Probiotics

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WHAT ARE PROBIOTICS?

Probiotics are various strains of bacteria and yeast that are beneficial to the health of the body through supporting the microbiome. The microbiome is the total group of microorganisms that live within and on the body. We can break this into different sections such as the skin microbiome, the oral microbiome, and the gut microbiome. There are various schools of thought to just how many bacterial cells there are in the body, but conservative estimates say that bacteria cells outnumber our human cells by 1.3:1 (1). Others estimate a whopping 10:1 ratio of bacterial cells to the trillions of human cells that make up our bodies. It is safe to say, we are just as much human as we are bacteria. These bacteria, for the most part, offer health-promoting mechanisms for the wellbeing of the body by protecting from pathogens, supporting the immune system, breaking food down for assimilation, and even creating vitamins for the body to use (2,3,4). We believe nurturing the microbiome is foundational to overall health and will play a large part in the future of medicine and reversing chronic illness.

WHAT FACTORS IMPACT THE MICROBIOME?

Unfortunately, there are various lifestyle factors that can contribute to the degradation of the microbiome in humans (5,6,7,8). These include:

  • Mode of delivery at birth

  • Overuse of antibiotics

  • Sugar consumption

  • Gluten consumption

  • Medications

  • Stress

  • Aging

  • Lack of exercise

  • Poor sleep hygiene

  • Excessive alcohol consumption

  • Smoking

WHY SUPPLEMENT WITH PROBIOTICS?

There is abundant research to support the use of probiotic supplementation. The obvious and most researched aspect of probiotic supplementation is for gut health. We are given our microbiota from mother when traveling through the birth canal. Later on, various dietary and lifestyle factors contribute to the health or decline of the microbiome. As mentioned above, the standard American diet being full of refined, processed foods along with stress, aging, illness, antibiotics and other medications can lead to gut dybiosis. When gut dysbiosis, or an imbalance of beneficial and pathogenic bacteria occurs, supplementation with probiotics can play a valuable role in correcting it.

We know that 80 percent of the body’s immune system is housed within the gut in the Gut Associated Lymphoid Tissue (GALT) (9). The GALT is responsible for having a healthy and balanced immune system as well as maintaining the integrity of the gut lining. In reality, all that separates our bodies from the outside world is a layer of enterocytes- just one layer thick! How important it is to nourish these cells!

Additionally, the health of the brain is directly influenced by the health of the gut through the gut-brain-microbiome axis by its bidirectional communication. In fact, 95% of the body’s production of serotonin, a neurotransmitter responsible for mood regulation, happens in the gut (10). We see this in our practice time and time again, those with problems in the gut likewise have problems in the brain. Anxiety and mood disorders, brain fog, memory loss, and autism are associated with inflammation within the gut (11,12).

WHAT DO PROBIOTICS HELP WITH?

The benefits of supporting the body with probiotic supplementation are far-reaching. It is difficult to specify since health impacts are multi-system and multi-factorial, but here are some additional benefits according to research:

  • anti-aging (13,14)

  • allergy prevention (15,16)

  • asthma (17)

  • autism (18,19)

  • autoimmune conditions (20, 21)

  • blood sugar regulation & diabetes (22, 23, 24)

  • cancer (25)

  • cardiovascular health (26)

  • depression (27)

  • digestive health (28)

  • eczema (29)

  • immune support (30, 31)

  • inflammation (32)

  • leaky gut (33, 34)

  • mental health (35)

  • obesity prevention (36)

  • oral health (37)

  • skin health (38)

  • small intestine bacterial overgrowth (SIBO) (39,40)

  • thyroid health (41)

WHAT TYPE OF PROBIOTICS ARE BEST?

There are numerous probiotic supplements available on the market. In fact, at our clinic we have many different probiotic formulations to meet the needs of the individual patient. We choose different probiotics based on each patient’s presentation. 

Cultured Probiotics

These are typical probiotic strains cultured in a dairy medium and are by far the most widely available on the market. Strains in this category include Lactobacillus, Bifidobacterium, and others. These strains are important to the health of the gut. Probiotics in this category can be beneficial and life-saving for many. Yet for some, they may be cause for further gastrointestinal upset or do not offer the specific strains of bacteria that their bodies need.

The vitality of these probiotic strains largely depends on the environment in which they are stored. Typically these probiotics need to be either kept in an air-tight package or refrigerated, or at least a a shelf stable temperature. With the variables of transportation, these probiotics can succumb to decreased effectiveness.

Soil Based Organisms & Spore-Based Probiotics

The soil beneath our feet has millions of microbes, both beneficial and harmful. We believe humans should interact with dirt frequently- eating unwashed organic produce or getting our hands and feet as close to the earth as possible. The wisdom of the health benefits of coming in contact with soil is well…as old as dirt!

In our practice, we have found that many people tolerate soil based organisms, and are highly effective in most patients.  Soil based organisms (SBOs) are shelf stable, resist the harsh environment of the upper gastrointestinal tract and stomach, and do not require special methods to ensure it reaches the lower gastrointestinal tract. These organisms are also stable in higher heat environments, ensuring they have not been damaged during transportation.

