Probiotics. We’re betting you’ve heard of them, have a vague idea that they’re good, and wonder if you should be taking them. But this is one area where we also see a lot of confusion. Supplementation of healthy bacteria willy-nilly, without knowing what or why you’re doing what you’re doing, can be just as detrimental to your health as doing nothing at all. So before you stock up on pills or start mainlining sauerkraut, let’s get the complete low-down on all things probiotic from today’s guest expert, Dr. Tim Gerstmar of Aspire Natural Health.
What are probiotics, and what role do they play in the body?
Let’s back up a second before talking about probiotics and talk about gut flora. Inside our digestive tract we have somewhere around 100 trillion bacteria happily living in us. We’re like a giant high-rise building, and the bacteria are our tenants. About 7 lbs of “you” is really bacteria that live in your intestines, from your mouth to the other end.
Our understanding of gut flora has advanced by quantum leaps in the past decade or so but we’re still just scratching the tip of the iceberg here. We now know that our gut flora helps us properly digest our food, protects us from pathogens (harmful microorganisms), helps us detoxify harmful compounds, produces vitamins and other nutrients, keeps our guts healthy, and balances our immune systems.
Probiotics are a culture of “good” bacteria. Most often when we say the word probiotics we are talking about a supplement (a pill or powder) of beneficial bacteria, but we also use the word probiotics when talking about fermented foods.
What gets your gut bacteria out of whack in the first place?
There are a number of things that will disrupt our balance of gut bacteria, but two of the biggest things for most people are stress and antibiotics.
There was a nifty study I saw on rats a while ago. These rats are genetically identical, living in the same controlled environment, and eating the same standardized food. One group (the control) was left alone, while the other group was regularly stressed. Examination of their poop (there is a fun job!) showed marked differences in their gut flora – which means stress alone is enough to derange your gut bacterial balance. Personally I think chronic stress is at least on par with diet (if not more significant) a factor in causing disease.
The other big thing that will destroy your gut flora faster than you can say lickety-split are antibiotics. Don’t get me wrong, I’m a big fan of antibiotics when used appropriately. But we’ve way overused and abused antibiotics – taking them for viral infections (antibiotics do nothing for viral infections), not completing courses (leading to antibiotic resistance), and using them wholesale in all of the animals in the factory-farming system. Studies have shown that the good flora is decimated by antibiotics – and in some people, never recovers back to baseline without intervention. If you take one thing away from this article, please always use probiotics with antibiotics! (Don’t take the two types of pills at the exact same time, but do take probiotics at an alternate time of day while you’re taking your antibiotics).
Some other things that get our gut flora out of whack are: C-section birth, bottle feeding, early introduction of food (some controversy here), low soluble fiber diet (not enough fruits and veggies), toxic exposures, and poor digestion (low stomach acid, poor pancreatic output of enzymes, issues with bile secretion).
What are some symptoms of gut dysbiosis?
Symptoms of gut dysbiosis fall into two broad categories. First, almost any major disease or dysfunction. I know this sounds a bit glib, but knowing how tied up the gut flora is in the function of the human body, I believe that almost any major disease or dysfunction is going to involve dysbiosis either as a cause (primary or one factor among many) or as a result of the disease. If your health is “messed up,” you probably have a gut dysbiosis.
Second, gut dysbiosis manifests itself commonly as digestive symptoms, including (but not limited to) gas, bloating, heartburn /GERD, constipation, diarrhea, IBS (irritable bowel syndrome), and IBD (Crohn’s and ulcerative colitis, among others).
Where do probiotics come from?
Probiotics are bacteria, and bacteria are on everything – so in a sense, our bacteria come from everywhere. Most of our probiotics historically are coming from two places though: dirt and food.
First, hygiene wasn’t such a big issue back in the day – people ate a lot more dirt, and didn’t run around squirting Purell on every exposed surface, human or otherwise. Our ancestors had exposure to far more soil based sources of bacteria.
In addition, historically probiotics were a regular part of our daily diet. Before refrigeration, fermenting foods was one key way we preserved them. Most of the Neolithic “traditional” cuisines around the world served fermented foods daily, if not at every meal – so there’s our food based sources of probiotics.
Today, food-based sources of probiotics include anything fermented and not pasteurized, as pasteurization will kill the bacteria. These foods include sauerkraut, kimchi, lacto-fermented fruits and vegetables, non-pasteurized yogurt, kefir and cheese, non-pasteurized meats like salami and some sausages.
Nowadays we also have supplements of probiotics, in pill or powder form.
Does a Paleo diet typically reduce the need for probiotics? Does healing the gut help restore a healthy balance of gut flora and fauna?
Gut health and gut flora are a very chicken and egg type of thing. Bad gut flora causes poor gut health. Poor gut health causes poor gut flora. Depending on how severe the dysfunction, sometimes we have to address both in order to get things working properly, sometimes not.
There are a variety of reasons that a gut can be messed up. If the main reason is food-based (i.e., if the person is having food reactions), then a program like the Whole30® is superb for helping. However, if the dysfunction includes a hefty gut flora component, I haven’t found a standard Paleo diet by itself (without specifically including food-based sources of probiotics) is enough to make the gut healthy.
However, a generally Paleo lifestyle (which includes such thing as adequate sleep, appropriate exercise, and stress management) along with fermented foods would reduce the need for probiotics.
Do you see any issues with the Paleo diet in terms of gut bacteria balance?
Yes. A general Paleo diet doesn’t emphasize probiotic sources like fermented foods or probiotic supplements, which I think is a problem. Also, occasionally you’ll see people on a “Paleo” diet who aren’t eating much in the way of fruits and veggies. Not enough soluble fiber in the diet can also be detrimental to the gut flora.
How does someone know if they need probiotics, and what kind is the best?
I think everyone needs “probiotics” on a regular basis, but I’m super picky about my probiotic supplements. With a lot of other supplements you can get good brands over the counter (OTC), but not so much with probiotics. There hasn’t been a lot of testing that I’m aware of in this area, but what little I know of was pretty damning to the OTC probiotic market. Most were contaminated with pathogenic bacteria (“bad” stuff), or did not meet their potency/strength claims, or failed to grow (were non-viable). Meaning at best you wasted your money, at worst you hurt yourself more by taking the supplement.
In my practice, I use the high end stuff you get from the better supplement companies. Most aren’t easily available to the general public. Here are a couple of suggestions:
- Don’t go to the bargain bin for your probiotics. If you can buy 4 for $1, you’re getting what you paid for.
- Use a reputable brand – I’ve seen good results with the Jarrow brand (which is available OTC), and one brand I use I’ve seen pretty available on the Internet is the Klaire Labs line.
- Look for potency/strength. We’re not exactly sure how strong probiotics need to be, but in general stronger seems better. An 8 billion/dose is the minimum I’ll use, and often I’m using stronger doses than that. A lot of OTC brands are down in the 2 billion/dose range, which most of the time just isn’t going to cut it. And if they don’t list the dose (some probiotics have secret proprietary formulas or some such) don’t bother with it.
- Be suspicious of the kitchen sink. This isn’t as hard and fast a rule as the others, but I’ve seen a lot of crappy brands try and look impressive by putting a lot of strains in their formulas. Most of the high grade probiotic supplements we use have around 1-6 strains in them. Is that ideal? Probably not, but if you see a brand with 10+ ( especially if it’s vague on the counts), there’s a reasonable chance they’re padding out the product to try and make it look more impressive than it is.
So what, specifically, can people look for in a probiotic supplement?
In general, right now, you’re looking for strains of Lactobacillus and Bifidobacterium. Let’s illustrate this with the label off of the Jarrow product I linked to above.
You can see this product contains six strains. The three on the left and top one on the right are labeled “L. something” are the Lactobacillus strains. The two on the right labeled “B. something” are the Bifidobacterium strains.
You can tell this is a good product by the letters and numbers after the names. For example, “L. acidophilus LA-02”: the LA-02 is the pedigree of this strain. This strain of acidophilus has been purified, genetically characterized and then registered. The company (Jarrow) then bought the right to use that strain, took a pure sample and grew it to put in this product. Do you have to have those numbers to have a good product? No. But the presence of those letters is the sign of a quality product, as the company spent the extra dollars to get a pure, genetically characterized strain.
Anything else you think would be helpful for our community?
Probiotics are critically important, and the data just keeps piling up. I honestly think our understanding of gut flora is going to revolutionize our understanding of health and disease, and you’re just going to see it growing in importance over the next few years.
I believe everyone needs a baseline probiotic intake. If you’re healthy and you make or buy non-pasteurized fermented foods and eat them at least a few times a week, I doubt you need probiotic supplements. If you’re sick, you’re probably going to need to do a lot more than just that.
One last thing. If you think you’re very dysbiotic – you have a very disordered gut, or serious health problems – you’re going to want to start slowly with this stuff. Taking tons of probiotics or gobbling up tons of fermented foods is probably going to make you feel bad, bad, bad. The changing gut ecology brought on by an “overdose” of probiotics is going to send your system topsy-turvy and can lead to many issues, including diarrhea or constipation, fatigue and/or brain fog, body aches and flu like symptoms, skin “stuff” including rashes, and possibly a worsening of the symptoms you already have. So start slow. If using fermented foods, start with a teaspoon once a day and build up from there. If using probiotics, go with one of the lower potency probiotics to start with, possibly as low as 1-2 billion/dose, and gradually increase from there. (And, as always, it’s best if you can work with a naturopath or a functional medicine practitioner.)
