Sunday, November 18, 2018

Update on Probiotics

Winter came early this year! Here's a picture of my car as I was leaving work the other day... I was not prepared for the sudden storm!

So with the cold season comes an upsurge of sniffles, cough... sickness ranging from sinus infections, bronchitis, pneumonia to the flu. As antibiotics get prescribed, many take probiotics in hopes of warding off side effects such as diarrhea or yeast infections. While there is some evidence of promise that probiotics would help, one should consider carefully whether or not the benefit outweighs potential harm.

Here are a few things to consider and an update on this topic since my previous post in 2012.

First of all, what are probiotics?
- foods or supplements that contain live bacteria and yeast that are considered "good" bacteria and can alter the bacteria in the gut

How do probiotics work?
- your gut is full of bacteria but when "good" bacteria gets wiped out, for example during a course of antibiotics, this can cause GI issues like diarrhea
- the idea is probiotics replace these "good" bacteria to help restore gut function to normal or to prevent the imbalance in the first place

When are probiotics being used?
some common uses include the following:
- during antibiotic use to prevent diarrhea or yeast infections
- during late pregnancy and baby's first six months to prevent allergies / eczema
- in low birth weight infants to prevent NEC (necrotizing enterocolitis)
- in patients with diarrhea caused by viruses
- in patients with IBD (irritable bowel disease) to lessen symptoms
- in patients with IBS (irritable bowel syndrome)
- in patients trying to lose weight
- in patients with depression and/or anxiety

Does it really work?
- promising evidence that it can benefit antibiotic induced diarrhea in healthy persons
- not enough data to show prevention of allergies or NEC
- bottom line is more research needs to be done in all areas

What are the potential risks and down sides?
-  since there is no FDA regulating the over counter products, the amount of bacteria and type of bacteria in the different products can vary so much and may not match what the label is claiming
-  even if the labels match the content of the bottle, the different types of probiotics vary widely and how they may help certain conditions also vary widely so it is difficult to determine which would benefit someone in which situation
-  there is even question whether your stomach acid would make the probiotic ineffective by the time it reaches your gut, so it may not be effective at all
-  there is risk for an immunocompromised individual to become very sick from the active bacteria being introduced

So bottom line is there is not enough research and data studying all the different risks and potential side effects of taking these supplements. Best to discuss with your health care provider whether or not you would benefit and to proceed with caution.
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