I need to use antibiotics – what effect do they have on my microbiome? This is a great and important question. Antibiotics have been a fantastic discovery and millions upon millions of lives have been saved by them. Initially, they were thought of as the magic bullet and could treat most conditions but, as time passed, we soon realised that there was going to be trouble ahead. Firstly, bacteria are really smart and soon learned to develop resistance against antibiotics. Initially not a major issue as our pharmaceutical experts kept finding new agents and tried to keep one step ahead of the bugs. Scouting parties were sent all over the world to look for new bacteria from which to create new antibiotics and some were found in amazing places. Cephalosporins were discovered off the coast of Sardinia near a sewage discharge pipe! Another was found in Easter Island (Rapa Nui) in the Pacific.  Yet another area of assault involves viruses that can kill bacteria, so-called bacteriophages, and which were the hope before penicillin was developed. They are still used in Eastern Europe and their use generally is being resurrected. Secondly, we knew that bacteria were a great source of agents to kill other bacteria, but we did not realise till recently that they are also a great source of resistance! A set of bacteria found at the bottom of a cave in New Mexico in 2012 shocked the profession. This cave is millions of years old and the water takes thousands of years to percolate to it. The organisms are thought to be at least 30,000 years old and are resistant to almost every modern antibiotic! This is typical of Mother Nature. You never get a single effect without a response to go with it. If you can attack, then others learn to defend! The “antibiotic apocalypse” is worrying many but mankind lived for hundreds of thousands of years without antibiotics and is well equipped to deal with infection provided good health is maintained. This is why the microbiome is so critical to any intelligent person who wants to avoid antibiotic use. That is not to say you should not use them to save life but you should use them judiciously and with care and then compensate as I will explain below. An especially critical time is when we are very young and still “tuning” our immune system to look after us. We derive all our bacteria at birth from our mother and the natural process of birthing usually results in the mother’s faecal matter and skin bacteria inoculating the baby. We used to think this was a bad thing but now we know better. In many countries, the midwives actually take some faeces from the mother and contaminate the baby, especially after a Caesarian Section. They also rub the baby on the mother’s abdomen to get good skin to skin transmission. The mother’s first milk (called colostrum) contains large amounts of secreted antibodies from her which protect the baby until it has developed its own immunity – this is why breast feeding even if only for a few days is so critical. We do know that milk contains bacteria also and it may well be there are other agents. {Teaching point: Did you know that an entire group of bacteria has only been discovered in the last fifteen years and is just beginning to be classified? These bacteria are extremely difficult to culture and study and the work has been based on DNA analysis. They are thought of as the “Dark Matter” of the bacterial world because they seem to account for between 25 and 50% of ALL bacterial species on Earth! We know almost nothing about them or what effect they may have on our lives but I would hazard a bet that they will have some important link in the network that is Nature and Life! Watch this space! If you want to learn more, look up “Candidate Phyla Reaction”.] What should I do during my antibiotic treatment? The first thing is not to worry too much. Just make sure you discuss with the doctor to see if there are any alternatives and if not, then take them as advised. Often, antibiotics are used almost as a placebo in situations where they will not help – this is to be discouraged and you should not try and force your doctor into prescribing them unnecessarily. During the course of therapy, make sure you keep a close eye on replenishing your microbiome diversity because it is this that suffers especially with antibiotics. Make sure you are “farming” properly and feeding and restoring this diversity.  Once the course is finished, you must carry on for some days so that restoration takes place – don’t stop when the antibiotics stop! Other supplements might be worth taking such as extra vitamin B, C and D for a couple of weeks after. You are also aware of how important Au+ is in this equation and you should keep taking that as there is no evidence of any drug interaction and you do want everything going for you in terms of immune responses.

