December 11, 2018

How to become a probiotic pro

Patients often ask me if they should take probiotics to improve digestion, strengthen immunity and help with weight loss.

Yes, these are all true health benefits of probiotics, but there are a few things people should know before taking them.

First off, what are probiotics?

They are live bacteria and yeast that our bodies need to function well. We all have good and bad bacteria, and there should be a balance between them. We often take probiotics when we think we may have an imbalance.

For instance, patients are encouraged to take probiotics after a course of antibiotics to restore good bacteria that the antibiotics destroyed when it was getting rid of the bad bacteria. But we actually want to be taking probiotics during the course of antibiotics and not just after.

Probiotics have been traditionally used for the gut — however, when the microbiome is imbalanced, your mood, mental health, immune health, cognitive function and skin will be affected.

Pick the right strain for your condition.

It’s crucial to know what problem you are trying to address.

A strain that works for one condition will not necessarily be effective for another — and there is no “one strain fits all.” I recommend consulting your health care practitioner or a registered dietitian whether you need a supplement and which strains would work best for your condition.

The strain information should be on the label.

Besides the strains, what else should I consider in a probiotic?

Finding the right strain for your condition is the number one factor, but there are others:

• Soil-based, a class of probiotics

• Potency — at least 50 billion CFUs, or total number of bacteria

• No GMOs, short for “genetically modified organisms”

• Compliant with current Good Manufacturing Practices, or “cGMP"

• Expiration date that’s clearly printed on the package

• The package should be a resealable and opaque container

What’s the best way to take them?

Supplements come in several forms: time-released tablet or caplet, coated capsules, or microcapsules. Also look for one that contains prebiotics and the optimal combination of probiotics. If you opt to take a supplement, consult your doctor first.

You can eat prebiotics, such as starchy tubers (cooked and cooled), under-ripe bananas, raw dandelion greens, raw jicama, Jerusalem artichokes, and acacia gum, to help nourish the colonization if the probiotic lacks them.

Because bacteria are easily destroyed by stomach and bile acids, it’s important to ensure the probiotic delivers live bacteria or cultures once it’s consumed and released in the gut.

You can get probiotics without taking a supplement.

Keep in mind that you can also find probiotics in food.

Yogurt, kefir and fermented vegetables, such as kimchi or sauerkraut, are good sources of probiotics. Fermented vegetables contain lactobacillus plantarum, a strain that has been shown to thrive in the stomach’s acidic environment.

There are a few cautionary notes about commercial dairy kefir that has not been fermented long enough to kill the lactose, which cause problems for lactose-intolerant people. However, homemade dairy kefir is not an issue if it’s fermented for at least 24 hours because the lactose will be gone at that point.

I would caution against some yogurts because they have a significant amount of sugar or artificial sweeteners, which can cancel out any potential therapeutic benefits of probiotics.

What else should I know?

Probiotics might not work for everyone, possibly because of lifestyle factors that can impact their effects, such as a poor diet, inadequate sleep, smoking or drinking too much alcohol. Prescription medicines and emotional stress can also play role.

An analogy I like to use: The soil must be tilled before the seeds can be planted — we want to foster a nurturing environment for the colonization of the probiotics.

Contributor: Lori Chang, RD