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The Probiotics Question

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By Victor Acquista, MD

Author Pathways to Health: An Integral Guidebook

Special to PRIME

 Recently I have had a number of people ask me about probiotics. Some foods and supplements are heavily marketed and promoted on the basis of having probiotic effects. Is this just clever marketing hype capitalizing on a popular trend or is there legitimate science backing up claims to better health?

 The antibiotic dilemma

One place to try and answer these questions is first to consider antibiotics. We are pretty familiar with these products, usually pharmaceuticals, used to combat infections. They act in a variety of ways such as disrupting the cellular surface or metabolic processes within the targeted germ or microbe. Put simply, antibiotics are designed to “kill the bad germs.”

However, antibiotics rarely affect only the targeted germ. Frequently, antibiotics are harmful to beneficial microbes that inhabit our bodies. In fact, most of the microbes living on or within you are neutral or beneficial to your health. Without them, you would not survive. In many respects, antibiotics are frequently a “two edged sword’ simultaneously doing a good thing in helping to eliminate or combat a bad germ, but also doing a bad thing by reducing beneficial microbes.

 The microbiome

Our microbiome, – the universe of bacteria and microorganisms that each of us harbor – represents a population ten times greater than our number of cells. That amounts to a hundred trillion or so bacteria. Most of these inhabit our intestinal tract, home to many trillions of microbes. This unseen community of microbes within our gut performs essential functions such as breaking down nutrients in the foods we consume, promoting healthy digestion, synthesizing essential vitamins, etc. We know that alteration in the gut flora is associated with some disease states such as Crohn’s disease. We also know that many antibiotics upset the balance of beneficial microorganisms within our gut, which can be harmful. The results can be a minor nuisance such as some diarrhea or bloating, or quite serious such as a C. difficile infection.

 Probiotics to the rescue?

In some respects these deleterious side effects of antibiotics is what led to interest and investigation into probiotics. What could be done to help protect the gut flora and reduce or mitigate the undesirable side effects? Could we eat or drink something to help the good microbes inhabiting our intestines?

It turns out that the answer to this is, yes. The World Health Organization's 2001 definition of probiotics is "live micro-organisms which, when administered in adequate amounts, confer a health bene?t on the host." Wikipedia 

According to the Mayo Clinic, there's encouraging evidence that probiotics may help:

  • Treat diarrhea, especially following treatment with certain antibiotics
  • Prevent and treat vaginal yeast infections and urinary tract infections
  • Treat irritable bowel syndrome
  • Speed treatment of certain intestinal infections
  • Prevent or reduce the severity of colds and flu

Foods, beverages, and supplements with probiotics must have live microorganisms. Some common foods, drawn from an article on WebMD, which contain probiotics are: yogurt (with active cultures), unpasteurized sauerkraut, kimchi, miso, some fermented soft cheeses such as Gouda, kefir, sourdough bread, acidophilus milk, naturally fermented sour pickles, and tempeh.

 Should you supplement?

The active species of probiotic in a particular food or supplement may vary. Bifidus and some Lactobacillus strains are some of the more well known. In truth, there are many different microorganisms promoted as probiotics. It is advisable to research a particular food or supplement and discuss with your health care provider whether taking a probiotic is advisable.

The human gut flora is a complex community of microorganisms. While we know the foods we consume affect this microbial community, it is hard to say for any individual whether or not taking probiotics for general health is helpful. We do know about the use of probiotics to combat or mitigate detrimental side effects of antibiotics.

Some people advocate the use of probiotics as a means to improve our health. In my judgment we know less about using probiotics as a general supplement to our health. If we consider probiotics as, “A live microbial feed supplement which beneficially affects the host animal by improving its intestinal microbial balance," a definition proposed by Roy Fuller, and we believe the underlying gut flora can be optimized; probiotics might be a way to accomplish this.

Dysbiosis is a term used to describe microbial imbalance on or inside the body; most often it applies to the digestive tract. Probiotics might be a way of reducing such imbalance. This is an area we continue to learn about and study actively. At the present time, I am personally cautious about possibly affecting the balance in an undesirable way. I do believe that a varied diet, inclusive of foods and beverages mentioned above makes sense.

 Victor Acquista MD is an international speaker, author, and teacher. For information on his writings, presentations, and workshops: http://victoracquista.com/