Digestion & GI health

Probiotics — for life!

by Marcelle Pick, OB/GYN NP

• How intestinal flora benefits your health
• Causes of flora imbalance
• Do you need probiotics?
• Choosing the best probiotic

Our health is supported by trillions of beneficial microorganisms that comprise our intestinal flora. When our intestinal flora thrive, we can, too. But when it is impaired or imbalanced, we become more prone to acute health problems IBS and other digestive problems, allergies and asthma, urinary tract and yeast infections, hormonal imbalance, obesity, and many others.

The good news is, there are many ways to support your intestinal flora, including probiotic supplements. But when looking for the best probiotics the choices can be overwhelming — so let’s talk about what you need to know.

The flora in your GI tract — it’s a jungle in there!

Scientists estimate that a healthy woman’s body is inhabited by 750 trillion bacteria, yeast, and other microorganisms, mostly colonizing the GI tract. These microflora make up three to five pounds of your total body weight, and their genes are estimated to outnumber your own by about a hundredfold! There is ample surface area for these microbes to colonize in your GI tract, but competition for real estate is high. Through a process of “competitive exclusion,” your body determines which bacteria take up residence.

There are complex differences among the different strains of microbes. Individual species can be both beneficial and detrimental depending on a number of factors, including life stage, mutation, location in your body, and presence of other strains. What’s most important is not so much the sheer number of bacteria, but the balance among them.

Over the millennia, we’ve evolved a mutually beneficial, symbiotic relationship with our microflora. As long as we provide a hospitable environment, they remain as paying guests, helping our digestion, metabolism, detoxification, and maintaining a balanced immunological response to potential allergens.

The benefits of bacteria: digestion, immunity, and hormonal balance

Individual microbial strains inhabit certain sections of the GI tract, where they digest certain sugars, proteins, or fats. Many species manufacture B vitamins and vitamin K, while others break down carbohydrates for energy and bioavailability of minerals. Good intestinal flora helps prevent bloating, gas, and yeast overgrowth by controlling the pH level, or acidity, of the intestines.

Friendly microbes also help prevent disease in several ways. They deprive invaders of nutrients and secrete acids that less friendly microbes can’t tolerate well. They also reinforce the mucosal barrier of the intestines, which block dangerous pathogens, toxins, and allergens and helps the immune system “learn” which ones aren’t safe. Some bacteria stimulate the immune system by increasing T-cell counts, while others produce natural antibiotic and antifungal substances.

Beneficial microbes metabolize and recycle hormones, too, including estrogen, thyroid hormones, and phytoestrogens. This facilitates proper hormonal balance, which can help offset symptoms of menopause and perimenopause, and may protect bone and breast health as well. They also detoxify drugs and harmful compounds, and some may have anti-tumor, anti-cancer effects.

What causes floral imbalance?

Intestinal microbes can die off by the millions with illness, stress, medication use, and poor diet, but what we eat is the most important factor in keeping the gut healthy. Good bacteria feast on fiber. The bad guys love refined sugar and animal fat.

Given a ready supply of vegetables, legumes, and whole grains, good bacteria live long and prosper. Polyphenols, found in foods like garlic, green tea and ginseng, are also helpful in fostering friendly microbes. Fermented foods such as miso, tempeh, soy sauce, and yogurt introduce active probiotic cultures that help wedge out unfriendly bacteria.

Certain foods contain nutrients called prebiotics that set the stage for probiotic survival. Prebiotics help probiotics survive passage through the acidity of the stomach and small intestine, and foster their growth in the intestines and colon. They may also lower cholesterol levels and stabilize blood sugar, and are associated with decreased risk for osteoporosis. Prebiotics include fructooligosaccharides (FOS), and inulin, which are natural sugars found in bananas, chicory root, onions, leeks, fruit, soybeans, sweet potatoes, asparagus, and some whole grains.

For many of us, however, diet alone is inadequate when we need to reestablish healthy gut flora. Remember, we are talking trillions of bacteria here! And age, poor diet, stress, disease, and drugs all take their toll on our intestines’ little helpers. If you’re entirely free of intestinal distress or other symptoms, your diet is probably keeping you balanced. But for most women, we recommend probiotic supplements.

