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Why the same probiotic can work differently in different people: Microbiome science and a personalized approach



The illusion of a universal pill


In the modern world, caring for intestinal health has become a global trend. Advertising convinces us every day that to solve digestive problems, improve immunity or eliminate the effects of stress, it is enough to simply go to the pharmacy and buy a popular probiotic. However, in practice, doctors and patients are constantly faced with a paradox: a drug that perfectly helped one person get rid of bloating and normalize bowel movements has no effect on another person, and in a third person it provokes exacerbation of symptoms, pain and severe flatulence.

Why does this happen? Classical protocol medicine has long ignored this phenomenon, prescribing treatment according to standardized schemes.


However, modern 4P medicine (personalized, predictive, preventive, patient-centered) gives a clear answer: the secret lies in our internal ecosystem. The human microbiome  is a unique “superorgan”, the genetic imprint of which is more unique than fingerprints. Modern science proves that using probiotics individually  is not just a marketing ploy, but a biological necessity. In this article, we will analyze in detail how a different starting microbiome, nutritional characteristics, concomitant diagnoses and medication make the same bacteria behave completely differently, and why a personalized approach  from innovative companies such as Ediens is the only way to true health.


1. Diverse starting microbiome: There are no “good” and “bad” bacteria


The fundamental mistake of mass consumption of probiotics lies in the belief in the existence of absolutely "good" bacteria. It seems to us that lacto- or bifidobacteria a priori will only bring benefits. However, as Professor, Doctor of Biological Sciences Nadiya Boyko notes, each microorganism is like a separate entity with its own habits and character. The same objectively beneficial microorganism in the body of one person can act as a healer, and in the body of another - completely differently, sometimes even provoking inflammation.


It all depends on the patient's so-called starting (baseline) microbiome and its diagnostic correlation. In microbiology, there are no good or bad bacteria (unless they are direct pathogens); there is a concept of ecosystem composition and balance.


  • Enterotypes and strain conflict:  Each person has their own enterotype (the dominant group of bacteria that forms in the first years of life). For example, if your gut is dominated by bacteria of the genus Ruminococcus and you have a deficiency in mucus-degrading bacteria (mucin-degrading bacteria like Akkermansia ), your body will be prone to fermenting certain carbohydrates and dairy products. If you give such a person a standard probiotic grown on a dairy basis (or one that stimulates certain metabolic pathways), their “native” microflora will come into conflict with it. Instead of healing, active gas formation will begin.

  • Resistance to colonization:  Our native, commensal microflora is very resistant. It physically occupies space on the mucous membranes and does not want to let in “foreigners”, even if they are beneficial bacteria from an expensive pharmacy capsule. If a probiotic is chosen blindly, it will either transit through the gastrointestinal tract without taking root, or will die in the fight against your own old-timer bacteria.



2. Nutrition: We don't feed ourselves, we feed our bacteria


The second critical factor that determines the effectiveness of a probiotic is diet. You can take the best, most expensive probiotic in the world, but if you don’t feed it the right “food,” it will die. The bacteria feed on prebiotics—dietary fiber (fiber) and specific biologically active substances (BAS).

As scientists note, “we don’t feed ourselves, we feed microorganisms, and it is they who dictate to us: I want something sweet, I want a bun.” If a person’s starting microbiome is biased towards pathogenic flora (which loves sugar and fast food), and the person continues to eat like this, the probiotic taken will simply die of hunger in an aggressive environment.


That is why 4P medicine is inseparable from nutrigenomics. The same apple (or the same prebiotic) is digested completely differently by different people due to different bacterial composition. Algorithms from Ediens, for example, calculate an individual nutrition plan in such a way that food acts as medicine: local products are selected so that they suppress pathogens and serve as an ideal nutrient medium exclusively for those beneficial strains that need to be multiplied in a particular patient.


3. Diagnoses and Physiological Status: Inflammation and the Gut-Brain Axis


How a probiotic will work depends fundamentally on the current physical and mental state of the body (actual state / condition). The microbiome is directly involved in the regulation of systemic immunity, metabolism (obesity, insulin resistance), and the functioning of the central nervous system through the gut-brain axis.

  • Inflammatory processes (IBS, ulcerative colitis):  If there is already acute or chronic systemic inflammation in the intestinal mucosa, the immune system (e.g. dendritic cells) is in a state of hyperactivity. Studies show that the same microorganisms can cause a radically different immune response (pro-inflammatory or anti-inflammatory) depending on the environment they enter. The administration of a multicomponent probiotic “blindly” into the inflamed intestine can cause an unpredictable reaction.

