Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues Info

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A critically important and startling look at the harmful
effects of overusing antibiotics, from the field's leading expert


Tracing one scientist's journey toward understanding the crucial
importance of the microbiome, this revolutionary book will take readers
to the forefront of trail-blazing research while revealing the damage
that overuse of antibiotics is doing to our health: contributing to the
rise of obesity, asthma, diabetes, and certain forms of cancer. In
Missing Microbes, Dr. Martin Blaser invites us into the wilds of
the human microbiome where for hundreds of thousands of years bacterial
and human cells have existed in a peaceful symbiosis that is responsible
for the health and equilibrium of our body. Now, this invisible eden is
being irrevocably damaged by some of our most revered medical
advances―antibiotics―threatening the extinction of our irreplaceable
microbes with terrible health consequences. Taking us into both the lab
and deep into the fields where these troubling effects can be witnessed
firsthand, Blaser not only provides cutting edge evidence for the
adverse effects of antibiotics, he tells us what we can do to avoid even
more catastrophic health problems in the future.


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Reviews for Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues:

3

May 07, 2014

I've been doing a lot of research lately about the inner biome of the human being--all the micro-organisms which share space with us and help to keep us healthy. This book distills a great deal of that information into one coherent volume, which is great.

We have more bacterial cells in and on us than we have body cells. They help us with digestion, hormonal regulation, and immune responses. Without them, we would be hooped. Evidence is accumulating that the use of antibiotics has drastically I've been doing a lot of research lately about the inner biome of the human being--all the micro-organisms which share space with us and help to keep us healthy. This book distills a great deal of that information into one coherent volume, which is great.

We have more bacterial cells in and on us than we have body cells. They help us with digestion, hormonal regulation, and immune responses. Without them, we would be hooped. Evidence is accumulating that the use of antibiotics has drastically changed our inner landscape, wiping out some friendly bacteria which help us to live a more healthy life--we can perhaps blame celiac disease, food allergies, and asthma on changes in our gut bacteria.

You know that an author is seriously devoted when he is excited that anthropologists have found a group of South American indigenous people who have never encountered Western medicine and is thrilled to get fecal samples from them! To see a natural intestinal fauna which antibiotics have never decimated.

Like many authors with a relentless focus, Blaser is on a bit of a soap box. Doctors have been giving out antibiotics "just in case" and considering that they do no harm. He discusses antibiotic resistant infections and the real danger that we will soon have no treatments that work on diseases that we thought we had under control.

I was hoping for advice on what the average person could do to cultivate their garden, so to speak, but didn't find many suggestions, besides not pressuring your doctor to give you a prescription for every cold or cough that presents itself. I've been taking a probiotic supplement, which Blaser says is probably not harmful, but no one has proven that the organisms in the supplements are helpful ones either.

But this is a hot area of research, so I plan to stay tuned!

...more
5

Jun 13, 2014

This book should be required reading for anyone in the medical profession, parents, and policy makers (especially in agriculture and drug regulation).

In a clear and non-technical way, Blaser--an MD and former head of the Infectious Diseases Society of America--lays out the chilling story of how the unintended consequences of antibiotic use and overuse may be in danger of destroying civilization. That might sound ridiculously overblown, but his case rests on sound science. He likens the changes This book should be required reading for anyone in the medical profession, parents, and policy makers (especially in agriculture and drug regulation).

In a clear and non-technical way, Blaser--an MD and former head of the Infectious Diseases Society of America--lays out the chilling story of how the unintended consequences of antibiotic use and overuse may be in danger of destroying civilization. That might sound ridiculously overblown, but his case rests on sound science. He likens the changes happening internally to what we now call the "human microbiome" to the deterioration of the external environment under the assault of increasing CO2 levels.

I was particularly interested in the potential connection between obesity and early and frequent use of antibiotics in babies and children (and perhaps even prenatally, as mothers take antibiotics during labor). Blaser cites some very convincing animal studies. Though he is careful to say that the exact mechanism by which this may happen is not fully understood, he urges more research.

I, like Blaser, want to acknowledge the tremendous good antibiotics have done since their introduction a little less than a century ago. It's just that, as with all beneficial things, more is not necessarily better and it behooves us as individuals and as a society to understand the possible negative consequences of something that also does good. I'll say it again: everyone should read this book as an eye-opening view into the risks of a class of wonder drugs we once thought had only short-term, negligible side effects.
...more
4

Mar 09, 2014

An intriguing book. The author gives a broad overview of the microbes that live with all people and the effects of antibiotics on the the human microbiome. The author explains overuse of antibiotics--particularly in children and farm animals. Milk we buy in the grocery story can have measurable levels of Tetracycline and even though we may not think we are taking antibiotics we can be. The author explains the results found in many studies on mice, and the results of studies on humans showing how An intriguing book. The author gives a broad overview of the microbes that live with all people and the effects of antibiotics on the the human microbiome. The author explains overuse of antibiotics--particularly in children and farm animals. Milk we buy in the grocery story can have measurable levels of Tetracycline and even though we may not think we are taking antibiotics we can be. The author explains the results found in many studies on mice, and the results of studies on humans showing how the overuse of antibiotics are causing a variety of diseases.

My only complaint is that the author inundates the reader with evidence, study after study where it seems the results are clear, yet overall many people in the same field are skeptical.