Dr. Tim Gerstmar is a Seattle-based Naturopath who specializes in treating complex chronic diseases – those issues that leave most other doctors stumped. His area of expertise is in digestive health. He uses clinical nutrition (primarily Paleo, Weston A. Price and GAPS) and lifestyle counseling, botanical medicine (herbs), functional medicine, homeopathy in his practice. You can learn more about Dr. Gerstmar and Aspire Natural Health at http://aspirenaturalhealth.com, or contact him via Facebook (http://facebook.com/AspireNaturalHealth) or Twitter, @DrTimGerstmarND.
Reading this article was a lifesaver, truly. I have spent several weeks reading everything I could get my hands on related to probiotics. Reason….. my 19 month old son has severe eczema. It started at 3 months and has NEVER been under control to date. His pediatrician recommended we take him to a dermatologist, which I was completely against. I didn’t want him to take drugs, receive shots or spread toxic chemicals on his skin for the rest of his life. So, I took him to an allergist to try and treat the eczema from the inside out. Come to find out, he has an intolerance to eggs, dairy and peanuts which limits his diet quite a bit. I cook everything he consumes from scratch. My husband and I have bought expense, 100% organic cotton bed linens and clothing, and followed every single recommendation for people with eczema.
At 18 months, it hasn’t gotten any better. It is so frustrating as a parent to see your child in pain and terrible discomfort and not be able to help him. I finally gave in and we took him to see the dermatologist who did exactly as I had feared, put him on an oral prescription drugs along with SEVERAL prescription creams. This is when I started to research probiotics. I thought he may have a gut imbalance. From what I have read, eczema is usually the body’s way of pushing its ‘disease’ out. When he was born, he received an unusual, uncommon drug which I feel may have killed his ‘good’ bacteria which may explain the eczema.
Is there a brand and dosage someone could recommend for a 19 month old?
Hi Lisa,
Sorry to hear about your son’s challenges. At 19 months, assuming he’s not still breastfed, adult probiotics are probably just fine for him. You could try the Jarrow product or the Klaire Labs line. Start slowly, as it’s likely his skin will get worse if you push things too quickly.
Hope that’s helpful,
Tim Gerstmar, ND
Hi Doc. thanks for this info, i’ve been searching the web for good, simple, yet detailed info on probiotics and i’ve learned a lot from your post. I’m on the search for a good probiotic. The Flora formula from Primal Blueprint has “30 Billion Colony Forming Units per Capsule”. Is that too much to get started with? or is the 8 billion product from Jarrow enough to start with and to maintain my gut health in the long run? There is also a price difference, and while i definitely do not want to go cheap, i also don’t want to spend more than necessary.
Thanks Doc!
Thanks for an extremely informative article. I have experienced scalp problems (very thick flaky dandruff, scaling, scabs from picking at it), but my scalp has cleared up. Now my eyes have a red rash all the way around them that has developed over the last few weeks. It looks pink and a bit raised, and there are sometimes flakes in the morning. I have an appointment to see a naturopath this week, but your article raised some questions about probiotics that I have.
My question is about when and how to take probiotics, and how to combine with food sources of probiotics. Should I just follow the instructions on the Jarrow formula, for example, and take 1 capsule 3 times a day? I’ve heard recommendations before to take more than the listed dosage, which is why I ask. Should I also try to eat a few different types of fermented foods? I currently eat raw kraut about once a day. Sometimes I eat pasteurized yogurt (Noosa brand) and whole milk kefir. Besides the dairy, my diet is mostly Paleo, though a bit heavy on sugar in the form of fruit/dried fruit/coconut water etc.
Thank you!
Jenna
Looks like Jarrow makes a strain specifically for babies.
http://www.amazon.com/Jarrow-Formulations-Babys-Jarro-Dophilus/dp/B0013OSHDY/ref=sr_1_7?ie=UTF8&qid=1334786222&sr=8-7
I see that you deal with GAPS, yet don’t mention that GAPS standard Bio-Kult as a quality probiotic. I’d love your thoughts on Bio-Kult, as it is the easiest to store (without refrigeration).
Jen,
I can’t say for sure but that’s often to strong to start off with for people who have very disordered guts, more likely to cause a “die-off” reaction. When in doubt start with smaller dose.
Jenna,
Your naturopath will have more specific info for you, but generally we’re going to start low to avoid too many reactions, build up to a high therapeutic dose (so yes, above the amount on the bottle) and then when the guts are in good shape and things are going well, scale back to the smallest dose necessary for maintenance.
You can combine with food sources as well to get a broader, more rounded effect (each item will have different strains and concentrations of bacteria).
Fat Lazy Celiac,
Biokult is a nice product but at 2 bilion per capsule, I personally reserve it for people who’s guts are really disordered and who I want to start on a lower dose. GAPS calls for escalating doses and I find many people don’t want to take 6-8-10-12 capsules.
Hope that helped.
Best,
Dr. Tim Gerstmar
Does fermented yogurt/dairy still have lactose in it? I’d love to buy some probiotic-rich dairy but am worried it’ll flare me up.. . Thanks
Jessica,
Short answer yes, but it depends how long the fermentation has gone on. More fermentation = less lactose. My understanding is most store bought yogurts are fermented 3-4 hours and so still have quite a bit of lactose. The GAPS diet, in contrast, does allow yogurt but asks you to ferment it yourself for 24 hours which eliminates the vast majority of the lactose, and is well tolerated by many.
Another option is to ferment something like sour cream, higher fat and lower lactose content to begin with.
Best,
Dr. Tim Gerstmar
Dr. Gerstmar,
I really like Bubbies sauerkraut. Will this get the job done by itself and how little can be effective? Thanks!
David,
I like Bubbies too, but I’m skeptical that their product is non-pasteurized and thus has live bacteria in it. As for dosage, I don’t know. It depends on the state of your gut. If you’re a healthy dude, eat “some” daily. If not, it’s going to depend.
Best,
Dr. Tim Gerstmar
What are your thoughts on store-bought kefir, for someone on the Paleo diet? This is the kind I bought: http://www.lifeway.net/Products/Kefir/OriginalKefir/Original.aspx
Thanks for responding back to our questions!
Hi Jenna,
The same rule applies, it’s got to be live and not have been pasteurized after culturing. Many say they are live, and I’m skeptical of whether that’s true or not. The page you linked to was very light on info. They said 7-10 billion but is that per 1 cup serving, for the whole bottle or what? In general that’d be very “wimpy” as far as probiotics go.
Then there’s the issue of whether you’re dairy tolerant or not. I’ve seen many people with degrees of dairy tolerance due well with kefir, but most make their own at home. Kefir is really easy to make, so I would recommend making it yourself.
And it depends on the state of your gut. Otherwise healthy and dairy tolerant, may be just fine. Messed up, probably not going to cut it.
Hope that was helpful.
Best,
Dr. Tim Gerstmar, ND
Jenna,
We’re fine with store-bought (as opposed to make-your-own) kefir, but our standards are that it MUST be pastured and organic, and preferably full fat. The best part of kefir is (a) the dairy fat – good stuff, if it’s coming from a high quality source) and (b) the live cultures. If you’re buying traditional kefir from industrially-produced sources, you’re missing out on one of the two benefits, and getting potentially toxic tag-alongs (like hormones, antibiotics, heavy metals and other environmental toxins) – residues from the factory-farming system.
Best,
Melissa
I’ve never been a fan of antibiotics and usually just deal with being sick and let it run its course. However, a few years ago I was a guide in SE Alaska, which is a very wet environment. During guide training in February, I got an upper respiratory infection. Since I had to go on a mountaineering expedition in just a few days, I took the antibiotics the doctor recommended. Since I didn’t really know anything about antibiotics, I stopped taking them as soon as I felt better because they really upset my stomach. Long story shorter, ever since then, every February I get a bad cold which turns into a really bad cough and lasts for what seems like forever. Your article mentions not taking a whole course of antibiotics as an issue. Could probiotics help with this problem? I’m also curious if probiotics have a general boosting effect on the immune system? I used to never get sick, but have noticed that since I stopped guiding and settled into city life, I get sick a few times a year…
Hi Krista,
The problem with not finishing rounds of antibiotics is that it accelerates antibiotic resistance in bacteria, which is not a good thing. I’m a HUGE fan of probiotics after antibiotics, even if it’s been a while. The studies that have been done have shown that some people’s guts never recover after antibiotics without a little help.
Studies have also shown antibiotics to be helpful in preventing URI (upper respiratory infections; colds, coughs, etc) so it’s likely it would be helpful for you.
Hope that helps.
Best,
Dr. Tim Gerstmar
I’m doing a whole 30, so I stopped eating the lacto-fermented vegetables I made. I am sensitive to dairy and the Jarrow probiotics I bought have trace amounts of dairy and soy. Are there dairy free sources of probiotics?
