Thursday, January 2, 2014

Probiotics Were Number One In 2013

More research articles were written about probiotics this past year than any other topic in nutrition. Vitamin D, number one for the past several years, was displaced by both probiotics and omega 3 fatty acids. Please review my recent blogs on vitamin D and omega 3 fatty acids.

Probiotics are now recognized as having a profound influence on human health. Thanks to Jamie Lee Curtis the public is well aware of probiotics. However, there is some misinformation.

Each of us has between 500 and 1000 different bacterial strains in our digestive tract. Most of them can not be identified by simple stool testing. However that is beginning to change. Every month a few more species are isolated, identified, and then cataloged for future testing. If we could identify every microorganism in your gut, it would be as unique as a fingerprint.

The bacteria are divided into three categories – friendly, pathological, and comensal. The first two you understand. The third, comensal bacteria, can be friendly, neutral, or pathological. So even if you identify some of the bacteria are they friend or foe? Part of the answer can be determined by measuring the antibody response in the gut. If the secretory IGA is high or low, then the comensal bacteria are probably an issue. For example, some forms of Candida are friendly, others are comensal or pathological. If various strains of Candida are detected and the IGA is normal, they are probably not an issue. If the IGA is low, the immune system is being suppressed. If the IGA is high there is an overt infection that needs to be treated.

Probiotics can be friendly, pathological or comensal as well. Just because your body needs a specific probiotic, does not mean that I need or can even tolerate the same probiotic. We now know that all probiotics stimulate an immune response from the GALT (gut associated lymphatic tissue). If your secretory IGA is elevated, then many probiotics will further inflame the gut, even if the probiotic is dead on consumption.

Dead probiotics? There is a lot of hype in the ads about how many millions or billions of bacteria are in each probiotic tablet. But if they are not living they can not help you, but very likely will hurt you by adversely stimulating the GALT. Even if they are viable when taken, can you keep them alive? It’s pretty crowded in the gut with millions of bacteria in every square inch of the colon. New bacteria need to be fed to survive.

In general, healthy bacteria eat soluble fiber (contained in plants). When they digest the soluble fiber, they produce short chain fatty acids. Our cells that line the digestive tract then eat the short chain fatty acids. This relationship, including the stimulation of the GALT, is called “cross talk” and it is vital to our health and mutual survival. It establishes our initial immune response in the thymus. In fact, recent research suggests we should consider ourselves part of a collective of organisms rather than a host organism. These organisms actually modify our DNA and may even be the stimulus for evolution.

Unfortunately, we have taken what little we know of this complex relationship and commercialized it in the form of a daily probiotic. I estimate that 25% of my patient population takes probiotics daily despite my warnings. Just like vitamin C, vitamin D, and so many others, probiotics are not the cure all. However, the potential for harm is much higher with inappropriate use.

Take a probiotic after antibiotic therapy, chemotherapy, or radiation therapy. Take it short term. Limit your probiotics to Lactobacillus acidophilus and/or bulgaris unless advised otherwise by a health care professional. Test your probiotic to see if it is viable. When dissolved in orange juice, it should lighten the color within 20 minutes as the bacteria digest the sugar in the drink. If you suffer from dysbiosis, consult with a qualified nutritionist about taking any probiotic.