451: Viome Gut Microbiome Testing’s Results Interpretation and Food and Supplement Recommendations

Ally Perlina And Ashley James


  • No one good food is always good for everybody
  • What does metabolites do for the body
  • What does microbiome-induced stress mean
  • How does Viome help improve our health
  • What is the difference of Viome’s supplements

Are all foods, especially fruits and vegetables, beneficial for all people? In an ideal world, all fruits and vegetables would be good for everyone. But that is not the case. In this episode, Ally Perlina shares with us the revolutionary tests that Viome has created. She explains how they came about their food and supplement recommendations and how to interpret their test results. She also shares how their supplements are different from others.


Hello, true health seeker, and welcome to another exciting episode of the Learn True Health podcast. It's been a few weeks since I did this interview, so I do have more updates for you. I discuss in this interview the results of the Viome test. You may remember a while back, I interviewed the founder of Viome. Viome is a company where they send you an at-home test kit. It's very easy to use, and you give them a tiny sample of your blood and your stool. And then soon you'll also be able to give them your saliva. They run hundreds of thousands of genetic expression pathways on the bacteria of your gut and your mitochondria.

What that provides is allows them to see what your bacteria do in terms of what chemicals it makes once you eat. So when you eat something, the bacteria turn it into chemicals. Some of these chemicals are incredibly harmful and cause disease, and we don't even realize it. Someone could be eating a carrot and that's causing them to have health problems because their microbiome is transforming something seemingly helpful into a negative chemical for them specifically.

For me, it was actually very interesting. My results were incredibly interesting. I have implemented their advice, and I also started taking their supplements. Right away, which really shocked me, I noticed a change in my gut. I have good gut health, but I noticed this entirely new level of gut health. I’m like holy crow, that was amazing. I’m really very intrigued by the results. I think that if you have the means to do so, everyone should do a Viome test kit. It gives you the information you could not possibly ever get from going to any doctor. It's absolutely state of the art. Today I have on the scientist, the mastermind behind it all, so she's going to explain.

This is why it is a longer interview because she does go through my own results and then explains. I try to have her explain it from the perspective of other people as well and how this would also pertain to reversing disease, preventing disease, increasing longevity, reversing age. You can actually reverse cellular age, which is phenomenal and quite exciting. So all this information is shared today, and I want to let you know that Viome does give us a great discount, both on their home test kits and their supplements. Go to viome.com and use the coupon code LTH as in Learn True Health. So always use the coupon code LTH every time you buy from them and you'll get the discount.

I want to let you know that very soon, and for a very limited time during the American Thanksgiving Cyber Sale that's coming up really soon, they're going to be giving us an even bigger deal. So I highly recommend marking that in your calendar and checking it out.

You can also join the Learn True Health Facebook group because there are about six other wonderful health companies that have offered the Learn True Health listeners incredible deals for the cyber sales that are coming up during Thanksgiving. I’ll be releasing all that information into the Facebook group, and also email it out for anyone that's on the email list. You can get on the email list by going to learntruehealth.com, checking that out. Thank you so much for sharing this with your friends and family. Continue to share these episodes. They are life-changing. I’m really looking forward to hearing about today's episode. It's going to be a great one.

Photo by kike vega on Unsplash

[00:03:30] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is episode 451. I am so excited for today's guest. We have a very special woman on the show today. Ally Perlina, you and I have spent the last few hours talking about my results from my Viome test. Back in episode 441, we had one of the founders of Viome on the show—Naveen, and that was quite an eye-opener. I am really in love with Viome.

Now I've come to know that you're this mastermind—I don't want to say mad scientist, but you're the mad scientist behind it all. You have such an amazing understanding of the expressions of our microbes. When we feed them certain foods, they produce certain metabolites, and how those metabolites affect the rest of our body and potentially create disease or heal the body. We could really use food as medicine on a deeper more individualistic level when we understand our unique microbiome and also understand our cells on a deeper level, which is what your company allows us to do—much more affordably than I ever thought.

I’m really excited to have you here today to teach us more about how we can understand—on a cellular level—how to gain health. How to really, really gain health, how to really support our immune system, how to support all of our hormonal systems, how to support our body's ability to metabolize and to utilize nutrition all by making sure that we focus on what we can feed and what we shouldn't feed our unique microbiome. Ally, welcome to the show.

[00:05:39] Ally Perlina: Thank you so much, Ashley. I’m so privileged to be doing this with you. I really enjoyed our conversations so far. I think it's amazing how aware you are of all of the things that are important to look out for and pay attention to when it comes to your health. How curious you are about learning all of the different new technologies and ways of gaining insights about the biology of your body, which is what we're here to do. I think it is really important to get this understanding and to spread this word, which is what you're doing here. I’m more than happy to really delve into the results and the data and explain all of this because it's not always just about talking about the concepts. Because I think to make it relevant, you have to put it in the context of the actual person's results.

So here we are with your results, and I’m absolutely thrilled to be able to review it with you and your listeners.

[00:06:37] Ashley James: Awesome, very cool. Well, before we dive into that though, I want to learn a bit more about you and your background. What happened in your life that led you to become an expert in the science of the microbiome?

[00:06:52] Ally Perlina: What happened to me to make me such a mad scientist? What had to happen in my life? I will speak to that. I actually identify myself in a way as a systems biologist. That involves not only understanding the microbiome but really getting into the complexities and the mechanisms that turn all the knobs and all the different levels of our biological systems. From cells, even microbes are cells in a way. Some are unicellular, right? Our cells, tissues, and fluids to organs and organ systems. From the really biochemical levels of biology all the way to physiology, which is why at Viome, I’m a Chief Translational Science Officer. Translational science is basically about something I’ve been trying to do all my life is to translate the science of all of these different molecules, pathways, and the biology of the situation into something that is immediately actionable for health.

I’m a scientist that basically has all the background in biochemistry, cell biology, molecular biology, and human genetics as well, but who's always worked in a clinical setting—clinical or pharmaceutical type of setting. I worked with many different pharma companies. I worked for clinical diagnostic labs that became part of Quest for four years. I’ve really worked on things from drug and target discovery to clinical trials. More recently, before Viome, I worked at Human Longevity with Craig Venter that has its own basically clinic component called Health Nucleus and is still there. I was there from early on.

In all of the different endeavors and efforts, I’ve always created new novel innovations to connect all of the data at scale to inform clinical healthcare and wellness, especially here in Viome with the wellness space. It's more scientifically powered. I always felt like a lot of this expertise that we're given when we get our education, our training as scientists stays in the early discovery, the academics, or early discovery phases within pharmaceutical tracks.

But sometimes, we have enough knowledge to take all of these different points of information and analyze it in maybe some novel and creative ways to scale it, deliver it, and do something really sensible with it to impact the health of people right now. Not all of it needs to go through 12 years of any molecular specific drug development process. When it comes to health and wellness like food and supplements, there are so many things that are well-known that we want to be able to just package and scale that knowledge.

I've always been extremely motivated in actually harnessing this power in information. You can't do that without embracing the complexity. So in order to translate all that information to health care and to empower people to take control of their health, somebody out there needs to be able to get into the complexities of all the systems. Hence, the term systems biology where you really look at all of the different components and figure out what are the mechanisms of health versus disease. 

What are the mechanisms that can give us these points of intervention that we know how to deal with? We can take nutraceuticals. We can take nutrients from drugs or supplements and how they all work together. Because when it comes down to it, it's molecules in food, molecules in supplements, molecules in your drugs talking to molecules in your microbiome, talking to molecules in your cells, in your lymphocytes, in your brain cells. All of these routes of communication are what I basically specialize in. Those are some of the things we call pathways. That's the essential part of systems biology, which is needed to embrace the complexity and deliver something actionable for your health.

[00:11:17] Ashley James: How many pathways does a Viome test when they look at the full RNA sequencing and expressions of your mitochondria and their very complex microbiome?

[00:11:38] Ally Perlina: Good question, Ashley. It's about a couple of hundred thousand.

[00:11:42] Ashley James: Wow. Just a couple of hundred thousand. We went through a few of them, and we're going to talk about a few of them in our interview today. But that was one of my first questions because as we were going through them, I thought just how many pathways are you looking at. And each individual, as you were going through my results, it was so interesting that you said, if I were to look at half your results, I would have predicted differently the other half. And this is why it's so interesting how unique we are that we have to look at the full picture to see where each individual person is along their healing journey, and how we can help them right now.

My first time speaking with you I brought up that I had figured out that I could not eat eggs. That was the last thing to go to become whole food plant-based. I was still eating eggs, but I was basically like an ovo vegetarian. But I noticed I had these heart palpitations, and I didn't know where they were coming from. I don't know why they just presented themselves as they did. But I had completely changed my diet, and thus the microbiome changes I suppose. Because I'd shed all these other foods, it was the last animal product to go. And so these heart palpitations were so frequent they were getting kind of scary.

I consulted a cardiologist. I wore a device for several days and it monitored my heart. In the end, he said there's nothing wrong with your heart, but that there's a stressor. There's some stressor your body is going through that is putting your heart in this position, your heart's reacting to the stressor. He had no tools, of course. I mean, he was a great cardiologist, but he's like listen, come back to me when you need cholesterol meds. There was nothing beyond that he had for me.

The frustrating part is MDs are trained to catch us when we're ill and hopefully help us so we're not going to die at that moment. But they're not trained in how to take you from let's say just slightly poor health and help you get to optimal health. That's just not in their wheelhouse. Their wheelhouse isn't systems biology, looking at the way that each individual person works, how their genetics are expressing, and the genetics of their microbiome is expressing. That's where you guys come in.

I figured out, something just hit me. Why don't I do an experiment, not eat eggs for a while then eat eggs and see if that's it? I did that with other foods, but when I took eggs out, my heart palpitations stopped completely. And then about seven days later I had an egg, and by the time I'd finished eating the egg, the heart palpitations were back. And I thought this is very interesting. I attempted the experiment several times, and sure enough, I can give myself basically an irregular heartbeat by eating eggs or not.

You saw that in my gut biome. You saw it in my Viome results. You said, oh. When you said it, it was like watching a masterpiece. The way you explained how it all works and how that was feeding this particular microbiome, which creates this type of metabolite which then my liver converts to this, and then my heart reacts to it this way. All the pathways made complete sense from a to b. But as you and I talked, it became so clear to me. If we could explain to people who aren't biologists what a microbiome is, the bacteria, the complex system that is in our gut, and how much we need it for life and health. I came to the conclusion that it's like having a factory, having a pharmacy inside our gut. You like that.

Some people say it's like having an animal because it's about six pounds, so it could be like having a chihuahua in your gut. But it's actually much more complex than that. It's like having a pharmacy in your gut or a factory. What you put in is what it puts out, and the metabolites. So it's not that you necessarily have a bad microbiome, but it's that when I put in eggs from the choline, my unique microbiome is going to produce something that all these pathways then come together to irritate my heart and could lead to further heart disease down the road.

Whereas other people have no problem with choline and wouldn't have that reaction. But there are other pathways that you put into the microbiome, not necessarily sugar. Everyone thinks you eat sugar, it causes diabetes. Someone could put cauliflower or whatever, they could put something that's somewhat healthy for someone else, but because of how their pathways are expressing, they put that into their little pharmacy factory—which is their microbiome gut—into it, and then what comes out are the metabolites that would put the stressors on the body that could lead to diabetes, or either cause it or contribute to it. That you can see that many diseases that we're suffering could be corrected by making sure we know exactly what we as individuals should and shouldn't be eating.

[00:17:37] Ally Perlina: Right. So let me just get back to a couple of points you said that I think are really important, and maybe some of the listeners are well aware of them. But just to be absolutely clear, I think it's important to emphasize that no one good food is necessarily always good for everybody, and sometimes it can actually be bad, so it depends. And if you know what it depends on, then we would not be doing justice to health care and wellness. If we didn't actually delineate what it depends on, put it into some sort of logic, rules, and content, and scale it so it can help the masses. 

That's one of the reasons why when I came to Viome, I made it a huge point right away to make sure that when I developed the scoring system for the pathways or how we connect this to the personalization of the foods, that it's something that does not need another alley or anyone from my team in the loop to be able to actually release the results. That it's end-to-end automated. Because if we know what it depends on—whatever it may be—and when it's good or bad for you, then we need to be able to inform people so that at least they can make more biologically informed choices when it comes to eggs or broccoli.

So back to your egg example, what you have are two things why egg yolk may not be good for you, and it's actually on your avoid list. One of the things is TMA production by your microbiome. So your microbes actually use the choline that they would get from egg yolk, not so much from the egg white. That's still fine and a source of protein and all, but egg yolk is on your void because it has choline and choline is what serves as a substrate for your microbes in the gut to take it and then convert it to trimethylamine also known as TMA.

So when we say convert, it means there are some of these sequences of events that happen, and that's what we call a pathway. So a biological pathway is a sequence of molecular interactions or biochemical reaction steps that has a beginning, middle, and an end sort of tells you a story and says what is actively happening? What's coming? What's going? So in your case, in the egg case, that choline is coming and TMA is being produced and then it's going. TMA is trimethylamine, so microbes use the substrate as choline converted to TMA. We see those pathways because we see RNA. So it lights up the gene expression values along these pathways that we reconstruct. We build them so we can score them. We can see, okay, you have higher than usual trimethylamine production in your microbiome.

So what that means is that now that you have this TMA and it's made in your gut, it can actually then become available to the circulation. And through the portal vein, it can go to your liver where it gets naturally converted to TMAO. TMA as well to some degree is associated with harmful or no beneficial effects on cardiovascular health. So that could be some of the association. Again, I’m not claiming any causation and it causes multiple factors usually for something to actually go wrong, but it's a very, very peculiar phenomenon that you're sharing about your effects that you felt physically after eating eggs.

