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 use4,2
·
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
