From the Activia commercials starring Jamie Lee Curtis to the plethora of over-the-counter supplements on the market, probiotics have been infiltrating mainstream consciousness. But what exactly are probiotics? Should you be taking them? And if so, which ones and in what form? We got the scoop from the experts on everything you want to know about probiotics.
Let’s start at the top: What exactly are probiotics? They are helpful in restoring the good bacteria—or flora—in your gastrointestinal (GI) system. Particularly if you’ve been on an antibiotic regimen for a while, probiotics might be essential, as antibiotics tend to quash both bad bacteria (which ultimately makes you feel better) and the good bacteria in your system (which might actually make you feel even worse).
“In my practice, I recommend clients take probiotics following antibiotics,” says Elsie Kerns, a certified energy medicine practitioner and wellness educator based in Marlton. “Antibiotics suppress the symptoms but also kill all the good bacteria in the body, so it’s easier to pick up the next bug going around. Antibiotics also proliferate yeast problems. Without friendly bacteria in the gut, yeast takes over and creates a myriad of other unpleasant symptoms like bloating, brain fog and fatigue. Probiotics on a daily basis are an excellent way to help the body, and especially the gut, maintain health and wellness.”
“A lot of times when someone’s gotten antibiotics for, say, a sinus infection, it may change the bacteria they have in their colon and that allows some of the bad bacteria to multiply, and those can cause problems,” says Dr. Noel Martins, gastroenterologist with the Kennedy Health System, whose office is in Sewell.
So probiotics are useful in restoring good bacteria in your system, but if you don’t actually have any GI problems, should you be taking them simply as a matter of course? The experts we spoke to had differing opinions on the matter.
According to Carolyn J. Boyer, personal probiotic consultant for Natren Inc., “Probiotics are for everyone. They’re great for everyday dietary supplementation and for use as a preventive. They assist the immune system to build natural good flora and in the digestive system to help with the body’s pH balance.”
However, according to Dr. Ronald Ciccone, medical director for integrative family medicine for Lourdes Health System, whose office is in Collingswood, though everyone could benefit from probiotics, not everybody necessarily needs them.
Dr. Martins agrees: “I don’t think everyone should necessarily be on probiotics, but I think there are some people who can benefit from them. There’s not much downside—the main one is the cost—but there are some people who specifically benefit from them. I don’t tell every one of my patients to take probiotics. They may or may not help.”
“Probiotics might be considered ‘preventive maintenance’ versus ‘crisis management,’” suggests Kerns. “They support the immune system, aid regularity and digestion. Based on our processed diet, stress and now resistance to many antibiotic strains, as well as living longer, everything we can do to enhance personal health is to our advantage.”
What do the doctors we spoke with recommend probiotics for? “First of all, we use them as treatment for patients who have GI distress,” says Dr. Ciccone. “Many people have irritable bowel syndrome and many times it’s just a matter of imbalance of good/bad bacteria or enzymes in the GI tract.”
“The groups of people I tend to use them for are people with irritable bowel syndrome, bacterial overgrowth and C. difficile infection. I tend to use it for people who have had infections in their intestines and people who aren’t feeling well after having taken antibiotics,” says Dr. Martins.
According to Dr. Ciccone, what’s key is that everyone has his or her own biochemical makeup and that a specific probiotic treatment regimen will work differently for different people—or might not work at all. “It’s always good to give a combination of probiotic strains. The one we use in the office has about 12 different strains,” Dr. Ciccone states. “You’re trying to balance the good bacteria versus the bad bacteria. And it’s not just for balancing the bacteria; it also helps the immune system.”
“Probiotics need to be a combination of several strains,” agrees Kerns. “There are many excellent probiotic products to choose from but I generally recommend Natren products because they have quality super strains, proper processing and clinically proven results backed by scientific research. Natren carries probiotic products for every age, starting with babies, adults and even for animals. Natren has been in business for over 30 years and provides excellent phone support with their probiotic specialist.”
“Probiotics are important for everyone—young and old, sick or healthy,” adds Boyer. “There are probiotics for infants, children, teens and adults. Also, it’s important to purchase probiotics that are live cultures that are housed and shipped refrigerated.”
However even that claim, according to Dr. Ciccone, is controversial among experts in the field. “The consensus is—refrigerated or non-refrigerated—as long as it’s a good quality brand and manufacturer, the product is good.” And Dr. Ciccone emphasizes that if you purchase refrigerated probiotics, make sure you keep them refrigerated, otherwise they will essentially die and thus lose their effectiveness.”
Also, says Dr. Ciccone, whatever over-the-counter probiotic you purchase, make sure it’s one with a high dose of live active cultures. “A lot of times treatment doesn’t work on people because they take OTC probiotics and dosages are really low. You have to treat in billions; in some people they treat it with trillions. So you really need high doses of probiotics to make them work.
“Probably about half the contents of the bowels are bacteria—that’s 100 trillion bacteria. So if you think about treating it with a few billion, you can see how you’re not really making a big dent.”
But what if you don’t want to take pills? Yogurt and kefir are good options. “Activia has about 1 to 3 billion live active cultures, which is not a lot, but sometimes a small amount can actually help,” says Dr. Ciccone.
“If someone is concerned about taking probiotics, I usually suggest they have the yogurt with the live active cultures,” Dr. Martins agrees. “It’s kind of a milder way to change your flora.”
“Yogurt is a healthy, cultured food that is good for the gut,” Kerns notes. “However, many people cannot tolerate dairy, and following a round of antibiotics, it would take a long time to build up the good bacteria again with just yogurt. Probiotics as a preventive measure on a daily basis is one very healthy way to nurture the body and support our best defense system—our immune system.”
Boyer suggests powders or chewables as alternatives to pills. “Powders are a help with upper gastrointestinal conditions. As you drink them, they help coat the esophagus and get in the digestive system faster for more immediate assistance,” she says.
Ultimately, probiotics are good for restoring the balance of good bacteria in your gut. But, as with any other supplements or medications, it’s essential that you contact your healthcare professional or an expert in the field before starting on any kind of serious regimen of probiotics. Since everyone has a different biochemical makeup, it may take some trial and error to find the best combination of probiotics that work for you.
Dr. Martins also warns that if you start on a regimen because of mild abdominal pain or bloating, and you don’t feel better after a week or two, get checked out for the possibility of a more serious illness.
“We all need good flora in our digestive system to keep us healthy. Restoring the good bacteria by taking probiotics and removing the bad or unneeded pathogens is something we need to do on a daily basis. Our bodies need to re-establish the flora because we lose enough of the good on a daily basis through different means such as stress, diets, sickness and not enough rest,” Boyer says.
It’s important to take care of our bodies, and probiotics — in the right combination and doses —could be just what the doctor ordered.
Rozanne Gelbinovich works as a copy editor for The Drug Store News Group, a group of trade publications that covers the retail drug store, health care and pharmaceutical industries. She also is a weekly columnist for a NewYork, a free daily commuter newspaper distributed throughout the city, and keeps up her travel blog, Bitten (bittentravel.blogspot.com), where she combines her two passions: travel and writing.
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Ronald P. Ciccone, MD
Lourdes Health System
Noel Martins, MD
Kennedy Health System