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International Journal of Human Nutrition and Functional Medicine

www.IntJHumNutrFunctMed.Org

2015 Final PDF

physician confusion due to misleading and worthless [e.g.,

"

parasite present: taxonomy unavailable

"] laboratory

information.

6

) So, despite the bloom in research and the

exponential public awareness of dysbiosis, much progress still

needs to be made in order to help clinicians—and ultimately

patients—better appreciate, assess, optimize and maintain

microbiotal health—eubiosis.

Clinical Importance

The priority is to understand the role of dysbiosis in clinical

disease; patients are suffering day-by-day and hour-by-hour

because of microbial colonization, bacterial allergy, reactive

arthritis, systemic inflammation, fibromyalgia, insulin

resistance, neurocognitive impairments, autoimmunity, and

other manifestations of dysbiosis. The basic science and clinical

research data on these various phenomena is crystal clear and

intellectually sound but is rarely delivered in a manageable

manner so that time-pressured clinicians can perceive the

information in an interconnected context that expedites clinical

application in patient assessment and treatment. Personally, I

have generally approached clinical care with a sense of urgency,

for altruistic reasons and because I know the experience of being

persistently ill—in my case, the situation lasted for seven years

and still occasionally recurs, as discussed later.

Dysbiosis-Triggered Illness: Deconstructing the

Phenomena and Helping Our Patients

Dysbiotic illness can ultimately be understood as a

manifestation of human intolerance of the total microbial load

(TML) and more specifically the total dysbiotic load (TDL)

which is only one part of the total inflammatory load (TIL),

alternately described as the total

impairment

load—that is, the

total load of physiologic, biochemical, and psychosocial

burdens that promote inflammation or any type of

metabolic/physiologic/mental impairment. As I have said for

many years, dysbiosis is a disease state best described as a "bad

relationship" wherein neither the host nor the microbe(s) are

unilaterally "at fault" but rather that they are—for a variety of

modifiable

and

nonmodifiable

reasons—currently

incompatible. Conceptualizing dysbiotic illnesses as a

relationship

rather than as an

infection

—an extension of the

acute infection model wherein the microbe is presumed guilty

gives us three major areas of intervention:

immunorestoration, tolerogenic or adaptive, antimicrobial.

Clinical pathophysiology of dysbiosis-induced disease

: The total microbial load communicates to the human body in

general and the innate/adaptive immune systems specifically from various locations via specific molecules, which then are

"combinatorially summarized" in conjunction with the patient's physiologic profile—including genetic makeup, nutritional status,

xenobiotic load, sleep and stress status—to produce a

pattern

of clinical manifestations. Doctors are trained to diagnose and

treat the resulting prototypic pattern rather than the problems contributing to the pattern.

Image from cover and text of Vasquez

A.

Human Microbiome and Dysbiosis in Clinical Disease

. Published, copyrighted ©, trademarked ® by Dr Alex Vasquez and

International College of Human Nutrition and Functional Medicine 2015. [ISBN 1512360295 / 9781512360295]