It has been shown beyond doubt that an unbalanced gut microbiome can lead to a condition called Dysbiosis, which in turn can be the cause of a whole range of disorders like Diarrhoea, Irritable Bowel Syndrome (IBS), Inflammatory Bowel Disorder (IBD), Chronic Fatigue, Brain Fog, Abdominal Pain, Anxiety, Depression, Itchy Skin and many others. I have to mention that these conditions are strictly speaking not categorized as a “diseases” but a “functional disorders”, but that distinction means little to the person suffering from it and probiotics can still treat it. Dysbiosis itself can be caused by certain medicines like antibiotics, sudden changes in diet, toxins in your environment, too much alcohol, stress and anxiety.
Look, the whole gut environment is a very complex and as yet scarcely understood system and disorders in it are not discrete and easily identifiable. Treatment is therefore also unlikely to be as simple as taking a pill for a single symptom. People live such varied lives, and conditions leading to imbalances vary accordingly. What you eat and drink, how and if you exercise, how you handle stress, what toxins are present in your environment, what medications you are on, it all plays a role. Some people flourish on a vegan diet and some on a carnivore diet, and many on all the variations in between. What you eat (and don’t eat) will need to be part of your therapy. But when things go wrong it’s likely that taking probiotics will be beneficial to you and play a large part in your recovery.
Treating conditions related to gut imbalances with pharmaceuticals may bring immediate relief of specific symptoms but they do not address the cause, which is the imbalance of good vs pathogenic bacteria in the gut itself. When you have symptoms of pain for instance it may be necessary to take pharmaceuticals in the short term to relieve the pain, but you should definitely start addressing the dysbiosis itself by re-establishing the balance of good versus bad bacteria in you gut.
Top up on the good bacteria
Although the functioning of probiotics in the gut and supplementing them has not received the same attention as pharmaceutical research, the growth of the probiotics industry is an indication that more and more people are using them, and this is increasing the amount of research on probiotics and their benefits. Currently probiotics are not regulated like medicines in either the USA or Europe, but it’s use is fast increasing as the gut/brain interface and its relationship to physical and mental disease is being researched and better understood.
In theory increasing the number of good bacteria in the gut will decrease the pathogenic ones because they actually kill them. It has been shown experimentally that one of the good ones, Lactobacillus plantarum, reduces the populations of high gas-producing (bad) bacteria like Veillonella and Clostridia in the gut. This is preferable to trying to kill the bad ones with pharmaceuticals because almost all medicines have other unpleasant side effects which may worsen your dysbiosis.
Probiotics available on the market can be made up of a variety of beneficial strains which seem to improve specific health conditions such as general gut health, improving your immune system, relief for IBS and IBD, recovery after antibiotic use and so on. However trials have conclusively shown that a combination of strains are more effective than single strains. Research is still lacking to conclusively link specific probiotics to the successful treatment of specific conditions. However clinical trials on some products have shown that a variety of strains together can be an effective treatment for many disorders. The higher the diversity of good bacteria the better for your health, just like a variety of foods is better for your health.
Although there are hundreds of good bacteria strains in our guts and the exact mix differs from one person to the next, a number of strains are commonly grown and included in probiotic products.
Common probiotic strains in supplements
The two main types of probiotics found in supplements are Lactobacillus and Bifidobacterium. These are common to most people and are generally present in greater numbers. This is not a complete list but the following types may often be found in probiotic products:
- Lactobacillus plantarum:
Commonly used because it is of human origin and abundant and survives in the human gut. It is also easy to grow. It has significant antioxidant properties and also helps to regulate gut permeability. It helps to suppress the growth of gas-producing bacteria in the intestines and is beneficial for people suffering from IBS. It is useful for establishing and maintaining microbial balance and stabilizing digestive enzyme patterns. Experiments have shown that it can increase hippocampal brain derived neurotrophic factor, which means it may have a beneficial role in the treatment of depression. They are present in yoghurt, meat and some fermented plant foods.