Thanks.
Cindy,
Yes there are dairy free sources of probiotics and they’re going to be labeled dairy free or certified dairy free. Usually they’re higher end lines and are more expensive. I believe Pharmax’s HLC line is dairy free, but you should double check. There are other lines out there, you’ll just need to check the label info to be sure.
Also, often the trace amounts of dairy in probiotics are not an issue for people unless they are very sensitive.
Best,
Dr. TIm Gerstmar
I’m wondering if you could comment on the including varieties of kombucha (homegrown vs. storebought) and/or coconut water kefir (again, fermented at home vs. commercially available brands) in a paleo diet? It seems like these would be viable non-dairy probiotic options, but I’m unclear about their efficacy or potency, or if they are considered Whole30 approved?
HI Amey,
I’ll have to leave the Whole30 approved part to Melissa and Dallas, but let me see if I can answer the other part of your question.
There are really two pieces here. There’s the store bought vs home-made. Most store bought items ARE going to be pasteurized to increase shelf-life and for public health reasons, which means they’re NOT going to be viable sources of probiotics. Making these things at home – kombucha, kefir, yogurt, sauerkraut, etc, etc means you can ensure that they are alive and a viable probiotic source.
The other issue is ensuring potency and efficacy. This is where probiotic supplements from a reputable company make life easier because we can be confident in what you are getting, how strong it is, etc. Using probiotic foods, there’s no way to monitor with any precision what you’re taking in.
If you’re healthy and looking to maintain a good gut, that’s not likely to be an issue. So ensuring that you’re getting in a variety of probiotic foods mimics our ancestral pattern (at least from the Neolithic) and is going to be fine. If you’re sick and have a messed up gut, probiotic foods may work just fine for you. Being a doctor and looking for reproducible results in my practice, I use probiotics AND fermented foods to have better control.
I hope that makes sense.
Best,
Dr. Tim Gerstmar
Kombucha and coconut water kefir are both Whole30-approved, and encouraged.
Best,
Melissa
I have another question about probiotic supplements: when they say they need to be refrigerated, how serious are they? If I’m traveling, should I still take them with me, or will they become useless after, say, 5 hours of traveling. I’m currently using the Jarrow supplement.
Thanks for all your responses!
Hi Jena,
Sorry it’s taken me so long to respond. In general supplement forms of probiotics are reasonably stable. Yes over time at room temperature you will lose some of the bacteria, this is more measured in weeks and months than in days or hours. So personally I would have no problem taking a probiotic on a trip with me, even one that lasted a couple of weeks.
You should keep it in the fridge where possible, but if you have to take it out, that should be fine. Most reputable companies making a good product will actually package it with an overage, that is if it says 8 billion on the box they’ll package it with 10-12 billion to allow some loss over time and still meet label claims. Another reason in my book to purchase a good probiotic.
Fermented foods are a different story and will continue to ferment (and off gas, not good for luggage) if not refrigerated.
Hope that helps!
Best,
Dr. Tim Gerstmar
Have you done any research or heard of the probiotics from Living Streams? I’m just curious to know if its a good product or not. I dont see the number of strains in it so thats why Im wondering if you’ve ever heard of it. thanks!
Hi JoEllyn,
i had not heard of them before, but just did a quick scan of their website. It seems to be a lot of hype and vagueness around their products. I can’t say whether they’re good or not, they may be great, but personally I would steer away from it in favor of something I can recommend with more confidence.
Hope that helps.
Best,
Dr. Tim Gerstmar
Hi, this is such a great and useful article. I work in natural health in Australia and have spent a lot of time working in retail health food and pharmacies. So I appreciate there is a lot of variation in the quality of supplements. A favorite of mine here in Oz is one called “inner health plus” because they educate about the strain and it is refrigerated, although the rep said what you say that there is overage and that in lab tests it was fine at room temp for a few months. I can really tell a difference when I am taking my probiotics, especially in my skin!
Cheers, Fiona
Fiona,
Thanks for sharing, and helpful I’m sure for people in Australia. I’m glad you’ve had good experiences with probiotics, and yes I commonly see that they help the skin.
Best,
Dr. Tim Gerstmar
I just listened to a very interesting episode on RadioLab called “Guts” that talks about the implications of probiotics on a variety of factors, including behavior and stress. Very interesting and worth the hour’s investment.
Thanks for posting that Breanna. I’ll take a look at it. For everyone else, this looks like the link to the show: http://www.radiolab.org/2012/apr/02/
Best,
Dr. Tim Gerstmar
FYI–
I emailed Bubbies and asked them about their products, and this is the response I got:
“Our Pure Kosher Dills, Dill Relish, Pickled Green Tomatoes and Sauerkraut are all naturally fermented and cured in salt water brine using a lacto-fermentation process. These products contain live cultures and the enzymes that form from a natural fermentation.
The Pure Kosher Dills, Dill Relish and Pickled Green Tomatoes are 100% raw; the Sauerkraut in the jars has been flash heated but not pasteurized. This means that the sauerkraut is neither pasteurized nor raw. Bubbies Sauerkraut is heated in a steam bath bottle wash after the product has been sealed in the jar, and this does not kill off all the cultures, but rather just some of them that are producing the bulk of the carbon dioxide gas at that stage of the fermentation. The hottest of the jars reach 130-140 degrees – no higher; the result is an approximate 10% decrease in culture content vs. a raw sample; but a product that will not continue to give off gas once sealed in the jar. Without the heating our Sauerkraut will continue to ferment in the refrigerator resulting in bulging lids, leaking jars and a big mess within the distribution to retailer to customer chain.”
Hi Laurie,
Thanks for looking into it and thanks for posting. Nice to know!
Best,
Dr Tim Gerstmar
I was taking a probiotic everyday before I started to feel ill. I figured maybe I had too much bacteria in my system so I stopped it (like an idiot) and since then my body has waged war on me- my ENTIRE body.
I have a swollen lymphnode that occurred under my armpit, that I feel could also be due to 2 more wisdom teeth that should be extracted; bad dry cough; rash-type looking thing under my eye; etc.!
Don’t know what to do other than the probiotic- any suggestions? (I will be visiting some more doctors this week)
Thanks
Christina,
What you have going on is way bigger than “I stopped taking my probiotic.” I’d highly recommend seeing a good naturopath or functional medicine doc to look at what is going on systemically – and not just treat your symptoms. Perhaps Dr. Tim could recommend some basic testing to start with, but you need the help of a qualified expert – I doubt taking an OTC probiotic at random is going to be the end-all, be-all solution. Hope you feel better soon!
Melissa
Thank you for the information. I wish I would of known about probiotics after I had my open heart surgury! I even went and had a colonoscopy and endoscope and no one suggested I should take them! That was 4 yrs ago and I am just now finding out that this is the path I should be taking. I wish I would not of suffered for so long with digestive problems.
Great article! Thanks so much for the info. I have a curious case that I wanted to ask you about. I’ve been struggling with symptoms such as fatigue, malabsorbtion, bloating and such. These symtoms have seemed to steadily get worse for the past two years…I feel like I have been on a steady decline. A few months ago I started taking Raw Probiotics for Men by Garden of Life. The bottle says that there are 85 billion live cultures and 31 probiotic strains. I bought it at a health food store which kept them refrigerated and put them in the refrigerator when I got home. I started taking one in the morning and one in the evening combined with colostrum. After a few weeks I felt better then ever. Within a month I was a totally new person and absolutely delighted. I then doubled the dosage for a period and soon I had stomach cramps, bloating and gas. So I stopped taking them for about five days but then started back up on two a day, and occasionally three a day. That was about two and a half weeks ago. Since then my body has tanked and all of the previous symptoms are back in full force…along with some chills now. And it has been so discouraging after that period of feeling totally amazing and thinking I was over everything. So my question is this: did the probiotics lose their effect and are not working anymore? Is it even possible for them to stop working? Or did my overdose throw things so far off that I should have taken more time off of them? I am a 27 year old male and try to live a fairly health life…exercise and all. But my increasing fatigue and weakness from malabsorbtion is slowing draining my quality of life and what I can do. I had a breakthrough and then lost it. So any help would be super welcome! Thanks so much!
@Nicholas: I’m sorry you’re not feeling well, but not even Dr. Tim could give you recommendations without a full work-up. You need some lab work stat to see what’s really going on inside your gut – only then could your naturopath or functional medicine doc come up with an effective course of action. I’d take yourself immediately to a qualified practitioner, and see what’s going on inside. Sounds like your self-treatment, while effective for a while, didn’t actually fix the problem – time to call in the experts and peek under the hood.
Best,
Melissa
Hey folks,
Sorry I’ve been away for a while.
Christina,
Like Melissa said, there’s probably a lot more going on than just a probiotic supplement. I hope you’ve gotten a thorough check-up and hope everything is going well. Swollen lymph nodes are signs of immune activation and can be anything from a virus to cancer. Not something to freak over, but definitely something to follow up on.
