Probiotics are coming to the forefront in their contribution to overall health. This has been an intriguing and interesting evolution, from my perspective, as an integrative healthcare provider. Friendly bacteria are essential to the function of the human digestive tract and many other aspects of optimal biology. While clinicians have, for years, seen consistent benefits, the scientific validation has now been taking a significant step forward. While much work remains to be done, the health implications of friendly bacteria has become well documented.
This is not surprising given there are well over 400 different strains of probiotic, or friendly, bacteria in the human digestive tract and other areas of the human body. As a matter of fact, estimates have put the relative differential cell count at 10:1! That means, amazingly enough, that the number of bacteria in your body exceeds the number of your own cells tenfold. In effect, we could be considered more bacteria than human. I have always thought that this is a staggering concept to ponder. Friendly bacteria generally occur naturally in our diet and are also contained in fermented foods such as yogurt, kefir, and others. They occur naturally on fruits, vegetables, and leafy greens. The GI ecology can become altered for various reasons over time. This could include such things as a less than optimal diet, low fiber, antibiotic therapy, or the use of certain medications like an anti-inflammatory. These factors could induce GI irritation, and therefore destabilize the micro-ecology. In some rare cases this can even become fatal. Case in point would be the complication associated with the overgrowth of a certain pathogenic bacteria. Clostridium difficile overgrowth is generally associated with extensive, or prolonged, antibiotic use. When this alteration in normal ecology occurs, many patients are not responsive to treatment. Antibiotics options to treat clostridia are, unfortunately, limited. Some probiotics, however, such as Sarcomyces boulardii, have been shown to be selectively effective in preventing these bacterial overgrowth. Other forms of probiotic organisms have shown benefit as well. Unfortunately statistics show that upwards of 14,000 deaths occur in our country each year from clostridial infections that are not responsive to treatment. As a matter of fact, a May 2012 published study in the Journal of American Medical Association reviewed 63 separate controlled trials including a total of 11,811 patients which showed a significant reduction in occurrence of antibiotic associated diarrhea in those individuals supplementing a probiotic regimen in addition to taking a prescribed course of antibiotic therapy. There are several positive associations in clinical studies with probiotics.
Improvement in digestion assimilation from the GI tract.
Potential anti-cancer and anti-tumor properties.
Potential enhancement of oncology therapies and increased duration of lifespan in those suffering from metastatic cancer.
Treatment of halitosis, bad breath.
Improvement in irritable bowel syndrome.
Improvement in allergies and colic in children.
Improvement in vaginal health in women.
Improvement in cholesterol levels as demonstrated by a recent American Association meeting presentation showing a 12% reduction of cholesterol in supplementation with probiotics.
Support of vitamin synthesis in the GI tract.
Support of immune function both systemically and the GI tract or so-call the gut associated lymphoid tissue (GALT).
Improvement in diminishing the duration of cold or flu symptoms which was recently shown in a combination probiotic regimen administered by the University of Medical and Dentistry studies in New Jersey School of Health and Related Professions.
Enhancing the response of vaccines as noted in studies underway at Harvard looking at probiotic supplementation in the elderly to enhance immunologic response to food vaccines.
Treatment of chronic strep throat and tonsillitis.
Improvement in oral health and general recurrent mouth sores. This was demonstrated by International Journal of General Medicine using a particular probiotic called BLIS K 12 and even improvement in functional well-being and emotional health. Studies at UCLA using a newer technology of functional MRI showed better activity of brain regions associated with central control and emotional processing in individuals supplementing with probiotics.
Improvement in autoimmune conditions, in inflammatory conditions such as asthma, Crohn’s disease, ulcerative colitis, and various forms of irritable bowel syndrome, and possibly in addition to MS, rheumatoid arthritis, etc.
Interestingly, the evolution of probiotics in the context of modern medical care is also becoming species specific. For example, using specific forms of probiotic to treat specific types of conditions as becoming more commonplace. The probiotic Lactobacillus rhamnosus (LGG) has been shown to be potentially helpful in treating viral infections, particularly the GI tract, and also antibiotic induced diarrhea. Bifida bacterium animalis, which is a typical type of probiotic in some forms of yogurt and fermented foods, has shown improvement in digestion and assimilation. The popularity of probiotics has significantly increased in the minds of consumers as well. Last year alone, an increase in purchasing of probiotic supplements and fortified foods increased 22%, now totaling over 770 million dollars per year. I myself have seen substantial improvements in the above listed concerns in individuals supplementing probiotics and and anecdotally in otherwise healthy individuals. This sometimes includes an enhanced sense of well-being, GI symptom improvement, regularity and transit time. Many patients have noted if they discontinue their probiotic supplements, they often realize that they don’t feel quite as well. It is subjective, but consistent. Also important to understand is concept of the therapeutic dose. Whether it be probiotics or medications. For example, the probiotics most often available over the counter are generally of somewhat low potency. This may be adequate for general maintenance, but not often restorative. I have seen much better luck uniformly using a higher dose probiotic initially such as the compounded form EcoBiotic, which instead of the average 2.5 billion organisms per dose, is about 1.2 trillion organisms per teaspoon of powder. It also contains the 16 primary forms of probiotics found in the human digestive tract. The powder is easy to use, and can be mixed with foods such as yogurt, or in the case of those with dairy sensitivity, a coconut based yogurt. As it turns out, there are probably many other aspects of the micro-ecology of the human digestive tract that are relevant to our overall health. Worthy of an intriguing mention is the so called ‘autoimmune hygiene hypothesis’.
Research suggests that developing countries where higher risk of coexisting parasitic infection from food and water contamination have less incident of autoimmune diseases, such as Crohn’s disease, ulcerative colitis, rheumatoid arthritis, MS, and even asthma. The theoretic explanation is that over the course of time our human immune system has become adapted to encounter these common infections from our environment. these encounters may have an immune ‘balancing’ effect. Indeed, studies have shown that in Crohn’s disease, inducing a purposeful parasitic exposure with pig worms (Trichuris Suis ova), can show a very positive result. This was demonstrated by Joel Weinstock, M.D. at Boston’s Tuft New England Medical Center. In the course of treatment, a dose of 7,500 eggs was ingested by patients orally each two weeks for a period of 12 weeks. Significant reduction in Crohn’s symptoms were noticed and observed. Several patients have seen great benefit with this particular regimen. Even patients who may have been non responsive to conventional drug therapy. While that treatment is not an FDA approved, many patients have taken it upon themselves to order this protocol online from Europe.
Another intriguing therapeutic strategy for the re-inoculation of the GI microbiology involves ‘fecal transplants’ or ‘fecal bacterial therapy’. This has been shown to be of benefit in patients with clostridial difficile infections that have been non-responsive to conventional antibiotic therapy. The treatment utilizes a fecal sample, generally from a family member or spouse, and administering it through colonoscopy. Often dramatic and immediate positive results are seen in this context. Unfortunately, the FDA has created a potential delay by imposing further restrictions requiring each procedure to have an investigational new drug application. According to the American Gastroenterological Association, advanced paperwork must be completed and a waiting time of 30 days for consideration, and other restrictions, would mitigate the potential benefit of this treatment. Hopefully, those aspects could be worked out more efficiently in the near future. That said, it does become obvious the GI microbiology can have on health. Even in extreme cases such as Clostridial difficile super-infections.