Probiotics – The Good, The Bad and The Misleading

kombucha-cropped

I recently found myself in a health food store handing over my credit card to buy over a hundred dollars worth of supplements and food products promising to boost the health of my gut microbiome. In my basket was kombucha (fermented tea), kimchi (fermented cabbage) and a jar of probiotics promising ‘a range of health benefits supporting overall health and wellbeing’.

 

I had been reading about the amazing highly complex, highly diverse community of microorganisms that make the human body their habitat. The tiny critters living in our gut have been shown to play a key role helping us digest food and extract energy, they’re our first line of defence when it comes to disease and they can even influence our mood and behaviour. Last week I wrote about their link to obesity, inflammatory bowel disease, cancer, heart disease, multiple sclerosis and autism. So when I found myself in a store surrounded by products promising me the health benefits of ‘good bacteria’, I was a willing consumer.

 

It wasn’t until I got home that I realized I might have just repeated the same mistake I’ve made many times over since being diagnosed with an autoimmune disease. In the last ten years I’ve spent more than $30,000 trying everything from prescription drugs, to elimination diets and alternative therapies. So I couldn’t help but wonder if I’d fallen for the hype all over again. When it comes to boosting health and wellbeing, is there any evidence probiotics work?

 

The good news is there are hundreds of studies considering how we could use probiotics to treat illness. The bad news is that most of them are on mice. Here are some highlights:

 

  • Bacteria called Lactobacillus helveticus can decrease anxiety in mice if they were used in conjunction with a healthy diet.
  • This study showed that Lactobacillus reuteri can reduce the likelihood of mice to get infections when they’re stressed.
  • This study showed mice given Lactobacillus kefiri CIDCA 8348, which was derived from Kefir grains reduced inflammation.

 

In humans too there have been some promising studies showing that probiotics might be used to treat illness. For instance:

 

  • The bacteria VSL#3 and LCR35 are effective in treating irritable bowel syndrome.
  • This paper reveals that the bacteria Lactobacillus helveticus and Bifidobacterium longum can improve our mood and make us more resilient to mild stress.
  • This review paper analyzing 20 randomized controlled trials has promising findings for the use of probiotics in treating people with diarrhea.

 

But there’s an important point here. It’s extremely unlikely that the probiotics used in the trials I mentioned above are the exact same probiotics that you’re buying at your local shop. In some ways it’s like saying ‘I’m going to take a drug to cure my headache’ without considering what specific drug to take.

 

Another important thing to note is that these miniscule microbes have to be alive when you take them. They’re rather fussy and need specific conditions to survive. In fact it’s unclear whether the preparations you buy contain any living organisms after being packed, shipped, unpacked and placed on a shop shelf. Shockingly, this review of fourteen commercially available probiotic products found that only one actually contained the ingredients listed on the label. This review of probiotics for pets found that out of twenty-five products only two actually contained the microorganisms listed on the label. More than one actually misspelled the names of them.

 

All this is not to say that probiotics and the fermented foods that contain them definitely won’t work for you. If you’re looking for a probiotic for example to help with your IBS, my suggestion is to read studies showing which types of bacteria are being used in the clinical trails, then hunt down the ones the scientists are using. It may be more expensive but there’s no point in buying something that won’t work.

 

Ultimately, my conclusion is that while the microbiome is an exciting new area of research with profound implications for our health, we’re still very much only beginning to understand its application in the real world.

 

In all the research that I’ve done I haven’t come across anything to suggest that probiotic foods and supplements could give me adverse health problems, though I’m keen to hear from readers who may have their own experiences. The evidence seems to be mounting to show that it’s is not about trying to get more specific species of good bacteria, but rather about getting a healthy balance of the species. People who lack diversity seem to be vulnerable to disease.

 

As for my ill-advised and rather expensive trip to the health food store, I’ve now finished eating my jar of fermented cabbage (it’s actually delicious) and even bought some more. I really enjoyed my sweet, fizzy fermented tea drink for the flavor alone even if the health benefits are unproven. The alcohol content may have had something to do with it, though my husband assured me that I’d have to drink a case of the stuff before it would be considered a ‘big night out’ on kombucha. I won’t be replacing my jar of probiotic supplements, though I’ll continue to look for a product with more robust science behind it.