So this could be part of it or the main part of it that you have this TMA, TMAO pathway in which your gut microbiome plays a key role. And that is something that we can measure with our metatranscriptomics technology. That's how we go from basically gene expression that we get from your stool sample, gene expression from RNA sequencing called metatranscriptomics technology. It tells us how much are those genes expressed, are they up or down. How do they factor into these pathways that we have put together so we can tell you then what? Then it's like, okay, we get it that TMA is happening and more than what we usually see then it goes and can be converted to TMAO, which we know is not good for cardiovascular health.

So what do you do about that? One of the things is you can limit inputs into the TMA production pathway by the microbiome, so that's why egg yolk is on your avoid, it has a lot of choline in it. Whereas for other people, choline is actually just fine. It can be good for rebuilding your membranes and maintaining them. It can be good for the gut-brain axis and support some of the neuronal-glial health. So for you, it's good to basically stay away from egg yolk, and that's one of the reasons. The other reason that could have something to do with cardiovascular health is that you just have another score in your report that involves multiple pathways—hundreds of them actually—that assesses overall gut microbiome induced stress. Stress response, in general, there are many different types and different reasons for it.

So one of the things that you have is you have a sub-optimal score on your microbiome induced stress. That's a functional area score that involves many different pathways, and we'll cover many of them or at least some of them, which include sulfide production, ammonia production, and those things that can contribute to overall stressors that may come through the gut into your bloodstream. In your results, they're not enough to actually cause overall inflammation, we'll talk about that as well, but it could be a slight culprit besides the TMA-TMAO story.

And then back to the egg example, another reason why it's on avoid, it's not enough to just have one thing necessarily off a little bit. Sometimes it's more than one, many times it's more than one factor that places food into your superfood, avoid, or other categories. In this case, there is another factor that placed your egg yolk on avoid, and it's the fact that it's high in sulfur. With your profile, sulfur goes into the sulfide production pathways a bit too much—more than we'd like. So sulfide is not necessarily a villain, it's not necessarily absolutely bad, but when too much sulfide gas is produced in your gut, it can be disruptive to your gut lining and it can be—for apparent reasons—disruptive to your digestive symptoms and your gut health. It can also have a negative impact on your gut motility.

So because the egg has sulfur, it's one of the two main reasons why egg yolk specifically is on your avoid. Because you have too much hydrogen sulfide gas production by your microbiome. So that's another part of the story, and again, it's many to many. So the other part of that piece—the sulfide story—is actually your cruciferous vegetables. When you see a score that says sulfide gas production pathways, a lot of times, people will ask well what does it mean? What can I do about it? 

In our food recommendations, you can see when a food explanation refers to a specific score. You will see that in your egg yolk as well as broccoli and cabbage, it will tell you that the reason it's on your avoid has—or at least one of the reasons has to do with—your sulfide gas production pathway score being too high. It means we have too much of that activity lit up with all of the gene expressions along these pathways saying your microbes are making too much sulfide gas. What they use as a substrate is something that comes from these cruciferous vegetables. It actually explains in the paragraph there that a compound class called glucosinolates—part of the organosulfur compounds—is actually what serves as in a way a culprit. It can be good for some people, but for you, it's a culprit because it can serve as a substrate for the sulfide gas production indirectly.

First, it gets converted to sulfate, and then from sulfate, it goes and gets converted to sulfide gas by your microbiome. The thing that converts it to sulfate, Ashley, is myrosinase, and it's an enzyme that's in the vegetable and gets activated when you're chewing it. So raw vegetable chewing actually activates this enzyme and gives you more of the sulfate, which is a direct substrate for more of the sulfide gas production. So do you know what you can do if you still want to have a little bit of those avoid foods but you want to minimize the effect of this sulfate substrate production for your sulfide gas?

[00:26:40] Ashley James: What can I do?

[00:26:41] Ally Perlina: You can steam it just a little bit because it will destroy the enzyme because it's heat sensitive, so it will destroy or inactivate the enzyme in the food, myrosinase, which is needed to convert glucosinolates into sulfates. So you will diminish that action a little bit. It's not going to completely get rid of the organosulfur content in the food, and it can still—in one pathway or another—feed your microbes, but it really diminishes these results. Based on what people report, they actually see or feel less of that bloating or gas production.

So I would ask you, do you feel any difference or do you feel any gas production effects with cruciferous vegetables versus other vegetables like arugula, kale, or something?

[00:27:33] Ashley James: I would say yes. But up until I got my Viome results 17 days ago, I ate cruciferous vegetables daily. Although gas was always around in certain amounts, it wasn't smelly, so I didn't think that there was a big problem with it. I just thought, okay. I also eat beans although I soak them and cook them in the Instant Pot. But I do notice, especially raw broccoli, raw cauliflower, or raw cabbage—I really enjoy raw cabbage in a salad. Especially in kale and raw purple cabbage in a salad would produce gas more so than if I were to eat zucchini, for example.

[00:28:29] Ally Perlina: How about arugula, just because it came to me?

[00:28:32] Ashley James: I don't often eat arugula on its own.

[00:28:39] Ally Perlina: Spinach.

[00:28:41] Ashley James: Yup, I don't have a problem with gas in spinach. I do eat raw spinach, I eat cooked spinach. The arugula I do eat is fermented actually in a really delicious fermented arugula pesto.

[00:28:56] Ally Perlina: Mmm.

[00:28:57] Ashley James: Yeah, it's so good. If I have arugula, it's usually mixed with other greens, but I don't seem to notice quite a difference. But then again, like I said, up until 17 days ago, I was eating cruciferous vegetables for almost every meal. So gas was all the time. It wasn't unbearable though. But then again, most of the time, I would cook those foods.

The reason why I wanted Ally to give a little bit of a deep dive into my results, your results are going to be different, everyone's results are different. But just to hear how much information you get, how much guidance you get from a Viome test, and how unique each person's experience is going to be is actually quite exciting because, in the last few years, I’ve been the healthiest I have felt in a long time. As much whole food plant-based as I possibly can, and of course gluten-free. Ever since cutting eggs out, I feel great, but I felt like throwing darts in the dark. I’m going to try this, I’m going to try that, and I do love doing that. I do love listening to my body and trying different things.

I felt like there was a missing piece, and I really feel like Viome has been, for me, the missing link to pulling it all together for me because I would have never considered lowering my cruciferous vegetable intake. Never ever would have thought that. In the other foods that were recommended I reduce, those are my daily staples as well like coconut. Since I have cut that out—really significantly reduced coconut—and I feel like I’ve come into a new chapter in my health because I also understand why. 

Although everything that Ally says sounds quite complicated and science-based, I want her to explain the science behind it. When you get your Viome results, it's very clear, simple, and easy to understand. And then you click through and there's more detail. And then if you want to learn more, then you click through and then there's even more detail when you click through, and there are scientific references. If you want to just stay surface, if you're one of those people that just need to be told what to eat, what not to eat and that's all the bandwidth you have, then you get those. 

If you're like me and you want everything, you want the Ph.D. version of your Viome results, then you get that too which is exciting. I really do like how you have set up Viome so that people have to click through and click through and click through to chunk down into more and more detailed information so they don't get overwhelmed. The results themselves are not overwhelming, but at the first sight, I was disappointed I’m like, oh, this is it? And then I click through I’m like oh there's more, click through again, oh there's more. It is quite interesting. In the future, you guys are going to have even more coming out.

When I had Naveen on the show in episode 441, I had not taken the Viome test yet. And I have to share that I absolutely adore the test. It's a home kit. It is in a beautiful little box and the instructions couldn't be easier. They're very simple. And when I sat down to draw my blood, it is as easy as just a prick of the finger, and then and then this little tiny plastic thing sucks the drop of blood up into it. It's so easy to do. It's not intimidating at all. I commend you on how beautiful and simple the system is. It's not overwhelming. You just have to read the instructions in advance to know that you want to be fully hydrated, you want to do the blood sample in the morning. Just take some time to read the instructions and know when you're going to do the stool and the blood when you're going to do each one. And then you send it in. I really enjoyed the whole process of sending in my kit. I enjoyed the process of receiving all the information.

I then ordered your supplements, which we're going to talk a bit about that as well because you make individualized supplements based on the genetic expression of our microbiome and mitochondria and all the results—the cellular health results that you have. I’m very excited to receive those, so I hope to do a later interview talking about my experience with your supplements because I’m already on supplements, but my supplements are more just for the whole body health—vitamins and minerals—but your supplements are specific to looking at the genetic pathways, like you said, a few hundred thousand pathways, and supporting the body and coming back into balance in such an individual way. That's very, very exciting.

Photo by Pablo de la Fuente on Unsplash

[00:34:12] Ally Perlina: We'll talk about some of your supplements as an example, but I think that's a good idea to actually review your supplements and everything you've been taking and the Viome supplements that you'll get and then see how you're responding to them. then drill into it a bit more as a follow-up if you'd like.

[00:34:32] Ashley James: I’d love that.

[00:34:33] Ally Perlina: I think we noticed there were some themes or some things that you were already aware of, which is great. So some of your digestive related components like protein fermentation and being able to digest your proteins and keep your stomach acidity levels at the right level and optimal. So all of these things can be adjusted or manipulated, to some degree, with supplements. Some of them are digestive enzymes that you already know about, and some of them can come from foods as well as supplement delivered nutrients. So bromelain, papain come from pineapple and papaya respectively, and then there's betaine. Originally it got the name because it came from the beet.

Those are some of the natural ways to help your digestion, and in your case, the reason it's specific to your pathways that we see is that we do see some of these a little bit more active than usual. Protein fermentation pathways, which means that the microbes are fermenting aka metabolizing different proteins more than you would expect them to in the gut. That means that you, the host, did not make enough of an effort or enough turns in there in your metabolism to completely process all of the different protein sources that you get. 

Again, sometimes it could be the vegetable sources or the nuts and seeds that have a very dense protein that make it hard to process it all. Then it gets to your colon and then microbes go oh my goodness, a lot of unprocessed proteins. So you encourage those microbes called protein fermenters to be very active. So that means you encourage more and more of them to thrive. When there are too many of them, again, it's not about the microbes themselves. But what they're doing, they crank up these pathways that yield production of those types of—you could call it—the pharmacy is producing some of the chemicals that are not so good for you.

So what you see reflected in your report, not even something that is just behind the scenes that I’m sharing with you. But right in the report, it says you have high ammonia production pathways, you have high sulfide production pathways, you have high putrescine production pathways. All of these different things are byproducts of protein fermentation. So we talked about sulfide already. We actually just covered one type of pathway that came from sulfate or elemental sulfur in your foods, but we didn't cover the other side which means that actually sulfide in your microbiome can also be produced from sulfur amino acids, which came from your proteins. 

So that's another byproduct of protein fermentation. So you'll see a theme in what we talk about is that it's always like many to many, so there are multiple types of pathways and inputs that can feed one microbial metabolite production like sulfide gas. The way to mitigate the sulfide could be from many different foods, and some of them have a high content of a certain nutrient, and some have low content. we have all that part of the knowledge base so that we can tell you from many to many which foods or nutrients supplements are best for you and are most important superfood or to avoid them.

For the pathways, you could see that sulfide for instance it's part of the pro-inflammatory activity because it can have an inflammatory effect on your gut lining and overall, but it is also part of your protein fermentation theme. Those themes are like the functional scores that level in our UI you'll see that you probably already have, those are the functional score areas. Then there are the pathway scores like ammonia, sulfide, and putrescine that I just mentioned. Those are pathway scores that feed into the functional area scores, and multiple functional area scores ultimately get aggregated into the health level scores.

So on the level of a health score, you have gut microbiome health, you have cellular health, immune system health, and stress response health. Those health scores, you have them actually for the most part in an average zone. There’s also mitochondrial health I forgot to mention. But once you start drilling into it, you will actually see how, just like you said, you drill into it if you want to know the details. Why is it not 100%? Why is this score not perfect? Then you see that on a more granular level, aha, it's the protein fermentation, which is part of digestive efficiency. And then there's the inflammatory activity, which both have the sulfide gas production and ammonia production pathway score.

So as you drill in even further and you say, okay, my food said something about this sulfide thing. I want to learn about that score. Then you learn about that score and you see that actually, even that is many different pathways that can lead to sulfide gas production, which is why even in that pathway score, it's still plural. It's called sulfide gas production pathways because there are many, many different routes like hundreds of them that can lead to the ultimate production of sulfide by your microbes.

So understanding which ones of those are most lit up and how active those pathways are is what helps us to connect on the molecular level this whole system of many to many from scores on different levels to nutrients in either food and or supplements.

Anyway, bringing it back to the whole point is that you have various health areas, You have your digestion, and you have your protein fermentation. So to address the protein fermentation and the other route of sulfide gas production, that's why you see some of the digestive enzymes, which you're already getting in your supplements. You will see some of the foods that give you more bioavailable elemental amino acids, so some of the sprouted foods. I think you have the grapefruit and some of these like betaine and papain sources.

And then you also have to stay away from cruciferous vegetables for the sulfide reasons and things like that. So that tells you how many different areas of superfood and avoid recommendations, enzymes, and other types of nutrients in your supplements all have to do with various aspects of multiple scores. There's protein fermentation, there's sulfide reduction, there's an inflammatory activity, and all of these different components.

Sometimes, when people say, okay, just tell us exactly what is this one thing or how to improve this one score. A lot of times, there is more than one way to improve them, and to different people are different foods that will actually do the trick. So one score can influence many foods, and one food can be influenced by many, many different scores before it's actually placed into your minimize or avoid. So if you want us to like spell out every single piece of the logic that is taking place for your results, then it's almost like you have to be careful what you wish for because it could be hundreds of pages of different lines of code that took all these things into consideration and said okay, it's really avoid for you.

[00:42:20] Ashley James: Just avoid it.

