The gut microbiome houses trillions of microorganisms that impact the various body systems in ways researchers are still trying to unlock, including the brain and mental health states. Research currently shows that mood, pain, hormones, stress, sleep, etc. impact the gut microbiome in a variety of ways. But more research is needed to determine the 2 way relationship between the brain and gut microbiome and what impact the gut microbiome has on the brain and mental health states. Disruptions of the gut microbiome influence gene expression and in turn development of mental health disease. The stress hormone, cortisol, may also directly impact our microbiome by causing changes in blood sugar level and appetite. The relationship between the gut microbiome and brain impacts the other and may have a positive or negative effect on the other.