In today’s health landscape, the spotlight is on AI, wearables, and personalised medicine. Everyone is looking for the next big thing, the shiny new tool that will revolutionise healthcare. But here’s the twist. The revolution may already be inside us.

The microbiome, the vast community of microbes living in and on our bodies, isn’t just a scientific breakthrough. It’s more like a new operating system for human health. Think of it as la base de tout, the foundation beneath everything from our metabolism to our mood. And yet, most companies treat it like a niche, a wellness add-on, a probiotic here or a gut cleanse there. In truth, the microbiome should be front and centre in how we think about health in the 21st century.

The microbiome as an operating system

Let’s be clear, the microbiome is not a trend. It’s a biological infrastructure. It touches nearly every system in the body, from our immune function to our digestion, inflammation or our cognition, even how we respond to medication. You could say it’s the middleware between what we eat, how we live and how our bodies behave.

What’s fascinating is how interconnected it is. You tweak the gut and the brain responds. You change your diet and the microbiome shifts in hours. This isn’t speculation. It’s backed by an avalanche of peer-reviewed research. For example, scientists have found links between microbial imbalances and conditions like depression, anxiety, type 2 diabetes and even Parkinson’s disease or Alzheimer’s. The gut isn’t just the second brain, it’s the control tower.

Still, despite all this complexity and potential, most of the public conversation remains surface-level. Many people still think “microbiome” means “take a probiotic.” It’s like seeing the word “cloud” and thinking only of the weather.

Why doesn’t the market get it?

There’s a kind of cognitive dissonance in the industry. On one side, research journals are lighting up with groundbreaking findings. On the other, the market is flooded with oversimplified, commodified products. It’s dommage, really — a missed opportunity so far.

Most companies are stuck in old models. Supplement brands want to sell capsules. Pharmaceutical companies are hesitant to invest in something they cannot easily patent. Healthcare systems aren’t built to measure or monitor microbiome data, so they ignore it. The result is fragmentation or innovation without integration.

Part of the problem is legacy thinking. Western medicine is still largely reductionist. Diagnose, prescribe, repeat. The microbiome doesn’t fit well in that box. It’s dynamic, contextual and incredibly individual. In short, it’s messy. But that mess holds the key to solving some of our biggest health problems.

The opportunity: shift from product to platform

Here is where it gets exciting. What if we stopped treating the microbiome as a product category and started treating it like a platform?

The companies that will lead the next wave of healthcare aren’t just building new drugs. They are building new frameworks. They’re integrating microbiome insights into diagnostics, nutrition plans, mental health protocols and chronic disease management.

Already, some players are stepping up. Startups are using AI to analyse gut samples and generate personalised dietary guidance. One could think of “smart probiotics” that release targeted compounds based on internal signals. Research into faecal microbiota transplants—yes, exactly what it sounds like—is showing promising results for a growing number of conditions.

We’re on the edge of a paradigm shift, but only if businesses are ready to start building systems.

Where this is heading?

Make no mistake, the future of medicine will be deeply microbial.

Imagine routine gut testing as common as a cholesterol check. Imagine mental health treatments that go beyond talk therapy or Selective Serotonin Reuptake Inhibitors (SSRIs) to include microbial interventions. Imagine oncologists adjusting chemotherapy based on gut profiles.

Some of this is already happening. Researchers are exploring how the microbiome affects drug metabolism. Two people can receive the same prescription, but their responses might be totally different depending on their gut. Clinical trials are starting to include microbiome data. Insurance companies are probably watching this space closely. The momentum is real.

In the not-too-distant future, we’ll likely see personalised health recommendations based on a mix of DNA, lifestyle data and gut microbiota. C’est logique, because health is no longer only about our human cells. It’s about the ecosystem we live with.

What needs to change?

If this shift is going to happen at scale, a few things must evolve:

  • More education. Consumers and clinicians need to understand that the microbiome isn’t a luxury topic. It’s a foundation of modern health.
  • Better tools. Gut tests need to be accurate, affordable and give real insight. Too many still offer vague “eat more kale” advice.
  • Stronger regulation. The market is still the Wild West. We need better standards for testing, labelling and claims.
  • Interdisciplinary thinking. This is not just a biology problem. It’s a systems problem. We need scientists, psychologists, nutritionists, doctors and health professionals from different disciplines working together to build real solutions.

Final word

The microbiome isn’t a niche. It’s not a trend. It’s not a fad product to place next to collagen powders or plant-based substances. It’s the new operating system of health and the companies who understand that will shape the future.

Those who don’t will look back and realise they missed the biggest health tech shift since the genome. Ignoring the microbiome now is like ignoring the internet in 1995. It’s not just risky. It’s dangerously shortsighted.

Alors voilà. The revolution isn’t coming. It’s already here and it’s microbial.

Christian Roghi – PhD, MBA, DipMC trained as a molecular biologist and went on to research cancer progression at prestigious academic institutions across the EU, US and UK. During that time, he also started his first business.

He later moved fully into the business side, leading business development at the Institute of Food Research and the Quadram Institute Bioscience, the UK’s first and still the only microbiome research institute with an embedded gastroenterology unit. Christian has since worked within some of the most innovative microbiome companies including EnteroBiotix (Biotech, FMT), CosmosID (Next-Gen Sequencing, bioinformatics) and Eagle Genomics (SaaS, microbiome network science), where he helped shape strategy, commercial direction and ecosystem positioning across the microbiome space.

Today, through Big Bold Bridges, he catalyses strategy, drives execution and accelerates adoption across the microbiome space.