Diet, travel, stress, illness, aging and the use of antibiotics all contribute to an imbalance or “dysbiosis” of the intestinal tract leading to digestive problems. These problems cause some two million people to visit the doctor each year.
Probiotics – the beneficial bacteria in our intestinal tract – can help relieve gastrointestinal problems like constipation, diarrhea, bloating, cramping and gas by correcting your intestinal microflora imbalance. The good news is that these “beneficial bugs” maintain digestive balance naturally.
What are probiotics?
As a Greek word, probiotic means “for life.” In sharp contrast to antibiotics, probiotics are derived from probiosis which means a symbiotic relationship between two organisms. In short, probiotics are defined as living microorganisms that benefit the host by improving the balance of the intestinal flora. Probiotics balance and restore intestinal microbiota or protect against an upset in the equilibrium of the intestinal tract.
What are the most common probiotics?
The two most common groups of probiotic bacteria found in the human digestive tract are Lactobacillus and Bifidobacterium. While Lactobacillus prefers the small intestine, Bifidobacterium resides primarily in the large intestine. The best probiotic supplements are formulated with members from both groups of beneficial bacteria.
Within each of these groups (or genus) are different members or species (for example, Lactobacillus acidophilus and Bifidobacterium bifidum) and within species, different strains or varieties. Some, but not all strains are considered probiotics. Over 400 species of intestinal bacteria reside within the intestine in an organized manner. Each strain has its own territory within the intestines where it resides, similar to how plants group together. Hence, the reference “intestinal flora” or “intestinal microflora”.
Most of us associate probiotics with beneficial bacteria. However, a few probiotics are not bacteria at all but other microorganisms such as the yeast Saccharomyces boulardii.
What are lactic acid producing bacteria?
As the name suggests, lactic acid bacteria (LAB) are bacteria which produce large quantities of lactic acid. Most but not all probiotics are lactic acid producing bacteria. These gram positive bacteria convert carbohydrates to lactic acid without using oxygen. Some probiotics produce only lactic acid while others also produce acetic acid, ethyl alcohol and carbon dioxide.
Lactic acid producing bacteria can help relieve the symptoms of lactose intolerance. This is a condition where the body doesn’t produce enough lactase, the enzyme needed to digest lactose, the major sugar in milk and other dairy products, causing gastrointestinal symptoms.
Probiotics reduce lactose content be “predigesting” some of the lactose and metabolize it to lactic acid. The probiotic bacteria that survive the trip to the intestinal tract are available to provide additional lactase enzyme activity. If you are lactose intolerant, the best probiotic supplement will include plenty of LAB.
What are the beneficial effects of taking a probiotic supplement?
Although the benefits of consuming a probiotic supplement depends on the type of probiotic used and the amount consumed, most experts agree that daily consumption is beneficial to promote digestive health and to support immune system function.
Digestive Function. Regular use of probiotics shortens transit time which promotes regularity and increases stool volume and weight. Probiotics can resolve diarrhea (caused by bacteria or viral infection and antibiotic use) by balancing the intestinal flora. By “predigesting” some of the lactose in dairy products and metabolizing it to lactic acid, probiotics can also help relieve the gastrointestinal symptoms associated with lactose intolerance.
Immune Function. Taking a probiotic strengthens your natural defenses by providing a regular source of good bacteria. When the microflora of your intestinal tract is in good balance, your body’s immune health is strengthened and supported. Over 70% of body’s immune system is located in the digestive tract where specialized cells play an important role as first line of defense against invading bacteria. Beneficial bacteria occupy the lining of the intestinal tract and create a physical barrier to pathogens.
What is the naming system for probiotics?
The majority of probiotics are small single-celled bacteria and are categorized by genus, species and strain. For example, Lactobacillus acidophilus DDS-1 is from the genus Lactobacillus, the species acidophilus and strain DDS-1. Sometimes you’ll see the term Lactobacillus acidophilus or just L. acidophilus. These names are referring to the same thing. However, if you see a product that contains Lactobacillus this refers to the genus or family but gives no indication to the species. Keep in mind that many species of Lactobacillus exist and that the benefits of taking one strain versus another differ. The best probiotic supplements include information on the genus, species and strain. Companies like VitaMedica provide this information on their probiotic supplements.
What are prebiotics?
Prebiotics are special type of non-digestible carbohydrate that the beneficial microorganisms use for energy. With a ready available food source, beneficial bacteria can replicate in the intestinal tract. Probiotics directly repopulate the intestinal tract with the beneficial bacteria whereas prebiotics provide an environment which is hospitable to the beneficial bacteria.
Certain prebiotics, when used in adequate amounts, have been shown to provide health benefits including improved digestive function and intestinal environment, positive modulation of immunity and metabolism, improved lipid metabolism and improved absorption of dietary minerals. Not surprisingly, prebiotics complement probiotic functions.
The most widely accepted prebiotics are inulin – a type of fructooligosaccharides (FOS) derived from chicory – and oligofructose because human studies indicate their ingestion directly increases levels of Bifidobacteria in the colon. This substance is readily available in other foods such as bananas, tomatoes, barley, asparagus, artichokes and garlic. VitaMedica’s Probiotic-8 supplement is formulated with the prebiotic FOS.
