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Episode 45: What If A Probiotic Could Change Your Personality? [Straight From The Gut]

Maybe you’re on board with the fact that microbes help you digest your food and even regulate your hormones. Maybe you’re totally cool with knowing that they play a vital role in your skin health, or that they keep your vagina healthy. But your personality? Isn’t that...personal? 
Episode 45: What If A Probiotic Could Change Your Personality? [Straight From The Gut]

Maybe you’re on board with the fact that microbes help you digest your food and even regulate your hormones. Maybe you’re totally cool with knowing that they play a vital role in your skin health, or that they keep your vagina healthy. But your personality? Isn’t that...personal? 

New research is showing that being shy or outgoing might not be all about you -- some part of your social interactions are also driven by your microbes. On this Straight From The Gut episode, Andrea and Afif talk about this study, plus dive deep into the world of supplementation, including what to look out for when you’re buying them.  

They also riff on why no one has created a sleep probiotic, probiotic desks and steering wheels and a study on fungi living in the lungs. 

Have your own questions or resources that you’d like the team to discuss on-air? Email them to, or reach out on Instagram @BIOHMHealth

Approximate Timestamps: 

Andrea Wien (@dreeats) and Afif Ghannoum (@biohmhealth) talk about why leaving your shoes could be beneficial (3:57), COVID-19’s long term effects on microbes (4:49), research on the skin biome (7:33), sleep probiotics and a dive deep on the warning signs to know about when buying supplements (8:44), the future of customized probiotics (23:03), and a study on fungi in the lungs (30:51).

Mentioned On This Show:

BIOHM gut quiz 


Andrea Wien: Welcome to The Microbiome Report powered by BIOHM Health. I'm Andrea Wien, and I'm back today with Afif Ghannoum for another episode of Straight from the Gut, the series where we discuss the latest research news and what if scenarios about the microbiome. On this episode, we're talking about how to design our lives and our things around microbial health. We're going into a study on how personality, literally how sociable you are, is driven by the microbiome and a fascinating discovery about the fungi in your lungs and its impact on lung health. Enjoy the show. Afif, what's going on?  

Afif Ghannoum: Not much. September.  

Andrea Wien: Crazy. Insane. So I found this article and it was talking about... This was years ago, actually. There was a professor in Oregon named Jessica Green, and she was looking into how to map environments. So these are places like offices, malls, cars even, just places where people are inside, which right now everyone's pretty freaked out about. And she was looking at everything that surrounded how the microbial ecology of those places worked so that they could influence the design. So actually going into air conditioning ducts or looking at desks and thinking like, okay, what colonies live here? And then how can we design things to make it more health friendly?  

Andrea Wien: The example they gave too about the car was, I guess, Ford had reached out to her when they heard about her work, because there are organisms that can make your skin softer and smoother. And Ford was saying, "I could totally see it, the probiotic steering wheel." So I think it's an interesting thought. Now, especially with COVID, it would be hopeful and optimistic I think. Instead of just decimating all of these species that we're living with with different cleaners, which we talked about on the last show, maybe we could actually design things to work in harmony and give the symbiotic organisms a leg up on the pathogenic ones. I thought that was a really interesting thought.  

Afif Ghannoum: Yeah. And it's funny. You know Dave Asprey, founder of Bulletproof coffee. He has a company that is basically built around this premise. It's called Homebiotic. And I think their first product is literally a probiotic spray that you put good organisms into your house to help imbalance the microbiota of your home. And we actually with BIOHM helped them launch a home microbiome test. So you can literally swab around your house and get an idea of what organisms are living in your house.  

Now, what gets challenging about it is, and I don't remember if we talked about this last time, but so much of it is influenced not by just the structure, but for lack of a better term, creatures inside, right? So us, our pets are huge. There's all sorts of studies showing farmers, people have pets, basically people that are around animals that are coming in and out of the house are much healthier than people who don't have an animal coming in and out of the house, right? So it's funny because it throws... One of the things I feel since we've been kids has really changed is taking your shoes off when you come into the house, right? Everybody kind of does that now. And you wonder, is that actually not what we should be doing? We should be really fostering the probiotic ecosystem in our home.  

Andrea Wien: It's interesting. I guess it depends where you live too, right? When I was living in New York City, I certainly didn't want all of New York on my rug. But I guess if you live somewhere where maybe you're surrounded by some nature, you have to walk through some dirt on your way in, that would be perhaps a healthier ecological balance in your home.  

