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.)
Would you like the same formula that Dr. Gerstmar uses to heal people’s guts? To get the Quick Guide to Comprehensive Gut Treatment for FREE, just click HERE.
Dr. Gerstmar is an expert, with over 10 years of experience in treating digestive and autoimmune issues. He has lectured audiences both nationally and internationally, and is a member of the Affiliate Clinical Faculty of The School of Naturopathic Medicine of Bastyr University where he helps to train and mentor senior medical students to practice as doctors. If you’d like to learn more about healing digestive and autoimmune issues, visit www.aspirenaturalhealth.com or www.facebook.com/
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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… ;) )
Hi Emma,
The Jarrow probitics should be good to ship to Sweden. Most probiotics, though refrigeration is recommended, don’t absolutely have to be refrigerated. If they aren’t refrigerated their potency and shelf life decrease, but it’s not like they’re going to be sitting in the hot sun for months or anything. I think you should be just fine.
Best,
Dr Tim Gerstmar
Dr. Tim,
I found this article through a google search and have found it quite informative. Thank you for freely giving us this information~ I know you could charge for your advice and you don’t!
My question is about my daughter. She is 2 years old and has had problems with constipation and hard stools for since she was off of breast milk and eating table food (nine months old). She has never been diagnosed with IBS, but we’ve never known to ask, either. Regardless, we’d like to start her on some daily probiotics. We’ve found the Jarrow brand at our local health food store, but I’d like to know how much is too much to give her daily. She has also never been on any antibiotics. She is 2 years old and 29 lbs.
Hi Kristy,
I’m glad to help. In general there is no concern about “overdosing” on probiotics. The only concern is that if the gut is very disturbed than putting in large amounts of probiotics can really “shake things up” causing symptoms like gas/bloating, constipation or diarrhea, nausea, low grade fevers, fatigue, brain fog, or skin rashes. Not everyone gets this and different people can get varying symptoms in varying intensities.
So, in general if we suspect the gut is very disordered (or we test and find it is so) we start slowly with probiotics not because they are dangerous, but just to help people feel more comfortable.
I would consider starting at a dose of 2 billion/day for your daughter and building up from there.
I hope that was helpful.
Best,
Dr Tim Gerstmar
I have gut issues & will begin taking a probiotic along with a 5 day fruit cleanse. My question isc can I begin with Philips 1.5 billion cell pribiotic & gradually increase from there & do people take probiotics for the rest of their lives & if not how do you know when to discontinue use? Thanks
Hi Moet,
It sounds very reasonable to start with a low dose like 1.5 billion and build up as your system tolerates it. I believe that people need to have a steady source of probiotic organisms entering their system on a regular basis, as our ancestors did (from dirt & fermented foods in their case). Whether people choose to take probiotic supplements or eat fermented foods and get their hands dirty (gardening, hiking, playing outdoors, etc) is their choice.
Often I recommend people take probiotic supplements until their gut issues are settled, then, if they are willing switch off probiotic supplements and continue fermented foods for life.
I hope that helps.
Best,
Dr Tim Gerstmar
Thank you so much for your quick response. One more question I have a pretty healthy 4yo & a 10 yo that has skin problems. Should either of them be taking a probiotic supplement?? If not what are some probiotic rich foods I can give them?
Can’t wait to start Whole 30 in August. I’m always interested in healing the natural way. Is that program recommended for kids?
I’m sorry one last thing have you ever heard of gastrazyme & can that be taken along with a probiotic supplement to heal the gut?
My only question is how long should i take probiotics for? Most people say daily fora long time and some people say this could cause the body to not produce their own. Others say take them for 45 days and stop or witch the type of probiotic. Others say to take them for 45 days and stop completely. If you could answer this question it’d be great!
Hi Moet,
This is a very late response, but in case you’re still interested.
I believe EVERYONE, with maybe just a few exceptions, should be taking probiotics regularly (at least a few times a week or daily) – whether that’s probiotic foods such as fermented vegetables (pickles, sauerkraut, kim chi, pickled beets, etc, etc), fermented dairy (for those who tolerate; such as yogurt, kefir, fermented sour cream, etc) or fermented beverages (kombucha, beet kvass, etc). The key to these foods is that they must not be pasteurized as most of the common versions available are, because pasteurization will kill off the bacteria.
Gastrazyme by Biotics is a gut healing formula and would be fine to take with probiotics.
Best,
Dr Tim Gerstmar
Hi Enzo,
The simple answer is: as long as you need to take probiotics. I believe everyone should be taking beneficial bacteria on a regular, life-long basis whether from probiotic supplements or from fermented foods and “dirt” contact.
I personally tend to rotate brands and formulations of probiotics every 1-2 months to try to ensure a more broad spectrum intake. When people’s symptoms have improved/resolved and their stool test (if we are doing one) shows good levels of beneficial bacteria we move from more aggressive treatment to maintenance and depending on the persons preference will move off of probiotic supplements.
Hope that helps.
Best,
Dr Tim Gerstmar
Hello!
I just started taking ReNew Life’s “Ultimate Flora Adult Probiotic” It is a 15 billion Extended Release refrigerated capsule. I bought it from whole foods. I was wondering your input from that company. I saw you listed Jarrow & Klaire but I am skeptical to buy supplements online. Do you think ReNew Life’s line is effective?
(I am 22, eat decently clean, trying to cut down on gluten, and workout regularly)
http://www.renewlife.com/ultimate-flora-adult-15-billion.html
Also my boyfriend does not eat right and has been slacking on the exercise, he has digestive problems occasionally, should I up his probiotic formula? ReNew Life has more intense ones for colon health (80 billion)
http://www.renewlife.com/ultimate-flora-critical-colon-bifidomax-80-billion.html
What do you think?
