The scoop on probiotics

by Dr. Andrea Hilborn, ND

Originally published in the Kingston Whig-Standard

Probiotic supplements are everywhere now – should you be taking one? Let me help you decode some of the information about these microorganisms that have be shown to have wide-ranging health benefits.

A probiotic is a bacteria that lives in or on us that produces a beneficial effect. Bacteria are found all over our skin, in our digestive system- just about everywhere. Bacteria have recently been discovered in urine (which was thought to be sterile), and even in the placenta. Many foods contain beneficial bacteria: yoghurt, cheese, sauerkraut, and tempeh for example.

A probiotic supplement is a commercial product that contains particular strains of probiotics in a capsule, powder or liquid. Probiotic supplements are getting more diversified all the time. For example, you can now purchase probiotic vaginal suppositories, which are used to relieve the symptoms of vaginal yeast infections.

Probiotic supplements are not safe for severely ill or immunocompromised people.

lThe Lactobacillus species are the most common probiotic supplements, and the best-studied. They reduce the risk of antibiotic-associated diarrhea by 36-44%. Lactobacillus rhamnosus appears to be most effective at reducing this risk. The Lactobacillus species can aide in digestion of lactose and glucose, and treat urinary tract infections.

Bifidobacterium is another common group of species found in probiotic supplements. They are usually packaged with Lactobacillus, rather than being on their own, and have many of the same effects as Lactobacillus. In combination, Lactobacillus and Bifidobacterium species can reduce the frequency of respiratory tract infections, by a surprising 42%.

Saccharomyces boulardii is actually a fungus, rather than a type of bacteria. Saccharomyces reduces the risk of Clostridium difficile by 61%.

Escheria coli NISSLE 1917 is a beneficial type of E.coli. It alters the immune response of intestinal cells, decreasing the effects of inflammatory bowel disease. It has also been genetically modified to deliver molecules that promote wound healing and inhibit the attack of HIV.

Studies are currently underway examining the possibility of creating a probiotic cocktail from a healthy person, to give to a sick person. The 'fecal microbiota transplant' is delivered by enema. Providing a complex mix of probiotics this way may help treat inflammatory bowel disease and recurrent C. difficile.

Our understanding of probiotics is in its infancy. We are starting to see that calling a type of bacteria good or bad may be too simplistic. Helicobacter pylori is associated with stomach ulcers. We thought for sure that it was a bad bacteria. Now we know that less than 20% of people infected with H. pylori will go on to have serious consequences.

Vegans and vegetarians should use extra care in choosing a probiotic. Some contain fish meal and many contain milk ingredients.

In my practice, I only recommend a probiotic if there is a specific symptom I am trying to treat, as opposed to advising people to take them even if they are completely healthy. In my opinion, if you are healthy, your bacteria are probably healthy. If you are ill, your bacteria probably suffer. Fixing your bacteria with a probiotic may help your health, and getting healthy probably creates a good environment for healthy bacteria to grow in. It's a chicken-and-egg relationship.