April 24, 2025 • 35 mins
Please answer a few questions to help my podcast
The microbiome receives lots of attention, but what do we really know? In this episode, Dr. Bobby unpacks whether your gut bacteria are truly the key to preventing disease—or if the science still needs to catch up.
Microbiome buzz is everywhere—from promises of inflammation relief and weight loss to claims about mental health and longevity. But what does the research actually say? Dr. Bobby begins with four essential questions: Is the microbiome important? Does it change based on our habits? Do those changes cause disease? And can restoring it improve our health?
Using his open-minded skeptic lens, Dr. Bobby explains that while mouse studies offer compelling clues—like the famous “fat mouse, skinny poop” experiments showing weight gain linked to microbiome transplants—the same effects haven’t translated reliably in humans. A rare exception is C. difficile colitis. Here, fecal transplants have up to a 90% success rate, with medical societies endorsing this approach (source).
For other conditions like diabetes, rheumatoid arthritis, and Crohn’s disease, microbiome disruptions are well-documented. Still, whether these disruptions cause the illness—or are just innocent bystanders—is unclear. In diabetes, for instance, small studies and reviews show possible improvement in insulin sensitivity after fecal transplants (source) and mixed outcomes with probiotics (source), but nothing rivals the proven power of standard therapies like metformin.
Dr. Bobby also explores whether lifestyle choices—such as eating more fermented foods, fiber, and taking probiotics—can truly “reset” your microbiome and keep us healthy. The answer? These may enhance diversity and gut health, but current data doesn’t yet confirm long-term disease prevention. He references findings from the NIH Human Microbiome Project (source) and other studies showing how gut bacteria influence immune development, vitamin production, and digestion (source).
He also touches on terminology: probiotics are live bacteria (think yogurt and kombucha), prebiotics are their food (found in beans and whole grains), and postbiotics are beneficial byproducts. Each plays a role, but their direct impact on human disease remains uncertain.
Dr. Bobby closes with this: he enjoys homemade yogurt and sauerkraut, but doesn’t chase expensive probiotic supplements. “It can’t hurt and might help,” he says—but don’t expect probiotics to fully replace conventional treatment. As research evolves, he’ll continue to watch the space closely—and encourages listeners to let him know if this type of deep-dive, still-unsettled topic resonates.
Takeaways:
- Fecal transplants are a proven, effective microbiome treatment—for C. difficile, not for general wellness.
- Most microbiome buzz comes from animal studies, and evidence in humans is still preliminary and inconsistent.
- Eating more fiber and fermented foods likely supports gut health, but won’t replace proven medical treatments.
Complete Dr. Bobby’s feedback survey here to help shape future episodes.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Should we care about our microbiome?
Ideally, we'd have clearevidence showing that we're
healthy.
When we have a healthymicrobiome, our biome gets
disrupted and now illness occurs, and then, by getting our
microbiome back in shape, thehealth problem resolves.
(00:23):
Back in shape, the healthproblem resolves.
Unfortunately, we don't havethis type of evidence for most
of what folks say about ourmicrobiome Promising yes,
settled Much less so.
Speaker 2 (00:53):
Hi, I'm Dr Bobby Du Bois and welcome to Live Long
and Well a podcast where we willtalk about what you can do to
live as long as possible andwith as much energy and vigor
that you wish.
Together, we will explore whatpractical and evidence-supported
steps you can take.
Come join me on this veryimportant journey and I hope
that you feel empowered alongthe way.
(01:14):
I'm a physician, ironman,triathlete and have published
several hundred scientificstudies.
I'm honored to be your guide.
Speaker 1 (01:28):
Welcome my dear longevity-oriented listeners to
episode 36, the Microbiome, theFountain of Health, or we Just
Don't Know.
Well, if you read headlines andI certainly do they tell us
(01:48):
that the microbiome criticallydetermines our overall health,
whether we have inflammatorydiseases, whether we're gonna
lose weight, get diabetes, heartdisease, depression.
Now, is that proven?
Well, let's try to sort throughthe evidence together, and
(02:10):
there are a few questions that Ithink frame that dialogue.
First, is our microbiomeimportant to us?
Two, does our microbiome changeor get disrupted by things we
do or things that we eat?
Third, does an alteredmicrobiome lead to disease or is
(02:35):
it just an innocent bystanderand it is not the cause of the
disease?
And four, can we treat themicrobiome and those diseases
get better?
Well, what are the answers tothese questions?
Yes, the answer is that themicrobiome seems to be so
(02:58):
important and changing it canimprove our health if you're a
certain type of genetic mouse,but for people it's less clear.
Well, as my dear listeners know,I try at the beginning of each
episode to explain why.
Now, why are we talking aboutthis topic now?
(03:22):
And, as my listeners know, Itypically focus on areas where
the evidence is pretty clear,either pro or con, but it's
pretty clear.
Are there evidence-basedapproaches to improve sleep?
We've talked about that.
Of course the answer is yes.
Does exercise lower our risk ofheart disease?
(03:43):
Yes, is coffee good or bad foryou?
Listen to my episode and you'llbe reminded what I thought there
.
And the converse there's noevidence that I could find to
support the urban myth of eightglasses of water a day.
So up until now, all of theepisodes I've done now, I've
(04:06):
avoided topics where therereally isn't a clear answer from
the evidence, like themicrobiome, or I haven't talked
about artificial sweeteners orstem cell injections into our
joints or peptides or fluoridein the water, and I've generally
(04:26):
felt up until now that you know, talking about these topics
really might not be very helpfulfor you because there isn't a
straightforward answer.
But then I realized and you, myreaders, have sent me lots of
requests for topics I realizedthat if I'm uncertain about
(04:48):
these topics then obviously manyof you would also be uncertain.
So what I do bring to the tableis an ability to look at the
evidence, and maybe it'll behelpful to you for me to
summarize the evidence and tellyou what we know and what we
don't know, even if we don'tsolve the fundamental question
(05:12):
about the importance of amicrobiome or fluoride or
whatever it might be.
As always, I try to be anunbiased observer on these
topics.
Now, we all have biases.
I have a bias when I thinkabout how I approach new topics.
I like to think of myself assort of an open-minded skeptic,
(05:39):
meaning I don't jump in andassume it's all true, but I'm
open-minded about that topic.
So for my own case, themicrobiome before I began this
journey I was a bit skeptical,but I was open-minded and after
reading a lot of evidence andsummarizing, I have definitely
(06:01):
become more intrigued about itsimportance.
Am I convinced?
In some areas, yes, but in mostareas not quite yet.
