Conversations with Microbiome Labs

Course Content

1/13/25 Balance from Within: How Probiotics Are Transforming Vaginal Health with Alicia Galvin
12/17/24 Stool Testing: What You Need to Know with Alicia Galvin
59:28
10/24/24 The Female Microbiome: Clinical Insights and Practical Applications for Optimizing Women’s Health with Alicia Galvin
51:56
8/27/24 Immunoglobulins 101: How to Support Mucosal Immunity, Microbial Balance, and More with Sarah Ellis
1:07:12
7/30/24 Set the Foundation to Gut Health with Lacey Hall, MS, RD
59:22
7/9/24 Microbiome Foundations: Dysbiosis and the Gut-Organ Axis with Sarah Ellis
1:23:30
6/26/24 Food Sensitivities: FODMAP, Gluten and More with Lacey Hall
59:49
How to Build a Resilient Microbiome with Alicia Galvin 5/7/24
1:02:57
Pioneering Gut-Brain Axis and Digestive Support with Kara Siedman 4/9/24
1:01:03
Stress, Sleep, and the Impact of the Microbiome with Alicia Galvin 1/29/24
58:46
Feeling Zapped of Energy? Mitochondrial Rescue with Kara Siedman MBL 11/13/23
53:37
Acute and Long-Term Antibiotic Therapy Recovery with Sarah Ellis (antibiotic recovery) 10/18/23
1:05:02
Metabolic Conditions, Blood Sugar Balance, and Gut Health with Alicia Galvin (metabolic conditions)
57:23
The Forgotten Microbiome: Why Oral and Dental Health Matter and the guest expert is Dr. Haroldo Magarinos 8.21.23
1:00:13
The Gut-Brain Axis: Restoring the Gut for Better Brain Health and Mood with Kiran Krishnan 7.24.23
48:08
Weight Loss/Metabolic with Kiran Krishnan 6.27.23
59:38
New Research: Multiple Strains for Microbiome Support for Gut, Sleep & Mood with Kiran Krishnan 5/1/23
1:12:21
The Pediatric Microbiome: Gut Support Your Kids Will Actually Eat with Kiran Krishnan 4.17.23
59:49
K2: Beyond Bone and Heart Health with Kiran Krishnan 4.4.23
57:18
Spore-based Probiotics: A User's Guide with Kiran Krishnan
1:04:49
Maintaining (and Improving) Your Digestive Health Over the Holidays with Kiran Krishnan
58:54
Prebiotics and Probiotics with Kiran Krishnan
53:31
Vitamin D3/K2 — The Calcium Connection with Kiran Krishnan
49:12
The Deep Dive into Healing the Gut Lining with Kiran Krishnan
1:07:22
How Does Oral Health Impact Your Gut and Systemic Function with Kiran Krishnan
49:10
The Gut-Skin-Microbiome Matrix with Kiran Krishnan
56:52
The Thirteen Studies on MegasporeBiotics with Kiran Krishnan
1:22:14
The Role of Spore Probiotics in Gut Health
1:13:37
Microbiome Superpowers with Kiran Krishnan and Shivan Sarna
32:17
The Gut-Brain Axis and the Role of the Microbiome: Managing Stress Response and Sleep with Kiran Krishnan
Examining the Root Cause of SIBO - Going Beyond the Bloat With Kiran Krishnan
1:35:07
The Gut-Skin-Brain-Sleep Matrix and the "Psychobiome" with Kiran Krishnan
35:36
MegaSporeBiotic™
19:08
Microbiome Breakthroughs and the Future with Kiran Krishnan & Shivan Sarna
26:39
How To Diversify Your Diet Without Symptoms
18:55
How the Brain Is Impacted by Your Gut with Kiran Krishnan of Microbiome Labs and Shivan Sarna
1:16:44
Loving on Your Immune System and Staying Well This Winter (Recorded Oct 27, 2020)
1:44:19
How Does the Microbiome Control Your Immune System with Kiran Krishnan (recorded Sept 16, 2020)
1:00:06
Are Stool Tests Full of Cr@p? with Microbiologist Kiran Krishnan
1:15:11
3 -Step Total Gut Restoration Process
1:02:38
A Microbiologist’s Perspective on Small Intestine Bacterial Overgrowth
47:18
Immune-Gut Matrix: What You Need to Know Now with Kiran Krishnan and Shivan Sarna (Recorded Jan 28, 2021)
1:08:19

51:56

Hi. I'm Siobhan Sarna. I'm the founder of Chronic Condition Rescue. I have written a book called SIBO, Healing SIBO. My SIBO platform, which is small intestinal bacterial overgrowth, which is AKA IBS is SIBO SOS.

Coming up in January, you'll start to hear about the new science and wisdom of menopause summit, which is my 11th summit. Actually, I'm so excited about. I'm going to be calm, but I'm very, very excited about it. And it is, exactly that, the science of menopause as well as wisdom associated with it, because I think it's just, I'm not coming from the, it's a beautiful time in life and you're blossoming as a woman. That's not what we're gonna be talking about.

We're gonna be talking about 3rd acts, late bloomers, and science, and hormones, and the microbiome of the vagina and all kinds of fun things. I've never said vagina so much in my entire life, by the way, as I've been prepping for the summit. So it's been really fun and really interesting. Okay. Today, my very special guest is Alicia Galvin.

Now she is the clinical science liaison for Microbiome Labs. She's also a registered dietitian. She's also mother of 3, including 2 5 month old twins that just happened. She's doing great. She's a wonderful educator and teaches us about a variety of things.

We've learned from her about the gut microbiome. And today, we are talking about the vaginal microbiome. And this is a conversation that needs to come to the forefront. Just like the gut microbiome, they are related. I'm gonna hand things over to her so she can take it away.