Patti,
Agreed, it drives me crazy that the conventional medical system is not making extensive use of probiotics. They’re cheap (compared to many/most drugs and other therapies), safe and easy to use, there’s also a lot of good science behind them. Most MD’s just aren’t taught about them. Bottom line: if you take antibiotics, take probiotics (or at least fermented foods)!
Nicholas,
Thanks for the comment and sorry you’re suffering. I agree with Melissa you really need to find a good doc to give you a thorough evaluation. Basic bloodwork to look at your organ functions and I would recommend a stool test and probably a SIBO test as well. Hope you have some good docs local to you. If not, contact me and I can see about finding someone for you.
Best,
Dr Tim Gerstmar
Thanks Dr. Tim!
In retrospect I actually think I did what you said not to do in the last paragraph. When I saw that they were working I got excited and doubled the dosage. I’ve had alot of the symptoms that you said one would have if they did that. I haven’t taken any probiotics for about five days now and I’m slowly starting to feel better. How long does it usually take for one’s system to come back into equilibrium in the case of an “overdose?”
Hi Nicholas,
It’s easy to get excited and rush things. Symptoms usually calm down between a day or two and a few weeks, just depending on the person and what kind of state they’re in.
Hope you feel better soon!
Best,
Dr Tim Gerstmar
Hello Dr. Tim and whole9, I found your blog through a google search, read through the section and most of the replies and have some questions and concerns. Please bare with me, I understand a reply may not be immediate which is understandable. If ever there is a free moment I hope it can eventually be looked through and replied to when possible. Happy Holidays to everyone!
I became aware of probiotics for a little under a year now. My story is as follows. In my late teens I was overcome with sever acne and it went untreated for many years for lack of insurance and essentially ignorance. This was about 2000-01. After a few failed visits to a local Dermatologist this acne transcended into “Acne Vulgaris” It wasn’t until 2007 during a trip to Portugal that I finally treated received successful treatment. I went on Accutane for the suggested time, took frequent blood tests to make sure nothing was spiking due to the treatment etc and after about 5-7 months the acne seemed to finally run its course and dry up…..
Through 2008-11, I was beginning to finally enjoy life without that burden of insecurity and emotional stress that was acne (mostly back and neck acne by the way) Besides this acne i’ve never had any other conditions… So at the beginning of 2012 I went through a high anxiety-stress period in my life over the loss of a car and went through the time constraint and limited financial pressure of needing to find a replacement. The way i handled it, really took a toll on me. The stress got worse day to day leading up to the day that i finally found the ideal replacement. This day to day stress went on for approximately 1 month and 2 weeks.
Roughly 2 months later I came down with this random skin condition mostly on my scalp very vaguely on my face and minor spotty areas on my chest where my skin was scabbing and peeling.
My scalp suffered the most. Initially i was told it was probably eczema, then it was seborrheic dermatitis, and then psoriasis. I was even told at one point it was scalp acne. Meanwhile all I understood was that Doctors apparently get paid very nicely to not know much of anything and take shots in the dark. During the time frame of about 2-3 months i was given a multitude of medicine including antibiotics, steroidal creams and a bunch of other topical treatments. Once I decided this dermatologist was ineffective I was left with a halloween like bag of drugs 2 types of antibiotics and a heap of topical ointments and creams around 12 different medications in the time from of about 2 months or so.
Fast forward again to about 1 or so later and I begin having bald patches on my head and acne began to reoccur on my neck severely… the bald spots started off as smaller than a penny and some are now almost as large as my Palm. I have about 4 in total and 3 other smaller ones beginning to form… about 4 out of those 3 are showing hair growth. White hair in the form of baby fuzz…… I then decided to look for a dermatologist in Boston about an hour from me. I was givin shots in those balds spots and some steroidal topical cream to apply. I see very minimal results. I intuitively believe my hair loss was a result of taking those earlier multitudes of medications. The new dermo says i have alopecia now.
No one in my family that i know of has ever had it, neither have I. I was fine before now I have this and am left feeling like a lab rat, medical beta tester. I am wondering now from researching here and there about probiotics if my issues truly stem from antibiotics/medicines messing up my body’s function or throwing my system into disarray. Can Probiotics help me? How can I safely take them? Iv’e looked through Amazon, Jarrow site, GNC site, Vitamin World and I’m beginning to get overwhelmed by the abundance of brands and probiotic types. Is there different types of Probiotics that are applicable to a more particular issue or are they all similarly effective?
Sidenote: a year prior to this (scalp issues/bald patches) I had been changing my diet. I had cut out sodas and processed foods and was heavily eating chicken and brown rice, going to the gym about 3 days a week and consuming whey protein. To see my body then take a nose dive with something i hope was unrelated to my “positive” lifestyle change was a bit discouraging none the less. I just don’t know where else to go.
I apologize for the Saga and please take your time as I imagine this novel would intimidate anyone. I will patiently await any input.
Thanks
Gill,
Gill,
I can’t speak to your specific medical conditions, because (a) I’m not a doctor, and (b) you’re not my patient or client, but I will say that these are very common symptoms when one has gut disruption due to consumption of inflammatory foods. Probiotics may help, but it’s like putting a tiny band-aid over a crack in the dam… the real culprit may, in fact, be the foods you are eating, and their effects on your digestive system, particularly your small intestine.
If some of the “healthy” foods you are eating, like whole grains and whey protein, are creating gut permeability (what some call “leaky gut”), the effects aren’t just contained to your digestive tract. Because most of your immune system is stationed in your gut, and gut permeability means that things are getting into your body (via your bloodstream) that don’t belong there, your immune system is then placed into “overdrive” anywhere and everywhere your bloodstream goes. This can lead to symptoms anywhere and everywhere in the body, including hair loss, and skin conditions. These conditions are most closely related to consumption of gluten (found in wheat, rye, and barley) and dairy proteins (like whey).
We cover this material in great detail in our really easy to read book, It Starts With Food (http://bit.ly/whole9iswf). We explain which foods promote this kind of inflammation in the body, and how. We also talk about how you may be able to fix these symptoms and conditions just by changing the food you put on your plate, with our Whole30® program. The program overview and rules are available for free on our site (http://whole9life.com/whole30), and are outlined in great detail in our book.
In summary, I’d highly recommend a Whole30 for you immediately, to pull out the most common problematic elements in your conditions. If you do that for a full 30 days, you’ll see results if the food you’re eating is indeed contributing. Taking some probiotics during this period will certainly help your gut to heal, but without the dietary changes, I’m afraid the probiotics probably won’t make much difference on their own.
Hope that helps.
Melissa
Hi Gil,
Thanks for the comment, and I’m sorry to hear that you’ve been through such an ordeal. The amount of help I can offer in this venue is of course very limited, and I do recommend you find a good, knowledgeable ND or integrated physician to help you out.
Acne is often a result of:
1. High androgen states (testosterone, DHEA) – thus often an issue for teens and tweens
2. High insulin states
3. Dybiosis – “bad” bacteria on the skin
4. Gut dysfunction
So while some of the drugs can be helpful, obviously getting to the root of the problem is more better.
Bald patches (alopecia is just the medical term for baldness) are typically the result of:
1. Autoimmunity
2. Nutrient deficiencies
3. Hormonal dysfunction (low thyroid can cause hair loss for example, but it tends to be widespread over the head and not in patches)
4. High testosterone (really DHT) will cause the typical male pattern baldness (does not sound like what you have going on)
If you have the money available I recommend getting adequate testing to include: basic but sufficient blood testing (including thyroid, testosterone, and inflammatory markers), a stool test (to see what your gut bacteria look like), and possibly some more advanced nutrient testing.
Regardless of whether you can get the testing done, make sure your diet and lifestyle are in order:
1. Have you done a Whole30?
2. Sleep – make sure you’re getting plenty
3. Movement – are your moving regularly, but not excessively? Not WODing 6 days/week?
4. Stress management – sounds like a big deal for you
5. Social support – do you have good friends and family who support you and aren’t giving you “grief” about the hair loss and acne. Not feeling isolated?
I do think probiotics would be helpful for you. WIthout more testing it’s hard to say what you need, so I recommend getting a quality brand (a couple are listed in the article above) and starting with a slow introduction. Also, if you aren’t eating fermented foods I would recommend slowly bringing those into your diet.
Hope that was helpful. Happy Holidays (insert whatever winter holiday greeting makes you most warm & fuzzy)!
Best,
Dr Tim Gerstmar
Wow, more better?? Teach me to proofread. …much better.
Best,
Dr Tim Gerstmar
Wow thanks. That was an interesting and unique perspective. I love how i can get str8 answers or at least an intelligent and detailed approach on the internet. Yet when I’m digging for a Dr. who can at this point give me conversation/explanation vs pulling the prescription trigger it’s impossible. I get vague and redundant write off replies.
I guess my problem would be finding a good or educated Dr. What exactly is an “integrated physician”? I’ll see if i can locate an “ND” in the Boston area…. I have insurance, insurance should cover this kind of testing correct? Another thing i forgot to mention which i somehow believe was a potential related result of this was that…. Around the same time this year that all of this happened. Scalp issue/ reoccurence of acne/ and bald patches. I came down with noticeable “allergies” for the first time in my life. By tthis i mean all the standard heard about symptoms.