The author sends a strong message that new approaches need to be taken to both the diagnosis of infections (i.e. better methods to determine what infection if any we might have) and more emphasis of antibiotics that are targeted to individual strains as opposed to the broad spectrum solutions currently in use. ...more
5

Apr 08, 2014

WOW. This book was SO right up my alley but is not for every reader (I got a lot of "you're reading what??" Personal stories interwoven with sound science - absolutely fascinating and gives sound hypotheses for why we're seeing the modern plagues in today's society. If you've ever wondered why diabetes, allergies and other autoimmune disorder rates are rising so rapidly and want to go beyond the popular "hygiene hypothesis" I recommend this read! I wish I could start my children's first three WOW. This book was SO right up my alley but is not for every reader (I got a lot of "you're reading what??" Personal stories interwoven with sound science - absolutely fascinating and gives sound hypotheses for why we're seeing the modern plagues in today's society. If you've ever wondered why diabetes, allergies and other autoimmune disorder rates are rising so rapidly and want to go beyond the popular "hygiene hypothesis" I recommend this read! I wish I could start my children's first three years all over again; I will think about this every time we're sick and I'm faced with the choice of antibiotics. I recommend this to anyone interested in science and personal health. ...more
5

Jul 16, 2014

I had a biology teacher in high school who remarked that we, as Americans, think that if a little of something is good, a LOT must be better. (The remark was made in connection with how much we all wanted to fertilize the plants we were growing in his class.)

Antibiotics were truly a miracle when they were developed in the early 1900s. Drugs like sulfa and penicillin saved millions of lives, but it wasn't long before antibiotics were being overused for everything from "just in case" to I had a biology teacher in high school who remarked that we, as Americans, think that if a little of something is good, a LOT must be better. (The remark was made in connection with how much we all wanted to fertilize the plants we were growing in his class.)

Antibiotics were truly a miracle when they were developed in the early 1900s. Drugs like sulfa and penicillin saved millions of lives, but it wasn't long before antibiotics were being overused for everything from "just in case" to fattening-up the animals that end up on our dinner tables. I think many people are now aware of the rapidly growing potential for "super-bug" germs that are immune to antibiotics (which is already becoming a reality) and the need to back off the hand-sanitizer habit, but few know of the cost to our inner biome.

Say what? Inside our bodies we carry a LOT of bacteria - our biome. But before you freak out, just know that the overwhelming majority of them are harmless and many are probably not only beneficial but essential to good health. Wipe out those bacteria and you may be compromising your health. Children are especially vulnerable, and simply letting them have pets or eat a little dirt once in a while won't correct the situation. And the list of possible maladies that Dr. Blaser presents is mind boggling. Not only do we have to worry about infections like MRSA and C. diff, we also have increasing outbreaks of Salmonella, E. coli, and influenza. Plus Blaser suggests that changes in the bacterial component inside our bodies may be causing the obesity epidemic, some cancers, celiac disease, asthma and food allergies, juvenile diabetes, and maybe even autism. (His theorized connection to autism isn't to be confused with the disproved link to vaccinations.) On the plus side, he thinks it may also be responsible for making people taller.

Blaser isn't against using antibiotics, but rather a more judicious use of them - and currently we're using *way* too much of them. (He *is* very much against unnecessary c-sections, and yes it has to do with bacteria.) Some of his theories are based on somewhat tenuous evidence (he admits as much about autism), but his warnings are worth considering and it's a very scary scenario he paints. (In some ways this book is far more frightening than The Hot Zone: The Terrifying True Story of the Origins of the Ebola Virus or Scourge: The Once and Future Threat of Smallpox.) It had me wishing I had questioned my doctor further before accepting a recent prescription! My initial interest in the book leaned more toward how to improve the microbes in our bodies (which was touched on in The Hidden Half of Nature: The Microbial Roots of Life and Health), and he only briefly mentions pro- and prebiotics, and fecal transplants (yes, it sounds revolting, but... what if it could make you thin?). This was a great read, and easily understood even without a medical background. ...more
4

Feb 29, 2016

I recently read another book about this exact same topic.....Microbes. I liked that one, and I liked this one too. This was written in terms that ordinary people without a biology major or an MD after their name can understand.

This topic is thought provoking because it sheds light on things that have been taken for granted regarding present day and future medical care and the new health threats that seem to be popping up. This type of research on microbes is new, and hopefully it will continue I recently read another book about this exact same topic.....Microbes. I liked that one, and I liked this one too. This was written in terms that ordinary people without a biology major or an MD after their name can understand.

This topic is thought provoking because it sheds light on things that have been taken for granted regarding present day and future medical care and the new health threats that seem to be popping up. This type of research on microbes is new, and hopefully it will continue to be explored and researched. This book dealt a lot with the overuse of antibiotics and its effects on our health. It definitely provided food for thought. ...more
0

Aug 13, 2014

The following is excerpted from the book, "Missing Microbes" by Martin J. Blaser, MD. Blaser, former chair of medicine at NYU and president of the Infectious Diseases Society of America. He is one of a growing number of medical practitioners and researchers who believe that we are experiencing a growing array of "modern plagues," and that the cause of these plagues is rooted in our "disappearing microbiota":

"Within the past few decades, amid all of [our] medical advances, something has gone The following is excerpted from the book, "Missing Microbes" by Martin J. Blaser, MD. Blaser, former chair of medicine at NYU and president of the Infectious Diseases Society of America. He is one of a growing number of medical practitioners and researchers who believe that we are experiencing a growing array of "modern plagues," and that the cause of these plagues is rooted in our "disappearing microbiota":

"Within the past few decades, amid all of [our] medical advances, something has gone terribly wrong. In many different ways we appear to be getting sicker. You can see the headlines every day. We are suffering from a mysterious array of what I call 'modern plagues': obesity, childhood diabetes, asthma, hay fever, food allergies, esophageal reflux and cancer, celiac disease, Crohn's disease, ulcerative colitis, autism, eczema. In all likelihood you or someone in your family or someone you know is afflicted. Unlike most lethal plagues of the past that struck relatively fast and hard, these are chronic conditions that diminish and degrade their victims' quality of life for decades. ...