Chronic inflammation and cancer. There are many triggers that induce the formation of cancer cells and in fact we all produce several hundred thousand abnormal cells every day. However, if our immune system is working well, these cells are recognised and destroyed. We call this “Elimination”. With time and ongoing damage, the cancer manages to get a toehold and a balance forms between the formation of new cells and the body killing them off. This process we call “Equilibrium”. Prostate cancer in old men is a good example of a stable equilibrium in that the cancer causes little or no trouble, and the patient dies of old age with the cancer and not because of it. If the cancer is able to beat the immune defences, it then enters a state of “Escape” and begins to spread and cause trouble. A good example of this is a condition called mesothelioma. This occurs when asbestos (used a lot in the past for lagging and insulating hot pipes as well as in things like brake pads) is inhaled. Asbestos is a mineral and shaped in tiny needles which damage the lungs and induce inflammation – the body’s way of trying to get rid it. Because it is impossible to remove, the body tries to wall it off by forming fibrous tissue around the needles and this produces a condition called “asbestosis”.  Unfortunately, after many years, the chronic inflammation results in the formation of malignant change in these fibrous cells resulting in a nasty cancer, mesothelioma, and once these escape the patient is doomed. It is the constant irritation that results in malignancy after many years in this case. These are the three “E”’s of cancer development. In each case, it is the relationship between the cancer and the immune system that decides the outcome. Anything that can keep your immunity on its toes is bound to be of benefit and the key is to help reduce the chronic inflammatory process so that the body wins. There are many examples of such cancers and a common one in western society is colon and rectal cancer. In the USA, some 150,000 people will develop it each year, and there will be some 1.8million cases worldwide. It is the third commonest cancer and the second biggest killer. Whilst there is a hereditary tendency to develop this, there is no doubt that in general it is strongly related to diet and lifestyle and this is why we are so keen to harness the power of the microbiome and keep the immune system tuned.  We know that patients with chronic ulcerative colitis (UC) have a higher risk of developing cancer and the longer they are affected, the greater the risk. In rough terms, if you have chronic UC for 20 years you have a cancer risk of 20%, and if for 30 years it rises to 30%. Colonic inflammation is a bad thing. More worrying, is the recent observation from the US National Cancer Institute that the incidence of colon cancer is increasing in younger age groups and nearly one third of cases of rectal cancer are in those under 55.  What can be causing this? Usually, colorectal cancer is a disease of older people and those seen in the young tend to be the familial (genetic) kind. This observation is worrying because it is not all genetics and one has to look for an environmental cause. Clearly, it is likely to be related to lifestyle and diet. Eating foods that are processed and rich in the wrong fats as well as a poor fibre intake have long been suspected as culprits. The current improved understanding of the microbiome corroborates this and shows we need to really work at getting our gut in good order, hence the term “farming” the microbiome. You have to work at it! Further evidence supports a role for aurum in that it has been shown that induced colitis and adenoma formation (these are precursors for cancer) are prevented in experimental models where stress is also prevented. In summary, you need a well-tuned immune system, helped by a well-tended microbiome, and a good Natural environment allowing you to keep stress at bay if you are to remain healthy!

How does fibre fit into my microbiome “farming” diet? Fibre is the cellulosic component of many food ingredients and as we cannot digest cellulose it passes through into the large bowel. There it acts as a food for the resident bacteria which are able to digest it. So, animals that live on grass and other cellulosic material can only digest it and benefit provided they let it ferment in special stomachs containing the bacteria that can break it up. Humans are omnivorous but a lot of the vegetable matter we eat that is fibre will pass through and in theory only feed the gut bacteria. In fact, this is beneficial in so many ways to us and the bacteria. Fibre acts as roughage and helps to bulk our faeces and make it easier to keep the system moving and prevent constipation and high pressure in the bowel. A good comfortable bowel action is such a great comfort for one’s day! The condition known as diverticular disease is almost certainly a result of chronic high pressure which causes the wall to bulge out at weak points and produce lots of little sacs where material can stagnate and cause infection. This can be very serious and life threatening and is very much a disease of Western Society as those places with a natural high fibre diet are rarely affected. Did you Know! The Latin word ”diverticulum” means a bordello or house of ill repute! These little side rooms were sited along the main shopping mall, the “forum”, and were entered through an archway or “fornix”, hence the term to “fornicate”. You can’t say we don’t improve your classical education on this site! There is undoubtedly an association also with the incidence of cancer of the colon and those whose fibre intake is low and fat intake is high.  