Book Review: Missing Microbes

Book Review: Missing Microbes by Dr. Martin Blaser, M.D.

What do asthma, Celiac, Crohn’s & Colitis, C-sections, obesity, stomach cancer, and esophageal cancer all have in common? If you or a loved one has dealt with any of these conditions, you will definitely want to read Missing MIcrobes by Dr. Martin Blaser, M.D.

Thanks to COVID, I’ve had a lot more reading time on my hands. And I love to share books I think my readers would enjoy. Missing Microbes delves into how the overuse of antibiotics is killing our gut microbiome and fueling our modern plagues. Curiously, it was actually published in 2015, well before COVID. And it’s been sitting on my bookshelf since then. I finally got around to reading it recently. And WOW was I surprised by how much I learned. So I felt compelled to share some of it here. As Dr. Martin Blaser, a research scientist and MD at NYU, explains in Missing Microbes, while antibiotics definitely have their time and place, the overuse of them in our modern-day society has wreaked havoc on our gut microbiome.

Gut Microbiome 101

Let’s start with a little primer on the gut microbiome in case you’re not familiar. Our body is home to literally millions if not billions of microbes. They live on our skin, in our eyelashes, in our mouths. And really everywhere within us and on us. The vast majority live in our gut, or our stomach and intestines. These microbes share a symbiotic relationship with our bodies. And they are instrumental in almost all biological processes from digestion to creating vitamins within our bodies, and so much more.

One of the most important jobs of the gut microbiome is that it makes up about 80% of our immune system.

So when we’re Missing Microbes, our gut microbiome is depleted. And so too is our own natural defense system—our immune system. Shocking research on indigenous tribes from the Amazon, Sub-Saharan Africa, Australia, and Southeast Asia indicate that across the board, indigenous populations who have never been exposed to Western medicine or processed foods have around 2,500 different species of gut microbes. Whereas more Westernized civilizations only have somewhere between 500-1,000 different species. That means we’re down by about 60-80% of the normal species biodiversity that humans evolved to host in our gut. Or potentially down 60-80% of our immune system. So it’s really vital that we keep the remaining small population of gut microbes that we do have.

Keystone Species and Biodiversity

As with any ecosystem, when you lose keystone species, the entire ecosystem can collapse. This example of what happened when Yellowstone National Park eradicated wolves in the 1920s is similar to what happens in our gut when we lose our keystone microbial species.

Wolves were a keystone species to the Greater Yellowstone Ecosystem. And without wolves as predators, the deer, and elk overpopulated, eating all the willows and turning the river shorelines into grasslands. As Blaser explains, “Songbirds and beavers that depended on the willows disappeared. And without wolf-kill carcasses to scavenge, ravens, eagles, magpies, and bears declined. More elk led to fewer bison…coyotes came back to the park and ate the mice that birds and badgers relied on.”

The Greater Yellowstone Ecosystem virtually collapsed. But with the reintroduction of the wolves in 1995 Yellowstone started to thrive again. This same analogy can be seen in our own gut microbiome when we lose keystone species. Our entire microbiome can collapse, leading to SIBO (small intestinal bacterial overgrowth), C-Diff (a highly infectious bacterial infection), and H. pylori, (another potential bacterial overgrowth that can end up in the wrong place, or too high in number, but can also benefit some people.)

H. pylori

If you’ve ever had an ulcer, you may have heard of H. pylori. It’s a bacteria that normally lives in small quantities in our stomachs. And for some people doesn’t seem to do any harm at all. But for other people, it is linked to causing stomach ulcers and stomach cancer. So when doctors learned this, they thought, “great, let’s eradicate H. pylori in everyone, and prevent ulcers and stomach cancer.” But not so fast, as we just learned about Yellowstone above, everything in nature has a purpose. Even H. pylori. Turns out that while it can cause stomach ulcers and stomach cancer in some people, it also protects some people from getting esophageal cancer.

More research still needs to be done to determine who is benefited or not by H. pylori, and why. However, if you’ve been diagnosed with H. pylori and your doctor wants to give you a round of antibiotics to eradicate it, you may want to do your own research. There are also herbal remedies that work to remove it, like mastic gum. Talking with a functional medicine doctor or holistic practitioner may help.

Antibiotic Overuse

So while antibiotics are great if you have a serious infection, their overuse worldwide is rampant. In India, antibiotics are over the counter and you can buy them whenever you want and take them for anything without a doctor’s prescription. The antibacterial soap (or any antibacterial product from kids’ toys to kitchen cutting boards) craze of the past 20 years has done a number on our microbes too.

Unfortunately, in the US, it has also become commonplace to put antibiotics into the IV saline drip given to most pregnant women in the delivery room. Many of them don’t even know they are getting antibiotics…ostensibly to prevent a <.1% chance of newborns getting an infection, at the expense of the other 99.9% of newborns losing gut microbe biodiversity before they’re even born. But it turns out the vast majority of antibiotics used in the US today is in farming.

75% of all antibiotics sold in the US today are used in factory farming.

WHY Are Antibiotics Fed to Factory Farmed Animals?

The most surprising thing to me was WHY antibiotics are fed to factory-farmed animals. I had always assumed it was to prevent illness in animals kept in unsanitary, cramped, close quarters. But that’s not actually why big factory farms use antibiotics. Get this… research has shown that just one round of antibiotics causes weight gain. So farmers learned if they pump their animals full of antibiotics, they can feed them less and they’ll still gain more weight. WOW! Antibiotics interact directly not only with our microbiome but also our hormones. And it turns out, antibiotics can directly lead to weight gain in people too.