Hi, good article…only thing I would correct is that on a paleo diet you really should have probiotics (sourkraut is my favorite) and vegetables with every meal…I never ate as many veggies as I did when I became paleo! Anyway, just a wee thing, cause I didn’t want people to assume all we do is chug down steaks. I have a question though, on probiotic storage. I just made some fantastic raw sourkraut in a huge clamp jar. It is just salt and cabbage, and has fermented for just over thirty days. I wonder if I should leave it in the cupboard or refrigerate it after opening. Thoughts, guidance would be very much appreciated. Thanks!
This has been a very, very helpful article, and I appreciate it greatly – especially the part about starting slowly. I just finished my first successful Whole30 and – I suspect due to an overdose of ice cream in the two months prior – had quite a few “gut” issues (bloating mostly) during most of it. I’m now moving a Whole60 to further cleanse things out; mostly that just means I keep eating the way I eat (no gluten, no dairy) and avoid ice cream for two months.
I took your advice and ordered the Jarrow’s brand probiotics because they are capsules that I can break open and use half at a time at the beginning. I also got some Bubbie’s fermented pickle relish (YUMMMY!).
My question is this: I also have the NOW digestive enzymes. Should I take BOTH the probiotics and the enzymes, or just one or the other?
Thank you!
Hi Kirsten,
We’re definitely on the same page with regard to vegetables and ferments. The great thing is with fermented vegetables, you can get both!
Congrats on your ferment! I recommend you transfer it to your fridge unless you have a cool cupboard, ~50F, or so or eventually it will spoil.
Best,
Dr Tim Gerstmar
Hi LindaM,
I’m glad you enjoyed the article, and it sounds like the Whole30 is working for you. Good question. You would take both if you feel you need both. There is no risk in harmful interactions, so many people with digestive “problems” find benefit in both a digestive enzyme and probiotic.
I do believe that probiotics (or fermented foods) are necessary for life-long health, whereas digestive enzymes are not, unless there is a digestive dysfunction that requires them. So once things clear up for you I would wean off the digestive enzyme and switch to fermented foods if you desire.
Best,
Dr Tim Gerstmar
Hi Tim,
I had my gallbladder removed and do take supplemental digestive enzymes with meals though I try to eat a good amount of vegetables and raw salads along with brown rice and meat. Does not having a gallbladder mean I have a harder time with keeping good probiotics in my gut? I noticed you said bile can affect probiotics. Also, I have a new skin condition called “folliculitis” would putting probiotics on the skin help? Or does it only work from the inside out? Thanks for any feedback.
Hi Suzanna,
People respond differently to having their gallbladders removed. Many do just fine and even tend to “regrow” a pseudo-gallbladder over time. Others never recover their digestive capacity and need life-long supplementation. The relationship between bile and bacteria is very understudied, but in general, I think we’re safe saying that anything that removes part of the digestive system is going to have effects on the bacteria.
Folliculitis is a medical term for inflammation of the hair ducts in the skin. It can have a variety of causes, but you might try applying probiotics to the skin. I will often have patients mix probiotic powders into some lotion and apply to the skin for a variety of conditions. It’s not always helpful, but often is. Another product that I find quite helpful is called Skin Protect by Natura (conflict of interest: I personally sell (and use) this product). It’s full of beneficial “anti-inflammatories” like green tea and curcumin at high potencies and I often find it helpful for skin conditions. I might consider adding probiotics and Skin protect to a neutral lotion base and applying it. Worst case it should do nothing and you might find it very helpful.
Best,
Dr Tim Gerstmar
Hello Dr. Tim,
Thank you for the article. I looked at the Jarrow Formulas website but they do not have any Canadian distributors. Any tips for quality probiotics available here? I prefer not to buy online. Thank you in advance,
– Natalie
Hello, I just started taking probiotics and wondered if they should be taken at on an empty stomach or with food. The label says take once a day “preferably” with a meal but I’ve read varifying opinions on this. Is one or the other more effective? Or does it not matter?
I’m not that much of a online reader to be honest but your sites really
nice, keep it up! I’ll go ahead and bookmark your site to come back later on. Many thanks
Hi Natalie,
Unfortunately, I don’t have any experience with what is available in the Canadian market. I do give guidelines in the article above to help guide you to better quality probiotics. That’s where I would start.
I hope that helps.
Best,
Dr Tim Gerstmar
Hi Tracey,
Thanks for the question, it’s a common one and the source of confusion. By studying physiology and thinking the situation through, it is clear to me that probiotics should be taken with a meal.
The concern people have is that when we eat more acid is (supposed to be) secreted into the stomach and the worry is that the increased acidity will kill the probiotics. What we find however is that, despite more acid being secreted with meals, that the presence of food in the stomach “soaks up” the acidity and so the pH (or level of acidity) in the stomach actually rises (becomes less acid) then when the stomach is empty. When empty there is less total acid in the stomach but nothing to “soak it up” and so the pH is lower (the stomach is more acid). Plus if we consider that traditionally/evolutionarily probiotics came mostly from food (ferments and/or dirt on food) then it simply makes sense to take probiotics with food.
I hope that helps.
Best,
Dr Tim Gerstmar
Thank you. I will take this with me to the store and see what I can find.