 

Ultimately, rather than focusing too much attention on these foods and supplements, I’ll continue working on cultivating my microbiome diversity by way of a healthy, balanced diet, rich in unprocessed foods and fresh fruit and vegetables.

  • Meredith Hooke

    Great post! I have gotten a little too gung ho on the probiotic bandwagon too! You make a great point about which bacteria are we ingesting and is it even alive to begin with. Thank you for sharing.

  • Lynn

    Very informative and helpful. Like I said in my last post I am giving myself permission to pass for a while on the supplements. While not the primary intent of your post what also hit home for me is sometimes my inability to just "be" with a routine that seems to be working pretty well -it's as if the perfectionistic compulsive part of me keeps thinking there must be more I should be doing. It's hard to put into words as I am not saying not to try and be open to new scientific things -it's just that some times it seems I need to just be content and grateful with in my case; meditation, exercise, rest and as clean a diet as I can manage. Hope I didn't get too far off topic…..but I am horrified sometimes when I look at all the supplements and all kinds of other stuff I have bought(sometimes thrown away and then bought AGAIN) over time. I look forward to your posts and am very appreciative of your work. The Connection profoundly changed my life.

  • karielle

    I was having intestinal issues and was always tired. I have had my MD for 10 years, so he knows me. He recommended VSL 3. It is not a prescription. I trust him. He knows my body. In 2 weeks I felt wonderful. You have to know what you are using them for. Don't waste money if you do not know what part of yor body needs them see your doctor. I am staying on them.

  • Axel West

    Your Appendix, if you still have it, may well play a vital role; <http://blogs.scientificamerican.com/guest-blog/2012/01/02/your-appendix-could-save-your-life/&gt;

  • RocknRob

    I frequently suffered from UTIs so took antibiotics which then led to thrush. A vicious cycle! My naturopath suggested I start on probiotics. I was taking a commercial product but in March 2014 I started making my own kefir and am now also making kombucha. Much cheaper than buying expensive pills and much healthier because they are very definitely alive! I'm very happy – haven't had an infection since Aug 2014 – yay!

  • Brenton

    I made the kefirs until I went away last years and they didn't survive the attempted freeze. Bu over the past few months have been making my own fermented veges. Cabbage carrot and ginger worked well, so too red cabbage, beetroot and turmeric. Not sure if it will be warm enough over winter to continue but Im willing to give it a crack. Personally I love the taste and use as a condiment. Have had pretty good comments from friends who have tried it too. Does it help? Not sure, but its sure doing no harm. I couldn't tell you when I last had an infection…

  • Cherie Porter

    Diversity in our diets and removing antibiotics from the meats we ingest would help to recovery some of the good bacteria. But we've permanently lost a good portion of the we once had. But this may be the price we pay for overall health. Read this recent story from NPR: http://www.npr.org/blogs/goatsandsoda/2015/04/21/400393756/how-modern-life-depletes-our-gut-microbes

  • joe

    I echo everything you wrote in your post. For some (I'm one of them too), there is that perfectionist aspect that is not always necessarily a "bad" thing but just needs to be kept in balance/harmony since it also has its "good" aspects when needed. I'm also understanding the notion of contentment and gratitude — and started daily meditation after watching "The Connection" as well as continuing exercise, obtaining good rest, and having a clean, nourishing diet that's appropriate for me (which I've found evolves over time as I learn and age). I just discovered a great book named "The Good Gut" by Justin and Erica Sonnenburg which further emphasizes the conclusion of Shannon's post of cultivating microbiome diversity by way of a healthy, balanced diet,
    rich in unprocessed foods and fresh fruit and vegetables.

  • Lynn

    Thanks now I don't feel as weird. I can get overly obsessed about the diet thing too so I too am learning it's not so black and white and one size fits all. For me I have to work from the big picture or it's the perfectionism again…..I plan to look into the book.

  • http://192.241.214.193/ Shannon

    Thanks for the link Cherie. The idea that some of the types of gut bacteria are going extinct because of our modern lifestyles is fascinating.