[00:42:21] Ally Perlina: That’s how it goes. Just avoid it, or just get these supplements, it's good for you. Now, when we can, we highlight that. If you get your report and just even find on page—Control F or Command F—and you say score, then you will see all of the references in your food recommendations pages to any score. Whenever it's a very obvious one that you can pin it more or less on that one score to focus on, we do tell you that except you'll see more than one food most likely that alludes to that score when it needs help. That's just the thing.

We try the best we can and thank you for the kind words saying that we've done a pretty good job, but we need to do probably even better to strike that balance between giving people all that information because we truly want to empower them with all this knowledge. But at the same time, not overwhelming them and making it very simple and clear. Okay, some of these things, they're not optimal so you see it in the red. These are the foods you need to focus on, these are your superfoods, these are your avoid foods, and these are your supplements. 

So at least, if that's all they want to get out of this, they don't want to be burdened with all this extra info, they can get that and take it to action immediately on that day because that's extremely important. If you overwhelm people, it doesn't matter how smart you are, it's not about that. You're not helping them if it loses them. We need to be very much mindful of this concept of balance.

[00:43:52] Ashley James: It's interesting talking to you, I think I identified that I have been eating less and less protein from plant sources because it does—in large amounts—give me quite a bit of bloating. Even with too much tofu, it's upsetting, and just thinking about beans, I think I just have gradually been eating less and less or smaller portions, I should say. That and I’m very satisfied with how many grams of protein I consume. Although now I’m pregnant and my midwife has made it abundantly clear that she wants me eating more protein. But as far as the average female, 40 grams of protein for the average female is quite sufficient, 60 if you're an athlete, which is easily doable from multiple plant sources.

However, if I were to consume a great deal of any kinds of protein powder like pea protein, pumpkin seed protein, or edamame. Any large amount I would get bloated and that is interesting that you say that it's because you can see it in my microbiome that it is fermenting, it's not properly digesting, it's fermenting, and then it's leading to metabolites. What do these metabolites do to the body?

[00:45:32] Ally Perlina: Great question. So in your case specifically, I mean, I want to put it in the context that there are many things they can do, but there is this aggregate functional score called microbiome induced stress. I know it sounds quite general until you drill into it and you see exactly what it is. It will explain to you that within microbiome induced stress, which you have in the red zone so it's not optimal. it's not terrible or anything but it's in the suboptimal zone. You'll see that is where you have that ammonia production, uric acid, sulfide production, and even TMA production I believe as well. All these pathway scores are part of the microbiome induced stress.

So what does it mean microbiome induced stress? I mean, there are so many different types of stress. So microbiomes can secrete those or produce those metabolites, which are small molecules, and they can cross the gut lining, the intestinal barrier pretty easily even if you have a pretty good gut lining, which according to our test seems like you do. But some of these really, really small molecules like ammonia it's pretty tiny. It can really cross easily and go into the bloodstream, and in the bloodstream, it can really cause its own pro-inflammatory or stress response type of reaction. In a way, it can be somewhat of a toxin. Again, not to sound scary or anything like that, but it's all about the relative amounts. 

So sulfide, ammonia, putrescine, cadaverine, the byproducts of protein fermentation—that's one source. The other source of microbiome induced stress or potential pro-inflammatory type stress is your uric acid production, and that's something that can actually be felt or experienced by some people—to some degree, depends on how much of it you have and how quickly your body gets rid of it, mitigates it, or clears it.

All of these different pathway scores actually tell you well why you need to even know about this pathway? Because if it's not insightful for your health or it's not actionable, then who would want to log in just to learn biology, right? There are textbooks for that. Of course, we're learning something new about biology in this new context, but still, we only give you something that is insightful and actionable. You can read about it and there are references, but just to summarize, all of these different small molecules, the microbes make. If they make too much they cross the gut lining, and then they go into the bloodstream. And they can actually inflict a little bit of the damaging response to certain cellular membranes or stress your system to be able to keep up with clearing or detoxing some of these different molecular entities.

If you don't have your entire system up to the task, it's somewhat of a warning sign to make sure that you mitigate that. That's why for the overall health level of stress response health, you're still fine, You're in the average zone. But when it comes to microbiome induced stress, that's where you can read more about these pathways like ammonia, sulfide, and the other ones that I just mentioned so you could see what it does to your body. We already talked about some of the foods and digestive strategies that you need to focus on that are part of your recommendations and foods and supplements so you can be prepared and mitigate.

So even if nothing really palpable is already happening, the point is to keep you in the wellness space and keep as much illness optional as possible so that you can take action on your biology. Like you said, you don't want to just throw darts at some fad diets or trendy supplements. You want to be able to make biologically informed choices that are smart for you, that are informed by your own pathways, your own biology with molecular-level precision. That's basically what we're all about. I hope that answers your question, or if you want, we could go more specifically.

[00:49:49] Ashley James: Well, I love that you said biologically informed choices. I mean, that's a writer downer right there. I told you about my history with the ketogenic diet, the paleo diet. I’ve been on at least 25 diets. I’ve read every diet book you could touch because I’m a seeker of health, though. I was trying to figure out what my body best requires. Everyone that writes a diet book says that theirs is the best and they have the science to back it. When I went through the institute for integrative nutrition—it's a year-long health coach training program—you learn a hundred different dietary theories, and every week we're trying a new one. Once you learn one you want to try it.

Within the first week or so, we're doing the raw vegan diet. I lasted six days on that. I felt fantastic, but boy was I gassy. I expected the gas to go away because all the raw vegans say that'll go away, that'll go away, and now I know why I was gassy, first of all. Luckily, the gas is not smelly, it's just plentiful. So when I was doing the raw vegan diet, that was just like I could have powered a vehicle. Each experience with different health routines showed me just how wrong it is to listen to one expert and do one diet that's apparently supposed to be for everyone. Because if I can't eat cruciferous vegetables because of the genetic expressions of my unique microbiome, then any diet that incorporates cruciferous vegetables is not going to be beneficial to me as an individual.

But with the ketogenic diet, which many have touted as being just a miracle for them, left me in such a bad state of health that it took me a few years to recover. And it left my husband in such a bad state of health that he was immediately put on two medications—actually three I believe and then he was down to two—because it damaged his kidneys. We were actually under the supervision of a naturopath while we were doing this ketogenic diet, but it destroyed my husband's kidneys. It took him a few years, but he was able to completely recover using natural medicine. That's when we adopted a whole food plant-based diet, that was right around that time. For me, it damaged my liver and I had such bad digestive distress from the ketogenic diet.

Again, if we apply what you're teaching, which is making biologically informed choices based on the unique complexity of the own expression of the bacteria that are in us and part of us, then we can craft the most healing diet for us. If someone leans more towards eating paleo, more towards eating the Mediterranean, more towards eating their native diet—maybe their South American, Central American, or Asian diet. If they lean more towards looking at their ancestors and eating more what their ancestors ate in that way and they feel good, then they take your kit and they get the results back. Your kits give you lots of foods you can eat. You give lots of foods that are superfoods that are incredibly healing for your body, and then you give a dozen or so or two dozen absolutely avoid these, and here are the reasons why.

Someone could take that and adapt it to any way of eating that best suits them. But since I have removed all of the do not eat that you have on my list, and since I have increased the superfoods—which I’m so excited about, I’m absolutely loving them—without guilt, I am avidly eating my avocados again, and all the other things in the superfood list. You even give how much of each one to reduce. Here, just have half a cup of this at most. I’ve taken that so seriously and I really feel—in the last 17 days—a huge shift in my digestion, even though I am going through the stages of pregnancy that would actually leave me in worse digestion. I’m feeling the least bloated I have in a very long time.

I came to Viome without any real health concerns. I just wanted to take it to the next level, but people come to you who have major health problems, who have MS, have Hashimoto's, or have major gut dysbiosis. I have several listeners who have expressed concerns that they now can only eat a dozen foods or less because most foods make them sick. They feel very pinned into a corner where they now only have just a small handful of foods that they can eat because they've done an elimination diet and they've really discovered that almost everything makes them sick.

Well, if they had this information at hand it would help them to understand why. Maybe something as simple as the supplements that your results show because you show here is the different digestive enzymes you're low in. If you were to incorporate those, then maybe they would have been able to then eat a larger variety of foods. Because it's not always about what we're allergic to, it's about what metabolites our microbiome produces, and those metabolites can cause damage.

Now just to get back to some very specific examples because this is all wonderful information you're sharing, but I want people to be able to relate it to their life specifically. Can you give a real-world example of a metabolite or metabolites that are created in the gut, and what symptoms or illness could people have as a result of specific metabolites created by the microbiome?

[00:56:42] Ally Perlina: Yeah, absolutely. So we talked a little bit about a few of them. Just to say that look, if you have microbiome-induced stress or inflammation, then you may have all kinds of feelings of either a toxic burden where you feel a little unwell, tired, queasy; or you may have more brain fog because it can also cross. Those things can cross the blood-brain and gut blood barriers. That could be one of the themes but, I didn't touch on the other themes.

There are really well-known pro-inflammatory molecules that are produced by the microbiome like LPAs—lipopolysaccharide. Specific types of lipids and carbohydrate subunits, that's why the lipopolysaccharide. Saccharide is for the carbs, and lipo is the lipid part. They get together and in slightly different conformations based on what microbes are there. they can be actually found in the blood especially if you have more of a leaky gut. The reason I didn't bring it up right away, especially in your context, is because you don't have an LPS score for LPS biosynthesis. The production of this LPS molecule, you don't have it in the red, you don't have it as suboptimal. So you're more or less fine on that, and you also have a good gut lining health score.

In general, we do see quite a few. It's a pretty common case. I would say 30% of our Viome population, quite a few people have LPS production on the higher side. And if it goes hand in hand with your gut lining score being suboptimal as well, then you're really at risk of triggering an immune response. The way it happens is this LPS molecule, which is just part of the normal outside coding of some of the microbes, not all. It goes into the bloodstream and it elicits this immune response. The blood cells start to notice it and recruit other blood cells, say hey, come over here. We've got an issue. So to do that, they have to secrete certain molecules themselves, and that's the signaling that happens now on the blood side of things, which we also test with the health intelligence kit. The service gives you this kit to test the blood that you mentioned already.

So you collect your blood. We look at gene expression, not only within your microbiome now, but now we look from the blood side to see are those pathways on, and are they really active that tell us that you have immune triggering happening a bit too much? Do you have it really high? Because that's exactly what can happen if some of the pro-inflammatory metabolites can cross the gut lining and actually instigate some of this reaction. So that the T cells of different kinds will start to get overly active and secrete these proinflammatory molecules in order to combat the foreign type of substance that has entered the blood. And those molecules are called some of the cytokines or pro-inflammatory cytokines. Maybe some of you have heard of interleukins and TNF alpha.

It can cause other types of molecules to be elevated. And ultimately, if they don't come down, so to speak, then some damage can be done to cellular components and membranes. And a lot of the cellular energy can be expanded towards mitigating this inflammation, which really should not even be there in the bloodstream, as opposed to healing and rejuvenating itself. In that sense, we're waiting to get to the point like okay, well, how do I sense it? How do I feel it aside from testing it?

That's the tricky part because depending on what you're doing to yourself, what you're eating, what you're susceptible to, and what else is going on, inflammation can actually take residents in different parts of a human body. some people, like I said, the inflammation can actually be manifested in the brain, in the mind, in such a way that is just subtle enough that you won't think of it like aha, I feel inflammation because you just might experience a little bit of irritability, insomnia, brain fog, confusion, or anxiety.

Actually, some of the pro-inflammatory pathways that can stem from the gut microbiome have been implicated in lowering dopamine levels, which can make people feel depressed. They have also been implicated in the pathogenesis of neurodegenerative diseases because if enough of these molecules or the microbes themselves like the small viruses from the gut can actually go all the way through the blood into the brain, they can activate now inside the central nervous system. They can activate pathways to where the glial cells actually overreact, and then they start to get destroyed and inflammation in the brain can cause neuronal damage, which then contributes to—like you were mentioning—a mess and other things. They can be part of the entire picture of some of the neurodegenerative, cognitive, or mood disorders. So that's one set.

And then another set of inflammation examples that we all probably heard of a lot is the autoimmune joint conditions. There's the more local, obviously, IBD—inflammatory bowel disease, which is right there in the gut. And then there are a lot of customers that say that following our regimen really helps them who have joint, skin, and other types of inflammatory conditions where you can really see it and feel it. Because inflammation is not created to be equal in any one organ. Whatever you have going on, it depends on the ecosystem and the system's biology of the entire body of all the systems. Wherever you have the weakest link, that's where inflammation will take residence and manifest itself first and foremost and then all the other places.

Some people may not feel it or may not realize that aha, this could be some low-grade inflammation, and some people may truly feel it. Where you feel it completely depends on you, but some of the top symptoms that seem to have improvement in time within our customer base—and we have over 100,000 customers now—deal with mood and autoimmune inflammatory conditions from psoriasis, to rheumatoid arthritis, inflammatory bowel conditions, to mood and sleep, and cognitive and digestive disorders in general. Like I said, it can be different places where it manifests itself.

I wanted to ask you, so far, when we talk about any of these pathways. We talked about TMA a little bit, but then there was a set of pathways you had suboptimal like ammonia, sulfide, and uric acid. Would you say that any of them—even just from reviewing the information—ring a bell with something that you know you had before or you could feel before?


Photo by Kinga Cichewicz on Unsplash

[01:04:25] Ashley James: In regards to?

[01:04:32] Ally Perlina: So uric acid, for example, is something that can come from either purines or protein fermentation, but it's something that people may not feel and other people may feel it if a lot of it accumulates. And that's what's causing gout usually, so I’m just curious.

[01:04:42] Ashley James: Got it. Okay. Absolutely, yes. My blood results from the last few years have shown higher levels of uric acid, especially when I ate meat. Especially back when I did a ketogenic diet, my liver was incredibly angry at me. It was actually sticking out. It was quite inflamed. I had to get an ultrasound and they said I didn't have a fatty liver, I didn't have a cirrhosis liver. I just had an inflamed liver, very angry from the ketogenic diet, and then a very high uric acid level.