Well, I'm not going to knowwhether this helps you without
you letting me know.
I have a questionnaire thatwill ask you just a few
questions about my podcast.
(06:22):
Please go to it, answer it.
I've added a new question thatrelates to these type of more
uncertain topic areas.
Let me know what you thinkabout it, because otherwise I
really don't know how I can besthelp you.
Okay, time for the microbiomebackstory.
Well, the claims about themicrobiome and its importance in
(06:47):
health and in disease areremarkable.
The implication is, if we couldonly just fix our microbiome,
you could cure inflammation andlose weight more readily, not
have diabetes or other kinds ofthings.
Now it isn't just headlines.
There are over 250 companiesreally focused on the microbiome
(07:12):
.
There are tens of thousands ofscientific studies.
Of course, I went to the expert, which is Amazon, and asked how
many books are there?
Now, amazon, in its summary,doesn't say how many books.
Once it's beyond 1,000.
But there's at least 1,000books on the microbiome that are
(07:33):
indexed in Amazon and there'sat least over 1,000 supplement
choices.
Again, they don't tell me ifit's 5,000, 10,000 or more.
There's lots and lots ofexcitement about this.
There's lots of studies but, aswe'll find, almost all of the
work has been in the laboratoryor in animals, where, in these
(07:59):
animals, we might artificiallycreate an abnormal microbiome
and bad things seem to happen tothe animals.
They get sick and then, forthose animals, we give them a
good microbiome and things seemto get better.
But you know, mice are notpeople.
Well, in this uncertain topicarea, I will do my best to tell
(08:24):
you what seems to be convincingand what may not yet be.
Well, we need some backgroundinformation about what is the
microbiome so that we're all onthe same page as we sort through
this.
We have trillions of bacteriathat are just sitting around in
(08:47):
our mouth, our nose, in women'svaginas and in the gut, and the
gut has received the mostattention.
It's also all over our skin.
Most of the discussion of theGI tract and the microbiome is
(09:08):
focused on bacteria, but themicrobiome also has viruses and
fungi and parasites.
So that's a piece of thispuzzle.
Although we know less about that, a lot of the excitement about
the microbiome is the vastquantity of it.
There's more bacteria in ourmicrobiome than there are cells
(09:29):
in our body.
How can we just ignore thatnumber of things in our body?
And if you add up all thegenetic material, that
information in each and everyone of those bacteria, it's
perhaps 100 or 150 times moregenetic information from those
(09:52):
microbiome bacteria than thereare in our own body.
There are thousands of speciesof bacteria in our bodies and,
as the research goes that, if wehave a healthy gut, if we are
doing really, really well, wehave many, many, many, many many
(10:12):
types of those bacteria in ourGI tract.
There's diversity.
Now I will point out it doesnot appear there's such a thing
as an optimal microbiome.
We all differ.
It's not like a blood pressureor cholesterol, which I can tell
you.
This is a safe number.
This is where it starts to getmore risky.
(10:34):
We honestly don't know what theperfect microbiome is.
And we each have our own profileand it changes over time and it
varies by location.
Our small intestine has certainsets of bacteria.
Our large intestine may havedifferent and that diversity may
change as we get older,especially after age 70.
(10:56):
People talk about some of thebacteria lactobacillus and
bifidobacterium and that theseare good bacteria to have.
And there's now excitementabout a bug called Ackermansia
that is hard to grow in the laband that's why we didn't know it
(11:16):
was around as much as it is.
So a lot of excitement there.
Initially, when we'redeveloping in our mother's
uterus, we don't have amicrobiome, but as we get
delivered through a vaginalapproach, we pick up the
microbiome from our mothers.
(11:37):
If you have a C-section youdon't quite get that and there's
some question about what thatdoes for us and the development
of the young baby.
So what does the microbiome do,or what do we think it does and
I'll focus for the moment onthat predominant thing which are
the bacteria.
Well, one of the things yourmicrobiome bacteria do is they
(12:01):
help us to digest food.
Think of a yummy piece ofbroccoli, and especially the
really starchy, cellulose-ladenstem that's hard for our normal
stomach acids and acids in ourintestine to break down by
itself.
Those fibers, those starches,those complex carbohydrates need
(12:25):
help, and the microbiomebacteria help us to digest that.
So if we didn't have a goodmicrobiome, we might not be able
to break down some of our foodsand get the nutrients from them
.
It's also a protection scheme.
Imagine having soldiers thatfight off invaders.
(12:48):
Well, good bacteria in ourmicrobiome help, as the theory
goes, to fight off bad bacteria.
So if you have a healthymicrobiome, you can resist some
of these pathogens anddisruptions.
Also, the microbiome bacteriahelp us to synthesize certain
(13:10):
vitamins, certain B vitamins andK vitamins that otherwise we
might not have.
So we're very thankful for themfor doing that.
And the microbiome in our GItract helps in the development
of our immune system, and it mayhave something to do with
(13:30):
changes in our immune systemover time.
Well, I want to at leastmention a few terminology
elements, because we hear aboutthem and we often get confused.
So the probiotic when you hearpeople say you should take
probiotics, that's giving thegood bacteria.
So if you have yogurt orpickled vegetables or kombucha
(13:54):
or kefir or sauerkraut, that isfull of some of these bacteria,
and so that's why you'll oftenhear that this would be good for
us to eat on a regular basis,or you might hear about
supplements that containcapsules of these type of
bacteria.
So that's a probiotic.
(14:14):
A prebiotic is basically givingyour bacteria the right food.
So if you eat pectin andindigestible carbohydrates, like
whole grains and beans andcertain fruits, that may help
(14:34):
our microbiome as a prebiotic,because we're giving food to
those bacteria.
Now it also might increase gasthat develops, but it also helps
those bacteria.
Then there's something calledpostbiotics.
Now these bacteria may producecertain compounds that could be
(14:56):
beneficial.
So a postbiotic is giving thosecompounds that might help us as
well.
So this is what's supposed tohappen when you have a happy,
diverse microbiome.
But obviously we're having thistopic because we think it has
something to do with disease.
So now let's think a little bitabout disrupting the microbiome
(15:21):
.
So first we've talked about thehappy microbiome and some of
the things it's doing for us.
But that biome can getdisrupted and that has a fancy
name, which is called dysbiosis.
So you may have heard the worddysbiosis, but it's just a
disruption in the microbiome andwhen that happens, the bacteria
(15:42):
change.
You get more of this type, lessof that type.
The diversity of having lots ofdifferent types of bacteria may
lessen.
