Should You Take a Probiotic?

Should you take a probiotic?  This is one of the most common questions I get asked after my gut health presentations and by my clients.  

The growing awareness about the need to have a healthy microbiome is a good thing.  There are about 100 trillion microbial organisms in our microbiome, made up of mostly bacteria but also viruses and fungi.  These microbes are needed for us to survive and to digest our food. About 70% of the microbiome is in our gut and affects not only our digestion but also our immune system, skin, respiration, and even our moods. 

If you have done some investigating, you will know that there is controversy about probiotic supplements.  Some doctors say to take a supplement, others say don’t.  

The truth is that research into the microbiome is still in its early stages.  We do know that optimal health depends on a richly diverse ecosystem in our microbiome.  Often, the microbiome is likened to a rainforest. Research has shown that the microbiota of hunter-gather tribes is much more diverse than that of people in developed countries. 

Many people know that their microbiome may not be healthy because they are experiencing digestive and other symptoms.  In our society, we are conditioned in the “pill for every ill” philosophy, so naturally, there is a tendency to look for a pill to cure an unhealthy microbiome … and development of businesses to make and sell them!  

Before rushing to take a probiotic, here are some things to consider.  

We humans have lived and thrived for thousands of years without taking a probiotic.  Our microbiomes may not be thriving now, but what is the cause of that?  

Interestingly, a baby’s first microbiome comes from the mother in a vaginal delivery by way of fluids the baby is exposed to along the birth canal.  An increase in cesarean section births meant that many babies did not receive this microbiome at birth. Recently there has been growing practice of swabbing a baby delivered by cesarean section with the mother’s vaginal fluids.  Colostrum, the initial breastmilk, contains the perfect food for that first microbiome … it’s not even digestible by humans!

A baby’s first microbiome comes from the mother in a vaginal delivery.

Being too ‘clean’ could also be part of the problem,  Overuse of antibacterial soaps and hand sanitizers and simply not ‘playing in the dirt’ enough to get exposure to microbials has resulted in less diversity in the microbiome. The result can be a microbiome which is out of balance, with more of the “bad” bacteria, eventually causing a leaky gut and possibly even autoimmune or other diseases. 

Even if a probiotic supplement is taken, the new culture won’t flourish and sustain if it is not supported by the right diet and lifestyle.

The good news is that a healthy microbiome can be cultivated by eating the right kinds of foods and if supported by a healthy lifestyle. 

Many cultures throughout the world eat fermented foods like kimchi, miso, tempeh, sauerkraut, yogurt (homemade), kefir and kombucha.  These foods help feed good bacteria.  

Traditional cultures also included prebiotic foods, which feed the good bacteria and help them flourish.  These include things like artichoke, garlic, leeks, onion, barley, flax, and oats. 

Getting outside, digging in the dirt, and having a pet all help expose us to bacteria and help diversify our microbiome. 

However, there are times when it may be necessary for you to take a probiotic. Working with a naturopathic doctor, you could analyze your own personal microbiome and determine if supplementation is needed. 

You get what you pay for with supplements, so make sure it is a quality supplement with good bacteria strains like bifidobacteria and lactobacillus. Change up the probiotic so that a variety of strains are introduced, and eat the right foods to support them.  If probiotic supplementation is not supported by a quality, healthy diet, then it is just money wasted.  

Another note regarding probiotics: people with SIBO (small intestine bacterial overgrowth) should NOT supplement with probiotics, even probiotic foods.  If there is an overgrowth of bacteria in the gut, we definitely do not want to add more bacteria, even good ones, until the overgrowth has been cleared.  For more on SIBO, read these articles  Part 1 , Part 2 , Part 3 and Part 4.

In the not-too-distant future, I hope that individualized medicine will make it simple and inexpensive for everyone to have their microbiome analyzed.  Some companies, like Viome, provide microbiome testing, although the price makes this out of reach for many people. 

Should you take a probiotic?  Now, you can make a better-informed decision. 

As we see so often, the power lies with each of us to make decisions on food and lifestyle which best support our health.  That’s empowerment!

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