¿Cómo puedo mejorar la salud de mi microbioma?

Welcome to the Dr. B Newsletter, a curated healthcare email that delivers vetted reads on whole-body health. Our microbiome is a collection of trillions of gut bacteria that help us digest food, regulate our immune system + fight disease. But it takes work to separate gut fact from fiction. So this week, we toss some fitfluencer red flags into The Checkup. Then share the latest findings on the microbiome + aging, medication and food. And wrap up with news about the Covid-19 health emergency, stubborn ringworm + OTC birth control pills. Let's nosh our way into…

• The Checkup: what to do + not to do
• Gut Health: aging + healing + protecting
• Healthcare: Covid-19 + ringworm + Opill
• Dr. B Treats: bacterial vaginosis!

The Checkup

• 2 in 3 fitfluencers peddle harmful advice. How to spot them
• Spot fake TikTok sign language that’s harming deaf people 
• The updated mammogram recs = 20% more lives saved
• How to talk (+ what not to say) about a pregnancy loss
• For the climate + our bodies, we should eat more beans
• What are skin tags + can you remove them safely at home?
• Have an anxious dog? Human psychology is here to help
• Girl push-up guidelines are outdated. Push-up right

Forever young (gut)!

A new study found that centenarian's microbiomes teem with microbes linked to youthfulnesses!

As we age, our gut bacteria changes with us. Some beneficial bacteria decline. Others that trigger inflammation + disease increase. This is one reason why we get more cancers and other diseases when we’re older.

In the study, researchers dissected the poop samples of those who’ve lived beyond 100. No matter their health status, the centenarians had a unique blend of gut bacteria usually found in younger adults! This suggests that when it comes to living a longer life, being young in gut may eclipse being young at heart.

Read the article for details + tips on nourishing your microbiome.

Got C. diff? There’s (now) a pill for that

Time reports that the FDA just approved SER-109—the first pill to restore beneficial gut bacteria in people with C. difficile (C. diff) infections.

C. diff is a bacterium that can overwhelm a digestive tract after antibiotics have wiped out beneficial gut bacteria. It causes diarrhea and colitis, which trigger dangerous weight loss + dehydration. C. diff is antibiotic-resistant and spreads easily. So around one in six people who get C. diff get it a second time within two months.

In studies, almost 80% of participants given a cocktail of good bacteria via SER-109 remained reinfection free. Until now, microbiome rebalancing has only been possible through fecal transplants. (They're an effective treatment but not easy to get.) Up to 16,000 people die from C. diff every year. So this is excellent news!

While we’re talking bacteria: BV is a common bacterial infection that causes itchy + uncomfortable symptoms around the vagina. Now, Dr. B can help you get effective BV treatment without leaving home.

Learn about our online consultations + BV treatments

A gastro gives advice

Dr. Shilpa Ravella is a gastroenterologist + the author of A Silent Fire: The Story of Inflammation, Diet & Disease. In MindBodyGreen, she shares five under-discussed gut health facts.

1. Intestinal health is vital for immune health. An imbalanced gut is an inflamed gut. This increases inflammation + leads to autoimmune diseases, cancers and more.
2. 95% of us don’t get enough fiber. Fiber cultivates helpful gut bacteria that nourish our gut barrier, improve immune function, prevent inflammation and improve gut diversity.
3. Food diversity > important than quantity. Eating a variety of foods promotes gut diversity more than bulking up on one trendy ingredient.
4. Ugly food is good for us. Imperfect-looking foods grown without pesticides contain more beneficial nutrients than their prettier counterparts. 
5. Fermented foods are vital. Even a few tablespoons of yogurt, kimchi + other fermented foods helps. They may have lower amounts of probiotic bacteria than supplements. But their bacteria variety is more diverse. And again—diversity is key.

Healthcare 411

3 things you should know about the end of the Covid public health emergency (Vox). Insurers no longer have to offer free Covid-19 tests, vaccines + treatment. Our Covid-19 hospital treatment costs will go up—about 8% of the population is uninsured + will have to pay in full. Telehealth access expanded by Medicare + Medicaid will fizzle—Medicare protections continue until the end of 2024; Medicaid varies by state. And smaller hospitals that survived only because of additional government funding will lose those funds. On top of that, SNAP benefits are being reigned in + millions are losing Medicaid benefits.

First US cases of treatment-resistant ringworm found in patients in New York City (CNN). Two unrelated women in NYC have been diagnosed with ringworm caused by *Trichophyton indotineae—*a recently-discovered, antibiotic-resistant fungus. One of the women had not traveled internationally, suggesting community spread stateside. The CDC encourages healthcare providers to monitor ringworm infections closely, noting that testing techniques often misidentify them as other ringworm types. Patients should avoid sharing clothes or hats with anyone who has a rash + avoid close contact with those with ringworm.

What to know about Opill—the birth control pill FDA advisers support making available over-the-counter (Forbes). First approved for use in 1972, an FDA panel unanimously voted to authorize over-the-counter sales of Opill. Sometimes called the mini pill, Opill contains a synthetic form of progesterone. It prevents pregnancy by stopping ovulation, thinning the uterine lining + thickening mucus in the cervix, which makes it harder for sperm to reach an egg. Progestin-only pills have few side effects and health risks. But read the story for concerns + next steps.