- Lactobacillus acidophilus:
This probiotic can improve general gut health by restoring and maintaining microbial balance, preventing overgrowth of pathogenic bacteria, protecting the gut lining and supporing the immune system. In combination with other probiotics and prebiotics it can help lowering cholesterol, reducing the symptoms of IBS, fight colds and flu, treat vaginal infections and assist with weight loss. It is present in many fermented foods.
- Lactobacillus casei:
This is the dominant bacterium used in fermentation of cheddar cheese and fermented Sicilian green olives. It is also widely used in the dairy industry. As a probiotic it can help with treating antibiotic-related diarrhoea, especially in children, as well as inhibiting the growth of ulcer-causing pathogen Helicobacter pylori in the gut.
- Lactobacillus rhamnosus:
This bacterium is commonly found in the human gut where it is able to persist naturally. It is also found in female reproductive systems. As a probiotic it can help with different kinds of diarrhoea including traveler’s diarrhoea, antibiotic-induced diarrhoea and rota virus diarrhoea in children. It helps to balance the gut microbiome and has been shown to establish a harmless relationship with Helicobacter pylori by competing with it for substrate and binding surface on the gut lining.
- Lactobacillus salivarius:
Generally present in the gut, this bacterium is effective in suppressing a range of pathogenic bacteria. As a probiotic treatment in combination with other strains it can treat IBS and bacterial overgrowth in the small intestine, and has been used in the treatment of pancreatic necrosis.
- Lactobacillus reuteri:
This bacterium is the most prevalent Lactobacillus species in the gut of healthy mammals and birds. It produces a natural broad-spectrum antibiotic which is effective in fighting pathogenic organisms (bacterial, fungal and protozoic) in the host. Although not present in the gut of all humans it can effectively colonize the gut after oral intake. It can treat a variety of diarrhoea diseases in adults and children. It has been shown to improve dental health and is considered by some to be the most effective probiotic against intestinal infections.
- Lactobacillus paracasei:
This bacterium is able to survive the gut environment better that some others and helps with digestive function, boosting the immune system and energy levels. One study even showed that the strain could be helpful for fighting infections.
Once in the body, L. paracasei moves into the gut, where it, like other strains, starts to work its magic. Research suggests it could be a natural approach for infant diarrhea and because of this, some infant formulas already contain this probiotic strain. There’s also a promising study examining its effectiveness for relieving symptoms of chronic fatigue syndrome.
- Bifidobacterium bifidum:
This is one of the first bacteria to colonize the gut of breast-fed children, and is associated with maintaining good health in children. Prevalence decreases with age but supplementing it as a probiotic has shown to be effective in balancing the gut microbiome, treating diarrhoea and assisting with the digestion of food and the uptake of vitamins and minerals from food. It is often used as part of a mix of strains in probiotic supplements.
- Bifidobacterium lactis:
As a probiotic this bacterium can assist with iImmune system modulation. It also helps with balancing the gut micrbiome and relieving the symptoms of IBS and diarrhoea. A particular strain of B. lactis, known as HN019, has been shown to have a significant impact on people with metabolic syndrome. It can improve dental health and help to regulate blood sugar levels.
- Bifidobacterium breve:
This bacterium forms a major part of the microbiome in the colon of breast-fed babies. It decreases with age but can be supplemented as a probiotic. It has strong anti-inflammatory qualities. It can assist with treatment of gastro-intestinal disorders like IBS, IBT, antibiotic induced diarrhoea and intestinal irritation. It can strenghthen the immune system and is a strong suppressor of the pathogenic fungus Candida albicans.
- Bifidobacterium infantis:
This bacterium alters the balance of several types of bacteria in the GI tract in ways that may help reduce inflammation.
They are thought to have actual physiological effects on GI tract and helps with gut conditioning. They improve the gut environment, suppresses gut putrefactive substances, and improves the fecal properties and defecation state (remission of constipation or diarrhea). They produce acetic acid with a strong bactericidal action, which impedes the growth or colonization of harmful bacteria within the colon. It also helps to modulate the immune system.