I didn't experience gout like the typical person does where it's in their big toe. I had this pain at the base of my foot almost like plantar fasciitis. I was like, I wonder is this plantar fasciitis, is this a bone spur? And just on a gut instinct level—and this is long after I had left the ketogenic diet but right before I transitioned into eating no meat at all. I grabbed some tart cherry juice from the health food store, and I started drinking between two and four ounces a day of the concentrate, and I'd add it to water. And very quickly, within a day or two, the pain in my foot was gone. I know that tart cherry juice is also very anti-inflammatory. It helps the body produce more melatonin, so people get great sleep when you take it. It's a wonderful whole food supplement to take, and it's quite delicious. But knowing that the pain went away immediately I thought, that must be basically gout in my foot manifesting.

At the time, I never really cared for organ meat, so I wasn't gorging on any kind of meat. But my naturopath did say that based on looking at my diet and looking at my blood work, I tended to lean more towards having a build-up of uric acid. That's something though that I feel like I’ve gotten under control because I don't eat any meat so there's really a low purine diet. And then I avoid the other foods that contain purine. And then if I ever do get that feeling in my foot, I just start drinking the tart cherry juice. Although, I haven't had it lately, which is quite exciting. But my liver is getting healthier and healthier. It's interesting because that actually came up in my Viome results, which I never thought that there could be a link to the metabolites produced from the bacteria in my body.

[01:07:36] Ally Perlina: So that is actually very, very interesting because it can actually accumulate to some degree in different tissues, and you may feel a little achy or a little bit of stiffness or limitation of movement, and that could be due to uric acid. Uric acid is something that can be pro-inflammatory, and it's interesting what it's made of by the microbiome. The pathways can come from either the urea cycle, which is from the different amino acid inputs, so back to your protein fermentation protein digestion patterns. Or it can come from purines and purines are high in different meats, fish, seafood, and also some of the vegetables as well.

You could see in your results the haddock, for instance, is to be avoided because of the purines in it, the uric acid potential to promote those pathways. For you, if you did want to eat some fish maybe once in a while, salmon would be a much better choice. Whereas I think it's also halibut, haddock, and trout would not be good because they have a lot of purines. It's not just organ meats and you've done yourself a great favor that you avoid that because of the TMA issue that we talked about and the protein fermentation and digestive efficiency issue. But also now because of the purines.

Some people feel absolutely great eating all kinds of meats, and they cannot take all of these different vegetables. They get so bloated and they feel awful, right? Just like you said, some people feel absolutely great on a ketogenic diet and it's like the biggest blessing that happened to them. But it's not just one type of diet that works for all. Unfortunately, it's usually some complexity of different mixes of things that work just for you. You are your own personalized menu that you need to work out for yourself, and there's just no shortcut around that.

In your case, you've done so great that even before having this information, you've avoided all of these different meats, organ meats, and those types of foods because you naturally just don't have the biology to deal with them in the best way where something beneficial would happen to you. It's actually on the contrary. Plus they come together with all of the TMA, the lipids, and the fats, which could be also tough for your liver. And we also see some of these bile tolerant organisms in there. 

So together with that and the uric acid pathways, it's really painting this more comprehensive picture now that especially that you've shared some of these things with me that you won't do well on this high protein, high-fat diet. Whereas other people I know personally and based on the stats as well, they do so and they report that they feel great on even a really greasy protein diet. But they cannot take all of these different starchy vegetables.

Again, no healthy food is healthy for everybody, and no specific source of protein or whatnot is necessarily a villain either—or good or bad. It all depends on personalization, and that's the real trick. The key is in that that you have to basically deal with the complexity to do what's right for you and to be biologically informed about it.

[01:11:30] Ashley James: I feel like the next question that's on everyone's mind is, is it forever? Because we're taught that the microbiome is always changing and that we could take probiotics. Although that's been disproven that probiotics drastically change the microbiome. But we could eat fermented foods, go gluten-free, eat organic, get a variety of different prebiotics, and nourish a more diverse microbiome. Over time, can we change our microbiome so that it would create different metabolites?

[01:12:17] Ally Perlina: That's a great question, actually. In terms of changing the microbiome, people are taught to think about microbiome as this list of microbes and seeing how much of who's there do I have. What we're doing is a bit of a paradigm shift in that you care less about who is there and how much of them are there. You care about how active they are, but most importantly, you care about what they are actively doing? So that's the microbiome part. And then you care about the host because in your case, you have a microbiome actively doing some of this pro-inflammatory activity in your gut. That's why you have a microbiome score called biofilm chemotaxis and virulence pathways are not optimal.

That would make somebody worry and think well, they're making something that signifies that there is some harmful pro-inflammatory activity. But then you also look at the closed part and you see that actually your immune system activation score—which would tell us if you have ultimately a high level of inflammation or not—is actually on the good side. Whatever happens in your gut stays in your gut. So you still need to take care of it, right? But you need to see what is being produced, what is being actually excreted, secreted, and made that I need to worry about.

On the level of the gut microbiome, you don't want to necessarily make it a super task to completely rebuild it because you have to actually get the most out of the hand that you’re dealt. The microbiome that you have, the easiest way to reap rewards from it is to get the microbiome you have to do what's right for you. You figure out, okay, if I give it so much of this sulfur, cruciferous vegetables, organ meats, or salt, your microbes are stressed out by too much salt or whatever and that's bad for your probiotic microbes. You want to lower that a little bit.

You figure out, based on our recommendations, what are those things you need to optimize in your diet. Even with the microbes you have, you get them to give you the best nutrients. With all of the greens that you eat—and it shows, all of the really beneficial complex carbs that you ingest—turn into really nice butyrate production. Not everybody has that. That's actually not a given that just because you eat vegetables you have high production of butyrate. It's a very beneficial short-chain fatty acid, and it may just be one of the main reasons why your gut lining is pretty happy because it's a very good nourishing component that colonocytes use for energy and it helps the anti-inflammatory effects. Even if you have your microbes secreting these virulence factors and things like that, you have some of the mitigating strategies in place as well.

When you ask about how do we take this to action and what does it all mean? You have to see—on the grand scheme of things—first of all, are my microbes really doing something bad? Not so much who is there, but are my microbes doing something bad? Is there something that tells me this is what you need to improve the score? Because if you just do that, you may already have some really beneficial outcome of that, even if who is there—the microbes themselves—have not drastically changed. And then you basically end up with a story that is not about rebuilding the entire microbiome because most of it is neither good nor bad. Most of the microbiome is just that's your normal at this point. Completely trashing it is not necessarily a good thing, and you're not going to take antibiotics to do that either.

What's important is to reach a balance, and by balance, I don't mean just a balance of good versus bad microbes because, again, most of them are neither good nor bad. But the balance of these beneficial versus harmful activities and functions. Balance of good versus bad pathways that give you good versus bad biochemical outputs—these metabolites, these molecules that then go into your bloodstream or can protect or harm your gut lining.

That's a different way of thinking because you're thinking what is happening, that is what matters. And what's happening is telling me what I should do to my system. So it becomes less about treating a microbe and looking at the microbiome more as a means to an end, not the end game itself. Microbes tell us something about the host like your digestion, your patterns of what's happening with your fats and bile acids, and things like that. They can tell us those secrets about you in a way, and so we need this very important readout from microbial activities.

But that doesn't necessarily mean that based on it we're going to expect to overthrow our entire microbiome. Actually, we should expect to reap the rewards of our microbiome that we have, and then if some changes are needed, the way you go about it is not with some antibiotics or anything like that, but by enhancing your probiotic and prebiotic activities so that you get the right ones. And even for probiotics, yeah, I mean there's some controversy out there, but the thing is these probiotics do have different actions even down to the strain level. So not all the lactobacilli are the same. Not all acidophilus species are the same.

So even strain by strain, they have different benefits and they produce different things. Some can actually have histamine promoting effects. Yeah, and people can get this sensitivity when they get certain probiotics. Whereas other people need more of a boost to their immune system, and they need that very much so they'll take those probiotic species and they'll feel great. It's just that people haven't figured it all out, and they're trying to go black and white again to go quickly. Probiotics: good, bad. And doesn't it remind you back to how we were talking about ketogenic: good, bad? Meat: good, bad? Or paleo: good, bad? We just want to hear that because it's really easy to act on.

What I want to remind people of is that it's not all good or bad, it depends, and it depends on your personal biology. The key is in personalization, and you can't personalize if you don't have the molecular level details to do it with molecular-level precision. We try to do that work for you, and hopefully, that helps.

[01:19:02] Ashley James: I love it. You said earlier before we hit record that your goal is to help people embrace complexity and do something good about it. Health is complex. You just totally threw a few listeners for a loop that some of them could have actually developed further histamine problems, meaning increase their allergy symptoms by taking what they thought was a very healthy probiotic. Everyone knows that we should all be in some form of probiotic. This is the thing that everyone says, be on probiotics.

I am quite fascinated because you brought me back to when my son was an infant and he developed food allergies. We were trying to figure out why, but we did have him on a bunch of probiotics and he started to express more of a histamine reaction. And I just wonder if that was one of the things? Of course, it's never one thing only, like you said, it's an accumulation of several things. But if we can look at a few hundred thousand pathways of the genetic expressions of our very complex microbiome that creates all of these pharmacy-grade chemicals in our body, some of which masterfully. Some of which help us to feel happy. Some of which help us to have healthy thyroid function. 

25% of our T3 is converted in the gut. 90% of our serotonin comes from the gut. We keep hearing these things from health experts, but you take it way deeper by going let's look at your individual gut microbiome. 

Now you have so many clients now that you can see the metadata as they do, and I’ve actually had some listeners reach out to me and say I’ve been doing Viome for the last few years and they shared their experience. And my Naturopath, I came to her for my annual physical after I had submitted my results and I was looking forward to receiving them from Viome. She said, oh, Viome. Obviously, she didn't mention their names, but she said I have had several patients who couldn't figure. We did allergy testing, we did everything, and we went through all the tests that naturopaths have, which is so much more complex than most physicians because they're looking at the body as a whole system. 

They couldn't pinpoint, but Viome—your test—was able to get the person the different cases that she had, was able to help them get exactly the information they needed that they couldn't get from other tests because you're not looking at a food allergy or an immune response. You're taking it to a whole new place that is not looked at from anywhere else. It's quite exciting.

Coming back to the real-world application. If someone is tired, they have brain fog, they have the laundry list of symptoms that they're not incredibly happy with—weight gain, the stress in the body like high cortisol, and fatigue. How much of that can be corrected by knowing what to feed your microbiome? How much have you seen corrected? Since you can look at the meta-analysis of so many clients, as they retest and as they share their results, what have you seen accomplished in people's health as they've utilized the Viome results in their life?

[01:23:21] Ally Perlina: Well, it could be on a level of these pathways and microbial communities and how active they are, and it can also be in terms of the symptoms. Some of the common responses in terms of improvement that people see—besides the ones I mentioned about just mood, some of the pains and aches, and things like that—are sleep, brain functioning, and just overall energy. That's another one I did not mention, but it's energy, performance, stamina, and endurance. 

I’m not just talking about athletic endurance because we do have a number of really professional athletes that turn to us and they really like our program, but it's more about actually just endurance of going through the stresses and burdens of life. Some people have it really tough and some people maybe have it even tougher with all of the COVID times, unfortunately. It just helps the body rejuvenate itself and protect itself, and some of that can come from microbes just simply making more of the short-chain fatty acids. That can help on even the epigenetic level and it can help reduce some of the inflammation.

And then other people, it could be more of the immune-boosting effects. Certain microbes can promote immune stimulation but in a way that you need it, not the inflammation to be lingering or anything like that, but the immune-boosting effects. And can promote epithelial cell turnover in the gut, which helps your gut lining be healthy. You seem to have a good gut lining, but certain communities of the microbes start to produce these nutrients that are basically like your B vitamins, vitamin K, and things that you may think you're getting from your pills or your diet. But at the same time, when it's made naturally in the gut from something that is already part of your biological ecosystem and it's in that right place basically at the right time, then there's nothing like it that you can just like swallow as a pill. 

So they can make antioxidants for you, which can then protect your cells, give your cells more energy, and that is something that you can even feel on the overall system level. Even some of the lipids and things that can enhance the functionality of your mitochondria and cellular membranes can also be promoted from the pathways that get turned on by a microbiome.

So back to the real world, it's really just a number of different things that can be responsible for the success that we see. Even B12, we see a lot of that being produced by the microbiome. We see if there are glutathione and selenium pathways activated in the microbiome that can be part of the antioxidant theme. We can see if microbes are helping you detox in a way and help you mitigate any of the reactive oxygen species, which is part of the oxidative stress, and then we measure that in the blood test now with the Health Intelligence Service. That gives you that blood kit and helps you understand your stress levels and your mitochondrial health. Your mitochondrial health is actually pretty good, but it's not perfect, so maybe you need a bit more of that boost.

Back to foods and supplements, you could see that you’re recommended some of the resveratrol, nicotinamide riboside, but it may not be good for everybody. For people who have high senescence, NAD may actually promote that if you also have high inflammatory pathways. But if you don't, it may be great for you. 

Now if you take that and if you take some people to take Metformin just because they read something about it, but you may need to supplement as well with some of these polyphenols that nurture the microbiome and the gut lining and also have the anti-aging and antioxidant effects like quercetin, curcumin, and resveratrol. Because without it, you don't know when some nutrient that is just like being buzzed about is good for you or it's actually harmful to you. 