"The autoimmune form of diabetes that begins in childhood and requires insulin injections (juvenile or Type I diabetes) has been doubling in incidence about every twenty years across the industrialized world. In Finland, where record keeping is meticulous, the incidence has risen 550 percent since 1950. ... But the disease itself has not changed; something in us has changed. Type I diabetes is also striking younger children. The average age of diagnosis used to be about nine. Now it is around six, and some children are becoming diabetic when they are three.

"The recent rise in asthma, a chronic inflammation of the airways, is similarly alarming. One in twelve people (about 25 million or 8 percent of the U.S. population) had asthma in 2009, compared with one in fourteen a decade earlier. Ten percent of American children suffer wheezing, breathlessness, chest tightness, and coughing; black children have it worst: one in six has the disease. Their rate increased by 50 percent from 2001 through 2009. But the rise in asthma has not spared any ethnicity: the rates were initially different in various groups, and all have been rising. ... No economic or social class has been spared.

"Food allergies are everywhere. A generation ago, peanut allergies were extremely rare. ... Ten percent of children suffer from hay fever. Eczema, a chronic skin inflammation, affects more than 15 percent of children and 2 percent of adults in the United States. In industrialized nations, the number of kids with eczema has tripled in the past thirty years. ...

"Why are all of these maladies rapidly rising at the same time across the developed world and spilling over into the developing world as it becomes more Westernized? Can it be a mere coincidence? If there are ten of these modern plagues, are there ten separate causes? That seems unlikely.

"Or could there be one underlying cause fueling all these parallel increases? A single cause is easier to grasp; it is simpler, more parsimonious. But what cause could be grand enough to encompass asthma, obesity, esophageal reflux, juvenile diabetes, and allergies to specific foods, among all of the others? Eating too many calories could explain obesity but not asthma; many of the children who suffer from asthma are slim. Air pollution could explain asthma but not food allergies. ...

"The most popular explanation for the rise in childhood illness is the so-called hygiene hypothesis. The idea is that modern plagues are happening because we have made our world too clean. The result is that our children's immune systems have become quiescent and are therefore prone to false alarms and friendly fire. ...

"We need to look closely at the microorganisms that make a living in and on our bodies, massive assemblages of competing and cooperating microbes known collectively as the microbiome. ... Each of us hosts a ... diverse ecology of microbes that has coevolved with our species over millennia. They thrive in the mouth, gut, nasal passages, ear canal, and on the skin. In women, they coat the vagina. The microbes that constitute your microbiome are generally acquired early in life; surprisingly, by the age of three, the populations within children resemble those of adults. Together, they play a critical role in your immunity as well as your ability to combat disease. In short, it is your microbiome that keeps you healthy. And parts of it are disappearing.

"The reasons for this disaster are all around you, including overuse of antibiotics in humans and animals, Cesarian sections, and the widespread use of sanitizers and antiseptics, to name just a few. ...

"The loss of diversity within our microbiome is far more pernicious [than the overuse of antibiotics and resulting antibiotic resistance]. Its loss changes development itself, affecting our metabolism, immunity, and cognition.

"I have called this process the 'disappearing microbiota.' It's a funny term that does not immediately roll off your tongue, but I believe it is correct. For a number of reasons, we are losing our ancient microbes. This quandary is the central theme of this book. The loss of microbial diversity on and within our bodies is exacting a terrible price. I predict it will be worse in the future. Just as the internal combustion engine, the splitting of the atom, and pesticides all have had unanticipated effects, so too does the abuse of antibiotics and other medical or quasi-medical practices (e.g., sanitizer use).

"An even worse scenario is headed our way if we don't change our behavior. It is one so bleak, like a blizzard roaring over a frozen landscape, that I call it 'antibiotic winter.'" ...more
4

May 04, 2014

While I had to endure microbiology lectures and practical courses during my undergrad studies I never was too interested in it and just rote-learned the Krebs cycle as requested. I pretty much preferred living things that you can more easily observe on a macroscopic level and actually do stuff (i.e. animals. And the irony that I'm now exclusively working in silico, often without ever seeing 'my' organisms isn't lost on me…).

So I'm by no means an expert on any microbes and microbiomes, but by While I had to endure microbiology lectures and practical courses during my undergrad studies I never was too interested in it and just rote-learned the Krebs cycle as requested. I pretty much preferred living things that you can more easily observe on a macroscopic level and actually do stuff (i.e. animals. And the irony that I'm now exclusively working in silico, often without ever seeing 'my' organisms isn't lost on me…).

So I'm by no means an expert on any microbes and microbiomes, but by now I can see the appeal in working on those topics and Blaser does a good job in conveying his fascination with bacteria as far as I'm concerned. A lot of the book is about how the bacteria that colonize us are neither strict mutualistic nor parasitic/pathogenic symbionts, but live in a state of amphibiosis. Essentially living on a continuum between symbionts and pathogens, depending on external factors. Which I think is a pretty good view that one doesn't find too often from my experience. As one prime example Blaser focusses on Helicobacter pylori, the bacteria of Nobel fame that is primarily associated with ulcers, but Blaser argues at length (and not too bad) that H. pylori can indeed not only be a pathogen but also a pretty useful creature to have around.

Besides this Blaser devotes much of the book to describe how our obsession with keeping bacteria away from us, easily giving antibiotics and even using it for growth stimulation in livestock may be responsible for many of the ailments that have risen over the last couple of decades (asthma, allergies, diabetes, obesity, certain types of cancer etc.) due to a change in the microbial communities we carry with us. While his general arguments seem plausible I'm not sure how much of it is overselling the available evidence (and I couldn't be bothered to read primary literature tbh). But this blogpost by Jonathan Eisen gives at least some hints that this may be the case. Nevertheless, I think the argument for using less antibiotics, especially if the potential benefits of the usage are small, does hold.

