Probiotics: what do they do?

Today, probiotic supplements are marketed to support many ailments and you may be asking why and if they are worth the money. Before discussing the benefits of probiotics, the gut microbiome needs to be explained. Bacteria make up 10 percent of our body weight and there are 10 times more bacteria in our gut then the cells of our body. This bacterium is our microbiota and we have about 500-1000 different types of bacteria in our digestive system. There are billions of microbes in the mouth and small intestine and trillions in the large intestine. The microbiota acts like an organ and is a major component of the immune system. A healthy microbiome protects us from disease, allows us to maintain a normal weight, and keeps our overall health in check.  No two people have the exact microbiome, but our microbiome is different from our ancestors due to medications, climate, breast-feeding versus bottle-feeding, stress, C-sections, lack of exercise, and more processed foods in the diet. These factors cause disease producing bacteria to build up leading to symptoms such as diarrhea, bloating and gas, and is a major cause of irritable bowel syndrome, and are the basis for the SCD diet to treat IBD, which promotes rebalance of the gut microbes. The bacteria in the gut communicate with each other and our genes to help regulate metabolism and the immune system. If there is a microbial imbalance or too few microbes in general, then some existing bacteria mix may become harmful. Bacteria from the Bacteroides and Firmicutes families make up about 80-90 percent of the bacteria found in our gut. The next most common bacteria are Actinobacteria such as Bifidobacteria and Proteobacteria such as H Pylori and E Coli. Humans have lived in harmony with these normal strains of bacteria by consuming fermented foods, being born vaginally, and putting fingers in our mouth (commonly seen among children). The bacteria that cause chronic disease are usually found in small quantities but when given the opportunity will begin to thrive and cause illness.

So, the next question to answer is how does probiotic bacteria help us? First, a probiotic is a specific type of bacteria or yeast, and each type has a specific effect on the human body. The benefits are numerous including improved digestion reducing intestinal inflammation, regulating peristalsis which improves diarrhea, constipation, and IBS, and balancing intestinal pH.  Probiotics have been found to improve lactose intolerance, increase absorption of minerals, decease symptoms of allergies, asthma, and eczema, and protect against auto-immune illnesses. Finally, probiotics can help regulate metabolism, normalize cholesterol levels, and support healthy blood pressure. 

Now that we know the benefits, what is the best way to obtain these beneficial bacteria? The two most beneficial bacteria to our intestinal flora are the lactobacilli, found in the small intestine and bifidobacteria found in the colon. Both bacteria need to be consumed daily since they are not naturally found in the digestive tract and only live in us for 12 days. These bacteria secrete acetic, formic acid, and lactic acid making the intestinal environment unfriendly to invading microbes. Lactobacillus also produces antibiotics effective against bacteria such as strep and staph.  The regular consumption of cultured dairy products and other fermented foods is important for those who are healthy, but supplements may be necessary to rebalance the intestinal flora once disease producing microbes have established themselves in the gut. To obtain these healthy probiotics from food think cottage cheese and yogurt versus milk, sauerkraut versus cabbage, and tofu or tempeh versus soybeans. For example, traditional sauerkraut has been eaten by Europeans to help with ulcers and other digestive problems and lactose intolerant people worldwide have consumed cultured dairy products such as cottage cheese, yogurt, and kefir. Asian cultures eat pickled daikon radish and kimchi. Other probiotic rich food and drink include miso, olives, raw vinegar, traditionally made sourdough bread, wine, chocolate, coffee, black tea, kombucha, brine cured pickles, and fermented vegetables. It’s also important to consume foods with prebiotics since they play an important role in maintaining good health and stimulating the growth of beneficial bacteria, lactobacilli and bifidobacteria. They also acidify the intestinal flora which allows for better absorption of minerals. Foods high in prebiotics include asparagus, bananas, fruit, garlic, honey, legumes, onions, peas, yogurt, oats, bran, Jerusalem artichokes, and leeks. 

So, if you chose to take a probiotic supplement consult with your medical provider and the following tips should be considered.  Many supplements on the market look similar but can vary greatly in their effectiveness. It’s important to consume well-researched probiotics that have been shown to be useful in the clinical setting, always look for a batch number and date, and when possible, purchase them from a health professional or someone who has done the research for you. Typically, the best probiotic supplement is a combination of lactobacillus and bifidobacterial strains. You may also choose to purchase a dairy-free probiotic. The most effective test is to try out several different ones and see which one your body likes best. The number of organisms per dose does not necessarily give an indication of effectiveness, but whether the probiotic contains living viable organisms which can adhere to the gut lining, although research has shown that even dead probiotics can be beneficial to the immune system. Be aware that some microbes are inactivated by stomach acid and are essentially useless. Look for enteric coated capsules when taking probiotic supplements. Finally chose a probiotic that is refrigerated to ensure the life span and potency and a probiotic that contains a prebiotic such as FOS and inulin which provides nourishment for the bacteria. For dosing consider taking 1 billion to 25 billion organisms daily depending on the severity of your condition. Begin taking them at a low level and increase the dose slowly. If you experience worsening symptoms such as gas, bloating, and diarrhea, stop taking them. When the disease producing bacteria and fungus are killed off, they release chemicals that can cause worsening symptoms. Once symptoms have resolved, begin taking them again in small amounts and symptoms should subside. If symptoms continue, consult your medical provider.

It’s important to remember that probiotic supplements can be helpful but are not a magic cure and are expensive. Getting your probiotics from fermented foods; cheese, yogurt, pickles, kefir, miso… and always eating your probiotic with prebiotic fiber: oats, asparagus, onions, garlic, honey, bananas is the best way to rebalance your microbiome. It’s always best to consume a diet of minimally processed whole foods which contain natural probiotics and prebiotics, exercise daily, participate in stress reducing modalities such as yoga and deep breathing, and make following a healthy lifestyle one of your top priorities. 

Lipinski E. Digestive Wellness. Strengthen the Immune System and Prevent Disease Through Healthy Digestion, 4^th Edition. McGraw Publishing. 2012.