Okay, Don again. Sorry if I’m not pronouncing that correctly. “I’m noticing that stool testing making recommendations can appear to be hard to come to a conclusion unless we get more experience into your clinical recommendations. I’m learning from your materials that parasite using bacterial landscape is still not as clear. For example, when is a bacteria supposedly beneficial versus dysbiosis? I’m picturing our clients may come and expect a clear verdict and expectations based on lack of knowledge. How do you explain your clients about expectations and if there may be multiple testing and trial and error methods in order to help them.”
Chris: Good question. I’m always very direct and transparent with my patients. With Blastocystis hominis, for example, which may be something you’re referring to, I’d say, “Look, there’s still controversy about the pathogenicity of this organism. There’s a lot of research that suggests that healthy people can harbor it in their stool and not have any problems. There’s actually also a lot of research that suggests that it’s correlated with IBS and other gastrointestinal symptoms, and if it’s treated in those people, then their symptoms will improve. What do we make of this apparent contradiction? Well, it’s probable that the context is what makes the difference.” If someone has Blastocystis but may have overall healthy gut microbiome, maybe it’s not an issue, whereas if someone has taken a lot of antibiotics or they weren’t breastfed when they were a kid, they have some other issues that have impaired their microbiome, then maybe Blastocystis is problematic in that context. I might also explain that Blastocystis may have different subtypes, some of which are less pathogenic and some of which are more. I do treat them as adults, and I say, “The science is not crystal clear on this, and here’s what I would suggest based on my clinical experience.” Not only does that not turn off most patients, most patients really appreciate that level of candor and honesty, and they trust someone who is willing to admit that they don’t have all the answers and they don’t know, so that’s my approach. Again, other people may approach it differently, but I’ve found that to work very well.