If you take things that inhibit some of these pathways, you may need to supplement with CoQ10 so you don't deplete your energy because having too much NAD in a certain context without supplementing with CoQ10 may not be the most optimal mix for you. So that's where we get to this whole next chapter which I’m sure we'll talk about some more that I’m really proud of is the personalized supplements where we take the nutrient level precision even farther and give you your own personal blend with your name on it of exactly what you need and nothing that you don't. Because there's so much of the good stuff that can actually cause harmful mixtures for some people—but not others—that we want to actually simplify for you and deliver it so that you just need to stick to these capsules and a stick pack per day with pre- and probiotics. 

You will get exactly the dosages that are specific for you, exactly what you need and none of that extra redundant or harmful stuff that you don't.

[01:28:54] Ashley James: Right. I can imagine that there are supplements that I’ve taken that have choline in it because that's healthy for some people, but not for me based on my microbiome. You've actually cued me to want to go and look at all my supplements and see which ones may have choline in it because I’m going to chuck those, for me. I could give them to my husband, maybe they're good for him. It's so interesting.

When I got my Viome results, I remember I was sitting on the couch with my family. We were all hanging out. I opened up the app. You can do it in a browser. My husband, he's all thumbs so he doesn't like using his phone. He used the website and he quite liked that, and then I used the app. I thought that when I did the kit that I wouldn't buy the supplements. I thought I’ve got enough supplements, I’m just going to follow the food recommendations. 

I think within five minutes of receiving and reading through—I hadn't even finished, I mean, there's a lot of information. I remember having been going to read it to me, what does it say? And I’m like, there's a lot of information here. I’m going to have to digest this in chunks. As I’m going through all my information, of course, it's so easy because you start off by just giving—here are the foods to eat, avoid, and eat less of, and here are your superfoods, which is simple. But then, of course, I want to know more and want to know more and go deeper and deeper into my results. At each turn, it would explain why my microbiome is expressing in this way which produces this and these pathways are happening. Here are the supplements that can help to mitigate that or help to push it in this direction. I thought, how comprehensive is this? It’s amazing.

One of the supplements they’ve wanted me to take was the tart cherry, basically, a cherry extract, which you say comes from tart cherry juice. That’s my exact experience, my body really resonates with that. Your test shows that my unique and individual supplement that you guys would create for me—I looked through and I recognized some of the ingredients as foods, superfoods, or extracts that I have really resonated with. And then there's a laundry list of different wonderful probiotic strains and explaining why these for me specifically. 

You compile them together and ship them off to me as a monthly supply. I thought it was so funny that I opened up the app, sure I would not buy supplements from you, and within five minutes, I’m like, I want to try this. This looks so cool. It's made just for my body and just for me, and it's going to help me come back into balance even more. It got really exciting especially because most of it's from whole food sources that are very specific extracts.

Now, you guys give a discount, which thank you so much. The coupon code is LTH as in Learn True Health. When you buy the Viome kit itself, you can use the coupon code LTH to get the listener discount, but you can also use the coupon code LTH when you order the supplements, and that's nice too. I got a little bit of a wonderful discount, so thank you, and I placed my order and I’m looking forward to them arriving. 

It's only eight capsules. You and I have talked about this because I thought how could you have eight capsules for anyone regardless of their size, but then again, it's not about all the cells in the body. It's really about the microbiome and about the metabolites it creates and about supporting cellular health on a different level. Plus these are very refined extracts that are quite concentrated, so you assured me of the potency. Tell me about the results that people are getting from these supplements. Have you had any feedback, or have you performed studies? I know that even gold medalists are part of your program.

[01:33:17] Ally Perlina: Yup. Precision supplements is a completely brand new program. We just started it, and we're going to do all kinds of studies to report our results, but until this moment in time, for all these years we've been recommending off-the-shelf branded supplements before we started making our own, and that's a completely different type of setup as you can probably imagine. You're limited to only what is formulated and commercially available to suggest to people. We would still operate on the level of nutrients. Look for any supplement that has the following ingredients, but we have no partnerships or we don't endorse any brands. We don't even talk to them. It's completely unbiased. What that left us with is basically the impetus for this whole precision supplements program.

Yes, we've heard of some really good feedback and good results that we've collected and we have the numbers to show it, but they were so limited and hampered by our inability to choose to just get the nutrients from the available formulations that you need in the amounts that you need so you don't have to take 200 pills if you don't need them, and none of the extra stuff that comes with it that you do not need.

If you know that these are the only providers of this particular ingredient, and whoever makes the ingredient is selective about who they give it to sell the ingredient, then you're stuck with whatever those providers formulate. If they formulate it with magnesium stearate, silica dioxide, and all of these different things in high amounts that are not good for you, there's very little control you have. You basically cannot have the flexibility to just pick out the active ingredients in the best concentrated potent form without all of the extras, without the fillers, with picking the right sources and types of the capsule itself, or what should go in the stick pack. We just wanted that flexibility.

Even though we do have some preliminary reports to tell us that yes, we are on the right track with supplements, this program is completely new. We just launched it and are very excited about it, but that doesn't mean that there is no evidence behind our recommendations. Actually, my team and I spent so much time on all of the different rationales and references so that even to the point that it could be overwhelming to some people because we don't want to make it look like we just list some ingredients and we just think it's going to be good for you. 

We actually specify exactly which mechanisms of action are being targeted by these ingredients, and which scores are tied to these mechanisms of action. We also give you this bibliography that tells you, okay, it has been shown that this ingredient has antimicrobial effects. 

For instance, for you, Ashley, you have some of these oral microbes, which are not necessarily pathogens, but they get into your gut and they are overly active. They're more than you would like them to be. That means that maybe some of the nutrients that solve your stressors’ types of pathways that also have antimicrobial effects would be great for you. We try to shoot most birds with fewer stones and give you just those nutrients that you need. You have ginger, I believe, in your foods, and you have mastic gum in your supplements—among other things—that have some of the beneficial polyphenols and carbs. But also have the antimicrobial effects that you need to keep these populations of microbes at bay, and the other ones that are also responsible for the biofilm and chemotaxis types of pathways.

We try to address all of these different things giving you exactly why this is recommended for you and giving you the references. It’s the summary that you don't get anywhere just by googling an ingredient. You'll get some high-level things. But in the actual recommendations for every food and supplement ingredient, you'll see exactly why it's recommended for you.

Back to the eight capsules topic, it’s actually the dosage that is very custom-tailored to you. Just because everybody gets eight capsules does not mean that everyone gets the same dosage whatsoever. Actually, everybody gets a completely different dosage. So cherries are something that has actually already worked well for you. For you it's 879 milligrams in your supplement mix of this cherry powder, other people will only have maybe 300 milligrams of cherry powder, and many people won't have any of the cherry powder. You need the cherries and not just because of the uric acid and other of the pro-inflammatory pathways, but because it also helps to feed some of your microbes associated with beneficial metabolic fitness pathways. That's one of the scores that you need to improve.

In every single one of these nutrient explanations, you will see what scores it helps improve, it also helps with your cellular stress, and then basically why you need to take them and the evidence is there. For our program, we will show in more formal clinical studies what the evidence will be, but for now, the evidence for every single one of them is there. The dosage is there to fit perfectly within eight capsules the things that are most important for you in a dose-dependent way to address your biology.

[01:39:03] Ashley James: I love it. I’m so excited. Ally, do you take the supplements that Viome creates?

[01:39:09] Ally Perlina: Oh, I take everything. I’ll try anything twice.

[01:39:14] Ashley James: I mean, you're part of this system. You're the Chief Translational Science Officer. Who came up with your title at Viome? Did you come up with that?

[01:39:29] Ally Perlina: It’s a team effort.

[01:39:32] Ashley James: it's a team effort, I bet. When you first started taking your own supplements based on your unique Viome results, what did you notice? Did you notice anything different at first when you started taking them?

[01:39:50] Ally Perlina: Yeah, the ways that stress and inflammation manifest in my body are headaches. I’m such a headachy person. I’ve had headaches since 10 years of age, and I have all kinds. The works, basically from migraines and some of the hormone-related ones to things that I think are more because of my protein fermentation issues. I do eat animal products and things like that. I’ve gone through phases in my life when I went completely vegan and vegetarian and somehow I keep going back to having more of a variety including the animal products in the diet. I think that I’m actually not doing well for myself with those things. When I take bromelain and some of the protein proteolytic types of enzymes, I notice that it helps me. It does better for me even with headaches and things like that.

Also just in terms of stress, and I do have a little bit of a histamine thing coming and going depending. I had asthma as a kid, so when I take quercetin along with other things, I know that's one of the ingredients that seems to make me feel better. Without it, it’s not the same. I do notice that some probiotics, I swear they do make me feel—I get itchy eyes. I don't have it all the time, but I get itchy eyes from some probiotics. I don't want to give any probiotics bad names, but there are some probiotics that have even been published to cause a bit more of this histamine sensitivity, or even in the gut, they bring about like the Th17 response. Which for some people could be good because with just a little bit of inflammation in the colon environment, you will stimulate the rejuvenation and proliferation replenishment of colon cells, which you need for your gut lining to be young and active. But if too much of that happens, then you don't want to elicit that response. 

I’ve learned a little bit from all kinds of trials and errors, and I try branded supplements too. I try so much, I rotate them, I forget them, I order new ones, and I try our own, and I try all the packets from our suppliers, obviously. I noticed that some of the probiotics just cause a little bit of the itchy or whatever response in me, and some things will illicit headaches. If I have too much B12, I’m done. I can have just excruciating tension headaches, debilitating ones.

[01:42:37] Ashley James: This is when you take over-the-counter supplements, not your unique Viome supplements?

[01:42:44] Ally Perlina: Actually, for me, if I take too much B12 from anywhere, I’m going to be in trouble. But having said that, methylcobalamin is much better for me than cyanocobalamin for B12. And I hear that's also true for other people. So the type of formulation, the chemical formula that you pick to get your active ingredient in is also very important. The source, where you derive, what is the natural source of the supplement, how is it extracted, how is it prepared, what are the excipients in the formula? Are there any fillers used? Is the capsule vegan or vegetarian? What's it made of? All of those things actually play a role. 

Yes, it's very important to make sure that all of that is well selected and quality control because not the same B vitamin is the same in all the sources. But just in my example, with B12, I just know that if I take too much B12 some people think that more is better and it clears because it's water-soluble it's no problem. But I’m really sensitive to it and I’m sensitive to some of the bifidobacteria. I just am and other people are not.

[01:43:55] Ashley James: That makes a lot of sense considering if you had the MTHFR expression mutation snip. I’ve heard it called different names, but basically if you have MTHFR issues that non-methylated—sorry?

[01:44:16] Ally Perlina: Sorry, just some polymorphisms that can come up that make those issues more or less—the variance in your DNA that can make you a poor metabolizer or not.

[01:44:28] Ashley James: Right, polymorphisms. Thank you. I was reaching for that terminology. Do you know if you have the MTHFR polymorphism?

[01:44:39] Ally Perlina: Not the kind that's well documented. More like benign, not the kind that's really debilitating. I get messed up with B12, whether it's methylcobalamin or cyanocobalamin. Too much B12 messes me up.

[01:45:00] Ashley James: Can you see in your Viome readings? Is it a gut thing? Is it a microbiome issue, or is it something else that has you specifically sensitive to B12 when taken in excess?

[01:45:19] Ally Perlina: I’m not sure, that's a mystery. But I have read on some, just browsing reviews of commercially available products that have high dosages, there's always a subset of people who gave one star who say, oh terrible headaches. Of course, it's a subset so the product can still have high ratings. But if you go to the one-star reviews, especially for products that have 45,000 reviews, you get a really nice sampling. So you get to see those people who really suffered, what did they suffer from? Except my package didn’t, pills were broken, that's the usual. That happens sometimes.

[01:45:52] Ashley James: Right. What were their symptoms?

[01:45:54] Ally Perlina: Yeah, that's how I learn. We really try to do our absolute best to do no harm. Even when it's something that is not a known medically-documented fact, we still all do our research—going to Amazon and other things. We have our PubMed phase, which is the bulk of it. And then with my team, we actually have this thing—we call it like the industry market perspective research. When we're done doing our sciency, geeky stuff, and then we put it aside, and everybody in the team owns their condition and owns their ingredients and say, for your ingredient, your condition you own. Now go to Amazon and then search all of the reputable brand products where there are tons of reviews and search the one-star reviews and see what people are hurting from when they're taking this product. Because maybe, it could be related to the active ingredient, maybe not, but it's good to be aware of that.

That's part of the research that we do. You got to do it. That's the reality check because you may have PubMed saying how great everything is, but then what if you're about to give it in a certain default dose for a certain score or biological area, and then you see actually all the bottles that happen to have it above one something milligrams have more reviews reporting like debilitating headaches, your eyes twitching, or insomnia.

There’s a lot that talks about palpitations, by the way, that has to do with ginkgo, ginseng, and some hidden caffeine sources and things like that. Some people are sensitive to it, some people are not. The fast metabolizers can be sensitive to just about anything. Just a little bit of that can make somebody feel really wired and not able to sleep. People even have anxiety sometimes. It's good to see those reviews, and it's really revealing.

Then you go back to PubMed and you search all the different results reports from either case studies or actually broader types of research work, and then you realize, aha, now it makes sense because it puts it more in the sciency geeky way again. But what prompts it sometimes is actually people's anecdotes and personal reviews. It's really important to keep that reality check and the perspective of how people actually feel so we don't do any harm.

Photo by Usman Yousaf on Unsplash

[01:48:13] Ashley James: I love that you go and use the reviews as market research to collect data. That's so smart. I’ve actually done that. I’ve actually looked at one-star reviews of supplements myself. It's very interesting to collect that information and then wonder why. Why is there a percentage of people that have this issue where the large majority doesn't, but there's going to be a small percentage that do? Why is that? And then digging deeper. I love that you did that.

You are so in touch with your body. You’ve figured stuff out. So you've had headaches, and now the root cause. Have your headaches diminished, or do you feel like you completely have control over them now that you have implemented your Viome results and you take the supplements that are recommended by your Viome results?