Well, there are various thingswe know that can disrupt your
microbiome, things likeantibiotics and laxatives and
certain hormones and certainother drugs, proton pump
(16:03):
inhibitors and the like.
But other times our microbiomechanges and we're not exactly
sure why.
Is it something we ate?
Was it additives in certain ofour processed foods?
Is it just bad luck?
Or is the microbiome changes?
(16:25):
Is it due to other diseases ofthe body?
So here is the crux of so muchof the discussion and
controversy Do changes in themicrobiome, which, as we'll talk
about, really really do occur?
Does that lead to the disease?
And the converse if we canreset the microbiome, will it
(16:52):
cure the diseases?
So our last episode, we talkabout flossing and I made the
argument that oral health, whichis related to bacteria and
things in our mouth and gums,might be related to heart
disease.
And, as I mentioned, is it thatthe bad bugs or the change in
(17:12):
the bugs, or the bugs that canget in our body from injured
tissues in the mouth, does itcause the heart disease?
Or is there a common link?
Like smoking, smoking causesheart disease.
Smoking also disrupts our mouthhealth.
Smoking causes heart disease.
Smoking also disrupts our mouthhealth.
So is it the bad bacteriagetting in our body causing
(17:34):
heart disease, or is itsomething else that just the
changes we observe in thebacteria is an innocent
bystander?
That is the critical question.
And, as you've heard me andothers say, correlation is not
causation.
So seeing a disruptedmicrobiome in people with
(17:56):
diabetes or MS or other thingsdoesn't mean that disruption
caused the disease.
And if it didn't cause thedisease, then improving your
microbiome may not affect thedisease by very much.
This is the crux Is it thecausative factor or is it just
(18:19):
an innocent bystander?
And it's so important becauseif it's the causative factor,
then we want to protect ourmicrobiome and when our
microbiome gets unhappy, we wantto help it get back to being
healthy.
That's the crux of this.
So, as I said, when I began myjourney of looking at the
evidence here, I began with someskepticism.
(18:41):
But as I read more some ofwhich I already had known, but
some of which I obviouslylearned and knew there are
definitely areas where I amconvinced the microbiome is
front and center causes theproblem and we can make it
(19:04):
better.
But I'll then get ourselvesinto the areas where the
evidence, frankly, isn't soconvincing.
So let's begin with where Ithink it's really solid that the
microbiome is at the center ofa health problem and that's in a
colon infection or largeintestine called C difficile,
clostridium difficile.
Sometimes these bad evilbacteria take over in our colon
(19:30):
and when that happens, it causescolitis or inflammation of our
colon.
This often often typicallyhappens after patients have been
given antibiotics, often in thehospital, where these are
really strong antibiotics andthey wipe out all the good
bacteria in our colons and thebad ones, the C difficile ones,
(19:54):
take over.
This is a really big deal and ithas a high mortality.
From 6 to 30% of peoplehistorically who got C difficile
colitis died and there's been atremendous amount of excitement
around what are called fecaltransplants.
(20:15):
Now it probably sounds kind oflike what you think it is, which
is you're going to take stoolor the elements of stool from a
healthy person and put it intopeople who have this infection,
or sometimes they even collectit from you before you go to
surgery and have big antibiotics.
So you're ready if you needthis transplant.
(20:38):
And it turns out these fecaltransplants, which is putting
good bacteria back into yoursystem, has an 80 to 90% success
rate for this C difficilecolitis, so you're improving the
biome and it fights off thosebad bacteria and people get
(21:01):
better.
And this is getting to be verywell accepted Specialty
academies you know the groupsthat license and certify certain
doctor's specialties.
They are supporting this.
So I would say the evidence hereis really strong, really
convincing for this one area.
But is there convincingevidence in other areas?
(21:25):
There's been a tremendousamount of focus on weight gain
and weight loss and whether ourmicrobiome might determine
whether we're likely to gainweight or whether we might be
able to stay skinny.
Now I would say there iscompelling evidence.
But there's compelling evidenceif you're a mouse.
(21:48):
So there's been a whole seriesof really exciting what I call
fat skinny mice studies.
And what do they do?
Well, they take obese mice andtake the poop from the obese
mice.
So you're getting themicrobiome, the bacteria, and
you give it to skinny mice and,lo and behold, the skinny mice
(22:09):
get fat.
Well, conversely, if you takeskinny poop and give it to fat
mice, the fat mice get skinny.
Wow, this is amazing.
And if you take the poop fromobese humans and give it to the
skinny mice, lo and behold, theyget fat.
But when you try this in peopleand it has been tried in people
(22:32):
and you give skinny poopelements to obese folks, it
doesn't change their BMI, theirweight.
So this is typical of themicrobiome field and it's why
I've sort of tended to avoidtalking about it in other topics
like this.
The mouse information isfascinating, but it either
(22:56):
doesn't work in people or ithasn't really been tested in
people.
And to make matters even worse,these are not normal mice.
Because you might say, well, itworks in normal mice, it might
work in normal dogs, and if itworks in normal dogs it might
work in chimpanzees and then inpeople.
But these are not normal mice.
These are genetically andspecially raised mice that
(23:22):
really begin their life with nobacteria in their guts.
These are like a blank canvas.
Bacteria in their guts, theseare like a blank canvas.
So I think this is anextraordinarily exciting set of
data, but do I think it appliesto humans?
At the moment I can't quite seethat it does.
We'll learn more, maybe peoplewill try new approaches, maybe
(23:45):
it'll work.
Okay, so we've talked about thecolitis.
That seems to be important, fat, skinny mice, important for the
mice.
Let's go on to some otherdiseases where there's a lot of
discussion around the microbiomeand that is immune diseases,
inflammation diseases, thingslike ulcerative colitis or
(24:07):
Crohn's disease or rheumatoidarthritis or multiple sclerosis.
So we do know, as babies aredeveloping, you have immune
cells in our intestines and theyhelp develop our immune system.
And as you get older, theseparts of our intestine produce
(24:32):
antibodies and certain types ofcells, t-cells.
And we know that if there'sdysbiosis, if there's
disruptions in our microbiome inour intestines, that immune
development might be affected.
And so here's one of thetheories or mechanisms.
(24:55):
Now, mechanism isn't evidenceof what happens, it just gives
us a theory.
So if you have a good biome,some bad compounds that get into
our intestines may not beabsorbed.
But if you have a bad biome andyou can't protect yourself,
some of these compounds caninjure your intestines and when
(25:18):
the intestinal wall is injured,some of those bad things can get
in our bodies and raiseinflammation blood things,
things that we could measure,like C-reactive protein or
interleukin-6.
