February 1st, 2021

Help Your Microbiome

1) Eat a very diverse diet that is predominantly plant based
2) Emphasize the ingestion of fiber based complex carbohydrates
3) Eat food that is the least processed and as fresh as possible
4) Avoid foods that are known to cause intestinal distress, extremes of bowel function including diarrhea and/or constipation. This includes food allergies and sensitivities


5) Avoid foods that contain antibiotics and pesticides that could harm resident beneficial bacteria

Probiotics - the next adjunctive piece of a healthy intestinal recovery after starting a high quality diet.

Probiotics are bacterial microorganisms that confer a health benefit to the host upon ingestion and have been well shown through studies to have diverse disease modifying effects. Probiotics can be delivered in a food based form as in kombucha, kefir, kimchi, sauerkraut or as a concentrated capsule of various microbial species.

Most commercially available probiotics are a restricted snapshot of the diverse microbes that reside within us. The two main strains of bacteria commercially sold as probiotics are from the genus bifidobacter and genus lactobacillus. They are but two of the many including escherichia, enterococcus, bacillus, streptococcus and many others. If you look at a PCR or polymerase chain reaction analysis of stool, you will find many different bacterial groups that provide many advantages and disadvantages based on the makeup. So in truth, when we discuss taking most commercially available probiotic products, we are talking about a small select group of beneficial microbes. Frankly, it is quite amazing that they are as useful as they are. The future will likely be a shift towards missing microbes that offer specific benefits based on an individuals health need as opposed to the current rudimentary approach of one size fits most everyone. That being said, what do we know about the current probiotic situation?

The best and most well studied application for probiotics is in the realm of antibiotic associated diarrhea. When we take antibiotics for an infection or a perceived infection, we disturb the makeup of the intestinal microbiome. This disruption allows potentially unhealthy species to flourish where once healthier ones resided. This change can make the intestine go through a period of inflammation and associated diarrhea. This can be short lived while taking the antibiotic or long lived in the case of clostridium difficile overgrowth post antibiotic use. The latter can be a life threatening condition in some. In all cases, the microbiome is disrupted for a period of time. The resolution back to normalcy can occur by the discontinuation of the antibiotic, promoting a strong whole foods plant based diet and the addition of targeted probiotics. C. difficile may require further therapy depending on the symptoms and persistence.

The best studied probiotic for antibiotic associated diarrhea is Culturelle GG. However, there are many others that can have the same beneficial outcome. The many types are beyond the scope of this newsletter, however, most contain lactobacillus and bifidobacter species. The probiotic effect is transient lasting weeks to months and generally recognized as safe. Remember from the January 4th newsletter that discussed how these microbes have many beneficial effects including immune modification, fatty acid production, microbial competition, and much more. These properties come to bear during the healing process.

Not everything is rosy however as there is a real but extremely rare risk of the probiotic turning pathogenic. This is an issue with any person with immune system deficiency including AIDS, congenital immune deficiencies, on chemotherapy or any drug affecting immune function or any cause of decreased immune activity.

Other applications for probiotics currently include inflammatory bowel disease, irritable bowel syndrome, necrotizing enterocolitis, acute gastroenteritis, milk protein intolerance and food intolerance in general. The differing probiotics available for each disorder are getting more and more specific and require a full fund of knowledge to help the consumer choose. It is no longer and really never has been a good idea to randomly use a probiotic without guidance.

Effective doses are increasing as the research has shown that higher multi billion range doses confer better advantages to the host. Multi strain probiotics are likely more beneficial if the dose is correct. This truth is still debated among my colleagues. The more diversity within the probiotic supplement the more likely you will receive more positive and varied health benefits. This also happens to follow the research that the more biodiverse a microbiome is the healthier the host. Think of a rainforest. Biodiversity is the key to communal survival. This happens to be a repeated theme throughout biology.

My take on probiotics is this: They confer a benefit in the right situation with the right complementary diet and lifestyle changes. If you use probiotics without any other health changes, you will throw away good money as the benefit will be minimal at best.

Therefore, I will repeat myself:

1) Eat a very diverse diet that is predominantly plant based
2) Emphasize the ingestion of fiber based complex carbohydrates
3) Eat food that is the least processed and as fresh as possible
4) Avoid foods that are known to cause intestinal distress, extremes of bowel function including diarrhea and/or constipation. This includes food allergies and sensitivities
5) Avoid foods that contain antibiotics and pesticides that could harm resident beneficial bacteria
6) Avoid all medicines and ingested toxins that are microbiome toxic - especially antibiotics and antacids
7) Exercise for 60 minutes daily as walking or any other activity you WILL do consistently
8) Stay mentally relaxed and learned

 Dr. M
Mekonnen Curretn Opinion in Biotech
Hempel JAMANetwork
Johnston Cochrane