[01:49:13] Ally Perlina: Well, yeah I think it really helps, I just don't always do my best. Sometimes it's the basic things like I don't go outside, drink enough water, or something, and that can mess you up no matter what.

[01:49:32] Ashley James: Wait a second, you're human? You ate a big piece of chocolate cake last night, what?

[01:49:39] Ally Perlina: I don't have a sweet tooth, thank goodness because then I would be even more in trouble. I mean, I eat anything and I try to be more mindful of what's good for me. And I know, by the way, for me I cannot do raw broccoli. I mean, not so well or raw cabbage, but I can do the sauerkraut. I’m okay with that, also not too much. But our servings, actually if you see the one you have on superfoods for sauerkraut, it's not actually a really high amount. That's why for you, with all the fermented and probiotic type of components, it's really good. Same for me. I’m actually the same way in that regard. 

I cannot do really high amounts of raw cruciferous vegetables, but if it’s sautéed like the brussels sprouts and things like that then they do better. I actually feel better. I feel really great with kale. I can do spinach, you can do spinach too by the way because your oxalate pathways are fine. You have the microbes that help you process your oxalate, which is you're not as likely to be facing gallstones or kidney stones as some people are who don't have that extra helping from the microbiome actively processing oxalate.

I know what I need to do. I’m just saying it’s a matter of me knowing how to control all this stuff and then me actually taking control on a daily basis and sticking to it. That's a little bit harder to control, but I do my best. I know exactly and I’m guilty of being my own enemy.

[01:51:14] Ashley James: I love that you brought up the oxalates. So my friend Naomi and I—she went whole food plant-based after I did, but I was easing into it and she went 100% overnight. The two of us have shared wonderful meals together, and we even film ourselves cooking in the kitchen together. We created a membership called Learn True Health Home Kitchen where we teach all kinds of delicious meals that are super wholesome. She got a scare because she realized that she was eating a ton of spinach. We became a little obsessed with a few of these dishes that are so spinach heavy and so delicious.

In between the huge amount of spinach and kale she was consuming, there began a concern in her family about how much oxalates she was consuming. I don't think she's ever had a stone. She's never had a scare of a stone—kidney stone or otherwise—but of course, we hear about this. We hear that spinach is healthy but you shouldn't eat too much of it because it's high in oxalates and you could get stones from it. She never had any symptoms. I kind of laughed because I’ve gone through phases where I ate pounds and pounds of spinach and I’ve never had any problems. It is interesting that my microbiome processes it for me so that I could manage to eat a lot of spinach on a regular basis.

[01:52:47] Ally Perlina: Not a lot, not a huge amount.

[01:52:49] Ashley James: Okay. Eat a nice bowl of it. I’m lucky to have never had that problem, never had stones—kidney stones or any stones in my body. I’m quite happy that I haven't had it.

[01:53:05] Ally Perlina: Good, that's great to hear.

[01:53:07] Ashley James: She hasn't either, so the two of us who have been heavy on spinach at times in our lives have not had that problem. I wonder if she also has that same aspect in her microbiome where it helps to process oxalates. Whereas other people may not and they may be super sensitive to spinach and just have to avoid high foods with a lot of oxalates in them. It's interesting that we could look at that and we could see why some people get kidney stones and others don't. It could actually be their gut biome, which is one of the contributing factors to preventing kidney stones. I mean, that's fascinating, right?

[01:53:54] Ally Perlina: Absolutely.

[01:53:56] Ashley James: And there’s so much we could talk about, get into, and understand how the body works in relation to the metabolites the microbiome is producing.

[01:54:07] Ally Perlina: Right. Speaking about microbiomes, we didn't really talk about probiotics. Well, we talked about some of the potential side effects. But some of the probiotics ones you have I believe like lactobacillus rhamnosus gg. There are different strains of it, but some of the strains that you have are actually known to counter the sulfide gas producing activities in your gut. It's like the microbes that you put in as probiotics can also counter the effects of microbes that are already in your gut. 

Instead of always thinking of let's say just getting that nutrient to manipulate the pathway, to take something away, or to supplement with something, one of the things we supplement with is this specific lactobacillus is just one example. But there are also microbes that actually help counter ammonia production in the gut that happens to be activated by other things you do like protein fermentation that you have. You have ammonia production and sulfide gas production, and these microbes will counter the effects and the activities and suppress the effects of these other microbes that are engaged in these pathways making the sulfide and ammonia.

All these things we do explain in those narratives the explanations, but I think that's very important to be mindful of because it's slightly a new science. The effects are stemming from that all the way to the hypothalamus-pituitary axis. Also, you brought it up several times in the conversation, but the endocrine balance that's a whole other story altogether. We see the connections with microbes and then your own cellular health and foods from the endocrine perspective as well. In some cases, you need more of the hormone boosting type of microbes like Tribulus Terrestris, and I think you have that one. There are also other nutrients that we have that boost some of the specific hormone levels or just help you modulate them. In a way, they help the body adapt and tune to its own best levels.

Then there are those activities that we see where microbes actually go and recycle some of the estrogen metabolites into more powerful potent forms of estrogen, which could be great for women who are entering menopause or postmenopausal but may not be so good for people who don't need even more estrogen because that can contribute to some of the sensitivities. It could contribute to weight gain, it can be pro-inflammatory, it could even potentially be carcinogenic.

We can see those pathways, and then we can see in the blood side—we'll come out with those scores really soon in the near future to actually show it to the users as well. We will see if on the blood side we see a lot of this androgen receptor or estrogen receptor ESR1 hormone stimulation of the transcription factor program that then turns on a lot of the different cellular signaling pathways. That is something we can see from this blood test as far as the Health Intelligence Service. Then that can be modulated appropriately with some of the nutrients that we have.

Then when it comes to the foods, for instance back to cruciferous vegetables, you might know that you don't want to have a lot of those if you have an underactive thyroid like hypothyroid function. That is something that traditional regular western medicine has accepted I think for a while because even for those who have hyperthyroid people who need to lower the activity one of the drugs, I think that's one of the older drugs that used to be given, maybe still is given. Now it's called PTU, propylthiouracil. It was actually made from an extract of cabbage. It's one of those components, among others, that makes cruciferous vegetables responsible for lowering the thyroid effects.

It’s basically one huge interwoven circle cycle complex system there that we're deciphering at the moment.

[01:58:29] Ashley James: Right, interesting. Some functional medicine doctors have shared with me on the show that they do not limit cruciferous vegetables for their hypothyroid patients. In fact, they don't see any difference if they have their patients eat it or not eat it. They think the benefits—for those whose microbiome can handle it—of cruciferous vegetables far outweigh any thyroid diminishing effects. It's interesting to look at. We have to myth bust at every turn these old beliefs that have been the health system for so long. We have to come back with a fresh look and go, is this true for everyone? Is this true for every hypothyroid case? Especially when we can take our Viome results and look at someone, okay, you have a hypothyroid but it shows that you actually do really well on cabbage or broccoli. It would be very interesting.

[01:59:40] Ally Perlina: Right, benefits outweigh the risks, in which case you may have some. Maybe it's still not going to be a bucket of broccoli that for some people could be good, but I agree. You could also do it in different ways with steaming, without steaming, and figure out the way that works best for you. The fermented cabbage could be better than raw cabbage and all these things.

[02:00:00] Ashley James: Right, absolutely. There's a well-detailed questionnaire that we fill out after we mail in our test kit. One of them is asking what supplements or medications we're on. Do you take into account people's medications when creating the individual supplements to make sure that they don't interact with each other in a negative way?

[02:00:28] Ally Perlina: Absolutely. Especially for supplements, we needed to make sure that we work it out absolutely right. We still, of course, put a label that just like with any dietary supplement, if you're on medications and have certain medical conditions, you need to consult your healthcare professional. We're not trying to replace the need for medical guidance, but at the same time, we've taken care of all of these different interactions. 

For people who are let's say on SSRIs and some MAOIs, they will get tryptophan for instance not on their list or it would be an avoid food equivalent, but for supplements. It'll be on their to avoid. In terms of nutrient recommendations, they won't get that. Then for people who take ACE inhibitors, there's going to be a specific potassium limitation or avoiding potassium in people who take blood thinners, vitamin K, and many other rules. People who are taking metformin and statins, will get extra priority to make sure we get them the CoQ10 or PQQ that they need to make sure that they replenish that mitochondrial energy production activities and all these things. We take all that into account.

[02:01:57] Ashley James: Yes. Over 20 years ago, I was put on Metformin and it made me sick as a dog and I immediately stopped taking it. I had every symptom. Anytime I have a client that's on medication, I like to go down the list of all the side effects of the medication just to make sure they're not experiencing it because it's very concerning. I’m a health coach, I’m not a doctor, and I always tell my clients that you definitely want to work with a holistic doctor like a naturopathic physician that's licensed to be a physician because they have a deep understanding of how the body works and also how the body interacts with supplements and medication. I’m really concerned that doctors do not sit down with their patients and really scrutinize over every symptom that appears after they get on medication.

I can't tell you how many clients I’ve worked with where they tell me they're on Metformin, for example, and I say, okay, let's just go through and read the actual list on the Metformin website of the complete list of potential side effects. I had a client in the hospital for eight months with acute appendicitis caused by being on Metformin. That in rare cases, Metformin can cause appendicitis. She lost over 80 pounds because she could not eat. For over a year, she could only con sip tea and bone broth, and this was all stemming from. 

Now, this is, of course, a rare event, but medication can, in some cases, have a detrimental effect. I’m really looking forward to the day when like Viome, the pharmaceutical industry could make a unique and realize that based on your DNA and based on all of your body's biology, that Metformin would be a horrible drug for you because they could tell. Could you imagine the day when they could make a special exactly what you need? Oh, your body just needs this pathway and needs this just to go in this direction. We could incorporate holistic medicine so much smoother just like Viome is doing.

But anyway, I’ve had several clients who realize that they're, after talking to them and going through the list, if you look at what Metformin does—I mean, we're picking on Metformin as an example but it could be any pharmaceutical, over-the-counter or prescribed drug. That one of the side effects is hypoglycemia and another side effect is hyperglycemia. What they're taking to treat could actually exacerbate, in some cases. But you're right, any medication we take can reduce nutrients in the body because it’s something that the body has to metabolize.

In the case of cholesterol medication, either cholesterol medication depletes the body of CoQ10, and it is mainstream knowledge that those who are taking—now I do not know why they don't just put CoQ10 in with the cholesterol medication, but they have to supplement with CoQ10. I think that people should supplement a lot more CoQ10 than they're told to take. But Metformin depletes the body of certain nutrients. Magnesium is a nutrient that is often depleted by many over-the-counter and prescribed drugs.

[02:05:25] Ally Perlina: Exactly, yeah. And B vitamins.

[02:05:28] Ashley James: B vitamins, exactly. Selenium or glutathione. We're looking to help bring the body back into balance. We want to go to medicine because we're sick and we want to feel better. In some cases, it’s a matter of life and death and these meds are going to save our lives, and in other cases, we're going to the wrong doctor. The doctor that's not going to actually tell you how to heal or reverse disease, but just going to put you on a med to manage certain things but are going to have a bunch of other symptoms pop up. This is where I get so frustrated because medicine should be personalized like Viome provides.

I love that you guys do take into account the medications people might be on, the supplements people might be on when constructing their unique supplements for them. Is there any feedback that you've gotten? I know it's a fairly new program. You guys have really bet-tested it a great deal. Is there any feedback that you've gotten from taking the supplements that are specifically designed for people that just pops into your mind that you'd love to share?

[02:06:36] Ally Perlina: You know what, let's table this for when you have taken yours and we will have more feedback from people just like you who've already experienced this. Because I don't want to stretch it based on one-off internal examples or anecdotes from ourselves, basically. It just won't be a fair representation of information.

[02:07:00] Ashley James: I’m curious. I want to know what everyone in the lab because I’m sure all of you guys are your own guinea pigs, and I want to know. I know that Naveen has shared his results and his wife's results and how amazing—they've had such a great experience. And of course, everyone in your lab is having fun experiences. Okay, I’m looking forward to that. I’m looking forward to having my own experience with the individualized supplement for me and then coming back and talking more about it.

This has been so much fun Ally. We could really talk a long time, and you did touch on several times that the metabolites that come from our microbes—based on what we feed it—can actually stress the body to the point of cancer, could create carcinogens, and could even increase unhealthy estrogen levels, which is absolutely linked to breast cancer and in men is linked to prostate cancer.

[02:08:00] Ally Perlina: Yes, androgen pathways of all different kinds actually. That can come from the microbiome, not just estrogen.

[02:08:08] Ashley James: And they say, statistically, one in three people—the average standard American diet eating person—will have a diagnosis of cancer in our lifetime. My mom died of liver cancer, my dad died of heart disease—two major illnesses that we look to correct with diet and prevent with diet as well. Anything you can share about how Viome can help people to live so healthy or correct certain things in their life that we could prevent cancer?

[02:08:41] Ally Perlina: I guess this is not surprising if it comes as an answer from me, but we really just invest all that we got, not just from our own brains and expertise, but from all of the published clinical trials in literature and from the internal studies that we have to empower you with actionability in your hands. You don't have to yourself, or your Naturopath or any other doctor read 200,000 pathways because even ourselves—as uniquely positioned as we are—we're not doing this manually day in and day out. It would be impossible to keep it unbiased and objective.

What we do is we pour every single bit of actionable information and insight into our entire infrastructure that gives you these recommendations for foods and supplements. I mean that's part of a mission. That's always been the driver in my mind and my heart. What I do is to make sure that we can scientifically power the medicine, and that stems from specific functional areas that we cover today to the overall wellness, and illness prevention, and longevity. It stands to actually revolutionize, not only the wellness space but also how we approach pharmaceuticals, not just nutraceuticals. Because we do collaborate with pharma, and we're going to do more of that. That is something that brings me back to the eight years that I spent working with various top pharma in the world to help understand these pathway outcomes of drugging different targets.

