Many health-conscious people these days are taking probiotics on a daily basis, spurred on, no doubt, by the endless stream of hype that is the Internet. When we see a new practice become common, it’s always a good idea to take a moment to investigate and reflect.
First, what are probiotics? Surely, this term would never have occurred to anyone if we had not first had antibiotics. As we all know, antibiotics are designed to kill (anti) life (biotic). So, probiotics are an attempt to promote life. The agents of promotion in probiotic supplements are live bacteria or fungi normally found in a healthy gut.
These bacteria enter the infant digestive tract in the birth process. This natural inoculation normally occurs in the birth canal during delivery. The vaginal bacteria (bacteria are often referred to as flora in this context) resemble those found in the healthy gut. Interestingly, children delivered via Caesarian-Section begin life with intestinal bacteria that come from the mother’s skin. This is one of those fascinating phenomena that are not fully explained with our scientific thinking. How does that miraculous transfer of bacteria occur during surgery, especially when the mother’s skin is heavily swabbed in anti-microbial fluids? Breast-fed infants normally experience healthy growth of bacteria in their guts. Formula-fed infants don’t get this boost.
Research seems to indicate that infants born vaginally and who are subsequently breast-fed have fewer allergies and autoimmune conditions later in life, due, at least in part, to the advantage given by balanced gut flora. The current scientific evidence seems to indicate that the immune system and gut flora have a pretty complicated relationship. The immune system is “trained” in a way by the different organisms found in the gut. It’s likely that a healthy immune system keeps the so-called “bad” bacteria in check, but does not completely eliminate them.
The key here is that a healthy balance of gut flora has to be maintained. The average digestive tract contains pounds of bacteria, with some deemed beneficial, some neutral, and others considered harmful. Some researchers are reconsidering calling any of them harmful under normal conditions of health, given that their presence may help regulate and improve the immune system. Most bacteria reside in the colon, with a little in the stomach and small intestine. These bacteria play many roles in the body beyond tuning the immune system, some of which are beginning to be understood. They assist in the digestive process, and aid in detoxifying some substances, such as medications. They seem to help maintain clarity in the mind. Pretty interesting.
When an imbalance is present, this means that some species of bacteria or fungus that is normally kept in check by intestinal conditions and the immune system becomes predominant, and the “beneficial” bacteria shrink in numbers. This contributes to symptoms more widespread than the expected effects on gas and bloating or bowel function. It’s important to remember here that we artificially divide the body up into separate systems and parts. The body itself is continuous, and ripples in one area can and do reverberate freely throughout the whole.
Why would anyone need probiotics? We live in a time when balance everywhere is in jeopardy, and the colon flora is no exception. Obviously, antibiotics kill without discriminating between beneficial of harmful bacteria. Antibiotic use leads to a predominance of whatever bacteria or fungi are not killed by the drug. Stress and lack of sleep, so common in our world, also seem to distort the intestinal flora balance. Bad food, also called American food, also contributes. Smoking changes the gut flora, as does alcohol, constipation and diarrhea.
How much probiotics should you take? This is an interesting question. We always think more is better, and look for the count, in billions, listed on the label. As everywhere in life, more is not necessarily better. There appear to be times when consistently ingesting billions of bacterial colonies actually promotes imbalance. More pertinent, perhaps, are considerations of whether the promised bacteria are actually alive in the bottle, and whether they are contaminated with less desirable species of bacteria.
Most important is to make sure that the bacteria can grow once you’ve taken them. Probiotics can be likened to seeds. Once planted, they need to grow. Remember, there are pounds of bacteria in the gut. Whether you add 5 billion or 15 billion units doesn’t matter much if your system doesn’t provide the conditions needed for the bacteria to take root and multiply. Seeds need rich soil along with water and sunshine in appropriate amounts.
What’s the environment in your gut? Will it provide the required soil, sun and rain, so to speak? Ideally, it shouldn’t be necessary to continually take probiotics, just as you don’t add seeds to your garden every day. If stress, insomnia, poor diet, medications, etc., are still in the picture, adding probiotics does not address the root cause. Your gut flora, like your health, reflects the totality of your being.
You may note that different brands of probiotics proclaim that they contain different species. Each one purports to be the one that is perfectly balanced for you. Now we’re at the point in many articles of this type where the author warns you that all of the available brands of probiotics on the market contain the wrong type or proportions of bacteria, and that our exclusive proprietary blend is the only one that really works. And by the way, it’s on special today. Act now! This is the sort of nonsense that drives Internet sales, but should give one pause. What research could possibly indicate the exact type and proportion of organisms needed by all people at all times?
The bottom line is that probiotics serve you best as a temporary bridge to help your gut return to a balanced state. I routinely prescribe them when a patient has been on antibiotics or will be using them. I’ll also use them at times when a patient’s symptoms don’t improve in the expected way. I must say that I’ve never seen them perform the miracles described online. We have a couple of trusted brands that seem to reliably work, most likely because the manufacturer found a way to keep them alive until they reach their destination in your colon. If you wonder whether probiotics might help you, feel free to contact one of our doctors.