Dr. Martin Blaser’s own scientific research first using mice and then observed in people show conclusive evidence that any antibiotics given to children under age two result in a significantly increased risk of developing obesity as an adult. And the more rounds of antibiotics you have taken as a child, the greater the risk of developing obesity as an adult. Shocking. [This was the only part of the book I did not love… if you’re an animal lover and don’t like scientific research on animals, you might want to skip reading about the mice experiments.]

Celiac Disease

So what do asthma, Celiac, Chron’s & Colitis all have to do with antibiotics? It turns out that having a few rounds of antibiotics as children or young adults also significantly contribute to these diseases. Antibiotics can also contribute to intestinal permeability. In fact, a large percentage of people have been diagnosed with Celiac disease shortly after taking a round of antibiotics, myself included! I had a bad bout of food poisoning in Thailand in 1997 for which I was given a heavy dose of antibiotics. Chronic gut and skin issues ensued for two years after that until I was finally diagnosed with Celiac disease. Celiac is the inability to digest the protein gluten (found in wheat, barley, rye, and processed foods). Gluten acts like shards of glass tearing the intestinal lining when a person with Celiac ingests it.

While Celiac is genetic in nature it is also considered an auto-immune disease. You need to have the gene for Celiac, which is then triggered by some toxin (like an antibiotic) causing the gene to be “turned on”, creating the auto-immune condition (epigenetics). Possibly taking antibiotics kills off the microbes that were initially protecting the Celiac gene from being turned on. The incidence of Celiac disease has quadrupled since the 1950s when antibiotic use became prevalent. And it’s not just that they know how to diagnose it better, there’s actually more of it occurring.

Missing Microbes graphic

Recovering Your Microbiome

According to Dr. Blaser, it takes a minimum of six months to recover your microbes after taking just one dose of antibiotics. That’s if you can even recover them at all. Sadly, some may be lost permanently. Interestingly, there was also a study reviewing medical records of people who had contracted H1N1 flu in 2009. It turns out that a large percentage of them had taken a round of antibiotics in the month prior to contracting H1N1.

Maybe their immune system had been depleted enough by that one round of antibiotics to the point where they could not fight off the H1N1 virus? I had also contracted H1N1 back then—the sickest I’ve ever been in my life! And this news makes me want to go back through my own health records to see if I had perchance taken any antibiotics in the month prior?! It also makes me wonder about COVID-19… How many of the people who are the sickest, have compromised gut microbiomes? No doubt Dr. Marin Blaser is looking into that already.

Antibiotic Resistant-Bacteria

With so much overuse of antibiotics these days there is a big concern for the number of antibiotic-resistant strains of bacteria. There are biggies like MRSA where few to no antibiotics are effective against it anymore. And there are now even antibiotic-resistant strains of tuberculosis and gonorrhea. But another fascinating aspect of how microbes work is that bacteria can actually share protective molecules. So if one strain of bacteria is antibiotic-resistant, they can share their resistance (think of it as a shield of armor) with other nearby microbes, making those microbes resistant too. No bueno!

Many herbal remedies are “antibiotic” in nature, (one example is oregano oil for eradicating foodborne illnesses), and microbes don’t seem to become resistant to these natural, plant-based “antibiotic” remedies.

So What Do Missing Microbes Mean For Us?

We should strive to take as few antibiotics as possible in our lifetime. And especially when it comes to children under two years of age. Many young children are given antibiotics for ear infections which are most likely viral in nature. But when parents ask their pediatrician for antibiotics, many doctors are reluctant to say no. They fear lawsuits if something were to go wrong with the child.

It’s interesting to note many young children are also sensitive to dairy. And chronic ear infections in children can be a major symptom of dairy sensitivity. In my own family, when one of my nieces was very young she had chronic ear infections. Her doctor wanted to do surgery to put tubes in her ears. But thankfully her parents agreed to my suggestion to take her completely off dairy for six weeks to see if that helped.

Luckily, her ears cleared up. And by keeping her off dairy she didn’t have ear infections again. Although unfortunately, she’d already had plenty of rounds of antibiotics by then. As Dr Mark Hyman says, “dairy is meant for baby cows, not humans.” Upwards of 75% of the US population has a dairy sensitivity, but most don’t realize it. And the dairy industry has done a great snow-job making us “think” we need dairy to survive. But that’s another topic for another post.

C-sections and Missing Microbes

Something else that can mess with our gut microbiome is to be born via C-section. Babies born vaginally get inoculated with good gut bacteria from their mom as they come through the birth canal. But new research in countries like Brazil and Italy where C-sections have become the “normal” way to give birth these days, shows that babies who are born via C-section are missing microbes. They actually have an abundance of skin bacteria in their guts. And skin bacteria definitely don’t belong in our guts. So if you’re considering having a c-section out of convenience rather than as an emergency, you might want to do more research about how that could affect your child’s health down the road. Some forward-thinking doctors are now swabbing the C-section baby’s face with vaginal fluid as soon as it’s born to help give them more robust gut flora.

Dr. Martin Blaser shares lots more fascinating information in Missing Microbes, about how our microbes are meant to help us thrive. And how we can help our microbes in return, and reclaim our health in the process. This is honestly one of the most informative books I’ve read in a long time. And it’s written for the layperson. Though he goes into a bit of scientific research in parts, it’s all written in an entertaining, easy-to-read style. And it is quite a page-turner. Plus it’s only 200 pages long, so I easily finished it in a few days.

What you’ll learn in reading this book will impact your health for the rest of your life. So I highly recommend putting it on your list for Santa!

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