27 Things You Didn’t Know About Probiotics, Probiotic Guide and Condition Index

Not all of us walk around aware that there is a living, thriving, non-human colony of organisms that resides in our digestive tract. Our large intestine is home to four pounds of beneficial bacteria, collectively known as the microbiome.


For perspective, consider that the liver, one of our largest organs, typically weighs 2-4 pounds. The microbiome consists of thousands of different strains of bacteria, totaling up at around one hundred trillion cells.


Bacterial cells outnumber human cells by a whopping ten to one ratio. They provide innumerable functions for us, many of which are likely undiscovered as of yet, but include digestive, absorptive and assimilation functions. The microbiome influences the immune, endocrine and cardiovascular systems.


Probiotics are a supplemental form of beneficial bacteria that can be used to bolster the microbiome, balance immunity or to be used for specific conditions. So much research is pouring out into the media regarding probiotics and the microbiome it is hard to keep up.


It turns out that there are a lot of good reasons to consider probiotic supplementation:


  1. Probiotics help regulate bowel function, improving both constipation and diarrhea
  2. Probiotics aid in the digestion of proteins to free amino acids
  3. Have lactose intolerance? Probiotics aid in the digestion of lactose, improving intolerance
  4. Inflammation is a cornerstone of many digestive and functional disorders, and probiotics reduce intestinal inflammation
  5. Probiotics optimize intestinal pH, creating an unfriendly environment for pathogenic bacteria, yeasts and other harmful organisms
  6. Short chain fatty acids are a major fuel source for the cells in the gastrointestinal tract. Their source of manufacture? You guessed it: probiotics and the microbiome
  7. Probiotics aid the microbiome with the manufacture of the B vitamins and vitamin K
  8. Probiotics ?humanize? certain plant compounds such as flavonoids so that they can be used by our cells
  9. Probiotics slow diarrhea
  10. Probiotics prevent and treat antibiotic-associated diarrhea
  11. Probiotic supplementation is (should be) a cornerstone of IBS treatment
  12. Probiotics buffer against food poisoning
  13. They also buffer against toxins released from bacterial, yeast or parasitic infection
  14. Supplementation with probiotics aids in the treatment of urinary tract infections, yeast infections and thrush
  15. Probiotics don?t just help with bacteria, yeast and parasites. If you catch a cold or have another viral infection, probiotics can help with that, too
  16. Probiotics optimally activate and support the immune system
  17. Following in that thread, they can help prevent autoimmune conditions
  18. Probiotics help break down and rebuild hormones
  19. The microbiome serves a role in body composition, altering leanness and fatness
  20. Probiotics recycle bile acids, indirectly boosting digestive fire in yet another way
  21. In those with liver disease, probiotics reduce ammonia levels in the blood
  22. Have allergies or eczema? Probiotics are an oft underutilized tool in their treatment
  23. Even your heart loves probiotics, which aid in cholesterol balance and help lower triglycerides. Some research shows they help lower high blood pressure, too
  24. Probiotics help reduce gas and gas pain
  25. They help protect the entire gastrointestinal system, starting at the top by keeping teeth and gums healthy
  26. Mamas-to-be who take probiotics have babies who have optimal body composition and fewer ear infections, eczema and allergies
  27. Mamas-to-be who supplement with probiotics return to their pre-baby weight faster than their non-probiotic taking counterparts


As you can see, probiotics can thus be used for a wide variety of health conditions, encompassing virtually all gastrointestinal conditions and complaints, and spanning to autoimmune, allergic and infectious diseases as well.


What to look for in a probiotic


As a healthcare provider that focuses on digestive health, this is one of the most common question that I hear not only in the office but also on my blog and social media. There are so many probiotic products out there on the market, it can be tough to wade through them all.


I have a few criteria that I suggest to those looking for a good probiotic.


