Probiotics: the Lipstick Stained Glass

Probiotics: something advertised and added  to everything from yogurt to capsules to “promote immune health and enhance supportive benefits.” The “friendly” bacteria.

Did you ever know someone who lied to you, but within their lie was a grain of truth? Yes, politicians – but now you know someone else, the entire industry trying to get you to buy their food or supplement that contains “friendly bacteria.”

Here is the grain of truth
Your colon contains bacteria that live there normally. The bacteria occupy a space, they prevent other bacteria that are harmful from occupying that space. If you get rid of some of those “friendly” bacteria, then some of the harmful bacteria can take that place and cause disease. The big, bad bacteria (ok, small, microscopic but with an attitude) that cause disease after antibiotics is called Clostridium difficile (often called C. diff), which causes “antibiotic associated colitis” that can range from diarrhea to perforation of the colon and even death.

There are other bad bacteria that, even if small amounts are ingested, can cause problems- like food-borne illness, for example – Salmonella. There have been some very good science done showing that some “pro-biotic” bacteria could reduce the infection in poultry, and in cell cultures.

There are some small studies, done with a pediatric population with antibiotic associated diarrhea that have very specific indications. For example: one type of bacteria called Lactobacillus rhamnosus (573L/1, 573L/2,573L3) shortened diarrhea caused by a virus called rotavirus, in children, but did not improve the diarrhea caused by other virus types.  The amount of that Lactobacillus found to be therapeutic was also quite specific. And, as has been noted in these publications, not all the probiotics on the market are effective.

Of the many types of bacteria out there, some have been tested in clinical situations, some have not.  Some have been found effective for one type of diarrhea (antibiotic induced, or viral induced) but not effective for another.

The amount of bacteria to be effective in these studies is also regulated. The amount found in the supplements is not. Think of pro-biotics having to have a specific number of bacteria like a pill with a dose. You know that 2 Advil will help your knee pain, and 1/2 Advil won’t do a thing, and a whole bottle of Advil can kill you– same with probiotics.  There is no regulation as to the amount of bacteria in the pills, and certainly the bacteria can grow (much like leaving food out on the counter for a day- bacteria grow quickly).

Putting bacteria in yogurt, or milk, without regard to quantity, how long they might last on the grocery shelf, or without regard to the type, is the equivalent of walking outside your house with a loaded shotgun, firing it in the air without looking, and hoping you hit a duck. When these “probiotics” including those in yogurt, have been cultured what is found in them does not correspond to the label, and sometimes the “friendly bacteria” grown are not friendly – and sometimes they are dead.

Here is the whole truth
Most of the bacteria that are used in yogurts or given in the “live probiotic” pills are not bacteria that have been tested,  to support the claims made. There have been tests done with some bacteria, and on humans with small studies and specific indications (a type of diarrhea, or a type of ulcer, with a type of bacteria with a specific amount). For the bacteria to be useful, it has to be a specific indication, with a specific kind of bacteria, and a specific quantity of bacteria. Instead, there is a “shotgun” of bacteria that are used.

A company that prides itself on healthy products has never performed any human testing on probiotics, and the ones they use are not always native to the colon.

The bacteria found in yogurt are often not the same bacteria that are found in humans. They may have the same Genus name- like Lactobacillus, but not the same species found in humans. An American Robin is Tardus migratorius – and the blackird is the Tardus merula – two different species – which act differently. Bacteria are the same – they may have a similar sounding name- but how they behave in the colon are different. But as you can see above- some bacteria, even substrains of the bacteria, are effective for some conditions, but not others. First, one needs a diagnosis – then the specific treatment.

The bacteria that are taken that are not a part of the normal colon will quickly pass through the colon and can’t be found after they are no longer taken. Of course, the alternative might be that they stick around, form a new colony- and one has to hope that it wouldn’t be a bad thing- but it could very well be.

Since the Food and Drug Administration cannot regulate this industry, they can say almost anything in vague terms, without a single bit of proof. But sometimes they cross the line, as Dannon yogurt who agreed to pay 21 million dollars to settle deceptive advertising about health benefits. The investigators accused Dannon of improperly claiming its DanActive yogurt drink could “boost the immune system” and prevent colds, flu and diarrhea in children. In June 2011, the U.S. Marshals seized the probiotic products from UAS Laboratories which included DDS Acidophilus, DDS Plus, and more. This firm also claimed the products could treat or prevent colds, flu, infections. Companies still make vague claims- but cannot make specific claims.

Do not use probiotics with infants or premature babies, or in people who have compromised immue systems

These products SHOULD NOT be used with infants or premature babies. While some studies show some probiotics in hospital settings, are safe – there are some “probiotics” that are not. Giving these children with immature immune systems bacteria can harm them. Stimulating the immune system with bacteria is no different than eating, drinking, or getting the normal bacteria we get every day. Humans consume lots of bacteria, including the type that are found in your gut- every day; from the food we eat, to the people we kiss, to the bottled water we drink- we consume a lot of “probiotics” daily. Save yourself some money- and kiss for your daily probiotics.

Looks like they should be asking if you want unleaded or not

There is one useful time when the probiotics work. It is called a fecal transplant. Backed by science, and fifty years of good research, people get feces from a healthy person, mix it with some salt water, and deliver it to the person with the colitis by either nasogastric tube, enema, or colonoscopy. The difference between fecal transplants, and commercial probiotics, is that the transplant works, because it is putting a normal bacteria into the person.  The patient won’t taste it or smell it – but the science behind fecal transplant works.

Probiotics are the latest unproven remedy for “everything”. Often  what a company is selling you is a capsule full of bacteria- untested, thought to be harmless, and yet not to be used with people who have “compromised immune systems.” Odd that such a warning exist if it is suppose to help “your immune health” isn’t it.

But before you buy the next pill with a probiotic, ask yourself this: would you eat food from a restaurant that had the chef’s hair in it? Would you drink out of a glass that was used by a stranger, and had lipstick on it? Because if you take probiotics you are taking bacteria that are not “normal” and have not been tested- and taking them in a higher dose than drinking out of that lipstick stained glass.

Dr. Terry Simpson About Dr. Terry Simpson
Dr. Terry Simpson received his undergraduate and graduate degrees from the University of Chicago where he spent several years in the Kovler Viral Oncology laboratories doing genetic engineering. He found he liked people more than petri dishes, and received his MD. Dr. Simpson, then became a renowned weight loss surgeon, and a leading advocate of culinary medicine. The first surgeon to become certified in Culinary Medicine, he advocates teaching people to improve their health through their food. On the other side of the world, he has been a leading advocate of changing health care to make it more "relationship based," and his efforts awarded his team the Malcom Baldrige award for healthcare in 2011 for the NUKA system of care in Alaska. A frequent contributor to media outlets discussing health related topics and advances in medicine, he is also a proud dad, husband, author, cook, and surgeon “in that order.” For media inquiries, please visit www.terrysimpson.com.

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