Thanks for being here, and let's go. Alright. Well, thanks so much for having me back. I missed you all, and I'm really happy to be talking about to Shavaughn's point, I think a conversation that really, isn't discussed enough, but it is such an important aspect of women's health because as we'll see, vaginal health plays a huge role in women's health in general. There's so many women's health specific conditions that really stem from an imbalanced, vaginal microbiome.

And there's certainly a connection between the gut microbiome and the vaginal microbiome, as we'll talk about, today. So I'm hoping that you can walk away with some clinical pearls and, some nice conversation points. So let's just first discuss the importance of this microbiome, which is super critical, and we're gonna be going through some of the different elements that influence the ecosystem and the environment of the vaginal microbiome, and also through a woman's lifespan. So that's what's really interesting is that there's this lifespan change that happens with our flora in the vaginal tract, and it's impacted by several different, environmental elements Sarna like diet and hormones and that type of thing. So, there's a lot that we can do to really influence its health, and that can play a big role in women's health overall.

So what characterizes a healthy vaginal microbiome? Well, first of all, you're you're supposed to have a really high abundance of lactobacilli species who are, producing things like D lactate and hydrogen peroxide. You're also supposed to have a low bacterial diversity, which is a little bit of a divergence from what we normally talk about because when we're talking about the gut and, our intestinal microbiome, we want a lot of diversity. We want lots of different species. We want lots of variety.

That is the total opposite of what we want in the vaginal microbiome. We really want low bacterial diversity that's predominated by lactobacillus species. And the reason for that is because lactobacilli are responsible for producing that d lactic acid, which helps to keep that pH very acidic in the vaginal tract, and that's what helps to prevent a lot of this overgrowth of different pathogens. And there are 4 dominant species. We have l crispatus, l gasseri, l gensinii, and l einers.

So lactosels, einers, and the different, what we call, community state types, which is what we'll talk about, will be dictated by which one of these left bacilli is predominant in the vaginal tract. Alright. So the microbiome does fluctuate throughout a woman's, lifespan. So, and there's another image on the next slide that we'll go through, but you can kind of see how there's this sort of bell curve of the pH and, like, the bacilli. So it starts out in childhood and pre puberty before estrogen kicks in.

Starts out pretty low in lactobacilli, and then it has more of a neutral pH. And then you get this rise of lactobacilli species, especially as that estrogen level builds, through that adulthood and reproductive years. But then as you start to go into perimenopause and menopause, you can see that there's this decline in lactobacilli, and you start to actually revert back to more of that neutral pH because of some of the composition changes that happen. Happen. So there's really kind of a bell curve that happens throughout a woman's life.

And so it fluctuates too. The estrogen plays a big role in this as well. So some of the fluctuations are are really from that estrogen level, but, there can be other factors as well. So this also is another way to look at it, but you can see the other changes that are happening in the vaginal tract as you're going through the lifespan. So the epithelium or that cellular layer that lines the vaginal tract, it's thin when we're little, pre puberty, and then it starts to thin as you go towards menopause.

And a lot of that, again, is related to that estrogen level. Mucus also is very thin, in childhood and pre puberty, and it is thin during menopause. But you get this really nice thickening, or you should, a healthy vaginal tract has this really nice thick layer of mucus, during that puberty and reproductive and, through pregnancy. Estrogen label levels, as you can see, fluctuates. So we have low, obviously, when we're young, and then it rises and then it depletes, through menopause.

Glycogen also changes, and glycogen is the fuel source for that lactobacilli. So that decrease in glycogen, or low glycogen levels when you're young and then the decreasing levels as we get older, that plays a role in that lactobacilli fuel, that's needed and can contribute to some of that lowering of, those levels. And then the pH also fluctuates, so it's pretty alkaline or more neutral when we're young and and gets more acidic as we get older. Diversity changes, so there's actually some different microbial changes. So there's not a whole lot of lactobacilli in the beginning, and lactobacilli does decrease towards the end, but we're supposed to get a really nice robust lactobacilli, increase as we go through that sort of reproductive and through puberty and then through pregnancy.

So we can see that here. Now one of the things that lactobacilli is so critical for is pathogen control. And so we're gonna talk about things like BV and, candida and urinary tract infections because all of those have a, a root in having an imbalance or not enough lactobacilli species because of the byproducts that lactobacillus species produce, like bacteriocins, which are very antimicrobial, producing the lactate, which is helps to keep the environment acidic, and the hydrogen peroxide. Blanket cells also helps to prevent the adherence of pathogens. So it creates these, what are called biosurfactants, that help to interfere with the attachment sites that these pathogens use to try to grab on to the epithelial layer and try to attach and start to proliferate.

And it also helps to what we call coaggregate or basically bind up and attach to that pathogen. So if you have a lactobacilli that's sort of binding and attaching and neutralizing that pathogen, then the natural fluids of the body can help to eliminate it. So lactobacilli, not only is it what they're producing, but it's also some physical interaction with these pathogens that's preventing that pathogen from proliferating. So if you have really nice robust lactobacilli that are making these byproducts, like bacteriocins and hydrogen peroxide, and you are inhibiting pathogens, and then you have nice robust, release of lactic acid, and you have proper levels of estrogen, nice low levels of pH, you have a thick mucus, and you have a thick vaginal epithelium, these are the characteristics of a really nice healthy vaginal tract, and this is what we're looking for in terms of what's considered optimal. Now if you have dysbiosis risk factors and a lot of these are gonna be the same risk factors that are gonna be influencing our gut, bacteria.

So pretty much if you have gut dysbiosis risk factors, those are similar in, vaginal dysbiosis risk factors. So age, as we talked about in hormones, can play a role. Sexual habits can play a role. Medications, like antibiotics, obviously, can play a big role just as it would in the gut. Vaginal products like lubricants or tampons, those can play a big role in vaginal dysbiosis.