  1. Make sure it has Lactobacilus and Bifidobacter strains in it
  2. Look for one that has at least 20 billion CFUs for general use, closer to 100 billion CFUs for those with GI complaints or conditions. If you cannot tolerate probiotics, consider bacterial overgrowth, SIBO (small intestine bacterial overgrowth) or dysbiosis
  3. A lot of probiotic products try to be everything at once – they have enzymes, prebiotics, veggie powders etc in them. I have found these to be not as effective/well-tolerated as straight-up probiotics. When looking for a probiotic, make sure it ONLY has probiotics in it. For the most part, these are better tolerated and get the job done.
  4. If you have a dairy sensitivity, make sure you look for a label that says ?hypoallergenic? that is free from milk and other allergens. Probiotics are often grown on a dairy medium so beware!
  5. Find a probiotic without dye in it. Align, a common and popular probiotic peddled by gastroenterologists, has blue dye in it. Sigh. Additionally, it only has one strain it (albeit a good one for IBS) at a very low dose. You can do way better
  6. Did I mention stay away from prebiotics? Prebiotics often are what make people say they can?t tolerate probiotics. If you eat vegetables, you get plenty of prebiotics and don?t need to supplement with them. Prebiotics include FOS and inulin.
  7. Don’t worry about your stomach acid getting in the way. Many probiotics are marketed as being able to withstand the harsh stomach environment as if they are special or different from others. They only way people are inoculated with beneficial bacteria is through consuming them. From an evolutionary perspective, these beneficial bacteria can withstand the low pH of the stomach to colonize the large intestine.


For over the counter brands of probiotics, I recommend Jarrow, Mercola and VSL#3 (the latter is the priciest by far). For brands that you can only get from a healthcare provider, I recommend Klaire Labs, Designs for Health, Pharmax and Xymogen.


You can get specific if you want

Certain strains of probiotics work particularly well for unique conditions and symptoms. You can match up if you?d like, and understand that it is more important to get the probiotics in your body than it is to delve into the nitty gritty details. Think big picture :) You?ll notice that much of what is covered here is covered already in the above section for general recommendations


Irritable Bowel Syndrome: Bifidobacter lactis, Bifididobacter infantis, Lactobacillus bulgaricus, Lactobacillus reuteri, Lactobacillus rhamnosus


Inflammatory Bowel Disease (Ulcerative Colitis, Crohn?s, microscopic/lymphocytic/collagenous colitis): Lactobacillus acidophilus, Bifidobacter breve, longum and infantis, Streptococcus thermophilus


Pouchitis: Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacter breve, longum and infantis, Streptococcus thermophilus


Diarrhea: Lactobacillus acidophilus


Antibiotic-associated/travelers diarrhea: Lactobacillus acidophilus, Saccharomyces Boulardii, Lactobacillus reuteri, Lactobacillus rhamnosus, Lactobacillus casei


C. Dificile infection: Saccharomyces boulardii, Bifidobacter infantis and longum


Yeast infection: Lactobacillus reuteri and acidophilus


Colic/Cradle Cap: Bifidobacter infantis


Eczema: Bifidobacter infantis, Lactobacillus acidophilus


Yeast Infection: Saccharomyces boulardii, Lactobacillus acidophilus and reuteri


Urinary Tract Infection (UTI): Lactobacillus acidophilus and reuteri


What about probiotic containing foods?


Truth is, modern day humans eat far fewer probiotic-rich fermented foods than our ancestors did. Foods like kimchi, kombucha, soy sauce and sauerkraut should certainly be rotated into the diet several times weekly. I have noticed in particular a surge in fermented drinks, with kombucha ?breweries? popping up all over the place, and the addition of kefir water products in places like Whole Foods and other natural markets.


For those without GI disturbance, a concerted effort to get these products in on a regular basis would be beneficial, without additional supplementation necessary. In those without issues to dairy, small amount of yogurt or milk kefir can be considered, but should be second to fermented veggies and drinks.


All things considered…


Probiotics are pretty incredible, and the microbiome residing inside us even more so. We are at the threshold of understanding the multilayered and seemingly infinite functions these guys provide for us. It makes one wonder who is steering the ship….

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