Hi Tim – thanks for the great info. I think you’re correct that gut flora and your health are strongly linked. My mom has a whole series of diseases including overweight, diabetes and lupus that all seem to be connected to her long standing wheat allergy. I was chatting with a friend who has celiacs, and we realized how confusing it is that living, viable probiotics are so healthy, but in order to digest them they must go through the extremely acidic environment in our stomach. Do these probiotics survive that adventure and make it to our intestines unharmed? Are there probiotics present in alcoholic beverages such as homebrewed cider, mead, wine? And is there cause to incorporate multiple types of fermented foods in your diet? I brew and drink kombucha daily, but are there some strains that perhaps I’m not getting from this one source? Do you know if there are digestive enzymes in kombucha as well as probiotics? And do you think that the amount of sugars in kombucha is unhealthy? I looked up the whole30 program and I’m guessing that kombucha would be out of the picture.
Thanks!
Madee
Hi Madee,
Most probiotics DO make it through the stomach acid intact. Of course some will be killed, but if you think about it, in the past, all probiotic bacteria (from food, dirt, etc) have had to go through the mouth and thus the stomach. Also, I do recommend taking probiotics with meals as the food in the stomach actually makes the stomach less acidic and increases the number of bacteria which survive.
There are probiotics in UNPASTEURIZED alcoholic beverages, though the majority of what’s in them are yeast (yeast produce alcohol) so while fine, I wouldn’t count on them as a primary probiotic source.
I do recommend, as much as possible rotating your fermented food sources / probiotic supplements to try and get as wide a variety of species as possible. I personally have not seen great luck with kombucha as a primary probiotic source, but I’ve heard other people have.
Kombucha can also have quite a lot of sugar and can be a “healthy” soda – which is not what we’re after. The sugar levels tend to reflect how long it’s been left to ferment (or can be added to commercial products), so I recommend drinking less sweet, more sour products whenever possible.
Hope that helps!
Best,
Dr Tim Gerstmar
Hi Tim, Thank you for the information on the gut and probiotics. I’ve recently begun taking probiotics due to constant bloating and constipation even after improving my diet. My nutrition is basically vegan (not 100% because I will eat meat every and then), I eat lots of whole fruits, vegetables, beans, very little salt, and slim to none processed foods. I’ve made this change in my diet for 6 weeks now and have included an hour of exercise 5 days a week, yet I’m still regularly constipated and bloated, which is why I began taking probiotics supplements. I’m on my fifth day on probiotics with 50billion CFU, and I’ve seen no improvements. Could this be causing/worsening my ongoing stomach issues? I don’t feel well, and am desperate. Any advice you can provide I would greatly appreciate it!
Thank you,
Yazmin
Hello Tim,
I recently began using Ultimate Flora critical care 50 billion probiotics, which claims to have 10 different strains. After 3 days of use, I have developed acid reflux, headache, fatigue, and mild abdominal pain. From reading this article, it seems as though this may be related to a die off of bad bacteria. Is it acceptable to decrease the frequency to every other day versus buying a lower dose probiotic for daily use? Thank you.
Kelly
HI Yazmin,
It’s difficult to say what’s going on without a lot more info. I’m not going to tell you to eat more animal products if that’s something you don’t want to do, but I will tell you that many people (who I see) have found great improvement to their health, both digestively and in general from adding more animal products to their diet. Many, at least temporarily, find that removing legumes/beans from their diet can help their digestive systems, esp with symptoms like gas & bloating. Beans are difficult to digest (can be somewhat improved by traditional soaking practices) and can be tough on a compromised digestive system.
I would also consider adding a digestive enzyme to your protocol which may provide some relief. If the probiotics and digestive enzymes don’t help and things don’t improve, I would recommend seeking someone out to do a full evaluation and find out what needs to be corrected. I do distance consults and there are probably good practitioners around where you live.
I hope that was helpful.
Best,
Dr Tim Gerstmar
Hi Kelly,
You can try an every other day dosing regimen or even less, one every three days for example and see if that works for you. I find most reliable results from reducing the potency.
Best,
Dr Tim Gerstmar
Hi, I started taking probiotics (50 billion) 2 days ago as reccomeneded to me by a holistic lactation “expert”. After talking with several people it is suspected that I have a “leaky gut” which could be the cause of my 3 month old being sensitive to my breast milk. I have gone dairy and gluten free, and the probiotics were suggested as a way to help heal the gut. However, over the last 2 days my stomach has been cramping and gassy. My 3 month old has not been sleeping very well at night. I’m going to look for a smaller dose to take, but I’m second guessing taking any at all while I’m breast feeding. Maybe starting small with fermented foods would be better?
Hi Kristi,
I do think probiotics are especially important for pregnant moms/new mothers, so I would recommend using them and getting your gut in good order.
From what you have said it does sound like the brand/potency is not a good match for you or your baby. If I were in your place I would go down to an 8 billion/cap product (or possibly less). You may also consider getting a specific baby probiotic formula for your 3 month old such as HMF Natogen by Genestra/Seroyal and give it to them directly as well.
If you’d prefer you can try slowly introducing fermented foods as well or instead of the probiotics (obviously not to your 3 month old).
I hope that helps.
Best,
Dr Tim Gerstmar
My doctor just told me to start giving my son Culturelle probiotic that has 1 billion CFU with only Lactobacillus GG. He’s not having anu problems I just wanted to get him started on one. Is this a good product to use for my 4 year old? It’s in single serve packets so should I give him the entire packet or maybe start with half a packet?
Hi Moet,
Culturelle is fine. It is one of the better studied brands of probiotics. The GG after Lactobacillus is like I talked about in the article above a marker of the “pedigree” of the Lactobacillus. 1 billion is a very low dose in my book, but may be sufficient, I don’t know what’s going on for your son.
If his digestion is “very messed up” you might want to start with 1/2 packet for a few days and if everything is fine increase to 1 packet a day. If that clears things up, great. If not, you may need to move on to something stronger.
I hope that helps.