Our diet, so we have a really high sugar diet or a highly refined diet, very low in polyphenols. Because one of the things that really is helpful, fuel for our left of the cell I Mark wonderful polyphenols and reds and oranges and yellows, in terms of our produce and fruits and vegetables. So we're deficient in that or if we're eating a diet that's, more more along the lines of a standard American diet, then that's gonna influence, just as it would with the gut. Stress levels for sure, just as it would with the gut microbiome. Stress can disrupt the vaginal microbiome.

Tobacco use and the gut microbiome, of course, this wouldn't be a microbiome let's talk if we didn't talk about the gut microbiome. But, it really does influence, vaginal factors and vaginal dysbiosis. So you have to have a healthy, GI tract and a really nice, robust gut microbiome to influence a positive and healthy vaginal microbiome. So what would a disrupted, vaginal tract look like? So if you don't have the enough of the lactobacilli, you have low abundance, and so you're not getting these byproducts like lactic acid and hydrogen peroxide and bacteriocins.

This is what's gonna lead to a higher risk of those pathogens to come and invade. And so you're gonna get, a whole lot more of this imbalanced vaginal microbiome and get a much higher risk of things like BV or potentially adverse pregnancy outcomes. And it's gonna affect the pH, mainly to more discharge. Obviously, if you have lower estrogen and lower glycogen production, you can get a thinner mucus and a disrupted vaginal epithelium. So this would be considered an imbalanced vaginal tract that is gonna be more likely to, invite things like BV and and candida and cause issues.

Now as I mentioned, when we think about our vaginal microbiome, it's classified into what's called community state types, and it's essentially just a way for us to group depending on the bacterial composition in the vaginal tract. It helps us to group and identify the state type or the environment that is characteristic of that particular microbial makeup. So we'll go through each one of these. There's 5, and each of them has a little bit different, unique, stamp to them. So the healthiest would be what's called state type 1 or CST 1, and this is going to be predominantly made up of lactobacillus crispatus.

This is the healthiest of the community state types. It has the lowest pH. It's also going to be the most resistant to transition, so it's much more stable, primarily because L Crispus is known for making something called D lactate or D Lactic acid, which is much more effective in keeping the pH low and keeping everything really nice and stable. So we wanna have more D Lactate produced than L lactate, which we'll talk about here in a minute. And it really maintains stability throughout the woman's menstrual cycle.

So one of the things that can happen during a woman's menstrual cycle is if you think about it, there's, you know, blood that's released, and it's and blood is not acidic. Blood is much more alkaline. So what can happen is when women go through their, menstrual cycle and if you have a whole lot more of this alkaline fluid floating around in the vaginal tract, that can cause a fluctuation in the pH, and then that can lead to issues, you know, yeast infections or or issues, in a woman's monthly cycle. So if someone has a community state type 1 and they're much more stable, it's less likely that their menstrual cycle is gonna trigger some stripe some type of dysbiosis. So, this is what we really wanna try to strive for.

Now l Gastritis dominant would be what we call community state type 2. It's not super common. It is associated with a pH. It's a little bit more alkaline, you know, 4.4, but it's not it's not considered an unhealthy community state type. And if women, are pregnant and they have had a type 2, they might transition to type 1 during pregnancy.

Not super common, but it does it does happen. But it's not really associated with diseases. So this is sort of considered Mark of your neutral. It's not the healthiest, but it's also not the worst. It's just kind of a neutral community state type.

Lactobacillus iners, if if that's predominant, that would be state type 3, and this is a little bit more alkaline. It's over a pH of 4.5. It's not in of itself negative. It's more about what are the other bacteria that are present because maybe this could be a healthy community state type, but if you have other factors or other microbes there that are alongside it, there might be some issues with dysbiosis and could have some poor stability. So not one that we really wanna have, but it's not horrible.

And the reason why it fluctuates is because of this l lactic acid that's made by the l liners versus the d lactic acid. So it's much less effective in, inhibiting the microbial species and causing that, you know, much more acidic pH. And it can transition to more of a BV type. So, so again and if we're thinking about the spectrum of what we want, 1 would be the best. 2 is kinda neutral.

3 is kinda getting towards maybe a little bit of a concern, but it's not it's not the worst, and it can have higher baseline concentrations of more inflammatory molecules that can really affect the GI or the vaginal tract. Now we have community state type 4, and this is the one that is has the highest microbial diversity. And remember, we don't want micro high microbial diversity, and it doesn't have lactobacilli. So this is gonna have really minimal amounts of lactobacilli, if any. So you're gonna have a much higher risk of things like BV and Candida.

It's least stable, so it's gonna fluctuate a lot during a woman's menstrual cycle. So remember, if you have that more alkaline fluid and that blood that's in there, it's gonna fluctuate and potentially, lead to an increased risk of those Allison. And it's very highly associated with a lot of negative women's health outcomes, so things like endometriosis, bacterial vaginosis, and miscarriage. And it's very, very, prevalent in these non lactic acid producing species, so the pH is much, much higher, much higher pH, not acidic at all. And it is much more common among black and Hispanic women.

So there's a bit of a cultural shift in here. And so this is the type that we really wanna try to work on if if you're seeing this in in your patients or if you yourself are struggling with the community state type for then we really wanna do some work there. Now lactobacillus gensinii is not very common. We don't really know a whole lot about this particular, community state type. It has a fairly decently low pH.

We just don't know a whole lot about it. So, you know, it could be healthy. It, you know, it doesn't seem to be all that associated with more of these negative outcomes, but, it's not gonna be the one of those common ones that we'll see. Now what's the impact? So as I mentioned, the top 3, so b v, urinary tract infections, and yeast infections are probably some of the most commonly, associated risk or issues with vaginal dysbiosis, and we'll talk a little bit more about each of those.