There is also a strong relationship between a high fibre diet and avoiding one of the commonest causes of abdominal pain, so-called irritable bowel syndrome (IBS – not to be confused with Inflammatory Bowel Disease). It is amazing how much benefit you can derive by simply paying attention to your fibre intake and microbiome at the same time as keeping stress levels under control, or at least coping with stress responses. By ensuring that we have enough fibre in our diet, we ensure that our resident bacteria in the microbiome are well fed and “farmed” and so maximise the commensal effect (mutual benefit) that we want and is so essential to our immunological wellbeing. I tried fibre and I developed a lot of colicky pain in my abdomen. Why? I treated patients with Irritable bowel for nearly forty years and soon learnt to ensure that added fibre was introduced gradually. At one time, the easiest source of fibre was bran but this often caused colic as it was too rough! You have to think of a workman’s hands – when you first start working they are soft and sensitive and can blister easily. (My surgeon’s hands are like a baby’s – more than five minutes gardening is impossible without wearing gloves!). After some weeks however, the skin gets really tough and copes and you can manage without gloves. The same applies to the gut. Start with small amounts and preferably soluble fibre which is far gentler, before adding more insoluble types. I used to “prescribe” psyllium husk (also known as ispaghula) to be taken as two dessert spoonfuls in a tub of yoghurt or in orange juice at least twice a day. After six weeks you could then be more adventurous and should be able to tolerate the hard stuff! Make sure you take lots of water with the diet as the material swells and absorbs water which makes it soft and jelly like. For those who want to pay, you can use supplements sold as Metamucil which come in sachets and are easy to use. You can discuss with your pharmacist but, frankly, good old psyllium husk in yoghurt is so easy why pay more? Can you give me some examples of soluble and insoluble fibre? Soluble fibre is contained in psyllium but also oats (great as they are also gluten free), barley, carrots and similar root vegetables, citrus fruits and apples. Pease are also good though other legumes such as beans have more insoluble material. Insoluble fibre is in many beans, wheat (watch out for gluten sensitivity), brassicas (cauliflower, broccoli and cabbage), potatoes (keep the skin!), and many nuts.  Prunes and dried fruit have been known for many years as an aid to help constipation and the best agent to get your bowels working is prune juice! So good that I always used it on my patients after major surgery to get the bowels working, rather than chemical laxatives or harsher natural ones based on cascara etc. What matters is that you “farm” your microbiome by giving it food which you cannot digest but which actually helps you indirectly by improving gut action but especially by maintaining a great immune system. The extra effects on blood sugar and diabetes, lowering cholesterol, and keeping weight down are surely well known to you and add up to helping you lead a healthier and longer life!

Not only are they good but they seem actually essential!  Studies on very large numbers of children show clearly that those who are able to play in a rural and green environment are healthier for it. It’s all about mud! These observations have been published in major peer reviewed medical and scientific journals and here are some examples: A Swedish study looking at just over 1 million children (yes – One Million!), showed that exposure to dogs and farm animals reduced the risk of asthma by the age of six years. (Published in the Journal of the American Medical Association Paediatrics in 2015). A Danish study on over 800,000 children showed that ADHD (Attention Deficit Hyperactivity Disorder) risk was far lower in those brought up in areas with access to green areas, such as city parks, than otherwise. (Environmental Health Perspectives Journal in December 2020). A Finnish study on children’s playgrounds showed that changing a concrete surface to one composed of natural forest floor material positively enhanced their microbiome and their immune regulation. (Science Advances October 2020) A German study comparing urban and rural living and the effect on social stress on their immune system clearly demonstrated that those from a rural environment and who worked with animals did far better. (Proceedings of the National Academy of Science 2018).  A US study comparing immune responses and asthma rates in children from Amish and Hutterite communities was especially fascinating and important. The Amish lead a more traditional rural life with more exposure to animals than the Hutterites who embrace more modern technology and do not allow pets in the home. The researchers swapped dust from their households and looked also at animal models and were able to show that the Amish had better innate immune responses and less asthma. (New England Journal of Medicine in 2016). A similar study from Finland and Germany swapped dust from a farm like environment to rural homes had a similar effect, so the benefit is indeed transferable and real.(Nature Medicine 2019). The Australians need no convincing in that many schools now encourage outdoor learning and have noted a dramatic fall in classroom violence, misbehaviour and suspensions. Many other countries including the UK are also beginning to promote outdoor schooling, perhaps a silver lining to the COVID pandemic! Where do mycolicibacter fit in? All these studies have focused on bacterial diversity and those that tend to live and multiply on the skin and in the gut (the Microbiome). For sure, diversity is the key and there is no single “magic” organism that is the answer.  Mycolicibacter are transient commensals to the microbiome – this means that they do not live on or in us but pass through on a regular basis as and when they are ingested. They do not colonise the gut or skin. However, their presence in the environment and especially mud and soil, makes them important players in the equation because of their special effect on immunity. Most are harmless but some are not. In addition, they all have different effects on immune responses, whereas we know far more about the safety and action of aurum. We have mentioned before that other agents in soil and water, such as helminths (worms) and other, potentially harmful, bacteria also help to “tune” immunity and form part of the basis for the Old Friends Hypothesis. We do not want to risk any bad effects and who wants to eat worms anyway?! Aurum was present in the natural environment and we know that replacing it when exposure has been lost is an important factor in maintaining a strong immune system. Doing so in a safe and controlled manner has to be a sensible way forward.