Best,
Dr Tim Gerstmar
Are fermented foods like kombucha safe for people on PPIs and low acid diet (due to GERD, 2 ulcers in 2009 and a hiatal hernia – which of course is an ongoing condition). I’ve had to give up so many foods that I love (bbq sauce, vinegar, coffee, chocolate) in addition to those I don’t care much about. I’m also gluten-intolerant, so on GF diet and following a Paleo diet for lactose/casein intolerance, am grain free, don’t eat nightshades and avoid some other foods as well. I cook almost all veggies for easier digestion. Had been dx’d IBS in past as well. Take Align, Culturelle didn’t sit well. Other recommendations?
Hi MJ,
The only concerns I could potentially see with fermented foods and a low acid stomach is first, an increased risk of gut infections. If the fermented foods have gone “bad” (infected with a nasty microorganism) someone with low stomach acid would be missing a key defensive mechanism to protect themselves. So getting a quality brand or being careful when making your own would be smart. The only other risk I’m aware of would be if you’re reactive to the food – like someone who is dairy intolerant eating yogurt, etc.
Unfortunately, I can’t give more advice without a workup, sorry.
Hope that helps.
Best,
Dr Tim Gerstmar
Hi Dr. Tim,
Thanks for the informative article. My neighbor just gave me some probiotics to try, and they seem to have all the good ingredients you’ve listed in your article. My question is: they’re packaged as being for women over 50 (Garden of Life brand), and I’m a 38-year old male. There are a bunch of extra vitamins in these pills, but the only ones that aren’t in the daily vitamin I already take are: Folate(133mcg), and Molybdenum (19.5 mcg). Can I take these safely, or should I bite the bullet and go buy my own “male appropriate” bottle? Thanks for your advice.
Hi Erik,
I had a quick look at the product and I don’t see any reason for concern. It’s a probiotic with some vitamins and some digestive enzymes wrapped together in one product and marketed for women (at a quick glance I didn’t see anything in particular that was specifically for women over 50, so it looks like it’s just marketing).
If I were you, I’d give it a try, as long as it’s not expired.
I hope that helps!
Best,
Dr Tim Gerstmar
Hello Tim, thank you for all your information provided here, and your caring responses to people who have emailed you for guidance. We have a little 9 month old baby with stool impaction. X ray has shown it to be severe, and a paediatrician has given treatment with daily oral treatments of lactulose, ongoing, and treatment with glycerol suppositories daily, planned for quite some time – there hasn’t been a lot of success yet, the impaction is still there. The young mother is afraid to continue giving solid foods, and has stopped solid food for a week now. The baby is having water with a little olive oil and prune juice, and infant formula. She was a C section baby and breastfed for 5 months exclusively.
She did have a course of antibiotics early in life, and also was given probiotics during the course of antibiotics. She has not been a hungry baby, but always difficult to feed. Do you have any ideas that could help ? They would be very welcome to say the least. Thank you so much. Corry Geale.
Hi Corry,
Thank you for the comment and I’m sorry to hear about this situation. Treatment is going to depend on where the impactiong is. If it were my child, I would consider actually doing an enema if the impaction is low enough to physically try and remove the blockage.
Other treatments that might be helpful are going to be anything that can break down the mass, which might include high dose enzymes or emulsifying agents. I might consider trying docusate sodium which is an over the counter stool softener which is cheap and available everywhere.
Otherwise you have to think, what conditions are allowing the blockage to occur and look to correct those. Is the normal peristaltic action (movement from mouth to anus) occuring? Is the child constipated? Is the digestion working normally?
I hope that helps.
Best,
Dr Tim Gerstmar
Hello Dr. Tim,
I have been experiencing a lot of burping from deep within but haven’t been able to pass gas through farting. Sorry to be so blunt. I am eating a gluten free mostly sugar free and fruit free diet since June 1st. I eat small meals drink plenty of filtered water and 8 to 16 oz. of plain goat milk keifer. My stools had been very loose and are firmer now, but still not right. At night I wake up with night sweats because I have gas, that is difficult to pass. I do not have any abdominal pain from it though. I have slowly increased my probiotic intake from 2 billion and am now taking about 130 billion a day. I take Ultimate Flora critical colon 80 billion at night and Ultimate Flora critacal care 50 billion in the morning. I also take 2 or 3 RAW enzymes Women 50 and wiser, from Garden of Life before meals and 1 to 2 Oceans 3 Beyond Omega 3 also from Garden of Life. And #6 Kali Phos 6x cell salts from Hylands. Sounds like a lot when I write it out. Also, I do Reiki on myself about 3 times a day. I was diagnosed with IBS, and had a colonoscopy that only showed a small amount of diverticulitus, which the doctor said would not cause these symptoms. Can you offer anything different I should be doing. I just started on the large amounts of probiotics within the last two weeks, and switched to the Ultimate Flora just a few days ago. Thank you~
Hi Marianne,
I, of course, can’t diagnose you over the internet. My primary question would be, has the situation gotten worse since taking the probiotics? It sounds like it MIGHT, be an issue with SIBO (small intestinal bacterial overgrowth) which is where bacteria overgrow into the small intestine. These bacteria will make gas as they eat food – gas in the intestines comes from bacteria and yeast. If probiotics seem to make the situation worse, I would strongly consider this a possibility. The testing I would do at this point would include a stool test such as Doctors Data Comprehensive Digestive Analysis or Genova/Metametrix GI Effects stool panel (which would look for yeast issues, digestion and a number of other factors) and a Genova Bacterial Overgrowth test (I do use these tests, but get no reimbursement from the company) to get a sense of what’s going on in your gut and then we could design treatment from there.
I hope that helps!
