Best CBD Oils For Pain: Top 3 Brands of 2021
Nobody should have to live with pain. Since many prescription painkillers are both addictive and dangerous, more people are turning to CBD as a natural means of relief. If you're new to CBD, our guide to the best CBD oils for pain will help you find the brand that's right for you.
Many people suffer with debilitating pain that derails their lives. Traditionally, severe pain has typically been treated with therapies such as physical therapy, occupational therapy, massage therapy, and of course, prescription pain medication. And while those therapies help immensely, prescription pain medication can be both dangerous and addictive.
In light of this fact, more people are turning to CBD oil as a natural means of relief from tough chronic and acute pain. But which CBD oils are the best? How does CBD tackle difficult pain? We will answer these questions and more in our guide to the best CBD oils for pain.
How Our CBD Oil For Pain List Came Together
Even though there are a good number of CBD oil brands out on the market, figuring out which brands are the most clean and the most effective can be a very daunting task. While you may feel tempted to make an impulse buy, it really pays to spend some time doing the research in the long-run. In thinking about brands and oils, you should really pay close attention to the effectiveness, quality, and purity of the oil as well as the brand's reputation.
If you still feel overwhelmed and befuddled, please don't worry. We've taken the guesswork out of the research by doing the bulk of it for you. Before we selected our top three brands, we set up stringent guidelines to follow. We then used these guidelines to whittle down our list until our top three brands remained.
In thinking about the top CBD oils for pain, we focused on:
- How long the brand has been in the industry
- Oil ingredients
- Reviews and comments by verified customers
- Whether or not the brand used a third-party lab to test its products
- If the lab results were made easy for customers to find
- Hemp sources
- Articles from both niche experts and CBD journalists
- The overall purity of the oil
- Brand reputation
- Product price
As we worked our way through the brands, not surprisingly, our list became quite lengthy. In light of that, we hunkered down and cut our list down even more until we were left with the top three brands that you will read about below.
3 Best CBD Oils For Pain
#1 FAB CBD Oil— Full Spectrum and Most Effective
FAB has been in the CBD business since 2017. Everyone who works at FAB takes health and wellness very seriously. To that end, FAB's mission is to use premium supplementation, science, and innovation to allow everyone to have access to a healthy lifestyle.
The FAB team believes in transparency, creating high quality products, and having a stellar customer service department. FAB never uses any additives or dangerous chemicals in any of its products. All of the organic Colorado hemp that the brand uses is free of herbicides and pesticides.
FAB CBD has been commended time and time again for its exceptional customer service. Each member of the FAB team goes out of their way to address every customer's questions and concerns. The fact that there are a host of verified positive customer reviews on the brand's website attests to this fact.
Every single one of FAB's products is made from the cleanest, most pure extract possible. FAB's full-spectrum CBD oil comes in strengths of 300mg, 600mg, 1200mg, and 2400mg, and in flavors of citrus, mint, natural, berry, and vanilla. All of the brand's products are tested by ProVerde Labs, an independent third-party laboratory.
Specific Criteria for Choosing Our Top Three Oils
When we selected our top three CBD oil brands, we looked at:
- Hemp Sources — All of the hemp that FAB uses comes from Colorado. The hemp is organic and is free from herbicides, pesticides, and other chemicals. FAB also uses state-of-the-art cloning and harvesting practices and machinery.
- Reputation — FAB has a strong reputation among other top CBD companies as well as customers, journalists, and CBD insiders. Reading all of the positive verified customer reviews gave us all the verification that we needed.
- Price — FAB's oils range in price depending on the strength that you choose. Overall, we found the oils to be both effective as well as affordable. In fact, the pricing falls in line with many other reputable brands out on the market today.
- Effectiveness — When it comes to full spectrum products, FAB makes some of the best around. Not only are the oils safe, they're also effective, clean, and are of the best quality. Verified customer reviews on the brand's website confirm the effectiveness of FAB's full-spectrum oils.
- Our Thoughts and Conclusions — We love FAB's amazing line of products. Along with full-spectrum oils, the brand also offers gummies, a topical cream, CBD dog treats, CBD-free super greens, a brand new calming CBD vape, as well as a recently introduced CBD Body Salve. FAB is our top pick not only because of the brand's stellar reputation for customer service, but also because FAB has a solid line of CBD products and truly believes in transparency.
Elixinol strives not only to learn about hemp, but to also teach others about it. To that end, the brand seeks to teach everyone around the world about the healing benefits of hemp. The team at Elixinol is dedicated to science, research, and crafting innovative products that are loaded with terpenes, flavonoids, and cannabinoids.