  • http://192.241.214.193/ Shannon

    Well done for finding the time Benton. Totally agree that fermented food is delicious as a condiment.

  • http://192.241.214.193/ Shannon

    That's great that you make your own. Cheers to your good health!

  • http://192.241.214.193/ Shannon

    Thanks for the link Axel.

  • http://192.241.214.193/ Shannon

    VSL#3 seems to the strand that's being used in the trials for IBS so I'm excited to hear it's working for you. What an amazing MD you have to be so insightful.

  • http://192.241.214.193/ Shannon

    Hi Lynn, I know what you mean about always looking for the next thing to make us even 'better'. I too have been known to spend ludicrous amounts on supplements without considering that the reason I go for supplements is they are an 'easy' (mostly untested) solution to other deficiencies. Too much stress, too much processed food, not enough sleep etc. Thanks for reading.

  • http://192.241.214.193/ Shannon

    Hi Joe, that's amazing that you started meditation after watching The Connection. I'm reading a lot about diet at the moment so I'll check out that book. Thanks for the recommendation.

  • http://192.241.214.193/ Shannon

    Hi Meredith, Thanks for reading the post. I hope there are some trustworthy probioitics out there. I just haven't found any that the independent scientists are endorsing. Most of the scientists seem skeptical.

  • Dee

    I can't remember if I found this dietician's website via another post of yours Shannon. Even if I did, I reckon her website is worth another mention in the context of this blog post and your conclusion about a healthy and balanced diet:
    http://www.bloomnutritionist.com/the-whole-food-plant-based-diet/

    There are some great recipes and ideas on this blog. I love the plant-based lunch suggestions:
    http://www.bloomnutritionist.com/blog/2015/2/14/how-to-make-a-balanced-and-nourishing-plant-based-salad-for-lunch

  • Merian

    Hi Shannon – also important to consider pre-biotics – those goodies that provide the nutrients required by the useful species in the gut. If you are adding probiotics you need to give those guys what they need to flourish. Plant sources include globe artichokes and dandelion leaves. I think you can also buy supplements but as always the natural sources are probably more effective. Thanks for all your hard work – I love reading your great articles.
    Merian x

  • Kathy E

    For those interested there is a big study going on that you can easily be a part of and have the microbes in your body tested. It is a study that was started at the University of Colorado and recently moved to California. It is pretty interesting. I took a free course on coursera.org called Gut Check: Exploring Your Microbiome . It was fascinating to learn about the microbes and the changes that have occurred over time and how it has affected us. I am in the medical field and I have noticed in my own personal experience that there is a big raise in autoimmune diseases and in allergies related to our weakened immune systems. It makes sense that is is related to the changes in our microbe system. Anyway, at the end of the course there is information about the American Gut Project where you can be tested to see what microbes you have in your body. It does charge a donation fee to cover the costs of testing. If you are interested go to humanfoodproject.com. There is a lot of information there and also information on participating in the study.
    Kathy E

  • Cecilia Peter Freeman Strous

    Not from the last 500,000 year historical perspective, not from a majority perspective however but from a
    health perspective we are plant eaters. Eating just plants and perhaps not always cleaning them perfectly will get us the natural probiotics that our system needs. This would not contain any lactobacteria as we are not naturally milk drinkers or dairy users after the age of 3.

    Dr McDougall states that the only supplement we need is B12 as hygiene has driven bacteria producing this
    vitamin out of our lives. From my own research and experience this makes sense.

    Most studies we find have been funded by the industry trying to sell. Most studies are heavily biased and
    it is not easy separating the wheat from the chuff.

    Good reading are Dr McDougall’s books or The China Study by Colin Campbell.

    If it were to be correct that from a health perspective we are plant eaters that would mean that the
    following industries have a lot to loose:
    * Dairy
    * Meat
    * Fish
    * Egg
    * Pharmaceutical

    * Health
    * Processed food

    You might be aware how much the Tobacco industry faught for their profits, and they still are….. What
    tactics and mean fighting do you think all these industries together could possibly come up with in order to defend their current share? Nothing direct of course, they are hiding behind “interest” groups and “not-for-profit” organizations as they do not want any negative publicity directly associated with themselves.