Afif Ghannoum: But it is interesting to see that if you ask most people, "What do you think grows in your house?" you hear things like black mold and this. It's always negative, or it's always the wet basement. It's never about encouraging the natural fauna of your home. It's funny, we have a moss wall in our house and it's like a living fungi. You know what I mean? And we kind of left that because there's a reason in nature the ecosystems build with the fauna that's around. So it'll be interesting to see how they start designing homes, offices for a lot of that natural fauna and ecosystem.  

Andrea Wien: Yeah. And my hope is that it's not just, well, let's just create antimicrobial surfaces, which already exist in and doorknobs and desks and tables and things like that. But hopefully it's a little bit more comprehensive than that.  

Afif Ghannoum: It'll be interesting to see what COVID does because I feel 10 years ago was sort of the era of spray everything down unlimited hand sanitizer use. And then last 10 years, we kind of came out of that and realized maybe you don't want to be killing all these organisms. It's actually good for our immune system. And then COVID hits. And now, people wiping down grocery bags like, and you understand why. But you wonder, is it going to be this shift where the feeling's like better be safe than sorry. But the problem is longer term maybe it ends up creating issues. We don't even think about it. It's like these little sort of butterfly wing effects that we don't realize down the road. Do we end up having more children with allergies and things that their systems are just not getting challenged because we're really crazy anal now about the bubble effect, right? So it's going to be interesting to see long-term does the pendulum swing back to sort of middle over this?  

Andrea Wien: Totally. And I wonder too if there's some type of partnership opportunities. So we had Rob Dunn on a couple months ago on the show and he has a project where his lab is actually cataloging different species that live within our homes. And so I think to date, I might be getting the numbers wrong on this, but he's had a hundred thousand different entries. So people just take a picture of something they see in their house, right, a bug or whatever, and send it to them. And then they catalog it. And they're keeping kind of this running tally of all of these things that live within people's homes. But maybe there's another step to that where it's like this Dave Asprey thing, the home microbiome test that you guys did. It's like, okay, let's go even more granular to the things that people can't take photos of and see what's really under the surface.  

Afif Ghannoum: A million percent because, again, the example I always use is one of my dad's papers, the paper he actually named the microbiome, he found 101 different species of fungi in the oral cavity in this few centimeter space. Now imagine an entire house, a basement, decks, think of all the areas that organisms can be grown. So that guy, you're saying it was literally creatures, not organisms, he was recording.  

Andrea Wien: I mean, his latest book is all about organisms. And so it is that as well, but obviously people in their homes can't see that. So he has kind of a couple of different separate arms of the project and of his research. So he's done a lot with sourdough, for example, and how baker's homes are so different because of how they're cooking with sourdough starters and touching it with their hands all the time. And their skin microbiome is actually different. So I'm totally blanking on the name of his book right now. But we did a whole episode with him.  

Afif Ghannoum: Yeah. It's funny because my dad literally just did a white paper on the skin microbiome, and one of the things he was asking me to read it basically for typos, I'm like a system where he's like, "I think you'd find this interesting," which is code, "Can you make sure there are no typos?" And there are a number of organisms that are associated with skin elasticity, smoothness of the skin, things like that where it's wild to me, that it could actually impact wrinkles, right? Who would think that? You would think maybe it would irritate cuts and things, but the fact that it can actually impact how taut your skin is, that's wild.  

Andrea Wien: And right. And that opens up the question of, well, this is another item that we have on the list, I guess, but starting to create probiotics specifically for, and you're starting to see this. Skincare companies are putting probiotics into their skincare lines, but it's like, I don't know that they actually know what strains are valuable for certain things yet. I think they're just thinking probiotic is a buzz word, but you had put a thing on our list. Why hasn't anyone created a sleep probiotic?  

Afif Ghannoum: Yeah. So my thinking with this is sleep... Let's take a step back. We always talk about gut health being multifactorial. So the big ones we were talking about is genetics, your diet, the way you exercise, and lifestyle, right? So lifestyle is stress, the way you sleep. And those things are very tied together, right? If you are very stressed, hard to sleep. Some people genetically are light sleepers. I was looking through my 23andMe health summary and it said genetically likely to be a light sleeper. And I'm like, that's wild. You know what I mean? I didn't even realize that. So my thought was because sleep really is tied to microbiome health, it's kind of surprising to me that no one's tried to optimize sleep through probiotics and vice versa.  