There are many triggers that induce the formation of cancer cells and in fact we all produce several hundred thousand abnormal cells every day. However, if our immune system is working well, these cells are recognised and destroyed. We call this “Elimination”. With time and ongoing damage, the cancer manages to get a toehold and a balance forms between the formation of new cells and the body killing them off. This process we call “Equilibrium”. Prostate cancer in old men is a good example of a stable equilibrium in that the cancer causes little or no trouble, and the patient dies of old age with the cancer and not because of it. If the cancer is able to beat the immune defences, it the enters a state of “Escape” and begins to spread and cause trouble. A good example of this is a condition called mesothelioma. This occurs when asbestos (used a lot in the past for lagging and insulating hot pipes as well as in things like brake pads) is inhaled. Asbestos is a mineral and shaped in tiny needles which damage the lungs and induce inflammation – the body’s way of trying to get rid it. Because it is impossible to remove, the body tries to wall it off by forming fibrous tissue around the needles and this produces a condition called “asbestosis”.  Unfortunately, after many years, the chronic inflammation results in the formation of malignant change in these fibrous cells resulting in a nasty cancer, mesothelioma, and once these escape the patient is doomed. It is the constant irritation that results in malignance after many years in this case. These are the three “E”’s of cancer development. In each case, it is the relationship between the cancer and the immune system that decides the outcome. Anything that can keep your immunity on its toes is bound to be of benefit and the key is to help reduce the chronic inflammatory process so that the body wins. There are many examples of such cancers and a common one in western society is colon and rectal cancer. In the USA, some 150,000 people will develop it each year, and there will be some 1.8million cases worldwide. It is the third commonest cancer and the second biggest killer. Whilst there is a hereditary tendency to develop this, there is no doubt that in general it is strongly related to diet and lifestyle and this is why we are so keen to harness the power of the microbiome and keep the immune system tuned.  We know that patients with chronic ulcerative colitis (UC) have a higher risk of developing cancer and the longer they are affected, the greater the risk. In rough terms, if you have chronic UC for 20 years you have a cancer risk of 20%, and if for 30 years it rises to 30%. Colonic inflammation is a bad thing. More worrying, is the recent observation from the US National Cancer Institute that the incidence of colon cancer is increasing in younger age groups and nearly one third of cases of rectal cancer are in those under 55.  What can be causing this? Usually, colorectal cancer is a disease of older people and those seen in the young tend to be the familial (genetic) kind. This observation is worrying because it is not all genetics and one has to look for an environmental cause. Clearly, it is likely to be related to lifestyle and diet. Eating foods that are processed and rich in the wrong fats as well as a poor fibre intake have long been suspected as culprits. The current improved understanding of the microbiome corroborates this and shows we need to really work at getting our gut in good order, hence the term “farming” the microbiome. You have to work at it! Further evidence supports a possible role for aurum in that it has been shown that induced colitis and adenoma formation (these are precursors for cancer) are prevented in experimental models where stress is also prevented. In summary, you need a well-tuned immune system, helped by a well-tended microbiome, and a good Natural environment allowing you to keep stress at bay if you are to remain healthy!   View this post on Instagram A post shared by Aurum+ (@weareaurumplus)