But you can also have some other negative pregnancy outcomes, endometriosis. There can be some cervical cancer, triggers. There's pelvic inflammatory disease, fertility issues, STIs, gynecological cancers. So as you can see, we we wanna have a nice healthy vaginal microbiome. But I'd say the top 3 are are the most common that most people struggle with.

So bb is associated with that loss of protected sloptopacillus. It's also, associated with more of the gardenrella, candida. So there's a lot of other negative bacteria and and pathogens that can be there. And it's actually pretty common. It can be asymptomatic.

So you can have women who have no idea that they have it, unless they're testing. But up to almost 30% of women, of reproductive age have this. So it's a quite common, scenario. And like I said, about 84% of those don't have any symptoms. So they might have a disrupted vaginal flora, and they don't even know it.

And they're walking around, with this potential issue going on. But it can definitely increase different risk of things like sexually transmitted infections, and typically antibiotics are the first line therapy. So whether it be oral, vaginal, Sarna combination of the 2, that's the typical treatment for BV. But it has a very high recurrence rate, especially if the underlying issue of a person's dysbiotic vaginal flora is not addressed. They might go through and do antibiotics, potentially disrupt the vaginal flora even more, get rid of the BV, but not fix the underlying issue.

So somebody is gonna be much more likely to have this recur, and it is associated with, adverse health outcomes. Now with Candida, this is also associated with the loss of that protective lactobacilli, and it's typically the Candida albicans or other Candida species. And, again, very common. About 75% of women will have at least one episode in their lifetime. So it's, you know, between this and BV, a lot of women are struggling with this.

And it it's pretty typical after someone's had a round of antibiotics. So how many of you have had the scenario of you had a UTI, got an antibiotics, and then gotten a yeast infection, or you've, you know, heard of somebody or worked with somebody where that's been the case. Because, again, those antibiotics are killing off those lactobacilli species. You're losing that protection, and then you're, making that ecosystem a little bit imbalanced and increasing the risk of that candida to grow. Now with the urinary microbiome, what's interesting about the urinary, bladder microbiome is that it's also primarily lactobacilli.

And so, again, kind of a similar situation when we think about, what's really healthy and and producing that proper pH for the proper types of microbes to live there. But also too, if you think about just basic anatomy of the vaginal tract, the urinary tract, and the rectum, they're all in very close proximity to each other. So there can be some crossover between, proximity to each other. So there can be some crossover between the 3. And so when you have someone with a really imbalanced vaginal, tract or they have an imbalanced urinary microbiome, then that can they can play off of each other and can trigger more UTIs.

So what do we do about this? How do we know if somebody has an issue with their vaginal microbiome? Well, you wanna test, don't guess. So vaginal microbiome testing really starts to look at that root of the problem. So it looks to see, okay, what is their community state type?

What is their composition? Problem. So it looks to see, okay, what is their community state type? What is their composition of the flora that's in there, and are they at risk for potentially having more pathogens come in? One thing that you Sarna keep in mind because of the menstruation, you wanna test a week before or after.

You don't wanna test during for obvious reasons, but, you wanna test either a week before or after. You can also get at home vaginal pH strips. So you can see, is that pH in a proper level? Is it, you know, around that four level for pH? And also hormone testing.

So as we mentioned with estrogen and glycogen, they're sort of this dual action that, of this bell curve. Because estrogen is stimulating that glycogen production, which, remember, is that food for your lactobacilli. And so if you have low estrogen, then that, as we saw, can lead to those imbalances of the microbiome. And then, of course, gut microbiome testing, because there is a direct link between the gut composition and the vaginal composition. The community state type 4, the one that is least stable that is associated with all these adverse health outcomes, that is also most highly correlated with gut dysbiosis.

So if someone has vaginal dysbiosis in a community state type 4, even 3, there's some research, look at the gut because it could be stemming from the gut or at least correlated. So with the vaginal health kit from biomeffects, it's powered by the same wonderful whole genome sequencing technology that our stool test is. But this is just a sample report. So you can see here that if, you know, once, someone goes through and they, do a vaginal swab, they send their test kit in, and we are able to look at their composition. So as you can see here, this would be considered a community state type 1 because it is predominantly that lactobacillus crispatus.

So this is what we would be wanting to see from, the vaginal health kit as far as results. So you look at the composition, you can see the relative abundance, and then it does tell you what community state type you are. So this, in this case, would be a type 1. And then it looks at all of the other lactobacillus species that are associated with that particular sample. So it'll look at the top ones, the cruspatus, the gastrari, the inners, the gensinii.

But then you can look at a lot of different other lactobacillus species that may or may not be present or in low concentration. So it gives a really nice, report on how robust is that person's lactobacillus in their vaginal tract. It also looks at opportunistic bacteria. So you can see a few of the things that are looked at here, especially this gardenrella, which one thing I wanna mention. So you see it's in low concentration.

As long as you have a really robust lactobacillus composition in the vaginal tracts, something like this may not be as much of an issue because it's very stable. It's gonna keep that pathogen at bay. It's gonna keep it in low levels, and so you're more than likely not gonna have an issue with BV even if there's the bacteria that's there that could potentially trigger it if you have a lot of the other lactobacillus, species present. There's also some pathogens that are looked at, and then fungi. And so you can see in this case, no fungi were Siebecker, and none of the pathogens were detected.

So who would be a candidate? Definitely someone who has any history of vaginal related conditions. You know, what is their CST? How can we support their microbiome? And, if they've had previous, you know, vaginal health conditions that also resulted in, antimicrobial prescriptive agents, then this would be someone that you'd wanna see what is going on with their vaginal flora.