So right now condition-specific probiotics is, I obviously look at these all the time, it's I don't want to say scammy, but a lot of times it's not the probiotic. If you see a product and it's probiotics for mood, when you actually look at the ingredients, it's not the probiotics that they're claiming is improving mood. It's some sort of herbs that's been studied for stress relief, right? So that's something to look out for, right? Especially when you see condition specific probiotics, a lot of times it's not the probiotic in the formula that they're claiming is going to help that issue. It's some other ingredient they've paired with probiotics, but they're trying to sell it as a condition-specific probiotic. So to me that's a little deceptive.  

Andrea Wien: Yeah, for sure. This is different though from the psychobiotics more of on the medical side of things where they're starting. That's a different topic.  

Afif Ghannoum: When people make claims in the dietary supplement space, you do not need to go to FDA to get preapproval. It's basically an honor system. You, as a company, are required to stay within the bounds of the FDA regulations, but a lot of people will take liberties with that honesty system and they'll make pretty aggressive claims, right? So my rule of thumb is be very weary of any supplement, but definitely in the probiotics where they're making a pretty heavy duty claim around either a condition or a symptom, because I'm not aware of any company that's gone through approvals by FDA to get those types of claims.  

Now there's some people that are starting to get it in pure therapeutics, right, probiotics that are kind of like biological drugs. That's different. I'm talking about if you were looking on Amazon or you're at your local Whole Foods and you're seeing some product that's got a pretty aggressive claim, turn around and try to understand how are they making this claim.  

Andrea Wien: Yeah. Yeah. I mean, right now everyone's capitalizing on how hot the microbiome is. So of course, they're going to try to make those claims everywhere they can. And I think a lot of people don't realize that you can do that without going through some type of channel. And so if someone complained, if they complained to the FDA about someone making a claim, would then the FDA be forced to look into that or still no?  

Afif Ghannoum: So that's a great question because a lot of times I'll have some entrepreneur that's like "I want to sell a product that says this." And I'll usually say something along the lines of "I don't think you can make that claim legally." And they'll say, "But this other company is doing it." And what I try to explain it is like, look, the way the FDA works is they will regulate claims. But their ultimate thing is safety, right? If the FDA has a problem with a company, they'll typically send them what's called a warning letter. And it's literally a warning. We're looking at your claims. We don't think you have the science to back them up. You have 15 days to explain how you're making this claim. And 99.999% of the time the company is out on a limb. They don't actually have the science, right? So a few years ago, FDA sent a warning letter to a bunch of companies that were marketing pain creams like those menthol type.  

Andrea Wien: Like Tiger Balm and that kind of stuff. Yeah.  

Afif Ghannoum: They were marketing these products for diabetic foot pain. Okay. So FDA came down like a ton of bricks. Why? Because they're worried that a diabetic that's having foot pain is losing circulation and that's why they're in pain. So they want that person to go to a doctor. They don't want them to see at some random drug store a diabetic foot pain cream, use that for two weeks not realizing their circulation is dying, right? So FDA went aggressively after them because it's a real safety issue for diabetic patients, right?  

Now take some other type of claim, random example like eyebrow thickness supplements, right? There are a ton of products like that. Now people would be surprised to know that a product that says it can make your eyebrows thicker, that's a drug claim. That's not a cosmetic claim. So you're saying your product can actually make eyebrows thicker. Now, if someone blatantly brought to their attention, they might say something. But the reality is they have so many bigger priorities that someone buying a product that it didn't really help with your eyebrows. It's not really a safety issue, right?  

Andrea Wien: Right. Unless it's like, oh, people are going blind because they're using your product.  

Afif Ghannoum: Federal Trade Commission may come after you for, yeah, we're going into the weeds here, for false claims. But the FDA rule of thumb, they're way more concerned about products that could present a safety issue. Now, interesting tidbit for our female listeners. You'll notice a lot of these sort of eyebrow fullness products. And the only reason I know this is I helped a woman one time market a product in this space. If her product said, like I said, makes eyebrows thicker, that's a drug claim. She had to say "creates the appearance of thicker eyebrows," right? So look at any of those products that are lash products, eyebrows even hair. If it says things like gives you the appearance of thicker hair, that's technically a cosmetic claim. So, it's just as a consumer of all these types of products, really pay attention in anything that seems like overly wordy. There's a reason a company's doing that. You see what I'm saying?  

Andrea Wien: Yeah.  