Best,
Dr Tim Gerstmar
Hi,
I recently purchased Garden of Life Probiotics for Women and then read that soil-based probiotics, which are these Garden of Life, may be bad for you. Is this true? Should I not be using these?
Thanks,
Stephanie
Hi, I was wondering how long you start to see results after starting probiotics? I have a high vegetable diet and as much as I love them,w they KILL my stomach (gas, bloating, and cramps). I am taking 30 billion right now and just purchased Jarrow and will go up to 40 billion once I receive them.
Thanks!
Jennifer
Hi there,
I was wondering, if I am adding a lot of fermented foods to my diet (coconut milk kefir at breakfast, sauerkraut at lunch every day) do I still need to take probiotic supplements?
Thanks.
Camille
Hi again Dr Gertsmar
I’ve increased the Kefir somewhat during the last month, at most 3/4 of a small cup after a large meal and less for a snack. My gut has settled, but I still wake in the morning initially feeling yucky and usually sweat a little during the night and seem to urinate a lot at times.
Seems to me that I still have plenty of toxins to come out, and it can be a long drawn out battle of attrition, would you agree?
Regards Brian
Hi Stephanie,
Thank you for the comment and I’m sorry about taking so long to respond. I have not heard about any dangers with soil based organisms. I have also not seen them be particularly effective. Of the people who come to see me in my practice many have tried the Garden of Life products with little to no benefit, so I do not generally recommend them. Having said that, if they are working for you keep using them. If you have any resources that talk about harm from soil based organisms, please send them my way.
Best,
Tim Gerstmar, ND
Hi Jennifer,
I wish I had a straightforward answer for this. Unfortunately it depends. How “messed up” is your digestion / bacteria? How long have you had issues going on? How quickly does your body respond to treatment?
I’ve had people respond very quickly, within 2 weeks with major improvement, and with some of my patients we’re still slogging away 2 years later making improvement.
Best,
Dr Tim Gerstmar
Hi Camille,
If you’re eating a good amount of fermented foods on a regular basis and do not have any significant digestive problems then it is unlikely that you need to take supplemental probiotics.
Best,
Dr Tim Gerstmar
Hi Brian,
“Fixing” the gut, as well as moving from unhealthy to healthy can, unfortunately take a long time. I usually tell people, depending on how ill they are that they’re looking at 1-5 years to truly become healthy. This doesn’t mean they’ll feel terrible for that whole time, but that it can be quite a process.
The quick fix, better in 30 days mentality very, very rarely works for chronic illness.
Best,
Dr Tim Gerstmar
Hi Dr.Tim,
I know that this was published some time ago and that you may not see my question, but here’s hoping…
I am a 36 year old, active Pilates instructor who has had 3 cesarean births followed by more than 10 years of digestive distress. I kept waking up every day hoping that I’d feel better. It hasn’t happened yet.
I would say that for the last 10 years, I have been in chronic pain. Daily I experience constant bloating, massive gas from both ends (as soon as food enters my stomach and if I’ve gone too long between meals), cramping and abdominal pain, anxiety,brain fog, no sex drive, and I am really tired all of the time. I have chronic constipation, despite the magnesium and digestive enzymes that I take with meals (I supplement with fermented cod liver oil as well).
For many years, I would only have a BM every 7-10 days. I now have 1-3/day but each one is a laborious event, taking 20-45 minutes each time, even with a stool to increase the angle at my hips and while massaging my guts. Often I leave the bathroom feeling like my BM is incomplete, but my haemorrhoids just can’t handle another minute on the pot.
I’ve addressed my concerns with my GP and been brushed off with ‘women are always constipated, eat more fibre’. I have been diagnosed with IBS, but the Gastro said that there’s nothing that I can do about it, aside from more fibre of course.
I have been Paleo for almost 2 years now, without diversion, and it’s helped a little, but not nearly enough. I eat bone broth from grass fed, pastured animals regularly and have recently started a low fodmap diet, so no coffee or chocolate for this tired, cranky girl! As of 6 months ago, I’ve developed some sort of psoriasis on 2 of my fingers. I’m taking it as a sign that the yuck is trying to find a way out of my body. I’m sure that I have SIBO and need help greater than the hours spent with google can offer me. I just can’t keep living like this. It’s making me crazy, but worse than that, I feel so bad for my family. I’m just not myself.
After all of that typing, my questions are: How can I convince my doctor to test me? What kind of tests should I be asking for? What can I do myself to encourage gut healing? I’m in BC, but too far from you for a consult. Maybe you have a colleague in my neck of the woods? Thank you so much for taking the time to answer all of these questions, it’s really very generous of you and much appreciated.
Hi Brooke,
I’m sorry to hear about all your troubles. I definitely think you need a thorough workup by a doc (or other practitioner) who’s trained to look at what ails you. Your symptoms are not normal and not just something women have. You want to make sure your thyroid is evaluated and made sure it is functioning normally as part of your evaluation
The SIBO test is called a Hydrogen/Methane breath test and is done with either lactulose or glucose. Most regular MD’s, I have found, are completely clueless regarding this test, though I was pleasantly surprised to find a patient who brought the test in from their gastroenterologist the other week, so it’s slowly becoming more popular.
If you’d like to email me at info at aspirenaturalhealth.com and let me know where you are I’d be happy to see if I can help you find someone nearby. I do do phone/Skype consults as well.
Best,
Dr Tim Gerstmar
Please I have been suffering from bad breath for over 12years now. I remembered I was of the habit of taking antibiotics at will because antibiotics is available over the counter in the country where I’m from.Though now I live in the US “ut the problem still persists.I have tried everything possible under the sun;I have taken my tonsils out,did Endoscopy,did h.pylori breath test, took acid reflux med,taken diflucan,did candida diet,i was on Renewlife 80billion probiotic for months, all to no avail.
