Staged gut intervention: depopulation before repopulation
Moore explained that many people cycle through probiotics without seeing improvement because they never address the underlying 'anchoring elements.' He likened the situation to a boat with an anchor: to move it, you must first lift the anchor. The test looks at specific taxa and functions that pull the microbiome into a dysbiotic state. By targeting those with evidence-backed natural antimicrobials or binding agents like activated charcoal, you create vacancies. Only after those niches open can probiotic strains effectively engraft. Fasting, when used appropriately, is another potent depopulation tool that he has published on. The appendix's role as a source of inoculum also means that individuals without an appendix may need a longer or more carefully managed repopulation phase. He stressed that these recommendations are personalized using metadata from an intake questionnaire.
Pathogenic bacteria often occupy specific metabolic niches and adhere to the gut epithelium via biofilm formation. Depopulation agents disrupt biofilms or directly kill overgrown pathogens, freeing up attachment sites and nutrient sources. After this bottleneck, the lower microbial density allows administered probiotics or endogenous appendix-resident commensals to colonize without competition.
We need to address these different pillars or these different anchoring elements before we can start providing more directed therapy. Everything kind of has to be staged with the microbiome because it is an environment.