Recommended: for anyone who wants some good reasons to abandon an overly antiseptic lifestyle. ...more
4

Jun 13, 2016

Seeing the subtitle of this book, you might think it’s about the overuse of antibiotics which causes diseases immune to every method we have to treat them, especially the practice of giving antibiotics “just in case” and feeding antibiotics to animals (which actually helps them grow faster). In fact, while he does bring those issues up, Blaser is also concerned about an unforeseen effect of antibiotics: they’re killing “good” bacteria, with which we’ve co-evolved and which provide us with Seeing the subtitle of this book, you might think it’s about the overuse of antibiotics which causes diseases immune to every method we have to treat them, especially the practice of giving antibiotics “just in case” and feeding antibiotics to animals (which actually helps them grow faster). In fact, while he does bring those issues up, Blaser is also concerned about an unforeseen effect of antibiotics: they’re killing “good” bacteria, with which we’ve co-evolved and which provide us with advantages (even if they aren’t always unmitigated advantages).

This is the sort of thing that’s really fascinating to me, even if I’m not sure I’m 100% comfortable with some of the things he refers to as “modern plagues” — especially not autism, because hey, I don’t think my friends with autism are “ill”. I think they just think differently, and society has the problem. In any case, Blaser does have some interesting research backing up his ideas, and the first half of the book does a very good job of explaining how we form our own personal microbiomes — and the catastrophic effects (viewed in the long term, as an average, not necessarily for a single person) of our modern health system, which actually destroys, undermines, or even prevents the formation of our microbiomes. Caesarian sections, for example.

I think Blaser’s theories might feel a little overstretched at times, but I don’t mind going along with the basic principle: we have these bacteria in our bodies for a reason, we tolerate them for a reason. We don’t really know the effects of what we’re losing, and the invisible advantages and protections it might offer. This much is definitely true, and also the fact that we’re overusing antibiotics as a kind of “better safe than sorry” — except it is going to make us very sorry, via antibiotic resistance alone.

I found this an enjoyable and pretty well-supported read, with the caveat of course that I’m only on the first year of my BSc and most of my knowledge comes from pop science and online courses.

Originally posted here. ...more
3

May 30, 2014

I picked this up because I was actually a subject in one of Dr. Blaser's experiments a few years back when I worked at NYU--the study was about the microbiome of people who do or don't have eczema and I was a control subject, which required me to walk downstairs to his lab every few months and have a grad student swab my elbow, cheek, and knee.

The book was worthwhile but I wish Blaser had put more effort into explaining the science at a deeper level. While he avoids the faux-peppy style I've I picked this up because I was actually a subject in one of Dr. Blaser's experiments a few years back when I worked at NYU--the study was about the microbiome of people who do or don't have eczema and I was a control subject, which required me to walk downstairs to his lab every few months and have a grad student swab my elbow, cheek, and knee.

The book was worthwhile but I wish Blaser had put more effort into explaining the science at a deeper level. While he avoids the faux-peppy style I've complained about before, he explains binomial nomenclature and other topics that you'd think any adult bothering to pick up a book like this would understand. The "how" in "How the overuse of antibiotics is fueling our modern plagues" means "I'm going to assert that" instead of "I'm going to explain in detail the means by which."

To backtrack a little, here's Blaser's thesis in a nutshell. Humans are covered with zillions of bacteria that live in different mixtures in different parts of the body, like the skin, intestine, or vagina. (Whenever I think of this, I picture Mr. Burns's Spruce Moose freakout on The Simpsons.) We are overusing antibiotics in a variety of contexts: using them in a knee-jerk way when they're not even needed for minor complaints; giving them to livestock to promote growth; giving them to children in a critical window of their development; using broad-spectrum antibiotics which are efficient to develop and sell rather than narrow-range ones that don't cause as much collateral damage to the microbiome. Antibiotics don't kill all the bacteria, but they change the environment so that helpful ones may lose out or destructive ones get a leg up. Blaser tries to show how this imbalance could be implicated in all sorts of modern conditions like asthma, obesity, etc.

The research is still in early stages, so he doesn't yet have a pill full of specific bacteria to fiddle with your natural population and knock out your allergies. Still, the book could change your behavior in terms of what kind of food you buy (do you pay extra for the no-antibiotics chicken?) and what you ask your doctor for (do you beg for antibiotics, or start questioning whether they're really needed?). Also, he is trying to raise awareness of antibiotic-resistant bacteria and the possibility of a fast-moving superplague we're not equipped to fight.

This was a fine read, but I could have walked, not run, to read it. ...more
5

Oct 05, 2019

I love books like this.

Taken from the book jacket:

Martin Blaser "is the director of the Human Microbiome Program at NYU, served as the chair of medicine at NYU and as the president of the Infectious Diseases Society of America, and has had major advisory roles at the National Institutes of Health."

He has studied the bacterium H. pylori extensively. Linked to stomach ulcers, gastritis, and ultimately stomach cancer, this "stomach bug" is generally treated aggressively when found. Interestingly, I love books like this.

Taken from the book jacket:

Martin Blaser "is the director of the Human Microbiome Program at NYU, served as the chair of medicine at NYU and as the president of the Infectious Diseases Society of America, and has had major advisory roles at the National Institutes of Health."

