Should I be taking a probiotic?

Probiotics have become a popular buzzword in recent years, with many in the health sphere assuring us it is the answer to all problems. The popularity of probiotics has meant the market is now saturated with hundreds of different options yet very little explanation on which one to go for and why.

What are probiotics?

Probiotics are live microorganisms (bacteria and yeast) which can past on benefits to the host (us) when consumed in sufficient amounts. They can be found in foods such as yoghurt and other fermented foods or, through supplements. There are thousands of different probiotic strains and therefore a lot of variety in probiotic products. Each strain will elicit a different action on the body and therefore will benefit us in different ways.  This is why it is important to know what probiotic strain you are picking.

Probiotics and fermentation

Fermentation is the process in which an organisms converts a carbohydrates into an acid or an alcohol substance. When bacteria are introduced to food, in the right conditions to make them thrive, they proliferate and exert beneficial functions to human health. Microbes make a home in the food because it provides them energy; they feed on sugars and turn them into things like vitamins, beneficial for the host.

The process of fermentation yields many benefits. Cultures around the world have been eating fermented food for decades. However, this increased attention around probiotics within the wellness sphere has driven the food industry to mass produce fermented foods which are often pasteurised and no longer contain live cultures.

How do they work and why can they be beneficial?

Probiotics elicit there action in numerous ways:

  1. they help to balance the gut microbiome with beneficial bacteria. Persistent imbalances in microbiota affect gut immunity and is implicated in numerous disease states.
  2. they help improve gut barrier function; preventing unwanted substances entering the gut and therefore reducing immune system activation and inflammation.
  3. they produce short chain fatty acids and antimicrobial substances like bacteriocins which collectively helps to reduce infection and inflammation . 

Probiotics are also thought to have indirect, systemic effects.

  • 70% of the immune system resides in the gut. As a result, many chronic health conditions are thought to be due to chronic gut inflammation. If probiotics can help populate the gut with beneficial bacteria and support the immune system, it is thought that they can help with inflammatory-based conditions.
  • 90% of serotonin is made in the gut.  This is our mood-regulating, happy hormone and brain neurotransmitter. Symptoms of low mood, depression, anxiety are often associated with low serotonin and anti-depressants actively try and upregulate this hormone. If probiotics help keep your gut happy, there is argument that they can positively benefit the nervous system through this mechanisms.

What foods contain probiotics?

  • Cheese and yoghurt made from milk and cream
  • Kombucha made from tea and sugar
  • Sourdough made from flour and water
  • Sauerkraut and kimchi made from cabbage and salt
  • Miso made from soybeans 

It is important to make sure that the probiotic is present in these food. For example, many yoghurts say ‘made with live cultures’. This means that live bacteria were only used to ferment at some point during the process, it does not mean that the bacteria is actively present. It is important to make sure that the product lists the specific strains of probiotic so you know that it is legitimate.

If I can get it from food, why bother considering probiotic supplement?

Whilst there has been a great deal of research conducted on probiotics, there is still much unknown and for the general population, my advice to improve gut health would be to focus on increasing the diversity of food in your diet

With this being said, there are a few medical conditions whereby research has found probiotics to be beneficial:

–       Inflammatory Bowel Disease

–       Irritable Bowel Syndrome

–       Travellers’ Diarrhoea

–       Antibiotic -associated diarrhoea

–       H Pylori

–       Lactose Intolerance

–       Anxiety

–       Diverticular disease

–       Urinary tract infections

All of the above is based on research into the specific condition. In these trials, the specific probiotic strain and dosage was tightly regulated. Therefore rather than getting any old probiotic, it is important that you are getting advice from a healthcare professional which knows which strains offer benefit for each condition.

What should I be aware of when taking probiotics?

Probiotics are not a fix to gut health and your other health problems. They are only part of the picture. The state of our gut, and therefore our health, is dependent on many factors: stress, diet, exercise, antibiotics, medication, age, early life experiences. In fact, addressing some of these first may have a more profound impact on your gut and your symptoms than supplementing with probiotics. 

There are also potential side effects of taking probiotics; cramping, nausea, loose stools, and some populations are specifically advised against probiotics. It is important to check with your healthcare professional before going on probiotics.

In addition to the above, we still do not know how effective probiotics truly are, with questions over whether the individual can actually absorb the probiotic? How do the supplements survive the acidity of the stomach? If they are so sensitive to changes in environment, do they die when not kept at specific temperatures? Many of these questions are still under investigation. 

We have also got to consider the fact that we only share approximately 10-35% of our microbiome with another person. Therefore, buying an off the shelf probiotic, which may contain an abundance of a microbial strain that you already have sufficient levels of, is not going to solve anything and may in fact elicit symptoms.

My opinion:

As a practitioner I have seen how powerful probiotic supplementation can be, when done correctly. However, too often I see people buy over the shelf probiotics in hope of fixing all their symptoms. Like a drug, probiotics need to be targeted and you need to know why you are using them.

If you feel that you could benefit from a probiotic supplementation or want some sense of direction to help improve gut health please feel free to book in a call.

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Melanie Wilkinson

I am a Registered Nutritionist, Nutritional Therapist, Neuroscientist, and former athlete. I specialise in weight management, chronic health conditions, and female and mental health, catering specifically to high-achieving, executive-level individuals navigating a busy lifestyle.