My tongue is whitish/yellow especially when I wake up in the morning.I also constantly clear my throat.Dentist,Ents and Mds have ruled out any infection.Im currently working with an homeopath(homeopathy doctor) who told me by problem is “bad bile”.I have been seeing him for 2months,no change sofar.Pls do you think might be intestinal yeast overgrowth because of my abuse of antibiotics or the bile the homeopath told me?
If you could help,I will highly appreciate it.
EDITED VERSION:
Please I have been suffering from bad breath for over 12years now. I remembered I was of the habit of taking antibiotics at will because antibiotics is available over the counter in the country where I’m from.Though now I live in the US, the problem still persists.I have tried everything possible under the sun;I have taken my tonsils out,did Endoscopy,did h.pylori breath test, took acid reflux med,taken diflucan,did candida diet,i was on Renewlife 80billion probiotic for months, all to no avail.
My tongue is white/yellow especially when I wake up in the morning.I also constantly clear my throat.Dentist,Ents and MDs have ruled out any infection.Im currently working with a homeopath(homeopathy doctor) who told me by problem is “bad bile”.I have been seeing him for 2months,no change sofar.Pls do you think my problem is intestinal yeast overgrowth because of my overuse of antibiotics or the bile the homeopath told me?
If you could help,I will highly appreciate it.
I recently started taking Align for 2 weeks per my doctors suggestion to help with bloating. It was like a miracle, my abs became flat for the first time in a long time. After the two weeks, I went off Align and a few days in, I am so bloated, I look several months pregnant and my abs are no longer visible. Should I take Align everyday now?
Are there any risks to taking Align everyday?
Also, I use to suffer from reoccuring yeast infections, but once I started eating yogurt everyday, they stopped occurring. Overtime I have become intolerant to dairy, even the yogurt. Will Align help prevent the yeast infections, or do I need a different probiotic strain?
Thanks!
Hi Dr. Tim,
Which of the Klaire Labs probiotics capsules do you recommend for GERD , acid reflux and possible IBS. I have already been taking culturelle Lactobilllus GG. and want to switch to something more well rounded with more strains???
Hi Dr. Tim
One more thing. I noticed one needs an authorization code to purchase probiotics from Klaire Labs.
How do I obtain that code to order probiotic supplements from them directly, or perhaps do you sell them from your site?
Hi MI,
Sorry for the long delay in responding to you.
The trick is not in some special treatment, but in finding out what is causing the bad breath. It sounds like you’ve had a lot of workup, but in thinking logically, bad breath is going to arise from the mouth, teeth (do you have root canals, gum or tooth problems?), sinus (history of sinus infections? chronic post nasal drip?), throat or stomach typically. It’s uncommon but possible for bad breath to arise further down in the digestive tract – do you have issues with chronic constipation? Have you had a stool test done to evaluate gut health?
I’m sorry I can’t offer you the answer. You just need someone to think logically through the issue and test appropriately to find out the source of your bad breath. I hope the work with your homeopath is working well for you. If I can help in the future, please let me know.
Best,
Dr Tim Gerstmar
Hi Susan,
I believe probiotics whether in the form of supplemental probiotics or fermented foods should be eaten on a daily or near daily basis by most people. Obviously taking probiotics reduced bloating meaning improved digestion and reduced inflammation, then when you stopped the symptoms returned meaning that the gut had not stabilized.
I know of no risks of taking probiotics daily.
Yeast infections are most often allowed to occur by disordered bacteria (dysbiosis), hence how women commonly get yeast infections after taking a course of antibiotics. Probiotics are often extremely helpful in preventing yeast infections – either fermented foods or supplements. It sounds like Align has worked well for you, so I would suggest continuing it.
Hope that helps!
Best,
Dr Tim Gerstmar
Hi Mark,
The exact strain that’s best for you is going to depend on the results of a workup, but in general I like the Klaire Labs Therbiotic Complete as a strong, well-rounded product that gets consistently good results for me. If you can’t find the product online, you can contact me and we can get them to you.
I hope that helps!
Best,
Dr Tim Gerstmar
Hi Dr. Tim,
Is Kombucha a good source of probiotics?
How often should a person drink 16oz of Kombucha to maintain healthy gut flora? A few times per week? More? Less?
I have not been able to find much information regarding Kombucha and would love it if you could help me!
Will you please email me back at: cristeyr@yahoo.com ?
Thank you so much!
Very informative article.
Do you have any recommendations on an oral probiotic to treat extensive bacteria in the gum area or to treat oral lichen planus?
Thank you so much!
Hi Kathleen,
Personally I have not seen kombucha by itself be particularly effective in the restoration of good gut flora. If you have a healthy gut, I recommend that people are consuming fermented foods at least a few times per week, and ideally daily – kombucha could be part of that.
I agree, there is not much “real” info on kombucha out there, mostly people repeating miracle stories and the same bit of info over and over. A quick Pubmed search turned up about 50 articles on kombucha most showing that it reduced oxidative stress and protected the liver from various toxins.
Most of the bottles I have seen label that a bottle contains between 1-4 billion probiotics. If true, that would make them a relatively weak probiotic source.
I have had a patient recently who found that even a shot (1oz or ~30mls) of kombucha aggravated their gut symptoms, indicated significant dysbiosis.
I hope that helps!
