Restoring Gut Bacterial Microbiome.. Do Probiotics Work?

[Viking]

There are a lot of questions about probiotics that come to mind, and I am curious how people view what might actually work to fully restore proper gut bacteria after antibiotics.

The intestinal tract is home to about 1000 species of bacteria. Presumably when you take antibiotics, many species, perhaps hundreds of species, are wiped out.

Probiotic formulas at best, might reload a dozen or so strains. And often just one or two strains.
And thats assuming that they are...
Viable when you buy them.
Can survive stomach acid.
Are strains that can actually attach to the inestinal lining, and colonize.

How do probitoics actually work then? Do they set conditions for regrowth of the 1000 or so normal species? Perhaps by driving out pathogens? Or by changing intestinal pH so other stains can regrow?

Does anyone have a model of how this works? Or to what degree it actually does? If you've done it sucessfully, please let us know.

Best Regards,
Viking

 

[dan062]

Hi @Viking,

I've nothing appreciably useful to add other than that after spending quite a lot of time attempting to learn about the microbiome the past two weeks my questions replicate yours more or less exactly.

I know that @snowathlete is also exploring this area and might have some light to shed on some of the above.

Unfortunately, it's an extremely new area of research (I can't help but feel that with Metchnikoff's writings way back then, more research money should have been dedicated to this far sooner than it has been), and more time seems to have been dedicated to trashing out the microbiome's role in disease associations (particularly C.diff) than in answering the million dollar question, for us, of 'how do we fix it'.

My uneducated guesses:

The gut flora do seem to eventually 'bounce back' from antibiotics in the sense that proportions and composition of the major commensals do eventually rebound. However this depends upon both time and the antibiotic used. Some are worse than others.

Studies that are and have compared Westerners' gut flora with those of indigenous people, have found the most striking difference to be that the Westerners exhibited far less diversityin terms of the number of strains.

I therefore think it's entirely possible that given the gut flora's 'long tail', with lots of species in very small numbers, that many of these smaller populations could, indeed, be irreversibly eradicated by broad spectrum antibiotic use, especially when used repeatedly.

I think it's generally accepted that the common probiotic strains do not colonize. However they may be able to exert a beneficial effect on the flora in general by favouring the growth of good species and inhibiting the not so good ones.

As to how to get the 'missing microbes' back, assuming that they are gone. Fecal transplant is an obvious option but I'm not sure of any other way at present.

The major problem is that many of the commensals are not culturable in the lab or commercial settings, which explains why the probiotics on the market do not correspond in any way to the most populous strains in the gut (lactobacillus and bifido are way down the list).

I'm sure others with better knowledge may be able to give you a better answer.

 

[Viking]

Dan.. looks like we have been doing the same homework the past few weeks.

My current apporach is this...
Probiotics... a brand called Repleniss by Interplexus ( impressive CDSA before and after results, and less food and supplement allergies after taking it )
Coconut Kefir...... I also saw improved tolerance to foods and supplements after a few months on this. ( worked it up slowly to about 1 cup a day)
Low sugar / gluten free diet.

A few thoughts ..
I was on enormous amounts of antibiotics... first for frivolous infections / acne, which is what created my leaky gut, and then later I was on large amounts of anti parasitics. Antiparasitic meds, and botanicals, can also really disrupt gut bacteria, a fact I did not realize until my food and supplement allergies worsened substantially.

I have tried numerous probiotics.. some showed no effect on CDSA testing, others made a big difference. I suspect some brands have just sat on store shelves to long or have been damaged in shipping.

Viking

 

[dan062]

I'll check that probiotic out. It's a very hefty dose at 55 billion.

I'm going on the paleo diet (I keep meaning to start and then defer) for the simple reason that since I started eating mostly vegetarian, a few years ago, my health seems to have generally declined.

There are lots of other factors, of course, but I think that everything comes down to guesswork at the moment -- both in the terms of the science and how we can try to apply it for our benefit.

Encouraging that that probiotic worked based on the CDSA. I think it's very possible that regular probiotic intake could indrectly shape the contents of the existing flora -- much like how a developing infant's microbiome may be shaped by its mother's breast-milk, which contains lots of the same beneficial organisms we see in supplements.

A couple of other non dietary things I've read regarding what we can do to influence what we have:

- Circardian rhythm seems to effect the microbiome (jet lag studies). I presume from these that keeping in sync with the natural cycle would be beneficial somehow.
- Exercise benefits it (Irish rugby players study). But obviously very difficult in our case.
- Less stress = better microbiome.
- Alcohol definitely has seems to have a detrimental effect on it. Caffeine seems to be a mild prebiotic but obviously could play into leaky gut big time so wouldn't take the chance.

Let me know if you work out answer to any of the above.

 

[snowathlete]

There are a lot of questions about probiotics that come to mind, and I am curious how people view what might actually work to fully restore proper gut bacteria after antibiotics.

The intestinal tract is home to about 1000 species of bacteria. Presumably when you take antibiotics, many species, perhaps hundreds of species, are wiped out.

Probiotic formulas at best, might reload a dozen or so strains. And often just one or two strains.
And thats assuming that they are...
Viable when you buy them.
Can survive stomach acid.
Are strains that can actually attach to the inestinal lining, and colonize.