If they've had fertility struggles, if they've had recurrent miscarriages, if they have endometriosis, or if they have PCOS, definitely recurrent UTIs and knees infections, if they're going through the process of trying to conceive. Just because there can be a lot of adverse pregnancy outcomes, with, imbalanced flora in the vaginal tract. Anyone trying to conceive, I would consider someone who you would wanna see what's going on. It pairs really well with a biomeffects test, as I mentioned, because there's this cross pollination, so to speak, between the gut bacteria and the vaginal microbiome. And our gut dysbiosis can definitely lead to that vaginal dysbiosis.

So, you know, if you have someone who has an imbalanced vaginal tract, you wanna be thinking about a stool test to see what else is going on. Because as I mentioned, type 3 and 4 have associations with certain microbes that actually came from the GI tract. So because of that close proximity, this is why you'd wanna be thinking about that gut vaginal axis, because if you have a really healthy microbiome, it can go both ways. You know, women who have a higher concentration of Alcrispus in the stool are more likely to have a healthy vaginal microbiome composition. So it's it works both ways.

Healthy gut, healthy vaginal tracts, unhealthy gut, potentially unhealthy vaginal tract. So definitely don't forget about gut health when we're thinking about women's health for many reasons. And more than just the vaginal, microbiome, we have a lot of other microbiomes related to women's health. We have an endometrial microbiome. We have a cervical canal microbiome.

I mean, that's the thing that I think is so amazing about the body is we used to think that a lot of these areas were totally sterile, didn't have bacteria. And now what we're finding is, oh, not only do all these areas have bacteria, but also if there's imbalance in those places, it can be bacteria, but also if there's imbalance in those places, it can be related to so many different, chronic diseases that, you know, seemingly wouldn't you wouldn't think would have a microbiome connection, but they actually do. So, so I wanna put this here because I thought it was kind of a cool schematic to show the different compositions, the healthy compositions of the various women's, microbiomes and how that relates to the gut microbiome. What would be some additional support? So beyond just, you know, probiotics and, the various lifestyle factors, you know, these are really some things to think about.

So, avoiding inflammatory foods and high glycemic foods, again, to kind of throw off that pH. As we mentioned, diet plays a big role as part of the vaginal dysbiosis risk factors. Fermented foods are great, for lactobacillus. So sauerkraut and kefir and, you know, any of your fermented foods and fermented vegetables, kimchi. You know, those would be great for supporting lactobacillus in the gut, which could then translate to the vaginal tract.

Flavonoids, especially cranberry and pomegranate, so thinking about those reds, not only supportive of things like acromancia and our beneficial microbes in the gut, but also can be helpful, for the urinary tract, and urine preventing urinary tract infections. So garlic and thyme and cinnamon Sarna wonderful herbs and seasonings, and then, of course, our vitamins, our fat soluble vitamins along with calcium, zinc, and selenium Mark all, beneficial fuel sources for our, microbiome. Now as I mentioned, there can there's a half about half of women at some point in their lives are having some sort of bacterial imbalance, and that is a problem. Now most commonly, that's the BV in the yeast, as I mentioned, which can lead to all these various symptoms. But one of the things that is really, I think, amazing, is the research that's emerging on the use of probiotics and how probiotics taken orally can actually help to restore the vaginal microbiome, can reduce things like BV and yeast infections, can reduce things like UTI.

And so this is a a really wonderful emerging area of research because it means that we can actually do something. So it's one thing to know that there's a problem. It's another to test to confirm that there's a problem. But then what do you do about it? And that's where probiotics are really, really carving out their little niche and being able to to facilitate, the recovery of of some of this.

And so bringing in these combination strains of lactobacillus, various clinical trials have shown that it can help with that prevention and improvement of symptoms, for sure, which is wonderful if you have someone who's dealing with, you know, discharge and odor and itching. They wanna have symptom relief. So it's one thing to change the microbiome, but does it also help with the symptoms? And so with that, I wanna tease some very exciting news that we at Microbiome Labs have is that we are launching the very first women's health products at Microbiome Labs. And so we have a vaginal balance product that we'll be launching in January.

We have a pregnancy support probiotic that's gonna be launching in January. And so part 2, I will be back in January after these products launch, and we will be going into a deep dive on the reasoning behind the formulations. I'll go through the science and the clinical studies that really show some impressive positive outcomes in a pretty short period of time, for women's health as well as for pregnancy and also for, the outcomes for the offspring. There's some interesting data on probiotic supplementation and benefits in the offspring. And then how do you use them?

So really practical applications. So the who, the when, the how. How do you use these with your patient populations, and how would you maybe integrate these if you're doing vaginal health testing? Or if you're, you know, talking to your doctor about this, how could this be incorporated? So stay tuned.

That'll be I'm very excited about this. I'm really very excited about these formulations, especially myself having just gone through pregnancy and my own fertility journey. I just feel like it's gonna change the face of women's health. And I don't say that to be dramatic. I say that because I really believe it.

Because when you look at the science, it's it's pretty phenomenal, and I'm I'm very excited to talk about that in January. So this is our summary. I don't think I need to go through it necessarily, but just, basically, we wanna support the women's vaginal tract, and we can do that, with, you know, diet, lifestyle, and probiotic supplementation. But you have to know what you're dealing with, so it's important to test. And with that Beautiful.

Yeah. Beautiful. Beautiful. Thank you. Let's put some love into the chat.

That was amazing. So here's the thing. I've got a a couple of questions for you, but also that we do have 15% off the vaginal microbiome test that is from microbiome labs. So that is through a special dispensation from the mother Shivan over there. And, I put the the information below so you can or actually, I should say it's in the chat.

I'll pop it in there again. You know what? Alicia, I just went to the website. How do we find it on the website? Because it wasn't, like, blatantly obvious to me.

