Optimizing the gut-microbiome

Emerging research on gut–microbiome supports the use of synbiotic supplementation

Chiropractic care emphasizes natural healing, homeostasis and the body’s innate intelligence, all of which are mirrored in the gut-microbiome’s role in regulating health. Doctors of chiropractic (DCs) are uniquely positioned to educate patients on integrative approaches, and the incorporation of evidence-based gut support interventions complements the scope of conservative care.

The case for synbiotics in the gut–microbiome

DCs have long championed integrative, patient-centered care that goes beyond symptom suppression to address the root causes of dysfunction. As evidence accumulates around the gut–microbiome and the systemic health axis, a compelling case emerges for the inclusion of synbiotics (probiotics and prebiotics) as adjuncts in chiropractic practice. These agents, once considered niche wellness products, are now recognized as key modulators of inflammation, immunity and metabolic health.

The pursuit of longer, healthier lives has driven scientific inquiry into the intricate systems that maintain human vitality. At the core of this exploration lies the gut-microbiome; a dynamic ecosystem whose influence extends far beyond digestion. Emerging research highlights the critical role of prebiotics and probiotics in modulating the gut-microbiome, unveiling profound effects on immune function, metabolic integrity, cognitive health and inflammation; all hallmarks of biological aging.

A shift toward metabolic clarity

Few conditions better illustrate the importance of accurate terminology than metabolic-associated fatty liver disease (MAFLD). Formerly labeled non-alcoholic fatty liver disease (NAFLD), the previous name defined the disorder more by what it wasn’t (alcohol-related) than by what it was. But as physicians and researchers began to uncover the deeper metabolic roots of this increasingly common liver condition, it became clear the nomenclature needed a serious upgrade.

MAFLD reflects a more precise and meaningful diagnosis, one that highlights its tight links to a cluster of metabolic disturbances, including fluctuating blood sugar levels, obesity, Type 2 diabetes, elevated triglycerides, cholesterol imbalances and high blood pressure. These factors paint a picture of a broader, systemic malfunction in how the body processes and stores energy. As the new name implies, it is metabolism, not martinis, that lies at the heart of this modern epidemic.

The microbiota-mitochondria connection to gut–microbiome

MAFLD is a dysfunctional production of energy deep down at the cellular mitochondrial level.  One of the major drivers of all these metabolic-associated diseases is misdirection of glucose and fatty acid metabolism away from energy production and into fat storage, with a buildup of both fatty metabolites and sugar metabolites in the bloodstream. And, it is all driven by an unhealthy gut-microbiome.^1,2

Research shows a critical link between mitochondrial efficiency and alterations in gut bacteria.  The cross-talk between microbiota and mitochondria is a wonder to behold. Mitochondria are now recognized as critical targets of microbiota, and the microbiota as the highest-ranking “major general” of homeostasis. Effective treatment of MAFLD (and its clinical ramifications) must include probiotics and prebiotics.^3,4

The MAFLD overload of fat in the liver reflects the hepatic manifestation of a systemic lipid metabolism disorder. Intestinal bacteria play a crucial role in the development of liver steatosis, fibrosis and inflammation. Research now reveals the mechanism involved. There are 437 clearly identified mitochondria-related metabolites; 325 overlap with gut microbiota metabolites. There is a constant cross-talk between microbiota and the energetic functions of all cells in all organs of the body.⁵

Final thoughts

In essence, optimizing the gut-microbiome through synbiotic supplementation of pre- and pro-biotics may represent not just supportive therapy, but a foundational shift in how we approach metabolic health. As chiropractic continues to evolve alongside advancements in integrative health, gut-microbiome modulation will likely become a cornerstone of personalized care. Incorporating prebiotics and probiotics not only aligns with the chiropractic ethos; it expands the potential to restore function, reduce inflammation and empower patients to thrive.

Metabolites of gut bacteria modulate energy metabolism, oxidative stress, reductive stress and inflammation by their communication with hepatic mitochondria via the microbiota-gut-liver axis (and with other tissues via the microbiota-gut-adipose, -brain, -hypothalamus and -muscle axes). Mitochondrial dysfunction thus emerges as the pivotal pathological feature in MAFLD, and parallels perfectly the incidence and severity of obesity, chronic fatigue, major depression, insulin resistance, Type 2 diabetes, elevated serum lipids and all associated “diseases of aging.”  There is absolutely no way to metabolically control all these sequelae of dysfunctional cellular energetics until you restore mitochondria-enhancing microbiota.

Guy R. Schenker, DC, a Pennsylvania doctor of chiropractic since 1978, is the developer of the Nutri-Spec System of Clinical Nutrition, which eschews symptom-based nutrition in favor of individualized metabolic therapy. Nutri-Spec offers a stage of life diphasic nutrition plan (SOLID DNP) empowering each patient to live stronger longer. Schenker can be reached at 800-736-4320 or nutrispec@nutri-spec.net.

References

1. Garcia D, et al. Genetic liver-specific AMPK activation protects against diet-induced obesity and NAFLD. Cell Rep. 2019;26(1):192-208.e6. https://pubmed.ncbi.nlm.nih.gov/30605676/. Accessed July 16, 2025.
2. Hinchy EC, et al. Mitochondria-derived ROS activate AMP-activated protein kinase (AMPK) indirectly. J Biol Chem. 2018;293(44):17208-17217. https://pubmed.ncbi.nlm.nih.gov/30232152/. Accessed July 16, 2025.
3. Grabacka M, et al. The PPAR-α regulation of the gut physiology in regard to interaction with microbiota, intestinal immunity, metabolism, and permeability.Int J Mol Sci. 2022;23(22):14156. https://pubmed.ncbi.nlm.nih.gov/36430628/. Accessed July 16, 2025.
4. Zang R, et al. Gut microbial metabolites in MASLD: implications of mitochondrial dysfunction in pathogenesis and treatment. Hepatol Commun. 2024;8(7):e0484. https://pubmed.ncbi.nlm.nih.gov/38967596/. Accessed July 16, 2025.
5. Piomelli D.A fatty gut feeling. Trends Endocrinol Metab. 2013;24(7):332-3 https://pubmed.ncbi.nlm.nih.gov/23567058/. Accessed July 16, 2025.