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Should You Take Probiotics?

Probiotics are living bacteria normally found in the human digestive tract that are usually ingested to improve the quality and quantity of the gut’s beneficial bacteria. One of the goals of taking a probiotic is to shift the population of gut bacteria toward one that is more healing and low inflammatory. But most people don’t know that probiotics do a lot more than just influence the population of the microbes that live in your gut.

Many studies have shown that probiotics can repair a leaky gut, reduce intestinal permeability and help increase the production of butyrate (a short chain fatty acid made by good gut flora that is very good for us).  In their role as influencers on the gut microbiome, probiotics have been found to specifically reduce proinflammatory bacteria such as Escherichia coli, Enterobacter aerogenes, Klebsiella pneumoniae, Streptococcus viridans, Bacteroides fragilis, Bacteroides uniformis, and Clostridium ramosum. When these and other potentially harmful bacteria are present in high amounts, they create a pro-inflammatory, leaky gut causing condition called dysbiosis. (1)  The term dysbiosis was introduced over a century ago by the Nobel Prize laureate Elie Metchnikoff, who used it to describe a disruption of the normal balance of the bacteria in the gut and then proposed using yogurt with active bacterial cultures to improve both the gut and human health.(2)

Probiotics have gotten bad press recently because many people believe that probiotics are like seeds that plant themselves in the gut and that they are supposed to grow there and flourish.  When studies recently showed that probiotics in fact pass through us in about 6 weeks, the buzz was that people shouldn’t bother taking them. This absolutely is not true, because probiotics exert their influence without needing to plant and grow.  They help improve the whole ecosystem of the gut and also have a huge role to play in helping treat inflammation like arthritis, and immune system imbalances like autoimmune disease.

For example, researchers have studied the use of probiotic supplements to treat the dysbiosis of inflammatory arthritis and found that probiotics improve symptoms in arthritis sufferers.  Generally speaking, when it comes to arthritis, probiotics are thought to improve all the functions of your good flora, including helping T regulator immune cells work better and live longer, turning off inflammation and repairing the gut lining and tight junctions.  Because probiotics help treat a leaky gut, and because of the gut-arthritis connection, it follows that they would also treat systemic inflammation and arthritis, and they do!  

The bottom line? The strains researched in arthritis with the most evidence for an anti-inflammatory effect are Lactobacilli:  casei, acidophilus, reuteri, rhamnosus GG and salivarius. There is also good evidence for Bifidobacterium bifidum.  Bifidobacterium infantis, E coli nissle, and Lactobacillus plantarum were found to improve tight junctions and heal leaky gut, even if they weren’t studied for their effects specifically on arthritis. This data tells me that a multi-strain formula that includes as many of these as possible, with a priority given to those that have been studied in arthritis patients, is best when using probiotics to reduce inflammation.

If you have arthritis or any inflammatory condition, taking a probiotic is a great place to start.  But to treat dysbiosis, functional medicine offers a more complete approach that includes an herbal program to clean the “weeds” out of the garden.  The HealMyGut program can be done by itself, or as part of the Arthritis Challenge.  

And finally, I leave you with a brief suggestion for choosing a probiotic.  This can be confusing! I prefer to use a multi strain formula that has as many anti-inflammatory strains as I can find.  I love Klaire Labs, because they have been around as long as I’ve been practicing Functional Medicine (almost 2 decades!) and I know they work since I have been using them all this time.  My favorite product is Therbiotic complete, because it includes all the above strains. That’s why I use this for my private label BCH! PURCHASE HERE

Klaire Labs Therbiotic Complete: 12 strains

  •      Lactobacillus rhamnosus
  •      Bifidobacterium bifidum
  •      Lactobacillus acidophilus
  •      Lactobacillus casei
  •      Lactobacillus plantarum
  •      Lactobacillus salivarius
  •      Bifidobacterium longum
  •      Streptococcus thermophilus
  •      Lactobacillus bulgaricus
  •      Lactobacillus paracasei
  •      Bifidobacterium lactis
  •      Bifidobacterium breve

 

[1]  Parian A, Limketkai B, Shah N, Mullin G. Nutraceutical Supplements for Inflammatory Bowel Disease. Nutrition in Clinical Practice. 2015. Vol 30, Number 4. 551-558.

