Under what circumstances do you consider the presence of ​Prevotella to merit treatment, particularly if the patient has one or more autoimmune diseases?

This is really a good question because as we’ve been doing the GI-MAP stool test in [the] clinic, we’ve had a lot of ​Prevotella​ come back. I honestly would say almost, like, 95 percent of our patients have ​Prevotella​ in their stool, so this has caused Chris and I to have a little bit more pause on treating Prevotella. When I talked to Chris about this, he hasn’t found the research to be very supportive of ​Prevotella​ indicating an autoimmune disease; [it’s] more likely that they’re just the population of people that have had autoimmune disease have had Prevotella​ in their stool but not necessarily able to show, like, a causative relationship to that. So, for us right now, we are not treating ​Prevotella​ when it comes up on a stool test, even if the patient has autoimmune disease. I will say that there’s a caveat here again. Usually, there’s something else going on in the gut where we are treating, so we’re generally still doing an antimicrobial protocol for our patient that may also have ​Prevotella​. I’ll be honest, they haven’t seen ​Prevotella​ decrease or come down often with an antimicrobial protocol or even with prescription treatments when we’re trying to target other organisms, and, again, when Chris and I have talked about it, there’s a little bit of a theory that this may also be present in people with higher-fiber diets. So there’s a question that as our patient population who tends to yield a little bit more on this Paleo side, this whole-foods higher-fiber diet, is that really what we’re seeing here with the presence of ​Prevotella​ versus truly an autoimmune issue? I mean, I just have to think that if 95 percent, almost 100 percent, I would even say, of the people that we run the GI-MAP test [on] have ​Prevotella​. I mean, it just doesn’t seem statistically important or possible to really form, like, a causative relationship, so I hope that answers your question. At this time, it’s a little bit of a question mark, but we are not treating it. We’re not going after it. I’ve had a patient with, like, rheumatoid arthritis [who] had ​Prevotella,​ and we did use some antimicrobial protocols; we did some prescriptions for different gut bugs and it did end up decreasing, [but] his symptoms did not change. We actually were able to get rid of the Prevotella,​ but [the] symptoms remained the same for him, and we’ve been kind of targeting some other things. We’re still learning, I think, a little bit about it, and I will make sure to keep you guys updated if we get more information.