Knowledge base · Personal health

The gut-brain axis: how gut and brain communicate

The gut and the brain continuously exchange signals. That exchange runs in both directions: the brain influences gut function, and signals from the gut in turn reach the brain.[1][3]

Which routes does this communication follow?

Research describes four main routes that complement one another:[1][2]

  • Nerve pathways, including the vagus nerve and the extensive nervous network in the gut wall.[4]
  • The immune system, which relays inflammatory activity via signalling molecules.[10]
  • Hormones, including substances involved in the stress response and in satiety.[2]
  • Substances produced by gut bacteria, such as short-chain fatty acids and other metabolites.[1]

What does the research suggest?

Studies describe associations between gut microbiome composition and mood, stress response, cognitive function and certain mental health conditions. These are generally associations found in population studies or findings from animal research; cause and effect have not been demonstrated.[5][8]

In pooled analyses, microbiome-targeted interventions show at most small effects on depressive symptoms, with variable study quality.[6][9]

Gut bacteria may influence processes involved in the availability and regulation of substances that play a role in neurotransmission — for example, by contributing to the conversion of nutrients that serve as building blocks. How strong this influence is in humans, and under which circumstances, is still being investigated.[2][7]

A complex field of research

Mood and cognition are shaped by many factors at once: sleep, medication, lifestyle, social circumstances and genetic predisposition. Within that picture, the microbiome is one factor. This makes it difficult to isolate effects, and explains why study results vary.[7][8]

Medical nuance

A gut microbiome analysis does not provide a diagnosis and cannot establish or rule out psychological or psychiatric conditions. If you are experiencing symptoms in this area, assessment by your GP or treating clinician is the first step.

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Scientific references

The information on this page is based on recent scientific literature. Below is a selection of key review articles and systematic reviews on the gut-brain axis. These publications form an important basis for current knowledge about communication between the gut microbiome and the brain. Because this field is developing rapidly, new insights are added to this knowledge base regularly.

Reference 1

The gut microbiota–brain axis in behaviour and brain disorders

Nature Reviews Microbiology · 2021 · Narrative review

Zeer hoog

Reference 2

The microbiota–gut–brain axis

Physiological Reviews · 2019 · Review

Zeer hoog

Reference 3

The brain–gut–microbiome axis

Cellular and Molecular Gastroenterology and Hepatology · 2018 · Review

Hoog

Reference 4

The Gut-Brain Axis: Interactions Between Enteric Microbiota, Central and Enteric Nervous Systems

Annals of Gastroenterology · 2015 · Narrative review

Hoog

Reference 5

Gut microbiota and major depressive disorder: A systematic review

Journal of Affective Disorders · 2020 · Systematic review

Hoog

Reference 6

Effects of microbiota-targeted interventions on depressive symptoms: Systematic review and meta-analysis

Neuroscience & Biobehavioral Reviews · 2019 · Meta-analysis

Zeer hoog

Reference 7

Brain–gut–microbiota axis in depression: A historical overview and future directions

Brain Research Bulletin · 2022 · Narrative review

Matig

Reference 8

Gut microbiota and mental health: A systematic review

Neuroscience & Biobehavioral Reviews · 2024 · Systematic review

Hoog

Reference 9

Psychobiotics and the Microbiota–Gut–Brain Axis

Trends in Neurosciences · 2016 · Narrative review

Matig

Reference 10

Microbiota–gut–brain axis and neurological disorders

Journal of Neuroinflammation · 2020 · Review

Matig

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