Such as sneezing a dozen times immediately after waking up, itchy eyes, throat etc… lol I was like “wtf?! really? Allergies now?”
I did look through the Probiotics you mentioned and I also looked at typical OTC probiotics at general grocery and pharmacy stores and noticed the contrast as you mentioned of these brands not having as many types of of strains listed.
The reason I was asking how i should take them (Probiotics) and what “strength” if you will, I should begin with is because i read cases where people were over doing doses and went from feeling well to feeling not so well… I’de never take more than the recommended dosage unless told to by a physician but are these “ill” effects a standard process for any Probiotics taker? Also if you don’t mind what is a “Slow introduction”? The recommended dosage listed on the bottle or even less?
I will take a look at this “Whole30″ haven’t really browsed the links on here much yet.
Another aspect of acne i never understood is why are the acne prone areas so isolated or why are they area specific to begin with if all my skin is well… on me? In other woods why does my belly or arms etc retain that “normalcy” smooth look, while the other areas look like they can’t seem to keep it together?
Thanks again for all your input. Conversation is greatly appreciated IMO it goes hand in hand with prescription. People need to understand what their problem is, why it is, what it is they’re taking and the boundaries and limitations of those prescriptions/medicines/supplements.
Thank you kind sir!
Merry Xmas eve!
Gill,
also whats you’re honest opinion of Colloidal silver. Thanks again!
Gill,
The idealist is often a person who helps other folks to get productive.
Gil,
An integrated physician is an MD who is willing to step beyond the confines of conventional medicine and embrace a more inclusive view. Here are some internet terms you can use to look around. Integrative, holistic, or alternative MD. Some but not all DO (doctors of osteopathy are also going to practice in a way you are looking for). You could also look for doctors who practice functional medicine. Also, plugging my profession, NDs (naturopathic doctors), are, in my very biased perspective, the very best integrated physicians. You can find a list of us at http://www.naturopathic.org or look up Naturopathic Doctors Association. Of course, if you can find someone with sufficient skill you don’t necessarily need to see a doctor either which opens up more possibilities, but it can be very confusing when you first start looking into things.
Also, I and many other people do phone/Skype consults so you have many options.
Some of the tests I talked about will be covered by insurance, others will not. Also many integrated physicians and practitioners are not going to be in the insurance system. It’s frustrating for people to have to pay for our services, but you’ve been around and around the conventional system (as have many) and got very little help. If you want a doctor who’s not going to reach for the prescription pad, you will probably have to step outside the system.
Allergies are just another symptom that your immune system is out of whack.
For most people, starting with a probiotic dose of 2 billion/day with a meal is very safe and unlikely to provoke problems.
Skin is complex and I don’t pretend to have all the answers, but just like different parts of the brain are different (even though they are all “brain”), so different areas of the skin are different as well. Their thickness, underlying tissue, concentrations of hormone receptors, levels of keratin, hair, sweat glands, etc are all going to vary.
Hope this was helpful.
Best,
Dr Tim Gerstmar
Gil,
Colloidal silver is a whole other topic for another day. It can be helpful for a variety of conditions, it can be abused, and it can have side effects. I do use it, but don’t recommend people use it indiscriminately.
Best,
Dr Tim Gerstmar
Thanks a lot! You have been extremely helpful actually. Very enlightening. I will look into finding a integrated/ND MD.
If I may have one final inquiry. I’ve been playing with the idea of beginning a vitamin regimen. A multivitamin and a Vegan Omega-3 with DHA/EPA could I include Probiotics capsules with this or is it unsafe to mix Probiotics with other supplements?
I shared my exchanges between us with my GF and she had reminded me that less than a year before all these said symptoms/issues I described began happening that i had taken a FLU shot. It was my first in probably over 10 years. I don’t get sick often. Probably just “normal” which id’e describe moderately sick once a year… Could that have played a role? I hear that flu shots are either completely bad or they are ok for some but have not so good effects for others.
Lastly, Iv’e read through the Whole30, initially i thought it may have been a diet but then i realized that it looks more like a detox. Am I correct? Otherwise i don’t see why so many vitals would be cut out…. oats, nuts etc…. Eitherway, I’m definitely planning to take this challenge my GF may also join me!
Thanks again for all your help and time. You’ve been exceptionally helpful, maybe more so then all of my consults combined over the years as far as information and explanation and I will def be looking into a ND near me…
Gill,
I have a question regarding probiotics specifically formulated for women. I am debating between purchasing the Jarrow you have referenced or the Klaire Labs Ther-Biotic Women’s. Is there a significant difference in the benefit of these products for a nursing woman? I am currently tackling thrush with my 10 week old. I currently take a probiotic (I just started about 3 weeks ago) and I bought a supplement without really knowing much. Now that I am educating myself, I’m trying to determine what would be best for me.
Thanks,
Shannon
Gil,
I don’t know of any issues with combining probiotics with any other supplement or medication.
Given that your issues seem to revolve around your immune system, it is theoretically possible that a vaccine could have been “the straw that broke the camel’s back”, but, honestly it’s extremely unlikely you’ll ever know one way or another.
The Whole30 could be either. You could use it as a 30 day “detox” and then reintroduce foods that you want and tolerate. Many other people find that their health is so improved and they feel so good that they use it as their “forever” eating style.
Best of luck!
Regards,
Dr Tim Gerstmar
Hi Shannon,
The Klaire Women’s formula is designed to provide extra benefit with vaginal issues (yeast infections, discharge, etc). If you’re having those kind of symptoms then you’re probably find extra benefit with the women’s formula over the Jarrow, if not then the Jarrow will probably provide all the benefit you need. Having said that both are good product lines and will probably work well for you.
Best,
Dr Tim Gerstmar
Thank you for your prompt reply!
I have some additional questions for you. My 10 week old daughter has been taking the Klaire infant probiotics to help with her reflux as recommended by our chiropractor. Now that she has developed thrush, I know this will help that too. Are there any other brands of infant probiotics that you recommend, looking at both quality and price? Do you know of any additional natural remedies for thrush, both for her as well as myself? I’ve heard castor oil on my nipples, but wondered what you would recommend.
I also have a 4 1/2 Year old daughter that I would like to get on probiotics regularly. I bought her a buddy bear probiotic supplement by renew life. The label lists only 3 probiotics and 1 billion cultures. For a child her age, what is the recommended number of strains and cultures for a probiotic supplement? Do you have any that you would recommend, looking and quality and price?
Thanks again!
Shannon
Hi Shannon,
This is getting into treatment advice, which 1. I can’t legally do unless you (or your daughter) is a patient of mine, and 2. is what I do for a living. But let me see if I can offer you a couple of general suggestions. The Klaire infant is a fine formula. If you daughter tolerates, I recommend being aggressive about the dosing. You could also dust your nipple with it before feeding. There are many anti-fungal treatments, but they need to be individualized for the situation. I would not apply castor oil to your nipples as it will most likely give your daughter diarrhea.
For your 4 1/2 year old you could continue with the Klaire line (he could take the normal “adult” probiotics) if he’ll take them. I’m obviously not a fan of the gummies unless that’s all kids will take.
Hope that helps. If you’d like to see about doing a phone/Skype appointment (there’s absolutely no obligation) please feel free to contact me.
Best,
Dr Tim Gerstmar
I have some additional questions for you. My 10 week old daughter has been taking the Klaire infant probiotics to help with her reflux as recommended by our chiropractor. Now that she has developed thrush, I know this will help that too. Are there any other brands of infant probiotics that you recommend, looking at both quality and price? Do you know of any additional natural remedies for thrush, both for her as well as myself? I’ve heard castor oil on my nipples, but wondered what you would recommend.
I also have a 4 1/2 Year old daughter that I would like to get on probiotics regularly. I bought her a buddy bear probiotic supplement by renew life. The label lists only 3 probiotics and 1 billion cultures. For a child her age, what is the recommended number of strains and cultures for a probiotic supplement? Do you have any that you would recommend, looking and quality and price?
Thanks again!
Shannon
Thanks much Tim! Your input has been very motivating… Iv’e also signed up at the forums so i can let you help other folks lol!! Sorry for so many Q’s….
Iv’e completely changed my diet, Iv’e picked up a probiotic supplement that i feel seemed really beneficial “Garden of Life RAW probiotic” The reason I ultimately chose this was because of it’s “whole food” content and I’m also brushing up on my cooking skills so i can eventually attempt a whole30 since one thing I fear, will be not knowing what to make with the expected limitations…..
I’m also planning to drop off on industry body wash products since about 99% of them are synthetic and chemical infused detergents. Iv’e purchased a handmade, organic, all natural cold process soap bar. iv’e also found a Naturopath in my area who also happens to be an MD and with that i mean he accepts insurances and the such… My local indie organic/health shop recommended him and spoke about many of the testing he provides that you speak of….
Thanks again!
take care sir!
Gil,
Hey Gil,
Glad to hear you’re doing well and have a plan of action! I hope things improve quickly for you. Good luck on the Whole30.
