How to choose the right probiotic for you
Probiotics are defined by the World Health Organisation as:” live microorganisms that, when administered in adequate amounts, confers a health benefit on the host” (Hill et al, 2014). They are also known as friendly bacteria.
They are often taken as supplements with gut health-boosting microorganisms.
Fermented foods are not probiotics although they do contain live bacteria that may have a probiotic like effect in our gut.
BENEFITS :
Traditionally probiotics have been used for the following:
a) With/post antibiotics to prevent diarrhoea associated with taking antibiotics . That is why doctors sometimes prescribe a probiotic supplement at the same time as an antibiotic. Better to take away from each others.
b) Improvement of immunity : probiotics can interact with your immune cells. Your gut is where most of your immune system is located. Evidence suggest that some probiotics, particularly the lactobacilli type can stimulate macrophage activity. A macrophage has the ability to locate and 'eat' particles, such as bacteria, viruses, fungi, and parasites.
d) IBS is one of the most popular research targets for probiotics : A Meta –analysis dated from 2018 – shows that particular types of probiotics are beneficial in reducing overall IBS symptoms and abdominal pains by decreasing visceral hypersensitivity which is believed to be one of the main contributing factors to IBS.
Probiotics may also help to modify gut transit time ie x 2 strains of bifidobacteria have been found to significantly speed colonic transit time.
However, the analysis did conclude that it was not possible to draw definitive conclusions about probiotic efficacy. due to the size of the study and inconsistent study design, strains, species and dose.
c) Prevent Dysbiosis and maintain intestinal barrier function
Certain types of probiotics may be able to strengthen the intestinal barrier by increasing mucous production in the gut. This is commonly called gut permeability.
They may also help by adding beneficial bacteria that balance the communities of bacteria in your gut microbiome. They can therefore compete with potentially pathogenic bacteria and fungi in the GI Tract for the limited space that is available. This is what we call the car park theory.
Other more recent applications: Inflammatory Bowel Disease, Lactose intolerance, Vaginal thrush, Endometriosis, Prevention of postpartum obesity,Prevention and treatment of atopic eczema,Anxiety, Depression,Small intestinal bacterial overgrowth (SIBO) prevention & treatment,Metabolic syndrome & type 2 diabetes,Obesity,Food allergies.
HOW TO CHOOSE A PROBIOTIC ?
The most popular microbes used in probiotic supplements are lactobacilli which can help maintain an acidic environment and support the immune system.
Also commonly used are bifidobacteria one of the first colonisers of the digestive tract. It is believed the play a role in the synthesis of vitamins minerals and amino acids as well as support immunity and health of the gut membrane.
S. boulardi is less known and is more beneficial to treat diarrhoea, it also has anti- candida properties, promote the growth of other beneficial bacteria , helps maintain the intestinal lining.
A common misconception is that probiotics re-seed our gut and that to be effective a probiotic must change the composition of the microbes living in our gut. However, typically probiotics do not take up residence. Instead, they pass through the gut, and interact with our immune system, our gut cells, dietary fibre and the microbes that live in our gut
a- The importance of choosing the right strain for the job
Probiotics are known by their genus, species and strain :
For instance:
Lactobacillus acidophilus LA5
Genus Species Strain
When looking for a probiotic is is very important to choose a strain that has been shown to be effective in studies for the specific condition you are dealing with.
Avoid products that uses ‘secret’ strains as I would see this as a red flag.
b- The dosage : Most successful probiotics research has utilised ≥10E+9 CFU per dose CFU is the colony forming units - the number of viable bacteria in the product. If you have a formulation with multiple strains, each strain must present the amount of ≥10E+9 CFU per dose. Less is likely to produce less therapeutic effects
c - The safety : Probiotics are safe for most people, but talk to your doctor if you are on immune compromising medications
For IBS: I have read studies that are showing that some Single or multi –strains can be useful. So again it does also depend on the individual but at least you can check the strains of bacteria and ensure that is is backed up by studies for either IBS-C IBS-D or both.
POTENTIAL DRAWBACKS:
There are many probiotics on the market with different levels and strains of bacteria.
The term probiotic is actually considered by the EFSA to European Food Safety Authority to be an unauthorised Health claim due to the lack of substantiated evidence.
The studies are too small , It is difficult to perform randomised control trials on one component of the diet. The success of probiotics also depends on how viable they are in the intestinal tract.
IN CLINIC :
I do use specific strains of probiotics in clinic that have been well researched and are suitable for my clients needs. It can also be trial and error to find the right probiotic that works for you as we are all different.
As previosulsy mentionned probiotics supplements are transient and it is therefore important that you also use diet and prebiotics rich foods to feed the bacteria that you are adding in.
Probiotics are usefull to use in clinic as from expereince they can give some relief to clients.
Fermented foods have also been shown to have a varied profile of bacteria that can change depending on the season, how long their have been fermented for and this is why when my clients are ready I like to incorporate those into their diet. Indeed, every batch of kefir or Kimchi will be made of different bacteria, eating those will in turn help to increase the diversity of our gut bacteria that we need to thrive. I believe that we will never be able to fully capture that diversity of nature in a man-made pill.