The term probiotics is fast becoming a buzz word for wellness and health benefits. But what exactly are probiotics and should you be concerned with them? It may be startling to learn that of all the cells in your body, only 10% of them are human. The other 90% are in fact, bacteria. The majority of the bacteria are beneficial, even essential to your health. We are all walking, talking ecosystems. The bacteria live all over our bodies, but the ones we are primarily concerned about in terms of probiotics are those in the gastrointestinal tract, specifically the large intestine. Each of us has a different composition of bacteria making up whats known as our microbiota (gut flora). This composition varies greatly between individuals depending on our diets, lifestyles and environmental factors. Over 160 different species of bacteria call your gut home. The aim of probiotics, put simply, is to deliver and optimize growth of the beneficial bacteria thus inhibiting the growth of bacteria which are not helpful to us.
The World Health Organization defines probiotics as ’Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host’.
Typically, probiotics come in pill, capsule or sometimes powder forms. The bacteria should be live and are often surrounded in a medium of some kind which they can feed off and survive. It is important to realize that in order for you to attain any of the health benefits from your probiotics they must be “live” when you consume them. Most probiotics with live bacteria will be refrigerated however there are some shelf stable brands on the market. Probiotics which have not been kept in the correct conditions will have reduced efficacy. Some brands over populate their products to allow for loss of some of the bacteria during shipping etc. In this way they ensure that by the time they reach the consumer they have the correct dosage of bacteria. The bacteria in your probiotics must also be viable. Think about it, in order for them to successfully colonize your lower intestine where they are most active and can convey their respective health benefits, they must first pass through the rest of your GI tract. This includes the highly acidic environment of your stomach, amongst other things. It doesn’t matter how many billion bacteria you consume in each tablet if they are all dead before they reach your gut. These are some of the reasons why it is important to choose the best quality probiotics you can and to seek advice from a health professional when choosing them.
What are the benefits of probiotics?
There is a growing body of evidence to support the use of probiotics in a plethora of different fields of health care. The health benefits of probiotics in various different forms have been recognized since antiquity. However, we are really only now beginning to fully grasp and examine the importance of the microbiota to our health. The potential of probiotics as treatment for everyday illnesses all the way to serious disease is becoming increasingly apparent with an ever increasing body of evidence support their use.
Studies have shown probiotics to be extremely useful in treating cases of diarrhea. One study showed a 42% reduction in the incidence of diarrhea brought on by antibiotic treatment. It may sound counterintuitive but probiotics can and often should be used in conjuction with antibiotics. Antibiotics do not always differentiate between which bacteria are harmful pathogens and which one are beneficial for us. They can often indiscriminately kill the good guys too! This is why many people experience diarrhea as a side effect when taking antibiotics. Apart from being unpleasant, diarrhea causes dehydration and electrolyte imbalances which can further impede recovery particularly in weaker or immunocompromised patients. Replacing the lost good guys by using probiotics during a course of antibiotics can help patients to avoid this complication altogether. When taking both simultaneously it is important to separate the doses i.e. take them at different times as this allows the probiotics to reach their best potential.
Probiotics have also been shown to have a role in treating conditions such as inflammatory bowel disease. These disorders of the bowel lead to pain, bleeding, cramping, poor digestion and absorption of nutrients from food. They can potentially end up in more serious complications such as bowel obstructions and strictures requiring surgery. A factor common to these disorders is an altered relationship between the body and the gut flora. Resident bacteria in the lumen have been shown to be a factor in the development and persistence of these disorders. The inflammation associated with these diseases is the body attempting to fight off pathogens in the gut. As your immune system can not always differentiate, this affects the good bacteria too. The reasons why the immune system attacks the gut flora in the first place is not well understood. Some theories propose that your body is reacting to changes in the population of the gut flora or changes in the behaviour of the flora and the chemicals they produce. Either way it is clear the the microbiota is intrinsically linked to these disorders. This has prompted scientist to investigate the potential benefits of manipulating the flora with probiotics. Bacteria such as lactobacilli have been shown to have protective immuno-modulating properties which can help alleviate the body’s inflammatory response. Alterations in the permeability of the gut can cause compounds to essentially leak out through the gaps between cells of the small intestine. This in turn leads to inflammation. Bifidobacterium, another probiotic strain, prevents damage to intestinal cells and helps to prevent increased intestinal permeability. There have been positive results from several studies in animals showing an improvement in symptoms of IBS from taking targeted probiotics.
