Not a day goes by that I don't read an article on the microbiome and its significant implications on our health. Why? Because every food and supplement you consume interacts with the lining of your gut, and your gut lining is home to a jungle of microflora. Prebiotics and probiotics help to improve the diversity and overall health of our microbiome. That said, telling you to take just any prebiotic and/or probiotic supplement is virtually as vague as telling you to take a pill; it provides you no guidance at all.

Prebiotics
So, what exactly are prebiotics? Prebiotics are non-digestible food ingredients that fuel bacteria; they essentially function as the fuel, or food, for probiotics. They support the mucosal barrier in our digestive tract, provide substrate to allow for the production of protective short-chain fatty acids (SCFA), and enhance immune function. Prebiotics stimulate peristalsis, helping to reduce gas and bloating. They function to boost healthy microflora and reduce pathogenic bacteria.

Foods naturally high in prebiotics include artichokes, asparagus, bananas, berries, chicory, dandelion greens, flax seed, garlic, legumes, leeks, mushrooms, onions, and more.

While prebiotic foods tend to be well tolerated, it is best to start slow when increasing your intake of prebiotic supplements to avoid any digestive upset. Over time, your bacteria get used to having more and more fuel and you generally won’t experience digestive upset. Difficulty with prebiotics supplements seems to occur predominantly with those who have dysbiosis and/or a high yeast/fungal load. It is best to start with prebiotic supplements that are composed of medium-chain molecules (i.e., partially hydrolyzed guar gum, oligofructose) and build a healthy microbial population. With time, you could then expand to use the shorter (i.e., xylooligosaccharides, short chain fructooligosaccharides, galactooligosaccharides) or longer (i.e., inulin, resistant starch) prebiotic molecules as your microbiome adapts. If you start with short or longer prebiotics right away, you have a greater likelihood of becoming uncomfortable with gas and/or bloating.
 

Probiotics

Probiotics are live microbial ingredients that, when administered in adequate amounts, confer a health benefit on the host. They function to improve intestinal microbial balance, facilitate proper digestion and absorption of nutrients, enhance the mucosal cell membrane, and prevent the deconjugation of estrogens and bile acids leading to an improved elimination of toxins and hormones. Probiotics may restore the gut microbiome and introduce beneficial functions to gut microbial communities, ultimately, improving gut inflammation.

Dietary probiotic sources include fermented foods, including sauerkraut, kim chi, tempeh, miso, yogurt, kefir, kombucha, and apple cider vinegar.

While more research is needed, there is a high level scientific support for the use of probiotics with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Probiotics may be helpful in managing gas, bloating, diarrhea, constipation, and/or abdominal pain.

There is limited, but encouraging, scientific support for the use of probiotics with the following:

•Cognition
•Sleep
•Thyroid health
•Female hormones
•Autoimmune conditions
•Metabolism
•Blood pressure & cholesterol
•Brain fog
•Mood: depression, anxiety
•Gut microbiota imbalance: SIBO, H. pylori, candida, pathogens
•Intestinal permeability

Bacteria are categorized by genus, species, and strain. Each probiotic bacteria MUST be identified at this level; each strain carries unique health benefits.

Lactobacillus acidophilus NCFM® 

         ⬆                ⬆            ⬆

   Genus          Species      Strain

Opt for a probiotic that denotes the specific strain(s) present, not just the species. Probiotic dosages can range from 100 million to over a trillion colony formation units (CFUs) per day. Effective CFUs should be based upon a strain’s (or combination of strains) well-documented clinical health benefits for that specific patient population. Some products MAY work better at higher CFUs than others. This may be due to weak activity of the strain or lack of strain-specific selection. For example, Lactobacillus acidophilus NCFMsupplementation offers a safe, effective way for children 3-5 years old to reduce flu and cold symptoms, missed days of school related to illness, and antibiotic use. Recent research has reported that Bifidobacterium animalis subsp. lactis B420 reduces waist circumference and food intake while helping to control body fat mass. Lactobacillus reuteri RC-14 has been found to prevent recurrent urinary tract infections (UTIs) in postmenopausal women. The combination of Bifidobacterium lactis Bi-07, Lactobacillus acidophilus NCFM, Bifidobacterium lactis Bi-04, and Lactobacillus paracasei Lpc-37 provide immune health support and relief for abdominal discomfort associated with loose stools and occasional diarrhea.

Generally speaking, probiotic supplements are very safe. However, because supplements are not regulated in a way to guarantee their ingredients and safety, if you're severely immunocompromised and neutropenic, you may want to avoid the use of probiotic supplements and/or discuss with your healthcare practitioner. Additionally, if you're undergoing treatment using immunotherapy, please discuss the use of probiotic supplementations with your medical team. More research is needed to determine if this combination is advisable or not.

Summary
Eat prebiotic and probiotic foods. Consider supplementation, particularly if you experience digestive challenges. When choosing a probiotic supplement, be sure to choose a product that lists specific strains. And if opting for a prebiotic supplement, start at a lower dose of medium-chain length and gradually increase to ensure bowel tolerance.