Adapted from episode 126 of The Perfect Stool podcast with Cheryl Sew Hoy, the CEO & Founder of Tiny Health, the most comprehensive microbiome platform for precision prenatal and children’s health and Lindsey Parsons, EdD, and edited for readability.
Lindsey:
Welcome to the podcast Cheryl!
Cheryl Sew Hoy:
Thank you, Lindey! I’ve been so excited to come on your show. You know why?
Lindsey:
Why’s that?
Cheryl Sew Hoy:
Before I started Tiny Health, and this was maybe even before 2020, I searched on Spotify, “What are all the stool test or gut health podcasts out there?” And I found yours and so I bookmarked your podcast. It’s been there for years. So it’s such an honor to finally come on your show because this is literally before I started Tiny Health when I found you.
Lindsey:
Awesome. Well, I’m glad to have you here. So what led you to start Tiny Health?
Cheryl Sew Hoy:
In 2020, I gave birth to my son, and that’s the year I also started Tiny Health. I started the company a week after he was born.
Lindsey:
That’s ambitious!
Cheryl Sew Hoy:
Well, yeah, I incorporated the company and I self-funded a study with eight moms who were giving birth the same time I was. So technically I started the study before I started Tiny Health since my story goes back to my daughter, two years before my son was born. So in 2018, I gave birth to my daughter by C-section. I was really researching the impact of C-section on my child. At the time, I didn’t know about any linkage between C-section versus vaginal birth and its connection to gut health. But since then, I’ve uncovered that you get your gut microbes from your mom at birth. You first get some vaginal microbes from labor and from passing through the vaginal canal, and then also some gut microbes from the fecal fluid during labor. Also through breastfeeding, the mom is continuing to transfer some gut microbes from her gut to her baby’s gut.
So then I was uncovering all this research about how bypassing the vaginal canal during birth can lead to a baby having a higher risk of eczema, allergies and asthma. I was kind of on alarm obviously, because of the C-section I couldn’t control and also trying to figure out if I can rebalance my C-section baby’s gut. I wanted to restore her gut by replacing the missing bacteria that wasn’t there to prevent her risk of chronic conditions. But obviously, I was in that research mode, so I didn’t get to see her gut. So when I was pregnant with my son, if this time I had to have a second C-section, I really wanted to know sooner than later so I could course correct earlier on. My daughter did end up getting eczema around six months, food sensitivites, she’s dairy and gluten intolerant, and she has a lot of gut issues and skin issues. I really wanted to prevent that for my son.
Lindsey:
Yeah, my son was also C-section. I did give him some probiotics sometime, but it may have been later on. But I was certainly aware of the issue at that point. So why do you recommend that expectant mothers test their microbiome?
Cheryl Sew Hoy:
Oh, yes. So I’ll follow on with my story and then come back to your question. I self-funded a study with nine moms, including myself, and tested their microbiome throughout the first year of life. I had gathered scientists and microbiologists who knew much more about this than I did to help me build this thing. And then we finally spent another two years of R&D (research and development) before launching the tests in 2022. Our flagship product was the pregnancy gut tests and vaginal tests and then also the newborn gut tests. All these were basically in the first three years, when there was a huge gap in the market, since there were no stool tests available for babies and moms at the time. And so with my son, who I mentioned earlier, I had that ability to test him and myself. With the study that I funded, I realized through my pregnancy microbiome that I didn’t have the “Bifs” (Bifidobacteria) that I was supposed to transfer to my son through a vaginal birth and through breastfeeding. If the mom’s gut is deficient, then even if she had a vaginal birth and was breastfeeding, she’s not transferring any necessary microbes to her child. Dr. Martin Glaser is a really well known microbiologist. Have you heard of him? He wrote this book called Missing Microbes.
Lindsey:
Yes, that’s what launched my interest in the gut microbiome.
Cheryl Sew Hoy:
Amazing. Yes, he’s well respected and I think there’s even a documentary now that he created with his wife.
Lindsey:
Awesome.
Cheryl Sew Hoy:
And so he talks about how the overuse of antibiotics is really causing a depletion of these essential microbes in our guts. And so that was the microbe that was depleted in my gut. I didn’t have any Bifidobacteria, I had zero. And that is the most essential microbe that a mom should have to transfer to her baby at birth, either through labor and birth or through breast milk. So it’s interesting now that we’ve been in the market for about two years, we’ve seen over 25,000 families. So we have a lot of samples, a lot of infant samples too. In 30% of the cases where the child was vaginally born and breastfed, they didn’t have any Bifidobacteria. Where we had the mother’s gut sample, the mom didn’t have any Bifidobacteria either. This is really interesting.
So I would recommend if I knew what I know now, and if I were to have a third child, I would try to restore my gut before trying to conceive, because it takes months for an adult’s gut to change. For example, if you and I were deficient in Bifidobacteria, it could take us at least three to six months, sometimes nine months, to see those Bifidobacteria recolonize, because we’re trying to make something that wasn’t there, maybe that was being destroyed by antibiotics. That was what I learned when I had to go through this path of thinking, “why don’t I have any Bifidobacteria?” I asked my mom how I grew up and she said I was formula fed and I had antibiotic exposure as a kid. Bifidobacteria are very sensitive to antibiotics, especially in early life, sometimes getting completely wiped out. If you don’t take care to restore the bacteria, it may be gone forever. So why I think everyone should do a stool test to really see if there’s any Bifidobacteria or Akkermansia, the other crucial bacteria that is important for your metabolic health and gut lining. I would check if you’re trying to conceive or if you are pregnant to see if you have Bifidobacteria and Akkermansia in your gut because these are two quite important bacteria to pass on to your child.
Lindsey:
If you’re going to reestablish it, is it B. infantis in particular that you want to restore? Or is it any Bifido combo? What do you guys recommend in that scenario?
Cheryl Sew Hoy:
Yeah, that’s a great question. So it depends, right? If you’re an adult with no bifidobacterium, frankly any bifidobacterium could be beneficial. But if you are planning to have a child, you really are looking for four specific bifidobacterium, which is what you mentioned. B. infantis, is probably the best adapted for digesting the mother’s breast milk, or specifically the HMOs in the mother’s breast milk, human milk oligosaccharides. HMOs are the prebiotic fibers that make up a third of the mom’s breast milk that the baby cannot digest. It is there for the bifidobacterium in the baby’s gut to digest. And so B. infantis is the best adapted in digesting HMOs in mom’s breast milk. The next best, maybe in no particular order, are B. bifidum, B. longum, and B. brevi. So we really want to see these four specific strains that are very good at digesting mom’s breast milk for the best child’s health. In the first year, we want to see these at 50-90% of the infant’s gut, frankly.