And these things that get inthe body and cause these changes
(25:38):
in our markers might causeinflammation.
So that's the theory.
Theory is great, but what do weknow in people?
Well, if you have ulcerativecolitis or Crohn's disease and
so you have really badinflammation in your intestines
and it causes really severedisease both in your intestine
(26:00):
and sometimes in the rest ofyour body, that when we find
these people and we look attheir microbiome, they're often
disrupted, they often havechanges.
That seem to be a problem.
But, as I said earlier, doesone cause the other?
Is it that disrupting themicrobiome at some level causes
(26:25):
us to develop, or at least maybethose of us that are
genetically predisposed to getulcerative colitis or Crohn's
disease?
Or does that disruption of theintestines for some reason we
don't really understand?
Does it change the microbiome?
So the microbiome is justsitting there and reflecting the
(26:46):
disease, not causing it.
Because of course, what you'dlike to find is if it's causing
the disease, then we can treatit.
Treat the microbiome, treat thedisease.
People get better.
So there have been studies ofgiving probiotics to people with
ulcerative colitis and Crohn'sdisease and a meta-analysis or a
(27:07):
summary of nine studies wherethey did this.
They found on balance it didn'thelp people with Crohn's
disease.
So with Crohn's disease maybethe microbiome isn't causing the
problem and solving themicrobiome may not solve the
problem.
But for ulcerative colitisthere are some people who seem
(27:29):
to get some benefits.
So it was inconsistent, butmaybe in the future it will be
more effective.
Well, what about multiplesclerosis?
Here too, the microbiome seemsdisrupted.
There are some interestinganimal studies.
There's one small study inpeople which showed a little bit
(27:50):
of benefit from takingprobiotics In rheumatoid
arthritis.
There's been a meta-analysis ofnine studies only 360 total
people.
So these are really tinystudies and they found that
probiotics might improve some ofthe markers of inflammation.
So the blood tests got a littlebit better, but it didn't seem
(28:13):
to change the symptoms.
So changing the blood tests butnot changing the symptoms, I'm
not sure how helpful that is.
Well, what about diabetes?
A lot of focus on diabetes.
Yes, if you take the microbiomeof people with diabetes, it
looks different.
It absolutely does, andsometimes it looks like that
(28:35):
disrupted or changed biome isassociated with worse blood
sugar control.
But it's always the samequestion Where's the chicken and
where's the egg?
Which causes which?
So in animals, probiotics canimprove the microbiome of the
animals and it does seem toimprove blood sugar control.
(28:58):
But in people we really don'tknow.
There was a tiny, tiny study ofnine people where they took the
microbiome of lean people andgave it to those who were
overweight or had metabolicsyndrome, and they found that,
lo and behold, they couldimprove the microbiome, give it
back its diversity, and therewas some improvements in insulin
(29:22):
sensitivity.
But will it treat the disease,treat the diabetes?
We just don't know.
There was a systematic review,a summary of 33 clinical trials.
Will it treat the disease,treat the diabetes?
We just don't know.
There was a systematic review,a summary of 33 clinical trials
on probiotics for people withdiabetes.
Some showed some improvementsin blood sugar, some showed some
improvements in blood pressure,some showed some improvements
(29:43):
in cholesterol levels, but itwas really inconsistent and no
study showed improvements in allthese different key areas.
Now, does this mean that themicrobiome isn't going to help
us for diabetes?
That's possible.
It's possible that we reallydon't have a connection like we
(30:04):
think, but we may not have shownthe benefit because the studies
aren't very high quality.
They're often very tiny andwhen you give people probiotics
it's not like giving a statinwhere we know exactly what
you're receiving and what dose.
The microbiome replacements,the probiotics, the microbiome
(30:33):
replacements, the probioticsit's a mishmash of different
things.
So it's not a standardizedtherapy.
So maybe we're not seeing thebenefits that are possible
because the therapy isn'tstandardized, but when I take a
giant step back.
So maybe the microbiome andtreating it could help our
diabetes?
Yes, it might, but at thispoint it's tiny amounts.
(30:53):
It's not going to replace yourmetformin or your ozempic or
other kinds of things, and thereis some data that suggests well
.
Maybe, as an addition toregular diabetic therapy,
changes to your microbiomeprobiotics might be helpful.
Okay, let's step back andsummarize.
(31:17):
There's a lot of excitement inthis area.
There's really compelling animaldata, especially in mice, and
there's lots of data that whenyou have certain diseases, the
microbiome is disrupted.
And there's only, though, asmall number of areas where
(31:37):
changing the microbiome back tosomething that looks more normal
makes a big difference, and wetalked about the C difficile
colitis, and maybe there's someinteresting data in many of the
other areas.
A lot of it is in animals.
Okay, so the risk is low.
What's the harm in eating somemore fiber and fermented foods?
(32:02):
It sounds good, it's not goingto hurt you and maybe, maybe it
will help.
So why not going to hurt you?
And maybe, maybe it will help.
So why not?
But keep in mind that thebenefits so far although there
is possible, there are somebenefits it's not going to
replace traditional, effective,proven therapy for your
(32:22):
rheumatoid arthritis or yourCrohn's disease or your diabetes
.
So it may be something to do.
It may help the disease, but itprobably, at this point, isn't
going to solve the problems.
And, of course, the keyquestion for all of us is if we
(32:43):
maintain a healthy biome byeating good foods and things
like that healthy biome, byeating good foods and things
like that will it help us avoidgetting chronic disease?
This is the ultimate question,but it's the ultimate question I
did not find an answer to.
It's an intriguing area ingeneral.
(33:05):
It's evolving and I'll followit closely and as key
information comes up, I'll shareit with you.
Well, do I feel good when I eatsome yogurt?
I do make homemade yogurt wecan talk about that another time
which is way better thanstore-bought.
Do I eat sauerkraut and feelgood about it?
(33:25):
Yeah, I do, but it isn'tsomething I require myself to do
every day.
I am certainly not rushing outand buying expensive probiotic
supplements, but it might behelpful in some cases.
It's certainly simple to do andif you like those foods, even
(33:45):
better.
Well, before we say goodbye, didthis type of episode work for
you?
Please let me know, send mecomments, take that
questionnaire.
That's a link in the show notes.
Let me know if episodes wherewe don't really have a simple
answer, whether you like them,whether you're actually
listening to them, or you shutdown and turn it off and go to
(34:09):
some other podcast fairlyquickly.
So, with all of that, I enjoydiving into topics and sharing
them with you.
