Dr. Kara Fitzgerald | New Frontiers in Functional Medicine, Longevity, Epigenetics The Bile Acid Imbalance Accelerating Aging: How to Detect & Fix It
Sep 25, 2025
Dr. Tom Fabian, a translational scientist and microbiome research expert, sheds light on bile acid imbalances and their role in gut health. He discusses how specific types of inflammation and microbial patterns can guide interventions to improve patient outcomes. Notably, Tom connects low butyrate levels to inflammatory bowel disease and reveals the surprising ways some fibers might exacerbate gut irritation. He emphasizes using StoolOMX and GI-MAP tests for precision medicine in complex cases, making science practical for clinicians.
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Primary Bile Acids Plus Low Butyrate Harm Mitochondria
- Excess primary bile acids and low butyrate can jointly damage colonocyte mitochondria and promote inflammatory dysbiosis.
- This two-hit metabolic disruption links bile acid malabsorption to worsened gut inflammation and barrier dysfunction.
Dysbiosis Is An Ecosystem Shift
- Dysbiosis is best seen as an ecosystem change: microbes plus the gut environment that supports them.
- Diagnostic stool tests should therefore measure both microbial taxa and environmental/metabolic markers.
Inflammation Is A Spectrum Defined By Immune Type
- Inflammation spans a spectrum and is categorized by immune cell programs (type 1, 2, 3) rather than a single definition.
- Identifying the immune type helps target downstream treatments in gut disorders.