Just a general comment, I do want to caution people, about “naturopathic” MDs or other providers. Many are great and it’s not my intent to run down anyone. If you like and are getting good results from any provider regardless of the initials after their names you should continue with them. But one, disturbing trend I’ve seen over the past couple of years as natural medicine gets more popular is medical providers trying to “cash in” on it by taking a little (insufficient) education and rebranding themselves as natural, “naturopathic”, holistic or green. Often these providers really don’t know what they’re doing and offer a sort of green-washed conventional approach. Their approach tends to be very formulaic (everyone gets the same treatment) and because they don’t really understand what is going on they can’t really explain or adjust the treatment.
My recommendation is always to ask a potential provider about their education. Practicing real natural medicine is hard! Especially with sick people. If they don’t have a good deal of education (not necessarily formal) they’re probably not going to be very effective. If they can’t explain why each piece of a treatment protocol is in that protocol, again, I’d be wary.
Didn’t mean to hijack this response, but wanted to put that out there.
Best,
Dr Tim Gerstmar
Hi Doctor Tim Gerstmar,
I’ve heard that you have to take probiotics with colostrum in order for them to work. Is that true?
Thanks
Lance
Hi Lance,
No, this is not true. Colostrum has a variety of health benefits, and may help improve the implantation of beneficial bacteria, but it is by no means necessary. Also people with dairy issues may not be able to tolerate colostrum without other problems.
Best,
Dr Tim Gerstmar
I see what your saying with what you said. The woman at this indie health store said she used to see a holistic dr and is now seeing this “naturopath” I’m hoping with her previous experience that her recommendation is a genuine one.
At the moment I’m not in any rush to see any Dr. The day i began my probiotics i dropped off with the antibiotic I was given for my acne (Dioxicylin) spelling? In combination I always started a strict diet and completely eliminated anything packaged processed or canned. No soda, no fast food or “Fruit” juices…. I’ve begun eating just veggies, fruits, fish and once in a while chicken, my sides are veggies or brown or brown rice. I’ve also eliminated dairy. Since the probiotics i’ve also only had water or almond milk to drink. I also take Minami Omega 3 Fish Oil (probably the best on the market)
I have also eliminated chemical applications such as “Beauty Bars” aka Detergent bars and have began using hand made, cold pressed soap consisting of natural oils but oxide colorants and fragance free…. Since then (about 3 weeks) my skin has drastically improved and my day to day energy is incredible….. My mental clarity is unparalleled and I feel like a new person to be honest. Like my real self had been lying dorment under whatever blanket of garbage i had allowed to smother over it…. lol
So far so good, i got (Whole30) in my back pocket….
Gil,
Congratulations! It’s great (and sometimes depressing) to see how what we put in and on our bodies affects us.
Best,
Dr Tim Gerstmar
Hello,
I was wondering what you thought of this article.
http://www.helladelicious.com/our-food/food-facts/2010/01/guidelines-to-choosing-a-good-probiotic
Specifically, they say that, say that more strains are better, which makes sense to me. Also, that many patients will experience die-off symptoms as the “good” bacteria replace pathogenic bacteria.
I am slightly confused now, as your article seems to say the opposite.
Thanks,
Poppins
Hi Dr. and Readers,
I am sooo glad I found this site. For 10+ years I have suffered from an extreme sensitvity to light (mainly artificial). when exposed to indoor light, tvs, computer screens, for more than an hour, My skin esp my face inflames, swells up and hurts like I’ve been in the sun for hours. A few years ago by accident i discovered that vit. e would cool me down.
I later read that vit. e acts as an inflammatory. It woudl cool me down for a little while but eventually stopped working. by chance i started taking Garden of LIfe probiotic for women. w/in days it was like my inflammation turned itself off.
i took 3 a day but toward the end of the bottle the inflammation started to come back. so i switched to primal defense b/c i thought it was stronger but it did nothing for me.
now i’m back to GOL for women and after 4 caps my inflammation is cooling again.
i’ve been to derms and rhematoid docs to check for lupus and other autoimmunity markers and all my test came back great. i was told i nothing was wrong w me. but how do u explain my inflammation subsiding liek that. clearly something is very wrong w/ me. and i have weird rashes on my face and i rarely do the sun.
i take mult. supps a day to cool me down. but they only seem to work when I am also taking the GOL probiotic.
I am completely baffled and scared the GOL pro-b will stop working again.
any ideas as to my problem?
Hi
I wanted to repost and give an update. I am on day two of the Garden of Life Probiotics for women and hallelujah – my skin is not burning.
It’s a miracle. I took two pills this morning – that’s 85 billion x 2 of the probiotic. And the effect has lasted all day. – well it’s 2pm so still some time to go.
No matter how long I’ve been exposed to light the burning feeling in my skin caused by exposure to UV light and UV sun rays has not kicked in.
I hope that someoune out there suffering like me who is searching for relief will find this website and my post.
In reading about probiotics i learned that there are many dfferent kinds and they all do different things. I suspect my probiotic formula is regulating my immune system, which was responding with painful swelling and burning in my skin when exposed to my two main triggers, UV light exacerbated by certain foods like dairy, chocoate, citrus fruits, etc.
10 years and nothing has worked this good. But I also know that it may not last. Maybe I’ll try to up my dose if and when that happens. Like I said the GOL for women worked last time and then not as good toward end of bottle. I thought I needed a stronger PB such as Primal Defense – which did nothing for me.
SOOOO bizarre how PBs work. I wish I knew the exact mechanism of how it’s working for me b/c it fascinates me.
Thank you God!!
Hi Marie,
Sorry I haven’t gotten back to you sooner. It sounds like you’ve found something that’s working well for you, so obviously you should keep doing it. I recommend against going up too fast too quickly as it causes symptoms for some. Slow and steady works well for many. It seems like the composition of that formula works well for you.
Thanks for sharing your experiences. And yes, the most likely explanation is that the bacteria are having a beneficial, calming effect on your immune system. We all want to know more, and the good news is there is a lot of research going on. Hopefully within the next few years we’ll have a lot more information.
Best,
Dr Tim Gerstmar
Great article and thank you for sharing your real-world knowledge of probiotics. I wanted to share a bit of my story to support your article.
Back in Sep 2012 I began to think I had celiac disease. I had 21 symptoms that all pointed to it. My skin showed signs of dermatitis herpetiformis, my gut hurt constantly, I alternated between diarrhea and constipation daily, meals created horrible digestive issues, daily headaches and migraines, and many other symptoms. My gastroenterologist agreed with my fear so he tested me with every possible blood, nutrition and physical test imaginable. What he found was only that I had low iron (not anemic levels), gastritis and a couple other minor problems. My blood vitamin levels were fine, the endoscopy showed no signs of celiac and we were stumped. He credited my ailments to malnutrition that had corrected prior to my testing, which was not done until November when I first visited him. He tested me the next morning so it wasn’t for his lack of expedience at all, but rather my waiting to go see him in the first place.
By the end of Sep I had begun taking supplements often recommended for celiac patients. Specifically, D3, magnesium, B complex, multivitamin, omega 3, calcium and probiotics. I began taking a 10 strain, 20 billion cell probiotic daily and, in conjunction with the vitamins and change in diet to gluten free, I felt amazingly better in just days. I was convinced at that time that the diet change was the major factor, but after my testing my gastroenterologist suggested I go back on gluten as a trial to see if symptoms returned. He knew it was possible I had celiac but the tests just didn’t detect it. So, I went back on gluten-containing foods and I had no negative effects and continue to eat them now.
Through all this the constant and biggest factor to my improved digestive health has been the probiotics. I not only feel better through digestion, but my overall health has improved and I have avoided all the illnesses in the house since I began taking them (colds, flu, etc). Digestion and movement are now normal and the doctor asked that I continue my regimen of supplementation for the year until he tests my blood levels again. He was adamant, like you are, that the probiotics will help maintain digestive health and the vitamins most likely corrected the other issues with skin and other problems. And cutting caffeine fixed the headaches.
I would urge everyone to take a probiotic. The feeling of no bloat, more regular and consistent bowel movements and improved overall health are testament to their effectiveness.
Hi Tim
A wonderful education from you, thank you very much.
Concise as possible:
Suffered with depression etc all my life. Give myself a gee up recently. Felt absolutely great, out cycling etc. Then after a few weeks started waking feeling yucky, stomach gurgling, flatulence, diarrhoea, ongoing and progressing to massive headaches, hbp, etc
Returned to sedentary lifestyle, sleeping late etc and symptoms very slowly diminished somewhat.
Another episode the same last year, but curtailed activities earlier to prevent escalation, but major digestive disturbances continue and hissing in head maybe after eating certain foods.
I think my body initially and temporarily rallied itself against the lifetime battle with bad gut flora, but eventually and inevitably the bad flora reasserted itself with more aggression, would you agree with this Tim?
Bought GAPS book. Took first Bio-Kult capsule yesterday. Very positive that things can only get better.
P.s I know it’s not going to be feasible, but what’s to stop anybody from using a supplementary capsule as a yoghurt starter?