As such, Elixinol employs experts, research scientists, medical doctors, and veterinarians that work together as a team to study how cannabinoids affect the body to improve life. Elixinol creates full-spectrum CBD oils, topicals, and capsules. The brand does not use a third-party lab to test its products, but does, however, employ its own experts to rigorously test each one of its products.
Elixinol's Full-Spectrum CBD Oil
Elixinol's full-spectrum CBD oil is created from hemp that the brand grows itself in Colorado. In doing this, Elixinol controls the creation of its products from seed to sale. Elixinol's full-spectrum CBD oils come in Organic Balance or Daily Balance varieties. The Daily Balance is available in Cinnamint and Natural flavors and in 133mg, 500mg, 1000mg, and 4000mg of CBD per bottle.
- Source of Hemp — Elixinol grows its own organic hemp in Colorado.
- Reputation — Elixinol has a reputation for having a top-rated return policy as well as a large product variety. The brand is also praised for having high-quality CBD oil oral applicators. Overall, Elixinol has a solid reputation among its customers.
- Price — The oil prices vary depending on the amount of CBD in the bottle.
- Effectiveness — Elixinol is also known for having a strong quality full-spectrum CBD oil. The brand also has verified positive customer reviews on its website attesting to this fact.
- Our Thoughts and Conclusions — Elixinol strives to educate others about the healing powers of hemp. The brand is involved in the creation process from seed to sale and even has its own in-house lab to test its products. Having said that, Elixinol does not use an independent third-party lab to test its products. There are also reports that the order processing time is slow. The brand does, however, have a solid reputation for producing products with a solid reputation.
Endoca's mission is to be an industry leader when it comes to innovating ways that hemp is extracted. The brand sells a line of natural CBD extracts. Endoca strives to cultivate and extract CBD from organic hemp that is free from chemicals, toxins, and other preservatives. The brand is a champion of the environment and uses sustainable practices in how it cultivates the hemp.
Endoca has a broad line of full-spectrum CBD oils including a 300mg Raw CBD Oil and CBD Hemp Oil and a 1500mg Raw CBD Oil and Hemp Oil. All of the brand's oils are gluten-free, non-GMO, and vegan.
- Source of Hemp — Endoca is based out of the Netherlands. The brand uses organic farming practices and believes in keeping things simple and as natural as possible. Endoca's hemp is grown in Northern Europe in Scandinavia.
- Reputation — The brand has a strong reputation for worldwide delivery and organic and effective products.
- Price — The price of the products depends on how much CBD is in the products. The brand does its best to provide affordable products to customers from all over the world. Having said that, the pricing on the products does tend to be on the expensive side.
- Effectiveness — Endoca's products are 100 percent organic, and are full-spectrum. The brand strives to create highly effective products through natural methods.
- Our Thoughts and Conclusions — Endoca is another reputable brand that strives to create an all-natural, effective line of CBD products. Even though the brand is based in the Netherlands, they do ship worldwide. They offer free shipping in the United States on order over $74. Endoca uses a third-party lab to regularly test all of its products, and those results are made available to customers online. Even though the brand has a solid reputation for creating strong products, they do lack flavor options.
What is the Difference Between Chronic and Acute Pain?
Many people are under the impression that pain is just pain. What many don't understand is that pain can be separated into two different categories: chronic pain and acute pain. With chronic pain, the pain lingers well after an injury healed or a traumatic event has ended. Conversely, acute pain will stay for a brief period of time before slowly going away as an injury has healed.
It's fairly easy to treat acute pain, chronic pain is more difficult to get a handle on. Pain is considered chronic if it lasts longer than 12 weeks. Chronic pain manifests itself as feelings of burning, aching, and cramping sensations throughout the body.
Chronic pain can be found in such conditions including:
- Nerve damage or inflammation
- Trauma pain
- Surgery pain
- Low back pain
- Cancer pain
- Psychological pain
- Tension or migraine headaches
- Inflammatory bowel disease
- Chronic fatigue syndrome
According to the U.S. Pain Foundation, 50 million Americans endure some sort of pain each day. And while there aren't any tests that can proficiently measure pain, doctors fall back on diagnostic tests and patient testimonies to try to figure out both the extent of the pain as well as its location. As far as diagnostic testing goes, doctors will use bloodwork, imaging, nerve conduction tests, neurological assessments, genetic testing, strength assessments, and others to diagnose the pain and determine the best course of treatment.
Sadly, anyone can experience chronic pain at any age. However, many physicians are finding that chronic pain is more prevalent in older adults. Chronic pain is more common in people who are overweight, previously injured, female, obese, or who have had any type of surgery. As mentioned earlier, some common therapies for chronic pain include chiropractic, massage, yoga, physical therapy, psychotherapy, acetaminophen and NSAIDs, or prescription pain medications, anticonvulsants, or antidepressants.
