Probiotics: Beyond the Bathroom

(Originally posted on bcotoronto.com on Aug 9th, 2012)

Over the last decade the term probiotics has become fairly regular in marketing along with other monikers like “active yeast cultures” and others. Just like most health facts that have been appropriated by mainstream marketing the whole story is not told. People end up taking about these yogurt and other fermented products touting their new found regularity without knowing the true benefit of what they are doing. If more people knew about the truth behind probiotics then we would be seeing a much greater demand for them.

So let’s pull back this curtain and start-off by talking about what probiotics actually are. Our intestines are filled with bacteria called the intestinal or gut “flora”. We need these bacteria to survive as they play a pivotal role in our digestion, immunity, and general health. But not all bacteria are good for us. There are a certain few bacteria that we as a species have developed a symbiotic relationship with over the millennia. These are our intestinal probiotics. All other bacteria are not good for us. The ratio of good to bad bacteria is important to our health. If there is a majority of good bacteria we will get the nutrients we need from our food and the protection the bacteria provide. On the other hand, if there is a majority of bad bacteria then we will have any number of symptoms that can either lead to or mimic other serious conditions.

The question on everyone’s mind now is, “how do my bacteria become imbalanced like that?” Well, there are a number of ways but the most common one is antibiotics. Western culture relies very heavily on antibiotics as treatment and we have developed a habit of prescribing these drugs without confirming the presence of a bacterial infection. There is a common misconception among the general consumer that an antibiotic is a laser-focused tool that only seeks out and kills the infectious bug. I have no idea where this notion came from but it is completely untrue. Antibiotics kill all bacteria, both good and bad, that do not have resistance to the chemical. So every time we take a round of antibiotics we are decimating the bacterial population. There is no guarantee that the good bacteria will re-populate the intestines before the bad. In fact, it is highly unlikely due to the significantly greater number of bad bacteria than good bacteria.

Another way this imbalance occurs is through deficiencies. The point of a symbiosis is that both species benefit for the situation. In the standard North American diet we are sorely lacking in good soluble fibre (vegetables, legumes, etc.) which the good bacteria in our guts need to survive. The bad bacteria can survive in more harsh conditions. Therefore the majority of North Americans are slowly starving their good bacteria and the bad ones are taking over.

This is a terrible state of affairs and we all need to make sure that we have a large population of good gut bacteria to rely on and here’s why. There has been a huge amount of research done on the effects of probiotics and the proper doses and ratios. In fact, there are almost 7000 articles on the topic in PubMed. This mountain of research has shown that our gut flora is important for multiple reasons. It helps heal the gut when dealing with leaky gut and food sensitivities as well as helping decrease the symptoms and sometimes preventing regular allergies. By acting as a barrier for other bugs the probiotics decrease the rate of infection as well. This is so widely accepted that some researchers suggest using probiotics in intensive care units to decrease the risk of acquiring a new infection while in the hospital.

Probiotics have also been used to successfully treat yeast and urinary tract infections in women as well as many skin conditions in controlled trials. The mechanisms of action of these effects are yet to be discovered.

It has been discovered that some probiotics also have a cardiovascular benefit though changes to the level of activation of the enzyme that creates cholesterol within our bodies. The same enzyme that most Statin drugs target.

Of course, there is also the use that the marketing world has grabbed hold of; bowel regularity. Probiotics help to regulate bowel movements and alleviate diarrhea.

So here is what I suggest. One bottle of probiotics should be taken (as directed, not all at once) if you are prescribed a round of antibiotics, suffer from diarrhea for more than 3-4 days, and have stomach/GI cramping or bloating. Anyone who has ever had a round of antibiotics in their life should probably go through a bottle as well just to be sure. Probiotics are generally considered safe for the critically ill and pregnant and breastfeeding women so there is minimal risk involved.

As always thanks for reading,
Dr. Ben

P.S. – If you have any questions about this or any other topic, please feel free to e-mail me at drroffey@gmail.com or leave a comment below.

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