I hope you get something fromit and, with some feedback from
you, I'll know whether to domore topics like this in the
near future.
So take care, enjoy yourmicrobiome, have your yogurt or
(34:31):
your sauerkraut if you wish.
It can't hurt, may help.
Stay tuned for more evidence.
Speaker 2 (34:42):
Thanks so much for listening to Live Long and Well
with Dr Bobby.
If you liked this episode,please provide a review on Apple
or Spotify or wherever youlisten.
If you want to continue thisjourney or want to receive my
newsletter on practical andscientific ways to improve your
health and longevity, pleasevisit me at
(35:05):
drbobbilivelongandwellcom.
That's, doctor, as in D-R Bobby.
Live long and wellcom.
Should we care about our microbiome?
Ideally, we'd have clearevidence showing that we're
healthy.
When we have a healthymicrobiome, our biome gets
disrupted and now illness occurs, and then, by getting our
microbiome back in shape, thehealth problem resolves.
(00:23):
Back in shape, the healthproblem resolves.
Unfortunately, we don't havethis type of evidence for most
of what folks say about ourmicrobiome Promising yes,
settled Much less so.
Speaker 2 (00:53):
Hi, I'm Dr Bobby Du Bois and welcome to Live Long
and Well a podcast where we willtalk about what you can do to
live as long as possible andwith as much energy and vigor
that you wish.
Together, we will explore whatpractical and evidence-supported
steps you can take.
Come join me on this veryimportant journey and I hope
that you feel empowered alongthe way.
(01:14):
I'm a physician, ironman,triathlete and have published
several hundred scientificstudies.
I'm honored to be your guide.
Speaker 1 (01:28):
Welcome my dear longevity-oriented listeners to
episode 36, the Microbiome, theFountain of Health, or we Just
Don't Know.
Well, if you read headlines andI certainly do they tell us
(01:48):
that the microbiome criticallydetermines our overall health,
whether we have inflammatorydiseases, whether we're gonna
lose weight, get diabetes, heartdisease, depression.
Now, is that proven?
Well, let's try to sort throughthe evidence together, and
(02:10):
there are a few questions that Ithink frame that dialogue.
First, is our microbiomeimportant to us?
Two, does our microbiome changeor get disrupted by things we
do or things that we eat?
Third, does an alteredmicrobiome lead to disease or is
(02:35):
it just an innocent bystanderand it is not the cause of the
disease?
And four, can we treat themicrobiome and those diseases
get better?
Well, what are the answers tothese questions?
Yes, the answer is that themicrobiome seems to be so
(02:58):
important and changing it canimprove our health if you're a
certain type of genetic mouse,but for people it's less clear.
Well, as my dear listeners know,I try at the beginning of each
episode to explain why.
Now, why are we talking aboutthis topic now?
(03:22):
And, as my listeners know, Itypically focus on areas where
the evidence is pretty clear,either pro or con, but it's
pretty clear.
Are there evidence-basedapproaches to improve sleep?
We've talked about that.
Of course the answer is yes.
Does exercise lower our risk ofheart disease?
(03:43):
Yes, is coffee good or bad foryou?
Listen to my episode and you'llbe reminded what I thought there
.
And the converse there's noevidence that I could find to
support the urban myth of eightglasses of water a day.
So up until now, all of theepisodes I've done now, I've
(04:06):
avoided topics where therereally isn't a clear answer from
the evidence, like themicrobiome, or I haven't talked
about artificial sweeteners orstem cell injections into our
joints or peptides or fluoridein the water, and I've generally
(04:26):
felt up until now that you know, talking about these topics
really might not be very helpfulfor you because there isn't a
straightforward answer.
But then I realized and you, myreaders, have sent me lots of
requests for topics I realizedthat if I'm uncertain about
(04:48):
these topics then obviously manyof you would also be uncertain.
So what I do bring to the tableis an ability to look at the
evidence, and maybe it'll behelpful to you for me to
summarize the evidence and tellyou what we know and what we
don't know, even if we don'tsolve the fundamental question
(05:12):
about the importance of amicrobiome or fluoride or
whatever it might be.
As always, I try to be anunbiased observer on these
topics.
Now, we all have biases.
I have a bias when I thinkabout how I approach new topics.
I like to think of myself assort of an open-minded skeptic,
(05:39):
meaning I don't jump in andassume it's all true, but I'm
open-minded about that topic.
So for my own case, themicrobiome before I began this
journey I was a bit skeptical,but I was open-minded and after
reading a lot of evidence andsummarizing, I have definitely
(06:01):
become more intrigued about itsimportance.
Am I convinced?
In some areas, yes, but in mostareas not quite yet.
Well, I'm not going to knowwhether this helps you without
you letting me know.
I have a questionnaire thatwill ask you just a few
questions about my podcast.
(06:22):
Please go to it, answer it.
I've added a new question thatrelates to these type of more
uncertain topic areas.
Let me know what you thinkabout it, because otherwise I
really don't know how I can besthelp you.
Okay, time for the microbiomebackstory.
Well, the claims about themicrobiome and its importance in
(06:47):
health and in disease areremarkable.
The implication is, if we couldonly just fix our microbiome,
you could cure inflammation andlose weight more readily, not
have diabetes or other kinds ofthings.
Now it isn't just headlines.
There are over 250 companiesreally focused on the microbiome
(07:12):
.
There are tens of thousands ofscientific studies.
Of course, I went to the expert, which is Amazon, and asked how
many books are there?
Now, amazon, in its summary,doesn't say how many books.
Once it's beyond 1,000.
But there's at least 1,000books on the microbiome that are
(07:33):
indexed in Amazon and there'sat least over 1,000 supplement
choices.
Again, they don't tell me ifit's 5,000, 10,000 or more.
There's lots and lots ofexcitement about this.
There's lots of studies but, aswe'll find, almost all of the
work has been in the laboratoryor in animals, where, in these
(07:59):
animals, we might artificiallycreate an abnormal microbiome
and bad things seem to happen tothe animals.
They get sick and then, forthose animals, we give them a
good microbiome and things seemto get better.
But you know, mice are notpeople.
Well, in this uncertain topicarea, I will do my best to tell
(08:24):
you what seems to be convincingand what may not yet be.
Well, we need some backgroundinformation about what is the
microbiome so that we're all onthe same page as we sort through
this.
We have trillions of bacteriathat are just sitting around in
(08:47):
our mouth, our nose, in women'svaginas and in the gut, and the
gut has received the mostattention.
It's also all over our skin.
