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 Herbal Medicine: Pro-Life Therapy with Probiotics  
The human body is a walking ecosystem. Although we do not usually think of ourselves in this way, the fact is that we are "home" to trillions of microorganisms that live on and inside us. We are actually made up of 90% bacteria cells (100 trillion) and only 10% animal cells (10 trillion). Every person harbors more microorganisms in their gastrointestinal tract than there are people in the world, or have been in all of history. The gums, teeth, hair, and skin are also richly populated with many types of microorganisms.

Although some of the microorganisms inside us may be harmful, the vast majority are not. In fact, they are necessary for good health. Human beings have evolved with these microorganisms, and we have developed a symbiotic relationship with them. For instance, beneficial bacteria in the intestines help digest foods, create vitamins (such as B-12 and K), and inhibit the growth of disease-promoting pathogenic bacteria. Without these beneficial or probiotic microorganisms, as they have now come to be called, we could not survive.

Throughout history many peoples have traditionally eaten certain cultured and fermented foods that are rich in beneficial microorganisms and can increase digestive strength and general health. For instance, fermentation with lactic-acid forming bacteria, including Lactobacillus acidophilus, is one of the oldest methods of making cultured foods such as yogurt and sauerkraut. In ancient days, this process was inadvertently initiated in milk and vegetables using the organisms naturally present in the raw food, the air, or on utensils. Today, genetically-selected starter cultures are used commercially, and the industry for foods and supplements that contain probiotic organisms is rapidly growing. Many scientific studies over the last 50 years have shown that probiotic organisms can improve the nutritional quality of foods, as well as produce antibiotics, anticarcinogens, anticholesteremic substances, and substances that break down and recycle toxins for their human host.

In keeping with the analogy of the body as an ecosystem in itself, the rich supply of microorganisms in the intestines have been given a special name: the intestinal microflora, or IM as I will call it for short. The IM is an amazingly complex mixture, containing an estimated 400-500 different species of bacteria (at least 17 families and 50 different genera of bacteria). Among these many species, there may be dozens, or even hundreds, of different genetic variants or biotypes. All areas of the gastrointestinal tract contain bacteria, but the colon is by far the most heavily populated. The upper small intestine is mostly sterile, but the lower small intestine and stomach have limited numbers of various species of microorganisms, depending on conditions there. The mouth and vagina also harbor a rich microflora, which probably plays a role in the health of these areas of the body, too.

Why are there so many different species and biotypes of microorganisms in the intestines? Well, if you think of the IM as a very basic physical link between our bodies and the external environment, it begins to make sense. The purpose of the diversity of the IM is to be able to adapt to the great diversity of environments that our bodies may come into contact with. **Studies show that the predominant species or biotypes of bacteria in the IM are constantly changing. The IM is a swarming, evolving world of bacteria that is continually responding to changes in diet, climate, microorganisms in the environment, and other factors that have yet to be determined. Thus, if we are forced through necessity or climate to subsist on a certain kind of food that we cannot digest very well, then the make-up of the microflora will change so that it can produce the enzymes needed to help us extract the nutrients we need from that food.

For example, most people in the United States would not do well eating large quantities of lichens. However, the Laplanders from Scandinavia are known to eat certain lichens, and can gain nourishment from them. Similarly, if you eat a great deal of meat, or if you eat a high-cellulose diet, your IM will adapt accordingly. So you can see that the IM must be considered a very important homeostatic mechanism in the body, helping us to survive and even thrive in varying environmental conditions.

Benefits of Probiotic Organisms
There are two ways to approach the subject of the probiotic organisms that constitute the IM. One way is to look at the positive roles that these organisms play in the body. The other is to study factors that negatively affect or harm them. To start on a positive note, let's look first at the benefits of having abundant probiotic organisms in the body.

Below I have gathered information on eight main points of interest. These are the major benefits of adding probiotic organisms to the diet, whether in a pure form such as L. acidophilus supplements, or in the form of traditional fermented and cultured foods.

Please note that some of the benefits discussed below have been definitively established, while others seem likely but have yet to be proven beyond a shadow of a doubt. In particular, certain benefits, such as lowered risk of irritable bowel syndromes or a cancer-protective effect, have been suggested by laboratory and clinical tests in Europe and Japan, but have yet to be verified by thorough double-blind studies in both animals and humans. Some of the needed research is already under way, while some of it still waits to be done.

