Conscious Choice: Probiotics

August 1999

Probiotics

Nourishing Our Friendly Flora

by Laura Hoofnagle

For some of us, especially those trapped in traditional Western medical modes of thinking, bacteria is a dirty word. Bacteria cause disease, right? Hence the antibacterial hygiene products and antibiotics our society consumes in ever-growing quantities.

Wrong. Some bacteria cause disease, others, if nourished properly, can go a long way toward preventing it.

By the time we are four days old, our digestive systems are loaded with bacteria. Because the stomach is highly acidic, most bacteria settle in the small and large intestines, and are present in particularly large quantities in the colon.

Under normal circumstances, bacteria in the digestive system live in balance and harmony, but factors such as poor diets and overuse of a variety of medications can throw the system off balance and lead to a host of difficulties. Proper protection and nourishment of our healthy bacteria, then, are very important to good overall health.

What are probiotics and what do they do?

It has been said that there are more bacteria in our digestive systems than there are cells in our body. The colon alone contains trillions of bacterial cells. Bacterial cells can be classified in one of four hundred to five hundred types — both healthy and dangerous. Twenty types make up three-quarters of the total and are present in large amounts.

The two strains of bacteria recognized as most important to health are lactobacilli and bifidobacteria. Lactobacilli (which include lactobacillus acidophilus and lactobacillus casei, among many others) are concentrated in the small intestine and bifidobacteria reside primarily in the large intestine — mainly the colon. Our relationship with these bacteria can be described as symbiotic — we provide them with warm dark environments where they can flourish, and they provide us with disease protection and improved health.

The Anti-antibiotics

It is now known that where antibiotics are concerned, it is possible to have too much of a good thing. Harmful bacteria are shrewd and wily organisms, and over time will mutate until they become resistant to the particular strain of antibiotics which formerly kept them under control. Overuse and misuse of antibiotics actually encourage the mutation process, since they in effect give the harmful bacteria "practice" at resisting substances they must "learn" to overcome.

Probiotics go a step further (and in the opposite direction) than antibiotics, in a gentler and more discerning way. While antibiotics mow down every organism in their path, probiotics support the growth of good, healthy probiotic bacteria, which then can not only fight but actually prevent the growth of harmful microorganisms, whether old, new, or mutated. Probiotics produce natural antibiotic compounds or bacteriocins, proteins that kill a much narrower range of organisms — and are often more lethal to the harmful ones — than commercial antibiotics. Probiotics can also stimulate the immune system’s production of white blood cells.

A three-pronged defense

Probiotic bacteria form a protective barrier that helps prevent noxious compounds (e.g., clostridia, E. coli, salmonella, shigella and candida albicans, a form of yeast) from attaching to intestinal walls and being absorbed. In healthful quantities, they can crowd out the offending pathogens or cover the areas of the intestinal walls to which the pathogens are fond of attaching. Or the healthy bacteria can "starve out" the harmful bacteria or fungus so that they have no choice but to pass through and out of the intestinal tract. (For example, probiotics like lactobacilli and corynebacteria are responsible for metabolizing glycogen and glycose, sugars that are favorite nourishments of candida.) This crowding or starving out process is known as competitive exclusion.

A third defense probiotic bacteria provide against unhealthy intruders is a lowering of the intestinal pH. Probiotics produce several types of acids (including lactic, acetic, and formic), which discourage harmful organisms that thrive in alkaline environments, a main offender of which is, again, yeast.

Digestive and nutritional helpers

Some probiotic bacteria produce lactase, an enzyme which helps alleviate symptoms of lactose intolerance. Most, including l. acidophilus and lactobacillus bulgaricus (a transient probiotic that can be found in yogurt and does not live in the intestines but merely passes through and helps normalize the environment) secrete lactic acid, which aids in the absorption of important minerals such as calcium, copper, iron, magnesium, and manganese.

