I can give some context for what may have happened because I went through something similar.
My two cents is the biggest factors were the keto and the stress. A low carb, high fat diet does not traditionally feature intact plant cell walls, or what we otherwise know as "fiber". There are literally thousands of different of variations of "fiber" of which we have catalogued only a few, but these structures feed the microbiota in your gut. And they really do depend on fiber in a profound way.
Without this fiber, they tend to starve and adjust to feed on the epithelial lining of your gut. It also gives an opportunity for the pathogens in your gut to "takeover", especially when paired with the stress since most of the "beneficial" microbes will tend to die off.
When you read stories of people who got an autoimmune problem, there's almost always a period of severe stress prior to it. My working hypothesis is this impairs the immune system which is what keeps the pathogenic bacteria in check through several mechanisms (pathogen-associated-molecular-pattern detection or PAMPs for instance).
Through much, much trial and error and a lot of scientific article research, I've found the most consistent way to restore microbiota ratios is with Vitamin D, followed by a clinically tested probiotic like Visbiome, followed by Kefir. The Vitamin D alone at moderate to high doses will get you very far, although it doesn't necessarily restore diversity (since Vitamin D in of itself does not contain any microbes) but it helps shift the balance of microbes through a variety of biochemical functions.
Vitamin D also helps with gum disease in my experience and in a way no other supplement or product has so far. Highly recommend and you don't even have to take a high dosage to see it for yourself. You just have to be consistent.
One last thing I'll say is that for whatever reason taking the supplement seems to work better than exposing yourself to sunlight, which is unusual, but there may be something about the biochemical pathway Vitamin D takes when consumed as a supplement as opposed through the cholesterol-synthesis that happens with UVB.
"Through much, much trial and error and a lot of scientific article research, I've found the most consistent way to ..." etc..
Unless one has done proper, randomized, medical trials, I don't see how anyone could use such unambiguous language.
These n=1 experiences lacking in objectivity and also likely proper measures might help us discover new ground for things that might work (i.e. the basis for a trail), but without any testing it's not something any reasonable person should be walking around saying 'works', unless you mean to indicate you're referring to the literature.
You remind me of those doctors that needed clinical evidence to prove babies don't feel pain during surgery lol.
But I will say, everything I've said lines up with the scientific literature, so I can have my cake and eat it too, backed by both personal experience (skin in the game) and an informed understanding of the biochemistry at play and randomized, controlled trials with large populations.
If you're curious, and not just trying to nitpick out of a deep, misplaced sense of cyncism, I highly recommended diving into the literature and doing some reading.
Elicit.org is one of my favorite tools for gathering information, although the "Takeaways" can be sometimes be wrong so I highly recommend reading the abstract too.
You remind me of the legions of people on the internet who think they have understood or discovered something due to dubious interpretation of relationships which are non-causal, especially among application of self care or care of others.
I have a colleague who hands out TCM 'remedies' every day, she and her patients all believe they work, in the medical sense, in a very rational way.
Even though 'Western Medicine' has a pretty good foundation, it's layered in complexity and ambiguity.
So if someone had some recurrent, acute issue, that was solved with some diet or action change that was discernibly impactful - maybe. That would be worthy of note.
For example: "I had chronic fatigue - mostly we changed my diet to low carbs, no alcohol, regular sleeping and basic cardio + vitamin D due to deficiency and within a few months it was gone". That rings reasonable.
But 'these are 10 things that worked' raises many red flags.
I've had CFS myself - and ran the gambit of different angles of attack on it, and it's a tricky set of symptoms that doesn't even represent a verifiable ailment: CFS, lethargy etc. is the result of a bunch of different things which we do not even fully understand.
More important note what I just said: 'symptoms' not an 'underlying condition'. There are multiple things that cause them. Even the notion of treating 'symptoms' before arriving at a proper diagnosis is a pretty giant red flag.
Some of symptoms described could feasibly be the result of forms of ulcers, cancer, HIV, iron deficiency, kidney problems, liver problems, adrenal gland problems, gluten intolerance etc. etc..
So no - we don't just go to 'Probiotics and Vitamin D' - necessarily.
