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Dr Dominic Farsi, PhD RNutr's avatar

Really great article Daniel 😁

My PhD research had colorectal cancer and the microbiome within it and it is certainly an exciting area of great potential, but like you say, an area we need more research on to better understand the involvement and also like you explain, potential in helping diagnosis (which would be amazing) and treatment which could be massive.

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Vas Priebe's avatar

Nice to finally hear doctors discussing what’s been going on behind the scenes for so long. ☺️🤗 I’ve been patiently waiting. 18 years ago when I would discuss all of the above with docs in regards to MS, the message was lost. Now, over time, the news is becoming more accepted and mainstream which is great. What we eat matters. How we care for our bodies matters. And as someone who’s been monitoring my gut for 18 years, I will say that those at home tests aren’t a total waste. Sure, always back up finding with your docs, but they aren’t a bad place for some people to start and/or check in. I took a test through Viome because I knew something was up… the foods that it highlighted confirmed my assumption of SIBO. I then went to my ND for additional bloodwork and testing (breath test for SIBO) to find that yes, I did have SIBO. We made a treatment plan, SIBO is cleared. Anyway, so happy to hear MDs talking about this stuff. It’s very important. My cousin has ulcerative colitis with a history of Melanoma and her GI doc told her diet doesn’t matter 😔 so sad he is so uniformed. It’s really damaging to patients.

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Daniel Flora, MD, PharmD's avatar

Yes, with our current health system encouraging quantity over quality you will have providers who don’t take the time to listen or learn a new perspective in their own practice. I will say that in our hospital there are many wonderful docs who do take time and care deeply about their patients. I’ve learned who to refer to to make sure my patients only see that caliber of doc,

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Vas Priebe's avatar

That’s amazing. So grateful for docs like you. With your knowledge of the body we can accomplish so much! Especially when docs listen to the reality of the patients with the chronic diseases who have had success. 😊🙏

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Kaitlin Pielage's avatar

LOVE that you addressed this! I agree that there is so much more to unpack in the gut! Can't wait to see where we are in 10 and 20 years with what we learn!

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Barbara Parker's avatar

Fascinating. I hope we get there. I am a lung cancer survivor currently in remission. I have had bowel issues since I was very young. I have so many autoimmune issues especially now.

The life saving chemo, radiation and immunotherapy has triggered pneumonitis that keeps reoccurring. The radiation I received was stronger than it should have been. (This was brought to my attention during a second opinion and then confirmed elsewhere.)

I've been on steroids for 5 months. Every time I start scaling back, I get worse.

I keep to a high fiber diet. I drink kombucha mixed with miralax and take a probiotic daily. It keeps me regular but, I can't seem to shake the pneumonitis.

The steroids are horrible.

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marvin von renchler's avatar

Has any thought that your last name is the perfect one for the topic? lol. No med training at all here--just a curious mind suddenly (hope it s not too late, Im 71) studying everything I can about nutrician and health, but Ive been facinated about gut microbiome every since it started to be a topic. I said long ago on my own to folks that just gobbling any old yogurt and taking all the massive amount of suppliments that all say PROBIOTICS without definition was possibly a waste of time and money---all fueled by corporate greed. It seems that over the last few years weve become exponentially more accurate with research and discovery, mixed with common sense. This aint our mom and dads medicine any more. It bewilders me to even start thinking of trying to classify all the bacteria and finding their individual correlations to certain diseases

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April's avatar

I'm surprised I didn't hear kombucha recommended, unless I missed it....... available at most supermarkets & if you love it like I do ♥️, an easy at home DIY fermented drink to add to your diet!

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Daniel Flora, MD, PharmD's avatar

Fermented foods: Yogurt, kefir, sauerkraut, kimchi, miso and kombucha! There are probably a few I missed but any of these work

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marvin von renchler's avatar

Here's a breakdown of each fermented food based on its effects on the gut microbiome, probiotics, and overall benefits:

1. Yogurt

Probiotics: Contains Lactobacillus and Bifidobacterium species, which support digestion and reduce gut inflammation.

Nutrients: High in protein, calcium, and B vitamins.

Best for: General gut health, lactose digestion (if containing live cultures), and immune support.

2. Kefir

Probiotics: More diverse than yogurt, containing up to 50+ strains of bacteria and yeast, including Lactobacillus, Bifidobacterium, and Saccharomyces species.

Nutrients: Rich in protein, calcium, and bioactive peptides.

Best for: Restoring gut flora after antibiotics, improving digestion, and boosting immunity.

3. Sauerkraut

Probiotics: Contains Lactobacillus plantarum and Leuconostoc species.

Nutrients: Rich in fiber, vitamin C, and antioxidants.

Best for: Supporting digestion, reducing gut inflammation, and providing prebiotics (fiber for good bacteria).

4. Kimchi

Probiotics: Contains Lactobacillus, Leuconostoc, and Weissella species.

Nutrients: High in fiber, vitamins A, C, K, and anti-inflammatory compounds.

Best for: Gut diversity, reducing inflammation, and improving metabolic health.

5. Miso

Probiotics: Contains Aspergillus oryzae, Lactobacillus, and Bacillus subtilis.

Nutrients: Rich in protein, essential amino acids, and antioxidants.

Best for: Supporting gut microbiome balance and immune function, though heat (e.g., in soup) may reduce probiotic benefits.

6. Kombucha

Probiotics: Contains Acetobacter and Gluconacetobacter, along with yeast species.

Nutrients: Antioxidants, organic acids, and trace amounts of B vitamins.

Best for: Digestive support, detoxification, and balancing gut pH, though sugar content varies.

Comparison & Best Choice:

Most diverse probiotics: Kefir

Best fiber & prebiotics: Sauerkraut, kimchi

Best for general gut health: Yogurt, kefir

Best for immune & metabolic benefits: Kimchi, miso

Best for digestion & detox: Kombucha

If you want the most probiotic diversity, kefir is the best. If you prefer a fiber-rich, gut-friendly option, sauerkraut or kimchi is better.

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Daniel Flora, MD, PharmD's avatar

Thank you for the excellent review. Very helpful. Posted to notes.

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Dr. Chris Salierno's avatar

As a dentist, I appreciate the P. gingivalis shout out. We are truly in our infancy in understanding the oral microbiome and how it relates to the gut.

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Daniel Flora, MD, PharmD's avatar

Yes, I agree. Oral health and cancer could probably be a topic of its own. Maybe something we could explore in more depth here?

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Dr. Chris Salierno's avatar

That would be very interesting! I’d be happy to help.

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Daniel Flora, MD, PharmD's avatar

I’ll add it to the list!

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Jan D Pifer's avatar

So why is Ivermectin still banned? I’ve gotten some from All Family Pharmacy, been giving it to Jim for 6 months, and he not only feels better, his lung tumor is shrinking! Now I’m going too add hydroxichlorequin.

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marvin von renchler's avatar

Uhhh are you in the correct topic thread?

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