Fiber helps probiotics to thrive. The end product in probiotics’ breakdown and processing of a good high-fiber diet is short chain fatty acids (SCFAs) which are absorbed and used as energy in the colon. One such SCFA, butyrate, nourishes and energizes colonocytes, cells that make up the colon’s lining. Increased butyrate has caused marked improvements in many cases of colitis, and it is now thought that healthy colonocytes are linked to decreased chances of colon cancer.

Probiotics also can help prevent or decrease food sensitivities and other discomforts resulting from "leaky gut" syndrome. Many reactions that are initially thought to be incurable food allergies are actually food sensitivities, manifestations of "leaky gut" syndrome, which occurs when partially digested food particles (along with toxic molecules and disease-causing bacteria) are allowed to pass through damaged intestinal lining.

The poorly digested food particles activate antibodies and, in turn, white blood cells, which perceive the food particles as a foreign invader and threat. The battle between the white blood cells and the food particles produces oxidants, which cause irritation and inflammation, often in areas far from the original intestinal permeation. Each subsequent time the food is eaten, similar irritations and inflammations occur.

Treatment for "leaky gut" syndrome (once it has been diagnosed by a comprehensive digestive analysis) includes a full regimen of probiotics, along with enzymes and amino acids, to rebuild the weak intestinal walls. Proactive probiotic supplements and dietary improvements, of course, can prevent "leaky gut" in at-risk individuals, usually those with high-fat, low-fiber, high-stress, low-exercise lifestyles.

Improved liver function is another benefit linked to probiotic use, since the liver has fewer toxins to deal with if the probiotics are working. Another gain is the reduction of serum cholesterol, because probiotics convert cholesterol into a less absorbable and more eliminatable form. But that’s not all. Benefits also include along with lowered blood pressure and normalized hormone levels.

In addition, probiotic bacteria produce vitamins like vitamin K, vitamin A, B vitamins one, two, three, and 12 (thiamin, riboflavin, niacin and cobalamine), biotin (a B-complex vitamin), and folic acid. The acids produced by probiotics also can speed the removal of elements which may be toxic or even carcinogenic. It has been suggested in some studies that a lower stool pH is associated with a decreased risk of colon cancer, and alkaline (basic or non-acidic) stools can be an early warning sign.

Protection from surprise invaders

Friendly flora help increase our resistance to food poisoning, too. Like other disease-causing bacteria, food poisoning compounds such as salmonella are hampered not because the probiotic organisms kill them, but because probiotic bacteria make their intestinal homes too acidic for the microbes to survive. Lactobacilli have been shown to be very helpful in the prevention of another unexpected invader — travelers’ diarrhea or Montezeuma’s revenge. Individuals traveling to foreign countries should place themselves on a generous regimen of probiotics, so that the intestinal tract is in optimum condition to cleanse itself of the new and strange bacterial invaders it will certainly encounter.

How can we keep a healthy balance?

High-fiber diets are important to probiotic nourishment and overall digestive health, and should also include yogurt — try to find an organic or minimally processed brand that contains live, active cultures such as lactobacillus acidophilus or lactobacillus bulgaricus. (L. acidophilus can also be purchased in dairy-free supplement form for those who are dairy-free or lactose intolerant.)

Things to avoid

Deficiencies in probiotic bacteria are often the result of a lifetime of less-than-healthy health practices. The long-term effects of overusing antibiotics have already been mentioned. Aspirin, as well as non-steroidal anti-inflammatory drugs like acetaminophen and ibuprofen can be overused and cause deficiencies in probiotic bacteria. Steroidal medications like cortisone and prednisone can deplete beneficial bacteria, as can oral contraceptives, large amounts of sugar or alcohol, and stress. Often these factors are not implicated until a patient sees a natural health practitioner with a serious complaint. Individuals with an eye on long-term health can decrease their risk of serious digestive or digestion-related problems by keeping the above mentioned factors to a minimum and by making sure probiotics are present in healthy quantities, often with the help of probiotic supplements.

