A few weeks back, my little family was making a lot of trips to the Emergency Room. My partner had developed a skin infection, and although he was started on antibiotics during the first visit, the pain he was experiencing was so unrelenting that we ended up there three days in a row. While the circumstances of our being there were less than ideal, it did end up prompting both of us to look a little deeper into a topic that is always at the forefront of functional medicine treatment: probiotics.
Now, me being me, no one in our house goes on an antibiotic without being on a probiotic as well. Most of us know that antibiotics don’t just kill the bad bugs, they kill the good ones too. Many people experience GI distress while on antibiotics because we rely on intestinal bacteria to help regulate our colon, um, situation. But the role of our little bacterial buddies goes much farther than just lower intestinal health: they have a hand in our metabolism, hormones, a huge role in our immune system as well as more and more research showing they influence our mental health as well. We could go on all week about how important gut microbes are, but I’m going to make a valiant attempt to do it in a couple paragraphs so I can move on to chatting with you about two OTHER parts of the probiotic conversation that are equally important: who should be taking them, and how they should be taken. Ready? Go!
Here’s a mindblowing fact: the bacterial cells in the human microbiome (a fancy word that means the native bacteria living in your gut, also known as “gut flora”), outnumber your own human cells ten to one. That means you, as the biological concept of you, are more bacteria than human. Or, as it was asked by one doctor, are we just bacteria “having a human experience”? As ridiculous as it sounds, the latter might actually be true based on just how many systems and processes our microbiome affect on a daily basis. Let’s check out the list, shall we?
1. Metabolism and Hormones: More and more research is connecting metabolic diseases such as diabetes type II and heart disease to disruptions in gut flora. The truth is, that our microbes make a lot of decisions for us about which metabolic and hormonal pathways are dominant in our bodies. How do they do this? Well, there are over 500 different strains of bacteria living in our intestines. Depending on which ones are present and how many of each, different substances can be created as a response. In a little while we’ll talk about HOW different strains end up in different people and cause all kinds of heck (also called gut dysbiosis).
2. Immune Function: This one is a biggie and we could spend all day (or month) on it. That being said, it’s absolutely impossible to have any sort of conversation about the microbiome and the immune system without at least introducing the topic of intestinal permeability.
….What the heck is that?
Intestinal permeability occurs when the tight junctions between cells in your gut lining become, well, less tight and more permeable or “leaky”. Think of tight junctions as guards at a gate: if the guards go missing, all kinds of undesirable villains can get through the gate. In this case, the villains are pieces of food the body wasn’t ready to absorb, bacteria (good or bad) and viruses. After these guys get through the unguarded gate, the immune cells on the other side run after them, jump on them and then travel with them through the bloodstream to the liver and all points beyond. This has a couple consequences:
-The immune response triggers a further immune response that creates low-grade inflammation in the body and can disarm the body’s ability to STOP the inflammatory process
-The “immune cell/bad guy” complexes can get deposited in tissues like joints, cartilage, etc, causing a further immune response there
…Why do we care?
Because more and more evidence is showing that the inflammation resulting from intestinal permeability is at the root of many autoimmune diseases. It also promotes the development of other inflammatory diseases such as coronary artery disease, and since other hormones like cortisol try to squish the overactive immune response, they get worn out by such a big job: and then things like adrenal exhaustion can occur.
…Why does it happen?
Glad you asked! Many things can trigger intestinal permeability, but I want to save them for a different conversation. What is important to note here is that a healthy microbiome can do two things for your gut lining:
-Gut flora assists the tight junction “guards” by making it harder for stuff to get passed them to the leaky junctions
-A healthy microbiome actually helps shut the immune system OFF when it becomes overactive or inappropriate. How amazing is that??
3. Mental Health: New bodies of research are showing that our microbiome affects our mental health, especially when it comes to depression. There is more serotonin in the gut than anywhere else in the body, and our bacterial population affects and modulates this as well. Stay tuned for more research into these concepts, its happening fast these days!
Phew! Ok. That was a lot. Let’s regroup. We’re going to move on to a section I’m going to call…
How Things Go Terribly Wrong and How to Fix It
Lots of things in our modern world can negatively affect our little bacterial friends. A quick run down of the incredibly non-exhaustive list:
1. Antibiotics. Self explanatory.
2. Food allergens
3. Difficult to digest foods for some people (often dairy, gluten)
4. Sugars and processed foods…throw off the natural balance of bacteria in the gut TOWARDS the guys that promote inflammation and metabolic trouble
5. C-Section delivery
6. Formula feeding vs breast-feeding
Lets leave it there for now. Some things on that list there’s not a whole lot we can do about, so let’s focus on some of the things we ALL CAN do to promote a healthy microbiome:
1. Eat a lot of fiber. This gives our flora something to munch on to thrive better
2. Stay away from processed, “fake” foods that are hard for the body to breakdown and can change the microbial balance in the gut…cut down on the amount of sugars you eat as well
3. Supplement with probiotics if you are at risk.
So who are these at risk people? If you have been through the antibiotic ringer, if you have known food allergies, autoimmune disease, take anti-inflammatory medications like ibuprofen or anti-stomach acid medications regularly, or if you know your diet could use some serious work, consider putting a little microbial love in your life. Honestly, most of us could probably use it at the end of the day, since bacteria do so much to protect our gut lining from the trials and tribulation of modern American life.
The next question people always ask is how to supplement. I must admit, I have been giving people the wrong advice for years. I always thought that food was an insufficient source to get ENOUGH probiotics if people are truly at risk for microbial disfunction and intestinal permeability, but boy was I wrong. All the research these days is actually now staying that fermented foods are the best way to get your daily dose of microbes. These are foods like kombucha, sauerkraut, kefir, kimchee and, of course, yogurt (Plain, no sugar added, full fat if possible, must say “contains live cultures”. We’re not talking your kids GoGurt, here.).
Most probiotics you can buy at the drugstore in pill form are more convenient: but they only contain a few strains of bacteria and unless they come with a protective coating, many of the bugs get destroyed by stomach acid before they can even hit the intestines. So get it from food if you can: one cup of fermented food or beverage is enough. If you can’t, if you cant stand the idea of sauerkraut and you can’t eat dairy, the pills are ok. Look for the ones with a coating that have at least four strains of flora.
Ok. That was information overload I know. If you think you got it, great! If you want to know more, feel free to leave comments or questions and I’ll answer. I also recommend Missing Microbes, a fantastic book by Martin J. Blaser, MD that will fill you in on (most)everything I was not able to hit on here. It’s a huge topic, but its so important to understand it. Thanks for stopping in everyone!!