Are Probiotics Necessary? Sorting Fact from Fiction…

By Melissa Hohaia, Naturopath – We have witnessed a huge explosion of research and understanding into ‘gut health’ and it’s impact on our total health as a species. Long gone are the days where a doctor would prescribe a course of antibiotics and not consider recommending a course of probiotics afterwards. We are even witnessing new research into the powerful effect of certain strains of bacteria on allergy reduction and treatment of autoimmune conditions. But is this enough, and are we on the right track?

I dare you to walk into any pharmacy or health food store and ask to see their extensive ‘probiotic’ section. You may have even been sold a probiotic from one of these stores after mentioning to the sales consultant or pharmacist that you have been on a course of antibiotics. What you may have not realised though is that some of the probiotics on the market are ‘wasted space’.

I have been practising in Natural Medicine for over a decade now and even in this short time I have been privy to changing information and new understandings of just how probiotics work and which ones are beneficial to our health.

Rewind 10 years ago. As a new graduate I was taught that the health of a patient’s gut is crucial to their overall health and that if the gut environment is not ideal then it can lead to further health complications. This was a general understanding, which was scoffed at by a large percentage of the medical professionals that I encountered at the time. Lecturers told us that we needed to give super high doses of probiotics to ‘over-power’ and ‘win the fight against the bad bugs in a patient’s gut’. We were told that the strains of bacteria that we used would kick the pathogenic organisms to the curb and then colonise in the patient’s gut – restoring heath. Whamo – it was apparently that simple!

We had some stuff right, but a lot of stuff wrong – and it is only through more research and a deeper understanding of the organisms that live inside us that we have come to update our understanding.

One of the most important realisations has been that we are actually made up of only 1% human DNA – the other 99% is microbial DNA! We are literally a walking, talking, breathing petri-dish!

We are only at the tip of the iceberg when it comes to understanding exactly what this means for our health, but we are realising that the diversity of the microbial populations is a key factor. We know that every person will have slightly different microbial populations and the diversity is a determinate in different states of health. (Lower diversity seems to equal poorer health.)

We have discovered that even the time it takes you to sunburn, the quality of the sleep you get, your attraction to mosquitos, and the way that your body copes with a slice of cake can all come down to your microbes living in you!

Collectively, these microbial colonies are referred to as your microbiome. The intricate balance of your microbiome is essential to your health and any disruption in this balance can be devastating. When there is an imbalance in your microbiome it is referred to as ‘dysbiosis’ and it involves a loss of beneficial microorganisms and an increase in pathogenic organisms (such as yeasts, fungi, bacteria, or parasites). There are ten main causes of dysbiosis and I have summarised them in the diagram below.

 

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One of our goals as Naturopaths, is to help correct dysbiosis and one of the ways we can do this is with probiotics. The way we understand how probiotics can do this has changed dramatically since I graduated. Gone are the days of using super-strength-megadoses and relying on multiple strains of various bacterial species to colonise your gut. We have come to realise that probiotics don’t colonise your gut – they are merely passing through your intestinal tract and communicating to the other microbes that live there.

There are three levels of microbe classification (see diagram below). You have your CORE microbes which are a part of the permanent foundation of your microbiome. Then there are your VARIABLE microbes, which are regularly changed or shifted based on your external environment. And then there are your TRANSIENT microbes, which are just passing through but do have the ability to change and alter the variable and core microbes.

 

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When we use probiotics, we are ingesting microorganisms that simply communicate and rearrange the more permanent microbes that live within us – it is not actually them that end up hanging around! And what this means for probiotic use is that it is not about ingesting multile strains and megadoses – it is about using the RIGHT strain of microbe at the RIGHT dose. This very specific supplementation allows the correct communication to take place and the beneficial shifts in your microbiome to take place. If your microbiome is low of Lactobacillus, it is not that you need to ingest lactobacillus – you just need a probiotic that is going to talk to your lactobacillus and encourage it to grow.

We still have a lot to learn about the microbiome and how we can get it working best for the health of a patient. But for now, don’t get sucked in and waste your money on probiotics that can’t communicate properly…seek the right advice from the right practitioners. Your microbiome will thank you for it!

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