Then as they grow older, they get more exposure to solids, nature, pets, and their guts diversify. You don’t want to ever see 90% bifidobacterium in a toddler at two years old. I was researching and in the first six months of life to the first year, there’s a very specific trajectory of gut maturation that an infant should be following that is best adapted for training their immune system, because the baby doesn’t have any gut microbiome in the womb. There was some controversy back then and debate about, “oh, maybe there is”, but there isn’t a microbiome in the womb. The science is pretty settled in the recent year, that the major transfer, the colonization, happens at birth. There’s some passing through, but there’s no colonization in the womb. So what this means is that the baby is born pretty much without an immune system. And their immune system is being trained by these bacteria, these microbes, right?
I always describe the gut like a theater room with only 10 seats at birth. And as the infant grows, the seats in a theater expand. When they start solids, it makes them go to 20 seats, when they’re just kind of nibbling stuff, and then when the solids have been established, maybe it expands to 50. And as they grow up past one year, it’s quickly expanding to 100 seats, 200 seats, etc. You and I, at our age, probably have 300-500 species, or seats in that theater. So our theater is huge and very complex by now. But an infant’s theater is very small and developing. So that’s why those early years are so crucial to get the right balance, because this right balance of beneficial versus unfriendly bacteria is there to train their immune system on what’s friend, what’s foe in order to recognize if they should react to it. So the reason why eczema, allergies and asthma are so tied to the gut microbiome in the early days is because of their gut dysbiosis. It is a sign that their immune system wasn’t trained correctly by the right balance of bacteria.
Lindsey:
It’s overreactive?
Cherry Sew Hoy:
It’s overreactive. Yeah, it’s proinflammatory. In these babies’ guts, we often see zero bifidobacterium. So instead of the four bifidobacterium that we just mentioned, which take 9 out of 10 seats in the theater, it’s the other way. It’s maybe zero bifidobacterium and nine out of ten seats filled by E.coli, Klebsiella, maybe streptococcus, staphylococcus, etc.
Lindsey:
All opportunistic bacteria that at higher levels are pathogenic.
Cheryl Sew Hoy:
Yes. And babies still can tolerate that much. Sometimes parents are shocked when the gut of their baby is 90% E.coli. They ask, “Is my baby sick”, and the answer’s no. Babies, again, are born without an immune system. So they can still tolerate really high amounts of unfriendly bacteria. But you do see it in terms of symptoms, you get a colicky baby, a gassy baby, a baby that can’t sleep very well, etc. And then you get eczema when he starts solids at six months. So that high level of unfriendly bacteria and opportunistic pathogens is sitting there, creating this really inflammatory event in their guts and not training their immune system properly. And so when they finally are met with a dietary allergen or new thing at six months, they get triggered, and then eczema happens.
Lindsey:
Yeah. And so given that you guys now have sequenced all these infant microbiomes, I’m curious, because there are different strains of B. infantis. And some are a lot more expensive than others. So I’m wondering, is the B. infantis you’re finding in the guts of healthy babies who have the right microbiome the same as any one of the strains they’re selling out there as probiotics? Or are there are a number of different possible B. infantis strains that are good enough?
Cheryl Sew Hoy:
Yeah, this is a great question. We’ve seen some native B. infantis from a mom and a baby. It’s really hard to say, we would have to do a proper study. And we do have the data now to really dive into it. But this is what we could do in the future, in terms of “is the innate strain better than a supplement or probiotic?” Who knows? Probably, right, if the mom had B. infantis, it’s likely superior because her breast milk and her HMOs in the breast milk have probably adapted somewhat to her own B. infantis to help it colonize in the infant’s gut. But again, the problem with our society and modern lifestyle is that most adults are missing B. infantis, including myself. So then when that happens, the infant really needs a supplemental B. infantis that is well studied, clinically backed, and they’re not all equal.
When you talk about probiotics, you can’t just grab a bottle from the shelf and think, “oh, yeah, I’m taking probiotics”, or “I’m giving my child a probiotic and I’ll be fine.” No, because different strains have different functions. And even within one type of bacteria, like you mentioned, there’s so many different strains. And, for your audience, when I talk about strains, they are the numbers and letters behind the probiotic. So, for example, B. infantis EVC001*, is one that we recommend. The brand name is Evivo, right. It is the most clinically-backed B. infantis for infants, but I would even take it for adults too, because it’s so potent. And if an adult is missing some B. infantis, I would take that to help it recolonize the gut.
Lindsey:
I actually just bought some, and I’m going to make Bifido yogurt with it.
Cheryl Sew Hoy:
Nice! Did you buy the HMO supplement* along with it?
Lindsey:
I did not buy any HMOs yet.
Cheryl Sew Hoy:
Okay. If you want to recolonize you have to have the prebiotic for the probiotics to colonize. Otherwise, you have to keep taking the probiotic, because it is going to give you a transient effect. But again, without the food there, they’re not going to stick around, they are just going to pass through and give you a short term benefit. You have to keep taking it every day.
Lindsey:
For the rest of my life?
Cheryl Sew Hoy:
Maybe, but ideally the goal is to help it recolonize in your gut. Again, I think it took me three months of a prebiotic and probiotic combination. And then I sustained it with a diet that supports the sustenance of these probiotics once they’ve colonized in your gut. Things like a high fiber diet, polyphenol rich foods, etc. So it takes effort, which is why coming back to the mom question before, if you do want to conceive in the year, I would start restoring your gut now, as it may take you six months to get there. Remember I had zero “bifs” and I managed to get it up to 10, and then it became 8% for a long time, without any supplementation. And now it’s kind of back down to zero because I moved to Texas from California, and I realized my water supply here is terrible. We tested our water and there’s arsenic and lead and uranium in my water, that’s a whole different story. But it goes to show you how many factors externally, environmentally and dietary-wise could influence your gut, which is why we encourage proactive testing twice a year as an adult or an older child. That way you catch these things before they turn into symptoms. So now I’m trying to work it back up to 8% where I was before.
Lindsey:
Yeah, I wonder whether you really can recolonize. Whether you do have to essentially supplement with the probiotic or take the prebiotic once you supplement with the probiotic indefinitely in order to keep these strains alive, if they haven’t naturally settled. I know the gut microbiome of an adult is a lot more settled than that of a child. It’s easier to alter it in a child. So, normally, what would you say are the primary differences then between the infant microbiome and when does it start to settle into the adult microbiome?
Cheryl Sew Hoy:
Yeah, that’s a great question. So think of the theater example, that being 10 seats at birth and then it increasing over time. As children are licking the floor or you have a pet, the pets are bringing in that diversity from outdoors into indoors, which is why there are studies showing that if you have a dog or a cat at home, your kids are less likely to have food allergies, because it’s bringing in a lot of diversity that we’re missing in a modern lifestyle. So the infant gut is malleable in the early years, because it’s so small. If you think about it, imagine you just put in like nine good guys and one bad guy inhabiting the theater room. Or let’s just say the flip side, right? Nine bad guys and one good guy happens to be in that theater room. In the first few months of life, it’s easier for you to come in and be like, “Hey, move away, let me give you a probiotic or introduce breastfeeding,” assuming the mom had the right bacteria. Breastfeeding is very healing. If the mom had B. infantis, you just have to breastfeed, you don’t even need to supplement with a probiotic. Mom’s B. infantis can come in and chase those bad guys out and take those seats in the theater. So it’s very easy in an infant gut, frankly, as long as breastfeeding is involved, because of the HMOs.