Prebiotics

It is important to note that prebiotics are just as important to a thriving microbiome. Prebiotics are types of fiber found in vegetables, fruits, and legumes that feed the beneficial organisms in the gut. These types of fiber are not digestable by humans, but digested by gut bacteria. One of the by products of this the production of the short-chain-fatty acid, butyrate (42). Butyrate is known to show various beneficial impacts on the body including anti-inflammatory effects in the colon. Not only do we need to be sure we have a proper ratio of beneficial probiotc bacteria in the gut, but we need to make sure they are fed so that they can thrive. Foods high in prebiotics include:

  • Apples

  • Asparagus

  • Bananas

  • Beets

  • Cabbage

  • Carrots

  • Chicory root

  • Dandelion greens

  • Garlic

  • Jerusalem artichoke

  • Jicama

  • Onion

  • Radishes

Fermented Foods

Consuming quality cultured and fermented foods are excellent ways to give the body a dose of beneficial bacteria. These foods include:

  • Fermented vegetables such as sauerkraut, kimchi, or pickles

  • Kefir made from cows milk, goats milk, nut milk, and coconut milk

  • Kombucha and Jun tea

  • Yogurt made from cows milk, goats milk, nut milk and coconut milk

  • Kvass prepared with beets, fruits, etc.

It is important to understand that cultured and fermented foods can be problematic or exacerbate symptoms in some individuals. For example, for individuals with fungal overgrowth, eating fermented foods could just add fuel to the fire so to speak. On the flip side, it has also been argued that consuming probiotic foods in the best way to consume probiotics. We recommend talking with a functional medicine or nutrition practitioner to help decide if fermented foods are appropriate for your situation.

OTHER NOTES ON PROBIOTIC SUPPLEMENTATION

It is also worth noting that we do not recommend purchasing probiotics from big box stores or Amazon because it is impossible to know how the supplements were transported and stored as well as whether or not they are viable live organisms. Another relatively new method of purchasing supplements is through multi-level marketing or direct sales companies that employ people with little or no healthcare training to endorse their products. Unfortunately, there is no one size fits all approach to probiotics and we have yet to see any produced by these companies that are close to what is available through doctors. While this method of sales has helped to make gut health and probiotics more mainstream, please exercise caution in purchasing probiotics through those venues.

Works Cited

  1. http://www.microbiomeinstitute.org/blog/2016/1/20/how-many-bacterial-vs-human-cells-are-in-the-body

  2. https://www.sciencedirect.com/science/article/pii/S0966842X16301433

  3. https://www.sciencedirect.com/science/article/pii/S1319016413000819

  4. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-3038.2005.00224.x

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872692/

  6. https://academic.oup.com/jn/article/147/7/1468S/4743654

  7. https://www.ncbi.nlm.nih.gov/pubmed/25701044

  8. http://jpp.krakow.pl/journal/archive/12_11/pdf/591_12_11_article.pdf

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2515351/

  10. https://www.ncbi.nlm.nih.gov/m/pubmed/28164854/

  11. https://www.ncbi.nlm.nih.gov/m/pubmed/25689247/

  12. https://www.ncbi.nlm.nih.gov/m/pubmed/30344525/

  13. https://www.ncbi.nlm.nih.gov/pubmed/26741377,

  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646295/

  15. https://journals.lww.com/co-allergy/Abstract/2008/06000/Pre_and_probiotics_in_the_prevention_and_treatment.7.aspx

  16. https://journals.lww.com/jcge/Abstract/2004/07002/The_Role_of_Probiotics_in_the_Clinical_Management.9.aspx

  17. https://www.ncbi.nlm.nih.gov/pubmed/28784701

  18. https://onlinelibrary.wiley.com/doi/full/10.1002/bies.201400075

  19. https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-016-0887-5

  20. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213508/

  21. https://www.ncbi.nlm.nih.gov/pubmed/28556916

  22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498615

  23. https://link.springer.com/article/10.1007/s00394-016-1300-3

  24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078018/

  25. https://www.ncbi.nlm.nih.gov/pubmed/27144297

  26. https://academic.oup.com/nutritionreviews/article-abstract/72/1/18/1933319

  27. https://www.mdpi.com/2072-6643/8/8/483/htm

  28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500982/

  29. https://www.ncbi.nlm.nih.gov/pubmed/28784701

  30. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006993/

  31. https://www.ncbi.nlm.nih.gov/pubmed/24499072

  32. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490534/

  33. https://www.ncbi.nlm.nih.gov/pubmed/26720180

  34. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3864899/

  35. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/

  36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4761174/

  37. https://www.researchgate.net/publication/41547287_Probiotics_Health_benefits_in_the_mouth

  38. https://www.sciencedirect.com/science/article/pii/S0094129811001313

  39. https://www.ncbi.nlm.nih.gov/pubmed/19352343

  40. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311309/

  41. https://drknews.com/good-thyroid-health-depends-on-good-gut-health/

  42. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1728045/