Ask Sofia: Should I take a probiotic?
Most people know that a daily probiotic or the occasional yogurt is a good idea, but not everyone knows why or understands the options available when it comes to getting their daily dose of healthy bacteria.
Probiotics are the live bacteria found in food and supplements. They are similar to the bacteria found naturally in your gut and provide a wealth of beneficial effects, such as balancing and regulating the immune system, reducing inflammation, decreasing carbohydrate malabsorption, improving nutrient status, pain relief and more. The strong connection between the gut and brain connection means that all of this can have a direct influence on mood and cognition.
“You might be shocked to learn that about seven pounds of your body weight is composed of bacteria living in your intestines! The gut is home to about 100 trillion bacteria – or 10 times the number of cells in your body,” said Allie Nowak, physician assistant and functional medicine specialist at Clinic Sofia. “However, not all probiotics are created equal.”
When purchasing a probiotic, Nowak recommends:
- Be an educated consumer: There are two primary types of probiotics, including lactic-acid bacteria probiotics, which are readily available at most grocery stores, drugstores or coops. This is the same bacteria found in fermented foods (sauerkraut, kombucha, kimchi, fermented vegetables, kefir, kimchi, grass-fed yogurt). The other option is soil-based/spore-based probiotics, the same bacteria found in nutrient-rich soil. They have the ability to “seed” the digestive tract with bacteria that will flourish and support a healthy microbiome overall. They are also well-tolerated and very stable. Nowak often recommends soil-based organisms because of their superior tolerability and colonization of the G.I. tract, coupled with fermented food sources of lactic acid bacteria.
- Read labels carefully. Examine the list and names of probiotic strains. If the specific names of the strains of probiotics are NOT listed on the label (it just says “live organisms”), this is a red flag for poor quality. The top probiotic strains to look for on your bottle include soil-based organisms, lactic acid bacteria (especially Saccharomyces boulardii, and possibly Lactobaccillus rhamnosus, Bifidobacterium bifidum, Bifidobacterium breve, Lactobaccilus plantarus, and Bifidobacteria infantis) and fermented foods (look for “live and active cultures” or make homemade versions). Also look for probiotic “colony forming unit (CFU)” count: Generally speaking, the higher the CFUs, the better. Look for a supplement with CFUs of 50 billion or more.
- Make your own. Don’t underestimate the value and importance of probiotic foods—the concentration of organisms can be significantly higher in some fermented foods. For example, one cup of kefir contains approximately 2.35 trillion CFUs compared to most probiotic supplements that only have a few billion. Fermented foods are much cheaper than commercial probiotics. You can make really large batches of sauerkraut only using cabbage.
- Variety is the spice of life. The best strategy is to take a wide spectrum of microorganisms, including lactic-acid producing bacteria, soil-based organisms, and beneficial strains of yeast (such as Saccharomyces). Nowak recommends rotating probiotics every two to three months to keep the gut guessing.
“As with any new change, it is wise to start slowly. When you start a new probiotic, you may initially experience a slight worsening of pre-existing symptoms, such as bloating, gas, acne, diarrhea or constipation, before you see improvement,” Nowak added. “Consider starting with one capsule every other day, then moving to one a day when you are feeling good.”
In addition to probiotics, prebiotics are essential to healing the gut, which are the starches and fiber found in foods like garlic, onions, leeks, Jerusalem artichokes, mushrooms, dates, fruits, cooked and cooled potatoes, cooked and cooled white rice, legumes and plantains that serve as FOOD for the beneficial bacteria in our gut. Put simply, probiotics are the bugs themselves and prebiotics are the food the bugs need to survive and multiply. Ultimately, you need a combination of both for a healthy gut since prebiotics help your probiotics stay around and increase beneficial bacteria.
If you have any additional questions, Nowak is available for consultations and is accepting new patients at Clinic Sofia OBGYN.
