I am writing this article to question common myths about probiotics. The World Health Organization (WHO) defines probiotics as “live micro-organisms which, when administered in adequate amounts, confer a health beneﬁt on the host”.
A common belief is that we take probiotics to re-populate our gut with healthy bacteria, and consequently gain some health benefit. Although this notion is mostly harmless, based on research studies conducted over the past 15 years, it is not entirely accurate.
You may have heard that after taking antibiotics you need to re-populate your gut bacteria. It is surprising that we have heard this for decades but people did not think to do studies to prove that when you take a capsule of bacteria you will later find that same bacteria growing in your gut. Not too long ago studies actually found that only 0.01% - 0.1% of probiotics taken actually make it to the colon alive, much less stay there for any length of time. The same holds true for fermented beverages or cultured foods. However, the ferments (things that cause fermentation) in them have their own beneficial effects and they nourish your current microbiome.
What about the belief that using refrigerated probiotics is better than those on the shelf because they are still alive? If a probiotic cannot survive at room temperature, it certainly will not live in your stomach at 98.6 degrees.
In order to overcome this problem of survivability, probiotic manufacturers have attempted different strategies such as enterically coating their probiotics in a special capsule, using incredibly high doses of bacteria, or directing ingestion 30 minutes before or after a meal with a lot of water. These strategies have proven to be very hit or miss - you may get lucky with a high quality brand.
This brings me to a very important concept. People point out that probiotics have been used for decades with very good health benefits. How could they work if most of them do not survive into the colon? Probiotics that do not survive into the colon are not true probiotics (the definition states that they need to be alive). Instead, researchers call these substances “biological response modifiers”. This means that when taken, they affect our biology in a presumably good way. So even though they are not alive, they still help you, but you have to take them continuously to receive their effect. This means you’ll get a short term benefit but no long lasting changes to your microbiome. Biological response modifiers include: L. acidophilus (it’s presence changes the pH in the gut in a beneficial way), and the DNA of many ‘dead’ probiotics have immune modulating effects.
Some people believe they should find a probiotic product that works for them and just stick with that long-term. Unfortunately, there are anywhere from 6-20 different strains of bacteria in most products, but we have 1500-2000 known strains in our gut. I cannot stress enough that diversity is what is important for your microbiome, and taking the same 6-20 strains year after year will undoubtedly upset the delicate balance of your microbiome. You need to rotate them regularly.
To make better choices in probiotic selection, the final concept I would like to discuss involves strain specificity. We need a little biology review here. Let us take a popular probiotic called: Lactobacillus acidophilus NCFM as an example. In biological classification, the genus is Lactobacillus, the species is acidophilus, and the strain is NCFM. A good analogy is the domestic dog, Canis familiaris. The genus is Canis, the species is familiaris, and the strain would be the breed of the dog. You can see that the entire species of dog is quite similar, but the strain (breed) makes each dog stand out. The same is true of probiotics. If you want a probiotic to have specific characteristics, such as survivability or health benefit, you need to look at the strain. You will notice strains labeled with some kind of abbreviation - this indicates that it is a patented strain that has been well studied for it’s specific benefits.
Some examples of strain specific probiotics are:
L. rhamnosus GG will improve symptoms of urinary tract infections and help with infant diarrhea (it also survives stomach acid)
B. infantis 35624 improves symptoms of IBS
B. lactis Bb-13 stimulates the immune system
L. casei DN114001 lessens the duration of colds and flues, and diarrhea in children
L. reuteri DSM17938 helps with infant colic and antibiotic associated diarrhea
L. GR-1 improves vaginal health
L. helveticus R0052 and B. longum R0175 help with mood
L. reuteri Protectis®(DSM17938) is a strain that Gerber bought and trademarked as Infant Colic Drops
Finally, I want to let you know that there are true probiotic products out there sold as “probiotic spores” and sometimes as “Soil Based Organisms” (SBOs). Spores are a part of a true probiotic’s life cycle. When outside the gut they protect themselves with a sheath that can withstand just about anything until they find binding sites inside the gut, and transform into a bacteria that will soon become a part of your microbiome. This is a new product market - some are well tested and some are not, so be careful.
We are in a new phase of knowledge about probiotics, and need to update some old dogmatic ways of thinking. I want people to know that they will get far better results, avoid unintentional harm, and waste less money on products if they understand the concepts in this article.
The keys to intelligent probiotic use:
Diversity is very important. Rotate the strains that you take every 2-3 months and make sure you take Spore or SBO forms at least 4 times per year.
Strain specificity provides powerful and focused effects. Ask your practitioner for help (as I would not trust the internet to have correct information in this new field).
Use high quality brands and strains that are well researched or patented.
Don’t fall for gimmicks like low quality enteric coatings, complicated instructions, or very high doses.
Still include fermented beverages and cultured foods in your diet. Also have plenty of ‘prebiotics’ to nourish your microbiome.
Consider using Pre-biotics and Probiotic Phages (viruses designed to aid probiotics)
Keep up the good and avoid the bad habits described at the end of my last article entitled “The Importance of Your Microbiome”.
Please contact me to learn more (I am happy to share my research references). I also invite you to contact me if you are interested in ordering professional grade probiotics, patented strains and/or probiotic spores. You cannot buy these anywhere else locally at this time, and you may benefit from professional help in choosing products.