The Benefits of Maintaining a Healthy Indigenous Microflora or Probiotic Supplementation

1. Boosting the Immune System

2. Inhibiting the Growth of Pathogenic Organisms

3. Prevention of Diarrhea from Various Causes

4. Cancer Prevention

5. Reduced Risk of Inflammatory Bowel Disease

6. Improved Digestion of Proteins and Fats

7. Vitamin Synthesis

8. Detoxification and Protection from Toxins


Microflora Formation in Infants
The formation of the IM begins at birth. As the infant passes through the birth canal, she or he is "inoculated" with microflora from the mother's vagina (Midtvedt, et al, 1988). Later, breast-feeding provides bacterial and immugenic substances that create a simple flora of Bifidobacteria, a genus of beneficial lactic-acid producing bacteria especially common in infants and babies, such as B. bifidum, B. infantis and B. longum, and a few other beneficial anaerobic bacteria. This early IM influences the development and composition of the final, adult IM. Significantly, studies show that a formula diet can allow potentially pathogenic bacteria, such as clostridia and anaerobic streptococci, to proliferate in an infant's digestive tract. It has also been found that the addition of cow's milk to an infant's diet can have negative effects in that it can decrease the numbers of Bifidobacteria in the intestines and increase the pH and numbers of bacteroides, which are sometimes considered to be a less (Drasar, et al, 1986). Thus, once again, so-called "improvements" over breast-feeding may not, in fact, be improvements at all!

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Negative Side Effects of Antibiotics
There is no question that antibiotics are invaluable medicines. In emergency situations--such as in the case of a child on the verge of death from meningitis--antibiotics are literally life-savers. Even in many less extreme situations, they can be extremely valuable. Nonetheless, antibiotics are too often overused in current medical practice--with marked negative side effects, one of the greatest being damage to the intestinal microflora.

The effects of a weakened IM, for reasons explained previously, can be quite detrimental. Once probiotic organisms have been destabilized and stripped off the walls of the intestines, potentially pathogenic organisms such as Candida albicans, Staphylococci, and Clostridium difficile have much more opportunity to proliferate. This can lead to infection, sepsis, diarrhea, and colitis (Hill, 95). Significantly, these conditions usually coincide with a reduction in the number of L. acidophilus in the intestines (Lidbeck, et al., 1988).

The conclusion one should draw from the research cited is not that antibiotics should be discarded, but that their use should be minimized. Also, when their use is essential, it is best at least to combine them with probiotic supplements to maintain the IM. Below I explain five simple steps to take to reduce the risk of side effects from antibiotics.

Ways to Minimize the Side Effects of Antibiotics

1. Avoid unnecessary use of any antibiotic.
2. Use antibiotics for as short a period as possible.
3. Use narrow-spectrum rather than broad-spectrum antibiotics.
4. Always take probiotic microflora supplements.

Many of these, including ones containing Lactobacillus spp., have been shown in studies to minimize the unwanted side effects of antibiotic therapy, such as diarrhea (after Hooker and DiPiro, 1988).

Commonly Asked Questions About Probiotic Supplements
Now that you are more familiar with the benefits of probiotic supplements, you may be interested in trying one of the commercial products which are available in most natural food stores. The following information on commercial products came from a number of sources including a review of the available scientific literature, my own personal experience, and from a conference on Probiotics sponsored by the National Nutritional Food Association (NNFA). This conference brought together some of the acknowledged experts in the field, including Dr. K.M. Shahani, probably one of the world's leading authorities on probiotics.

Why bother to take a probiotic supplement at all? Remember that besides antibiotics, a number of common environmental influences can strongly affect our resident microflora, including
  • Chlorine and other bacteriocidal chemicals which are often added to city drinking water
  • Chicken and other commercial meats will likely contain residues of antibiotics added during their growth in pens and other unhealthy living quarters
  • Pesticide and herbicide residues may be present in various fruits and vegetables
  • Excessive sugar, fat, red meat and refined foods in the diet may promote undesirable species in the IM
  • Raw vegetables contain natural compounds which may inhibit the implantation of probiotics
  • Alcoholic beverages inhibit the implantation of probiotics

Today, a wide variety of probiotic supplements are available in several forms:
  • Powder--introducing measuring devices (spoons, etc.) into the powder may lead to contamination; more susceptible to moisture and oxygen than capsules and tablets
  • Capsules--may be the most desirable way of taking probiotic supplements; more protected from contamination, oxygen, and moisture
  • Tablets--protected from contamination, moisture, and oxygen better than powder, but the heat produced during the tableting process may damage organisms
  • Liquid--studies show that many liquid supplements are weak, and some contain few, if any, organisms; if fresh and of good quality, they can be useful for douching and gargling and are more pleasant to take than capsules or tablets for some people; an alternative: try opening a capsule or two and mixing it in distilled water for a more potent liquid dose
  • Dairy products that contain added organisms--dairy products containing lactobacillus and other probiotic organisms provide a mild dose of probiotics and perhaps help lactose-intolerant people digest it.

