VIOME GUT INTELLIGENCE TESTING

The gut microbiome — the ecosystem
of trillions of bacteria, fungi, and other microorganisms living in your
digestive tract — is not just a digestion story. It is a hormone story. A mood
story. An inflammation story. A weight story. Research continues to demonstrate
that the composition and activity of your gut microbiome directly influences
estrogen metabolism, serotonin production, immune regulation, and metabolic
function — all of which are particularly relevant for women navigating
perimenopause and menopause.

Standard care never looks here.
Coastal Women’s Medical does.

What is
Viome Gut Intelligence testing?

Viome is the most advanced gut
microbiome analysis commercially available. Unlike older stool tests that
simply identify which bacterial species are present, Viome uses
metatranscriptomic sequencing — analyzing the actual activity of your gut
microbiome, not just its composition. This means Viome shows not only which
organisms live in your gut, but what they are actually doing: which metabolites
they are producing, which pathways they are activating, and how that microbial
activity is affecting your health.

The result is a comprehensive
analysis of your gut ecosystem paired with highly personalized food,
supplement, and lifestyle recommendations — all of which Dr. Yehl interprets
alongside your hormone panel, metabolic labs, and health history.

What
Viome measures

The estrobolome — the collection
of gut bacteria responsible for metabolizing estrogen — is of particular
importance for women. An imbalanced estrobolome can cause estrogen to be
reabsorbed into circulation at elevated levels, contributing to estrogen dominance,
mood instability, weight gain, and increased cancer risk. Viome gives Dr. Yehl
a window into this process that no standard test provides.

Why gut
health matters for women in midlife

Hormonal metabolism

Your gut bacteria play a direct
role in how estrogen is processed and eliminated from your body. When the
estrobolome is dysbiotic — out of balance — estrogen is not cleared properly,
contributing to symptoms of both estrogen excess and estrogen deficiency
simultaneously. Optimizing gut health is therefore an integral part of hormone
optimization, not a separate wellness pursuit.

Mood and mental health

Approximately 90% of the body’s
serotonin is produced in the gut. The gut-brain axis — the bidirectional
communication pathway between your microbiome and your nervous system —
directly influences anxiety, depression, cognitive function, and emotional regulation.
Many of the mood symptoms attributed to menopause have a gut health component
that is never investigated in standard care.

Weight and metabolism

Certain gut bacteria are
associated with increased energy extraction from food, increased fat storage,
and impaired insulin sensitivity. Others support healthy metabolism and body
composition. GLP-1 — the hormone targeted by semaglutide and tirzepatide — is
partially regulated by gut bacteria. Understanding your gut microbiome can
inform why weight management is difficult and what interventions will be most
effective for your specific biology.

Inflammation

Gut dysbiosis — an imbalanced
microbiome — is a major driver of systemic inflammation, which in turn
accelerates biological aging, worsens joint pain, disrupts sleep, and increases
cardiovascular risk. Reducing gut-derived inflammation is one of the highest-leverage
interventions available in longevity medicine.

Immune function

Approximately 70% of your immune
system is located in and around your gut. Gut health directly determines immune
resilience — how quickly you recover from illness, how well you tolerate
stress, and how effectively your body manages autoimmune activity.

How it
works at Coastal Women’s Medical

Step 1 — Test kit

Your Viome Gut Intelligence test
kit is ordered through Coastal Women’s Medical. A sample collection kit
is shipped directly to your home. Collection takes approximately five minutes
and the sample is returned by mail — no lab visit required.

Step 2 — Analysis

Viome’s laboratory performs
metatranscriptomic RNA sequencing of your sample, analyzing the active gene
expression of your gut microbiome. Results are typically available within 2–3
weeks.

Step 3 — Physician
interpretation

This is what separates gut testing
at Coastal Women’s Medical from ordering a kit online. Dr. Yehl reviews your
Viome results alongside your complete health picture — your hormone levels,
your metabolic labs, your body composition, your wearable data, your symptoms,
and your goals. The recommendations you receive are not Viome’s generic
algorithm output. They are Dr. Yehl’s clinical interpretation of what your gut
findings mean in the context of everything else she knows about your health.

Step 4 — Personalized
protocol

Based on your results, Dr. Yehl
will recommend specific dietary modifications, targeted probiotic and prebiotic
supplementation, and lifestyle interventions to restore microbial balance,
reduce inflammation, and support hormonal and metabolic health. Follow-up
testing is recommended annually to track progress.

Pricing

Viome testing is available to
patients on any membership tier as an add-on. It is particularly recommended
for patients experiencing persistent gut symptoms, mood instability, difficulty
losing weight despite appropriate interventions, immune challenges, or those
who want the most comprehensive longevity picture available.

Who
should consider Viome testing

•      
Women experiencing
bloating, IBS, constipation, or digestive discomfort

•      
Patients with mood symptoms
— anxiety, depression, or brain fog — not fully explained by hormone levels
alone

•      
Women struggling with
weight management despite GLP-1 therapy or lifestyle interventions

•      
Anyone with autoimmune
conditions or frequent illness

•      
Patients with skin
conditions such as eczema, rosacea, or psoriasis

•      
Women interested in a
comprehensive longevity baseline

•      
Patients on hormone therapy
who want to optimize estrogen metabolism and clearance

Frequently
asked questions

Is this the same as a
food sensitivity test?

No. Viome Gut Intelligence is a
metatranscriptomic analysis of your gut microbiome’s active gene expression —
it measures what your gut organisms are actually doing. Food sensitivity tests
measure immune reactivity to specific foods. They are different tools
addressing different questions. Many patients benefit from both.

Do I need to stop any
medications or supplements before testing?

Probiotics should ideally be
paused 2–4 weeks before collection for the most accurate baseline. Antibiotics
should be avoided for at least 4 weeks prior. Dr. Yehl will provide specific
preparation guidance when your kit is ordered.

How quickly will I see
results from the recommendations?

Gut microbiome changes in response
to dietary and lifestyle interventions typically become measurable within 4–8
weeks, though some patients notice symptomatic improvements within 2–3 weeks of
implementing changes. Annual retesting allows Dr. Yehl to track your
microbiome’s evolution and adjust recommendations accordingly.

Is this available via
telemedicine?

Yes. The test kit is shipped to
your home and results are reviewed with Dr. Yehl via telemedicine. Viome
testing is available to patients in New Jersey, New York, Florida, Colorado,
Washington, New Mexico, Michigan, and Wisconsin.

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