He has studied the bacterium H. pylori extensively. Linked to stomach ulcers, gastritis, and ultimately stomach cancer, this "stomach bug" is generally treated aggressively when found. Interestingly, Blaser and colleagues have established that while H. pylori can cause negative health outcomes in later life, it may also be protective against other diseases like asthma, esophageal adenocarcinoma, and possibly a whole host of other diseases earlier in life, a notion supported by research performed by Blaser and his cohorts. And, good or bad, it appears that H. pylori is slowly disappearing from the human microbiome.

Blaser's main point seems to be that humans have evolved as a complex ecosystem in which some inhabitants can be helpful at some turns and harmful at others. And thanks to relatively new changes like the invention of antibiotics, the increased incidence of C-section, and other changes to our environment, our microbiome may be undergoing a shift. It is possible, even likely, that this shift may be contributing to the increased incidence of diabetes, asthma, food allergies, and auto immune diseases...possibly others.

He acknowledges the importance of antibiotics, which save lives. Yet, he also points out that until now we did not know what the true cost of using them was/is. Assuming there was no downside to taking them, we may have been too indiscriminate and overly liberal when prescribing them, using them even if not absolutely necessary because we assumed they could only help and never hurt. But as we learn more about the role of microbes, whether they are good, bad, or possibly both, the more that assumption is looking to be false. In the end, like H. pylori, antibiotics could be both beneficial and harmful at the same time.

He also worries about antibiotics that are given to livestock, not to treat disease, but to fatten them up. He fears it will not only contribute to antibiotic resistant strains of harmful even deadly bacteria, but may also be exposing us to antibiotics indirectly through the foods we eat.

He also worries about the increasing prevalence of birth by C-section. It has been shown that babies born via C-section are missing certain microbes that appear critical for optimal health and development of the baby. And while the microbiomes of both groups eventually converge so that by age three there are no significant differences, the damage may already have been done. Again, he is not saying women should not have C-sections, just that we might not truly understand the long-term risks to the baby.

Bottom line: we are only now beginning to understand the immense impact the bugs living among us and even in us have. And as we learn more, we need to rethink standard practices to ensure that we aren't throwing out the baby with the bathwater, or worse, drowning the baby in the bathwater. We also need to take these bugs seriously and remember that they are older, and, at least from a evolutionary standpoint, wiser. They aren't simply going to go away. Good thing, too, since we need them probably more than they need us. And if we hope to avoid another massive plague thanks to a microscopic organism, we better start being smarter about how we use the antibiotics we currently have in addition to finding new ones. (He claims that the pharmaceutical companies have found many of the easy ones and aren't particularly motivated to find a cure for rogue bacteria like MRSA, simply because it isn't cost effective.)

Good book written with a lot of passion, yet not alarmist in its message. ...more
5

Dec 16, 2014

An excellent analysis of the war between antibiotics and our microbiome. The material was very well-composed; as a microbiologist, I felt comfortable without being bored. I think that someone who isn't in the field would enjoy the book as well thanks to the author's concise explanations of historical and current practice. A cut above most of the pop-science books out there!
4

Dec 11, 2016

Dr. Blaser's premise is that we are doing serious damage to our bodies by emphasizing the idea that all bacteria is bad and must be eradicated. He begins by giving the reader a background on how bacteria and humans evolved together. It was dense with science, but still understandable to the average reader. This sets the stage for the exploration of how bacteria, sometimes specific species or strains, work with our bodies to mention normal bodily functions. Modern chronic illnesses are discussed Dr. Blaser's premise is that we are doing serious damage to our bodies by emphasizing the idea that all bacteria is bad and must be eradicated. He begins by giving the reader a background on how bacteria and humans evolved together. It was dense with science, but still understandable to the average reader. This sets the stage for the exploration of how bacteria, sometimes specific species or strains, work with our bodies to mention normal bodily functions. Modern chronic illnesses are discussed in relation to missing important bacteria, such as obesity, asthma, Type 1 diabetes, ulcers, irritable bowl syndrome and Crohn's disease, and throat cancer. Experiments are described and explained to further his argument.

Dr. Blaser does not condemn anyone; he is really trying to educate the public to re-think their use of hand sanitizers and asking for antibiotics from doctors for the slightest sniffle. Also, he shows evidence that America's high rate of C-sections may be a factor in why more children are diagnose with food allergies and hay fever. Therapies, treatments, and possibly cures may come from finding which bacteria is missing and re-introducing them into the human body. It was thought-provoking and interesting while still being scientifically useful for medical professions. ...more
3

Jan 19, 2018

Preamble:
--In studying standard of living, I see political economy as a core framework to study, on which numerous components interact: health, environment, agriculture, science/technology, culture, gender, etc. Each one of these has a compelling, nonlinear history. Here, we consider health.

The Good:
--As several reviewers note, the first half of the book summarizes our relationship with our microbial neighbors (i.e. Western history, current situation). Sadly, viruses and the history of vaccines Preamble:
--In studying standard of living, I see political economy as a core framework to study, on which numerous components interact: health, environment, agriculture, science/technology, culture, gender, etc. Each one of these has a compelling, nonlinear history. Here, we consider health.