When evaluating a probiotic product, questions such as what kind of product is best, how long to take it, when to take it, do the organisms really implant in the colon, and what benefits they have are often asked. Although the experts don't always agree on these points, there is enough agreement to offer the following answers, probably the best information on the subject available at this time.

Commonly-Asked Questions about Probiotic Products
(Taken from the scientific literature, my own experience, and mostly from the NNFA Probiotics Conference.)

When should I take the product? Before meals? Between meals?
Most experts feel that first thing in the morning on an empty stomach (when stomach acid is at its lowest levels) or just after meals, when the food can buffer the acid.

How much is best to take?
For therapeutic benefits, about 4-10 billion viable organisms/day is about right.

What species are best? Is a mixed-species product better or a single species (like Lactobacillus acidophilus)
The main species used in probiotic supplements are L. acidophilus, L rhamnosus, L. bifidus, L. casei, L. plantarum, Bifidobacterium bifidum, Streptococcus faecium, and others (Sandine, et al 1972, Speck 1976).

This is a controversial question, and not easy to answer. Some experts (like Dr. Shahani) feel that Streptococcus faecium is an excellent probiotic species and can be taken alone, or with other microorganisms. Some feel that only Lactobacillus acidophilus and bifidobacterium should be used. My experience tells me that because traditional fermented foods contain a variety of organisms, a mixed species supplement is best. On the other hand, many people get excellent results from single species products. My suggestion is to try both kinds and see what results you get--ultimately, you are the best judge.

Can I trust the product to deliver what it says on the label?
Tests show that there are some excellent products on the store shelves, and some poor-quality products. Experience and talking with owners or supplement staff in natural foods stores will usually provide helpful guidance. Above all, don't be afraid to ask questions about any companies products. They should be able to provide tests and hard facts about the species that they have, the potency, when it was manufactured and so forth. I will also suggest that you don't buy any product unless it has the manufacture date right on the bottle. All of these products, especially lactobacillus and bifidobacterium, lose a lot of potency after 4-10 months.

Should the product be refrigerated? Some products say yes, some no.
Products last longer when they are refrigerated. Many of the experts I have heart on the subject say that the best products are ones that are refrigerated. Only species like Streptococcus faecium does not need much refrigeration.

Indications for Probiotic Supplements

1. Maintaining the Probiotic Flora during antibiotic treatment

Begin taking immediately, take up to 2x recommended dose during antibiotic therapy, then follow product label.

2. Constipation

Long-term use can help promote regularity.

3. Diarrhea

Short-term or long-term use can help prevent diarrhea.

4. During pregnancy

Probiotic supplementation during pregnancy can promote regularity and support nutrition during this important time. A probiotic supplement during breast feeding may also be helpful.

5. Programs for infants and young children

Supplementation with bifidobacteria may help support immunity, help establish a strong probiotic flora, protect against diarrhea and other bowel disorders.

6. Counteracting Infections

Urinary tract infections (cystitis)

Lactobacillus supplementation may help prevent recurrent infections.

Bowel infections

A probiotic supplement taken regularly may help prevent chronic infections.

Gum and tooth infections

Take a probiotic supplement and rinse the mouth regularly with a solution of 1 capsule of lactobacillus supplement to 3 ounces of water.

Vaginal infections (Clamydia, Trichomonas, Candida)

Take a probiotic supplement containing lactobacilli and douche regularly with a solution of acidophilus, made same as above.

7. Irritable bowel syndrome

Long-term use of a lactobacillus or mixed-species supplement may help prevent irritation and other symptoms of irritable bowel syndromes.

8. Chronic gas

After beginning a new probiotic supplementation program, one may find that above normal amounts of gas are produced for a short while (up to a week). This condition will normalize and gas may be reduced or relieved.

Ease into a probiotic program by taking 1/2 the recommended amount for a week or two.
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 About The Author
Christopher Hobbs LAc, AHG Christopher Hobbs is a fourth generation herbalist and botanist with over 30 years experience with herbs. Founder of Native Herb Custom Extracts (now Rainbow Light Custom Extracts) and the Institute for Natural Products......more
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