“…Even though the formation of large amounts of the reduced metabolites of DG3 (for example, dihydrodigoxin [DHDG3]) ( Fig. 1) in a significant minority of patients was known for some time (1,2,4,18,(21)(22)(23), it was only recently discovered that this conversion of DG3 to DHDG3 occurs within the gastrointestinal tract (17). Further, the organism Eubacterium lentum, a grampositive, obligate anaerobe and normal member of the intestinal flora, was identified as a bacterial species that can perform the reduction (5,6).…”