So the key here is that the HMOs in the mom’s breast milk is the modifier of a dysbiotic gut or a very imbalanced gut. There are some infant guts who have too much beneficial bacteria and not enough unfriendly bacteria. And that’s not healthy either, because we need some unfriendy bacteria to train the immune system, like one out of ten should be unfriendly. So, in the literature, this is what we’re seeing. Even clinically, because we do a lot of survey data on babies. We have a lot of data on what makes a healthy infant gut and what doesn’t, because it’s so simple. It’s so much easier to characterize what healthy infant gut is and what an unhealthy infant gut looks like. For adults, it’s much harder to categorize that definitively. And we’re not looking for one universal, healthy microbiome in adults anyway because everyone has their unique microbiome. But in infants around the world in the first six months of life, their only food is milk, right? So their gut isn’t really influenced by different cultural diets and maybe weather or environments yet, it really is consistent. So in the first six months, it’s very clear what should be there and what shouldn’t be there. And as they eat solids, that’s where it gets a bit more complex.
I think post one year, it gets more complex depending on diet and culture and all kinds of things, but still malleable because some kids are still being breastfed at one year old. And again, the more there is breastfeeding, the more malleable it is, meaning the easier it is to change the infant gut if there are imbalances. In America, most people are not breastfeeding anymore. I did breastfeed my son for two and a half years and my daughter for 18 months. So yeah, obviously everyone has their own personal journeys, but around three years of age is when the child’s gut reaches what we call “adult-like maturation”. In the literature, there’s a transition phase seen between ages three to five years old. So I would say maybe a three year old’s gut is pretty close to an adult in maturity, a five year old is a bit more definitive. If we take a five year old’s gut test and if we have the mom’s or dad’s stool tests, it often maps very similarly. I can tell they’re living together and that they’re in the same family because the child’s microbiome tends to look more like the adult microbiome by five years old.
Lindsey:
Do you think that’s because they’re sharing saliva essentially, or because they’re eating the same foods?
Cherly Sew Hoy:
All of the above, 100%. There have been studies published lately that the family microbiome is a thing. I can tell, because I’ve seen tens of thousands of microbiome results. I can even tell if the partner, boyfriend and girlfriend are already living together or not. Sometimes a partner will come in for something and I’m like, “Oh, you’re living together, aren’t you?” or “You’re not living together” or sometimes I can tell that their husband is working elsewhere and eating a different food. The living environment, the food, the diet, everything influences your gut. So the more similar things you do as a family, the more similar your microbiomes will be. We started with the infant gut and mom because babies cry and have symptoms, and parents are trying to find a way to help and to get answers that maybe their pediatricians can’t give them. This research is relatively new. It’s not really in medical school yet. It takes an average of 10 to 15 years for groundbreaking academic research to get into medical practice. And for me, I couldn’t wait that long. So I really wanted to start this company to bridge that gap.
Parents come to us because they are trying to course correct their infant’s gut or rebalance it and make it better. But we’re like, “what about you, your child’s gut is eventually going to look like yours.” Doing a stool test on the parents is important from a perspective that you can’t just course correct in a point of time, because it’s your lifestyle, it’s a repeated thing. You have to have good dietary habits as well, not everyone just needs supplements. But if you do need them, you should know what specifically you need based on your tests, whether you do a stool test for your gut health or a blood test or nutrition test, we always believe in testing and not guessing. And then lifestyle changes too. A lot of parents were being educated on very toxic, household cleaning supplies like antibacterial soap. Many parents are really cautious with germs and bacteria and viruses because of the pandemic. And so we’re overusing these antibacterial soaps, which eventually gets into our child’s mouth and gut. It’s not just killing the bad bacteria, it’s killing the good bacteria as well.
So we’re giving a lot of education on lifestyle changes as well. People are not spending enough time in nature and outdoors. It may sound generic, but it is true. Modern humans are deficient in diversity. We used to spend 90% of our time outdoors, and 10% indoors. But now it’s the reverse, right? We’re spending 90% indoors, and 10% outdoors. So the simple things, like opening your window once a day for at least 30 minutes, are going to change your environment and your household to invite some of that outside microbiome in to help your child diversify. So, all this is to say that you have to think about your family’s microbiome holistically, and not just help your child without caring about your own microbiome.
Lindsey:
You mentioned eczema and asthma and things like that. Are there any other signs you might see to think, “Oh, my child’s microbiome might not be properly developing?” I know if you had a C-section, that’s sort of an obvious thing. But if you didn’t have that…
Cheryl Sew Hoy:
Because the lifelong immune system training of the child is so tied to their gut bacteria at birth, knowing what I know now, why wouldn’t you test early to get that snapshot of what was there at birth? So the earliest sample you can take is the seven-day sample after your birth and that will give you a clear idea of what the baby’s gut was like at birth. If you wait two or three months, you can start to see if mom was breastfeeding if she had to B. infantis or Bifidobacteria transferring to her baby’s gut. So, by then, if the baby had zero Bifidobacteria by three months, then we know the mom didn’t have it. And by the way, fathers and/or siblings can pass it on to a baby too. Sometimes we do see a mom without Bifidobacteria, but the infant has Bifidobacteria, so we don’t know where the good bacteria came from.
But sometimes when we have an older sibling who maybe went to daycare and had bacteria colonize from daycare friends or their dad, we see that passing on to the infant. So it’s really interesting. If the baby is completely deficient of it, that means nobody in the household likely has it, so everyone should be working on introducing it. A C-section is definitely a problem because the baby’s being exposed to the antibiotics from the procedure and also not passing through the birth canal. However, again, the breastfeeding is the number one modifier of an infant’s gut. So yeah, that is very healing. But there’s various things that you can do to restore an infant’s gut.
Lindsey:
Yeah. But are there any other conditions that you might see in your child that would clue you into the fact? I’m sure there’s people listening who have one year olds and two year olds and three year olds, what might they be seeing in their child that would let them think that maybe something went wrong with microbiome?
Cherly Sew Hoy:
Yeah. The common things in infants are a colicky signature or gasiness, these are very common symptoms. Maybe the baby’s crying a lot, and maybe not meeting that colic definition specifically. But as a mom or a dad, you have a gut feeling that something is off. By far the most common issues that parents come to us with are eczema and allergies. And now there’s a lot of protein-allergy kind of symptoms. But again, colic and sleep issues are also very correlated with the infant gut. So almost all the kind of common baby symptoms that you can think of can be linked back to the gut, and it could specifially be linked back to Bifidobacteria.
Lindsey:
Having had a child, I would say that loose stool is a normal thing for a breastfed baby, liquidy sort of yellowish stool, right? My son was breastfed, but also bottle fed because I didn’t have enough milk. So I know that they tend to have more solid stool if they’re being bottle fed too. I just wanted to bring that up.