How Can CBD Oil Help Treat Chronic or Acute Pain?
These days, many people are turning to more natural methods as a means of treating their pain. Cannabidiol, or CBD, is found in the cannabis plant. CBD will not cause any euphoric sensations like tetrahydrocannabinol, or THC, (another well-known cannabis compound) will. Any full-spectrum CBD oil contains both THC and CBD. By law, however, all full-spectrum products are required to contain less than 0.3% THC.
When THC and CBD come together, they produce what's commonly known as the entourage effect. In the entourage effect, the compounds within CBD boost each other's positive effects while minimizing each other's negative effects. In essence, they work together in a symbiotic relationship. So, while THC can typically cause nausea, when paired with CBD, the nausea is decreased while pain reduction and appetite is increased.
CBD oil is wonderful in chronic pain reduction because it reduces the inflammation, pain, and discomfort that derives from some of the health conditions that we mentioned previously. Many studies continue to prove that CBD oil is great at tackling tough pain from health conditions such as:
Recently, researchers have found that CBD oil can help both manage and relieve difficult pain. The body has its own endocannabinoid system, or ECS, that contains endocannabinoid receptors that work to regulate how the body responds to pain. Moreover, CBD also helps to boost serotonin levels, therefore enabling "feel good" sensations while the pain is being decreased. The endocannabinoid system, which can work without CBD, functions to bring the body back to a natural state of balance.
How Much CBD Should You Take?
This is a common question posed by those who are new to using CBD. The simple answer to this question is that there is not a set dose of CBD that everyone should be taking. Everyone is different, therefore everyone reacts differently to CBD. A great rule of thumb to go by when it comes to CBD is to start low and go slow. Likewise, when it comes to CBD, higher is not always better when it comes to the dosage. Mid-range doses have been proven to be more effective than low or high doses.
The best way to begin taking CBD is to start by taking 5mg of CBD once a day for one week. If after one week you are not feeling any relief from your pain, go ahead and increase the dosage to 5mg twice a week. After a week, do a check in with yourself to gauge your level of pain relief before stepping up to a higher dose. Just like with any type of medication or natural supplement, your body needs ample time to get used to a new CBD dosage as well.
A great example of the instructions is this: begin by taking ½ dropper of FAB CBD's 300mg full-spectrum oil once a day for about one week. This equals about 5mg of CBD. After one week, increase your dose to ½ dropper twice a day for a week. This equals about 10mg of CBD. While you are going through this process, regularly check in with yourself to see how you are feeling and what your pain levels are. Your overall pain levels will be the best gauge as to whether you should be increasing your dose or not.
Does CBD Oil Have Any Benefits?
CBD and THC are just two of the over 100 other cannabinoids and compounds found in the cannabis plant. As stated above, while THC brings on feelings of euphoria, CBD does not. In order to create CBD oil, the CBD must first be extracted from the hemp or cannabis plants before being diluted with a carrier oil. Next, the oil is infused with different natural flavors, or no flavors at all, before it is bottled and sold in a variety of strengths.
A host of studies show that CBD is excellent at helping to alleviate many difficult to treat health conditions such as anxiety, depression, epilepsy, osteoarthritis, Crohn's Disease, Parkinson's Disease, and others. The simple fact that CBD works with the body's endocannabinoid system to help regulate pain and boost serotonin levels clearly demonstrates that CBD is quite beneficial. Likewise, countless CBD users can also attest to the fact that CBD oil has helped them in some way, shape, or form with their chronic pain and other issues.
When it comes to benefits, CBD has many. And when it comes to pain, chronic pain, and back pain, it helps to understand how CBD works so that the benefits can be fully appreciated that much more. When most people think of back pain, they tend to only think of low back pain. But there are, in fact, different types of back pains that can be relieved by taking CBD.
Some of the more common types are as follows:
- Muscle Strain — Muscle strain is caused when muscles are overstretched or pulled too tight. Muscle strain commonly stems from rigorous sports activities, weightlifting, and rigorous on the job activities. CBD can benefit this type of back pain because it will help to reduce inflammation and pain while helping the body to heal quicker.
- Sciatica — Sciatica is a type of injury that occurs when the sciatic nerve is impinged, or pinched, between the muscles of the lower back, hips, and buttocks. Sciatica happens when a herniated disk, bone spur, or narrowing of the spine presses down on part of the nerve. Some common sensations stemming from sciatica are numbness down one or both legs, inflammation, and pain. Recent research shows that CBD can be effective at treating the pain and inflammation caused by this condition.
