A test that returns 50 numbers seems designed to overwhelm. In practice, Viome's scoring system is organised around a small number of clinically significant indicators that immediately clarify where intervention is most needed, supported by layers of contextual data that allow for more specific guidance. The challenge is knowing which numbers matter most, what they are actually measuring, and how to connect them to decisions you can make.
This article breaks down the four score domains, identifies the highest-priority indicators in each, and explains what the scores mean in terms of practical health management — without overstating what they can or cannot tell you.
The Four Score Domains
Gut Health covers the functioning of the gut microbiome: Gut Lining Health, Microbiome Richness and Diversity, Active Inflammatory Activity, Digestive Efficiency, and Gut Metabolic Fitness, among others. These scores describe the current state of the digestive ecosystem and its relationship to systemic health.
Cellular Health measures what is happening inside your own cells — distinct from the microbiome but informed by the same RNA sequencing technology. Mitochondrial Stress, Cellular Aging markers, and Biological Age estimates are included in this domain. These scores reflect cellular-level function that correlates with long-term health trajectory.
Oral Health covers the oral microbiome — a distinct but interconnected ecosystem that research increasingly links to cardiovascular health, systemic inflammation, and even cognitive function. Oral Microbiome Balance and Periodontal Risk are the primary scores in this domain.
Systems Health synthesises across domains to assess Immune Function, Metabolic Health, and Brain Health indicators — providing an integrated picture of how the different biological systems are performing collectively.
The Three Gut Health Scores That Matter Most
Gut Lining Health is the single most important score for most individuals. It measures the functional integrity of the intestinal barrier — how intact the tight junctions between colonocytes are, and whether the gut is permeable to bacterial components that should remain contained. A low Gut Lining Health score is the upstream driver of the majority of chronic gut-derived health issues: systemic inflammation, food sensitivities, immune dysregulation, and metabolic dysfunction. In most protocols, improving this score is the foundation on which everything else is built.
Research from multiple independent groups has found that gut lining integrity is predictive of systemic inflammatory markers, metabolic health outcomes, and even neurological function. It is among the most actionable single variables in microbiome health management because it responds relatively quickly to targeted dietary and supplemental interventions.
Active Inflammatory Activity identifies which specific pro-inflammatory microbial functions are currently expressing in your gut — not merely which inflammatory-associated bacteria are present, but which are switched on and producing inflammatory compounds right now. This distinction is the reason RNA-based testing provides significantly more actionable information than DNA-based testing for this particular metric. A bacterium that is present but dormant does not require the same intervention as one that is actively producing LPS or other inflammatory mediators.
Microbiome Richness measures the diversity of your gut microbial ecosystem — the number of distinct species and the evenness of their distribution. The evidence for higher diversity as a proxy for gut health resilience, metabolic flexibility, and disease resistance is extensive. Low Microbiome Richness is not a diagnosis of any specific condition, but it is a reliable indicator of a gut ecosystem with reduced functional redundancy and greater vulnerability to disruption from diet, stress, or antibiotics.
These three scores — Gut Lining Health, Active Inflammatory Activity, and Microbiome Richness — taken together, provide a strong indication of Gut Type and the most urgent interventions required. This is why quiz results and full test results tend to align closely.
From Numbers to Personalised Protocol
The value of the test lies not in the scores themselves but in what Viome derives from them. The personalised food list — categorising 500+ foods as Superfoods, Enjoy, Minimise, or Avoid — is generated from the active metabolic profile of your specific microbiome, not from general nutritional principles. A food classified as a Superfood for one person may appear on another person's Minimise list because of differences in which bacterial species are present and active.
The personalised supplement protocol is similarly derived from your specific deficiencies and overactivities. Rather than a general probiotic recommendation, it identifies which specific strains your microbiome lacks, and which prebiotics will feed the species that need support without amplifying those that are already overrepresented.
It is worth being clear about what these scores do not tell you. They are a snapshot of your gut's current state, influenced by recent diet, stress, illness, and medication. They describe functional microbiome activity, not a fixed biological destiny. They are most useful as a baseline — a measurement point from which the effect of interventions can be tracked over time — rather than as a one-time diagnostic.
Get your estimated Gut Type in 3 minutes. Use the full RNA test when you want lab-grade confirmation and a personalised food and supplement protocol.
Sources & Further Reading
- Franzosa, E.A., et al. (2014). Relating the metatranscriptome and metagenome of the human gut. Proceedings of the National Academy of Sciences, 111(22), E2329–E2338.
- Plovier, H., et al. (2017). A purified membrane protein from Akkermansia muciniphila or the pasteurised bacterium improves metabolism in obese and diabetic mice. Nature Medicine, 23, 107–113.
- Qin, J., et al. (2012). A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature, 490, 55–60.
- Lloyd-Price, J., et al. (2019). Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases. Nature, 569, 655–662.