Afif Ghannoum: They're [crosstalk 00:15:30] a lot of times because if you buy a product that says "makes your eyebrows appear thicker," you assume it's going to make it thicker. You're not thinking it's basically saying it creates the illusion.  

Andrea Wien: Yeah.  

Afif Ghannoum: Well, yeah. So anything where they're saying that they're trying to stay this side of not making a drug claim, which is improves your wrinkles. I'll give you another example. We had a product that was for dry mouth. Dry mouth is one of those things that if you take a lot of medications or older people their experience is their mouth gets very dry, right?  

Andrea Wien: Stoners.  

Afif Ghannoum: A very big segment of the dry mouth community. If we said "makes your mouth more moist," that's a drug claim because it sounds like you're making them produce more saliva. But if you say "helps a mouth stay moist," messing up the wording here. But basically it was like-  

Andrea Wien: Helps alleviate dry mouth feeling or something. Yeah.  

Afif Ghannoum: An oral moisturizer claim, right? So it's all of these things you start to see. You're threading a needle on how you can make claims. So just being wary. Once you understand that, a lot of these products you start seeing like, "Oh, I understand what they're doing here."  

Andrea Wien: To bring it back to the supplements, you can always email companies and ask them for their research. So I've done that a lot for clients where I'm looking into a new product claims to help with something. And I'll say, "Is there any science to back that up? Can I see the research? Can I see?" And a reputable company will have that to show you.  

Afif Ghannoum: A million percent. And the category supplements generally is night and day from even 10 years ago. So 10 years ago, a lot of the companies were using pretty subpar manufacturing processes. The science was kind of shady. Now, because we actually supply ingredients to other companies, it's almost a level of pharmaceutical manufacturing. This story always brings to light just how much you need to pay attention, right? So you know private label products, right?  

Andrea Wien: Mm-hmm (affirmative).  

Afif Ghannoum: So everybody knows they're cheaper. So you'll go and say, "Well, why would I buy the brand when the drug store version is 50% cheaper?" Well, I'll tell you why you want to buy the brand. So two years ago we're looking for an additional. We had a new product coming out and we were looking at this manufacturer. So I go to visit them in Arizona, and they had these lines going and they were making, it was some outrageous number, a million kilos of supplement powders a month. Okay. And you see these lines whirling and I'm like, "Oh, well who do you sell these to?" They're like, "Oh, a lot of the retail private label brands, that's us." Right. We're like, "Oh, okay. Interesting." And then there was this gigantic box that every bottle was going through and I go, "Well, what's that?" They go, "Well, we get a lot of our ingredients from China. And so we run all the powders through a magnet. So it grabs the heavy metals that may be in the bottle."  

Andrea Wien: Which is not that effective. It can't be. You've told me that story before. And I have relayed that to so many people and so many clients. And I'm like, "Please, please, please do not buy your supplements from the drug store or from the grocery store." Find someone who has access to more better grade supplements because it's so true. They're just filled with junk. And a lot of times the active ingredients are and even active.  

Afif Ghannoum: I could not believe what I was hearing. When this guy was saying this, I'm looking at him like, "Are you for real? That's the plan? It's not source better ingredients." And basically it's like, how do you think if the drug store is selling you that for $5 a bottle, which means the guy who sold it to the drug store, sold it to them for $2.50 and he bought it from the factory for a dollar, how do you think everybody can make money along the way, except cutting corners every which way? You know what I mean? I cannot emphasize that enough. That's what you're getting. Listen, not every private label product is like that. But again, when you look at things and it's like, how is this possibly so cheap, that's usually an indicator that they have to do something in order to get the product that cheap, right?  

Andrea Wien: And buying direct from someone alleviates a lot of that because you don't have as many of the supply chain issues.  

Afif Ghannoum: So another thing to that point is a previous brand I owned, we sold on Amazon, right? And a consumer emails us and says, "Hey, I bought product off Amazon, but the expiration date was smudged out." And I said, "That doesn't make sense. Can you send me a picture?" And so when we looked, sure enough, it had been smudged out, right? So we looked because we said, "You didn't buy that from us. That's old labeling. It was a third party seller." And so what we did is we saw there were 10 other people selling our products on Amazon. And we did a surprise buy. Andrea, three of them completely counterfeit. It wasn't real product. Four of them, they had removed expired expiration dates and put new fake expiration dates. So we had this whole investigation going on with Amazon and it was a disaster.  