Most of the discussion of theGI tract and the microbiome is
(09:08):
focused on bacteria, but themicrobiome also has viruses and
fungi and parasites.
So that's a piece of thispuzzle.
Although we know less about that, a lot of the excitement about
the microbiome is the vastquantity of it.
There's more bacteria in ourmicrobiome than there are cells
(09:29):
in our body.
How can we just ignore thatnumber of things in our body?
And if you add up all thegenetic material, that
information in each and everyone of those bacteria, it's
perhaps 100 or 150 times moregenetic information from those
(09:52):
microbiome bacteria than thereare in our own body.
There are thousands of speciesof bacteria in our bodies and,
as the research goes that, if wehave a healthy gut, if we are
doing really, really well, wehave many, many, many, many many
(10:12):
types of those bacteria in ourGI tract.
There's diversity.
Now I will point out it doesnot appear there's such a thing
as an optimal microbiome.
We all differ.
It's not like a blood pressureor cholesterol, which I can tell
you.
This is a safe number.
This is where it starts to getmore risky.
(10:34):
We honestly don't know what theperfect microbiome is.
And we each have our own profileand it changes over time and it
varies by location.
Our small intestine has certainsets of bacteria.
Our large intestine may havedifferent and that diversity may
change as we get older,especially after age 70.
(10:56):
People talk about some of thebacteria lactobacillus and
bifidobacterium and that theseare good bacteria to have.
And there's now excitementabout a bug called Ackermansia
that is hard to grow in the laband that's why we didn't know it
(11:16):
was around as much as it is.
So a lot of excitement there.
Initially, when we'redeveloping in our mother's
uterus, we don't have amicrobiome, but as we get
delivered through a vaginalapproach, we pick up the
microbiome from our mothers.
(11:37):
If you have a C-section youdon't quite get that and there's
some question about what thatdoes for us and the development
of the young baby.
So what does the microbiome do,or what do we think it does and
I'll focus for the moment onthat predominant thing which are
the bacteria.
Well, one of the things yourmicrobiome bacteria do is they
(12:01):
help us to digest food.
Think of a yummy piece ofbroccoli, and especially the
really starchy, cellulose-ladenstem that's hard for our normal
stomach acids and acids in ourintestine to break down by
itself.
Those fibers, those starches,those complex carbohydrates need
(12:25):
help, and the microbiomebacteria help us to digest that.
So if we didn't have a goodmicrobiome, we might not be able
to break down some of our foodsand get the nutrients from them
.
It's also a protection scheme.
Imagine having soldiers thatfight off invaders.
(12:48):
Well, good bacteria in ourmicrobiome help, as the theory
goes, to fight off bad bacteria.
So if you have a healthymicrobiome, you can resist some
of these pathogens anddisruptions.
Also, the microbiome bacteriahelp us to synthesize certain
(13:10):
vitamins, certain B vitamins andK vitamins that otherwise we
might not have.
So we're very thankful for themfor doing that.
And the microbiome in our GItract helps in the development
of our immune system, and it mayhave something to do with
(13:30):
changes in our immune systemover time.
Well, I want to at leastmention a few terminology
elements, because we hear aboutthem and we often get confused.
So the probiotic when you hearpeople say you should take
probiotics, that's giving thegood bacteria.
So if you have yogurt orpickled vegetables or kombucha
(13:54):
or kefir or sauerkraut, that isfull of some of these bacteria,
and so that's why you'll oftenhear that this would be good for
us to eat on a regular basis,or you might hear about
supplements that containcapsules of these type of
bacteria.
So that's a probiotic.
(14:14):
A prebiotic is basically givingyour bacteria the right food.
So if you eat pectin andindigestible carbohydrates, like
whole grains and beans andcertain fruits, that may help
(14:34):
our microbiome as a prebiotic,because we're giving food to
those bacteria.
Now it also might increase gasthat develops, but it also helps
those bacteria.
Then there's something calledpostbiotics.
Now these bacteria may producecertain compounds that could be
(14:56):
beneficial.
So a postbiotic is giving thosecompounds that might help us as
well.
So this is what's supposed tohappen when you have a happy,
diverse microbiome.
But obviously we're having thistopic because we think it has
something to do with disease.
So now let's think a little bitabout disrupting the microbiome
(15:21):
.
So first we've talked about thehappy microbiome and some of
the things it's doing for us.
But that biome can getdisrupted and that has a fancy
name, which is called dysbiosis.
So you may have heard the worddysbiosis, but it's just a
disruption in the microbiome andwhen that happens, the bacteria
(15:42):
change.
You get more of this type, lessof that type.
The diversity of having lots ofdifferent types of bacteria may
lessen.
Well, there are various thingswe know that can disrupt your
microbiome, things likeantibiotics and laxatives and
certain hormones and certainother drugs, proton pump
(16:03):
inhibitors and the like.
But other times our microbiomechanges and we're not exactly
sure why.
Is it something we ate?
Was it additives in certain ofour processed foods?
Is it just bad luck?
Or is the microbiome changes?
(16:25):
Is it due to other diseases ofthe body?
So here is the crux of so muchof the discussion and
controversy Do changes in themicrobiome, which, as we'll talk
about, really really do occur?
Does that lead to the disease?
And the converse if we canreset the microbiome, will it
(16:52):
cure the diseases?
So our last episode, we talkabout flossing and I made the
argument that oral health, whichis related to bacteria and
things in our mouth and gums,might be related to heart
disease.
And, as I mentioned, is it thatthe bad bugs or the change in
(17:12):
the bugs, or the bugs that canget in our body from injured
tissues in the mouth, does itcause the heart disease?
Or is there a common link?
Like smoking, smoking causesheart disease.
Smoking also disrupts our mouthhealth.
Smoking causes heart disease.
Smoking also disrupts our mouthhealth.
So is it the bad bacteriagetting in our body causing
(17:34):
heart disease, or is itsomething else that just the
changes we observe in thebacteria is an innocent
bystander?
That is the critical question.
And, as you've heard me andothers say, correlation is not
causation.
So seeing a disruptedmicrobiome in people with
(17:56):
diabetes or MS or other thingsdoesn't mean that disruption
caused the disease.
And if it didn't cause thedisease, then improving your
microbiome may not affect thedisease by very much.
This is the crux Is it thecausative factor or is it just
(18:19):
an innocent bystander?
And it's so important becauseif it's the causative factor,
then we want to protect ourmicrobiome and when our
microbiome gets unhappy, we wantto help it get back to being
healthy.
That's the crux of this.
So, as I said, when I began myjourney of looking at the
evidence here, I began with someskepticism.
