Probiotics - Should We Take Them?

Choosing a probiotic can feel like guesswork. There are so many myths and misunderstandings around them. I often see people reaching for a jar off the shelf in the supermarket, with no real understanding about what they do and whether they’ll help.

Most of us are led to take probiotics because we have digestive discomfort, such as IBS, or after taking antibiotics, because we’ve had thrush or a digestive upset, or we’ve heard they can help maintain the microbiome. We’ll either get them from a chemist, do a bit of a google search, or ask a friend.

Probiotics are also promoted on social media for all kinds of things from general health to brain health and hormone balance!

Even as a nutritional therapist it can feel like a difficult path to tread. I increasingly don’t recommend probiotics in my supplement protocols, in favour of prebiotics, fibre and fermented foods, unless there’s a specific strain that I know will help. Or if I’m honest, when we just want to try something to see if it’s helpful when all else has failed!

What Are Probiotics?

Probiotics are the live bacteria that confer a benefit to our health. We can find them (for consumption) in supplements and fermented foods.

Many of us have been recommended probiotics to support gut health, and also to resolve gut issues, such as IBS, IBD, constipation, diarrhoea and bloating. However, there are some things to bear in mind before you part ways with your money, as they may not be having the effect you need. 

1. Probiotics may not be suitable for people who are severely immuno-compromised. In these cases, professional advice should be obtained before taking them. 

2. If a probiotic doesn’t state the strain of bacteria on the bottle, you might not be getting the most effective and researched bacteria.  This looks something like:

Lactobacillus (the genus) Rhamnosus (the species) GG (the strain).

Or Bifidobacterium (genus) Lactis (species) BB-12 (strain)

If your bottle says Lactobacillus Acidophilus and nothing else, how do you know that you’re getting the right type of bacteria for your health issue? There are thousands of different types of bacteria in our guts.

3. It’s worth knowing that probiotics don’t generally populate the gut. So, by taking millions or billions of bacteria, they won’t just get into the digestive system and stick around. The current understanding is that they confer a benefit by several methods as they pass through the digestive tract - including - messaging to the gut microbiome to increase certain beneficial species, reducing inflammation, supporting the gut barrier, or discouraging the growth of unhelpful bacteria.

4. Supplements that contain multiple or many strains of bacteria are not always better. Some bacterial strains can compete with each other and to date research may not have been carried out on how different strains interact with each other. We just don’t know exactly what effect this will have on each person. We need to bear in mind that each person may have a different reaction to certain bacteria. So, one person may find a species helpful. Whilst another may not. Our microbiomes are unique to us – like our fingerprints!

5. For general gut health and bacterial diversity which is associated with good health overall, you may be better increasing your intake of fermented foods, as there is evidence that they will increase diversity and reduce inflammation. These are foods such as sauerkraut, kimchi, kefir, kombucha, yoghurt, miso, naturally fermented pickles and tempeh.

6. When deciding which format to take, this isn’t clear cut. Liquid probiotics aren’t necessarily better than capsules, and the best format for you may depend on what and where you need to focus. 

So, what is the answer?

1. Choose a supplement that is researched well for a specific effect and has the tested strain of bacteria on the bottle. More bacteria and more strains aren’t necessarily better!

There are very well researched strains for use after antibiotics (Lactobacillus Rhamnosus GG or LGG), for Urinary Tract Infections (Bifidobacterium Lactis BB-12 and LGG together), Ulcerative Colitis remission (E. Coli Nissle 1917), and Thrush and Bacterial Vaginosis (Lactobacillus Acidophilus La-14 and Lactobacillus Rhamnosus HNOO1)

2. For general gut health focus on increasing your intake of fermented foods – aim for a couple of portions a day. A tablespoon of sauerkraut at lunch and some live yoghurt or kefir for breakfast.

3. Also focus on prebiotic foods that feed a healthy microbiome and encourage healthy bacteria to grow. Prebiotics are foods with certain types of fibre that promote healthy bacteria.  A fascinating area that I’ll write about another time!

I hope you’ve found this article useful. Do get in touch if you need help with digestive support. An uncomfortable and disrupted gut can really affect your quality of life and there is so much we can do to help.

As well as gut health clinics, I offer functional stool testing to help pinpoint where, why and how your gut is causing you discomfort.

 Please get in touch for a free Introductory Call to find out how I can help you.

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NB The source of this information is a BANT webinar from Dr Megan Rossi and this article has been created by Alexis Prior - No AI was used in the preparation of this blog!