Probiotics

Probiotics

Dr. Carm's Explanation

Probiotics are one of Dr. Carm's favorite supplemental topics. Most people benefit from taking probiotics (either by pill or naturally). However, please consult with your "certified" physician before changing or adding any supplements to your regime. Remember, Dr. Carm's information is not meant to treat, prevent, or diagnose any diseases or illnesses.

Some Basic Facts

As most people are aware, your digestive tract starts with the mouth and moves down the esophagus into the stomach. The stomach acid mixes with the food where it is broken down (partially digested) to be absorbed for nutrients in the intestines. The food enters the small intestines first, where digestive enzymes (on the intestine's wall) breaks down the food even more. This is moved through the large intestines where the water (and electrolytes) is removed, and microbes (bacteria) digest the remaining food. When completed, the waste (usually solid) is excreted.  

  Now let's focus on the microbes we saw in the large intestines. These are your natural probiotics found in your body (such as Bacteroides, Lactobacillus acidophilus, Escherichia coli, and Klebsiella). [No, I did not make those names up. They are real! And no, I’m not quite certain of how to pronounce them correctly.] These bacteria are good for you. In fact, they are essential for your body to receive their nutrients.

I think it would be safe to say that you never really think about these little guys at all. Am I right? Well, if there aren’t enough of them there, you're going noticed!

[Insert evil/dramatic music] Sometimes, too many bad bacteria can get into our systems, such as Candida, which takes over the good the bacteria. [Candida can cause problems throughout the body, although they are most commonly known for yeast infections. However, other forms involve thrush (the white gunk that you see on your tongue), or in your digestive tract (which we will discuss in a minute). It can even cause bladder infections! These nasty little things can grow rapidly and wreak havoc all over. They can be hard to gain control over.] When your good bacteria cannot handle this overgrowth, it does not absorb the food properly. Therefore, your body does not get its nutrients. With Candida, for example, it eats your simple carbohydrates before your body has a chance at them. When you have a type of yeast infection, this is why you always feel hungry or crave sweet things. The Candida wants more and your body isn’t receiving its proper amount.

The same can be said if you kill the good bacteria. This can happen when you have a bad infection and take an antibiotic. The antibiotic cannot distinguish between the good bacteria and the bad, so it destroys them both. A nice clean sweep! Luckily, your body can produce more good bacteria, but sometimes this is not quick enough. Usually in this case you get what is called C Diff (we can discuss this problem in later postings, but let's just say it's a very extreme form of diarrhea. If you had this, then you know it is not pleasant.)

So what can you do? Well, there are many choices.

1.) Do nothing [this option is good for those that are lazy, don’t care about health, or are actually relatively healthy] 

2.) Panic [this is a slightly more entertaining option for the public around you]

 

3.) Supplement your microbes with regular doses of probiotics. 

Let’s focus on option 3 since the other options are easy to accomplish without much direction.

I know what you’re thinking: “Dr. Carm, I don’t want to take pills.”; “Dr. Carm, I’m too busy. I don’t want to worry about this.”; “Dr. Carm, isn’t there an easier way to help my gut?”; “Dr. Carm, you look fabulous today.”

And, I would reply: “Well, thank you!” 

However, we should really get back to the information on probiotics. The good news is there are natural foods that contain good bacteria.

Probiotics are found in:⁶

Yogurt

Pickled vegetables

Fermented bean paste (ex. Tempeh, miso, doenjang)

Kefir

Buttermilk (or Karnemelk)

Kimichi

Pao Cai

Sauerkraut

Soy sauce

Zha cai

Please remember: do not digest any foods that you are allergic to. [You would assume this would not need to be said, but unfortunately, it does.]

Probiotics are a tricky business. The microbes live in certain temperature, reproduce, and die.  It’s hard to know just how much good bacteria make it into your gut. Probiotics are not federally regulated, and therefore knowing for certain the bacterial count when you buy a product is not going to happen. Not long ago, Dannon that carries Activia (a popular yogurt brand) was sued for false claims of probiotics in their product.⁵

Does this mean that all probiotics are worthless? No, it just means you have to have more knowledge in products you buy.

Q&A

1. Will I die if I do not take probiotics?

Yes, you will die. (By the way, you will also die if you take probiotics.)

2. What? Dr. Carm, you're not making any sense?

First, Dr. Carm always makes sense.
To clarify: probiotics cannot make you immortal, hence you will die. Everyone dies. I guarantee it (eventually).

3. So what are some good tips?

Breathe. Yep, that’s it. Keep going. Doing good….

Oh, wait! Tips for probiotics?

Well, if you want a better chance of having the probiotics reach your intestines before the stomach acid destroys them, then I would suggest a capsule that has a special coating to make it through the stomach. You should keep these probiotics in a cool, dark place – i.e., your refrigerator. Take the pills as directed. Usually it tells you to take two capsules daily. In this instance, I would suggest taking the first at least 15-30 minutes before you eat breakfast with only enough water to get it down. This assures that it will not dissolve in the stomach. Then, repeat this at night. Make sure you haven’t eaten anything for about an hour before you take the pill.