So my rule of thumb is if you're buying a product off Amazon, only buy it from actual Amazon or the company that manufacturers it. Don't ever buy it from a third party seller because literally we investigated these people because it was all counterfeit. It's illegal. And it was like these dingy houses in the middle of nowhere that this is where the product's coming from. Fake. They're not housing it properly. So just if you're going to buy anything on Amazon that is ingestible or frankly you're going to put on your body, buy it directly from the company or Amazon. Frankly buying directly from the company I think it's the best. But...  

Andrea Wien: Yeah. No, that's another great point. And I also told clients, "If you can, just don't buy it on Amazon to save the extra three bucks or whatever. Just get it direct or go to one of the-"  

Afif Ghannoum: Yeah. It's tough because I understand why people trust Amazon. If there's a problem with a product, they'll take it back. It's reliable shipping, especially now. I get that, you know what I mean? So, our view is we sell on both. We sell on our website and we sell on Amazon because some consumers have told us, "I buy everything through Amazon. I have Rewards. I have prime." All right. So if you're going to do that, if it's Amazon Prime, if it's being sold by the company or Amazon, that's fine. Just be very wary of buying things from third party sellers.  

Andrea Wien: And I've also told people if they do want to buy on Amazon, go to the website of the company and make sure it doesn't say, "We do not sell on Amazon. Please do not buy there." You could also email the company and say, "Hey, can you send me your brand on Amazon exactly. So I know that I'm buying from the right link." Because sometimes they can be a little deceiving too. Someone will add an extra character somewhere. It looks like you're buying from the brand and you're not.  

Afif Ghannoum: Yes. Yeah. And honestly it takes two seconds. Just go. Usually my rule of thumb where I know something's off is you go and you're like, "Oh, that's interesting. They sell mouthwash and head massagers."  

Andrea Wien: Yeah. All right. Let's move on to our next one, which kind of is in the same vein of customized probiotics. I'm thinking that could work for this. So there was a study done recently on personality traits and the microbiome. And this is something that I've talked to a few people about now. And I think people are, they kind of get a little defensive, like, no, it couldn't possibly be my gut bacteria that's driving this because it's so me.  

Andrea Wien: So there was a study. It was over 600 people. And they put them through interviews on everything from personality, behavior, health, lifestyle, dietary habits, socio-economic status, stuff like that. And then they tested their gut microbiomes and they found that people who had more gut diversity and higher abundance of certain types of gut bacteria, those people were more sociable. And the inverse was seen in extreme cases like what we were talking about with autism. So lower gut diversity and lower types of certain bacteria, and people, not necessarily everyone had autism, but you saw the people with autism in that category.  

And then secondarily, so interesting when they did fecal transplants in mice and gave the mice who were more sociable the other bacteria from other mice that weren't, they actually changed their temperament and their behaviors. So they were able to change how mice interacted with their environments. And so, this opens up so many things. Now we're starting to get really into not just, yes, you have the gut brain connection and it might deal with anxiety, depression, but also how you're just moving through the world as a social being.  

Afif Ghannoum: Yeah. Again, obviously we kind of say this a lot, but we're literally not even at the tip of the iceberg of understanding how all these things interact. It's like, there's all these cases. I think you know this. I'm a lawyer by background. And in law school, we would cover these cases of people that, totally normal people, AND then they'd have a car accident and have a head injury, or they had a brain tumor and they would start having criminal tendencies, right?  

And really the question was, okay, well the whole basis of criminal law is intent, right? If you intend to kill someone, that's murder. If you accidentally kill someone, that can either not be a crime or a negligence or something, right? But the intent piece is critical.  

So the question becomes, well, if someone is doing this criminal thing because of a change to their brain, do they actually have the intent, right? So it's similar to this where you're saying if... It's not wild that maybe 20 years down the road, you'll have people saying, "Well, my gut microbiota after this traumatic situation changed, and then I committed this crime." You know what I mean? And that sounds so wild and farfetched, but these connections are going to end up causing scrutiny because the question ends up being is this actually this person intending to do this behavior? You know what I mean?  

Andrea Wien: It's insanely wild. Do you think eventually that microbiome testing, gut testing will be kind of the norm when you go for your yearly physical?  

Afif Ghannoum: One million percent. So one of the things that people always talk about is if you want to see the future, see what rich people did 50 years ago, right? So whether it was yachts or whether it was experiential travel, those things 20, 30 years down the road ended up being sort of normally available. So I'm sure it was the same thing with air conditioning or whatever. At one point it was only certain percent of the population could afford it. And then it becomes mass adopted when costs come down, all those things.  