The Good:
--As several reviewers note, the first half of the book summarizes our relationship with our microbial neighbors (i.e. Western history, current situation). Sadly, viruses and the history of vaccines are not included, as they are not classified as living organisms.
--The mass and rapid concentration of people from 18th century industrialization/urbanization brought a feeding frenzy for harmful microbes. As always, there are many more social factors to consider behind “economic growth”. Public health was the social response, and much progress was made regarding prevention. However, in terms of what happened when things went wrong (i.e. doctors/medicine), bloodletting lingered into the 20th century; for the magic pills, penicillin for public consumption occurred after WWII.
--A result of the evolving, anti-reductionist understanding of the natural world is the appreciation of microbes and how essential they are to life, from making up much of the human body, to their role in soil fertility (The Soil Will Save Us: How Scientists, Farmers, and Foodies Are Healing the Soil to Save the Planet). This book opens a can of worms microbes: what consequences have 70 years of mass antibiotics use had on our bodies' microbiomes (and their functions)? The doctor author hypothesizes that a loss in the diversity of our bodies' microbiomes (in particular: gut flora) is a factor in many modern ailments such as obesity and the numerous developmental and auto-immune disorders.
--2 particularly interesting ideas:
1) Obesity: corporate agriculture has been using low doses of antibiotics on livestock to increase animal body mass, thus profits. Does this translate in human exposure to antibiotics (medical, food, environmental)? Gut flora is, after all, crucial in metabolism.
2) Developmental/auto-immune disorders: a newborn is rapidly introduced to microbes involved in development and immune system functions. How does the rising rates of Caesarean sections (evading the microbes of vaginal delivery) and prophylaxis affect this crucial stage and future development?

The Questionable:
--The second half of the book is speculative, because most of this research is ongoing. I share a concern with other reviews that this may not be clearly distinguishable for general readers. More constructively, I think a chapter that overviews the principles of evidence-based medicine/research would be most helpful. A favorite: Bad Science ...more
3

Jan 16, 2014

Are We Ready for the Next Crisis?

This book was reviewed as part of Amazon's Vine program which included a free advance copy of the book.

The over-prescription of drugs isn’t exactly newsworthy … in fact, I’ll bet you can’t even watch a half-hour show on network television without at least one commercial dedicated to a drug that allows the suffering masses to better endure some miserable malady. Living in a world that promises a solution for every problem seems to have led to the “I-Med” path Are We Ready for the Next Crisis?

This book was reviewed as part of Amazon's Vine program which included a free advance copy of the book.

The over-prescription of drugs isn’t exactly newsworthy … in fact, I’ll bet you can’t even watch a half-hour show on network television without at least one commercial dedicated to a drug that allows the suffering masses to better endure some miserable malady. Living in a world that promises a solution for every problem seems to have led to the “I-Med” path were currently on (“there’s a pill for that”). With his book, MISSING MICROBES, Dr. Martin Blaser explains how the unnecessary overuse of antibiotics (arguably the world’s most reliable and necessary medicine) may be leading to the onset of so many of modern society’s ailments: GERD/acid reflux, obesity, allergies/asthma, etc.

Blaser, a M.D. with 30 years of experience researching bacteria in diseases provides readers with useful background information on the role microbes play in life on earth before diving into the nuts and bolts on the overuse of antibiotics. I found the information touched-on in the first few chapters (microbes, human micro biome, pathogens and the development of antibiotics) to be the most interesting and informative parts of the book. The manner in which he lays out the basic biological elements of the human body and overall diverse function of its 100 trillion microbes is simply fascinating. While the major organs may get all the attention, the battle between the good and bad microbes is a perpetual struggle in which the outcome dictates healthiness over illness or life over death. Blaser effectively translates his fluency of medical science into a manner that is easy to digest for us “regular folk” … a big plus.

Once the biological basics are presented, Blaser dives into the gist of his argument that our current culture’s habit of over-prescribing antibiotics (especially to children) is resulting the plethora of headline-making medical crises. He succinctly points out that, like the military strategy of carpet bombing in lieu of a laser-guided strike, collateral damage occurs when powerful antibiotics are used to address a specific ailment … in addition to the bad microbes, the good microbes are eliminated as well, leaving more room for bad microbes to thrive and become stronger. He illustrates this by examining the common pediatric procedure of prescribing antibiotics to address strep throat; the strep disappears (for the moment), but the child’s natural immunity is weakened for future battles against pathogens. But he contends that it isn’t just doctors contributing to the problem; antibiotics are everywhere and the populace is consuming them almost daily without even knowing it via our food supply. The negative connotation of using antibiotics to fatten farm animals has become a cash cow (no pun intended) for those pedaling “organic” food. But, be forewarned; the high price you pay for “organic” chicken doesn’t factor-in the massive incidental consumption of antibiotics from a farms treated water supply.

Blaser backs up his arguments by providing medical science research/experiments that he personally was involved, as well as citing specific medical cases throughout the book. Common modern ailments, such as GERD, diabetes, asthma and some cancers were linked to the use of antibiotics in his medical research which certainly adds a degree of credibility. MISSING MICROBES is certainly thought-provoking and even down-right scary at times (especially the rise in MRSA cases). Our society is so fearful of pathogens that our efforts to get rid of them may actually be making them stronger. I even found myself recognizing that an underlying fear of germs has manifested itself into my use of hand sanitizer after using the gas pump … after reading MISSING MICROBES, that practice has ended.

Much of this book hammers away at the “too much of a good thing …” idiom; our culture so embraced the security of a “wonder drug” that eliminated a number of horrible maladies that maybe we’ve suppressed/ignored the possibility of potential consequences as well as ongoing biological evolution. While the book sheds light on a plausible concern, it is merely one professional’s opinion and I surely don’t believe this is a one-stop-shop resource on the issue. Is there another perspective on this subject? Did ALL of Blaser’s experiments support his argument? I always keep in mind that scientific declarations/postulations usually generate gracious (federal) funding when their hypothesis warrants enough attention (fear) … just a thought. Toward the end of the book, the author parallels the potential disaster presented by the overuse of antibiotics to that of “Global Warming” (uh oh). This simple, innocuous statement certainly made me wonder if antibiotic-overuse will be next “crisis” platform to be used/abused by politicians to manipulate/scare the masses … time will tell.
...more
5

Oct 01, 2014

Whatever you are reading now, stop and get your hands on a copy of this book.

