Probiotics: A tale of lemings and foxes

Probiotics have been quite the hot topic for a number of years now. For a hundred years, health conscious Americans have been aware of the beneficial effects of friendly bacteria, and for thousands of years, so have most traditional cultures, who have at least one fermented food that is considered to be pluripotent in its health-inducing effects.

Probiotics are healthy microorganisms--mainly bacteria and a few fungi--that live in our bowel. They have many important roles, the most capital of which is establishing a healthy immune system. This is much more far reaching than avoiding a cold now and again. Immune imbalances play a role in many disorders from autism to arthritis, from Crohn's disease to cancer. Probiotics also help digest our food and generate B vitamins. They also help prevent aggressive organisms from invading our gut, or worse, our blood stream.

Sounds like everyone should be taking probiotics, right? Normally, I would tell you to eat fermented foods, like yogurt, kefir and kombucha, which are rich sources of probiotics. And, I am telling you to do that. They are an important way of establishing and maintaining a lifelong healthy ecosystem within the bowel. However, if you have an immune imbalance, it will take more than eating these great foods to reverse the disorder. That is where probiotic supplements come in.

Unfortunately, the multinational food companies have co opted the revolution and corporatized it. I have been told by a reliable source in the industry that what is sold as kefir (Turkicized Arabic for "makes you happy") does not resemble the real McCoy any more than Trix flavored yogurt (I'm not making this up) resembles what Nana made in Crete.

Dannon has patented strains of probiotics and even renamed subspecies to include their company or product name to make you think that they poses some rare and exclusive line of proprietary strains of bacteria. So people rushed like lemmings to consume anything from cookies to chocolate that say "probiotics" on the label (Dannon has been fined $35,000,000 for making unsubstantiated claims on its products). I don't know if anyone has tested this, but knowing what we do about how difficult it is to get probiotics to adhere to the bowel when taken in powdered form, and made the right way, most of the enhanced foods are virtually useless for improving bowel function.

There are three reasons by people do not get good results with probiotics. First, they don't use high enough doses. According to the clinical trials, effective doses range in the billions, not millions. Second, they don't use the right strains. Most people don't realize that we have hundreds of different bacteria living in our bowel, and it varies by our age, the seasons, and individual metabolic needs and phases of life, such as pregnancy and menopause. Some of these organisms help us digest carbohydrates, others proteins, others make vitamins or do many of these tasks, so, choosing the right strain depends on understanding where the deficiency lies.

Don't even get me started on the foxes guarding the hen house. The New York Times had an interesting article about probiotics and how many of the experts on the panel had ties to major companies promoting probiotics. I will say though that the author of the article had a good point in that clinical studies to date have tested about 50 different strains of bacteria and fungi and have shown specific strains to be helpful for specific disorders and it may not be correct to generalize these effects to all strains or other disorders not studies. The point is that you can't just take "probiotics" for health any more than you would eat "food" for health. The food you eat depends on the health goals you have in mind.

The third reason people may not get good results with probiotics is that they don't use them long enough, or, don't transition from probiotics to fermented foods as a daily part of their diet once the symptoms have gone away.

In my clinic, using probiotics is part of a larger assessment of the terrain of the digestive system and the health of the other organs that effect or are effected by the bowels, such as the pancreas, the gall bladder, the immune system, etc. There are quick ways to asses dysbiosis--imbalanced microbial ecology in the gut--and specific lab tests, too. We look at the immune system, the endocrine system, inflammation, and many other factors that interplay in a subtle dance between the gut and the rest of the body.

Don't fall pray to foxes promising you a healthy gut with diet-antioxidant-probiotic-decaffeinated-rain forest-chocolate cola. It took time to enter a state of imbalance and good treatments give the body time to return to balance through measured and prudent treatments.

October is cancer prevention month, so for the rest of this month, I'll be blogging about cancer.