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Copyrights: Copyright © 2015 by author(s) and International College of Human Nutrition and Functional Medicine

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Citation: Vasquez A. Translating Microbiome (Microbiota) and Dysbiosis Research into Clinical Practice: The 20-Year Development of a Structured

Approach that Gives Actionable Form to Intellectual Concepts.

Int J Hum Nutr Funct Med


International Journal of Human Nutrition and Functional Medicine

Photos © by Dr Vasquez, 2013-2015


Continuing Education

• Microbiome • Dysbiosis • Infectious Disease

Translating Microbiome (Microbiota) and Dysbiosis Research into

Clinical Practice: The 20-Year Development of a Structured

Approach that Gives Actionable Form to Intellectual Concepts

Alex Vasquez DC ND DO FACN

Experience and Perspectives

Many years ago when I published my first books


and articles


detailing "dysbiosis", the word could hardly be found in the

Medline index, the topic was controversial at best and ethereal

at worst, the term "microbiome" (first published in French in

1949 and in English in 1988) was virtually unknown, and I spent

most of the time and space in my lectures and articles

substantiating and defending the condition's existence. These

days, everyone is talking about microbiome, dysbiosis, "leaky

gut" (thanks largely to Leo Galland MD), and my 1996 article

on “Silent Infections and Gastrointestinal Dysbiosis" has been

downloaded at least 4,000 times and is one of the top 1% most

popular articles on



In the preparation of my

dysbiosis lecture at a major functional medicine conference in

2010, I found that only 180 Medline articles indexed the term

“dysbiosis”, and now—slightly less than five years later—more

than 1,200 articles index that term. Obviously, the dysbiosis

concept has become better known to the point of actually being

popular, but this does not mean that clinicians understand what

to do with it. A recent article from the June 2015 issue of



perfectly summarized this discrepancy between

microbiota research and clinical action: "

In the three years since

the completion of the first phase of the Human Microbiome

Project, the number of scientific papers linking the microbes

that live in our gut to diseases ranging from diabetes and colitis

to anxiety and depression has grown exponentially. Yet, these

tantalizing connections have yielded few benefits from a

therapeutics standpoint




To the extent that this information is

being integrated into clinical practice at all, the current level of

practical application is a bit indelicate and cumbersome beyond

the most commonly repeated advice of advocating probiotics,

avoiding antibiotics, perhaps delving into using botanical

antimicrobials and laboratory testing. Breath testing (an

insensitive test for only one subtype of gastrointestinal

dysbiosis) and microbiologic testing have become popular to the

point of overuse as doctors grapple for clinical clues.

(Noteworthy in the conversation on functional laboratory testing

is that one functional medicine laboratory in particular used

inaccurate proprietary microbe-identification methods to extract

millions of dollars of patient and physician money only to

deliver innumerable wasted hours in patient suffering and

ICHNFM has many videos on the topics of dysbiosis,

persistent infections, and dysbiotic clinical conditions such

as fibromyalgia at

"Dysbiosis" is an important concept, but doctors cannot

treat concepts.

We have to define, describe, and deconstruct the microbes,

molecules, and mechanisms into their components, then rebuild a

conceptual scaffold and intellectual structure that becomes a useful

tool that, with study and experience, can be used in a clinical

setting to effective benefit.