What are some of the off-target effects or opportunities for repositioning from one disease to another? And also, what makes one person respond to Metformin, for instance, quite well, whereas other people have quite detrimental effects. What can be done to ameliorate that? Anything from companion diagnostics to adjuvant therapeutics and new therapeutics can actually come from this platform that we built because it all comes back to the molecules. 

If your molecules are telling you that from the microbiome this is what's happening, from the blood side this is what may impact your hormones, your health. This is what the immune system is stressed. Then you know these intervention points, which can be targeted with not only food or supplement nutraceuticals, but it can be targeted with actual drugs that can be already in development, or it can be a new generation of drugs that are made with this information. I feel like that's just part of the bigger future vision.

As for now, I think that this is for wellness. Taking the holistic approach, which we're all very passionate about food and supplements. If you get these tests, get familiar with your body, and don't shy away from grabbing this knowledge and seeing what it can do for you. Being more in tune with the information and with what your body needs. Because the more you get into it, the more prepared you will be to really shield yourself from various conditions and to augment this whole healthspan and lifespan. As you know, we have this aging score, which is a unique thing and a relatively new thing itself that you can also track over time and see if you are getting younger. You're younger than your chronological age, so congratulations on that.


Photo by Jay Castor on Unsplash

[02:12:38] Ashley James: Thank you.

[02:12:40] Ally Perlina: But that's also one of the things. It's a very important area called longevity. You think it's one area but actually, to extend longevity—like a healthy lifespan, that means you need to address all possible illnesses and prevent them or reverse them in order to prolong human health. Longevity is not actually just this one area just like any one disease. It's actually getting all the diseases, plus helping you stay at your best, your optimal, and your youngest feeling and looking. That's longevity, it's all the diseases taken care of and then some.

So now, we have—more than ever—this mechanistic insight into aging, and we publish that. I will send you actually the links to this publication and our glycemic response prediction, which is part of our recommendations that we discussed before. I’m very excited about it because our machine learning efforts—very proud of our AI—it's given us something that our data science group actually proposed for us to look at. My group, the translational science, we looked at it and was like, oh my goodness, this is a gold mine. The things that go up with age are those things that are more of the pro-inflammatory microbiome activities.

Like methane production, some of these gas production pathways actually happen to be going more and more and more pronounced with aging, so more associated with age. It makes sense because it can be harmful for your digestive system and therefore can contribute to your aging. Therefore, for some people who have really high methane production pathways—it's not the only thing, but they may also sometimes see a less favorable aging score. But what's fascinating is that we've seen the T cell deterioration and senescence, and all kinds of other types of gut-neuro and not so gut neurofunctional decline signatures as part of both GI—the gut intelligence, and also the blood transcriptome test features that were part of these pathway and functional knowledge nuggets within our aging model.

When we looked at what this AI machine learning model produced and we really dug into those features it was like these—sorry for the noise. When we look at all the features, it's like the mechanisms of this multi-functional, multi-system progressive decline started to just resurface in a new light. I’m quite excited about what we can do and to see how that score—along with all the others that are on a functional level telling you what's happening—may change when you take not only food recommendations into account now, but also take our precision supplements.

I think we should probably have a follow-up because so many new things were just delivered this year. The Health Intelligence Service, this aging score, and now the precision supplements. They're so new. They're all built on the foundation of something we did before, but they're so novel and new that I want to follow up with closing that loop. Maybe in a few months.

[02:16:12] Ashley James: Okay, sounds great. You say new, but it’s by no means not supported by science. You've beta-tested it. There's a lot that's gone into it. It's years in the making, and now it's finally available to the public, which is very exciting. It's everything you've built upon like you said. It's new that it's now finally available to us. Because I’ve talked to you guys several times and learned more about Viome. It's something that's been built upon for years, and I love that at the core of Viome is just a bunch of really geeky scientists that are very experienced and very excited about this. As am I, I’m very excited about it.

I love that you guys do your own studies. You're going to give me links to some of the studies. But you're constantly tinkering in the lab with a lot of guinea pig people, which is really exciting. One study I’m particularly excited about—we'll wrap up the interview by talking about this because I’ve taken up so much of your time. I’m so thankful you've been so generous with sharing with us. This is the cutting edge. I don't fully know if everyone completely has grasped how cutting edge this is. How unbelievably amazing this is. 

This would have cost over 10,000 or more even something like six or seven years ago to have these tests done in such a detailed way. This is something that Naveen talked about in our interview—episode 441,  but that because of the AI, it’s something that people can afford. You might have to save up for it, but it’s equivalent to a lot of other lab tests out there. Just the cost of it is something that the majority of the market can do, which is exciting because it's giving us access to information about ourselves, which is absolutely revolutionary. The fact that then we can take that one step further and look at a list of specific food extracts, of superfoods supplements—based on hundreds of thousands of pathways—understand why our body uniquely will respond in an excellent way to those foods specifically or those supplements specifically. And then why we should avoid others because of the metabolites that are created. Whereas other people could thrive on our do not eat list. It's so brilliant that this is really going to be the key or the answer, that missing piece of the puzzle for many people who have been seeking health for so long.

Now what I love is one of the studies you did was you did a continuous glucose monitor on a group of people, and then you took in a detailed account of the food they ate and how their body uniquely responded based on a glycemic index. I’ve read the book The Glycemic Index Diet. It was created by a cardiologist in Toronto who noticed that he actually had some patients completely reverse heart disease by changing their diet, and that got him really curious. He went through and saw that some foods will metabolize very quickly into sugar. You can eat fruit, it would metabolize quickly, whereas something slow like a complex starch would take longer. But I thought that everyone would react to potatoes the same way. I just thought, okay, it's on the glycemic index here and everyone reacts to it the same way. You guys found something very different. Share with us. 

First of all, how many people were part of the continuous glucose monitor study, how long did you do it for, and what were the results?

[02:20:17] Ally Perlina: Well, the whole study, it took us like a whole year to actually carry it out. That's also part of the enrollment. For several months, it was several hundred people, and a total of I don't know how many tens of thousands of meals ended up being tracked. We actually tracked the sleep and all of these things as well. We looked at their glycemic response. Every 15 minutes there would be a reading that gets electronically taken basically by the glucose monitor. In the end, we analyzed all of this data. Our AI team I did all these great analyses and built our own machine learning model so that we can predict if a white potato is good or bad for you, or the yams are actually good or bad for you. Because there's this never-ending argument. Which ones are more glycemic? Good or bad in terms of glycemic.

Being overly glycemic is something that you want to avoid. The more of these spikes you have of sugar spikes the more you're on the track to insulin resistance. Your insulin sensitivity really starts to diminish with those types of patterns. You want to avoid that. Also, this whole insulin resistance is part of a bigger inflammatory pattern that a lot of times just goes hand in hand.

Long story short, as a result of the study, we have our own model. And as features of the model, those things that the model takes as input, we have all the different levels of the data. The gene expression, the microbes that are active, and also some of the scores like scores that assess your metabolic fitness pathways and some of the inflammatory pathways. They can go on with their own outcomes for each individual once we process your sample along with other features to help us tell you if a banana is too glycemic for you or not. Because if it's not, actually it has some inulin, and it can feed your butyrate producers to produce more of that beneficial short-chain fatty acid for you. But if it's too glycemic, then you might see bananas on minimize. 

And then for potatoes, actually, potatoes can really enhance fecal and bacteria and [inaudible 02:22:47], which is another beneficial microbe that's a butyrate producer. You don't have that available as a probiotic, so you can't just take it. Plus, as you know, probiotics don't always stick around or colonize well. You want to be able to promote these beneficial microbes and their beneficial functions by having the right type of diet. For some people, white potatoes—I mean, not deep-fried of course—may be quite good. But for those people that have this predicted glycemic response outcome by our model that says it might be too high for you, they won't see the white potato in their enjoy or superfood list.

those are the types of things that help us personalize with much better precision. And it's very true about the berries. It's quite interesting. For some people, strawberry, raspberry, or blackberry maybe on the minimized list because of the glycemic response, versus for other people, they have no predicted high glycemic response and they actually feed your akkermansia, which for you is good. That's part of the reason you have all these berries—the strawberry, the blackberry I believe, and the cherries as well. Akkermansia is good for metabolic fitness and usually is associated with a leaner phenotype. Also, some of the berries—and you have pomegranate—feed some of the ellagic acid metabolizers that take ellagic acid and can turn it to urolithin A, which is a very powerful antioxidant that you would benefit from if you feed them those berries versus others don't. Plus, we also discuss the uric acid production and mitigating strategies with the sour cherry. For some people, it would be too glycemic so you cannot have it. But we will try to mitigate it with other strategies through food or supplements.

Taking all that into account, just to summarize, just another example that came to mind, what if you do need help with overall insulin sensitivity and sugar control issues? For some people, they cannot have some of the berries or they cannot have some of the beneficial prebiotic type foods. But let's say in supplements, we can suggest that for them, berberine might be good because it has sugar-lowering benefits. If you have these microbial opportunistic activities and some pathogens or the oral microbes, maybe for those people, berberine is especially good because it has antimicrobial properties. Whereas in food, you will get slightly different things recommended for you.

And then another example that I think Naveen likes very much but I think it doesn't even know that it came from my personal anecdote as well is with strawberry—just speaking of berries—may not necessarily be just a glycemic issue. It could be for some people that it's histamine inducing, because it's histamine inducing, you may not reap the rewards that strawberry has to offer. But you may get a lot of the anthocyanins and fisetin, which is a senolytic and basically anti-aging compound. Back to the whole longevity topic, you can get that as a supplement in your nutrients. In a way, that's your super ingredient. You take it and extract it, then you don't have to deal with either glycemic or histamine promoting properties of strawberry. 

That's just another example of personalization. The supplements are there to literally supplement what you can and cannot have in terms of the foods, and on both supplement levels, it's really this beauty of this systems biology dynamic interplay that we can see with our RNA data that we address because it's many-to-many. You could see many reasons why something can be avoided superfood for you, and many reasons why you may need a combination of foods and specific nutrients in your arsenal of this nutrient diet and recommendation plan. You have your own precision food and supplements that are made for your unique biology. 

There's just no simple way to summarize it all or display in like five bullet points because it is years and years of work that's based upon years and years of knowledge and evidence, and this new data that makes it all possible. I really truly believe in that. As we come up with more studies—we're constantly working on a lot more than we got a chance to cover—I will be happy to talk about it and then send you links for all of the things that we put out there so far.

[02:27:45] Ashley James: Wonderful, exciting. For those who don't have blood sugar as a concern, although one-third of those in the United States—and similar for other countries that follow the similar diet and lifestyle of those in the United States—have pre-diabetes or are diabetic type two, meaning more of insulin resistance, more of a problem at the cellular level not at the pancreatic level, which is type one. But the problems at the cellular level utilizing insulin and metabolizing carbohydrates, and there's a lot that goes into that. There are 16 minerals required to make insulin work correctly with the cell and when they're missing—chromium being the major one, vanadium being another—that insulin cannot work correctly with the cell.

And then there's evidence showing that eating a high-fat diet from oil or animal products actually promotes insulin resistance. Those that cut out oil, cut out animal products, see almost within a week increase in insulin sensitivity. I mean, all this stuff is coming together. Like you said, it's not just one thing. And then we have to take into account the metabolites created by our unique microbiome based on what we're feeding it and those metabolites will have an effect on the blood sugar and on our ability to metabolize the blood sugar. 

But looking at, why is it important for people who are not even remotely diabetic or pre-diabetic, and that is that Dr. William Davis, who I interviewed all the way back in episode 167—it feels like a lifetime ago—he's the author of Wheat Belly and also the author of Undoctored. That was a great interview because he explains that he gets people—in order to heal heart disease and reverse it and even prevent it—he has them monitor their glucose and everything they take in.

Let's say you do not have any diabetes at all. And even what you did with the continuous glucose monitor, if someone could wing that and get their doctor to prescribe them one. But he has them eat a meal, write it down, and then one or two hours later take their glucose and see—even though they're not diabetic—how does their body react two hours later? Is their blood sugar 140, 130, or is it 97? Where is it at? 

If you eat a meal and then you see that two hours later you still have high blood sugar, even though you're not diabetic, he says you got to look at what happened in that meal. What is in that meal and you need to write that down? Are you able to dial in your meals and eat foods that then you see a beautiful blood sugar, a nice rise up and then down, and the body comes back into balance? 

You notice that you can maintain your blood sugar in a very healthy way, then keep eating those meals. He says that has for him has been—and of course, he says everyone should avoid barley, wheat, rye, and in some cases oats. He's able to help people reverse heart disease and prevent heart disease by making sure that even those without diabetes have healthy blood sugar, and have a healthy glycemic response to all the foods they eat.

Your specific, based on your study, when someone gets the Viome kit from you and gets their own results, some of the foods they're told to avoid or to minimize are because their unique body and their unique metabolism microbiome will have a high glycemic reaction to those specific foods. Thus eliminating so much of that guesswork, and also setting them up. If they follow the Viome results as best they can—because we are human—they could be preventing heart disease and other diseases because they're keeping their blood sugar in balance as much as possible. 

That's really exciting that these are the biomarkers you're looking for, and you're looking to promote as much health as possible. Not looking to replace doctors, but really looking to change the health system by diving deep into the individual’s needs. That was such an eye-opener for me because I thought based on—I loved studying the glycemic index diet—everyone reacts to potatoes this way, and everyone reacts to strawberries this way. Not true. What a wonderful revolutionary study that you have published that you've done. That then you can take all that information and put it into the Viome experience as someone goes through.