So the reason I'm saying that is I know in our world in very high end concierge, functional medicine and just concierge doctors, they're doing all these types of tests and not just microbiome. They're doing telomere tests. They're doing all sorts of just deep blood work tests because that's what their clientele want and need in order to stay on top of their health, right? So looking down the road, these things, as pricing comes down, as the science continues to improve, as turnaround time improves because that's a big one, right? Right now, microbiome test takes between, let's say, three and five weeks to get the results. Well, at some point it will get down to a day, right? Just the way science works. That's when all of a sudden these things that become massed up. So yeah, I do think that's going to be the norm eventually.  

Andrea Wien: And I think it would be so interesting to be a teenager and think like, "Oh man, I'm feeling shy. Maybe I should take this strain of probiotic because then I'll be more outgoing to ask that person out on a date or something." I can see it really snowballing in terms of this personality trait thing. There's a lot of people who don't feel comfortable in how they communicate with other people. So I don't know. It opens up a real Pandora's box for me.  

Afif Ghannoum: And think about what drugs are going to have warnings because of their impact on the microbiome. Is that going to be a side effect warning? Is it something where some products will go out of vogue because they're so sort of nuclear on your gut microbiota? Again, this is why I come back to we're coming out of that phase of medicine where the pill fixes the issue and that's a solution. An easy one is antacids, right? Antacid, if you're dealing with a high acid production, take this pill, you can eat what you want, right? But we know those drugs can be very, very, very strenuous on your system, right? So it's now starting to go past that where people are saying, "Okay, not just functional medicine wise, but what are other solutions to this?" Because that pill that was the turn to thing maybe 15, 20 years ago, people are now becoming more wary of.  

Andrea Wien: And I talked to clients about this. You never go to the doctor and they take a pill away. So I think people are getting a little frustrated that they're going to their doctors. They're just adding another prescription to the list. And then another prescription next time you go to help with the issue that the first prescription caused. And it's like, suddenly you end up... My friend sent me a list of her parent's medication the other day. And it was like a full letter size sheet every single line. This one for sleep. This one for acid. This one for anxiety. This one for depression. It was unbelievable. I've never even seen anything like it. But you're very rarely going to the doctor and they're saying, "Okay, you know what? That fixed it. So we're just going to take you off that." it doesn't happen so much.  

Afif Ghannoum: Yeah. And look, there's economic incentives to keep people using drugs long-term. There's all sorts of, again, even the way you look at mental health psychiatry, and again, I'm making a blanket statement here, but just in general, psychiatry versus behavioral therapy is one is talk therapy, which is very effective. That's what the science showed. And the other is very much driven by medication, right? Even though the talk therapy often can get a lot of significant progress. Now that doesn't mean medication is inappropriate. Sometimes of course that's... The problem is all these things. There aren't absolutes either way. So it's just interesting to see where all these things go.  

Andrea Wien: There was a study that was done and it found a link between low fungi diversity in the lungs and the severity of acute respiratory distress syndrome. So essentially, first of all, the fact that there's even fungi in the lungs was a big finding not too long ago. Your dad did a lot of work saying, "Hey, we need to be paying attention to fungi and the microbiome in general and the microbiomes of the body." And he was ignored for a long time for the better part of 20 years from what I understand. Other scientists said, "No, let's just focus on the bacteria." So the fact that there's even mainstream articles now coming out about fungi diversity in the lungs, right, is pretty surprising. And then to find that there's this link.  

Afif Ghannoum: And it is surprising, but it really should not be. My dad always talks about the fact that when he was doing his PhD, what they noticed was that when you use an antibiotic on these animals they were testing on, fungi would overwhelm the animal, right? And it was like, that's interesting. When you remove one ecosystem, i.e., bacteria, the other can take over. And then we see that in women when they take antibiotics. Yeast infection is very prevalent in children when candida thrush takes over and you can see it in the mouths. Because their immune systems are still developing, candida takes over. So in the lungs, when you sent me that article and I was like, "This is not shocking at all." Because basically what that tells me is when there's likely a native fungal community in the lungs, right?  