Best,
Dr Tim Gerstmar
Hi Lynn,
I haven’t done too much research in this area, so haven’t looked for an oral specific probiotic product. A quick review says “…no species specific to the oral cavity has been found. In contrast, some species are found in both oral and fecal samples.7,8 Species commonly isolated from saliva samples include L. paracasei, L. plantarum, L. rhamnosus, and L. salivarius.7–10 Culture-based studies suggest that bifidobacteria are among the first anaerobes in the oral cavity.11 Indeed, both lactobacilli and bifidobacteria can be found in breast milk, suggesting early exposure of the oral cavity to these bacteria.12,13 Bifidobacterial species isolated from oral samples include B. bifidum, B. dentium, and B. longum.8,14,15”
If you were evaluating a product you’d look for those species. In general, I’ve had good luck with the Klaire Labs Therbiotic Powder held in the mouth. I would also consider xylitol, either as a powder held in the mouth of as xylitol gum. You may also need some antimicrobial agents such as myrrh (historically used often in the mouth) among many others.
I hope that helps!
Best,
Dr Tim Gerstmar
Hi
I’ve been suffering with BV for about a year now. I have tried all sorts of things to try and rid myself of this. I have drank probiotic drinks and taken pills etc. Is there any probiotic that I can take that will help balance my flora out so that I can get rid of BV.
Thank you so much
HI Anita,
I assume by BV you mean, bacterial vaginosis. Ultimately the solution comes down to the reason for BV. I’m going to assume that you’re not doing anything actively to disrupt the bacteria of the vagina such as douching or using other feminine care products. Many women also find benefit, for at least a while, either going without underwear or with a cotton only underwear to allow the area to “breathe”. Depending on the degree of dysbiosis you may need some active treatment to kill the “bad” microorganisms. This is often done in the form of suppositories. Because we don’t know if that’s needed, if it were me, I would start by taking a good probiotic by mouth and also taking a capsule and inserting it vaginally (you can coat it with a little olive oil or similar if needed) at night before bed. The capsule will dissolve during the night. There may be a small amount of discharge. I would consider that for a week or two and see how it helps you and go from there.
Best,
Dr Tim Gerstmar
Hi there doctor. I have recently been diagnosed with having yeast organisms in the prostate. A while back, I had a bacterial prostatitis caused by a UTI that went unnoticed. I took many different kinds of antibiotics for a very long time ( at the time, I was just asking for antibiotics without being sure of what was going on) When I was finally diagnosed with the prostatitis, I took a final one and a half month course of antibiotics equaling for like three to four months of antibiotic treatment. The pain never went away but my urologist said it was impossible I was still infected. Recently, I was told that I had yeast there. I’d rather treat it naturally with coconut oil but is there anything you could suggest for this? It has been going on for too long and I’m very young. If you were to recommend a probiotic, which would it be, and what other products would you recommend? Thank you so much
Hi again Dr Gertsmar
Not about myself this time, but something worrying me about my niece Emily, (who incidentally had a small procedure a few years ago concerning Ulcerated Colitis).
She give birth to a boy on 15th October, and I’m shocked to discover not only was the delivery Caesarean but apparently she also had trouble attempting breast feeding so it appears the baby has been on formula from the outset. I am, of course, worried about the lack and quality of inherited gut flora.
I aim to urge the parents to have a talk with a doctor here in the UK who is associated with Dr Natasha Campbell-McBride.
Would you agree there should be concern?
Regards Brian
Hi Lorenzo,
The prostate is a very difficult organ to treat in that it is compartmentalized (walled off) from the body. Even prescription anti-microbials have a difficult time getting into the prostate. I do not know of any probiotics tailored for the prostate and directly getting them in would be….uncomfortable. Given those limitations I would take probiotics by mouth and you certainly could apply probiotics to the head of the penis and the opening of the urethra, perhaps before bed, in the hopes that there might be migration down the urethra.
If you have yeast, I personally would opt for the prescription antifungal in this case, probably diflucan, and then you could combine it with natural antifungals like oil or oregano or others, taken by mouth for their synergistic effect. Antibiotics will not have any effect on yeast, and will often make the situation worse by killing off bacteria that help control the population of yeast
I hope that helps.
Best,
Dr Tim Gerstmar
Brian,
I don’t want to overstate the concern, but the baby certainly has some risk factors. Mother with UC, Cesarian birth and lack of breastfeeding. If it were me I would certainly be taking steps to help offset the risk of developing complications.
If you can find a good practitioner local to her, that would be the best option.
Best,
Dr Tim Gerstmar
Hello Dr. Gerstmar,
I recently ordered Dr. Mercola’s Complete Probiotics capsules. They have 10 strains and 70 billion CFU per 2 capsules. I eat a pretty healthy diet that is mostly free from preservatives, gmos, fast food, sugar, etc. I just started taking one capsule a day two days ago and other than having a bm come shortly after taking it, I don’t have any new symptoms. My question is, how do you know the probiotic is working and do you know anything about this particular product? In your article you stated that anything over 6 strains may be a “kitchen sink” product. Do you think this brand is one of those? Thank you!
Hello again!
Apologies, as I have one more question to add to the above. I read that it is important to switch up probiotics, because the bacteria in the gut can adapt to the probiotics and you may not receive the benefits anymore. Is this true? If so, how often should one change their probiotic brand and what does one need to know before changing the product to ensure they aren’t taking the same thing? Is rotating between two enough?
Thank you, Jasmine
Hi Jasmine,
I’ve never used Dr Mercola’s probiotic before, but took a quick look at it, and it seems to be a fine product.
As for how you know a probiotic is working, that can be tricky. If you have digestive issues (gas, bloating, constipation, diarrhea, abdominal pain, heartburn, etc), many improve with the regular use of a probiotic. If you’ve done a stool test, you’d like to see that problem areas correct. Otherwise if you are healthy, than the use of fermented foods and/or probiotics is, to me, mimicking ancestral conditions and also a “health insurance policy” and just like making sure you are getting enough vitamins and minerals not something you are going to notice other than just being healthy.
