The gut microbiome is an underutilised yet powerful, patient-centered target for both immediate and long-term health. Integrative health approaches offer a key opportunity to apply robust research while empowering patients to take control of their health. Rooted in our deep evolutionary connections to microbes, we start with the global picture of biodiversity loss and chronic disease, before exploring the barriers practitioners face in leveraging gut health—such as plant-based diets & current nutrient concerns, time constraints, knowledge gaps, and food quality. We will conclude with practical, integrative strategies to incorporate the gut microbiome into patient care for better health outcomes.