PROBIOTICS Q & A

Recently, I was interviewed by very popular beauty and health site TotalBeauty on probiotics (click here for the article) and I stressed the importance of healthy gut bacteria. But read on for what DIDN’T make it into the article and why I don’t recommend purchasing probiotic supplements:

Let’s start with the basics. What are probiotics and why are they important?

Probiotic literally means for life (pro=for, bio=alive). Probiotics are normal inhabitants of bacteria that live in our intestines- they are harmless, friendly and helpful microorganisms. The most helpful probiotics discovered from the stool cultures of newborn babies, who are only fed with their mother’s milk, are Lactobacillus, Bifida bacterium and Saccharomyces group of bacteria. In order to be called probiotic, bacteria has to be alive, be taken by mouth, be resistant to gastric acid, bile and other digestive enzymes and reach the colon alive where they multiply and colonize the entire colon. They then become the dominant species of bacteria in colonic microbiome population of almost 300 billion of microorganisms.

Probiotic are friendly, helpful bacteria and have a symbiotic lifestyle. They live on the food particles we eat but provide a very important biological function for us. These functions can be listed as follows:

They protect our intestine against the invasion of disease causing invasive bacteria by crowding them out and by producing inhibitory chemical molecules to prevent their growth. 

Probiotics help us to digest hard to digest foods like vegetable fibers and complex carbohydrates like lactose. 

They produce many vitamins like vitamin K, B-group of vitamins. 

Probiotics stimulate our immune system and regulate our immune reaction thereby preventing allergic autoimmune diseases, and many other not so well defined functions.

Do most people get enough probiotics from their food?

Yes, providing their diet is well balanced. These bacteria multiply in our guts.

How can we know we are getting enough?

As long as we are not malnourished or on a long-term oral antibiotic treatment, we are not probiotic deficient. We don’t have to worry about it.

Are there signs that we aren’t getting enough?

No, there are no clinical signs.

What are important things to look for when shopping for probiotics?

There is no need to take probiotic as supplements. Since probiotics are marketed as food supplements, they are not regulated by the U.S. Food and Drug Administration (FDA). Instead, I personally recommend for an individual to go on a probiotic rich diet such as yogurt, milk, cheese and milk-by products, kefir, sauerkraut or kombucha when taking antibiotics, instead of taking over the counter supplement probiotics.

Most  OTC probiotics contain only 1 strain of  good bacteria .Their quality and contents are not assured. I personally liked prescription probiotic VSL#3 for my patients with IBS, ulcerative colitis and ileal pouch. It contains 8 different strains of good bacteria and it’s quality is assured. 

Most probiotics are DOA when we by them. How the companies get away with that?

Probiotics shouldn’t be taken casually, they could be dangerous if you don’t need them. You only need probiotics under certain circumstances. The best thing to do is to check with your doctor and use only prescription probiotics if needed for these are controlled and regulated like drugs by our Government agencies.

What are the side effects of probiotics?

Allergic reactions, excess gas formation, bloating, passing excess amount of gas. One of my patients developed what I think it was a rare syndrome called Small Intestine Bacterial Overgrowth Syndrome (SIBO).

When should probiotics be taken and what is the proper dosage?

Probiotics should be taken with empty stomach when gastric acid and digestive enzymes activities are the lowest, so that they will not be digested. Proper dosage is not known because it is not possible to do scientific studies on the dosage. Considering that there are over 300 billion of microorganisms living symbiotically in our guts, proper dosage is only a guess work.

Do you have any more questions on probiotics? Feel free to comment below or reach out to me directly