I do like to rotate through various probiotics, trying to at least kind of mimic the large diversity of probiotic bacteria we’d be getting through soil, plants & animals, and ferments. I don’t have a hard and fast rule, but do try to vary at least every few months unless their is a need to stay with a particular product.
I hope that helps!
Best,
Dr Tim Gerstmar
Hello Dr. Tim,
I have a 5 week old exclusively breastfed daughter who seems to be having some reflux and gas. My pediatrician agreed probiotics may help her. I purchased Country Life Maxi Baby Dophilus (3 billion-50 mg per serving), but now I’m wondering if Klaire’s infant probiotic (10 billion-) may be better quality or possibly better for reflux and gas specifically??
Country Life has L. rhamnosus (600 million), paracasei (600 million), and salivarius (300 million), B. lactus (900 million), longum (300 million), and infantis (300 million).
Klaire’s infant probiotic has the same strains PLUS L. casei, L. gasseri and B. breve, B. bifidum.
Do you see any benefit of switching to Klaire’s formula?
Thank you!!!
Is there a type of probiotic that you recommend for reoccurring yeast infections, or will any strain do?
Hi I was told to use a probiotic from my doctor he was not specific he just said that I should get one in the billions. I am having a vaginal discharge and I was told I need to take a probiotic to gain some healthy bacteria. When I went to cvs there where multiple types of probiotics. The one that I picked said it helps prevent occasional constipation but I’m not constipated. I need a probiotic that helps prevent BV. My question to you is ok to use this probiotic since it says it’s for constipation?
my 27 month old just started taking probiotics (klaiir thera biotic complete powder), per the advice of a nutrionist. when people talk of knowing “it is working”, at that age, what am i looking for (my son talks but too young to communicate much on how he feels)? he had very bad bout of diarrhea today (day 4 of probiotic, 1/8 teaspoon dose), which was just hours after he took it (and hours after a normal bm). is his system too sensitive to this dose or is this a sign of the probiotic cleansing? he does have a cough so the diarrhea could also be from a virus but i thought i’d ask what i should be looking for.
Hi Melissa,
I, as well as many others, have had consistently good success using the Klaire line so that’s why I recommend them so often. Having said that if you’ve seen that the Country LIfe has been helpful for your daughter, than please stick with what works. However, if you haven’t seen good results, I would consider trying the Klaire product.
I hope that helps!
Best,
Dr Tim Gerstmar
Hi Susan,
When you say yeast infections, I’m making an assumption you are talking about vaginal yeast infections. The vagina is colonized heavily by acidophilus species, so you would want a probiotic that contains acidophilus. I have found most good quality probiotics to work just fine, and the handful of “women’s probiotics” out there mostly to be just marketing.
For vaginal yeast infections I recommend taking probiotics by mouth as well as inserting a capsule vaginally at night before bed. Many women see remarkable improvement with this simple regimen.
I hope that helps.
Best,
Dr Tim Gerstmar
Hi Tiara,
I answered your question partly in the comment above, but yes it would be fine to use a product labeled for constipation. The body’s bacteria play MANY, MANY roles. Companies are constrained legally in various ways what they can put on the box. Getting your bacteria in good shape is a major component of resolving yeast or bacterial vaginal infections.
I hope that helps.
Best,
Dr Tim Gerstmar
Hi Carol,
The question I would ask back is, why is your son being given probiotics? If it’s for general health reasons then you’re not likely to see any noticeable changes. If it’s for a specific reason – gas/bloating, eczema, diarrhea/constipation, etc, etc then ultimately you’re looking to see a change in those symptoms.
Giving probiotics can cause diarrhea, (infrequently) constipation, gas & bloating, as well as symptoms like fatigue, brain fog, rashes/skin flares, and occasionally low grade fevers. If in doubt or concerned, I recommend starting slowly and increasing the dose.
I hope that helps!
Best,
Dr Tim Gerstmar
Dr Gertsmar,
I realise there’s still a lot to learn concerning gut flora and different bacteria, but wonder if you could give me your opinion on this:
At the moment I’m consuming a small amount of Kefir, Sauerkraut and Kombucha during the day. Is this a fair regime or would it be more beneficial to give each one a clear field for a couple of days at a time? The good guys wouldn’t fight amongst themselves would they or add to die off?
Regards Brian
Hi,
I have been suffering with gut problems since I had a long dose of antibiotics, i am unable to eat fruit, vegetables, sugar or dairy without problems. I have seen a homeopath who recommended starting off on a highly expensive probiotic which contain 120 billion live bacteria, I found that take this along with Bimuno has worsened my symptoms. I have not been on probiotics before. Should I be starting on a lower dose? This is a brilliant page, ive seen so many conflicting reports on probiotics and am feeling slightly overwhelmed.
Thank you in advance for any advice you can offer, i am at my wits end.
Kind regards
Emma
Dr Gertsmar?, like you I hate to see people suffer and as you may be busy at the moment I hope you don’t mind me for the moment replying to Emma. If I’m being forward or you do not concur please delete this post.
Hi Emma? It sounds to me as if you may have “leaky gut”, I had it at the outset of my symptoms and it is truly terrible and my immune system was going haywire! I had to follow a regime for about two or three weeks recommended by Dr Natasha Campbell-McBride called the “introduction diet”. It generally consists of meat and bone broth to heal the gut.
Here is one link of many articles around to give you some insight:
http://articles.mercola.com/sites/articles/archive/2012/03/18/mcbride-and-barringer-interview.aspx
Just my opinion but 120 billion seems a lot to start out with, I only took 10 – 20 billion initially.