A recent study by Baldanzi, G., et al* published in Nature Medicine found that antibiotics have an enduring impact on the gut microbiome causing disturbances which can last up to eight years.

 

The greatest disruptions to the diversity and quantity of gut bacteria occurred within 1 year of antibiotic use, although the effects can sometimes last much longer. Some antibiotics were still affecting 10-15% of microbiome species four to eight years after treatment. 

 

Baldanzi and colleagues found that even a single antibiotic course could impact gut species. The antibiotics found most guilty of long-lasting effects are clindamycin, fluoroquinolones and flucloxacillin. Whereas penicillin V, extended-spectrum penicillin (i.e. amoxicillin) and nitrofurantoin caused much less of a disruption to beneficial bacteria.

 

The study also seems to support the hypothesis that antibiotic-induced microbiome disruptions may contribute to chronic health conditions such as diabetes and cardiovascular disease. The main reason for the judicious use of antibiotics, however, remains the rise of antimicrobial resistance which threatens the efficacy of antibiotic treatments.

 

All this being said, when found to be necessary, the benefit of antibiotics far outweighs the risk of infection. Rest assured, your doctor will weigh all factors when determining if an antibiotic is right for you. 

 

*Baldanzi G, et al. Nat Med. 2026; doi.org/10.1038/s41591-026-004284-y

 

 

 

 

Why does biotin matter for blood tests?

Biotin can interfere with certain blood tests and cause wrong results. This means your doctor could get lab numbers that are too high or too low — even though nothing is actually wrong (or something is wrong that the test fails to catch).

 

What tests can be affected?

Biotin can cause problems with many common blood tests, including:

• Thyroid tests (TSH, T3, T4)
• Heart tests (troponin, NT-proBNP) 
• Pregnancy tests (hCG)
• Vitamin D levels
• Parathyroid hormone (PTH)
• Certain cancer screening tests (like PSA)

Why is this dangerous?

Wrong test results can lead to:

• Being treated for a condition you don't actually have
• Missing a real problem that needs treatment
• Unnecessary medications, procedures, or worry

How much biotin is a problem?

Even small doses found in common supplements (5-10 mg) can cause test interference. The amount your body actually needs each day is very small — only 30 micrograms — which you typically get from food alone.

 

What should you do?

1. Tell your doctor if you take biotin or any supplement that contains it — check the label of your multivitamin, as many contain biotin.
2. Stop taking biotin at least 2 days before any blood test. Your doctor may ask you to stop it even earlier (up to a week before).
3. Don't stop any supplement without talking to your doctor first if it was prescribed for a medical condition.

Starting on July 1, Medicare is launching a bridge program that will provide temporary funding for the GLP-1 medications Wegovy, Zepbound and Foundayo when prescribed for weight loss. This funding is scheduled to last until December 31, 2027. To be eligible for this program, patients must meet the following criteria:

• be enrolled in a Medicare plan that includes Part D coverage or have a standalone prescription drug plan (PDP) through Medicare
• have been prescribed the GLP-1 for weight loss* and
• meet one of the following requirements at the time therapy was initiated:

• Body Mass Index (BMI) of 35 or greater  
• BMI of 30 or greater with a high-risk condition such as:
• heart failure with preserved ejection fraction
• uncontrolled hypertension (defined as systolic blood pressure above 140 mm Hg or diastolic blood pressure above 90 mm Hg, despite concurrent treatment with two antihypertensive medications) or
• chronic kidney disease stage 3a or above
• BMI of 27 or greater with a history of:
• pre-diabetes
• stroke
• heart attack or
• symptomatic peripheral artery disease

 

This coverage will require prior authorization, and if approved, you can obtain the prescription at your pharmacy for a copayment of $50 per month. Since this bridge program falls outside of Part D, these copayments will not apply to the Part D deductible or the out-of-pocket cap.  Prior authorizations cannot be submitted until July at the earliest.

 

At this point, we are waiting to receive more information from CMS on what lifestyle modifications will be necessary. We also need to wait until they release what the process will be to submit prior authorizations. Once we have this guidance from CMS, we will send another newsletter with updated information along with a survey to see who will qualify. 

 

What can you do while you wait to receive more information from our office?

• Call your Medicare plan to see if it is an eligible plan under the bridge program
• Calculate your BMI to see if you meet that portion of the requirements: CDC BMI Calculator

 

*If you are a Medicare Part D beneficiary who already has a prescription for a GLP-1 that is covered under Medicare Part D, such as diabetes or obstructive sleep apnea, you are ineligible for this plan.