The vaginal health kit? Yeah. Even though I've ordered it from there before for myself. Go to biomeffects.com. Okay.

Biomeffects.com. Yeah. That's where you would see, the different testing options, but it should be on the it should be on the website under the testing. I can look on the back. I just didn't see where testing was.

You know how that happens. Mhmm. It should it's probably biting me in the face. I just don't see it. Mhmm.

And then, so that's that's what I want. And what about for let me get you to some questions here. What would you recommend vaginal test would you recommend the testing for women with IC, interstitial cystitis? Absolutely. Yes.

Definitely. And I would certainly pair that with a stool test or look at the gut microbiome in that case too, especially and that, you know, I know that you've had, doctor Jacoby and various people on, but, I know IC is also related to, like, hydrogen sulfide SIBO. So you wanna really be looking at gut health along with the vaginal health in those cases. Absolutely. Okay.

So let me just show you something, and I can you can just guide us all here. So I went to BiomaFX. So that's the gut one. Here's the vaginal one. And if you click it, does it take you over to the ordering area on microbiome labs?

Let's see. So it says order vaginal health kit. And then you go to either patient or practitioner. Patient. So we can order direct without finding a practitioner.

So this is where I just wanna make sure, Mhmm. And Yeah. And I can, I can get without our back end people, and I can help you? Okay. So Mhmm.

Yeah. Let help help everybody get a hold of this because I put a link there. Can you just go to microbiome labs and see if you can find it with me? Because that's what the link I have for everybody's, and that's 15% off. So it's worth worth than a minute here to look for it.

Do is it staring at me? I hit products, gastro, digestive, cognitive, metabolic, immune, skin, oral pet, and total gut restore. I don't see it. So while while you're sorting that out, I'll just talk to everybody for a second. So I did this test, last year and I walked into my gynecologist office with it and she was like, oh, that's interesting.

Not realizing that we could test ourselves. And, you know, of course, she wanted to confirm because this is like her, you know, she's not used to this new test. And her test did confirm what your test found. So that was just like an interesting experience, but I felt like, something's going on. I want to find out.

So it was very empowering for me to do that. I do love testing, not guessing as we both do. And, are the probiotics that are coming, are they oral or vaginally Shivan? With chronic SIBO, I'm nervous about taking oral probiotics unless they are spore based. They are oral, but you could insert them vaginally.

So you could open up the capsules and do that. Quick question for you, Shamone. Do you have a patient, or a provider code? It's cbosos, s I b o s o s. So it looks like on the website, if you go to for patients Sarna you say purchase with provider code, it puts in where you put in the name, phone number, and then direct the direct to patient code.

And then I think you can log in and then get it from the back end in that way. Do you wanna send me so, Catherine, will the audience be ordering through Siobhan's direct to patient link? Yes. To order it is through her account and to read about it would be on bio m f x. Okay.

So you'll read about it on bio m f x.com, but it is through the patient to patient link, which is what I have linked. I'm just I already have, I'll just make one up. Janet Jones. Hang on. Let's see.

I'm gonna share my my screen so everyone can see if they wanna order, and then we'll get some more questions to you. Janet Jones, email address. Well, this is gonna work because I'm making stuff up. I don't know. Janet.

This isn't gonna work. Jones. Janetjones@gmail.com. I hope she doesn't get that number. This is something.

It looks like so Catherine is putting the Oh, thank you. You are direct to pay for me. Bullet. Yeah. I was like, we need a salesperson on it.

Thank you, Janet. Appreciate it. Appreciate it. Okay. But then, Janet, that's the link I actually have.

Where do we find the test link? Sorry. I've done this before, and it wasn't a big deal. Yeah. I don't remember it being Can you find that link on that page to, like, to find the test?

Okay. While they're doing the business stuff, Pam is saying if a man can reinfect or your sexual partner, how do you stop that cycle? That's a great question. It's tricky. I'm sorry.

Repeat the question. So if you have a sexual partner and you're Yeah. Continuing to infect each other? Yeah. Yeah.

Well, you would definitely wanna be on something to help with the vaginal flora as a preventative. I would also make sure that both partners are going through all of the dysbiosis risk factor things and looking at diet, lifestyle, stress, gut health. You know, that's gonna be more of a tandem. The both of you going through the whole process of basically correcting dysbiosis, you know, that's what I would say would be helpful from a root cause standpoint. If I order the test and I don't want to test right away, how long can I wait to use it?

You can I I there's not really there's because there's nothing in there that really technically, you know, expires? So I believe it's somewhere in the realm of I think they put something on there as, like, 6 months or so to a year even. So it's not it's not something that you have to do, like, right away. You just I mean, I wouldn't let it sit on yourself for, you know, 3 years. But, you know, if you wanted to wait a month, that's totally fine.

Are there constraints by state for new like, for example, New York? Yes. I believe so for New York. What is the customer service number or email address, I should say, for microbiome lab so they can call, reach out? Mhmm.

It's support? Yeah. Support at I have to look at that. Support at Novanessis. Oh my gosh.

Spell me. N well, Novozymes.novozymes.com. Okay. So that's the customer service email, and you can tell them we sent you. They'll love me even more.

Or actually do do try also c s Okay. Sir cssteam@gomegaspoor.com. So Dr. both of those. Cscsssteam@gomegaspore.com.

For for any, like we're still working on getting you the link. How can the product support menopausal, menopause vaginal symptoms? That's for down the road when the new product comes in January. Mhmm. Yeah.

Yeah. We'll talk more about that. Oh, yeah. We'll talk about that. Will it support will it support menopausal symptoms?

It could help with the vaginal dysbiosis that happens. Yes. For sure. Yes. Right.

