By David H. Rahm, M.D.
Q: I’ve been hearing so much positive press about probiotics, I’m wondering if I should take a probiotic daily in addition to my other supplements.
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.
It’s no wonder that the heartburn medication Nexium, with sales of over $5.6 billion, was the number one selling drug in the U.S. in 2012. While these medications provide symptomatic relief, they can also cause unintended side-effects.
Like in so many other areas of health, consumers are increasingly interested in more natural approaches to solve their digestive problems and probiotics offer a great solution.
What are Probiotics?
As a Greek word, probiotic means “for life.” In 2001, the World Health Organization (WHO) defined probiotics as “live microorganisms, which when administered in adequate amounts, confer health benefits on the host.” Probiotics balance and restore intestinal microbiota or protect against an upset in the equilibrium of the intestinal tract.
Why Supplement with a Probiotic?
Given that our intestinal tract is normally lined with beneficial bacteria, why would you need to take a probiotic supplement? The answer is diet and lifestyle. The typical American diet is high in fat and sugar and these foods does not create an environment that is hospitable to beneficial bacteria. Conversely, a diet that features plenty of fruits & vegetables along with unsaturated fats supports a healthy intestinal tract. Taking a probiotic helps replenish the beneficial bacteria in the digestive tract and promotes a healthy intestinal flora.
What are Prebiotics?
Prebiotics are an energy source for probiotics. Prebiotics like FOS are a special type of non-digestible carbohydrate that help the beneficial microorganisms replicate. Good prebiotic sources include chicory, Jerusalem artichoke, jicama, leek, onion, asparagus and bananas. With a ready available food source, beneficial bacteria can replicate in the intestinal tract. Some supplements like VitaMedica’s Probiotic-8 are formulated with both a prebiotic and probiotics.
How do Probiotics Benefit Health?
Given that probiotics line the entire intestinal tract, it’s not surprising that these microorganisms play a key role in digestive health. But, probiotics also support the immune system, enhance absorption of nutrients and even manufacture some vitamins. Exciting new research shows that probiotics may also play a role in weight management and in maintaining a clear complexion.
What are the Benefits of Taking a Probiotic?
The two primary reasons for taking a probiotic are to support digestive function and to strengthen the immune system.
Support Digestive Function. Digestive problems – from constipation and diarrhea to bloating and gas – affect up to 70 million Americans. Constipation is one of the most frequent gastrointestinal problems in the U.S., with the primary cause due to lack of fiber. Regular use of probiotics shortens transit time which promotes regularity and increases stool volume and weight. Probiotics can also resolve diarrhea (caused by bacteria or viral infection and antibiotic use) by balancing the intestinal flora.
Strengthen the Immune System. A healthy intestinal microflora may also help to strengthen your natural defenses. About 70% of the body’s immune system is located in the digestive tract where specialized cells help to defend the body against invading bacteria. The bacteria that line the intestinal tract help to defend against pathogens. Regular consumption of probiotics helps to strengthen this barrier.
Other reasons for taking a probiotic supplement include the following:
Decrease Symptoms of Lactose Intolerance. Fermented milk products such as yogurt, can help decrease the symptoms of lactose intolerance including nausea, cramps, bloating and gas. Individuals with lactose intolerance do not produce enough lactase, the enzyme needed to digest lactose, the natural sugar found in milk and dairy products. Probiotics that contain Lactobacillus reduce lactose content by predigesting some of the lactose and metabolizing it into lactic acid thereby decreasing the symptoms of lactose intolerance.
Rebalance the GI Tract After Antibiotics. Many antibiotics used today are not targeted but medium and broad spectrum. That means they kill bacteria without prejudice – killing both the bad and the beneficial bacteria that reside in the gastrointestinal tract.
Upsetting the natural balance in the digestive tract causes all sorts of digestive problems. But, the most common complaint associated with these medications is antibiotic-associated diarrhea. In fact, this negative effect is the number one reason why patients discontinue antibiotic therapy.
In women, another common side-effect of taking antibiotics is a yeast infection caused by an overgrowth of Candida albicans. This yeast normally inhabits your GI tract. But, if allowed to reproduce too quickly, can cause a yeast infection.
Probiotics restore bacteria lost due to antibiotics. Taking a probiotic helps to repopulate the digestive tract with beneficial bacteria to get your digestive function back to normal.
Address Specific Health Issues. Research has shown that certain strains of bacteria can be helpful in treating a number of health issues. A recent study showed that children in daycare given L. reuteri suffered less from fever, stomach infection and common colds than other children in the daycare setting. The strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 have both been shown to support vaginal health in women. Clinical studies using UAS Laboratories’ Lactobacillus acidophilus DDS-1 suggests that this probiotic can be effective in the prevention and recurrence of urinary tract infections.
What About Probiotic Foods?
The most widely recognized probiotic food is yogurt. This cultured dairy product is a result of the fermentation of milk under controlled conditions by lactic acid producing probiotic cultures (typically L. acidophilus, S. thermophilus and L. bulgaricus).
While a healthy food (provided you eat non-fat, plain Greek yogurt which is high in protein, low in sugar and contains no fat plus a good source of calcium), most yogurts have a relatively low bacteria count (1-2 billion Colony Forming Units or CFUs). Look for products that have the “Live Active Culture” seal which ensures that the yogurt contains 108 viable lactic acid bacteria per gram at time of manufacture.
A number of other foods naturally contain probiotics including Kombucha tea, miso soup, kefir (cross between yogurt and milk), sauerkraut, pickles, Kimchi (a popular Korean side-dish made from fermented and pickled cabbage) and tempeh (a meat substitute made from soy protein).
Including these foods in your diet is a good way to support a healthy digestive system.
What About Probiotics Dosage?
Colony Forming Units or CFUs, is a measure of how many bacteria are able to divide and form colonies. To support overall health and wellness, aim for 4 to 8 billion CFUs per day. After a course of antibiotics, the dosage should be doubled.
Probiotic supplements should provide this information on the nutritional panel. For example, Probiotic-8 provides CFU information for each of the 8 strains included in the probiotic supplement. A serving provides 8 billion CFUs.
Eating foods that naturally contain probiotics or eating functional foods that have prebiotics/probiotics added to them, is a great way to boost the microbiota in your intestinal tract. However, you need to consume quite a bit of these foods in order to obtain an appreciable amount of CFUs. Taking a probiotic supplement is a simple and easy way to replenish the beneficial bacteria in your GI tract.
While delivering probiotics in a supplement is convenient, this product delivery form can be challenging. 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.
What is Acidophilus?
Acidophilus is just a short-hand name for a common species of bacteria called Lactobacillus acidophilus or L. acidophilus which is found predominantly in the small intestine. In short, Lactobacillus is the name of a large family of lactic acid producing bacteria and acidophilus is one of the most important members of that family. Other members include L. casei, L. rhamnosus and L. salivarious.
Another large family of lactic acid producing bacteria is Bifidobacterium. This group primarily resides in the large intestine. A common species in this group is Bifidobacterium bifidum or B. bifidum for short. Other members include B. lactis and B. thermophilus.
Should I Take a Probiotic Daily?
Although the benefits of consuming a probiotic depends on the type of probiotic bacteria used and the amount consumed, most experts agree that daily consumption is beneficial.
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.