Personally - getting rid of energy drinks and sleeping a regular schedule 'cured' me but it's rather impossible to tell what did what. But merely seeking medical advice, and knowing it was not 'something serious' (like Cancer) was a huge load off my shoulders, which can affect recovery dramatically. In fact, I literally started feeling better the day I knew I wasn't dying. But that's just me.
If someone is feeling tired consistently and it's clearly not due to some obvious event or issue - then they should !! see a doctor !! and go from there.
I’ve arrived at similar conclusions and it seems roughly inline with research on gut biomes. My own autoimmune condition began after a stressful period with a negative emotional aspect. I’d also been eating less “healthy diet too”, etc.
The first line is vit-d and pro-biotics, especially if you have heavy inflammation and microbiome issue or have taken antibiotics.
Alongside those would be eating a generally “higher quality diet” with a fair bit of variety. Reducing sugar and avoiding highly processed foods and preservatives helps significantly. Foods with less antibiotics help too, so items like free range eggs, organic milk can be helpful. Vegetables seem less affected by organic or non-organic.
Fermented foods are pretty important in providing a wide variety of microbes. I’ve noticed that lots of traditional spices like turmeric or black pepper are beneficial. I have a pet hypothesis that most “traditional diets” in a region would adjust to include useful spices and come to “taste good”. Almost every regional cuisine also used to have a staple fermented food. Nowadays fermented foods are generally replaced by vinegar substitutes nowadays (sauerkraut, pickles, Kim chi). Ketchup has roots as a fermented chutney like tomato sauce for example. Obviously kefir and such are different.
Going more keto or alternatively vegetarian doesn’t matter as much once your gut biome can shift. Though often going keto or vegetarian tends to get people to start eating better quality food. It also encourages a wider variety of foods which help prevent mono-cultures forming in the gut microbiome.
However good food isn’t a cure all, just a helper too keep the microbiome healthy. It can reduce chronic inflammation alongside vit-d.
Thank you for sharing about the importance of fiber. What seemed to work for my wife: a regimen of three times daily for two weeks of herbs for dysbiosis (dill, tarragon, thyme, olive leaf and wormwood) then repopulation with fermented foods (mostly sauerkraut) and large intake of various fibre from beans, seeds, greens, and fruits.
I've noticed my mental health is so much better when I'm outside for an hour a day. I worry about aging and skincare, but decided I'd rather look old but be happy vs be miserable and look good! I generally wear a hat and high spf on my face, neck and chest but let everywhere else soak up the Vitamin D.
My two cents is the biggest factors were the keto and the stress. A low carb, high fat diet does not traditionally feature intact plant cell walls, or what we otherwise know as "fiber". There are literally thousands of different of variations of "fiber" of which we have catalogued only a few, but these structures feed the microbiota in your gut. And they really do depend on fiber in a profound way.
Without this fiber, they tend to starve and adjust to feed on the epithelial lining of your gut. It also gives an opportunity for the pathogens in your gut to "takeover", especially when paired with the stress since most of the "beneficial" microbes will tend to die off.
When you read stories of people who got an autoimmune problem, there's almost always a period of severe stress prior to it. My working hypothesis is this impairs the immune system which is what keeps the pathogenic bacteria in check through several mechanisms (pathogen-associated-molecular-pattern detection or PAMPs for instance).
Through much, much trial and error and a lot of scientific article research, I've found the most consistent way to restore microbiota ratios is with Vitamin D, followed by a clinically tested probiotic like Visbiome, followed by Kefir. The Vitamin D alone at moderate to high doses will get you very far, although it doesn't necessarily restore diversity (since Vitamin D in of itself does not contain any microbes) but it helps shift the balance of microbes through a variety of biochemical functions.
Vitamin D also helps with gum disease in my experience and in a way no other supplement or product has so far. Highly recommend and you don't even have to take a high dosage to see it for yourself. You just have to be consistent.
One last thing I'll say is that for whatever reason taking the supplement seems to work better than exposing yourself to sunlight, which is unusual, but there may be something about the biochemical pathway Vitamin D takes when consumed as a supplement as opposed through the cholesterol-synthesis that happens with UVB.