- Degenerative Disc Disease — ThIs painful condition commonly occurs with advanced age. In degenerative disc disease, the spongy discs that are located between the bony vertebrae break down over time, causing the vertebrae to rub and press against one another. Interestingly, a study conducted in 2014 found that CBD had strong anti-degenerative effects as well as positive results in treating neuropathic pain.
- Scoliosis — Scoliosis is a twisting of the spine that gets increasingly painful as time goes on. In the most severe cases, surgery, braces, and therapy are used to help correct the disorder. However, CBD can be helpful in reducing both the pain and inflammation, thus decreasing the need to prescription pain medication.
- Spondylolisthesis — This common condition occurs when the individual vertebrae shift in the back. The pain that arises can either be acute or chronic. Interestingly, this condition is more common among weightlifters and athletes because they take part in athletic activities that routinely put stress on the low back. CBD can help with spondylolisthesis because it has been shown to both reduce inflammation and alleviate pain.
- Arthritis — Arthritis that occurs in the low back is called spondyloarthropathies. This complex condition is caused by inflammation in the sacroiliac joints that leads to severe low back pain and spinal cord stiffness. Again, CBD oil can help alleviate this condition through its anti-inflammatory properties. An encouraging study conducted in 2017 found that CBD was extremely successful at treating persistent inflammatory pain.
Even if you aren't dealing with chronic or acute pain, you can still take CBD each day to support the overall health of your endocannabinoid system, which will help to keep your body in a state of balance in the long-run.
Is CBD Oil Safe?
Along with wondering how much CBD they should take, this is also a common question among new users. And while CBD has been increasing in popularity, so have the number of research studies done on it that closely examine the compound's safety and efficacy.
A recent study looking into the safety and side effects of CBD found that CBD is safe and has very few side effects. In fact, the side effects that the researchers did find were considerably mild in comparison to some of the side effects associated with prescription painkillers and other medications.
Some of the common side effects that some people feel include:
- Appetite changes
- Weight Changes
Considering that many prescription painkillers are both addictive and have dangerous side effects, it's not surprising that many pain sufferers are now turning to CBD oil as a way of helping to alleviate difficult chronic and acute pain.
Closing Thoughts on our CBD Oils for Pain Picks
In the best circumstances, pain can be annoying and short-lived. However, in worst case scenarios, pain can be chronic and last for a very long period of time. People who deal with chronic pain not only experience a loss of body function, they also experience a loss of their lives as they know it.
While many traditional therapies such as physical therapy, massage, chiropractic, occupational therapy, cryotherapy, and others do wonders at both alleviating pain and restoring overall functionality, the fact of the matter is that other treatments such as prescription pain medication come with an array of dangerous side effects.
Studies have proven time and again that CBD is a wonderful natural alternative to dangerous addictive painkillers. Not only is CBD safe, it's also proven effective in the treatment of such conditions like arthritis, fibromyalgia, depression, anxiety, nerve issues, sleep disorders, and others. Moreover, CBD has very few mild side effects as well.
Thanks to the work of scientists, CBD's healing properties have been documented in such a way that chronic pain sufferers are now experiencing hope and pain relief through regularly using CBD on a daily basis. If you're new to CBD, you should always take the time to do the research into different brands and products. While it may feel exciting to have a wealth of brands to choose from, keep in mind that not every brand is equal.
You should always take the time to do some research of your own so that you can confidently purchase the CBD product that will be the best one for you. Always take the time to look into the brand's reputation, product quality, transparency, use of an independent third-party laboratory, and customer reviews, among other things. You should also confirm that the products contain less than 0.3% THC in them, as this confirms that the brand is following the legal guidelines for CBD products sold within the United States. If you are feeling overwhelmed and confused as to where to begin, our article is a great first place to start.
While there are many great brands out on the market today, our research led us to the conclusion that FAB CBD was the top pick for the best CBD oil for pain. While it was a very close race to make our number one pick, it should be mentioned that Elixinol came in as a very strong second place. Both of these brands create solid, effective, high-quality full-spectrum CBD oils, believe in transparency, and do not cut corners when it comes to crafting some of the best CBD products available today.
If you have any further questions and concerns regarding CBD oil and whether or not it can help you treat your tough chronic or acute pain, do not hesitate to contact your primary care physician or specialist to set up an appointment to discuss things at more length. Considering the many side effects and the potential for addiction with prescription painkillers, it makes sense to give CBD oil a try. Natural is always better when it comes to boosting your health.
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By Ana Maldonado-Contreras
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>
Chronic Disease and Microbes<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>
Discovering Microbes That Predict COVID-19 Severity<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>
By Jeff Masters, Ph.D.
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