Should I look for a supplement that contains a probiotic and prebiotic?
Yes. The best probiotic supplements combine a probiotic with a prebiotic, forming what is called a synbiotic. This dual approach directly adds the beneficial bacteria to the digestive tract while providing a ready available food supply that supports colony development. An analogy is packing the family in the car for a road trip with plenty of healthy snacks for the ride. VitaMedica’s Probiotic-8 supplement is formulated with prebiotics and probiotics.
Is it better to take a single strain or multi strain?
This depends on your health objective. If you have a disease issue such as a urinary tract infection (UTI), a single strain that has been researched to specifically address this issue may be warranted. On the other hand, if you have medically diagnosed serious intestinal disorder – ulcerative colitis, an ileal pouch or irritable bowel syndrome – your physician may prescribe a much stronger probiotic supplement like VSL#3.
For general health maintenance and healthy digestive function, a probiotic complex formulated with multiple probiotic strains at reasonable CFU dosing (4-10 billion per day) is appropriate. A multi strain duplicates the natural process of eating probiotics in foods where a variety of strains are present. Given that the dominant probiotic families in the digestive tract are Lactobacillus and Bifidobacterium, the best probiotic supplement would includes members from both families. VitaMedica’s Probiotic-8 supplement is formulated with 4 strains of Lactobacillus, 1 strain of Streptococcus and 3 strains of Bifidobacterium.
How many Colony Forming Units should I take?
CFU or Colony Forming Units is an indication that the bacterium is live and capable of dividing and forming colonies. Importantly, more CFUs do not necessarily mean that the product is better or more effective. Different probiotics have shown to be effective at different levels.
The best probiotic supplement for you depends on your needs. It’s better to take a probiotic supplement that is indicated for the purpose (e.g., general health, UTI, digestive regularity) than take a high CFU count of a strain that is indicated for another health concern. But, most health experts recommend between 6 to 10 billion CFU a day. Just two capsules of VitaMedica’s Probiotic-8 provides 8 Billion CFUs per day.
What About Probiotic Efficacy?
One of the challenges of delivering a quality product is the ability of the probiotic to survive passage through the stomach. If the probiotic survives the stomach and bile acids, it then must adhere to intestinal cells and colonize within the human intestine. The probiotic also must be antagonistic toward pathogenic bacteria.
Probiotic bacteria are damaged by heat, moisture, light and exposure to air. Dried probiotic organisms, like those used in supplements, are activated when hydrated. Once activated, they quickly expire, so shelf life and viability through time of consumption are critical to an effective product. Live active probiotic cultures need to survive the harsh conditions of the stomach before reaching the small and large intestine.
Some strains such as Bifidobacterium and L. casei are better equipped to withstand this trip. The viability of some probiotics last longer when refrigerated. You’ll need to check the label of the product. Keep in mind that moisture and heat can easily destroy probiotics. Refrigerating probiotics helps to maintain their shelf-life.
The best probiotic supplement will also be enteric-coated. This ensures that the probiotic supplement bypasses the harsh conditions of the stomach and doesn’t break-down until the small intestine where the beneficial bacteria are liberated. VitaMedica’s Probiotic-8 is enteric-coated to ensure that the beneficial organisms are delivered to their intended destination.
What about antibiotics and probiotics?
Antibiotics are routinely prescribed after surgery to prevent infection. They are also prescribed for a number of health conditions like acne, bacterial infections, certain fungal infections and some kinds of parasites. Unfortunately, antibiotics kill both good and bad bacteria. With increased antibiotic use, some bad bacteria have become resistant and these species can upset your digestive balance causing diarrhea. Supplementing with a probiotic helps to repopulate your GI tract with beneficial bacteria bringing balance to the microflora and reducing symptoms.
The best probiotic supplement is formulated with Bifidobacterium (especially B. longum) as antibiotics are particularly detrimental to this group of beneficial flora. The hardy strain L. casei is also helpful against antibiotic associated diarrhea. VitaMedica’s Probiotic-8 supplement is formulated with the species Lactobacillus casei, Lactobacillus rhamnosus, Bifidobacterium longum, Streptococcus thermophilus to address the harsh condition of the GI tract after an antibiotic is taken.
How long should I take a probiotic supplement?
All studies documenting efficacy for probiotics use daily administration. Since probiotics are transient and do not necessarily adhere but interact with epithelial cells, a daily dosage is typically required.
In sum, the best probiotic supplements are formulated with resilient strains, at sufficient levels (CFUs), include a prebiotic and are delivered in enteric-coated capsules to ensure that the beneficial bacteria not only withstand the trip through the digestive tract but thrive once they reach their final destination!
David H. Rahm, M.D. is the founder and medical director of The Wellness Center, a medical clinic located in Long Beach, CA. Dr. Rahm is also president and medical director of VitaMedica. Dr. Rahm is one of a select group of conventional medical doctors who have education and expertise in functional medicine and nutritional science. Over the past 20 years, Dr. Rahm has published articles in the plastic surgery literature and educated physicians about the importance of good peri-operative nutrition.