Cherly Sew Hoy:
Yes. The range of normal is wide in infancy, right? I get asked a lot, “What if they only poo once a week but they’re breastfed.” And that could be normal, or “they poo five times a day breastfed.” And that’s normal. It’s really hard to say, but I think some stool is connected to cow’s milk producing allergies, like the mucousy type stool or the green stool. Your gut tells you something is off and you kind of know about it. And I would say just check in and do a stool test. As the baby gets older and is eating solids, we get more constipation issues, because a lot of toddlers don’t eat fiber, right? And so we tend to see fiber digestion or maybe low short chain fatty acids in those toddlers. And so that’s when we offer some strategies to parents in sneaking specific fibers in smoothies, getting more in their diet or encouraging their kids to eat more fiber in that sense. So yeah, constipation is a very common thing with older kids. We also see teens who have acne problems and skin issues. You’ve probably heard of the gut-brain axis. There’s something called the gut-skin axis, which is with eczema, acne and other skin issues. There is an association where probably there’s too much mucus-degrading bacteria in the gut that’s running down the gut lining, and that’s affecting the skin as well.
Lindsey:
So it’s creating some leaky gut with the kids?
Cheryl Sew Hoy:
Yeah. You could even say leaky skin…
Lindsey:
Leaky skin, right.
Cheryl Sew Hoy:
Exactly. So there is a connection there, which is why 80% of our immune system is in our gut. And that’s why it is very essential to take care of it. And when we’re eating, we’re feeding the microbes in our gut, as much as we’re feeding ourselves.
Lindsey:
Yeah. So have you seen now, since you’ve seen all these tests, that all of the kids born via C-section have a perturbed microbiome or are some of them are okay?
Cherly Sew Hoy:
Yeah, it’s interesting. 30% of vaginally born, breastfed babies don’t have a good gut, right? And I think something like that amount, 30% of C-section born babies have a really good gut. Fewer, but some. But again, I think the modifying factor is the breast milk. The length of being fed breast milk and whether the mom had the Bifidobacteria to transmit to her baby. And if not, it’s okay, it’s not the end of the world. Again, this is why we created Tiny Health so that it could be empowering to parents. There’s no guilt tripping, it’s nobody’s fault. My mom couldn’t breastfeed me because of her low supply too. It’s hard, right?
Lindsey:
It’s hard, you really have to be dead set and determined on it and willing to suffer all sorts of things. And even still, sometimes you might not succeed, I’ve discovered.
Cherly Sew Hoy:
And there is also a horrible maternal leave policy in America. So sometimes it’s a choice, and that’s fine. But we offer ways to support the baby’s gut if you’re formula feeding and you had a C-section. There are certain formulas that are better adapted at providing support to the infant gut and it comes down to prebiotics. So I would look for a formula with added HMOs which again help the beneficial bacteria colonize. So it just means that the C-section gut may need some more support and there are means to do it with all the supplements in the market right now. So we help validate because we had a C-section mom cry when we were on a consult call with her because her baby’s gut looked perfect, and she was like “I did all this work.” And the success with her baby’s gut validated her work. And we told her to stop that probiotic she was giving her infant because she was giving the wrong kind of probiotic. She was giving a lactobacillus-based probiotic, which didn’t change or impact her infant gut. And so she got rid of it since it wasn’t doing anything anyway.
Lindsey:
So back in the day, maybe 5-10 years after Martin Blaser’s book came out, there was a lot of talk about how babies get their microbiome from the vaginal canal and that you should reseed your baby’s microbiome by taking swabs. And then it all came out that most of it’s actually coming from the fecal matter that they’re encountering as they’re born. So I haven’t heard as much about the seeding your baby’s microbiome by putting fecal matter in their mouth, but I’m just curious. What’s out there in the world now about that topic?
Cherly Sew Hoy:
Yeah. Dr. Martin Blaser’s wife is Dr. Maria Gloria Dominguez, who is also a well-known researcher on the topic at Rutgers University. And she wrote one of the papers I read when I was researching this stuff. She was the one who came up with the idea of vaginal seeding after a C-section. So at the time it was a little bit controversial in 2018. That was when I had my daughter, so I did it anyway, the vaginal seeding. It is still not approved by ACOP yet to be frank. But there has since been a few more papers coming out to show that a baby swabbed with the gauze that was put in mom’s vagina for an hour before the C-section operation mimics the vaginal canal. You should do this within two minutes after a C-section and you put the gauze in the baby’s mouth and face to mimic the passing of the vaginal canal. The few studies that came out in the recent years did show that those babies look more like vaginally born babies than C section babies. So I would say there is some proof that it works.
Lindsey:
But they’re not using fecal material?
Cheryl Sew Hoy:
No, they’re not. To explain more, here too what the theory is. I do want to address that. Now that we have a vaginal test, I would encourage pregnant moms or those trying to conceive to also take a vaginal test so that you do have a plan B. Because you have your perfect plan A, which is your vaginal birth, but you should always have a plan B. I would say that I’m a good candidate for the vaginal swabs. My vaginal test came back all good. I have high lactobacillus in my vaginal canal and I’ve don’t have any weird bugs that I wouldn’t want to swab my baby with. Do the test so that you would have that option to discuss with your midwife or your OBGYN. So I highly encourage the vaginal tests. Also if your vaginal microbiome is not in a healthy state, there is risk for preterm labor and other pregnancy complications. So get that checked.
And then as far as some studies showing that baby’s guts are colonized with the mother’s gut bacteria, it is true. However, scientists at Tiny Health and others within the scientific community have a theory about the role of the vaginal microbiome. So lactobacillus is what should be dominating the mom’s vaginal canal. It should be 98% lactobacillus and very low diversity. An unhealthy vaginal microbiome is one that’s very low in lactobacillus, maybe 10%, or maybe none at all. And again, that’s linked to higher risk of preterm labor and things like STIs or STDs. So if we get an earlier sample, maybe a four-day sample or a seven-day sample, in some seven-day samples, we do see lactobacillus strains colonizing baby’s gut, but then it disappears very quickly. It’s almost like the lactobacillus are there to prime the baby’s gut and prepare for the seeding of Bifidobacteria from the mom’s gut.
So this is the theory. Lactobacillus and Bifidobacterium are two very common probiotics that you’ll find in bottles in the supermarket or the pharmacy. We think they go hand in hand; they kind of help each other. So we think the lactobacillus is actually playing a central role to prime the child. And then if mom had the Bifidobacteria to pass on to baby, it will colonize better. So if there was no lactobacillus, then maybe the Bifidobacteria for moms gut won’t colonize as well. So it does sound like all the stars have to align for the baby’s gut to be in the best shape. But it seems like that’s how nature intended it to be. However, because we have so many modern interventions, the process is being disturbed a little bit, which may explain why we see one in two kids today having at least one chronic condition. And this is a stat from the CDC. So I do think we are living today in a pediatric chronic condition crisis, where one in two kids have eczema, asthma, obesity, type one diabetes, that is the new accepted normal, but that new norm should not be acceptable. That is just way too high.