Some lesser known probiotics include:
- Streptococcus thermophillus:
The mention of the word “Streptococcus” may conjure up some vivid images of terrible disease-causing pathogens; however this particular species is benign and very useful. It is commonly used in combination with other bacteria in fermented milk products. It can survive high temperatures which makes it useful for that purpose, and for the same reason can be useful in the human small intestine, where it is also able to survive anaerobic conditions. Its use as a probiotic is a fairly recent development and it is usually used in combination with other probiotic organisms like Lactobacillus species. There is evidence that it assists with lactose intolerance, IBS and supporting the immune system.
- Enterococcus mundtii:
This is also a new addition to the probiotic stable of products. It can survive very acidic and hot conditions and may have beneficial properties as a probiotic. They can produce anti-microbial compounds but are themselves resistant to antibiotics. They rarely have pathogenic effects on humans outside of hospital environments but there are some safety concerns about their application as probiotics. For the moment it might be safer to avoid products that contain it.
- Saccharomyces boulardii:
Saccharomyces boulardii is in fact a nonpathogenic yeast that has long been prescribed for years for treatment of diarrhoea diseases caused by bacteria. Importantly, it has demonstrated clinical and experimental effectiveness in gastrointestinal diseases with a predominant inflammatory component, indicating that this probiotic might interfere with cellular signaling pathways common in many inflammatory conditions. It has also proven effective in Candida albicans fungal overgrowth.
Things to consider when taking probiotics
There are a number of things to look at when buying probiotics products from different manufactures, as they are not all the same:
- The minimum effective dose (MED) is considered to be 10 billion CFU (Colony Forming Units). Many products have less than this. Some probiotic organisms are better at surviving the journey through the acidic stomach environment and the bile in the gut, but generally the higher the number of CFU’s the better.
- The organisms in the products must be alive when taken. It is possible that many of them die from the date of manufacture until the time the product it taken. Make sure that the product guarantees the minimum live number of CFU’s until the expiry date. Don’t use the products after the expiry date, they may be ineffective by that time.
- Die-off of some organisms may be accelerated at room temperature. Keep probiotics in the refrigerator to ensure they stay alive.
- Although many studies focus on the effects of single organism probiotics, evidence has been found that combinations of organisms have a synergistic effect and may be more effective.
- Avoid products that contain things that you know or suspect you may be intolerant to like gluten and dairy.
Best probiotics for gut health
While the following list is by no means complete or definitive it provides and idea of what research has so far shown. Levels of effectiveness vary between studies and the parameters between studies also vary. While specific probiotics may prove to be effective or not for specific conditions under different conditions, general consensus is that at least they are not harmful.
|General Digestive Health
Diarrhoea (including caused by antibiotics)
| Lactobacillus plantarum
|Combatting Helicobacter pylori|| Lactobacillus rhamnosus
|Fungal infections|| Lactobacillus reuteri
|Pancreatic necrosis||Lactobacillus salivarius|
|Regulating blood sugar||Bifidobacterium lactis|
|Regulating cholesterol||Lactobacillus acidophilus|
|Dental health|| Lactobacillus reuteri
|Chronic fatigue|| Lactobacillus paracasei
The gut is a very complex environment and how well it functions has a broad range of effects on our health. To complicate it even further no two people’s guts are the same. It is a complex ecosystem where many good and bad (for us) microscopic organisms live in an ever fluctuating balance with each other and us.
There is a growing awareness that human health may be intricately linked with what goes on with those ecosystems living inside and with us. Modern lifestyles, stress, processed food and toxins can cause imbalances in our gut microbiome and have far ranging effects on our physical and mental health.
While correcting those lifestyle issues is necessary to put us back on a healthy path permanently, probiotics can be an important tool to achieve that. They are generally considered harmless so can be taken without undue ill effects as supplements.