Probiotics seem to be gaining in popularity over the last few years. When I began practicing as a pharmacist 8 years ago, I hardly ever answered questions from patients related to probiotics. Now it seems daily I will give a recommendation on which probiotic to use, when to take it, and why take one at all.
Lets start with why probiotics are important. Probiotics are the good guys in your gut, the bacteria who aid in the fight against bad bacteria entering the body. The actual definition of probiotic is: Live microorganisms that, when administered in adequate amounts, provide a health benefit to the host. Some names for these good guys are:
- Lactobacillus
- Bifidobacterium
- Bacillus species
- Saccharomyces boulardii.
Your gut is the place where nutrients are absorbed and is the first place where bad bacteria will run into the immune system. It is here that initial security forces are in place, to defend the body against the bad coming in and to heal any of the damages of infection and inflammation caused during battle. My husband is in the army and probiotics remind me of soldiers, fighting and fixing at the same time.
The concept of a large role of the immune system being centered in the gut was new to me. As a pharmacist, I understood the good bacteria are important to protect from having too much bad bacteria. I also knew to counsel patients on taking a probiotic while on an antibiotic to keep the good guys going… but didn’t realize just how important the gut was to health. Reading that 70% of the immune system lives in the gut was surprising to me.
A quick run down of the immune system….
The immune system is made up of 2 parts: the innate immune system and the adaptive immune system. The innate immune system consists of cells with antennae like structures to feel for any bad guys entering your body. These cells live on the surface of the intestine and send messages up the chain of command to the adaptive immune system when an enemy is present. The adaptive immune system cells adapt to the ever-changing battle field and will send into action the immune cells responsible for making the antibodies to kill the enemy. These immune cells ( T cells and B cells ) are located within the intestine lining.
This system functions like a perfect machine when everything is in order, but if the system malfunctions in any way it causes chaos for the entire body.
When all is well in the gut, there is a balance of bacteria that keeps the immune cells functioning as designed. The good bacteria help the immune cells to learn good from bad, self from enemy. They also help the body produce antibodies to respond to the enemy.
So how does the balance become undone?
We have all heard it is good for children to get dirty (or eat dirt if it is my kid…). There is truth in this statement, when not exposed to germs and bad bacteria, the body has no chance to learn that some are good and will instead attack all that is bacteria. When prevented too much from having germs enter the body, the good guys and the immune system may not achieve a strong working relationship to battle the bad bacteria together. In other words, do not be overly obsessive with hand sanitizer or having a disinfected and dirt free home.
Antibiotic use will put a patient at risk for unbalance since the good bacteria will get killed in the cross fire of attacking the bad bacteria.
A diet lacking in fermented foods (think sauerkraut, kefir, kombucha, yogurt) and fiber from grains, fruits and vegetables can lead to a lack of good bacteria colony in you gut.
So, how do you know if a probiotic is something your body needs? There are many signs given by the body when the good to bad bacteria balance is not right. When the gut is not happy, you usually can feel it:
Gas
Bloating
Constipation
Diarrhea
Cramping
Indigestion/acid reflux
Probiotics are also taken to prevent issues when taking an antibiotic. When used for this purpose, it is important to remember to take the probiotic either 1 hour before or 2 hours after antibiotic. This allows time for probiotic to colonize before antibiotic swoops in and tries to kill them all again.
While it is possible for a probiotic product to lead to an infection of bacteria in a bad way through your system, the bacteria used are already commonly found in the gut of humans. Patients with very low immune system function may want to use caution if starting a probiotic.
Now, how do you go about choosing the best probiotic? I prefer to recommend products that contain more than 1 type of probiotic. The greater the amount and diversity of good bacteria the more balanced and prepared the gut will be going forward against bad bacteria. I personally rely on probiotics daily because of antibiotic use, and have a few different options in my home to switch up the good bacteria and maintain a balance of colony types in my gut. I also enjoy drinking kombucha tea. (If you have not tried it, it comes in a large variety of flavors. Some will have a vinegar taste to them, but many do not. I have even had orange soda flavored kombucha tea!)
Your Health Matters
Tiffany Herring PharmD
**THIS AUTHOR AND SITE INTENDS ONLY TO SHARE INFORMATION AND NOT TO DIAGNOSE OR TREAT DISEASE.