Do you need probiotics?

How can you tell if your GI flora are out of balance? Here are some indications that you may need more friendly bacteria in your system:

• Symptoms of GI sensitivity (cramps, diarrhea, constipation, bloating, gas, IBS)
• Gluten sensitivity, sensitivity to sugar, or other food sensitivities
• Yeast infections, cold sores, thrush
• Urinary tract infections
• Headaches, migraines, stuffy nose, increased mucus production
• Joint aches
• Rosacea, acne, or other skin problems
• Other inflammatory conditions, like asthma
• Fatigue, irritability
• Chronic bad breath (halitosis)
• Increased symptoms of PMS, perimenopause, or menopause

(Note: Although these symptoms can indicate floral imbalance, they can also indicate more serious conditions. See your healthcare provider with any ongoing concerns.)

I also recommend probiotics during cold and flu season, and to help prevent food poisoning and parasites while traveling.

In addition, probiotics should be used when you’re taking antibiotics, and for at least two weeks afterwards. Antibiotics can be life-saving and absolutely essential — when used judiciously — but it’s so important to help the good bacteria grow back once the bad strains have been decimated. People with compromised immune systems, however, should consult an experienced healthcare provider when using probiotics.

How to choose a probiotic supplement

Probiotics come in a wide range of formulations, from encapsulated beads and powders to enteric-coated capsules and liquid functional foods. Most women prefer powdered probiotics in capsules that do not require refrigeration. We recommend buying smaller quantities more frequently to help guarantee the most active cultures, and keeping them in the refrigerator — unless it means you forget to take them.

The best general purpose probiotic supplements combine several beneficial bacteria with a competitive yeast. Look for supplements that contain Saccharomyces, Lactobacillus acidophilus, and bifidobacteria in the billions. Certain brands feature every probiotic organism ever described, or tout zillions of CFU’s (colony-forming units) per dose. But more is not always better when it comes to probiotics — the concern is that too many active organisms could produce the very symptoms we seek to alleviate.

The probiotic you choose should also include a prebiotic, such as FOS or inulin, to help the flora survive the acidic environment of the upper GI tract. We prefer inulin, as it’s a precursor to FOS and may have a less “sugary” effect on women who are prone to yeast infections. Some probiotics have an enteric coating, but we don’t consider this feature necessary as long as a prebiotic has been included in the formulation.

One additional concern is the way a probiotic has been manufactured. Be sure that you’re buying a supplement made in a GMP-compliant facility that is certified by the NSF, which helps ensure product purity, safety, and quality.

Naturally, the bottom line for a probiotic is how well it works. You should begin to feel a difference within a week or two but if not, I would encourage you to try a different variety, combination, or brand. Each woman’s body is a little different, and hence has its own ideal microfloral balance. These supplements are remarkably safe, so it’s okay to experiment. Just be sure to give it a couple of weeks to show benefits.

Because so many of our patients and Personal Program Members have asked us to recommend a probiotic supplement, we decided to formulate our own. Called Balanced Biotic, it has all the characteristics outlined above and, in our medical opinion, is an ideal probiotic supplement for women.

There are few probiotics of such high quality on the market today, but whether you choose ours or another brand is not as important as whether it works for you. Just make sure any probiotic you buy has the qualities listed above, and make sure you feel a difference.

Probiotics can’t do it alone

Probiotic use is generally safe, simple, and effective, but it’s no substitute for good overall health practices. Probiotics supply the flora, but you need a solid foundation of nutrition for those microorganisms to flourish and to be able to take advantage of the potential health benefits they can provide. That’s why we recommend probiotics as part of a combination approach that includes lifestyle and dietary changes, as well as a daily, high-quality multivitamin/mineral. It’s also why we offer our own probiotic only to Members of our Personal Program, who are already taking pharmaceutical-grade multivitamins.

When used alongside a healthy diet and nutritional supplements, probiotics can make a real, sustained difference in your long-term preventive health. So take a tip from the microscopic organisms living in your own body and pay attention to the little things! Sometimes they can turn out to be the most important of all.

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References & further reading on probiotics

 

Original Publication Date: 04/17/2006
Last Modified: 02/16/2010
Principal Author: Marcelle Pick, OB/GYN NP