Probiotics…Yes, No, Maybe?

Our gut has its own living environment or community of micro-organisms, called the microbiome. Your microbiome influences your metabolism, having a significant impact on your ability to lose weight, address anxiety or depression, or even impact your risk of disease. The microbiome communicates through the vagus nerve to your brain, which is known as the gut-brain connection or the gut-brain-axis (GBA).

Your gut microbiome consists of millions of tiny micro-organisms such as bacteria, viruses, or parasites. These organisms help us digest and transport nutrients and communicate through our GBA, so its composition requires diversity and balance to keep us healthy. Most of us have a limited gut microbiome biodiversity, because we eat the same foods, are exposed to toxins or antibiotics, or experience stress. This lack of diversity actually increases our risk of both physical as well as mental disease. The good news is that the microbiome composition can be trained for greater biodiversity through what we consume.

Probiotics may help you achieve a gut with increased biodiversity. If you have been exposed to antibiotics, you have certain diseases, or you are trying to promote your health, consider probiotics to promote greater microbiome diversity. These can be found in certain foods or supplements. As a note of caution, not all probiotic supplements are the same!

Probiotics-What are they?

Probiotics are living micro-organisms either naturally occurring in foods or available via supplementation. They are intended to help us stay healthy and help support our immune system. Probiotic rich foods include kimchi, beets, apple cider vinegar, sauerkraut, pickles, yogurt and others. It is important to know that the processing of some of these foods actually may impact whether the probiotics are living, which is important if you are taking them to support your microbiome. If you ferment your own foods and eat a small amount daily, this can be a great way to support your microbiome.

There is a huge market out there for probiotic supplements, so it is important to be informed about both the composition and quality of the product you are going to choose. Many supplemental probiotics only contain 5 different major strains, and some only 2, Lactobacillus and Bifido-bacterium. Some products may even not contain what the label states and supplements are not regulated by the FDA. So, it is important to consider that the type of probiotic may help or could even hinder your microbiome diversity.

Why should you consider probiotics?

Probiotics have been used to treat many diseases such as gastro-intestinal conditions, infant conditions, dental disorders, allergies, and others. Inflammation is a primary cause of disease. Probiotics are effective in reducing substances called pro-inflammatory cytokines that may be present in your body.[i]

Our immune system is impacted by our gut microbiome. In acute psychological stress, our immunity to viruses such as cold and flu actually may be supported with probiotics containing organisms such as bifobacterium bifidum.[ii]

Probiotics have been shown to be helpful for people with gastro-intestinal diseases such as Irritable Bowel Syndrome (IBS) to alleviate pain, discomfort, and abdominal distention.[iii]^,[iv] .  Studies support that probiotics can potentially help with constipation by reducing transit time of stool through the gut and increasing frequency of bowel movements.[v]^{, [vi]}

If you’re anxious or depressed, chances are if you have a gut that does not have a healthy microbiome and inflammation is contributing to or causing your symptoms. A recent study of depressed patients demonstrated that over half have elevated inflammatory cytokines. [vii] Even mental diseases such as schizophrenia have been associated with a disrupted gut microbiome. [viii] We know that a healthy microbiome plays a significant role in preventing disease and you can learn why it’s so important here.

If you have allergies, or are developing allergies, your risk is increased if you have gut dysbiosis, which is the term used for an unbalanced microbiome. [ix] This dysbiosis can also contribute to your risk of developing cancer or prognosis.  A recent study suggested that this may be true for colon cancer. [x] Also, studies of colon cancer cells show that the probiotic, Lactobacillus, showed significant ability to destroy a specific colon cancer cell. [xi]

Summary

The best way to support your microbiome is to have a healthy diet rich in natural foods and probiotics. There is a great deal of ongoing microbiome and probiotic research to help reveal how to best support health. In truth, complications from taking supplements are rare. If you are considering whether to take a probiotic supplement:

Yes, if you are re-setting your gut health, you have evidence of inflammatory diseases such as the ones discussed above, or you are taking antibiotics.

No, if you are severely ill with a significantly compromised immune system without conferring with your physician.

Maybe, even if you eat a diet rich in probiotics, are disease-free, or have been tested and have no evidence of inflammatory cytokine markers.

Learn more in my blog on the interplay of fiber, probiotics, and diet when you have arthritis.

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[i] Milajerdi A, Mousavi SM, Sadeghi A, Salari-Moghaddam A, Parohan M, Larijani B, Esmaillzadeh A. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur J Nutr. 2019 Mar 11. Epub 2019 Mar 11. PMID: 30854594

[ii] Langkamp-Henken B, Rowe CC, Ford AL, Christman MC, Nieves C, Khouri L, Specht GJ, Girard S-A, Spaiser SJ, Dahl WJ. Bifidobacterium bifidum R0071 results in a greater proportion of healthy days and a lower percentage of academically stressed students reporting a day of cold/flu: a randomised, double-blind, placebo-controlled study. Br J Nutr. 2015 Feb 14 ;113(3):426-34. Epub 2015 Jan 21. PMID: 25604727.

[iii] Zhonghua Nei Ke Za Zhi. A meta-analysis of probiotics for the treatment of irritable bowel syndrome. 2015 May ;54(5):445-51. PMID: 26080826.

[iv]Didari T, Mozaffari S, Nikfar S, Abdollahi M. Effectiveness of probiotics in irritable bowel syndrome: Updated systematic review with meta-analysis. World J Gastroenterol. 2015 Mar 14;21(10):3072-84. doi: 10.3748/wjg.v21.i10.3072.

[v] Dimidi E, Christodoulides S, Fragkos KC, Scott SM, Whelan K. The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014 Oct ;100(4):1075-84. Epub 2014 Aug 6. PMID: 25099542.

[vi] Miller, LE, Ouwehand AC. World J Gastroenterol. 2013 Aug 7;19(29):4718-25. doi: 10.3748/wjg.v19.i29.4718.Probiotic supplementation decreases intestinal transit time: meta-analysis of randomized controlled trials.

[vii] Osimo EF, Baxter LJ, Lewis G, Jones PB², Khandaker GM. Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels. Psychol Med. 2019 Sep;49(12):1958-1970. doi: 10.1017/S0033291719001454. Epub 2019 Jul 1.

[viii] Xu R, Wu B, Liang J, He F, Gu W, Li K, Luo Y, Chen J, Gao Y, Wu Z, Wang Y, Zhou W, Wang M. Altered gut microbiota and mucosal immunity in patients with schizophrenia. Brain Behav Immun. 2019 Jun 27. Epub 2019 Jun 27. PMID: 31255682.

[ix] Hua X, Goedert JJ, Pu A, Yu G, Shi J. Allergy associations with the adult fecal microbiota: Analysis of the American Gut Project. EBioMedicine. 2016 Jan ;3:172-9. Epub 2015 Nov 27. PMID: 26870828.

[x] Wei Z, Cao S, Liu S, Yao Z, Sun T, Li Y, Li J, Zhang D, Zhou Y. Could gut microbiota serve as prognostic biomarker associated with colorectal cancer patients’ survival? A pilot study on relevant mechanism. Oncotarget. 2016 Jun 15. Epub 2016 Jun 15. PMID: 27323816.

[xi] Chen Z, Hsieh YM, Huang CC, Tsai CC. Inhibitory Effects of Probiotic Lactobacillus on the Growth of Human Colonic Carcinoma Cell Line HT-29. Molecules. 2017 Jan 10 ;22(1). Epub 2017 Jan 10. PMID: 28075415.