Viome vs. Biohm: Which Is Best for Microbiome Testing?

Microbiome research is changing the way we practice medicine. After decades of refining the optimization of probiotics, we must now consider the nuances of prebiotics and postbiotics. Think of prebiotics as food for the gut microbiome and postbiotics as health-aiding metabolites produced by microbes.

Add to this the consumer trend of sampling and shipping one’s stool to a lab for “comprehensive” microbiome evaluation. In the spirit of entrepreneurship, several companies have entered the marketplace with home test kits that claim to do just that and provide diet and lifestyle advice based on their findings. I tested the theory by comparing the results of two prominent companies, Viome and Biohm. What follows is my experience completing these tests and comparing the results. Please note that I have no affiliations with these companies and paid for testing. As should be clear from the conclusion, my reporting is unbiased.

Testing

I ordered Viome’s Health Intelligence™ Test at a cost of $199 and Biohm’s Gut Test for $130. They both arrived promptly, and I planned to complete both tests on the same day, from the same fecal sample.

As you might suspect, taking a fecal sample isn’t the most fun thing to do, but in the interest of science, I scooped or swabbed a small portion of a morning bowel movement and prepared the sample for shipping. Both tests were clear in their instructions and easy to complete. I have a high threshold for disgusting things, having worked with patients for almost 20 years, but I would venture most people would be able to complete such a test with little difficulty.

Viome had an additional blood test that involved pricking a finger, pipetting the blood into four vials, and transferring the contents into a single tube. I found this rather annoying and messy despite being well trained in handling needles and lancets.

On this metric, Biohm wins for being less expensive and avoiding the hassle of a blood test. When comparing results, we’ll see whether the results from the additional blood test from Viome justify the extra expense.

Questionnaire

With samples complete and in the mail, the next step is to register online and fill out a questionnaire. The idea is to provide information about diet and lifestyle that correlates with the findings of the microbiome test. My impression is that this data is more useful to the company than to the client. We are in the very early stages of microbiome testing, and these companies are voraciously compiling data to strengthen their results algorithms.

I found Biohm’s questionnaire to be simple and basic; it didn’t take long to complete. Viome’s questionnaire took almost an hour and seemed excessive. For example, one question was, “How many areas within your teeth does food frequently get stuck?”

For this metric, Biohm wins for having a more concise questionnaire, but again, we’ll see if the results from sharing picky details with Viome justifies the extra time spent.

Turnaround Time

Viome was the quickest at 15 days, with Biohm taking 34 days for receipt of results. Both companies made their reports accessible via an online portal that allowed them to be downloaded and printed. Viome wins this round for speedy reporting, if that matters to you.

Results

Everything comes down to one central question: Are the results from testing the gut microbiome actionable?

For Biohm, the lab report was relatively straightforward and detailed the content of my microbiome, providing a percentage gradient of beneficial and pathogenic species. The report was brief but sufficient to supply a “gut score” at the cross section of microbiome diversity, phyla balance, beneficial species, and pathogenic species.

The second Biohm report was a brief listing of insights based on the state of my microbiome, such as “increase fruit and vegetable intake” and “increase exercise to support overall health and gut balance.” If that sounds a little generic, you’re right. Everything the report listed was common sense and provided no specificity.

The Viome report was less revealing. One report was 45 pages listing the microbes found in my gut but with no quantification or grouping into phyla. The report literally was just a list of probiotic genus and species without comments on the presence of absence of pathogenic species. 

The second Viome report was an 88-page discussion on categories of health, such as oxalate metabolism pathways and digestive efficiency (among other amorphous categorizations). While there was no quantification of probiotic species, this report rated these categories on a scale of 0 to 100 based on the microbiome results and the questionnaire. That struck me as being highly presumptuous, because my inner ecology is also predicated on nutrient status, toxicant exposure, lifestyle stresses, sleep quality, and many other metrics that a questionnaire does a poor job of objectifying.

The rest of this second Viome report gave diet and lifestyle recommendations based on my microbiome results. For example, I should “minimize” chard but can “enjoy” cucumber. There were plenty of things on that list that I know for sure don’t agree with my digestion, which questioned the validity of the entire report. 

Perhaps most disappointing was the lack of quantification from Viome, making it impossible to compare the microbiome results between the two labs. As a practitioner, I wanted to see the raw data and share that with colleagues. I contacted customer service to see if that information could be released, and here is the response I received:

Viome does not currently display microbe percentages or prevalences. We are interested in active cellular and microbial functions, as well as pathway activities. This information tells us what your active microbes are up to; activity is summarized in the scores you see in the results section.

We identify the organisms that are active and which metabolic pathways they are involved in when Viome synthesizes information from the RNA data in each sample. There is no direct link between one microbe and any given dietary recommendation. To carry out multiple functions, multiple microbes, genes expressed, and pathways are required. Your recommendations are based on how your microbes collaborate as a group.

Viome’s testing looks beyond just the presence of certain bacteria. Many microbes can perform the same function, and each microbe can perform multiple functions. Viome’s goal with our recommendations is to ensure that the organisms in your gut microbiome are performing the correct functions for your body.

Currently, we are unable to provide raw data of your sample analysis. Raw data are the real data reads of your RNA, and they can only be useable using our interpretative software.

That’s not helpful, because we have to trust Viome’s interpretation of the data with no option for a third party to make an independent assessment.

Based on this critique of Viome, you’d think Biohm is the clear winner—but not so fast. Returning to the central question of whether the information provided is actionable, my final assessment is that neither test is worthwhile. It strikes me that both companies are inferring way more about diet and lifestyle than the research currently supports. The science may ultimately get there, but it’s too early and there are far too many factors not considered, such as genetic predispositions and environmental toxicant exposures. To suggest that a questionnaire based on one’s phenotype is sufficient to drive recommendations seems superficial at best and presumptuous at worst.

Conclusion

In the end, it was impossible to compare the results from the two labs. They were just too different, and ultimately, both were insufficient. Here’s what they did have in common: They both ended by recommending supplements based on my microbiome, but even those didn’t agree because the supplements were tied to their product lines. 

So what’s my takeaway? You are the ultimate arbiter of what works and doesn’t work for your diet and lifestyle. There may be a future where microbiome testing provides actionable strategies, but we’re not there yet. I suggest you spend your money actually talking to a live human, preferably an integrative medical provider, and being heard and understood for all the facets of your being. A collaborative and patient-focused approach is the path to the greatest therapeutic benefit.