    I have come to believe we humans are mushrooms in the dark fed what mushrooms eat…..

    I have come to believe that capitalism leads to great production and great efficiencies but not necessarily
    in the areas that benefit society and mankind.

    That works for both the environment and also our health. They are both victims of are current system.
    We need wide spread insight into this so we can adjust this system for the benefit of all and future generations.

  • Kerryn Lockhart

    I love fermented foods, have done the Kefir thing and make my own Kimchi (delish!) but unfortunately it can have one draw back, they are high in histamine, which for people like myself who have trouble detoxing histamine can increase allergic symptoms. I have stopped the Kefir but still make Kimchi for my husband and indulge myself every now and then.

  • karielle

    Shannon, I had Diverticulitis. One attack. It had really drained me. I did put my own fiber diet together. My intestinal flora was all messed up. So the VSL3 helped to regulate everything. It has been 4 years now. IBS and other issues are so hard to deal with. They may not go away, but keeping them from flaring up is about all we can do.

  • http://192.241.214.193/ Shannon

    Hi Mez, I've just started reading up on pre-bioitics. They seem to be one the keys. Thanks for the tips about the natural sources.

  • http://192.241.214.193/ Shannon

    Hi Karielle, sounds like a really rough time. So glad to read that you've had some positive results from the right diet and the VSL3 probiotics. Wishing you wellness into the future.

  • http://192.241.214.193/ Shannon

    Hi Kerryn, I didn't know that the fermented foods can be diffcult for people with trouble detoxing histamine. Just another reminder that we really can't provide one solution for every person.

  • http://192.241.214.193/ Shannon

    Thanks for the comment. There is a very strong argument to be made for the benefits of a plant based wholefood diet.

  • http://192.241.214.193/ Shannon

    Thanks Kathy, I've just finished reading Professor Rob Knight's book. A great read. I believe he's one of the people involved in setting it up. Sounds like a great course.

  • http://192.241.214.193/ Shannon

    Hi Dee, I haven't come across this before so thanks for the links.

  • karielle

    Thanks Shannon. VSL 3 is very expensive. I guess you could say I cut corners with other things to keep my health. It is hard . Thanks for your response. Be well.

  • Mare Tomaski

    Greetings! I recently wrote a book called The Human Restoration Project and I've got a chapter dedicated to understanding gut microbiota. To help us all get a handle on exactly what we've got and we haven't got in our gut (play on words intended 😉 we can all get a swab test from Americangut.org. The more of us talking and writing on this the better! Many thanks for your Documentary and Blog!

  • http://192.241.214.193/ Shannon

    Thanks Mare, congratulations on the book.

  • karielle

    You are right Shannon.

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  • Mike Harper

    Good bacteria will help in preventing and improve certain
    conditions, particularly those conditions that affect the
    gastrointestinal tract – http://pronutrics.net/what-are-probiotics/

  • http://www.theconnection.tv/ Shannon

    Hi Mike,
    Thanks for taking the time to comment, however I have deleted the link to your probiotic blog which is selling probiotic supplements because to date the research on this is in it's infancy. All the leading microbiome researchers I have spoken to, as well as the peer reviewed academic papers I have read clearly state that we don't yet know enough about the link between gut bacteria and health conditions to be able to package it up in a product. I stay across this field of research as it's so very exciting but at this stage the only thing we know with any certainty is that a healthy diet, rich in whole foods and low in junk fosters a diverse gut 'wildlife' in the gut ecosystem.

  • Steph

    check out Ortho Molecular, they're sold by doctors instead of stores and have a lot of science behind 'em.

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About the author: Shannon Harvey

Shannon Harvey is a journalist and producer who was diagnosed with an autoimmune disease when she was 24 years old. Although doctors meant well, none could offer her a cause or a cure. Since then Shannon has been researching the latest scientific research linking her mind and body to health outcomes. Nearly 10 years have passed since her diagnosis and today Shannon is well and not taking medication. Shannon has worked as a television, radio and online journalist and producer and has a Master’s degree in Communications. She worked for the ABC and Fairfax before starting her own production company, Elemental Media. Shannon is the director of the feature film The Connection.

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