Lindsey:
So if you can start intervening at birth with the proper probiotics necessary, that really could make a big difference for their long-term health. So speaking of crisis, I’ve heard numbers now for autism like one in twenty-six kids or maybe just boys, I’m not sure which, was diagnosed with autism. And I’m curious, are you taking conditions when you take in these microbiome kits? And have you seen any kind of microbiome signature associated with autism or with ADHD or anything like that?
Cheryl Sew Hoy:
Well, we have done some work. But we haven’t added that signature into our platform yet. We do have predictive microbiome signatures for eczema, asthma, constipation, colic, etc., but not yet autism and ADHD just because the research there is quite new. We’re still untangling that stuff because for things like autism and ADHD, more likely than not, it’s bidirectional. So is it the imbalanced gut that’s causing the autism or behavioral issues? Or is it the behavioral issues that’s causing a bad gut? The answer is probably both of them, right? It kind of has a bidirectional effect, which makes it more complex and harder to untangle. But there are definitely studies that show that if you modify the gut, it leads to behavioral issues, so there is definitely a gut-brain axis connection.
In some studies, and we do like more kid and infant studies, we found a study where it has shown that an imbalanced gut in babies as young as six months old could be predictive of ADHD later in childhood. But again, that’s just one paper. So it’s a lot to untangle. Our science team is very rigorous in the way that we want to see multiple papers supporting the same notion, the same taxa, the same microbial signatures before we put it forth. But it’s emerging research, right? So we’re continuing to track it. We know that the gut bacteria produce metabolites, which can travel to the brain via the bloodstream crossing the blood brain barrier and then influence brain functions, which affects mood, cognitive functions and neurological health for both kids and adults. So we know there is a linkage. But yeah, we’re in pretty early days on that work.
Lindsey:
Okay. So I did the Tiny Health test, and mine was a Pro test, but I don’t know that I saw that offering on your website. Is that a new offering or something you have to go through a practitioner for? How does that work?
Cheryl Sew Hoy:
Yes, it is something that is practitioner-only available and I ordered that for you because you’re probably familiar with the more conventional PCR tests like GI Map. And so the Pro test that we offer has to be ordered by a licensed practitioner to help you interpret it. And the only difference between our regular tests and the Pro tests is that it adds on the stool chemistry markers, which are the calprotectin, secretary IgA and all those markers. So we do have it actually. If you go to tinyhealth.com/store, if you scroll down a little bit, you’ll see the Pro tests, if you click through it, it will bring you to the practitioner websites. We now do actually have a new practitioner website called poweredbytiny.com. That’s a bit more practitioner focused, because we realized in the two years that we launched, a lot of patients are taking their results to their doctors. And that’s how we have hundreds of doctors in our network now, because they want to learn more about how to interpret our tests. And a lot of them are functionally trained, they’re integrative or holistic health practitioners, and they want the stool chemistries. So we created the Pro tests for them to have additional measurements for host immune response.
Lindsey:
So does that mean that people can go to your website and order the Pro test and you provide the practitioner for the test?
Cheryl Sew Hoy:
They have to order it through their practitioner.
Lindsey:
Okay. They have to know the practitioner themselves?
Cheryl Sew Hoy:
Correct. Because they need someone to walk them through it. In the future, we may have our own health coaches. We walk folks through our shotgun sequencing results, the microbial part, because we are experts in it. And for the stool chemistries, we feel like we need the right practitioners who know those markers really well. So I think maybe in due time we will offer that, but right now they have to order through their own practitioner.
Lindsey:
Okay. So for the microbiome test, it is metagenomic sequencing, right?
Cheryl Sew Hoy:
Yep. It’s called shotgun metagenomics.
Lindsey:
So you only asked for a tiny bit of stool, like the Q-tip wiping of it. I’m just curious, how can you be sure that that properly, and in proper proportions, represents what’s in the colon, versus an entire vile of stool that is used for diagnostic tests like the GI Map or the GI Effects?
Cheryl Sew Hoy:
I’m so glad you asked this question. We get asked this so much. And, by the way, GI Map and GI Effects are not diagnostic tests. They are qPCR based, but at best you can call them a screening test. But it’s not diagnostic. Because to really properly categorize it as diagnostic, you do have to go through an FDA approval, which there isn’t such a thing right now in the microbiome. Those tests don’t have the proper regulations for the microbiome testing. That is part of the criticism in a way in our industry in the stool testing world. I wish there was more oversight. And in due time, I think they will come up with that. But for now, it’s just a screen.
But anyway, the PCR tests, some companies have a culturing component, which I know is less reliable. And for culturing, you do have to scoop a bunch of stool and if you’re doing multiple cultures. People have used cultures for decades. Scientists will take a small amount of stool and put it in a petri dish and grow it under the lab conditions. So the reason why we don’t use culture anymore is because we don’t think it’s reliable because it is biased with what you’re trying to look for. It favors rapidly-growing, oxygen-loving microbes, whereas most of the microbes in the human gut are anaerobic or oxygen-intolerant bacteria. For example, E. coli is usually oxygen loving so it grows more quickly in a petri dish than Akkermansia or Bifidobacteria. So the problem with culture is that it’s going to give you biased results that really are overblown. Clinically, I wouldn’t trust any culture.
Lindsey:
Yeah. I don’t pay any attention to culture if the test I’m looking at has it.
Cheryl Sew Hoy:
Yeah, so maybe some companies are still using that and culturing some, but I wouldn’t trust that at all. So when shotgun sequencing came up, it is basically a next-generation sequencing method that sequences your entire gut. We sequence all the bacteria, viruses, parasites, fungi, yeast, archea, everything in your gut. Versus the way PCR tests work is that you need to know what you’re probing for. You need primers for specific microbes that you’re looking for. So typically in a GI map or GI Effects, you get 30 plus microbes that you’re looking for, but you may be missing the full picture of what’s in your gut. The 35 microbes in that PCR test, does it represent maybe just 5% of your gut, or did that represent 95% of your gut? So, it makes a huge difference. I think PCR tests are great when you’re looking for specific things, like if you have the presence of candida or not.
But beyond that, it’s kind of less useful for helping you understand overall gut health, and learning if you have enough fiber digestion functions, short chain fatty acids, and things like that. The way shotgun sequencing works is that it chops out all the bacteria and all the microbes in your gut and reassembles the genomes to establish that you have 1% of E. coli strain D, or 2% of B. infantis, etc. There’s been a few papers published that show that with next gen sequencing, just taking a swab versus a stool sample yields the same results and represents your gut well, because the shotgun technology is able to chop up millions and millions of fragments in your gut. And it’s pretty even. There have been tests showing that sticking the swab into different parts of the stool versus just one part, we still get the same results. Because again, that tiny little fragment of fecal matter, is very well mixed, so it represents the large intestine quite well.
