Are probiotics worth the money?
As with any rapidly evolving field, the world of the microbiome and probiotics is filled with fascinating new findings, exciting insights, as well as a flood of misinformation. Our job is to sift through this barrage of information and find the useful nuggets—and there are many.
There is, of course, no concensus on what constitutes a helpful probiotic. I’ve previously discussed many of the shortcomings of the current crop of commercial probiotics, such as failure to specify strains (a huge oversight), not incorporating “guilds” or “consortia” of bacterial communities that collaborate, failure to include keystone species, i.e., foundational species that support the health and proliferation of other species, and inadequate numbers of microbes. Look at the BioGaia Gastrus that I originally used to make L reuteri yogurt: 100 million microbes of each of two strains, a very low dose crafted for infants. (This was my motivation for making L reuteri yogurt: to increase bacterial counts 1000-fold by using prolonged fermentation and adding prebiotic fibers.)
So, if modern commercial probiotics have so many problematic issues, are they worth the money? Even poorly-conceived probiotics do indeed yield some modest benefits. Among them:
- Compete with and thereby help suppress unhealthy species–esp. the so-called Gram-negative Proteobacteria such as E. coli and Klebsiella, as well as Gram-positives like Staphylococcus and Streptococcus.
- Increase intestinal mucus production—as mucus is protective, separating microbes and partially digested foods from intestinal cells.
- Production of vitamins—Many Lactobacillus species, for instance, produce B vitamins such as vitamins B2, B5, B9, and B12. Others convert vitamin K1 to K2. (The shift in species in SIBO, by the way, may cause K2 deficiency and the phenomena of abnormal calcification.)
- Production of metabolites—Fatty acid mediators lead to reduced blood sugar, reduced blood pressure, reduced fatty liver, reduced inflammation, deeper sleep and many other effects.
The best general probiotics are the ones that therefore contain a variety of species/strains, including at least a few keystone species such as Lactobacillus reuteri, Lactobacillus gasseri, and Bifidobacterium infantis. One good choice is Synbiotic 365 for these reasons. The only commercial product I am aware of that incorporates a guild effect is the BiotiQuest Sugar Shift designed by my microbiologist friend, Raul Cano, PhD, with a 40-year history of academic microbiology. (I have no relationship with the company except admiring the company’s two founders, Dr. Cano and Martha Carlin.) The mix of species/strains in Sugar Shift is optimized for maximal consumption of sugars such as sucrose, glucose, and fructose in the human gastrointestinal tract, converting them to the human-indigestible sugar, mannitol. By this route, 20 non-diabetic people in my DrDavisInfiniteHealth.com Inner Circle took Sugar Shift for 4 weeks and reduced their fasting glucose by 9.8 mg/dl. Sugar Shift also makes a fine yogurt. Better probiotics are on their way and I shall be discussing them as they are released.
Beyond these effects, you can achieve additional impressive benefits by choosing microbial species/strains that have been depleted or lost from the human microbiome and reintroducing them in higher numbers. This is tough to do with off-the-shelf probiotics, as they are typically sold (as with BioGaia Gastrus) in low counts. For this reason, we make yogurts or other foods using prolonged fermentation. People start to get overwhelmed here, so I tell them think about microbes like going to a restaurant. You walk in, the waitress hands you a menu. You don’t freak out and say “I can’t possibly order all these appetizers, main dishes, and desserts!” Instead, you pick and choose the dishes you want. Choose microbes this way, also: pick the species/strain for the effect you want. For example:
For smoother skin, deeper sleep, and greater empathy: choose L. reuteri. For the present, choose the DSM 17938 and/or ATCC PTA 6475 strains in Gastrus. However, I have designed a modest mouse trial in which we are going to explore the oxytocin-boosting and other effects with other strains. I shall report back in a few months when the data become available. My prediction: numerous strains of L. reuteri yield these effects.
For reduction in arthritis pain: choose Bacillus coagulans GBI-30,6086
For enhanced immune response: choose Lactobacillus casei Shirota and/or L. reuteri DSM17938
To reduce waist size beyond that achieved with diet: choose Lactobacillus gasseri BNR17
For reduced anxiety/depression: choose L casei Shirota or Bifidobacterium longum R0175 combined with Lactobacillus helveticus R0052
For increased mental clarity: choose Lactobacillus brevis multiple strains
For osteopenia/osteoporosis: choose L reuteri ATCC PTA 6475
For deep sleep: choose L reuteri multiple strains and/or L casei Shirota
If this approach interests you, I provide the recipes, microbe sources, and fermentation conditions (temperature, time, prebiotic fiber) in my Super Gut book. Like the changes you made in diet for Wheat Belly and Undoctored, it may all seem too complicated at first. But, once you get the hang of it, it becomes second nature and you can be fermenting like a pro and picking and choosing the benefits you desire.