  • Stress and metabolites:  Stress is one of the main factors that destroy the microbiome. Constant production of cortisol changes the pH and motility of the intestine. Beneficial bacteria should produce short-chain fatty acids (butyrate, acetate), as well as neurotransmitters (serotonin, GABA), which improve mood. If a patient has severe depression or PTSD, he needs specific strains that are able to synthesize these substances. A regular probiotic to improve digestion will not work here.


4. Medications and Antibiotics: The Trap of “Blind” Recovery


Perhaps the most common myth in modern medicine is that after a course of antibiotics, you need to drink any probiotic from the mass market. Gastroenterologists and microbiologists are sounding the alarm today: uncontrolled prescription of probiotics after antibiotic therapy can cause irreparable harm.

Professor Nadiya Boyko emphasizes: when doctors, after antibiotics, generally recommend a probiotic that they simply "hear" or that is promoted by pharmaceutical companies, this is "an even greater evil." Why? Because such a random drug continues to destroy a person's own, native microbiota, which has already been affected by the antibiotic. Instead of allowing the commensal (own) flora to recover, we throw an army of foreign bacteria into the intestines, which begin to compete for resources.


Prescribing a probiotic requires the same care and precision as prescribing an antibiotic. You need to know exactly which bacteria have died, which have become too numerous (for example, Candida fungi ), and which strain is capable of restoring this specific imbalance without harming the remaining beneficial flora.




Personalized approach: 4P medicine solutions from Ediens


For a probiotic to work reliably and effectively, it is necessary to abandon roulette and switch to evidence-based biohacking. Ukrainian biotechnology company Ediens offers a revolutionary algorithm of actions based on creating a unique Omics profile of the patient.


  1. Deep microbiome diagnostics (NGS) : Instead of the outdated dysbiosis culture, which only sees a small part of the flora, genetic sequencing is performed. This allows you to detect the DNA of all bacteria, determine the enterotype, the ratio of beneficial and pathogenic strains, and, most importantly, their metabolic activity (what exactly they produce).


  2. Targeted correction with pharmabiotics:  Based on the analysis, not just probiotics are selected, but pharmabiotics  - new generation biopreparations with clinically proven effects on specific nosologies (for example, the lines " My Second Brain " or " Metabolic Antistress "). They are used purposefully to suppress the found pathogens without harming commensals. If the patient wants to test a pharmacy probiotic, the laboratory can test it for compatibility with his microbiota.


  3. Algorithmic nutrition selection : Using proprietary IT algorithms and a database, an individual nutrition plan is created that takes into account diagnoses, physical indicators, and the state of the microbiome. This ensures that the introduced bacteria will receive the ideal environment for colonization.


  4. Creating a Personal Microbiota Bank : The ultimate in personalization is isolating and preserving your own, strongest commensal bacteria. If you ever get sick or need antibiotics in the future, you can repopulate your gut with your own microbiota that’s 100% right for you.


Conclusion

The era of universal pills is coming to an end. The fact that the same probiotic works differently in different people is absolutely natural, because each of us is a unique ecosystem. Different starting microbiomes, individual reactions to food, hidden stress and the effects of drug treatment make the “blind” prescription of probiotics ineffective and sometimes dangerous. Applying probiotics individually  is the only scientifically sound way. Only a personalized approach , based on a deep genetic analysis of the human microbiome , targeted correction with pharmabiotics and individual nutrition, can turn bacteria into a powerful tool for treatment, rejuvenation and active longevity.


Short questions and answers (Q&A)


1. Why did the advertised probiotic help my friend with bloating, but cause me even more abdominal pain? Answer:  Because you have a completely different starting microbiome (enterotype). The microorganisms contained in the preparation entered into a friendly symbiosis with your friend's flora, but entered into a sharp competitive conflict with your own bacteria, which led to inflammation and active gas formation. 

2. Why do doctors say that taking any probiotic after antibiotics is a “great evil”? Answer:  The antibiotic has already damaged your beneficial (commensal) microflora. If you then “blindly” take a random multi-component probiotic, these new (foreign to you) bacteria begin to aggressively displace and destroy the remnants of your native flora. The probiotic should be selected as strictly and personalized as the antibiotic, based on tests. 

3. Is it true that probiotics do not work at all without proper nutrition? Answer:  Absolutely true. Probiotics (live bacteria) need prebiotics (dietary fiber, cellulose) to survive and multiply. If you do not change your diet according to the needs of the introduced bacteria and continue to eat sugar or fast food, the probiotic will simply die in an aggressive environment or pass through transit without giving any results. 

4. What is the personalized 4P medicine approach to microbiome correction? Answer:  This is a rejection of universal protocols. Instead of guessing, a molecular genetic analysis of your microbiome is performed (an Omics profile is created). Based on this data, company algorithms (such as Ediens) select targeted pharmabiotics (with proven clinical effect) and develop an individual nutrition plan that will be ideally suited exclusively for your body. 



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