We know this from the scientists that work at Tiny Health, and they come from different universities like Washington University, Iowa, UCSF and places like that. Each lab usually does their own validation, because even the scientists want to know how the swabs compare to the whole stool. A lot of these studies are unpublished. And I wish these labs published more of these papers. But I often hear them saying, “We’ve done the test and it’s so consistent that we switched from stool samples to swabs.” And then also at Tiny Health, we have some families or some users just wanting to test how reliable and reproducible our tests are. They buy two swabs and sample it one day apart. And oftentimes, because we have a very good QC process, we’re like, “is this the same person? Did they submit two swabs?” And then so we email them to ask? Because we would know it’s the same person. It’s so identical, only the five top species might swap places just a little bit. But I can tell looking at a stool sample if this is your gut versus someone else’s gut.
Lindsey:
Ok, great! So I’m going to pull up my sample results and we can look at them together. I’m pulling up just the PDF file, since this is what I’ll put on my website for people to look at. So you can tell me what you see and what’s interesting and such.
Cheryl Sew Hoy:
I’ll send you the PDF, just so you have it, because I just pulled up your file.
Lindsey:
You can go to the show notes website to pull up this report so you can look along with us if you’re listening to the podcast.
Cheryl Sew Hoy:
You did the Pro gut health test, which includes the stool chemistry markers as we talked about. And this is a good snapshot that overall your gut test looks pretty decent. You do have seven things that need support, so I would focus on these areas. And then you have six things that can have optional support. So I would, in terms of priority, work on these first. The way we arrange our tests is through different categories, because again, I think sometimes stool tests focus too much on pathogenic or opportunistic pathogens, and not enough on the balance of protective bacteria. So we always start with asking, “Do you even have this beneficial bacteria?” And it seems like you do, but you are lacking some of them here. And we also tell you what kind of probiotic species we detect in your gut, if we do detect them.
And then do you have a lot of disruptive microbes that are opportunistic pathogens, or parasites, infectious microbes and things like that. I’m just walking you through each category that we show. So the third category is gut inflammation markers. So this is what you might commonly hear as leaky gut. I would come here to see if you have a leaky gut, but again, based on these test results, you don’t really have a leaky gut, which is nice. But what you’re lacking here, it seems to be beneficial bacteria. And maybe some borderline high levels of pathogens here, but no parasites, which is nice. Your short chain fatty acids are essential for your gut lining. And the most important one for adults is butyrate. So you do want to see good butyrate levels. For kids and infants, acetate is the most important.
So, because you did the Pro test, we are measuring not just the microbial production capacity. Basically do you have the microbial gene function to produce butyrate, acetate and propionate. We also measure the actual concentration. So it seems like your actual concentration for the most part is okay, though it is a little bit low. And that’s driven by your acetate being a little bit low. So the microbial functions are not performing so well. So there are action items you can take from a dietary perspective in your Tiny Health results portal. You’re also going to see from a dietary perspective, what specific fiber foods will help with these metrics and also supplements that could help. So there may butyrate supplements out there…
Lindsey:
I actually sell one!
Cheryl Sew Hoy:
Oh, you do?
Lindsey:
I have a product called Tributyrin-Max, which I take almost daily, but since I’ve changed my diet since these test results, I’m needing it less and less with all the fiber I’m getting.
Cheryl Sew Hoy:
Okay, well, it seems your butyrate is okay, as I only need to dive into the butyrate-producing capacity here. But yeah, seems like acetate and, I’m going to attempt to pronounce this, beta glucuronidase, I can never pronounce it well.
Lindsey:
Yeah, that was the most alarming one that I saw.
Cheryl Sew Hoy:
Yeah, you’re level is not so high. You can go down to the detail level on the bottom to see exactly how off you are. But we can come back to that. I think you’re just borderline high, which is usually linked to estrogen dominance. If it’s too high, it’s typically linked to your premenopausal state. It may cause issues in women’s hormonal health. So this one is very important for women’s health, especially as we get into those older ages. And then digestion absorption markers, you seem to have more complex sugar and fiber digestion issues. And we also have some dietary recommendations there on how to improve these markers. It may mean that eating specific fiber, and we’ll have to see what kind of fiber is triggered in you, may make you feel a little bit of discomfort.
So this is also a question we get asked a lot, “Oh, if my gut isn’t adapted to digest these fibers, and eating them causes me discomfort, then why should I eat them.” Ideally, the human gut can handle a large variety of foods. So if you eat certain foods, and if you don’t feel good, it’s kind of like the chicken and egg. You may need to eat more of that to encourage more bugs that can digest that, enabling you to eat a variety of foods in the future. Ultimately, that’s what we’d like to work towards. Some other stool tests tell you not to eat certain foods and eliminate it from your diet entirely. We don’t do that because we believe that sometimes eliminating certain food groups out of your diet may lower diversity and cause more issues. Again, it depends on what chronic conditions you have.
Some people are on a certain diet for good reason if they have specific digestive issues. But if you have a relatively healthy gut and you don’t have these conditions, then we would really encourage a large diversity of foods. And then some of these other markers under balance and robustness, you don’t really have an overabundance of one or two microbes. Some people have that, which makes diversity very low. And then we have a population chart here. That compares you with everyone that has taken Tiny Health tests. So at this point, maybe we’re closer to 30,000 samples. So definitely there are things you can work on. And I think you mentioned that you have had some conditions, right? And you were bloated when you were taking this test?
Lindsey:
Yeah, I have autoimmune SIBO. So I always have that. And I have been letting myself get sort of out of hand in preparation for a breath test by my doctor to get a hold of some antibiotics.
Cheryl Sew Hoy:
The SIBO bacteria that is connected to the methane-producing bacteria, methanobrevibacter smithii.
Lindsey:
Yeah I don’t have that one. That’s not my problem.
Cheryl Sew Hoy:
Yeah, you don’t have it. There’s no real good diagnostic tests for SIBO right now, because it is trying to measure what’s in the small intestines and overgrowth of bacteria in the small intestines. So right now, there is no known test to measure within your small intestines. And all the stool tests that you find in the market are only measuring the large intestine. So, even the breath test, which is the gold standard, is not perfect, it’s very sensitive. But certainly if you have the symptoms, then there could be other things that are triggering the symptoms. So if you go down to page five, this is where you go down to the detailed level, and all those things that were triggered, like your lower Bifidobacteria, but you do have B. infantis. So this is your native strain, which is nice. So maybe with a little bit of HMO, the right high-fiber diet and maybe some probiotic help, you can boost these amounts to a higher level. And Akkermansia, at least you have some. It is really important for your gut lining and metabolic health.
Lindsey:
I take a Pendulum product*, the Metabolic Daily. I have done that in the past and I’m doing it now. But, of course, I paused for a couple of weeks to take the test. But something’s still there, so I was glad to see that.
Cheryl Sew Hoy:
So it’s good because I have zero, but I did colonize some temporarily when I was taking Pendulum. As soon as I stopped, it disappeared. If you don’t have any, it’s harder to engraft, it’s just really hard. The fact that you have some is a really good sign. So again, if you have some, continue on the pendulum and the polyphenol-rich foods, and maybe an HMO, because you don’t want this to be too high too, right? Akkermansia* is a bacteria that replaces the mucus of the gut lining. So if you have too much, it’s degrading the mucus too quickly, and that could be linked to eczema and skin issues as well. So you don’t want that too high.
