The Complete Guide to Understanding Probiotics and Prebiotics
Posted Friday, September 13, 2013 at 07:47pm EDT
Guest post by Alexander Shikhman, MD
The human gut contains a myriad of microorganisms which form a well-orchestrated ecosystem known as microbiota.
Human microbiota plays a vital role in the human body via regulation of immune and inflammatory responses, production of certain vitamins and biologically active substances, scavenging of non-digested food components and human body metabolites (for example, uric acid causing gout) and feeding the intestinal lining.
Disturbances in the human microbiota caused by antibiotics, excessive carbohydrate consumption, prolonged use of birth control pills, immunosuppression and anti-inflammatory drugs can result in colon inflammation, yeast overgrowth, leaky gut syndrome and eventually trigger chronic fatigue, brain fog, insomnia and headaches.
Probiotics are live microorganisms that improve intestinal microbial balance and suppress pathogenic microorganisms. They can be consumed in the form of food supplements or as a part of live fermented foods such as pickled vegetables, sauerkraut, live yogurt, buttermilk, kefir, kimchi and gluten-free soy sauce.
Clinical and research data demonstrate that probiotics benefit people with chronic diarrhea and irritable bowel syndrome (IBS). Certain probiotic strains (Lactobacillus acidophilus, Lactobacillus casei, Lactococcus lactis) may help with the digestion of lactose, soy and animal proteins (Lactobacillus plantarum). Probiotics (Lactobacillus salivarius, Bifidobacterium bifidus, Bifidobacterium lactis) can be used for prophylaxis of colon cancer and to lower cholesterol and blood pressure (Saccharomyces boulardii, Lactobacillus acidophilus, Lactobacillus casei).
Another important aspect of probiotics (Saccharomyces boulardii, Lactobacillus acidophilus) is their ability to eradicate Helicobacter pylori – a microorganism causing gastric and duodenal ulcers and to reduce symptoms of antibiotic-associated diarrhea due to Clostridium difficile.
Recently, a particular probiotic, Bacillus coagulans, was shown to possess strong anti-inflammatory activity and benefit people with rheumatoid arthritis and ulcerative colitis. Finally, probiotics (Lactobacillus rhamnosus) can be used to treat various skin diseases like eczema.
Selecting probiotics for individual use may be tough to navigate due to the broad variety of strains, strengths and brands available in the market.
Commercially available probiotics come in the form of single-strain or multiple strain preparations. For general purposes, it is preferred to use multiple strain products to imitate the diverse environment of the human gut.
The amount of consumed probiotics is counted in Colony Forming Units (CFUs). In general, if you take probiotics just for maintenance of intestinal health, you should take 20-25 billion CFUs a day. During antibiotic therapy, increase consumption to 100 billion CFUs a day. Treatment of chronic yeast (Candida) infection, leaky gut syndrome and colitis quite often requires the daily dose of probiotics in the range of 100-500 billion CFUs a day.
The use of probiotics is not recommended in individuals with acute and chronic pancreatitis, in individuals undergoing stem cells and organ transplantation, as well as in individuals with a severely compromised immune system.
What are prebiotics and why are they important?
Prebiotics are non-digestible carbohydrate-based food ingredients that stimulate the growth of beneficial bacteria (bifidobacteria and lactic acid bacteria) in the gastrointestinal tract. In contrast to probiotics, prebiotics are not live microorganisms but rather heat-resistant fiber like substances.
The health effects of prebiotics are mediated via increased production of short-chain fatty acids by the stimulated bacteria, which feed normal gut microbiota and provides the energy supply to the epithelial cells that form the intestinal lining.
Natural products rich in prebiotics include various vegetables including asparagus, garlic, leek, onion, and artichoke. Another valuable source of prebiotics is brewer’s yeast.
My preferred prebiotic is mannan-oligosaccharides or MOS, a product derived from the cell wall of the brewer’s yeast, Saccharomyces cerevisiae. MOS is not only a prebiotic but also an immune polysaccharide—a molecule possessing one of the strongest stimulatory effects on mucosal immune responses. Another unique property of MOS includes its inhibitory effects on the attachment of pathogenic bacteria to the intestinal lining, restoration of intestinal villi and stimulation of digestive enzymes.
Other helpful tips:
Initial consumption of pre- and probiotics, especially at high doses and high CFUs, result in excessive gas formation, bloating and associated abdominal discomfort. Be patient– these problems typically disappear in 3-4 days.
In general, we recommend taking probiotics on an empty stomach. If you take probiotics at a dose equal to or above 100 billion CFUs, divide their consumption between AM and PM.
You do not need to take pre- and probiotics together. Prebiotics can be taken with meals.
Try to use non-refrigeratable probiotics, such as Bacillus coagulans, when you travel.
If you take antibiotics, separate the consumption of prebiotics from the antibiotics by at least 2 hours.