I highly recommend listeners go to viome.com, use coupon code LTH, get the listener discount. Get the test kit, it's really fun, and it’s such a great experience. The question that I was left with is how many times a year do I do this kit? Should I do it once a year? Should I do it every four months? If I take the supplements that are recommended, eat the diet that's recommended, how much should I see change, and when would be the best time to then test again? So that, okay, don't eat bananas, or now you can eat bananas. How many changes when you get the retest and how often should people retest in order to achieve optimal health?

[02:33:45] Ally Perlina: That's an important question to cover because many people say, okay, well I don't want to be bothered to do this too often. I also don't want to miss the changes that my body goes through as I follow the recommendations. We used to say every quarter, so basically three, four times a year. I think that may still be a good idea for the first year, or maybe just two times a year may be enough because we don't want to make people feel forced or burdened by multiple many, many times a year testing. Although some people like to get all of the digital data on their biology so they retest many, many times a year.

Just as a rule of thumb I’ll say for the first year, if you're especially going through a lot of changes, then at least two times would be good. And then from that point on, unless you just experienced something, you had a surgical procedure, or you had a huge change either huge good or huge bad—hopefully not bad. But when you see that there are some really big changes in the environment, you're trying a completely new lifestyle or whatnot, then you might want to retest just to get the before and after and see what it's doing to your body so you don't miss that moment of changes. But in general, twice a year would probably be a good overall benchmark to aim for. Does that make sense? One more part of the question that I didn't answer is how much change do you expect?

What we've noticed from our just internal observations is that when what we recommend for you to do is not that different from what you've been doing, so down to specific details like what do you use to target your TNF alpha or whatnot, that may change actually. But if the ultimate outcome is there is this action, this action, this action that you've already had covered with your food and supplement before whether you knew it or not, or if your diet is very similar like you did not eat animal protein or almost did not before, and now it's the same with the Viome diet. You did not eat milk products or dairy altogether, now it's the same, then your changes will not be maybe huge and drastic right away. 

Whereas those people who were eating drastically different diets before, got the recommendations and said, I’m going to change everything about my life. I’m going to follow this and this is a huge difference, then you do see more of the difference in their microbiome and their human blood transcriptome happening because you would always anticipate that. You know that there is a link between molecules in the food and your supplements and the molecular patterns in your body. When the change is drastic, you're going to see the change reflected in your body as well. You would expect to see more, and that's what we see. 

If you're more or less the same, then it will just take longer to move that needle, especially on these bigger aggregate scores that cover hundreds of pathways, and it may take a little bit longer. But that's okay, we still see those changes. Just keep up the good work. Some scores don't need improvement and they're not in the red zone, but you want to still get the more perfect score, or you want to maintain a good score that you have. That's why you should follow these recommendations. Just because you don't see earth shattering huge changes doesn't mean that it's not good or it's not working.

Testing a couple of times a year and expecting some changes because RNAs is dynamic and it helps us to be as dynamic as you are, but expecting them to be basically in a way dependent on how big is the change that you're implementing with Viome recommendations. That's how big of a magnitude of a change that you would be likely to see, and that's how fast it may or may not come.

[02:38:10] Ashley James: Exciting. Well, I’m excited. I’m excited to see this unfold. We've already had several listeners share in the Facebook group those who have been working with you and implementing results for a while shared that it has been amazing. They've gotten great results, something as simple as removing one food and adding in a few more can be life-changing for some people, but they just didn't know and they didn't know the science behind it. And then also, by following your system, by following the unique recommendations, it is going to alter the microbiome in a sense and create a more hospitable environment for the gut, for our hormones, and for everything. It's exciting.

Thank you so much for coming on the show and sharing all this information. I can't wait to talk with you again in a few months after I have been on your supplements for a while, after I’ve really had a few months to incorporate. I’ve been incorporating the results of the feedback that I got from the Viome test for the last 17 days already. I am not bloated. There were times when I really couldn't pinpoint what meal it was that I would feel like my belly button's about to pop off. It would come and go, but I always felt like I had lots of energy. Everything was good, it's just that was that one last piece. 

I haven't had that problem in the last 17 days, and that's very exciting. I can't wait to try the supplements. I’m so excited to hear from more of the listeners who are going to go to viome.com, use coupon code LTH, get the test kit. And then when they get the results, use coupon code LTH again to get the supplements and try it out. Come to the Learn True Health Facebook group and share your experience with Viome and share your experience with following the product, their recommendations, and what happened in your health. 

Just the fact that you're able to now control your headaches that were a lifelong problem and so many people suffer from migraines that aren't able to just put their finger on it. If they could get this information, what quality of life changer that it could be for so many people. The aches and pains that people have can go away because of the metabolites that the dysbiosis in their gut is producing based on what they're eating. Their aches and pains can go away. This is so exciting that the quality of life will really go up.

It'd be interesting if you could—maybe I’ll just put this in your thinking cap for you to gnaw on. What if we could somehow measure the quality of life index? Some kind of improvement score based on the quality of life—a decrease of pain, a decrease of inflammation, an increase of energy. And there's some way that you could score to see—over the course of a year, for example, that someone was working with Viome—how much of an improvement in the quality of life that they were experiencing. Have you thought of doing that?

[02:41:20] Ally Perlina: Yes, absolutely. We have these things called progress questionnaires, which you will probably see and you can fill them out every week. Some people fill it out less frequently, and you also have a bigger questionnaire when you re-test. After several months when you want to repeat the testing and you order your new kit you will also tell us about what things changed. 

Some of the things that we put into the questionnaire are actually some of those known standard medical questionnaires that are used by different medical systems. Alternative medicine, Naturopathic medicine, and integrated functional medicine are specifically geared at assessing your overall satisfaction with life. It's just different compilations of different questions that actually make up the core of such known questionnaires that have been validated to do exactly that. It's just a matter of actually coming out with the final ultimate score, and somehow displaying it or communicating it back to our users. That would probably be great at closing that loop. 

I really like that you put that thought in my head because we're actually reworking our questionnaires right now. I know it's a lot of questions, we all know that. We're trying to make it a little bit more smart and savvy on how the user experience goes with that. This could be a great time that you brought it up because we may think of how best to deliver some of the outcomes back to the users of what we learned about their progress and how we see them tracking along. Because for some people, they may not see improvements in scores really fast, but they may start feeling better. For others, it's fascinating, they may not feel better. Some even feel worse in the beginning. It's hard to change so much and stick to the new diet. But then we see after several months their scores improve. 

It's very interesting to have the biological metric as well as the overall wellness and lifestyle satisfaction metrics that we want to be able to analyze and meaningfully communicate back. I believe that would be a great way to close the loop.

[02:43:39] Ashley James: Exciting. Awesome, well thank you. I love hearing about all the work that you do. I just geek out on it. It's just so exciting just imagining where we're going to be 10 years from now, 50 years from now because of the work that you're doing. Do you ever think about that? I know you and I could talk forever, this is going to be my last question. But do you ever think about the future of medicine and how you and the work that you do with all of the wonderful co-workers in your lab that you guys are going to help shape medicine?

[02:44:18] Ally Perlina: Yeah, all the time. That's basically the big mission. We all come from different walks of life, but the same mission that Naveen actually puts out there as our tagline it's in a way my mission and mission of people in Viome is to make illness optional. It just sounds like it's too grand and huge, but you got to take some steps on how you're going to get there. If you don't have a route even planned out at all, then you're never going to get there just because you're going to say it’s too ambitious of a goal. We actually imagine that it will get us from the wellness space to something that gets more accepted by the healthcare systems that hey, this is actually really important. It's changing people's lives. We're going to be showing this in as formal of ways as needed with double-blind placebo-controlled clinical trials, which we already have geared up.

We've launched supplements, now we're getting into the more formal trials. I’m not going to say disrupt, but at least augment, enhance, and add to the health care system. One is from the health care practice, the other one is back to pharmaceutical industries like I said because you need to understand what drives these different patient cohorts to respond or not respond because that can be a make or breaker for the next big drug that can help people. But what if it only helps 45% of people marvelously, and some of it is actually defined by your microbiome-driven or the human cellular pathways that you can measure? And 45% would do just absolutely great, but the other—more than half the population—may not do so great. If you figure out what are these culprits and what are the different ways from food and supplement to help the future pharmaceutical trials succeed, that would be a huge breakthrough.

And then the ultimate breakthrough is to have new engineered probiotics and prebiotics that help us modulate our health and completely new chemical pharmaceutical compounds. Maybe it's a small molecule, maybe it's a monoclonal antibody, that is designed having this information in mind that is the ultimate next step. And then doing it in an integrative and again, biologically informed ways because we already know that. The medical system knows that there's no one drug that fits all perfectly. They almost just don't exist, or the ones that happened to exist. It was more like a lucky break and still, people have these side effects that we all know about.

To actually take control of all that, you have to embrace the complexity you have to actually figure it out. I feel like we're at the cutting edge of this and we're as close as anyone has ever come to this point in the world. When it comes to envisioning this life may be a decade from now, I think that first of all, people will be a lot more informed. The medical system will be a lot more equipped with these latest scientifically and technologically powered methodologies to serve you best in your health journey. The pharmaceutical companies will also adjust their ways and embrace these new perspectives to design new drugs and improve the drugs that maybe have failed at some point before. And all of that is to bring the different levels together to give you these ways to extend your healthy lifespan and reverse your already existing conditions with molecular level precision.

[02:48:03] Ashley James: I love it. Ally, thank you so much for coming on the show today. Thank you so much for sharing with all of us. You've been so generous with your time. And this is the cutting edge. We're hearing it first here.

[02:48:21] Ally Perlina: Thank you so much.

[02:48:22] Ashley James: We're willing to throw the old system out and help reinvent this new system that is more specialized, more personalized, and you guys are working on that. Thank you. This is awesome. Please, listeners, go to viome.com, check it out. Use coupon code LTH and join me in finding out exactly what you should and shouldn't be eating and supplements specifically for you and just see what happens. You never know. Even if you feel healthy, you never know. You could be taking it to a whole nother level just like Naveen shared in his interview. He and his wife were pretty healthy, and then it was like oh my gosh, that was health? I can't believe it. This is like a whole new level. It’s quite exciting

I am very much looking forward to the coming months and seeing the results that I personally have as well as hearing from all the listeners. You've said so much already. Is there anything that you'd like to say to wrap up today's interview or anywhere you want to point us, any directions you want to point us in?

[02:49:28] Ally Perlina: I just want to basically say that you should keep learning and seek the kind of knowledge that will empower you to take control of your health. I think, Ashley, what you're doing is just absolutely wonderful, you're brilliant at it, and you're so curious and you should stay curious. You're teaching others how to go about this. I actually appreciate that you said, my listeners, they want to know some of the geeky details. Maybe some will want to know even more so don't hold back, and some may skip through this and that's okay. 

I like that you're encouraging this, so you have this attitude of why don't you reveal a little bit more of the interesting facts that really make it what it is. What's it like to take this approach and then have it make a difference for your health because if you don’t understand it, you don't seek to, and you don't make people curious about it, then they're not going to be as empowered because they won't know. How does it matter? It's all the same, or it's all you never know what's really right. Tomorrow it's going to be wrong. But then when you really, really start to understand, it's like you feel more in control because knowledge is power.

I just want to say good luck on your health journey and, thank you so much for sharing this and for encouraging your listeners to be part of this journey of actually improving their knowledge, their health, and really taking true control of it. I’m not going to say just point you to one place and go to viome.com. You already did a great job about that. There's just so much unbelievably interesting fascinating information, and you can start by even googling something that is related to you, that's fine. But read the journals, read the news, stay informed, and stay curious. Don't let yourself get overwhelmed and give up. Just little by little, we're all on this journey together. Every day we're learning something. None of us have everything figured out. We don't have all the answers for everything. We're all learning all at our different levels one step at a time.

I just want to say, thank you, Ashley, for doing this. I just want to encourage people to keep at it and go along in your wellness and your learning journey together with you, Ashley. Thank you so much for having me here. I really enjoyed spending this time with you.

[02:52:03] Ashley James: Awesome. Thank you too, Ally. Stay curious.

[02:52:09] Ally Perlina: That's right.

[02:52:12] Ashley James: I hope you enjoyed today's interview. Be sure to use coupon code LTH when you visit viome.com to get the at home test kits. After you get your results with a test kit, then you can order their custom made supplements. I definitely encourage you to just try it for one month and see what changes you notice. I was very surprised at the changes I noticed in such a positive manner. And then all the science behind it and how much information you get about you specifically and how your microbiome and your mitochondria are working and how you can work with them to support your optimal health. It's just absolutely so fascinating how much unique information you get from this test kit. I highly recommend checking it out.

So use coupon code LTH at viome.com and then come to the Facebook group and share your results. We'd love to hear and learn from your experiences and learn from other listeners' experiences as well. Have yourself a fantastic rest of your day and enjoy the holiday season.

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Viome Gut Microbiome Testing’s Results Interpretation and Food and Supplement Recommendations – Ally Perlina
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Ashley James

Health Coach, Podcast Creator, Homeschooling Mom, Passionate About God & Healing

Ashley James is a Holistic Health Coach, Podcaster, Rapid Anxiety Cessation Expert, and avid Whole Food Plant-Based Home Chef. Since 2005 Ashley has worked with clients to transform their lives as a Master Practitioner and Trainer of Neuro-linguistic Programming.

Her health struggles led her to study under the world’s top holistic doctors, where she reversed her type 2 diabetes, PCOS, infertility, chronic infections, and debilitating adrenal fatigue.

In 2016, Ashley launched her podcast Learn True Health with Ashley James to spread the TRUTH about health and healing. You no longer need to suffer; your body CAN and WILL heal itself when we give it what it needs and stop what is harming it!

The Learn True Health Podcast has been celebrated as one of the top holistic health shows today because of Ashley’s passion for extracting the right information from leading experts and doctors of holistic health and Naturopathic medicine


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