We also see it shooting really high, like in inflammatory events. Your immune system may be reacting to some central inflammatory events, but it’s very temporary. When we see spikes to 14%, something happened, and then it comes back down. Yeah, it’s very mysterious. Akkermansia is a very mysterious bug. But we know that it is quite important and you do want some, a few percentage points would be just nice. And Fecalibacterium, it’s an anti-inflammatory marker. This is important. Again, through a lot of dietary actions, you can help improve this bacteria. But instead of going one by one, because this is a lot to go through, are there any specific areas that you want to double click into? We see a little bit of C. diff here, which is why it’s yellow, and this pops up with prior antibiotic use. So I would ask if you’ve had prior antibiotic exposure?
Lindsey:
Its been a long time, but I take antimicrobial herbs on a relatively regular basis as soon as the SIBO starts acting up, I’ll dose myself with herbs again, so.
Cheryl Sew Hoy:
Yeah, so we see some, not a whole lot, 0.05%. Let’s say keep an eye on it. And if you do need antibiotics, I would be more careful, because we know this tends to bloom with antibiotic resistance.
Lindsey:
Yeah, well, I can take some of my other product, my Serum Bovine Immunoglobulins with it.
Cheryl Sew Hoy:
I love SBI’s. I do that when I travel. I do that when I have high pathogenic bacteria, signs of gut inflammation, that works wonders to bind these toxins. So maybe it was higher before and then you’ve worked it down. Again, your gut doesn’t look that bad.
Lindsey:
I was pretty pleased with what I saw overall, except for the high beta glucuronidase. That was what bothered me because I know that that predisposes you to breast cancer and to colon cancer. So I made a quick turn about in my diet and have reduced meat drastically and have kicked up fiber and beans and lentils drastically.
Cheryl Sew Hoy:
Yeah, beans and lentils can really help. Again, looking at the range here on page nine, you’re just barely above. So I wouldn’t be too alarmed. It is borderline. I think what you’re doing right now should help, hopefully if you retest in a couple of months. Hopefully that gets it back into the green range. We’ve seen some people up into the right, and they have a lot of hormonal health issues.
Lindsey:
I’ve always been a bit estrogen dominant, but I’m in menopause now so I can’t imagine there’s a lot of estrogen circulating in my system, other than from the patch of estrogen that I’m wearing.
Cheryl Sew Hoy:
Yeah, for sure. So it’s good to keep it in check for sure at this age. We were wondering what the fiber digestion thing that was flagged, so resistant starch was flagged. We found that if you eat rice or potatoes, I would say cool it down first. I used to eat, as an Asian, hot rice and hot potatoes, we would just eat it hot. But now knowing what we know about resistant starch, we now wait for rice to cool down and even bananas, which I love bananas, I’m trying to buy more green bananas, because they retain more resistant starch. So if you’re low in that, in our action plan we do offer some of these tips on how to increase that.
Lindsey:
I make these grape leaves (see show notes for recipe) and part of them is rice and part is lentils on the inside and then a dressing. And it’s got oregano in it. And they’re just like the perfect resistance starch food and fiber food and I just am addicted to them.
Cheryl Sew Hoy:
Yeah, that’s great. So yeah, more of that, perhaps a different variety of them. Like maybe add some green bananas or something your smoothies. Yeah, and then this one, you have zero IMO. I am a little bit less familiar with this one so I’ll have to go back into their web portal to figure it out.
Lindsey:
Isomaltooligosaccharide. So basically you’re saying that I don’t have the bacteria to digest those. Is that what it’s essentially saying? Correct?
Cheryl Sew Hoy:
Not just the bacteria but the gene function to digest these complex sugars. So I think maybe it’s correlated to your low beneficial bacteria. So increasing the beneficial bacteria should help with this. And it can be found in fermented foods. How much fermented foods do you do?
Lindsey:
I make my own sauerkraut and I eat it every morning. That’s pretty much it. I occasionally used to eat yogurt. But every time I ate it, I felt sick. If I ate the entire container, I would feel sick. I would feel nauseous. Maybe I’m missing what one needs or maybe it’s the strains of bacteria and they’re starting to ferment in my stomach. I’m not sure what, but I’m going to try the Bifido yogurt with the with the Evivo and see if that helps things.
Cheryl Sew Hoy:
Yeah, yeah. And if possible, add an HMO.
Lindsey:
Yeah, the HMOs.
Cheryl Sew Hoy:
Yeah, and if you can tolerate adding some sauerkraut, even if it’s like bit by bit. Kefir, maybe, but adding these fermented foods bit by bit will help you hopefully gather some functions here.
Lindsey:
I have been eating sourdough bread.
Cheryl Sew Hoy:
If you’ve been doing one thing over and over again, and it’s not showing the results. A lot of times it’s the variety or the kinds of things, maybe just one thing is just not working. And your gut needs a different thing. And oftentimes it’s a variety of things, right? So yeah, you could try that. But let me see everything else, your vitamin production is perfect. Not everyone has all this in green. So I would say this is very good.
Lindsey:
And that’s all pulling from the bacteria that I have, or the amount of vitamins that are found in my stool?
Cheryl Sew Hoy:
Oh yeah, this is a good clarification. Again, this is actually the gene function of the bacteria. So not the bacteria directly, but your bacteria has the capacity to produce these vitamins. And, like if you have low amounts of damage, it may mean that you have to eat more of certain foods that give you more of that kind of vitamin. But it doesn’t measure the vitamins in your gut. It just tells you that the other essential role of your gut bacteria is to produce vitamins. I think this is not a very well-known fact. But your bacteria gives you vitamins, which is amazing, right? So it doesn’t mean you’re deficient, it just means that the contribution of your gut bacteria to this vitamin is either sufficient or lacking if that makes sense. And then you have to fill that more with dietary needs. But if you’re low in B12, a lot of people are often very low in B12, then you may need to supplement with the B12 supplement or eat more B12 rich foods.
Lindsey:
I was really glad to see that I had a normal level of proteobacteria and not an elevated level because the last stool test that I did of this nature, which was a 16S, I think 50% of my microbiome was proteobacteria and I have since been supplementing with butyrate, which has clearly turned that whole picture around.
Cheryl Sew Hoy:
Yeah, yeah. 16S is one of those earlier next generation sequencing methods to give you the full picture of your gut bacteria, which was a huge innovation. But I would say that today the 16S is a very outdated technology because it can only detect bacteria, not fungi or parasites or viruses. The way we compare 16S with a shotgun is that you make a photograph of your family members, and 16S gives you a blurry picture. So you don’t know if that’s like an extended family, if that’s uncle Tom or uncle Tim or auntie Laura or auntie Kim, whereas shotgun sequencing gives you a very sharp, high resolution picture of who and you can see Uncle Tom smiling and Uncle Tim frowning, it gives you that specific strain. It shows what they’re doing, how they’re functioning, are they happy, are they not, etc. 16S may have high false positives in that it may be mixing up an E. coli bacteria with something else that’s not E. coli. And so you may see higher levels of something that maybe is a little different. So again, like six or eight years ago, that would be the best technology, but we’ve really moved on from that since. Yeah, so this is good. I think it is very stable, DNA sequencing is very stable. If you were to do the stool tests a day apart, we’d probably get the same results. It’s very consistent.
