I Took an At-Home Poop Test

I never thought I’d be shitting on a flimsy paper hammock but here I am, hoping I don’t miss my target and that the paper doesn’t rip. I put myself through this delightful process because I decided to find out how my gut bacteria is affecting my health and if I should actually stop eating cheese once and for all.

There’s a growing body of research that links the bacteria in your gut to a number of things such as your weight, your mental health, how you react to certain medications, how your genes work, as well as a number of different diseases, such as Crohn’s and ulcerative colitis. And due to this growing popularity of gut microbiome research, a rash of at-home gut bacteria testing kits have popped up on the market all claiming to be able to help you improve or fix your health.

The testing kit I used is called SUPERBIOME from a Toronto-based startup lab called uBioDiscovery, and costs about $255 US, or $329 Canadian, for two samples to be taken as well as a 30-day supply of a probiotic supplement. (I was comped for the purposes of this story). The nondescript box comes in the mail and is equipped with a very basic set of instructions, two sample tubes, two “feces collection devices,” a bottle of probiotics and two pre-paid UPS mailing envelopes.

The particularly graphic act of defecating on a piece of paper that wraps around your toilet seat is step two and four of the gut bacteria testing kit. The first step is to activate your account and fill out the surveys about your background, diet and lifestyle; a.k.a. boring stuff.

After collecting and mailing your first “sample,” you then take probiotics twice a day for the next 30 days. You also have to keep a food diary for the first week, which made me feel like my every food choice was under intense scrutiny and being used as a benchmark for how well I was coping as an adult. (Hint: not well).

Still, I documented my food and and took all of the included probiotics without any major upsets. Then came time for sample number two (pun intended). My second sample was due right after the Christmas holidays where I’d eaten nothing but carbs, cheese, and red meat—not ideal dietary conditions for this kind of experiment. Nonetheless, I mailed off my samples to a next-generation sequencing lab where they would sequence the bacterial DNA in the sample and I waited for my results.

The kit boasts that my results will help me tailor my diet “to promote the growth of beneficial bacteria, and inhibit the colonization of pathogens.” In other words, by getting the DNA in your gut bacteria sequenced you can allegedly “make your microbiome healthier, which will, in turn, make you healthier,” says SUPERBIOME co-founder Aly Burtch.

Burtch and co-founder Alejandro Saettone analyze the results and send you a personalized report of what’s happening in your gut microbiome, as each type of bacteria can play a different role in the body, and they advise you on what you could do to make it better / healthier.

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That being said, when I read the fine print on their website, it noted that the results don’t “constitute medical advice” and are “meant to be used as a guideline.” Also worth mentioning, the kit still doesn’t look at fungi or parasites, both of which could impact your health. (Burtch clarifies that anyone purchasing the product would see a clear disclaimer before they buy explaining that it's not meant to be used as a diagnostic tool.)

It took until October for my results to come back, almost a year since I took the initial sample. (Burtch says that their turnaround time now is four to six weeks.) The results were kind of confusing at first glance. It was just a list of the various kinds of bacteria broken down into categories. Next to the name is the percentage I had of each and I could compare if it went up or down between sample one and two. I could also click on the names of the bacteria to find out what it was associated with, but it didn’t tell me if my results were in the high or low range.

I went back to Burtch to get the results decoded and she pointed out a couple of things that stood out. For example, my levels of Bacteroidetes were much lower than my Firmicutes. Firmicutes are really good at getting calories from food, so the more you have of them the easier it is to gain weight. This is why, according to Burtch, having high levels of Firmicutes is associated with obesity and high adiposity (fat storage). If you can reduce them by upping your level of Bacteroidetes, then you could theoretically lose weight.

She also told me that I had lots of Faecalibacterium Prausnitzii. “This is one of the most important beneficial bacteria in the human gut microbiome. This bacteria is an immune booster, and ferments dietary fibre producing butyrate and short chain fatty acids, which are important in maintaining gut health,” Burtch says.

The results also gave me recommendations on how to get my gut microbiome back in check. Mine said I should eat more high fiber foods such as fruits and vegetables, and avoid “inflammatory foods” like sugar, milk, processed meat, fast food and alcohol. Unsurprising, since that’s the standard advice given to literally everyone on how to improve their diet and overall health. They also say to start taking specific kinds of probiotics such as Bifidobacteria and Lactobacillus to improve digestion and my immune system, but I’m kinda skeptical since there’s not much evidence they are beneficial for your health.