How to take supplements

Different sources recommend different amounts of probiotic bacteria to create an optimum digestive environment. On the average, a good maintenance dose contains 1 to 2 billion lactobacilli and 1 to 2 billion bifidobacteria once a day (one-quarter to three-quarters teaspoon or one to four capsules of each type). Three times this amount is recommended for therapeutic purposes, but of course, the strength of the therapy also depends on the severity of the problem — check with your health practitioner when dealing with serious cases. Different strains of probiotics should be bought and stored separately, but can be taken together.

Take your supplements on an empty stomach or between meals with a full glass of water in order for them to travel down and reach the lower intestinal tract, unless you are taking them for the express purpose of aiding digestion, in which case they should be taken with meals.

During antibiotic therapy, a good dose is between 6 and 25 billion total viable probiotic cells per day. They should be taken as far away from the antibiotics as possible (for instance, if the antibiotics are to be taken every eight hours, the probiotic supplements should be taken four hours after the antibiotics). Probiotic therapy should be continued a week to a month beyond the antibiotic treatment period to replenish any beneficial bacteria lost during antibiotic use. Probiotic use should not interfere with the effectiveness of antibiotics.

The gas and bloating you may feel during the initial phase of probiotic therapy is normal, and is the only effect of probiotic supplement use that can really be considered a side effect. It is caused by the breakdown of the harmful bacteria and fermentation of the good. If gas or bloating are particularly unpleasant, reduce the amount of probiotics you are taking and slowly build up to the recommended dosage. This should make your digestive system more comfortable.

Store your supplements in dark cold places — liquid should always be kept cold. Freeze-dried products, if the freeze-drying is properly done, have significantly longer lives, and are a good choice if you expect your supply to last more than a few weeks. Powdered probiotic supplement containers should contain a small bag of desiccant, which is a not-to-be-ingested drying agent.

Pre-biotics

Fructo-oligosaccharides (FOS) which are sometimes referred to as pre-biotics, are linked molecules of fructose (which are indigestible by humans so have no effect on blood sugar) that feed, nourish, and increase probiotic bacteria, especially bifidobacteria. Some say pre-biotics alone are as good as probiotic supplements, since they increase the numbers of probiotic bacteria. FOS can be found in food like Jerusalem artichoke, onion, asparagus, garlic, chicory root, bananas, barley, wheat, rye, tomato, and asparagus root, brown sugar and honey, and of course in supplements. The average "healthy eater" who incorporates the abovementioned foods into the diet takes in about 800 mg. of FOS per day. The optimum recommended intake is two to three thousand mg. per day. Powdered whey protein (about one tablespoon in one-half cup of water one-half hour before a meal) also creates a supportive and nourishing environment for healthy bacteria in the large intestines and lower portion of the small intestines. A vegetable formation (made with plant fiber) is available for those who are dairy-free or lactose intolerant. Who would have thought that a little bacteria could do so much for so many?

So put down your Purell and take up probiotics. If you’re already healthy, they will normalize your gut, head off digestive disturbances, and reinforce your immune system. If you or your friends are ailing, they can help support treatments for illnesses ranging from diverticulitis to chronic fatigue syndrome.

Resources

Jensen, Bernard. Dr. Jensen’s Guide to Better Bowel Care. BJ International/Avery, New York, NY 1999.

Lipski, Elizabeth, M.S., C.C.N. Digestive Wellness. Keats Publishing, New Canaan, CT, 1996.

Mindell, Earl, R.Ph., Ph.D. Earl Mindell’s Supplement Bible. Fireside/Simon & Schuster, New York, NY, 1998.

Murray, Michael T., N.D. Stomach Ailments and Digestive Disturbances. Prima Publishing, Rocklin, CA, 1997.

Puhn, Adele. Healing from the Inside Out. Ballantine, New York, NY, 1998.

Tenney, Louise. The Natural Guide to Colon Health. Woodland Publications, Pleasant Grove, UT, 1997.

Wolfson, David N.D. "A Probiotics Primer" Nutrition Science News, Vol. 4, No. 6, June, 1999.

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