
Gut microbes eat medication - conse_lad
https://chemistry.harvard.edu/news/gut-microbes-eat-our-medication
======
ChuckMcM
The more we know about the microbiome of the gut the more interesting its
interaction with our health becomes. This is an example of a bacterium that
eats L-dopa (a drug used to treat Parkinson's disease). There are a number of
PhD's waiting to be handed out for additional research here I think.

~~~
theseadroid
I wonder how many diseases are becoming more prevalent because we eat
manufactured food on a long term basis. Additives have been approved on the
ground that they are not harmful to our body, yet we know very little in which
ways they may influence our gut microbes (e.g. [1]).

A higher proportion of North Americans tend to find certain kinds of
food/snacks from other cultures gross, yet the perfectly
sterilized/packaged/high-sugar food options here are probably much more
harmful.

[https://www.sciencedaily.com/releases/2018/10/181001101932.h...](https://www.sciencedaily.com/releases/2018/10/181001101932.htm)

~~~
devoply
Not only is this a period of great extinction, this is also a period of great
sterilization where we are trying to kill everything that eats anything that
we produce... as if we are not one of those things and somehow separate from
it all. In the end this war will either be won in which case we will probably
have a number of other health issues to deal with or lost in which we
recognize that there is no difference between us and the environment and that
we are both part of a whole that we can shape immensely.

~~~
rexpop
For a visceral encounter with extremes on this theme, read Kim Stanley
Robinson's novel "Aurora".

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chiefalchemist
> “But this kind of microbial metabolism can also be detrimental,” said Maini
> Rekdal, a graduate student in the lab of Professor Emily Balskus and first-
> author on their new study published in Science. According to Maini Rekdal,
> gut microbes can chew up medications, too, often with hazardous side
> effects. “Maybe the drug is not going to reach its target in the body, maybe
> it’s going to be toxic all of a sudden, maybe it’s going to be less
> helpful,” Maini Rekdal said.

To be fair (to our "hosts"), gut microbes do us far more good than harm. Yet
we continue to prescribe antibiotics like they're Pez candies, and hand
sanitizer'ed our way to "germ-free" because that's what sold the product.

~~~
raverbashing
Yeah but you don't get gut microbiota by eating with dirty hands, quite the
contrary, a severe gastric infection can mess with your gut flora

~~~
chillwaves
Our concept of "dirty" needs revisiting.

What is the actual chance of getting the infection you describe? And in what
conditions?

~~~
mrob
I wonder if there's actually something to the Raw Foodism movement, not
because of their nonsense claims about enzymes, but because raw food contains
more viable bacteria.

~~~
chiefalchemist
I've thought similar about microwaves. That is, using them to cook kills
microbes - bad ones, but also good ones.

~~~
mrob
How does a microwave kill microbes more effectively than any other cooking
method?

~~~
chiefalchemist
Microwaves. Not the same as gas heat, transfering thought a pan and into the
food.

Time. A thorough X seconds in the microwave is more convenient than standing
at the stove.

It's the tools. It's how they're most likely used.

~~~
nitrogen
If anything I'd expect microwaves' shorter cooking times and lower max
temperatures to leave more bacteria alive.

~~~
jstarfish
They also don't cook evenly. You can have a TV dinner that is half molten and
half frozen if you nuke it without the plastic lid.

Microwave sterilizers depend on steam to sterilize, not radiation. They just
get the water to that temperature quicker than boiling in a pot.

Results also vary by organism being eradicated. Hamster in a microwave will
end sadly. Cockroaches and ants will survive. Insects have less fatty tissue
to absorb radiation I believe. Bacteria has none, so you do the math.

~~~
mrob
Uneven cooking is because of standing waves within the microwave. Lots of
microwaves have rotating platforms to reduce this problem. If they're not
being forcibly rotated, small enough creatures can avoid being cooked by
staying at the nodes of the standing waves.

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ademup
It appears to me that this may be an opportunity to harness the gut to
intentionally deliver multi-stage options: perhaps relying on microbiome-
consumption for timing and\or changing strategy mid-digestion?

To what would have been my great loss, I almost gave up on this article after
reading the first three paragraphs. They set the stage for an agonizingly long
article that would have made me work hard to glean meaningful insight.
However, the rest of the article was somehow both consice enough for me to
stay engaged, and descriptive enough for me to learn. (This is my humble plea
to journalists to please forego this type of writing)

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phnofive
Not that it’s not an interesting workaround, but my reaction to hearing that
L-dopa is poorly absorbed by mouth was to wonder if other routes had been
tried[0]; seems simpler and more effective for those suffering with
Parkinson’s.