It's not gonna relieve you of a hot flash. Right. It's not gonna change your estrogen levels. It's not gonna bring back estrogen. But in terms of any of the vaginal type, you know, related symptoms to the low estrogen or to the low lactobacillus concentrations, it will it could help with that.

Yes. Okay. Katherine, were you able to find that direct link within the microbiome labs ecosystem on the website? Jen, do you have to stop any topical hormones or antifungal creams when taking the test? No.

Because it is a it's looking at the genes of the bacteria. So the only thing that you would wanna be mindful of would be, like I said, menstruation, timing, but then also antibiotic use. But other than that, you can test for this. Okay. This is the link directly to the information on the test.

Then patients would go to your direct to patient link to order above. Hoping that makes sense. This should take them right to the order for the woo hoo. Thank you, Catherine. Thank you, Catherine.

Catherine, can you do a test? Then just confirm, quadruple check, because then I need to change all of this in the email I'm gonna be sending later tonight. I really appreciate your care. Wendy, I use a small amount of vaginal estradiol 2 times a week, which has really helped my postmenopause dryness. Is that good or bad for the diversity?

And would I need to stop using you don't need to stop it before doing the test. But, yeah. I mean, estrogen is your vaginal Good. Ex friend. It's yeah.

It's gonna support that glycogen. It's gonna support the fuel source for your lactobacillus. So, yes, that's that's fine. Okay. Jenny, I've had trouble opening up tablets before and inserting through the vagina for probiotic.

Is there a recommendation of how to best do it? Is it okay to coconut oil? Shivan, opening up tablets before and inserting them? You can just put the whole capsule in there. Yeah.

You can just put the capsule in, or what you can do is you can open it and put, like, like, when you open a capsule and you have most of the powder in one half of the capsule, just insert that. So it's open so you get the release. Because here's the thing, if you have a if you don't have a low enough vaginal pH, that capsule may not break down. So you wanna have some way for that to get out and, you know, percolate throughout the area. So if you're so for women who have a higher pH, there might be an issue with actually getting that capsule open.

So, anyway, just all that to say, you can insert it, but I would recommend, trying to open it and then you insert it with half of, you know, half of it open. Great. That's a great tip. That's a great tip. How does your test compare to the EVVY test, e v v y?

Also, it's recommended to use boric acid, vaginally, and green tea, vaginally to treat b v. I'm fine with the boric acid, but can't tolerate the green tea at all. Any other comparable things for b v takes a lot. Do you take a lot of probiotics? Do you know the e v test?

No. I haven't looked at it specifically to compare, so I can't really speak too much on on that. I do know that it's a you know, it looks at the women's health elements. But, in terms of BV, so these probiotics that will go through with the science, they actually have some BV studies on them. So it actually helps with reduction of symptoms and also BV.

Okay. With some of the things that's coming up in January? Mhmm. Okay. In the meanwhile, the other thing I've heard about is taking, green tea and putting it, like, in a bath.

Yes. Like it's like a like a it's a sitz bath kind of or a Yeah. Yeah. Yeah. You can definitely do that too if you're not tolerating it more locally.

Okay. So I Shivan, let me see. Where are you? Okay. I found it.

Thank you. Yes. Click the link on the bottom there of the Katherine's chat and then hold on. Oh, come on. Hello, little mouse.

I want you to work, please. Thank you. Okay. And then we're gonna share screen. Boom.

Boom. So I clicked that link and this is what I clicked to the 2nd page, and here it is on the lower left right there. So you'd be getting 15% off. There you go. That's what I have for you.

Okay. Honestly, I, it's pretty straightforward once you get into the right link, so sorry about that. Okay. Now Rita stop share. Okay.

Rita is saying any recommendations with for men with high estrogen? I'm sorry. Say again? Any recommendations for men with high estrogen? So men with high estrogen is usually more of an insulin sensitivity cardiometabolic issue.

So if men have high estrogen, I would be thinking about what's their glucose and insulin and be looking more at the metabolic function that's going on with them. That's that's what those are what affect that aromatization of testosterone to to estrogen to increase their estrogen levels. Okay. And then if a person is transgender, male to female, is the treatment the same, also elderly, been on antibiotics? That is a great question.

I don't know. I'd have to see if there's been any research on that. Yeah. I also Sarna match it's your like, this is applying to everybody. Right?

Your your own anatomy. Your own microbiome. Yeah. So because Yeah. It's a great question.

Mhmm. I don't think we're there yet. I don't think we haven't yet. Yeah. I'm glad you're here.

Will you put the instructions on how to get a link to order the test in the email? Yes. I will. The slides are not gonna be shared. That is a bonus if anyone wants to purchase this by 8 PM EST.

That's a little incentive for those of you who wanna, like, make that move. We call it, like, quick action before 8 PM tonight. And then I also have another bonus for you, which I'm going to go find and show it to you. It's from Kiran Krishnan, who is the cofounder of Microbiome Labs. And, it is the, it's basically spore probiotics 101.

It's like a beginner's guide to spore probiotics. It's a session I did with him. He's wonderful educator and brilliant and, a true microbiome expert. And we will if you, order by 8 PM EST and then send us your proof of purchase tonight, please don't, like, send it to me in 3 days. Because my it's a heavy lift, as I say, for my customer service team.

And so just the sooner we can get it done for you, the better. And it's send me your proof of purchase to info at Cbo s o s. Don't need to be fancy. Just like, hey. Here's my proof of purchase, and then we'll know what you ordered because you it should be on the tag or the receipt or whatever.

And then we will send you that master class by Kiran Krishnan on Spore Probiotics, 101 users guide. So that's a little treat for you as well as the slides. So any other questions? We've just run out of questions. I don't wanna let, you know, cut it.

