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Should you be taking probiotics?

By on June 25, 2019 in Columnist with 1 Comment
Jim Brown

By Jim Brown, M.D.

One of our readers asked me to write about probiotics. 

Probiotics are live organisms, usually bacteria, similar to the beneficial microorganisms found in our lower intestinal tract. 

Proponents of probiotics think they are useful in obtaining better digestive health, maintaining immunity and helpful for some of our ailments. 

Probiotics are obtained by eating probiotic foods, such as yogurt, or taking probiotic supplements. These supplements are obviously popular as the global probiotic supplement market is estimated to reach $40 million in 2019.

We humans are loaded with bacteria, most of them primarily beneficial. 

The human “microbiota or micro-biome” includes all the organisms including bacteria, fungi and viruses that live on or in our bodies including in the gut, vagina, in bodily fluids and on our skin. 

It is estimated the total microbes per adult human is 100 trillion or 10 times the total cells that make up our adult bodies. 

These are mind-boggling numbers. We have thousands of different bacterial species inhabiting us as part of our healthy physiology. 

Most people think of bacteria as harmful “germs” rather than a healthy part of our physiology. 

Probiotics include bacteria, primarily lactobacillus and bifidobacterium as well as some yeast products.

Our natural balance of flora can be altered negatively by taking antibiotics intended to kill harmful bacteria, but as a side affect they also can kill our good bacteria. In that case, probiotics are potentially useful in restoring our natural bacteria balance. 

Taking antibiotics is not the only way our bacteria can be adversely changed. Our natural bacterial balance can be altered by excessive sugar intake (bacteria love sugar), lack of exercise and lack of sleep, as well as smoking. 

Chemical residues in foods can potentially disrupt the natural balance of our gut bacteria as well, which is another good reason to consider focusing on eating organic foods.

A probiotic healthy diet provides consistent complex carbohydrates, fiber and fermented foods. 

“Prebiotics” are fiber sources including legumes, beans, peas, oats, banana, beans, asparagus, garlic and onions that are also good food resources for our “healthy” gut bacteria. 

Probiotic foods include yogurt, especially Greek yogurt, as well as many foods that are fermented, usually using lactobacillus bacteria. 

In consuming yogurt with probiotic content, look for the label “Live and Active Cultures.” Many yogurt products are popular because of the high sugar content. They may be tasty, but in my view, the sugar kind of defeats the purpose. 

Lactobacillus plays an important role in the manufacture of fermented vegetables, pickles, sauerkraut, sour dough bread, some sausages and some wines. Other food sources of probiotics are kimchi, kombucha tea, kefir, non-pasteurized pickles and other pickled vegetables. If they are pasteurized, the good bacteria in them are killed. 

Lactobacillus has been used to help some digestive disorders including irritable bowel, upset stomach problems, bloating and excessive gassiness.

As I said, probiotic supplements are big business, but my question is: are they really that good for you or worth the cost? 

My major concern about these expensive and profitable supplements is they are not regulated, even in the United States. Our FDA will not approve of dietary supplements that claim to treat, mitigate or prevent disease. 

No probiotics supplements have been approved by the FDA for therapeutic purposes. In addition, the FDA does not even have a definition of probiotics but is currently considering a way to characterize them. This might help in reducing the unsubstantiated claims made by sellers, distributors and manufacturers of probiotic supplements. 

Manufactured supplements have been shown in some cases to be produced in less than optimal regulated conditions. Many are manufactured in countries outside our borders including China and India. 

The bacteria in these supplements have a definite limited shelf life, and if they are kept in storage too long, the bacteria in them will decrease. At room temperature the rate of bacteria lost can be as much as 10-15 percent a month. 

Lactobacillus and bifidobacterium should be refrigerated to maintain efficacy. After being manufactured, these supplements usually leave the manufacturer at room temperature and sit on shelves at room temperature before being purchased. 

The expiration date on these products is only an estimate of the possible life expectancy of these bacteria. In fact in some testing that has been done, there were instances where no live bacteria were found in the supplement, making them useless. 

Until there is regulatory oversight in the manufacture and claims made for these products, I will maintain a “healthy” skepticism.

As for me, I will stick to foods containing both prebiotic and probiotics. 

They not only taste good to me but most likely are also helpful to my gut bacteria.

Jim Brown, M.D., is a retired gastroenterologist who has practiced for 38 years in the Wenatchee area. He is a former CEO of the Wenatchee Valley Medical Center.

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  1. AronM says:

    Great informative article! Thank you for sharing this with us. I’ve been into probiotics for a long time, and this helped me a lot. I’m practicing not to take any dietary supplements over the counter because it has chemicals on it. I now prefer to eat organic foods that contain high probiotics and prebiotics.

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