4. There are so many different kinds of probiotics out there. What should I get? I don’t speak probiotic!

According to Dr. Mary Ellen Sanders [Yes, a real doctor!], she suggests the following for those who want a supplement to help the immune system: Bifobacterium lactis, Lactobacillus reuteri, Lactobacillus casei, and Bifidobacterium lactis. For diarrhea (from antibiotics) use S. cerevisiae, Lactobacillus rhamnosus, Lactobacillus casei, and Lactobacillus acidophilus.³

5. Do you take a probiotic?

Yep! Actually this is really the only supplement that I take on a regular basis. I take a low dose probiotic (500 million live bacteria when packaged per pill). It contains Lactobacillus acidophilus, Lactobacillus salivarius, Lactobacillus rhamnosus, Streptococcus thermophiles, and Bifid bacterium bifidum. [Writing this out makes it sound even more disgusting! Eww!!!]

The Lactobacillus acidophilus helps digest milk products and supports the production of natural antibiotics.  Lactobacillus salivarius helps reduce the effects of bad bacteria. Lactobacillus rhamnosus and Streptococcus thermophiles support the immune system.  Bifid bacterium bifidum helps reduce effects of bad bacteria, supports the immune system, and produces B vitamins.

Uses for Probiotics

·         Reduces and prevents C Diff from antibiotic use^4,2

·          Reduces diarrhea, allergy symptoms, constipation⁴

·          Relieves symptoms associated with IBS (Irritable Bowel Syndrome)⁴

·          Benefits mineral metabolism (bone density and stability)⁴

·         Prevents cancer⁴ (from laboratory animal testing)²

·          Helps against Lactase deficiency² (ability to digest lactose)

·          And weak evidence—supports lower cholesterol and triacylgylceral plasma concentrations¹ (from laboratory animal testing)²

Interesting Facts

·         One of the first known origins of probiotics is in the Old Testament—specifically, Genesis 18:8, where Abraham consumes "sour milk"⁴. It was also documented that Plinius (76 B.C.) used "fermented milk products" to treat gastroenteritis⁴

·          "Lactobacilli are among the indigenous flora colonizing the chicken's crop, the stomach of mice and rats, and the lower ileum in man"⁴

·         "Under natural conditions a protective gut microflora develops and there is no need for a probiotic supplement; but humans and farm animals live under rather unnatural conditions. We eat a great deal of processed and in many cases sterile food which may affect our access to, and colonisation by, certain types of bacteria"²

·          Three important and relatively harmless microflora include: lactobacilli, streptococci, and bifidobacteria²

·          L bulgaricus and streptococcus thermophilus are found in yogurts²

·          L acidophilus, L casei, enterococcus faecium, and bifid bacterium bifidum are strains usually found in probiotics²

·         Regular doses of probiotics help the bacteria to colonize in the gut²

A note of caution: Before changing your diet to include probiotics, please speak to your physician about any complications that might arise. Although probiotics are beneficial for most individuals (even children), there are studies that confirm more harm than good from them. For example, a studied showed that probiotics increased the death rate in individuals with severe acute pancreatitis¹

Questions to consider and discuss with others:

Have you tried probiotics? What are your experiences? What brand do you like? What natural foods do you find work best? Are you going to try probiotics? Any other input that you want to share?

¹Besselink, M. G., Van Santvoort, H. C., Buskens, E., Boermeester, M., Van Goor, H., Timmerman, H. M., Nieuwenhuijs, V. B., Bollen, T. L., Van Ramshorst, B., Witteman, B. J., Rosman, C., Ploeg, R. J., Brink, M. A., Schaapherder, A. F., Dejong, C. H., Wahab, P. J., Van Laarhoven, C. J., Van der Harst, E., Van Eijck, C. H., Cuesta, M. A., Akkermans, L. M., & Gooszen, H. G. (2008). Probiotic prophylaxis in predicted severe acute pancreatitis: A randomised, double-blinded, placebo-controlled trial. The Lancet, 371(9613), 651-659.

²Fuller, R. (1991). Probiotics in human medicine. Gut, 32, 439-442.

³Magee, E. (n.d.). 5 Things you should know about probiotic products. Found at http://www.webmd.com/diet/features/answers-to-your-questions-about-probiotics

⁴Schrezenmeir, J., & De Vrese, M. (2001). Probiotics, prebiotics, and synbiotics—approaching a definition. The American Journal of Clinical Nutrition, 73, 361S-4S.

⁵Walters, C. (2008). Dannon sued over probiotic yogurt claims. Found at consumerist.com

⁶Wiki: http://en.wikipedia.org/wiki/Probiotic

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