What can at-home stool testing kits tell us about our intestinal health?

Many companies sell stool testing kits for home use, but research shows that scientists themselves don't yet know when the microbiome in our gut is truly healthy.

The science behind the gut microbiome, the collection of bacteria, viruses, yeasts and fungi in our gut, is often portrayed as one of the most relevant areas of research in healthcare. Although some researchers also believe the research is overstated. One point of discussion is the usefulness of stool testing kits, with which you can submit a sample of your stool to determine if your intestinal flora is in good condition.

Research shows that many of the claims made in the group's guides are not supported by evidence. In addition, the tests are not good enough to obtain any information about your gut health. Should companies actually be able to sell this equipment?

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Useful or Shit?

Microbiome research began about twenty years ago. Thanks to advances in DNA reading, scientists have been able to learn more and more about the bacteria that live on and in us.

Doctors have long known that some infections result from the spread of harmful pathogens. But a revolutionary new idea was that subtle abnormalities in the microbiome could be the cause of diseases that at first glance had nothing to do with the intestinal system. This includes obesity, cancer and depression.

Despite the hype, the field of research has not yet fundamentally changed medicine. Fecal transplants, which transfer stool from one person to another to transfer beneficial bacteria, have so far only been used in rare medical situations. This is a severe form of diarrhea that occurs in hospital patients who have been given strong antibiotics.

The effectiveness of probiotic products, which aim to introduce healthy bacteria into the intestines, has generally not yet been proven in randomized, double-blind studies, the gold standard for medical evidence.

But that hasn't stopped some companies from selling microbiome-related products to the public. This has prompted the US National Institutes of Health to launch an investigation into the increasing use of stool testing kits among the general public.

It is too early to be certain

Health lawyer Diane Hoffman The University of Maryland and her colleagues found 31 companies worldwide that provide microbiome analysis kits to private clients. Based on the results of these analyses, users receive a report on the health of their intestinal bacteria, in the form of a numerical score. They may also be told that they have certain bacteria in the gut that are associated with specific medical conditions.

The main problem, Hoffman says, is that the science based on analyzing stool DNA is not robust enough to draw reliable conclusions. Previous research has shown that submitting identical samples to different laboratories produces different results. This may be due to differences in how samples are screened, or in the databases that companies use to evaluate the microbiome.

In general, companies do not disclose details about their analytical methods. “They are not required to share this information,” Hoffman said.

Even if we could accurately measure the amount of each type of bacteria in a person's stool, there is no consensus among doctors about which bacteria are associated with which condition, Hoffman says. “They don't have the data needed to determine whether someone's microbiome is healthy or unhealthy.”

Some companies that sell this equipment also have conflicts of interest. The research team found that nearly half of manufacturers sell nutritional supplements or probiotics, claiming that these products improve gut health. They recommend this based on the results of their groups.

The results surprised the microbiologist Leslie Howells From Nottingham Trent University in the United Kingdom no. Last year, I co-authored a reflective article on the research area in a scientific journal Nature microbiology. That article concluded that the field was vulnerable to “noise and misinformation.”

When it comes to stool testing, she says, “There are so many normal variations between each individual that it's meaningless.” “We don't know what a healthy microbiome is.”

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Megan Vasquez

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