Regards Brian (Sunderland UK)
Bill,
Thanks for sharing your story! Sounds like you are on top of things and caring for your health! And your doc sounds like a good one!
Yes, probiotics (really “good” bacteria) are necessary for your digestion (and body) to function properly. Most of us don’t eat much, if any, fermented food anymore and so leave our gut flora as a “crap shoot” as to whether it’ll be okay or not.
For those who are healthy, eat fermented foods on a regular basis. For those who are sick, in my experience, a probiotic is often mandatory.
Best,
Dr Tim Gerstmar
Hi Brian,
Getting good flora established can be a process. Sometimes easy, but often (at least in the people I see) more difficult. It sounds like you’re on the right track. A GAPS-style program can be very helpful for many.
And yes, I have had many patients use probiotics to start yogurt and other ferments. We can’t guarantee the quantity or strains in ferments so I recommend them as maintenance therapy for most people and use actual probiotic products for active treatment so I know what and how much is going in. In your case I might have you take the Biokult and yogurt made with it.
Also, slow and steady if you’re gut is really “messed up”. People who dump in tons of probiotics (and ferments) tend to suffer for it.
Best,
Dr Tim Gerstmar
Thanks for reply Tim.
Only third day and third Bio-Kult capsule but feeling pretty good, a little bit of hissing in head through “die-off”, but not bad atall. Will stick with Bio-kult for a while yet, slow and steady? yeah.
Regards Brian
Hi there. I appreciate this article as I was just standing in front of the probiotic section at my local health food store and was feeling completely overwhelmed. My 7 year old is having surgery and they will be giving him antibiotics to prevent infection. He is a very healthy kids. He drinks kefir (homemade) regularly and has never had nor needed antibiotics in his life. I am wanting to keep his gut flora healthy and wonder 1. Does it help to give him probiotics BEFORE the antibiotics since I have notice? 2. How much and how long should I give him probiotics? And 3. I have seen several Jarrow brands. Do you recommend FOS? I plan on ordering Klaire Labs but wanted to start him on something OTC immediately. Thanks!
Hi Holli,
If he is otherwise healthy then it’s not necessary to give probiotics before the surgery and antibiotics. If it were my son I would start probiotics right away after the surgery, while still taking antibiotics. If possible, give the probiotics at different times of day than the antibiotics (for example – antibiotics morning and evening, probiotics lunch and before bed).
I would continue the probiotics for around 30 days. If being very conservative could continue till 60 days without any risk.
Hope that helps.
Best,
Dr Tim Gerstmar
Thank you, Dr. Tim! I just ordered Klair Labs Ther-Biotic Complete. It seemed to be the most complete (and affordable) of the Klair Labs line. It has 25 billion CFUs per capsule. It says to take one a day (I’m assuming this is for an adult). I am wondering if I should give my 7 year old more since he will be on antibiotics? I was thinking 2 per day (there are 60 caps) so that would be a month’s supply. But is 50 billiom CFUS too much for a little guy?I have been reading about this subject matter extensively and so far it seems to me that you can not overdose on probiotics but I don’t want to do him more harm than good. Thanks again!
Hi Holli,
That’s a fine product. I think 2/day is totally fine. No, there is no danger of overdosing. We each (even kids) have TRILLIONS of bacteria living in us, so while 25 billion sounds like a lot, it’s really a modest dose.
The only side effect of probiotics can be intestinal distress (gas, bloating, diarrhea, constipation) or for those who are sick it can flare their symptoms. If your son is otherwise healthy he should do just fine.
Oh, and if his stools and digestion are “messed up” after 30 days, continue the probiotics and/or get some guidance. I’m sure he’ll be fine, and if he isn’t, in my opinion, it’s best to get it fixed right away.
Best,
Dr Tim Gerstmar
Thank you again! Is it best to give probiotics with food (or after…or does it matter?)?
Hi Holli,
Lots of debate about this on the internet. But the best science I’ve seen around this strongly suggests it’s best to give with food. It also mimics the way we’ve gotten our probiotics in the past – through the food itself and through dirt in/on/around our food.
Best,
Dr Tim Gerstmar
Dr Gerstmar
I have been looking for a good probiotic that is 100% dairy free and i found a formula from Jarrow Formulas Saccharomyces Boulardii with 5 billion per capsule.
One pill a day would be enough if you are within the paleo Auto-inmune protocol?
The capsules contian some elements that are derivated from corn, do you think that might be a problem?
Is there a dossage you recomend in probiotics for people that is sick? 2 months ago I had surgery and spent 10 days on antibiotics.
Is there any brand and dossage you recomend that is dairy free?
Thanks in advance.
Hi David,
S Boulardii is a little different. It’s not a bacteria, it’s a non-pathogenic (non-disease causing) yeast that we will often use alongside probiotics. Under normal circumstances it does NOT colonize in the gut (this is debated), but does it’s job and then passes out. It tends to kill bad bacteria and other yeast and improves intestinal immunity (sIgA).
In your situation if I was using S Boulardii I would use it concurrently with a bacterial probiotic. Klaire labs (no affiliation) product line is all certified dairy free so I think it could be a good choice for you.
Initial dosing is scaled to symptoms. If your digestion is really “messed up” or you are otherwise sick then I typically start people on low dosing (typically 8 billion/day or less) and work up to higher dosing.
Hope that helps.
Best,
Dr Tim Gerstmar
Hope that helps
Hi again Tim
I’m on the ninth day of one Bio-Kult capsule (2 billion), I’m also on the first stage of the Gaps diet, meat broth, ginger tea, small amount of home made live yoghurt etc.
I am getting a good nights sleep at the moment, but wake up in the morning feeling a little bit yucky with some palpitations, but certainly not as bad as I’ve been in the past. I also still get some hissing in the head (like a gas leak) to differing degrees, seems to be a reaction with what I’ve ate.
I had a bad 24 hours about 3-4 days ago, I think it might have been the Kiwi fruit I tried. I’m not sure about liquids (broth) either, but persevere on small amounts.
Does this sound like leaky gut, could you say how long leaky gut on this diet take to begin healing up? I am 58, and need to get out there and manage to take a job.
Regards Brian.
Hi Brian,
I’ve seen leaky gut massively improve in as short as 2 weeks, and as long as 18 months. It all depends on the underlying factors that are causing the leaky gut and how quickly/easily those can be resolved.
I try not to let anyone linger in early GAPS intro stages for long. Typically we try and move through the early stages within a few days for each, week at most. Some people do need longer, but hate to see people living off broth for weeks or months unless it’s absolutely necessary.
Best,
Dr Tim Gerstmar
Once again Tim thanks very much and all the best to you.
Brian
One last thing Tim.
I’m at this moment contemplating whether to order another batch of “Ubiquinol”. Have you any opinions on this supplement, and as it’s pretty expensive any idea how much is adequate to take?
I’ve just received an order of high quality Cod liver oil, Omega 3+6+9 oil and fish oil as recommended by Natasha. Want to get off to a good start in the interim, and think things are looking up
Regards Brian.
Hi Brian,
Let me answer in a general way because I’ve had this question many times. Is ubiquinol (form of CoQ10) worth the expense compared to ubiquinone?
The short answer, NO. Without diving into biochemistry here, CoQ10 is a fat soluble antioxidant that is especially important in the mitochondria (energy producing part of the cell). In the mitochondria it changes forms back and forth between ubiquinol and ubiquinone. So if you take ubiquinol, it is ultimately converted into ubiquinone, if you take ubiquinone it is converted into ubiquinol.
Ubiquinol seems to be somewhat better absorbed especially if things are in very bad shape, but the cost is significantly higher. Ubiquinone works just fine. Be aware that the form of supplement you get matters. Powders of CoQ10 are extremely poorly absorbed. You really want a gelcap and to take the supplement with some fat.
Hope that helps.
Best,
Dr Tim Gerstmar
I recently had a root canal… had a very badly infected root. I was given Vicodin and Penicillin. I got so bloated, that I gained 10 lbs of water weight in three days (a lot for someone who only weighs 118 normally)… I felt like a bloated dead animal. I thought maybe it was the Vicodin, so I quit taking it, and at the same time, started taking some Jarrow priobiotics. Never having taken priobiotics before, I started taking 4 per day (directions said up to 4/day, so I figured the more the better. I was desperate). I felt better within a day, lost ~ 4 lbs, but still felt bloated. I’m glad I found this site. I realize now that I was probably shocking my body by taking so many Yarrow pills all of a sudden. I will scale back to twice per day for now and see how it goes, and continue to take them for a while after I finish the antibiotics. Thanks for educating me!
Jenifer,
Glad we could help. Hope you feel better soon.
Best,
Dr Tim Gerstmar
A little update for people.
I’m on the 17th day of one Bio-Kult a day and feeling pretty good. I also find that a little of my homemade probiotic yoghurt and fermented saurkraut juice has a die off effect on me after an hour. This manifests as a tension ache in my back and feeling a little yucky, but no problem as I know this is natural as the battle between “the good, the bad and the ugly” goes on.
I will increase the bio-kult in time when I feel ready.
Tim? Thanks for your views on CoQ10, invaluable.
