Antony Underwood - Rethinking Probiotics: Evidence-Based Applications in Practice

I mean, very much now we've come to an understanding of strain specificity, and I don't think that was as well known to practitioners and certainly not to patients, uh, decades ago.

How have you seen that change?

Yeah.

There, there's been enormous change.

When I first started in the early 2000s, I was doing stool testing, but this was largely culture-based stool testing.

And as you, as you're aware, the, um, the DNA, um, uh, probe testing has uncovered, uh, a lot of, um, uh, different species of bacteria in the gut that we previously weren't aw- aware of, and this has become more and more into the fore.

So we're discovering these bacteria we had no awareness of, and also the significance of these, these species.

Uh, so there's been enormous change.

The other big change I've found was just the, the acceptance of the, the concept of the gut-brain axis.

So I remember giving lectures, uh, very early on in, in, in my career about how the gut could affect the, the mind, particularly in reference to autism.

And this was, you know, was a, a laughable concept.

It, you know, the-

Mm

...

the idea that that could even change or affect behavior was, it was not given any consideration.

But that's, that has changed a lot.

And regarding the, the strain's, uh, specificity, um, practitioners, I've also noticed, have become increasingly aware of the importance of understanding the strain and its particular benefits.

I'd even say patients are probably somewhat aware of it now as well, would you say? Do you find that?

No, I don't th- well, they are, they are aware of it if there is, say, there's a, a publication of aA strain that, a particular strain, um, that, uh, has some media attention, then they d- they do become aware of it, and they will s- try and seek out the strain.

Um, generally, they're not that aware.

They're, they are very much aware of the whole connection of the gut and the brain, though-

Mm-hmm

... and very receptive to approaches in that area.

That's been my experience.

So when you're looking at the research and you're looking at these clinically studied strains, there's enormous variation in what that actually means, uh, I find.