intestinal fungal overgrowth (SIFO)—symptoms; beta glucan, systemic disease implications; assessment; eradication; prevention of recurrences Intestinal methanogen overgrowth (IMO)—symptoms; assessment; eradication
Module 9: Strategies and tools for microbiome management Probiotics–composition, rationale, ineffectiveness; future directions Fermented foods–providing the microbiome-”molding” effects of important fermenting species such as Leuconostoc and Pediococcus species; basics of fermentation Prebiotic fibers, polysaccharides, polyphenols Fecal transplant and related methods Restoration of keystone species, upper GI colonization, bacteriocin production
Closing comments, overview, future directions Resources to follow new developments Resources for continued feedback and support Microbe sources for fermentation Recipes for selected microbial ferments
If you are interested in enrolling in this course (it is open to non-health coaches, also, as well as doctors, other health professionals, or for anyone interested in a detailed discussion about the microbiome), sign up here.