Brian,
Thanks for sharing your experiences with the board. It sounds like you’re being smart about it and on the right track.
Glad I could help.
Best,
Dr Tim Gerstmar
I loved the article. Lately I have been encouraging my exercise clients to concentrate more on achieving a healthy gut. I told them about foods, like almonds, to help ‘feed’ their good bacteria. Will almond milk help also or just the raw almonds?
Thanks,
Mary B.
Mary,
The primary benefit (that I’m aware of) from almonds is going to be the soluble fibers acting as pre-biotics to nourish the gut bacteria. All of those fibers are going to be lost in turning almonds into almond milk, so I don’t think you’d get much benefit from almond milk as far as gut bacteria.
Hope that helps.
Best,
Dr Tim Gerstmar
Ok Thanks! I’ll let her know. That was my guess but wanted to ask someone knowledgeable. Thank you for educating us!
Hi, 2 years ago I had a food sensitivity test done because my allergies to the environment were ever increasing. I had constant sinus infections and was in a constant brain fog. I also had a laundry list of health problems that looked like auto-immune things.Fibro etc…The sensitivity test showed that I was senstive to over 25 foods. The company that the test was through said that we may be able to add those foods back into our diets after rotating other foods and eliminating the food I am sensitive to. Well, after doing just that, all of my symptoms have gone away, and so have my environmental allergies..I have not had a sinus infection and i have felt great. Problem is…i have never been able to replace any of the sensitive foods and i have become increasingly allergic to other foods and to things like ibuprofen…so, could probiotics help?? My food allergies are getting out of control!
Hi Denise,
I see many people with similar situations to yours. It sounds like you have “leaky gut” which is why you are reactive to so many foods. Whenever a food “allergy” test lights up like a Christmas tree that is a red flag for a leaky gut situation.
Removing reactive foods is a good first step and sounds like it’s brought a lot of relief for you. However, I see many practitioners stop there which I feel is a tremendous disservice to patients. The second step is to heal the gut, allow the immune system to “calm down” and then begin reintroducing foods. Many foods should be able to go back into the diet, some may not.
Leaky gut is (most often) secondary to an inflammatory situation in the guts. Probiotics are a very important part of healing/normalizing the gut. I would start low and slow and build up your probiotic intake.
Hope that helps.
Best,
Dr Tim Gerstmar
Hi Dr Gerstmar,
I luckily stumbled upon your info and so much seemed to make sense concerning my health. I’ve had a lot of the issues mentioned by others, IBS, alopecia, seborrheic and contact dermatitis, and the list goes on and on, all this in only the past 1.5 yrs. You mentioned a website with doctors like you I might find in my area, but I guess my state is trying to catch up in this area of health. I have been to so many doctors, numerous/repeated tests and put on a laundry list of medications, nothing has helped. You also mentioned the possibility of a phone/Skype consult. Do you still offer this service? I am very much interested.
Sincerely, Tricia
Hi Tricia,
I’m sorry for the long delay. Yes, I do offer Skype/phone consults. Why don’t you email me: info@aspirenaturalhealth.com and either I can help you or can see about referring to someone closer to you.
Best,
Dr Tim Gerstmar
NIce to read what everyone has written, I’m learning so much already!
Dr. Gerstmar, how come I haven’t seen anyone mention two common probiotics that are sold out there with a “seemingly” very reputable backup……..meaning, Align and Culturelle?
I was diagnosed with IBS years ago and just recently had a colonoscopy done. All that came up was some rectal inflammation but other than that my gastroenterologist suggested I take Align and if I wanted to add to that, take Culturelle.
I just had to ask because I know these are patented products with a lot of research to back them up.
This is what I take today, one of each every day so I get the B. infantis – 1 billion and the Lactobacillus GG – 10 billion. I just started a little over a week ago and I feel somewhat better already, producing some healthy stools. Do you believe these products are good to take or are you still sticking by your Jarrow line? I just really value your input and am wondering if I should switch probiotics?
Thank you everyone out there for all the input, it’s been so educational !
Diana H.
I so appreciate all of this info! Because of this article, I opted to begin taking a probiotic supplement. But I found some conflicting info in the above. You mention Klaire Labs is a good line. I ordered the ther-biotic complete probiotic, which came shipped in dry ice. I must have flaked on some of the tips above when I ordered, because I’m noticing it has 12 strains of l and b, none of which are numbered.
Obviously it is an expensive product, but do these two characteristics mark it as not being as good as I’d hoped? What brand do you sell at your practice? So overwhelming….thanks in advance!
Hi Dr. Gerstmar and Melissa,
Thank you so much for your article. I have been working on healing my gut through diet for about 6 months now, and just started slowly adding fermented foods and probiotic supplements. They are definitely helping my digestion already.
My main symptoms are food sensitivities and seasonal allergy symptoms- but the allergy symptoms (dry, red, or watery eyes) are the most frustrating. I’ve figured out what diet is working for me now, I’m making bone broth to heal my gut lining, and I intend to keep adding more fermented foods and probiotics.
My question is in regards to birth control. I know it is bad for gut flora, but how bad? I’ve been on it for 10 years- they put me on it as a teen to help regulate my cycles. When I read it is a culprit it freaked me out and I’m wondering if I should go off it. I do not want to get pregnant for at least another 3 years. So I’m wondering, is it possible to combat the aide effects of the pill and still heal?
Or is it going to prevent me from healing no matter how hard I try? Thanks so much, hope you have some insight as I can’t seem to find the answer anywhere. Just that “it’s bad.”
Hi Tara,
Good question. You do hear that a lot and I agree I’ve never heard anyone specify in more detail.
It appears that gut bacteria are playing a significant part in metabolizing estrogen, and studies have found that giving antibiotics can result in birth control pill failure. J Steroid Biochem. 1984 Jan;20(1):217-29. Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones. Adlercreutz H, Pulkkinen MO, Hämäläinen EK, Korpela JT.
It would make sense that putting “extra” hormones directly into the gut would have an effect on the gut bacteria, but I haven’t been able to find any direct proof this is the case, so I can’t advise you how much this is messing up your gut (if at all).
I tend not to stress about this, unless you find that it seems to be a really big roadblock in recovering your health. Birth control is very important, so I try not to mess with what a woman has found works for her unless necessary. Many woman have found that they like IUD’s, so that might be something for you to explore should you wish to get off the pill. Otherwise, I would continue with what you’re doing, and if you’re not healing in a reasonable time frame, then consider the pill might be a problem.
I’ll also say that the pill has not resolved any of your issues with your cycles that were troubling you in the past. It merely covers over the dysfunctional cycles. Ultimately we want to get to the root of why you’re cycles weren’t working well in the first place and correct that.
I hope that helps.
Best,
Dr Tim Gerstmar
Hi Dr Gerstmar,
You’re article is amazing, thank you so much for writing it.
I have a question – I have very bad IBS and just started taking pro-biotics. There are so many different one’s – I’m getting confused.
I’ve taken Lee Swanson 66 Billion but now taking VSL3 which is 450 billion with 8 strains. Which would you say is the best one for severe IBS? In your personal opinion?
Please help
Thanks
Adam
Hi Adam,
I’m glad you found it helpful. Yes, it’s easy to get confused as there’s so much conflicting info out there. Let me see if I can answer your question.
VSL is pretty much considered a “top of the line” probiotic. Very high potency, very expensive, with some trials on serious conditions to back it up. As discussed in the article however, high potency probiotics might make the situation worse, so might not be appropriate to start off with. Since I don’t know any of the specifics of your case I can’t tell you which is best for you. It’s going to take a little experimentation on your part to discover what works for you. If you take VSL and things get worse, then you should stop and/or back off the dosage. If you take it and things get better, then obviously, it’s a good choice for you.
IBS isn’t one dysfunction, so again, trial and effort on your part will determine how effective probiotics are. Many with IBS suffer from something called SIBO which can be worsened with probiotics.
Sorry I can’t give you a cut and dried answer.
I hope that’s helpful.
Best,
Dr Tim Gerstmar
Hi!
I’m on my last day of antibiotics (since I had streptococcus in my throat that never wanted to go away…) Hate antibiotics but it was the only option unfortunately). I drink bone broth from elk, eat saurkraut, kimchi and fermented carrots but I want to buy a GOOD brand of probiotics but don’t know which one to buy…
I live in Sweden and we don’t have the Jarrow Formulas probiotics here, but I’ve found it on iherb. Which offering shipping to Sweden, it normally takes 7-10 days for it to arrive, but since the probiotics should be kept cool I wonder if there will be a problem since they don’t package it with ice when it’s an international shipping(!)
What are your advice? Should I buy it anyway? Is it really that sensitive against warmth?
http://www.iherb.com/Jarrow-Formulas-Jarro-Dophilus-AF-10-Billion-60-Veggie-Caps-Ice/22471
Would be SO thankful!!! or do you have any other brand you can recommend that I can buy from iherb?
Best wishes,
)
Emma ( a big fan of Whole 30 and have basically got whole sweden to try Whole30, since I run the biggest paleo blog and paleo instagram account here in Sweden where I have done a massive shoutout for whole30 and your book…