The results also suggest I switch to a paleo or vegetarian diet, but seems like kind of an extreme way to up my fiber intake.

But honestly, I’m not sure it really matters what my results are. As I came to learn there are a number of shortcomings with these at-home testing kits that make them no better than the Meyer-Briggs test is at telling you how well you’re going to do in a job.

“[The kits] are very much about scientific discovery. It’s going to be biased and it’s not going to be complete,” says Rob Knight, co-founder of the American Gut Project and professor at University of California, San Diego. (The American Gut Project also sells a testing kit.) These tests can probably tell you if you have a serious bacterial infection, he says, but they can’t yet diagnose patients with diseases and are unlikely to reliably provide the kind of personalized information they claim they will.

Knight explains the tests might be able to provide guidelines for a very specific sample population but if you try and generalize those results to a more diverse population you’d need to re-do an entire study. In other words, unless you fit the exact profile of the study they used to analyze your gut bacteria, your results probably won’t be able to tell you much, except for the species of bugs that make up your microbiome.

This can still be a cool thing to know if you’re curious. And some citizen science groups are hoping that with contributions from many people, the mysteries of the interactions and our microbiomes and health will be better understood. Right now, gut microbiome research is still very early days, and many of the studies that these tests base their analyzes off of are done with small sample sizes. Any links found between the gut and disease, weight, mental health etc. are correlational, not causational.

For example, I have high levels of Firmicutes which, as Burtch points out, is linked with obesity. But, for the record, I am nowhere near obese. So just because high levels are seen in obese people more than skinny people doesn’t necessarily mean that the bacteria makes you obese. One does not guarantee the other.

Also, the results only show a snapshot in time of your gut microbiome. While the gut microbiome usually remains relatively stable over time there is evidence that shows it can change rapidly, even meal to meal.

“Say you were eating a cheeseburger and a beer for lunch, you would see a change in your microbiome,” Burtch says. At the time I took my samples I was eating like King Henry VIII. There was a day where I ate cake for breakfast and dinner. And no, it was not just the dessert portion of a larger meal. Cake was the main event. There was also a day where I drank seven different types of alcohol (don’t judge me; my hangover was punishment enough.) With that in mind, my results can’t really be expected to paint an accurate picture of what my gut microbiome is usually like.

In order for me to get anything meaningful I would have to look at my microbiome over time, which is what SUPERBIOME is intended for. But that means I have to take more than two samples—and that’s gonna get kinda pricey. Jack Gilbert, faculty director of the Microbiome Center at the University of Chicago, estimated in a interview that it could cost consumers upwards of $6000 to monitor your gut microbiome over the months (or years) that would be needed to get any meaningful data.

But probably the biggest sign that these kinds of tests shouldn’t be taken too seriously is, as Knight points out, the fact that the FDA hasn’t approved a single one of these kits. (Burtch points out that the kit isn't meant to be a diagnostic tool, hence why they didn't seek approval.) So my gut feeling about these tests is that they’re fine to do as an experiment or perhaps learn a little more about what’s swimming around in your body but it’s important to understand the limitations of the results. You don’t need this test to tell you to stop eating like a trash. And if you actually have a gut-related disease go to the doctor and sort your literal shit out.

In response to these reflections, Burtch points out the following: "The SUPERBIOME kit not only provides you with the composition of your microbiome, but also with dietary suggestions based on your unique community of gut bacteria. The diet suggestions are not intended to be a long-term solution; instead the goal of following this diet is to help bring balance back to your microbiome, and an increased diversity. Many of our customers notice that when they eat a healthier and more balanced diet, they experience less bloating, faster digestion and less inflammation. Since SUPERBIOME is a monitoring program, it is a great way to track your microbiome over time, and see if there are certain symptoms that you are experiencing that are related to specific profiles of gut bacteria."

As for me, this test mostly just gave me some real world practice for when I need to do my colon cancer screening test in 25 odd years and serves as a great reminder that I should probably eat more fruits and vegetables this Christmas season.

11/8/18: This story has been updated to include a followup statement from Aly Burtch.

11/8/18: This story has been corrected to reflect the fact that paying customers get a pre-purchase disclaimer that the product is not to be used as a diagnostic tool, and updated to reflect the fact that the American Gut Project also has a microbiome testing kit. We regret the oversights.

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