February 20, 2024

Balancing the Microbiome: Adding Evidence-Based Botanicals to Your Chiropractic Treatment Protocols

By Kristen Klos-Maki, DC

We’ve all been there. You’re back from a (very expensive) continuing education conference, and your head is swimming with ideas – but no practical application. It seems like no matter what additional seminars you attend, certificates you hold, or wisdom you’ve gained from years in practice, you still have mystery patients you just don’t know how to treat.

There’s good news: We now know the microbiome offers a powerful therapeutic target with far-reaching effects.

But what does the gut microbiome have to do with your chiropractic practice? Plenty!

As chiropractors, we know even a small adjustment can have broad and potent benefits. This is especially true when it comes to addressing the microbiome. In a small animal study, chiropractic therapies showed an increase in the richness and diversity of gut microbiota.¹

Research is currently exploding in this area – and with good reason. Dysbiosis (imbalance in the microbiome) is being identified as a root cause of myriad illnesses, many of which you regularly see in your practice. Once you know what patterns to look for, you will be equipped to solve the root-cause mysteries that formerly stymied you.

For example, do you see any of these clinical presentations?

Knee pain leading to back pain and eventual migraine²
Osteopenia, sarcopenia³
Indigestion, bloating, reflux, constipation⁴
A patient no longer holding adjustments between visits

These issues may seem unrelated, but microbial dysbiosis is a possible root cause for each one. In fact, research indicates that chiropractic adjustments help modify the microbiome by increasing richness and diversity. So, intentionally or not, you are already directing therapeutics at the microbiome.

Whether your patients are coming to you with acute or chronic pain, are pediatric or elderly, or need an adjustment or functional medicine – they will be healthier with a diverse and vibrant microbiome.

Why Chiropractors Evaluate the Microbiome

Maintaining the delicate balance between pathogenic, probiotic, and commensal species in the gut microbiome is vital – especially when you consider that more than half of the body is made up of microscopic organisms. Every patient – even those only seeking wellness care – will see the best clinical outcomes when they are evaluated and treated for dysbiosis.

Here are some basic definitions related to the microbiome:

Microbiome – the entirety of microorganisms, including their genes, functional gene products, and metabolites, found in and on the human body at any given time.
Probiotics – viable, nonpathogenic microorganisms that exert health benefits beyond basic nutrition.⁵
Microbial pathogens – disease-causing bacterial, viral, parasitic, or fungal organisms.
Commensals – neither benefits from the other nor provokes any harm. Most bugs formerly thought to be commensal are now considered mutualistic
Mutualistic – both the microorganism and the host benefit. Research suggests that the relationship between our gut microbiota and us is not merely commensal but rather a mutualistic relationship.⁶
Opportunistic – microbes that often exist as commensals but can become pathogenic when out of balance.
Keystone – foundational species in the gut microbiome that support the balance of other beneficial species through their metabolic functions.

As you can see, not all microorganisms bring benefits. Balance is essential.

A balanced microbiome benefits us in the following ways:

Hydration – absorption of NaCl and water
Nutrient synthesis
Healthy epithelial cell proliferation
Maintaining both tolerance and competence in immune activity
Protection against pathogens by a barrier effect
Production of healthy metabolites (short-chain fatty acids) – more on that later!

What happens when balance is lost? Dysbiosis. Our bodies lose the beneficial activity of probiotics while gaining an additional mountain of metabolic refuse to manage – thanks to opportunists, pathogens, or both.

It's easiest to identify a microbiome out of balance in an acute situation (think frequent colds or a bladder infection). Harmful microbes temporarily have the upper hand, and the body rallies to manage the imbalance immediately, ideally restoring homeostasis.

But dysbiosis isn't always obvious. Daily living can affect microbial health in multiple small ways – resulting in a slow progression away from homeostasis toward inflammation and internal toxicity.

This dysbiosis starts to take a toll on the body. Patients might complain of fatigue, anxious thoughts, ongoing heartburn, or chronic knee or low-back pain. Sound familiar?

The vast majority of microbes reside in the gastrointestinal tract. The body has developed systems to maintain and restore microbial balance. It employs complex communication between the GI tract, immune system, and liver – interacting, even collaborating, with the microorganisms in the gut.