Oh, wait. I got 2 more. I don't wanna cut anybody off, but I also don't wanna keep you here if you have if you are done. Will you put instructions? Yes.

I will put that in the email. I have so much to do. And then, Rita, have you heard of calcium d glucuronate glucuronidate? Is that the right word? It adjusts estrogen levels in women.

Yep. So, beta glucuronidase is the enzyme that, is produced by certain gut bacteria that if you have too high of a level, it recirculates your estrogen that's supposed to be detoxified and eliminated in the stool. It can recycle that estrogen back into circulation. So to me, that it's kind of more of a gut dysbiosis detoxification issue when you have high beta glucuronidase because it's too much of an enzyme recycling estrogen that's really not supposed to be there. The body's already bound up that estrogen for elimination and detoxification, and it's going back into circulation.

So that actually causes more issues like PCOS and endometriosis and is related to that. So now calcium d glucarate is what's used to interfere with that enzyme. Combined 3 words. Thank you. Thank you so much.

That was great. Good job, Shivan. You you caught it. Thank you. Well, I this has happened more than once.

So I can Yeah. So calcium gluconate would be what you would take as a supplement to interfere with that enzyme to then kinda help balance out the hormone situation. So it's not gonna fix the the dysbiosis. So you'd still need to do gut work to work on that estroblone. But, it can help with lowering that enzyme.

Thank you for helping me. Okay. Jay Connell, so if you buy the test or actually, we'll just do this. If you buy anything, on microbiome labs tonight by 8, just send me that. That's fine.

You do get 15% off the entire cart or anything else. You want a probiotic, you want the breath enzyme. It's phenomenal, phenomenal products. They don't have a Allison. They have very special ones.

And so that's one of the reasons I love working with them because they're all very efficient. And and, so today, if you do buy by 8, you will get the slides. Can you send me your slides, Alicia? And I I think Lisa has. God bless Allison.

Okay. Alright. And we will get you the spork probiotic webinar. So by 8 tonight, whatever you want. Just send it to info at Cboe s o s.

How to order the stool test? Yes. That is also on the website. Typically, stool tests are not used to predict whether or not you have SIBO, but they are a wonderful complement to other testing. And you all do have a SIBO breath test.

What am I talking about? That's new. We do as of August. So That's huge. 15% off the SBO breath test from Aero Diagnostic Labs, who we love, who are incredibly accurate.

I know the owner. Yeah. Get a stool test. Get that CBO breath test. Excited.

Yeah. It's a great great compliment. Does. It's a perfect I totally forgot about that. Yep.

Then you'd have, like, so many things covered. Yes, Wendy, they will apply to the other products. Thanks for reminding me. I should have said that. Jenny, when you suggest cinnamon, does it matter if it's Cassia or Ceylon?

I don't know that I don't know that it matters. I haven't looked into that research and sort of that specificity. So I would say go with whichever one you prefer because they have a little bit different taste to them. Carla, until the new product, what's the best for the estro biome? Estrobolone?

Yes. That was Yes. Of course. Yes. So, of course, Megaspore just for helping with that balancing.

Meganeucosa because of the the citrus biflavanoids that help with that's kind of a polyphenol based prebiotic that helps to really fuel our beneficial microbes and our butyrate producers. I would say, actually, fish oil. So mega marine is very helpful in helping to balance the microbiome as well and lowering our our negative LPS producing bacteria. So I'd say those would be three things that can really start to shift that microbiome, to being Mark favorable. I I have a lot of people say to me that they just back to the cinnamon that they like the Ceylon.

Mhmm. Yeah. I see some people commenting on that. And they've they've I've heard of that beforehand as well. Mhmm.

That was an hour of power. Thank you so much. Allison. Next month, we're Sarna be talking about the stool microbiome test. So you could actually get it now.

Get tested. I don't know how long it will take. How long do you know how long it takes to get the results back? Yeah. It's about a 2 week turnaround.

So from the time that you test it, should so it's 2 weeks from the time the lab receives it. So I'd say from the time you're actually shipping it out, it's I would say 2 and a half to 3 weeks. So, yeah, if you if you do it within the next couple weeks, you you should definitely have it by then. So I can't remember when our date is. December 9th.

Okay. So we kind of skipped November? We just That was what Lisa told me. I don't know. Okay.

Yeah. We do whatever she says. I can do November. I'm doing whatever Lisa says. We do whatever Lisa says.

Just keep reading your emails, guys. Keep reading your emails because it's right there. Well, you know what? November messes up, so to speak, because of the holiday, I think. Because we usually do it at this time of the month, that they like, the 3rd 4th week.

Okay. Regardless, the next session when you see us, it will be on the stool microbiome testing that you can get from microbiome labs. So you may wanna get that test now with a 15% off and then have the results by the time we get together, Especially if it is that 1st week in December, that'd be really cool. And then, new product in January for Microbiome Labs for female microbiome vaginal health. And then in January, February, you're Sarna start to hear more and more about the new Science and Wisdom of Menopause Summit.

That is a master class summit. This class is going to be in it, so you can rewatch it then as well. I'm Sarna send it out to you tonight. And I think that's it. I thank you all so much for being here.

Thank you, everybody. Thank you. Okay. Lots of love. Appreciate you all.

I'm so so glad that you were here, and I'm so glad you're taking such great care of yourselves and that we have this resource because you should not be suffering. Okay? This is a great way to take really good self care of yourself. Work with your providers, but also have data to walk into that appointment. It really is going to help.

Hopefully you can work with someone who's like, oh, I know microbiome labs. I don't need to test again. Although I was lucky because my insurance paid for the doctor's test and it was fast. But you really are, you're getting to that empowerment stage by taking this data with you and transforming your health with it. So thank you.

Thanks. Great job. So much. Bye guys. Thanks.

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