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How Drugs Interact With Your Gut

The gut microbiome is a vital and important part of human health that touches so many aspects of our daily lives, yet it works in very unpredictable ways.

For example, consider how certain drugs interact with the human gut. Sometimes, they do work but not so well at other times, as we learned about statin drugs.

The very same thing may be true about metformin, the go-to drug prescribed for type 2 diabetic patients to control high blood sugar, according to a study appearing in EBiomedicine.

“For example, certain drugs work fine when given intravenously and go directly to the [blood] circulation, but when they are taken orally and pass through the gut, they don’t work,” says senior study author Dr. Hariom Yadav, a researcher at the Wake Forest School of Medicine.

As we’ve seen previously, metformin works well with the gut, although some patients who take it tend to experience more side effects (nausea, diarrhea and flatulence).

Based on their review of studies, Wake Forest researchers determined the metabolic capacity of a patient’s microbiome may influence how various drugs aimed at treating type 2 diabetes are absorbed and function in effective, inactive or even toxic ways.

“We believe that differences in an individual’s microbiome help explain why drugs will show a 90 or 50 percent optimum efficacy, but never 100 percent,” Dr. Yadav said.

Now, Wake Forest researchers are taking the next important gut-friendly step by testing prebiotics, a natural component of non-digestible plant fiber that feeds the good bacteria living in your gut, and probiotics that may help diabetes drugs work more effectively.

Could a multi-species probiotic containing 10 kinds of beneficial bacteria plus a handy prebiotic (FOS) like EndoMune Advanced Probiotic make gut-friendly difference in the way patients take their drugs?

The evidence is growing!


Your gut bacteria may determine how statins work…or don’t

Statins are a very handy and popular class of drugs that reduce cholesterol levels and lessen a patient’s risks of cardiovascular disease (stroke and heart attack).

Well-known brands of statin drugs like simvastatin (Zocor), rosuvastatin (Crestor) and atorvastatin (Lipitor) can be an advantage to human health when they work properly. Unfortunately, statins don’t work for everyone, and a 2011 study published in PLOS ONE suggests a gut bacteria link may explain why.

Overall, data collected from 148 patients enrolled in the nationwide Cholesterol and Pharmacogenetics (CAP) study who had taken simvastatin were reviewed by a research team led by a Duke University scientist.

In addition to examining health data from 100 patients whose LDL cholesterol dropped dramatically thanks to taking simvastatin, researchers also reviewed results from 24 patients who derived little benefit from the statin drug and an equal number whose response was deemed “fairly good.”

Scientists collected blood work before any patients had taken a statin to identify signs of specific bile acids and sterols (fat-like substances connected to the use and breakdown of cholesterol).

Three kinds of bile acids produced by specific gut bacteria were found in samples taken from patients who responded well to statins for six weeks. On the other hand, five different kinds of bile acids were produced in patients whose bodies didn’t respond well to statins.

The difference between both groups: because bile acids and statins share the same pathways (to the intestines and liver) and compete for dominance, scientists speculate that patients whose bodies produce too many bile acids prevent statins from reaching their intended target—the liver—where the production of cholesterol is controlled.

Researchers believe a blood test that screens for bile acids could determine who responds well to simvastatin and who doesn’t.

“It’s no doubt that metabolites from bacteria are playing an important role in regulating our systems,” said lead researcher Dr. Rima Kaddurah-Daouk at Duke University School of Medicine in a press release. “We’re at a very early stage of understating this relationship, but eventually we could take a quick chemical assay and get a read on where we are metabolically.”

A more recent study supporting these findings concluded increasing bile salt hydrolase (proteins produced by gut bacteria that alter the chemical properties of bile acids) may slow down weight gains and serum cholesterol in mice.

In both studies, researchers cited probiotics as a possible solution to lower cholesterol, another reason among many to protect and enhance the diversity of beneficial bacteria in your gut by taking a multi-species probiotic like EndoMune Advanced Probiotic.

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