When patients see me in my practice they often leave with a “prescription” to take probiotics. But to get the full benefits of probiotics you need to take the right ones in the right amount. Before I get to that, I want to explain what probiotics are and how they work.
Why You Need Probiotics
Probiotics are strains of bacteria that support your health. The term probiotic literally means “pro” for in support of and “biotic” pertaining to living organisms.
Probiotics help to:
- Support healthy digestion,
- Regulate your digestive function,
- Boost your immunity,
- Support your endocrine system,
- Support cardiovascular health.
While there are many strains of probiotics, Lactobacillus and Bifidobacterium are two of the most common strains you may see on food and supplement labels. These strains of bacteria improve digestion and help with the absorption of nutrients. They also help to modulate immune system function, reduce inflammation in the intestines, and even reduce symptoms associated with irritable bowel syndrome (IBS).
Research has also shown that certain strains of Lactobacillus and Bifidobacterium probiotics support the cardiovascular system by regulating the production and breakdown of cholesterol particles, as well as supporting healthy blood pressure and circulation.
Fermented Foods Give You the Benefits of Probiotics
Many cultures around the world prepare and eat fermented foods rich in probiotics, including:
- Kim chi,
- Beet kvass,
- Pickled vegetables,
- And other dairy products.
In fact, kombucha, which contains several strains of probiotics, is becoming a popular drink.
But in the United States, we use pasteurization processes to kill pathogens or “bad bugs." Although pasteurization is a necessary treatment for many of our foods and beverages since it destroys pathogenic organisms, it also destroys much needed probiotics. Unfortunately this means that most store bought fermented foods, including yogurt, contain few probiotics—unless they’re added back in after pasteurization.
The best way to get probiotic rich fermented foods is to make them in your own kitchen, just as your grandmother did. One of my favorite books on how to make fermented foods is called Wild Fermentation by Sandor Ellix Katz.
There are also other foods that you can eat besides fermented foods that can positively affect your gut flora. A recent study from the British Medical Journal showed that increasing dietary fiber can increase the amount of Akkermansia muciniphila probiotics in the gut. These probiotics are associated with favorable cholesterol, a better waist-to-hip ratio, and reduced cardiovascular risk factors.
Other studies have also shown that that the bacteria in our gut can affect the way we store fat and balance blood sugar levels. So, getting enough probiotics in our diet—and through supplements—is critical to good health. Plus, you want to eat fiber with your probiotics, since non-digestible fiber compounds act as prebiotics, providing fuel for the probiotics.
If You Eat Fermented Foods Do You Still Need Probiotics?
If I had to answer this question 30 years ago I probably would have said “no.” Today, however, my answer is “yes” since the soil has become increasingly sterile with the overuse of pesticides and herbicides, and getting a steady influx of probiotics into your gut is absolutely necessary.
One of the most troublesome herbicides in our environment is a chemical called glyphosate. Glyphosate was actually patented as an antibiotic, and the antibiotic mechanism not only kills off bacteria and fungus in the soil, it also reduces beneficial soil microorganisms.
To add insult to injury, antibiotics have been overused in both the livestock we eat—and in us humans—over the last 70 years. While antibiotics can be lifesaving, they affect the gut microbiota by reducing healthy bacterial strains. This can lead to an overgrowth of fungus (candida) and other pathogenic bacteria (clostridium difficile).
How Can You Find a Good Probiotic Supplement?
There are many probiotic formulas available that can help to replenish and support your gut bacteria.
When searching for a probiotic, you want to:
- Search for one with clinical studies that show it works.
- Look at the label to see how many colony forming units (CFU’s), or number of probiotics are packed in a formula. While the optimal dose remains unknown, it’s generally recognized in the medical community that formulas should contain at least 100 million CFU’s for proper colonization. But doses can be as high as hundreds of billions. And for formulas that list their strength in milligrams, you want to look for one that contains at least 350 mg of probiotics.
Some people find that when they first take probiotics they develop more gas and bloating. This is actually quite common, and is likely due to the subtle shift in gut microbiota and a change in your bowel pH (acidity). If this happens to you, you can reduce the dose for a few days and within two weeks the symptoms should resolve. Plus, some probiotics contain fructooligosaccharides (FOS), which act as prebiotics to help stimulate the growth of probiotics. These FOS’s can also cause abdominal discomfort in a small population of people.
Should You Take Your Probiotics With, Or Without, Food?
There’s actually a debate in the medical community about the best timing when it comes to probiotic supplementation. Some people believe probiotics should be taken on an empty stomach so stomach acids won’t degrade the probiotics. I’ve also read research that recommends taking probiotics slightly before or with meals as this leads to greater assimilation along the GI tract. Personally, I recommend taking a probiotic whenever it’s most convenient for you.
In addition to taking probiotics, it's important to:
- Avoid foods that will affect your gut bacteria. I tell all my patients to eat an organic diet as much as possible as doing so reduces your exposure to glyphosate and antibiotic residues in foods that affect gut flora.
- Reduce sugar! I can't emphasize this enough. Sugar in its many forms provides fuel for yeast species like candida in the gut which alters the gut flora and can set you up for a whole host of ailments.
- Invest in a water filter to remove chlorine from your tap water. Chlorine is a disinfectant that reduces the spread of viruses, bacteria, and other microorganisms. But it can also reduce the “good” bugs including healthy gut flora, so you want to make sure you are eliminating chlorine exposure with water filtration devices.
You May Also Be Interested In
- What You Need to Know About Irritable Bowel Syndrome and Leaky Gut Syndrome
- What You May Not Know About Naturopathic Medicine
- Dao MC, et al. Gut 2015; 371(26): 2526-2528.
- Bermudez BM et al. Annals of Nutrition and Metabolism 2012; 60:160-174.
- Saini R et al. Journal of Cardiovascular Disease Research 2010; 1(4):213-214.
- Guinane C et al. Therapeutic Advances in Gastroenterology 2013; 6(4):295-308.
- Tompkins TA et al. Beneficial Microbes 2011; 2(4):295-303.