(18:41):
But as I read more some ofwhich I already had known, but
some of which I obviouslylearned and knew there are
definitely areas where I amconvinced the microbiome is
front and center causes theproblem and we can make it
(19:04):
better.
But I'll then get ourselvesinto the areas where the
evidence, frankly, isn't soconvincing.
So let's begin with where Ithink it's really solid that the
microbiome is at the center ofa health problem and that's in a
colon infection or largeintestine called C difficile,
clostridium difficile.
Sometimes these bad evilbacteria take over in our colon
(19:30):
and when that happens, it causescolitis or inflammation of our
colon.
This often often typicallyhappens after patients have been
given antibiotics, often in thehospital, where these are
really strong antibiotics andthey wipe out all the good
bacteria in our colons and thebad ones, the C difficile ones,
(19:54):
take over.
This is a really big deal and ithas a high mortality.
From 6 to 30% of peoplehistorically who got C difficile
colitis died and there's been atremendous amount of excitement
around what are called fecaltransplants.
(20:15):
Now it probably sounds kind oflike what you think it is, which
is you're going to take stoolor the elements of stool from a
healthy person and put it intopeople who have this infection,
or sometimes they even collectit from you before you go to
surgery and have big antibiotics.
So you're ready if you needthis transplant.
(20:38):
And it turns out these fecaltransplants, which is putting
good bacteria back into yoursystem, has an 80 to 90% success
rate for this C difficilecolitis, so you're improving the
biome and it fights off thosebad bacteria and people get
(21:01):
better.
And this is getting to be verywell accepted Specialty
academies you know the groupsthat license and certify certain
doctor's specialties.
They are supporting this.
So I would say the evidence hereis really strong, really
convincing for this one area.
But is there convincingevidence in other areas?
(21:25):
There's been a tremendousamount of focus on weight gain
and weight loss and whether ourmicrobiome might determine
whether we're likely to gainweight or whether we might be
able to stay skinny.
Now I would say there iscompelling evidence.
But there's compelling evidenceif you're a mouse.
(21:48):
So there's been a whole seriesof really exciting what I call
fat skinny mice studies.
And what do they do?
Well, they take obese mice andtake the poop from the obese
mice.
So you're getting themicrobiome, the bacteria, and
you give it to skinny mice and,lo and behold, the skinny mice
(22:09):
get fat.
Well, conversely, if you takeskinny poop and give it to fat
mice, the fat mice get skinny.
Wow, this is amazing.
And if you take the poop fromobese humans and give it to the
skinny mice, lo and behold, theyget fat.
But when you try this in peopleand it has been tried in people
(22:32):
and you give skinny poopelements to obese folks, it
doesn't change their BMI, theirweight.
So this is typical of themicrobiome field and it's why
I've sort of tended to avoidtalking about it in other topics
like this.
The mouse information isfascinating, but it either
(22:56):
doesn't work in people or ithasn't really been tested in
people.
And to make matters even worse,these are not normal mice.
Because you might say, well, itworks in normal mice, it might
work in normal dogs, and if itworks in normal dogs it might
work in chimpanzees and then inpeople.
But these are not normal mice.
These are genetically andspecially raised mice that
(23:22):
really begin their life with nobacteria in their guts.
These are like a blank canvas.
Bacteria in their guts, theseare like a blank canvas.
So I think this is anextraordinarily exciting set of
data, but do I think it appliesto humans?
At the moment I can't quite seethat it does.
We'll learn more, maybe peoplewill try new approaches, maybe
(23:45):
it'll work.
Okay, so we've talked about thecolitis.
That seems to be important, fat, skinny mice, important for the
mice.
Let's go on to some otherdiseases where there's a lot of
discussion around the microbiomeand that is immune diseases,
inflammation diseases, thingslike ulcerative colitis or
(24:07):
Crohn's disease or rheumatoidarthritis or multiple sclerosis.
So we do know, as babies aredeveloping, you have immune
cells in our intestines and theyhelp develop our immune system.
And as you get older, theseparts of our intestine produce
(24:32):
antibodies and certain types ofcells, t-cells.
And we know that if there'sdysbiosis, if there's
disruptions in our microbiome inour intestines, that immune
development might be affected.
And so here's one of thetheories or mechanisms.
(24:55):
Now, mechanism isn't evidenceof what happens, it just gives
us a theory.
So if you have a good biome,some bad compounds that get into
our intestines may not beabsorbed.
But if you have a bad biome andyou can't protect yourself,
some of these compounds caninjure your intestines and when
(25:18):
the intestinal wall is injured,some of those bad things can get
in our bodies and raiseinflammation blood things,
things that we could measure,like C-reactive protein or
interleukin-6.
And these things that get inthe body and cause these changes
(25:38):
in our markers might causeinflammation.
So that's the theory.
Theory is great, but what do weknow in people?
Well, if you have ulcerativecolitis or Crohn's disease and
so you have really badinflammation in your intestines
and it causes really severedisease both in your intestine
(26:00):
and sometimes in the rest ofyour body, that when we find
these people and we look attheir microbiome, they're often
disrupted, they often havechanges.
That seem to be a problem.
But, as I said earlier, doesone cause the other?
Is it that disrupting themicrobiome at some level causes
(26:25):
us to develop, or at least maybethose of us that are
genetically predisposed to getulcerative colitis or Crohn's
disease?
Or does that disruption of theintestines for some reason we
don't really understand?
Does it change the microbiome?
So the microbiome is justsitting there and reflecting the
(26:46):
disease, not causing it.
Because of course, what you'dlike to find is if it's causing
the disease, then we can treatit.
Treat the microbiome, treat thedisease.
People get better.
So there have been studies ofgiving probiotics to people with
ulcerative colitis and Crohn'sdisease and a meta-analysis or a
(27:07):
summary of nine studies wherethey did this.
They found on balance it didn'thelp people with Crohn's
disease.
So with Crohn's disease maybethe microbiome isn't causing the
problem and solving themicrobiome may not solve the
problem.
But for ulcerative colitisthere are some people who seem
(27:29):
to get some benefits.
So it was inconsistent, butmaybe in the future it will be
more effective.
Well, what about multiplesclerosis?
Here too, the microbiome seemsdisrupted.
There are some interestinganimal studies.
There's one small study inpeople which showed a little bit
(27:50):
of benefit from takingprobiotics In rheumatoid
arthritis.
There's been a meta-analysis ofnine studies only 360 total
people.
So these are really tinystudies and they found that
probiotics might improve some ofthe markers of inflammation.