[2] Zeng MY, Inohara N and Nunez G. Mechanism of inflammation-driven bacterial dysbiosis in the gut.  Mucosal Immunology. Online publication 24 August 2016. doi:10.1038/mi.2016.75

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What is Dysbiosis – and What You Can Do About It

Dysbiosis is like having weeds in your gut garden

You have within you trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract.  This lively bunch of microbes is known as your microflora. Often referred to as “The Garden Within,” your microbial garden can shift out of balance. Think about how a garden can become overgrown with weeds. When that happens, we say a person has dysbiosis.

Three Ways Dysbiosis Can Impact Your Gut

  1. Too much of the bad stuff overgrowing in the gut is the most basic imbalance.  An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast (candida albicans is a particularly common and unwelcome yeast in large amounts), are two examples of overgrowth that cause dysbiosis.  An unwelcome virus or parasite can also cause overgrowth imbalance.

    To treat this type of dysbiosis we sometimes prescribe medications to kill unwanted bacteria, parasites, or yeast, but more often we use gentler, broad-spectrum anti-microbial herbs to weed the garden, improving the balance of good and bad bacteria. We also use probiotics and fiber-rich foods to encourage growth of the good while we get rid of the bad.
  2. Microbial undergrowth can be the culprit. It is rarer than the situation above, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise.  An under-abundance indicates we need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. We do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.
  3. Your microbiome settles in the wrong place. Living microbes are wanted, but we need them to live where they belong, and not take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well.  Herbs and antibiotics are our go-to for treating SIBO.

Could you have dysbiosis?

In our medical practice at Blum Center for Health, we suspect an imbalance in the flora (a dysbiosis) in anyone who complains of stomach troubles. Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have stomach upset after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating, we think of dysbiosis.  If you have bowel problems, like excessive gas, lower belly pains, constipation, or diarrhea – then dysbiosis is our prime suspect too.

Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, also make me suspect dysbiosis.  We are becoming more and more aware the impact our microbiome has on our whole being – our whole health – and our disease processes.

When I see someone whose health concerns are not primarily digestive in nature – even those who report having a perfect digestive system – I usually investigate their microbiome, and will almost always prescribe a probiotic. Why? Because sometimes dysbiosis is silent gut-wise, while still causing trouble in other areas of your body.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  

How do you know if you have dysbiosis?

How does your internal garden grow?  The tests we most often request are simple:  Stool, breath, and urine testing – all of which give us a picture of what your personal microbiome looks like.  We learn from the test results how many beneficial bacteria are growing, and how many malicious bacteria have taken up residence in your gut. We use that information to create your personalized treatment plan.

With some patients we assume dysbiosis without testing – and just get you started on the good stuff  – probiotics and healthy, fiber-rich foods.

Not sure if you have dysbiosis? Take our Assessment and find out!

How did you get this dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as does any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

What to do if you suspect you have dysbiosis:

If you live in our neighborhood, make an appointment! In our practice at Blum Center for Health we take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. We take your health seriously and get to the root of the problem rather than simply throwing medication at it. For more information, call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

 

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

 

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3 Simple Steps To Great Gut Health

By Susan Blum, MD

If you have gas or bloating after you eat, or if you experience constipation and/or loose stools, or any type of intestinal discomfort, you have a problem with how your gut is functioning. While this is commonly labeled irritable bowel syndrome, or IBS, the diagnosis doesn’t tell you why you’re having this problem.

Usually, the issue is something called dysbiosis, which means your gut flora isn’t healthy. You might have an overgrowth of harmful bacteria, yeast or parasites, or you might not have enough of the good stuff: those probiotics you find in yogurt and cultured foods.

But who cares about a little gas or bloating?

You should! Your gut flora needs to be fixed, because the symptoms you’re having could just be the tip of the iceberg. A whopping 70% of your immune system is located in your gut and if the flora are out of balance, you have an increased risk of something called Leaky Gut Syndrome, and this can lead to autoimmune disease.

Here are my tips to heal your gut, which will treat your symptoms and keep your immune system happy, too.

  1. For your digestive symptoms, find out whether or not you’ve got food sensitivities, which could be causing the problem. Check yourself for gluten and dairy by removing them both from your diet at the same time for three weeks, and then reintroduce each one at a time, four days apart and monitor how you feel.
  2. For your flora, eat cultured food every day, like coconut or almond milk yogurt and kefir, sauerkraut or kimchee, and consider taking a probiotic supplement.
  3. If the above doesn’t do the trick, consider a gut-cleansing program using herbs like berberine or oregano to remove the harmful microbes. Our new HealMyGut program will help you do just that!