The established ability of certain probiotics to counteract increased intestinal permeability has further reaching potential than just disorders of the bowel. As previously mentioned, the leaking of compounds out of the intestine leads to inflammation. This phenomenon has also been linked to food intolerance, particularly gluten and other inflammatory reactions such as eczema, asthma. Maintaining a healthy intestinal microbiota through probiotic use could help to avoid or alleviate these sensitivities. A recent study with 30 children in Australia used probiotics, namely Lactobacillus Rhamnosus to treat peanut allergy. In a randomised trial they found that about 80% of the children were subsequently able to tolerate peanuts. Other studies using Lactobacillus Rhamnosus and Bifidobacterium lactis have had positive results in treating infants suffering with atopic eczema. Some scientists hypothesize that the increasing rate of allergies is caused by our reduced exposure to pathogens due to improvements in hygiene. The theory is that the use of probiotics may be a safe alternative for providing bacterial stimulation which is necessary to our bodies. Probiotics have been shown not only to successfully treat allergies in infants but also to reduce the incidence of developing allergies in the first place. Though the mechanism of action is still not fully understood is is thought to be a combination of probiotics’ ability to strengthen the barrier function of intestinal mucosa preventing leakage and the fine tuning of the microbiota. Increasing the population of certain microbes in the gut puts them in direct competition with pathogenic bacteria for food and space and thus helps to reduce the population of harmful pathogens.
Probiotics may also be useful for detoxification. Many of the toxins in the body originate in the GI tract. These include undigested proteins and unhelpful bacteria. The introduction of the correct probiotic strains can help to rid the body of unwanted toxins. Some strain of bacteria can harvest energy from undigestible foods. The healthy flora can also out colonize the pathogens and detoxify the gut in this way.
One of the most exciting potential uses for probiotics is relating to obesity. Research has shown a consistent difference between the gut flora of slim individuals and that of obese individuals. Furthermore, one study in mice, the gut flora of a healthy weight mouse was replaced with those taken from an obese mouse. The healthy weight mice were fed the same diet as before but they became obese. Unfortunately, so far studies have been unsuccessful in doing the reverse- slimming down an obese individual using a slim individual’s gut flora. The research into that continues but what this research does show is a direct link between gut flora and obesity. The gut flora’s potential to contribute to energy harvest is another area of particular interest in relation to obesity. Research in the future may yield a definitive alternative using probiotics to the extreme treatments such as bariatric surgery that are becoming commonly used today.
The potential uses for probiotics are only just beginning the emerge. There is already encouraging research into the link between gut flora and diabetes, cancer and even depression. Further research and refining of their use we may see probiotics revolutionize the way we treat many illnesses. There are some obstacles to take note of when using probiotics. It is important to select appropriate strains. Different bacteria have different functions in the body and selecting the incorrect one may have no beneficial effect or it may exacerbate your symptoms further. Another problem is poorly regulated standardization of probiotics. There is a huge variety of probiotics on the market each with varying levels of efficacy and standards of production. If you have allergies you must exercise caution when selecting a probiotics to ensure it does not contain any of the allergens you are sensitive to. Just as you would with food. Your naturopathic doctor is one of the best resources for information on probiotics. The population of your gut flora is individual and unique to you. As such, you should have an individualized plan for taking care of them. One of our Naturopathic Doctors can help you to choose the correct strain for you based on your individual needs and help you to navigate the vast selection of probiotics on the market to help you find a reputable product that is best for you and your microbial friends.