[0]:[https://www.ncbi.nlm.nih.gov/m/pubmed/28405912/](https://www.ncbi.nlm.nih.gov/m/pubmed/28405912/)

~~~
maxerickson
There's an inhaled form:

[https://www.michaeljfox.org/news/inhaled-levodopa-time-
moves...](https://www.michaeljfox.org/news/inhaled-levodopa-time-moves-fda-
review)

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cryptozeus
“Why would bacteria adapt to use dopamine, which is typically associated with
the brain?”

As we train ourself with instant hit of dopemine every 10 seconds using social
media and other stuff, we have trained our microbes to do the same :)

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dghughes
I'm amazed that even chemotherapy drugs are consumed by gut microbes. I would
assume it's only the pill form taken orally.

>The gut microbiota has the potential to directly metabolise chemotherapeutic
drugs and also to modify the host metabolic milieu, indirectly altering host-
chemotherapeutic metabolism

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145523/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145523/)

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srndh
Reading this, I cannot help but wonder.

We are clueless about the gut microbes in our body, but know a lot about
dinosaurs. Most of the ocean floors remain inaccessible, yet we have a picture
of the black hole. We have no idea where exactly are airplanes in the sky, but
we are controlling rover on the surface of Mars that is sending us selfies.

I cannot help but wonder what if the Rover is actually on some unknown island
on Earth itself & the picture of the black hole is actually something else.

FYI: I am just bored & hungry.

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mamon
Is that the reason why it is advised against washing down pills with
grapefruit juice? I know that it can cause overdose of the drug, but I'm not
sure if it works by affecting those gut microbes or by blocking some digestive
enzyme that normally destroys like 90% of drug's active substance before it
can be absorbed.

~~~
ncmncm
Grapefruit interferes in a certain pathway in the liver. Some drugs are broken
down in that pathway, so they stay longer in the body and build up, dose on
dose, if you get too much grapefruit for too long. Other drugs are altered
into their active form, or an intermediate; then, interfering with that keeps
the drug from working at all. Furthermore, an intermediate form that is not
supposed to last may be toxic, so you not only lose the dose, but get poison
in its place.

It has lately become difficult to find grapefruit candy in the US. I wonder if
there has been a public health directive from the FDA or someone.

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yomly
After studying pharmacology and medicinal chemistry, I lost a lot of faith in
our current pharmacological medicine.

The tl;dr is that chemistry is incredibly complex and then biology is even
more complex and messy. Even if we think we understand the mechanism by which
a medicine may work, we definitely do not know how something will certainly
behave in the wider system OR whether something works the way we truly think
it does (by the time a medicine arrives in the place it needs to be is it
actually some chemical artifact after being "touched" so many times along the
way).

We have a complex system, and we don't have the author or source code to hand,
and we're still quite limited in how we can observe any changes. Any time we
do try to introduce something we basically have to pray that there are no side
effects

~~~
skue
> After studying pharmacology and medicinal chemistry, I lost a lot of faith
> in our current pharmacological medicine.

My reaction was just the opposite. There are so many aspects of physics or
other physical sciences that we take as basic knowledge and learn in grade
school, but which were discovered years ago by some of the greatest thinkers
of the past. It’s deceptively easy to wonder what it would have been like to
live back then when the science was young and discoveries seemed more readily
available. When you didn’t need to build a massive supercollider to validate
theories. Of course much of this thinking is probably a fallacy... hundreds of
years from now people will think similar thoughts about where we are.

And yet medicine quite clearly seems at this earlier stage. Think about how
far we’ve come in just the last century... we’ve only known about antibiotics
for 100 years and the structure of DNA for half that long. That’s not a reason
to be dismissive, medicine right now is in its early days and the people doing
the research are pioneers. Medicine today has so many opportunities for smart
people to contribute.

~~~
yomly
Right and that's fine - I agree an optimistic way to look at medicine is that
we have yet so much more to discover.

But I look at the massive pro-medicate industry that is incentivised to get us
to take medicine which is built upon disappointingly unrigorous discipline and
the confidence some doctors carry themselves on matters which really aren't as
clear cut as they think and I kind of want to nope out of the system - I'd
rather lean on my body to fix itself whenever I can.

(ironically the best doctors I know generally advise the same, the exception
being all the obvious cases where medicine has successfully intervened)

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superpermutat0r
Does this mean that people from Awakenings could have prolonged their state of
being functional through intravenous delivery of l dopa?

