• Nishtha Patel IFMCP

Probiotics: Why We Need Them and Choosing the Right Ones

Hippocrates said ‘all disease begins in the gut’ nearly 2,500 years ago and only now are we beginning to understand how the gut works and why it is so important to our general health.


The microbiome


Our bodies are made up of trillions of colonies of bacteria known as the microbiome, which is an invisible ecosystem made up of microbes such as bacteria, viruses, fungi, and protozoa.


The microbiome is found in several areas of the human body, including our gut, skin, liver, eyes, mouth, nose, reproductive tract and belly button. It contributes to a whopping 50 percent of our cellular makeup and is thought to be responsible for a wide range of functions including immune response, mood, and appetite. 


Although we don’t yet fully understand the complexity of the microbiome, one thing scientists do know is that there appears to be an interchangeable link between diversity of the gut bacteria and the susceptibility to disease. If the balance of beneficial bacteria is optimal, they can help keep the pathogenic (disease-causing) microbes under control, support the immune system, produce vitamins B12 and K2, and also create enzymes that destroy bad bacteria. When you have an abundance of good bacteria it can help crowd out the harmful bacteria and maintain an equilibrium in the gut. When these bad bacteria are in excess, this balance is disturbed and we end up with what is known as ‘dysbiosis’. Dysbiosis is thought to be associated with several diseases including cancer, inflammatory bowel disease, obesity, and possibly some autoimmune diseases.


Many different factors can contribute to dysbiosis, including diet, lifestyle, stress, food choices, medication (such as antibiotics, NSAID and corticosteroids), alcohol and recreational drugs. The environment we live in can also contribute to the composition of the state of the microbiome, for example, living in a damp home or living with high levels of stress. One way we can help restore dysbiosis in the microbiome, or also to keep it healthy, is by supplementing with probiotics. However, it’s important to note that not all probiotics are the same.


So, what are probiotics? 


Probiotics are live beneficial bacteria and yeasts that live in your intestines and digestive tract. They help to support the body’s ability to digest and absorb nutrients, as well as fight infections and prevent certain diseases. They are essential for keeping the gut balanced and promoting a healthy microbiome.


Live bacteria can be naturally found in certain fermented foods such as kefir, yogurt, and sauerkraut. However, for a standardised and therapeutic dose of live bacteria it would be worth looking at supplements that can be purchased in some pharmacies or health food shops. Most come in the form of capsules, sachets or liquids.


What to look for when choosing a probiotic


1. One that is able to survive the harsh environment of the stomach acid and colonise the gut.


The stomach is naturally designed to be acidic as it needs to be able to break down solid food in order for it to be properly digested, whilst also keeping bacteria away from our sensitive digestive system. The challenge is keeping the ‘good bacteria’ in the supplement without it dying in the harsh environment of the stomach. Certain beneficial species are naturally resistant to stomach acid. These include Bifidobacterium and Lactobacillus. 


2. One that contains live bacterial cultures, which should clearly be stated on the label.


The label should reveal the genus, species, strain and colony forming units (CFUs) of the probiotics at the time of manufacturing. For example, the bottle should read something like: 


Lactobacillus, bulgaricus, LB-51 super strain, 5 billion cfu


There is a lot of confusion about genus, species and strains. These are the names used to identify the bacteria.


The genus is the first word in a bacterium’s name; it’s the large group to which the bacteria belongs. In the example above it would be: Lactobacillus. The species is the type of individual bacteria (i.e. bulgaricus). Some bacteria have several strains, or differentiations of the species, and this is identified by the last part of the name (i.e. LB-51).


Now, CFUs may sound like something alien but these are simply the number of live bacteria you get per dose. Higher doses will provide more therapeutic levels of live bacteria. For daily maintenance, you might want to use around 10-20 billion, however, if you suffer with dysbiosis or have recently had a round of antibiotics you may want to supplement with higher doses, such as 75-100 billion.


3. A probiotic supplement with an ‘International Good Manufacturing Practice’ certification (cGMP).


This will ensure that you are receiving the highest quality probiotic that meets unequalled standards. This also guarantees that the product has been tested for potency and safety in all stages, from the culturing of the bacteria through to the printed expiration date. 

The two companies that I trust and recommend are Natren and Microbiome Labs. Both companies manufacture premium quality probiotics made from natural ingredients - without genetically modified organisms (GMOs) - and follow good manufacturing guidelines to ensure their products are superior quality.


Different strains of probiotics


Research has shown that certain strains seem to be more effective than others for supporting specific conditions. Therefore, you may get better results by taking probiotics that have been shown to achieve specific effects, such as controlling constipation and diarrhoea.

Probiotics that may improve constipation include B. longum, S. cerevisiae and a combination of L. acidophilus, L. reuteri, L. plantarum, L. rhamnosus and B. animalis. Strains that may be effective for diarrhoea included L. rhamnosus GG, L. acidophilus and L. bulgaricus. Specifically, Lactobacillus bulgaricus DDS-14 is a potent strain capable of antibiotic action against numerous harmful bacteria including E. coli and Staphylococcus aureus (bacteria responsible for causing serious infections such as UTIs). On the other hand, Lactobacillus Bulgaricus DDS-13 is a weak, ineffectual strain with none of the above capabilities. 

Prebiotics and why you need them


Prebiotics are found naturally in plants like Jerusalem artichokes, chicory, garlic and onions. They are made up of fibres that help to feed the good bacteria in your gut, so that they can work more efficiently. Using a garden analogy, prebiotics act like a fertiliser for the probiotics. 


The best way to ensure you have a healthy and diverse microbiome is to eat a diet consisting of a variety of fruits, vegetables, whole grains, and fermented foods and supplement when needed.

If you need more specific information on probiotics I would suggest that you book in with a nutritionist or functional medicine practitioner who would be able to guide you on specific strains, brands and dosages for your personal requirements. This is particularly important if you have gut dysbiosis and issues such as small intestinal bacterial overgrowth because in some cases probiotics can make you worse.

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