Why microbiome tests are currently of limited value for your clinical practice

Posted 29 July 2022

This article concludes:

Microbiome testing is still in its infancy. Here is a summary of some clinical takeaways that you can explain to your patients the next time they ask about the utility of microbiome tests:

  • Scientists have not yet defined a healthy or normal gut microbiome that can reliably predict whether a person will develop a particular disease.
  • Relying on stool samples for studying the gut microbiome is inaccurate as the microbiome in stool does not faithfully reflect the microbiome at the intestinal mucosa. The stool microbiome is stable over time and different from the luminal microbiome, which varies depending on each part of the gastrointestinal tract.
  • Some commercial microbiome test reports describe the patient’s gut microbiome profile in terms of “good” and “bad” bacteria. The behavior of a particular gut microbe depends on the environment in which it lives and interactions with other commensal species. For instance, some people are asymptomatic colonizers of the potential pathogens Clostridioides difficile.
  • That a commercial microbiome test provides a large amount of information is not an indicator of its reliability. Approximately 20% of bacterial gene sequences have not been identified and over 40% of the 10 million microbial genes have uncharacterized functions, which means the science on how to use diet or food supplements to correct specific levels of microbial metabolites is just not there yet.
  • Currently, fecal microbiome analyses have limited value in guiding treatment decisions as they provide little important information on gastrointestinal symptom severity, which are ultimately the beacon that guide your clinical decisions.

Read the full article for context.

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