How do probitoics actually work then? Do they set conditions for regrowth of the 1000 or so normal species? Perhaps by driving out pathogens? Or by changing intestinal pH so other stains can regrow?

Does anyone have a model of how this works? Or to what degree it actually does? If you've done it sucessfully, please let us know.

Best Regards,
Viking

My experience so far, while fumbling blindly in the dark trying to explore the same sorts of questions, is that probiotics are worth taking but are pretty limited because there isn't much diversity in the market. There are lots of papers out there on various probiotics. There was a recent paper actually which looked at several different probiotic brands and found many didn't contain the stated numbers on the packet and many didn't survive long and it found those that came as liquid did better.

Another paper I saw, which was being talked about on a blog about this sort of thing, suggested that taking your probiotic before a meal with a drink or food containing fat helped it survive the stomach acid, so I do that now.

My increasing strategy is to try and take many diverse genus, species and strains of probiotics and fermented foods that I can get my hands on, but not all at once - slowly and cautiously over a long period of time is how I am approaching it.

There are a number of good blogs looking at gut health, probiotics, diets etc and how it all impacts gut flora. A number of them seem to be coming from a paleo background, I'm not sure why, but there you go. I don't eat paleo but I guess I'm not too far from it now - my diet has been dictated to me by my food intollerances.

And of course there is uBiome and American Gut that some people on here (including me), and also on the bloggersphere have tested with and that is a new and developing source of useful information.

Kefir, by the way, didn't agree with me, which I assume was because of the yeasts. Glad it worked for you though.

 

[Gondwanaland]

I was on enormous amounts of antibiotics... first for frivolous infections / acne, which is what created my leaky gut, and then later I was on large amounts of anti parasitics. Antiparasitic meds, and botanicals, can also really disrupt gut bacteria, a fact I did not realize until my food and supplement allergies worsened substantially.

I have tried numerous probiotics.. some showed no effect on CDSA testing, others made a big difference. I suspect some brands have just sat on store shelves to long or have been damaged in shipping.

In that case you might have depleted magnesium from your system.

Some strains increase acidity depleting magnesium, and some strains help with magnesium absorption. Don't ask me which ones! That is my conclusion from self experimentation...

 

[Sasha]

If you take resistant starch, your probiotics hitch a ride and make it through to the colon. I take my probiotics with 4 tsp of potato starch. You can read all about this on the gigantic resistant starch thread (or just find a post by Gestalt and follow his signature link to his blog post about it for a quick summary).

 

[dan062]

Kefir, by the way, didn't agree with me, which I assume was because of the yeasts. Glad it worked for you though.

Had the same experience (and found having to constantly 'mind' it really annoying!).

I wonder are yeasts even supposed to be part of the gut microbiome? Everything I've read about it always seems to talk about bacteria.

 

[Sasha]

Had the same experience (and found having to constantly 'mind' it really annoying!).

I wonder are yeasts even supposed to be part of the gut microbiome? Everything I've read about it always seems to talk about bacteria.

The gut microbiome contains bacteria, viruses and fungi.

 

[dan062]

Thanks for the info @Sasha. Perhaps yeasts like s.cerevisiae can only be tolerated in low amounts and should certainly be avoided if you already have dysbiosis?

I find it interesting that Anti Saccharomyces Cerevisiae Antibody (ASCA) is a biomarker for Crohn's and Behcet's (and CFS and Behcet's seem to have quite a bit in common).

Put together a string of my main unanswered questions on the microbiome. I've only been looking into it for about a week (and have no background in science) so some of them may be elementary. If anyone has any answers please let me know.

http://forums.phoenixrising.me/index.php?entries/the-microbiome-unanswered-questions.1679/

 

[Tunguska]

The only things probiotics did clearly for me was help get rid of furry tongue and calm down a bad condition that was immune, fungal or viral-related (undiagnosable despite testing). I took between 50-500 billion a day of store-bought strains (500 for the worst, less for the tongue) to achieve those along with berries and starch. I assumed they worked by crowding out or eating bad bacteria or regulating the immune system. They've done little for my fatigue or depression though, including prescript-assist, and the same strains that achieved those are damned in blogs and posts for wiping out good bacteria like E. coli that's low in CFS. They had some other side-effects. Far from scientific. I was extremely desperate so no matter, I can't regret and I'd do it again. I take none at the moment and those problems haven't recurred so far. I assume I still have dysbiosis and have signs of it, I don't believe they repopulate everything.

 

[harmoniics]

My gut doctor put me on to SB floractiv probiotic by Bioceuticals that seem to work better than the other types. But before that I had to clean up my diet, kill off bad bacteria with meds such as golden seal (best to get a health care professional's guidance when using golden seal). I cultured my own coconut keffir - I used milk grains on coconut milk, then I would rest them in cows milk in the fridge between batches. You have to introduce keffir to your body slowly. Have small amounts until you get use to it. Particular kinds of foods such as chickpeas encourage the good bacteria to colonise.

I'm not sure how to prove how probiotic and live cultures work from a medical point of view. I kind of relied of my gut doctor's long list of qualifications in both allopathic and holistic medicine. The truth is, she did explain everything to me but it was hard keeping up with her. Only to say that her treatment worked.