So my father, as I was telling you, he identified 101 species of fungi in the oral cavity. Those were native organisms, right? They are just present all the time in the average oral cavity. So there's probably a baseline. And I don't know if they've done this microbiome in the lungs, right. And guess what? That native population is keeping the other populations in check and vice versa, right? So guess what happens? The fungi population drops. The other organisms are able to go bananas. And that's why you're seeing them. I assume. It's the same thing happening over and over, right? So that's why I'm saying it's not really that surprising because what we found is in an area of the body, when one population is allowed to overwhelm the other, you start to see problems.  

Andrea Wien: There's kind of two pieces of this that are interesting to me. And just to bring it back to this study quickly before we kind of move on from it is this acute respiratory distress syndrome. Apparently the method of treating it has just been to support the person. So mechanical ventilation of lungs is something that they mentioned in this article. But now that they're learning that actually the severity is connected to that diversity of fungi, that might open up interventions that can actually do more than just support the person with their symptoms, but actually help clear them of this disease in general.  

Afif Ghannoum: Guess what? When you introduce the ventilator, there's something called ventilator-assisted pneumonia because, guess what, grow in ventilators.  

Andrea Wien: Biofilms. Yeah.  

Afif Ghannoum: How you remove biofilms from ventilators, from catheters, anything in our body. So point being in trying to assist that patient, it actually could be exacerbating, right? So again, if you need a mechanical ventilator, something is definitely wrong. Clearly you need ventilators, but it just shows that it just compounds on itself all the issues, right?  

Andrea Wien: For sure. Yeah. And then my second thought when I read this and where we've been talking about it is we talk a lot about how do you take care of your gut microbiome and create diversity and help it flourish and skin microbiome and mouth microbiome and vaginal microbiome. We have access to all of those things in a way through the digestive tract and everywhere else. But how do you take care of your lung microbiome? Is it just a byproduct of doing all the other things? Or are we going to find out like, oh, actually, doing deep breathing is really helpful? There's all these things now as we start to learn about the microbiomes of different organs. How can we best support those?  

Afif Ghannoum: That's a great question. So my not even theory, likely how it would be is there's two... One simple example is probably some sort of [inaudible 00:35:22] that it would be some type of inhaler. But more likely, I think it's by just having other healthy microbiomes, right? So for example, we know that there's a connection between the oral microbiome health and the gut microbiome health. Why? Because the entire system is connected, right? So if there's an issue going on in one, there's likely an issue going on in the other. So the lungs, just think about it. Everybody's drank water and it's gone down the wrong pipe and all that good stuff because it's literally right there. So I think it's probably going to be less invasive than it seems to be able to maintain an optimized lung micro flora, right?. But to your point, you're not going to shove a prebiotic in your lung, right? So it's going to be interesting to see how do they actually control for that?  

Andrea Wien: Yeah. And I think it probably will go the way like you're saying. We just did an episode with the nurse midwife this month. It was September's episode. So she was saying for the most part, your vaginal microbiome, just leave it alone. Eat healthy. Live a healthy lifestyle. Don't stress, all the things we talked about and it'll take care of itself. So I have to imagine our ancestors weren't concerned about their lung microbiomes because they were just doing all the right things as part of their lifestyle, so...  

Afif Ghannoum: And usually a really imbalanced microbiome is an indicator that something's up with your immune system, right? Because the body is really good at self-regulating. So if you're taking care of your overall health, your microbiota is likely going to be in much better shape than if you're dealing with immune-compromised situation. And again, I harp on this, but everybody, when you say, "Is your immune system compromised?" People that "Oh, well I'm not sick, or I don't have an underlying serious condition." But you can compromise your immune system. We're being too stressed, not sleeping well, too much alcohol. Just like putting stress on your system to actually weaken your immune system.  

Andrea Wien: For sure. And we talked to Josh Gitalis about that and just immunity in general. And he had a lot of great things to say about that. And the marker of good immunity is not just not getting sick. Actually sometimes not getting sick is not good. So people can go listen to that episode to hear a little bit more about why that is. But it's an interesting time that we're in, I would say. Afif, thank you so much as always. We'll check in next month. And if anyone has any topics that they want us to chat about, feel free to send them over to Have a good one.  

Afif Ghannoum: You too. Take care.  

Andrea Wien: As always, thanks for listening. The Microbiome Report is powered by BIOHM Health, a total microbiome company with products designed to address the critical roles of bacteria and fungi in gut health. Check out the show notes for this episode by going to Again,, and clicking on the podcast tab. I'm Andrea Wien, and I'll catch you next time.


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