Antibiotics were once considered wonder drugs but now have become commonplace. Their overuse has led to concerns about the spread of "superbugs" (MRSA) that antibiotics will not be able to stop.

This author presents his research, albeit primarily on mice, that our overuse of antibiotics as well as C-section births and antiseptics has disrupted our microbiome - the relationship we have with bacteria. Not all bacteria is Whatever you are reading now, stop and get your hands on a copy of this book.

Antibiotics were once considered wonder drugs but now have become commonplace. Their overuse has led to concerns about the spread of "superbugs" (MRSA) that antibiotics will not be able to stop.

This author presents his research, albeit primarily on mice, that our overuse of antibiotics as well as C-section births and antiseptics has disrupted our microbiome - the relationship we have with bacteria. Not all bacteria is bad. We need it to digest our food, for example. That disruption may have led to a rash of modern plagues.

Have you wondered about the increase in food allergies, autism, and obesity? The common practice of prescribing antibiotics to young children may be a factor, if not the cause, of this increase. Broad spectrum (and least expensive) antibiotics may have killed the bacteria that caused the child to be sick but also the bacteria that would allow that child to digest peanuts or gluten. Early use of antibiotics may affect brain development in young children. Antibiotics are routinely used on livestock to get them to gain weight.

The author outlines the problem without a solution. He does not claim that the overuse of antibiotics is the only cause of our modern plagues, but he presents enough evidence to give me pause next time I reach for a hand sanitizer. ...more
5

Jan 30, 2014

I received a free ARC edition of this book through the Goodreads First Reads program and would like to thank everyone who made that possible.

I really enjoyed reading this. Some non-fiction and science books can be very dry, technical and boring but this was not one of those. It was very well-written and readable with some personal stories thrown in to illustrate certain points and the science was explained very well without going into unnecessary detail. I found the ideas and theories presented I received a free ARC edition of this book through the Goodreads First Reads program and would like to thank everyone who made that possible.

I really enjoyed reading this. Some non-fiction and science books can be very dry, technical and boring but this was not one of those. It was very well-written and readable with some personal stories thrown in to illustrate certain points and the science was explained very well without going into unnecessary detail. I found the ideas and theories presented to be very interesting, thought-provoking and plausible. The ARC edition that I read does contain some minor editing errors here and there but nothing major and I am sure that they will have all those kinks worked out in the finished edition. Highly recommended! ...more
4

Sep 28, 2018

Read this one to get an understanding of how antibiotics work and why you do not necessarily need a Z-pack for every sniffle. The author makes a case that we need more targeted antibiotics that do less collateral damage and that overuse or misuse of general antibiotics are killing off good microbes which the body needs and helping to render current drugs ineffective. Everyone should read at least the first half of this book. It is a great primer on antibiotics.
5

May 13, 2014

A fascinating book that links the overuse of antibiotics to the astronomical rise of such chronic health problems as obesity, asthma, diabetes, celiac and Crohn’s diseases, food allergies, and possibly even autism. Blaser will even make you think twice about regularly using hand sanitizer. Accessible, engrossing, and convincing.
2

Jan 17, 2015

Interesting ideas and research but conclusions are overblown as the author links every ailment to the microbiome. Do we even know what a "healthy" microbiome looks like or how it changes over time? The book also reads like an autobiography in spots, which is ok, except the author is too boastful and I found it detracted from the book.
5

May 28, 2017

I carelessly picked this book up assuming it was going to be about the way we're breeding superbugs through our overuse -- abuse, in fact -- of antibiotics as growth-promoters in the agriculture industry. In fact, while Blaser -- a very distinguished bacteriologist and specialist in infectious diseases -- does discuss this issue, albeit at less length than I might have liked, the real focus of his book is the way that our overuse of antibiotics in humans, especially infants, is crippling our I carelessly picked this book up assuming it was going to be about the way we're breeding superbugs through our overuse -- abuse, in fact -- of antibiotics as growth-promoters in the agriculture industry. In fact, while Blaser -- a very distinguished bacteriologist and specialist in infectious diseases -- does discuss this issue, albeit at less length than I might have liked, the real focus of his book is the way that our overuse of antibiotics in humans, especially infants, is crippling our microbiome, the ecology of bacteria living in our stomach, gut, skin and elsewhere, many of whose species are crucial to our ability to resist disease. (Caesarean deliveries, in that they avoid the transfer of a basic bacterial colony to the baby from the mother's vaginal walls and anus, are also a problem in this respect.)

Blaser describes his work pursuing this line of research, beginning with his suspicion that Helicobacter pylori -- the very same H. pylori that Barry Marshall and Robin Warren identified in the mid-1980s as the cause of stomach ulcers (thereby deservedly gaining themselves the 2005 Nobel Prize in Physiology or Medicine) -- was not the outright villain that the medical profession thereafter assumed it must be. As Blaser explains, the way that the species of our microbiota generally function is that their behavior depends on context. There's no question that H. pylori may cause peptic ulcers and even, if those go untreated, stomach cancer in later life, but are we ignoring the benefits an internal H. pylori population can bring in youth and the succeeding decades?

Blaser believes that we are, and he and various teams have amassed a mountain of convincing evidence that our dearth of H. pylori and various other vital bacterial populations is contributing to such "modern plagues" as childhood obesity, asthma, allergies, diabetes and possibly many more. That "possibly" is important: Blaser is quite specific in pointing out that his suspicions that conditions like autism might be due to antibiotic overuse in the first few months of life are no more than that, suspicions, while the connections between microbiome debilitation and, say, childhood obesity are very well evidenced by multiple lines of research.

