Which probiotics work?

 Fermented vegetables are a great source of probiotics and prebiotics

Fermented vegetables are a great source of probiotics and prebiotics

Throughout my career as a naturopath, I have been a non believer of how such simple strategies from our everyday environment can be game changers in our health and probiotics was no exception. Part of that experience is when we take something because we are told its good for us and then feel no different. There's a good chance that if you've taken probiotics before and felt no different for them that you probably didn't "need" them but were good illness preventative strategies for example after antibiotics. By the time you notice an improvement from taking probiotics you already have significant dysbiosis (an imbalance in the concentration of the different strains) and if you take a probiotic and it makes you feel sick you are primed for a disease state onset.

One way of thinking about the microbiome (the ecosystem that is your gut) is kind of like how the earth is populated. All these different plants and animals competing to get our patch of land to thrive on. Most of the time we keep each other in check but when a strain (population) becomes dominant it can change the ecosystem dramatically (kind of like how humans are polluting the earth and creating climate change but that's a different discussion all together). There are few factors involved in how a strain becomes dominant:

  • Terrain
  • Stress
  • Food sources

So how does this relate to the gut? 

There are millions of different strains of bacteria in your gut that are fighting for floor space where they can thrive in their little ecosystem. Some are health promoting, like bifidobacterium and lactobacillus, some are commensals (are there without causing harm unless they become a dominant species) like yeast and some strains of ecoli, some are pathogenic (illnesses causing symptoms like diarrhoea and gastro) like salmonella or shigella and then there's the worms and the parasites but they are also a conversation for another day. How well we maintain the balance between these microbes directly plays out in our overall health, affects the integrity of the gastrointestinal wall and affects immune regulation and systemic inflammation.

So how do we maintain the balance?

where possible avoid stressors

Our little belly critters have a lot to contend with these days, pesticides and chemicals in our foods, alcohol, poor diet, pollution, antibiotics and they are very vulnerable to stress. All of these factors play a part in stressing the population of our health promoting microbes. When these populations are weakened it allows the opportunistic commensals to gain territory and grow their numbers, getting a stronger colony. It also means we have less resilience to pathogenic microbes and parasites. These opportunistic microbes can also affect the permeability of the gut and can be a contributing factor to leaky gut and the onset of autoimmune conditions. 

"Naturopath tip: sometimes we need the dang antibiotics, we can clean up the mess later, just make sure you do."
 Kefir is another great food source of probiotics as they have up to 9 strains of beneficial bacteria!

Kefir is another great food source of probiotics as they have up to 9 strains of beneficial bacteria!

A word on antibiotics, sometimes we need them! Antibiotics and hygiene revolutionised health care at the turn of the century for good reason. These bugs do make us sick, especially in the immune compromised. Antibiotics kill all bacteria (so don't take them for a virus!) health promoting and pathogen alike, but do you know what they don't kill off? Yeast, so while you are taking the antibiotics, you are clearing terrain for yeast to grow in to. When you are taking antibiotics, make sure you are on a probiotic (yes the antibiotics will kill off what you're taking but you are just trying to stress the yeast and other pathogenic growth between antibiotic tablets, even getting a cheap one would be better than nothing!) Studies have shown that being on a probiotic while you are taking antibiotics actually IMPROVES the effects of the antibiotics! Just make sure that you are taking it 4 hrs away from your antibiotic. After you've finished your course of antibiotics get on the probiotics for at least 6 - 12 months. You want to help drive those health promoting microbes with both probiotics and prebiotics (foods they thrive on).

*** If you have been on an antibacterial for a long time like more than 3 months for things like controlling UTIs can you please contact me? There are much better ways of managing UTIs with natural antibacterial herbs that will benefit you in the long run. The long term use of antibacterials will only make it harder for your body microbiome to combat the pathogenic levels of your commensals which are causing the recurrent infections. ***

Food sources

What you eat directly influences which microbes you are growing but the microbes you are growing also drive your cravings. Sugars drive microbes like yeast and fats drive microbes like firmicutes. Ideally you want a diet high in fibers from leafy greens and colourful vegetables. If you think your gut bugs are driving your food choices lets chat.

"Naturopath tip: Kombucha isn't a probiotic replacement"
 Kombucha is a tasty drink with probiotic value

Kombucha is a tasty drink with probiotic value

A word on fermented foods. Not all 2 fermented foods are made the same they have different strains and different affects on the ecosystem. Fermented vegetables is the best source, they are the health promoting bugs that live on vegetables that we want to populate our gut. Kefir would be next as it has 9 strains of probiotics and so is the most diverse in microbes of the fermented foods. Miso is also another good option. A combination of these fermented foods can be a good way of maintaining an already healthy gut. They are also options for reintroducing probiotics for people with severe dysbiosis that just can't tolerate probiotics. These fermented foods would typically have about a billion microbes per serving size, where as your probiotics have anywhere from 35 billion to 500 billion. This means it can be a good way of getting a daily dose of maintenance microbes in.

Kombucha is grown on sugar so not our ideal health promoting microbe, while it can be better than nothing, it can make matters worse for people who already have dysbiosis trending towards sugar eating microbes and yeast. It is a yummy drink though and a good substitute for alcohol and soft drink. Yoghurt is good for those who tolerate it but only as natural greek yoghurt. By the time you add all the sugars and sweeteners into most of your commercial brands it loses its health promoting benefits and is more of a lolly.

terrain

Poor soil will grow weeds

It is impossible to have a microbe free gut. Your environmental exposures, food, microbiome of your parents and people in your life and bugs in your belly have a direct impact on what microbes you are cultivating. The health of your mucous membranes, making sure your pooping at least daily, getting at least 2L of water and feeding the health promoting colonies will grow more health promoting colonies. If we are not clearing our bowels of waste every day, not providing it with adequate water and fiber and not feeding our health promoting foods they will easily become overwhelmed by other microbes. 

gut healing protocol

Weed and seed, heal and seal.

Everything that enters our body is contributing to the ecosystem of the alimentary canal. We are either weeding our disease promoting microbes and seed our health promoting microbes or we are weeding our health promoting microbes and seeding our disease promoting microbes. We are either providing nutrients for healthy mucous membranes throughout the gut and keeping undigested particles and waste in the gut or we are damaging our gut wall and allowing undigested particles, microbes and waste through into the body. When the intestinal wall  becomes more permiable and starts allowing undigested particles, microbes and waste through we call this "leaky gut" and we are primed for disease. Our immune system recognises these particles as potential threats, they are supposed to be on the other side of the intestinal wall and so we set off a cascade of inflammation, food sensitivities and allergies, skin conditions, joint and muscle conditions and autoimmune disease.

what increases the permeability of the gut?

  • Gluten
  • SIBO
  • Diet like increased refined sugar, dairy, refined oils, chemicals, preservatives and pesticides in our foods
  • Chronic stress
  • Toxin overload from certain medications, chemical exposures in our environment and food and tap water containing chloride and fluoride. 
  • Gut dysbiosis (microbial imbalance)

In our current environment it is near impossible to not have some degree of dysbiosis and hyperpermiability so it is important to always be making choices that support our gut health. As a naturopath, when we have patients present with symptoms, our goal is to clean up the gut as well as correct nutritional deficiencies and see what we have left. In a lot of cases, just cleaning up the gut can resolves a lot of acute and chronic conditions.