But microbes also reside in and influence other parts of the body. From the mouth to the skin, to the bladder and even the middle ear, each niche in the body houses a unique and delicate blend of microorganisms.

It’s clear that the microbiome relates to health in all aspects – especially when it comes to your most challenging chiropractic cases.

Microbes Fundamentally Influence Local and Systemic Health

Inflammatory mediators from pathogens. When dysbiosis occurs, microbes produce metabolites that result in inflammation. The most well-known of these are lipopolysaccharides (LPS). LPS is a bacterial endotoxin found on the outer membrane of gram-negative bacteria – primarily in the gut. Its effects include:

Damage to epithelial cells and tight junctions, leading to gut barrier permeability.
Inflammation (chronic or acute) from binding toll-like receptor 4. This receptor is often associated with autoimmunity.
Release of pro-inflammatory cytokines through NF-κβ stimulation – known to contribute to systemic diseases such as:

cardiovascular disease
neurological disease through damage/permeability to the blood-brain barrier
autoimmune disease
disseminated inflammation

Beneficial metabolites from probiotic species. In a balanced microbiome, probiotic diversity and abundance benefit us by producing favorable metabolites. Short-chain fatty acids (SCFA) fall into this category. Probiotic microorganisms make SCFAs through enzymatic conversion and fermentation of undigested dietary residue like that found in soluble fiber in vegetables. Most notably, they include propionate, acetate, and butyrate. Emerging research shows SCFAs have multiple protective activities, including:

Maintaining healthy intestinal pH – enhancing nutrient absorption and microbial balance
Directly influencing and supporting healthy microbial composition
Exerting beneficial effects against intestinal inflammation and oxidative stress
Protecting intestinal epithelial integrity
Downregulating inflammation in systemic circulation^7,8

Production of either beneficial or pro-inflammatory metabolites depends on the species present in the microbiome. But a diversity of microbes is just as important as which species are present. That’s why clinical tools that help restore balance to the microbiome are so essential. Microbes are not enemies to be eliminated but an ecology to be nourished.⁹

Botanicals offer a practical, natural solution to balancing the microbiome.

The Power of Botanicals

Plants have developed tools to grow and flourish under the same environmental stressors humans face. Plants have an innate capacity to protect themselves – producing antimicrobial compounds, antioxidants, biofilm disruptors, and immune modulators. (Yes, plants have immune systems, too!)¹⁰;

Plants’ immunomodulatory activity calls innate immunity to action while downregulating pro-inflammatory pathways. Alterations in the intestinal microbial composition have long been associated with chronic inflammation.¹¹ In chiropractic care, we know that inflammation has far-reaching negative consequences.

Each plant offers multiple activities – with the potential to affect the microbiome and influence host health overall. When used in combination, a powerful synergy occurs – with effects growing exponentially.

No matter your chiropractic specialty or patient demographic, everyone who walks into your office has a microbiome that needs support. Pairing chiropractic care with evidence-based botanicals that cleanse and balance the microbiome can be a powerful way to support your patients’ health and expand your treatment protocols.

Research Backed Benefits of Biocidin

Biocidin® combines 18 botanical extracts and essential oils in a formulation that targets the entire GI tract – helping to maintain microbiome balance.

Diagram 1: Pilot research illustrates the effect of Biocidin® and its ability to remove unwanted microbes. Remember, gram-negative pathogens produce LPS, irritating the immune system and causing inflammation. The independently collected data in Diagram 1 shows that Biocidin® can have a profound effect on LPS levels.

Diagram 2: Additional pilot research evaluating the microbiome with full genome sequencing illustrates the ability of Biocidin® to cleanse while maintaining probiotic abundance – a selective antimicrobial. In that study, Biocidin® Liquid increased microbial abundance and diversity in most participants.

Resources:

Professional Benefits

Biocidin Academy

Balancing the Microbiome: Adding Evidence-Based Botanicals to Your Chiropractic Treatment Protocols

Why Chiropractors Evaluate the Microbiome

Microbes Fundamentally Influence Local and Systemic Health

The Power of Botanicals

Research Backed Benefits of Biocidin