The agricultural abuse of antibiotics for growth promotion is part of this pattern. No one knows quite why injecting farm animals with antibiotics -- any antibiotics -- makes them grow faster and fatter. What we do know is that some of those antibiotics remain in the meat, poultry, eggs, milk and so on that we (vegans aside) consume daily, meaning that, on top of the temporary courses of antibiotics our doctors might put us on, we're subjecting ourselves to, in effect, a constant low-dose course of antibiotics, with all the damage that this can do to our microbiota and hence our health.

Obviously antibiotics are often medically desirable, even necessary for a patient's survival, and Blaser several times goes out of his way to stress this point. Similarly for C-sections. What he's saying is that many, and perhaps the vast majority, of the courses of antibiotics we take, or administer to our children, are completely unnecessary, and, through disrupting the relationship we've developed over hundreds of thousands of years with the bugs inside us, are causing a gross health crisis, one that may be threatening our welfare as a species. Overprescription is the primary problem -- hurried doctors find that dashing off a prescription for antibiotics gets patients through the surgery nice 'n' quick, and after all "they can't do any harm," they might well have a placebo effect, and being given a prescription generally makes patients feel they've gotten their money's worth, so to speak. (There have even been instances of doctors prescribing antibiotics for viral diseases, like colds!)

The same effect, although on a smaller scale, is being created by our modern use of C-sections as almost a routine procedure -- it's easier and quicker for the health staff -- rather than as something done exceptionally when the life of the mother and/or child might otherwise be at risk.

In both instances -- overprescription and C-sections -- we do of course have some control over what's going on. Rather than just obediently follow that course of antibiotics, we can question how necessary it actually is. Likewise, mothers can question if that C-section is really essential.

When I was reading Missing Microbes I was impressed by how readably and smoothly Blaser had written it. Afterwards I discovered that he was assisted in the text by science writer Sandra Blakeslee! Congratulations to both of them. The sole exceptions were at the ends of some of the chapters, such as Chapter 14, where final fragments of text didn't seem to make sense. I soon realized that the chapters concerned ended on the very last lines of their respective closing pages (p184 in Chap 14's case) -- in other words, I suspect some very clumsy copyfitting (done to bring back a line or two from the next page) was the culprit. Blaser should have a stern word with his publisher.

Here's what I'd suggest is the book's money quote (p198), although I'd guess the final mixing of metaphors may be yet another product of copyfitting:

We talk about a pre-antibiotic era and an antibiotic era; if we're not careful, we'll soon be in a post-antibiotic era. This now is a major focus of the CDC,* and I share its concern. But I am thinking about a different concept, not only the failure of antibiotics because of resistance but also the increased susceptibility of millions because of a degraded [microbiotal] ecosystem. The two go hand in hand, but in a smaller interconnected world the second is a deluge waiting to happen and growing each day.

Even if some of Blaser's more extended speculations turn out to be unfounded, I'd say this is a book that ought to be on the reading list of any inhabitant of today's world. The content is fascinating and, as I've said, extremely readable, and it seems to me that much of what Blaser has to tell us is highly important.

[* Funding set to be slashed if Trump's budget goes through. -- JG] ...more
4

Apr 17, 2019

Very dense and informational. Author clearly is knowledgeable.

I do have a couple issues with this book. One is that it's pretty fearmongery, so be warned.

Another question I had that wasn't answered is how the author knows that another cause of the "modern plagues" is at play. I can think of 3-4 other major lifestyle changes that humans have had in the same period he is examining, and yet there is not a discussion of any of that.

The final issue I had was that he groups autism in with "plagues" Very dense and informational. Author clearly is knowledgeable.

I do have a couple issues with this book. One is that it's pretty fearmongery, so be warned.

Another question I had that wasn't answered is how the author knows that another cause of the "modern plagues" is at play. I can think of 3-4 other major lifestyle changes that humans have had in the same period he is examining, and yet there is not a discussion of any of that.

The final issue I had was that he groups autism in with "plagues" and that's pretty offensive.

All in all it was informative and I learned some stuff, but I am pretty sure we have a few decades more of research before we have answers. I'll chalk this up to "warrants further study." ...more
4

Dec 31, 2018

This book has a lot of very detailed medical/scientific information that my eyes glazed over. But the overall picture the author paints is very clear--antibiotic use is affecting us in ways we can only begin to imagine. Asthma, obesity, autism: all of these and more may be effects of bacterial imbalances inside of us. Our internal bacterial population is so complex; we've barely scratched the surface in understanding it. And yet he doesn't take an extreme "avoid all antbiotics" approach, which I This book has a lot of very detailed medical/scientific information that my eyes glazed over. But the overall picture the author paints is very clear--antibiotic use is affecting us in ways we can only begin to imagine. Asthma, obesity, autism: all of these and more may be effects of bacterial imbalances inside of us. Our internal bacterial population is so complex; we've barely scratched the surface in understanding it. And yet he doesn't take an extreme "avoid all antbiotics" approach, which I appreciate. ...more
4

Feb 24, 2019

Incredibly important book!!! If people actually read this one, we may have a chance to stop the epidemic of AB resistant bacteria- and perhaps also slow down the explosions of “modern diseases”, such as diabetes, celiac disease, allergy, asthma and obesity. I highly recommend this piece of scientific literature, as it presents medical research in an easy-to-understand and interesting way. The fifth star is missing because I think the book could have been shorter and still told the same story.
3

Oct 04, 2019

We think that cutting routine office visits to twenty minutes, fifteen minutes, even ten minutes will save money when in fact, with less time for doctors to examine and less time to think, we are incurring far greater costs through excessive testing and needless treatment.

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