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Why Do I Need A Probiotic?

Sarah Yousuff

Probiotics contain helpful, viable bacteria and/or yeasts that assist in balancing the levels of indigenous microorganisms in the human body.  Ideal probiotics from dietary sources include: kefir is very good, especially when made with raw milk (bacteria doesn’t grow well in pasteurized milk). Pickled foods have a good amount of probiotics (kim chee, sauerkraut, natto, etc). Also Lassi (Indian yogurt drink) and tempeh.

The average adult has 27 feet of small intestine and 15 feet of large intestine. 90% of our nutrients are absorbed in the SMALL intestine. It’s interesting that in mainstream medicine there are many different approaches to evaluating the stomach and large intestine, but we don’t have a good way to evaluate the small intestine despite it being a critical part of the digestive system. 

The gut is often referred to as “our second brain”. The highest concentration of nerves is found in the brain, second is in the gut and third is in the spinal cord.

"The gut can work independently of any control by the brain in your head—it's functioning as a second brain," says Michael Gershon, professor and chair of pathology and cell biology at Columbia. "It's another independent center of integrative neural activity."

An interesting article published by Dan Hurley November 2011 in Psychology Today (http://www.psychologytoday.com/articles/201110/your-backup-brain) discusses this in a very readable way.

Because the digestive system is involved in so many aspects of our health, more research is being focused on the delicate bacterial balance that lives within our gut. There have been approximately 400 species of bacteria identified, but 30-40 are responsible for 99% of what exists within your gut. The average adult has 2-3 pounds of bacteria within their digestive system. So what is the right balance? A ratio comprised  85% of ‘good’ bacteria versus 15% of ‘bad’ bacteria is ideal. In patients who have chronic intestinal problems, often this ratio is reversed. 

Why are we seeing this? 

The number one cause seems to be the explosion of antibiotic use. In looking at the problem, you may have to go as far back as birth. Was your mother exposed to antibiotics, especially late in the pregnancy? If so, you probably had dysbiosis (abnormal good bacteria/bad bacteria ratio) from day one. Were you delivered by cesarean section? If so, you didn’t have a chance to get colonized by good, healthy bacteria going through mom’s birth canal. Of course, if mom doesn’t have any good, healthy balance then baby gets that unhealthy balance as well. A large percentage of C-section kids are colicky. Adults with intestinal problems also seemed to have problems with recurrent tonsillitis, recurrent ear infections and strep throat as children which means that they have been exposed to a lot of antibiotics.

We need to understand the things in our environment that disrupt our bacterial balance. Most of it comes from dietary choices, primarily high caloric, low nutrient foods. High sugar is toxic to our gut: it feeds the ‘bad’ bacteria and kills the ‘good’. Other problematic exposure includes:

  • Antibiotics
  • Agricultural chemicals and pesticides
  • Antibacterial soaps

BENEFITS OF TAKING PROBIOTICS

Probiotics have more benefits than taking a multivitamin. 80% of your immune system resides in the walls of your intestine. It’s our first line of defense against the external environment.

Weight gain and obesity: recent study comparing two groups of women who had recently given birth. One group of women were on probiotics and the others was not. The group of women taking probiotics returned to their pre-pregnant wait much more quickly. An interesting study published 9/13/2012 by Cell Host & Microbe shows that gut bacteria increases fat absorption.

Some of the beneficial pharmacologic actions that have been attributed to probiotics:

  • Antibacterial
  • Antiviral
  • Immunomodulatory
  • Anti-infective
  • Anti-oxidant
  • Antiproliferative
  • Antifungal
  • Cardioprotective
  • Gastro protective
  • Antidepressant: every neurotransmitter that’s produced in the brain is also produced in the gut. In fact over 90% of serotonin is manufactured in the walls of your intestine. If someone doesn’t have a healthy gut, then they don’t produce enough serotonin making him/her more predisposed to depression and anxiety.
  • Radio and chemo protective
  • Up regulates glutathione and certain glycoproteins that help regulate immune response: interleukin 4, interleukin 10 and interleukin 12 
  • Down regulates interleukin 6 (cytokine involved in chronic inflammation and age-related diseases)
  • Inhibits tumor necrosis factor

Probiotics potentially benefit over 180 different disease states:

  • Irritable bowel syndrome
  • Depression, ADHD, autism, anxiety
  • Diabetes
  • Weight gain and obesity
  • Metabolic syndrome
  • Eczema (especially in pediatric population)
  • Allergies
  • Vaginitis
  • Preterm labor in pregnant women
  • Inflammatory bowel disease
  • Recurrent otitis media
  • Recurrent cystitis
  • Chronic diarrhea
  • Celiac disease
  • Acne: has been shown to clear acne in adolescents. Interesting approach. When at the dermatologist office, acne is often treated with an antibiotic.
  • Auto-immune disease (Hashimotos, rheumatoid arthritis, fibromyalgia)
  • Autism: incidence is 1/88. Parents of a child with autism or Asperger’s syndrome should read “Gut and Psychology Syndromes” by Dr. Natasha Campbell-McBride

HOW TO CHOOSE A PROBIOTIC

I recommend you find a probiotic with greater than 20 billion CFU and with multiple bacterial strains. Be careful, though, because there are some companies that are now coming out with products with hundred billion CFU. That’s a lot of bacteria that you’re putting into your system all at once. If your gut is not use to that type of volume, then be prepared to have significant “transitioning issues”. If you start to feel nausea or have issues with bloating, then you need to back down and take it perhaps every other day until those issues calm down. At that point, you can go back to taking your probiotic daily. It’s best to take your probiotic on an empty stomach; that’s why a lot of people take it at night. Dosing for adolescents and children is 8-10 billion CFU and infants 2-6 billion CFU. Also important is that the probiotic is that it is a multi-strain. You don’t want one that just has only acidophilus or Lactobacillus. Often included in the multiple strains of bacteria is a very healthy yeast, saccharomyces which colonizes in the small bowel and colon. Multiple studies on saccharomyces show ulcerative colitis and Crohn’s disease patient improve by calming down the inflammation and ulcerations. You can buy sacchromyces by itself (8-10 billion CFU).

Refrigerated versus nonrefrigerated? Here’s where it gets a little controversial. Ideally, refrigerated is the way to go. It’s usually stable up to 77, so it may be okay on your shelf. It needs to be in an airtight container. 

Another good question: isn’t the probiotic and destroyed by stomach acid? Multiple studies have shown that although there might be a small amount of bacteria loss due to stomach acid, it generally gets into the small intestine and is able to colonize appropriately.

Once you start probiotic, you should take it daily for six months at the very least. Overall, though, it’s very difficult to maintain that proper good bacteria/bad bacteria balance with all the chemicals and chronic stress we’re exposed to and I advise just continue taking it.

WHAT ARE PREBIOTICS?

Prebiotics are nutrients that help probiotics flourish. They’re kind of the fertilizer and is usually a complex sugar.

Normally we would get prebiotics through our diet. 8-10 servings/day of very colorful fruits and vegetables is best. Average American consumes 8 grams of fiber/day, when we ideally should be consuming 25 to 50 grams/day. You you need to increase your daily fiber consumption, gradually ease into it or you may experience unpleasant side effects such as excessive gas.

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