So the blood tests got a littlebit better, but it didn't seem
(28:13):
to change the symptoms.
So changing the blood tests butnot changing the symptoms, I'm
not sure how helpful that is.
Well, what about diabetes?
A lot of focus on diabetes.
Yes, if you take the microbiomeof people with diabetes, it
looks different.
It absolutely does, andsometimes it looks like that
(28:35):
disrupted or changed biome isassociated with worse blood
sugar control.
But it's always the samequestion Where's the chicken and
where's the egg?
Which causes which?
So in animals, probiotics canimprove the microbiome of the
animals and it does seem toimprove blood sugar control.
(28:58):
But in people we really don'tknow.
There was a tiny, tiny study ofnine people where they took the
microbiome of lean people andgave it to those who were
overweight or had metabolicsyndrome, and they found that,
lo and behold, they couldimprove the microbiome, give it
back its diversity, and therewas some improvements in insulin
(29:22):
sensitivity.
But will it treat the disease,treat the diabetes?
We just don't know.
There was a systematic review,a summary of 33 clinical trials.
Will it treat the disease,treat the diabetes?
We just don't know.
There was a systematic review,a summary of 33 clinical trials
on probiotics for people withdiabetes.
Some showed some improvementsin blood sugar, some showed some
improvements in blood pressure,some showed some improvements
(29:43):
in cholesterol levels, but itwas really inconsistent and no
study showed improvements in allthese different key areas.
Now, does this mean that themicrobiome isn't going to help
us for diabetes?
That's possible.
It's possible that we reallydon't have a connection like we
(30:04):
think, but we may not have shownthe benefit because the studies
aren't very high quality.
They're often very tiny andwhen you give people probiotics
it's not like giving a statinwhere we know exactly what
you're receiving and what dose.
The microbiome replacements,the probiotics, the microbiome
(30:33):
replacements, the probioticsit's a mishmash of different
things.
So it's not a standardizedtherapy.
So maybe we're not seeing thebenefits that are possible
because the therapy isn'tstandardized, but when I take a
giant step back.
So maybe the microbiome andtreating it could help our
diabetes?
Yes, it might, but at thispoint it's tiny amounts.
(30:53):
It's not going to replace yourmetformin or your ozempic or
other kinds of things, and thereis some data that suggests well
.
Maybe, as an addition toregular diabetic therapy,
changes to your microbiomeprobiotics might be helpful.
Okay, let's step back andsummarize.
(31:17):
There's a lot of excitement inthis area.
There's really compelling animaldata, especially in mice, and
there's lots of data that whenyou have certain diseases, the
microbiome is disrupted.
And there's only, though, asmall number of areas where
(31:37):
changing the microbiome back tosomething that looks more normal
makes a big difference, and wetalked about the C difficile
colitis, and maybe there's someinteresting data in many of the
other areas.
A lot of it is in animals.
Okay, so the risk is low.
What's the harm in eating somemore fiber and fermented foods?
(32:02):
It sounds good, it's not goingto hurt you and maybe, maybe it
will help.
So why not going to hurt you?
And maybe, maybe it will help.
So why not?
But keep in mind that thebenefits so far although there
is possible, there are somebenefits it's not going to
replace traditional, effective,proven therapy for your
(32:22):
rheumatoid arthritis or yourCrohn's disease or your diabetes
.
So it may be something to do.
It may help the disease, but itprobably, at this point, isn't
going to solve the problems.
And, of course, the keyquestion for all of us is if we
(32:43):
maintain a healthy biome byeating good foods and things
like that healthy biome, byeating good foods and things
like that will it help us avoidgetting chronic disease?
This is the ultimate question,but it's the ultimate question I
did not find an answer to.
It's an intriguing area ingeneral.
(33:05):
It's evolving and I'll followit closely and as key
information comes up, I'll shareit with you.
Well, do I feel good when I eatsome yogurt?
I do make homemade yogurt wecan talk about that another time
which is way better thanstore-bought.
Do I eat sauerkraut and feelgood about it?
(33:25):
Yeah, I do, but it isn'tsomething I require myself to do
every day.
I am certainly not rushing outand buying expensive probiotic
supplements, but it might behelpful in some cases.
It's certainly simple to do andif you like those foods, even
(33:45):
better.
Well, before we say goodbye, didthis type of episode work for
you?
Please let me know, send mecomments, take that
questionnaire.
That's a link in the show notes.
Let me know if episodes wherewe don't really have a simple
answer, whether you like them,whether you're actually
listening to them, or you shutdown and turn it off and go to
(34:09):
some other podcast fairlyquickly.
So, with all of that, I enjoydiving into topics and sharing
them with you.
I hope you get something fromit and, with some feedback from
you, I'll know whether to domore topics like this in the
near future.
So take care, enjoy yourmicrobiome, have your yogurt or
(34:31):
your sauerkraut if you wish.
It can't hurt, may help.
Stay tuned for more evidence.
Speaker 2 (34:42):
Thanks so much for listening to Live Long and Well
with Dr Bobby.
If you liked this episode,please provide a review on Apple
or Spotify or wherever youlisten.
If you want to continue thisjourney or want to receive my
newsletter on practical andscientific ways to improve your
health and longevity, pleasevisit me at
(35:05):
drbobbilivelongandwellcom.
That's, doctor, as in D-R Bobby.
Live long and wellcom.
Popular Podcasts
Bookmarked by Reese's Book Club
Welcome to Bookmarked by Reese’s Book Club — the podcast where great stories, bold women, and irresistible conversations collide! Hosted by award-winning journalist Danielle Robay, each week new episodes balance thoughtful literary insight with the fervor of buzzy book trends, pop culture and more. Bookmarked brings together celebrities, tastemakers, influencers and authors from Reese's Book Club and beyond to share stories that transcend the page. Pull up a chair. You’re not just listening — you’re part of the conversation.
On Purpose with Jay Shetty
I’m Jay Shetty host of On Purpose the worlds #1 Mental Health podcast and I’m so grateful you found us. I started this podcast 5 years ago to invite you into conversations and workshops that are designed to help make you happier, healthier and more healed. I believe that when you (yes you) feel seen, heard and understood you’re able to deal with relationship struggles, work challenges and life’s ups and downs with more ease and grace. I interview experts, celebrities, thought leaders and athletes so that we can grow our mindset, build better habits and uncover a side of them we’ve never seen before. New episodes every Monday and Friday. Your support means the world to me and I don’t take it for granted — click the follow button and leave a review to help us spread the love with On Purpose. I can’t wait for you to listen to your first or 500th episode!
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com