Lindsey:
And what is Shannon diversity?
Cheryl Sew Hoy:
Shannon diversity is comparing the diversity of your microbes. So like the evenness, meaning you don’t have a really high overburden bacteria on top, and then the rest are kind of little. I mentioned earlier that our grown up, adult microbiome has nearly 300-500 seats. So the more seats, the more species we find in the gut, the more robust and the healthier your gut is, and you have a decent amount, but it can be higher. So if we go down to your species breakdown, your microbiome breakdown here, we’re on page 11, which is the last part of the PDF report. And if you go to the app, you can actually expand each species to look at them. There are like citations, you can link out to PubMed articles to look at why we categorize these as variable bacteria. So you have 18% unknown bacteria, which just means that scientists haven’t been able to categorize these as good, friendly, or unfriendly bacteria because they are just less studied.
But if you were to count the number of species you have in the gut, because you’re in the gray, you may have closer to 300 than 500 species. If you’re in the green, maybe you have 600 species, and the higher the better, right? Typically, when I look at a shotgun sequencing results, I want to see the top 10 species, what is really making up the bulk of your gut, and I want that to have more greens than yellow. You have 12% of the top species, which is not bad, but what we don’t want to see 18% or 20%, which is when one bacteria is dominating the gut. So the evenness, the Shannon diversity index is also linked to evenness. So if you have a higher Shannon diversity index, then this could be more like seven, or eight, seven, seven, six, it’s more uniform throughout your gut, at least the first five to ten species.
So typically we want to ideally see some of these Blautia, which is linked to (I think) butyrate function and things like that being higher on top. And because you have your top three species as variable, like too high of these amounts of bacteria are linked to certain kind of conditions. Again, they’re not terribly high right now, so I wouldn’t be alarmed by these. But it’s just very interesting to know, right? Like, if you do have a family history of something. I see type one diabetes sometimes and Crohn’s disease here and there, so your top three species are kind crucial. Not to freak you out on anything or anything like that. But it’s just something interesting that is connected to what’s out there in the literature and detected in your gut and something to look out for.
Lindsey:
Fortunately, we don’t have any of that in myself or my family.
Cheryl Sew Hoy:
Interesting. So again, it may not be anything. Again, when we see these conditions, it’s connected to higher levels in people who do have these conditions than other people who don’t have the conditions.
Lindsey:
So let me just ask you, can people access their raw data when they do Tiny Health?
Cheryl Sew Hoy:
We don’t automatically offer that but we do have practitioners who write in asking for the CSV files, their raw data taxonomy files, and we manually produce them for people.
Lindsey:
Okay, so it’s possible, could a person do that for themselves or just a practitioner?
Cheryl Sew Hoy:
I’m just curious but why would you want that file? Are you maybe running your own analysis?
Lindsey:
Oh, some people like to upload those to websites like BiomeSite. If all the strains were listed in that report, which I assume they are, then that’s good. Because there was a couple of strains that I was worried about that are not good for your oral microbiome. And I had seen them in a prior metagenomic sequencing and had been using an oral rinse to try and clear them out. And sure enough, they were not on this report; I was really happy to see that. This was the Porphyromonas gingivalis and Fusobacterium nucleatum, which, together put you at risk of pancreatic cancer and other stuff. So I was really kind of worried that I had both of those.
Cheryl Sew Hoy:
You don’t want to see any oral bacteria in your gut, for sure. That’s not a good sign. But yeah, we’re glad we didn’t see any of that. We can definitely share the taxonomy files with you.
Lindsey:
So I know that you offer like a membership option. Can you tell people a little bit about what offerings you have now on the site so they know and then we’ll wrap it up?
Cheryl Sew Hoy:
Yeah, for sure. Thank you. So we do have a membership program called TinyPlus, where you do get two kits up front, and a consult call with our microbiome specialist. It is a 30-minute call to walk you through your report. The membership is $399. And I believe you may have a coupon code to share with your audience. If not, we will get you one.
Lindsey:
I know I got a link. And it may be that the coupon applies on the link. I’ll put it all on the show notes.
Cheryl Sew Hoy:
Okay, sounds great. Yes, so we did have that option because again, we think that this shouldn’t be a single time point. Whenever we have two data points of the same gut, we see the trajectory of change. And especially as it relates to early life, you want to see this trending and maturing in the right direction. Ask for an adult gut or an older kid, it’s proactive updating your baseline every six months. Because you never know when you need medication, when the diet changes, when you move, or get sick with a stomach bug, or need antibiotics, etc. So then having that baseline is really helpful to help you recover and restore the missing bugs. So let’s say for those reasons, the membership is really good as a proactive step for your overall well being and health.
Especially if you have an infant or you’re trying to conceive or you’re pregnant, I would even do it 3-4 times a year to sample the infant. We also have targeted programs, what we call targeted programs for people who are dealing with a chronic condition. So for kids, commonly it’s a lot of the symptoms we talked about earlier like eczema, allergies, constipation, even sleep issues. Older kids have different sets of issues, mostly constipation. And then for women who are experiencing fertility issues, we do have a women’s health program, that could be a combination of a vaginal and a stool test, or just the vaginal tests. So we have that too. For adults, we actually are coming out with a few digestive health programs to help you tackle some of these conditions as well. We also have a single kit that you can buy for $249, which comes with a consult call and you can figure out if you want to commit to a membership after that or target a program.
Lindsey:
Okay and I did find the discount code, it is called THEPERFECTSTOOL for $20 off.
Cheryl Sew Hoy:
Perfect.
Lindsey:
Anything else you’d like to share with us before we sign off?
Cheryl Sew Hoy:
You can find us at tinyhealth.com and if you’re a practitioner, we do have a practitioner program to support you in consulting your clients and we will train you for free. And you can find out about that through tinyhealth.com/practitioners. And then you can also reach me at hello@tinyhealth.com. I do read a lot of the emails coming in and on Instagram @tiny.health.
Lindsey:
Okay, awesome! Thank you so much!
Cheryl Sew Hoy:
Thank you!
If you are struggling with bloating, gas, burping, nausea, constipation, diarrhea, soft stool, acid reflux, IBS, IBD, SIBO, candida overgrowth, fatigue or migraines and want to get to the bottom of it, that’s what I help my clients with. You’re welcome to set up a free, 30-minute breakthrough session with me. We’ll talk about what you’ve been going through and I’ll tell you about my 3- and 5- appointment health coaching programs in which I recommend lab tests, educate you on what the results mean and the protocols used by doctors to fix the problems revealed. Or if you’re ready to jump in right away or can just afford one appointment at a time, you can set up an 1-hour consultation with me.
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