Can Pre- and Probiotics supplements actually improve gut health?
Research and my clinic experience say yes. Probiotics have been proven to be helpful in several conditions, such as irritable bowel, yeast infections, weaken immune function, and even weight loss. There is no ‘one-size-fits-all', so choosing the right probiotic can be a tricky task. You have to first ask yourself ‘what are you looking to achieve?’. If you’re looking to improve digestive health, such as gas, bloating and irregular stools, look for a probiotic that's rich in bifidobacteria, such as b. animalis and b. infantis. For repeat yeast infections and urogenital health, you’re better off with lactobacillus species, such as l. acidophilus, l. rhamnosus and l. reuteri. Furthermore, some probiotic strains are not seen in the human microbiome but have been shown to prevent traveller's diarrhea or antibiotic-associated diarrhea, such as s. boulardii. 

     Autoimmunity is an umbrella term for a number of medical condition with one common problem: the immune system. In autoimmunity, the body’s immune system mistakenly identifies healthy cells as invaders, and attacks them. This disease can present in various forms, and can affect any part of the body. For some, autoimmunity can disrupt hormone production, as in Hashimoto’s or Graves. In other people, it can present as symptom of inflammation, fatigue, and pain. Some people even experience neurological changes, as in cases of MS.
     And while autoimmunity is not news to modern medicine, the increased number of reported cases per year is. It poses the questions -  why are incidence reports on the rise, what, if anything, is causing its increase, and is there anything we can do about it?

​According to a new study presented by Dr. El-Salhy at the United European Gastroenterology week in Spain, fecal microbial transplants (FMT) may significantly improve the pain and distress caused by irritable bowel syndrome, if transplants come from what has been termed a 'super-donor'.
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The double-blind, randomized control trial study found that 75-89% of recruits aged 18-75 receiving 30-60 g of endoscope administered feces into the duodenum donated same day from a human 'super donor' reported significant benefits in their overall IBS symptoms after 3 months, with no long term adverse effects (1). Slightly greater benefits were observed in the patients receiving higher dose transplants and/or repeat transplants (2). Furthermore, Dr. El-Salhy suggested that preliminary results show 90-95% of the patient who responded are still well 1 year later, and 50% are 'cured' (3). 

We all know that getting enough sleep is important. But how important? Sleep impacts our mental health, emotional health, and physical health. But with our busy lives and hectic schedules, it’s often easy to put a good night’s rest on the back burner.
 
Sometimes, even when we get into bed at a reasonable hour, we may not be able to fall asleep or stay asleep. However, recent research confirms continuous sleep deprivation can have more far-ranging consequences on health than we may have once realized, with negative impacts demonstrated on our intestinal microbiomes, immune system, insulin resistance and weight management, amongst a myriad of other health issues.

     One of the core principles of functional medicine is to nourish the body and ensure it is getting the appropriate balance of nutrients to stay healthy. Traditionally, this was achieved in a hunter-gather diet by eating colourful whole foods and by practicing “nose-to-tail” eating of meat, which included the consumption of skin, cartilage, marrow, tendons/ligaments, and other parts of the animal that are now typically discarded. Unfortunately, much of this practice has been lost as a result of prepared meats, microwaves, and canned soups over homemade stocks. As a result, our diets have become deprived of an important protein, known as collagen.

      There is a lot of noise in the health industry lately about collagen supplementation. The concept of supplementing collagen attempts to regain what we’ve lost from our primitive diet, but the question becomes if supplementation has any benefit.
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Benefits of Collagen
I’ll admit that when I first heard about the trend of supplementing collagen, I wasn't on board. It made no sense to me. Collagen is a tissue found in our bodies made from amino acids, vitamin C, etc. So how could supplementingthe end product collagen benefit us? But as it turns out, research in mice shows that hydrolyzed collagen peptides (from gelatin) have a 95% absorption rate at 12 hours after intake, and it distributes in the body similar to that of raw amino acids, with the exception of cartilage (1). Collagen was seen to concentrate more than twice as high in cartilaginous tissue that raw amino acids (1), giving collagen some unique benefits. So, I jumped on the bandwagon.

Bone broth is a rich source of nutrients. It contains protein, cartilage, gelatin, and minerals, especially calcium. It’s easy for our body to digest, tastes delicious and fills a home with an aroma of goodness while cooking. Bone broth is inherently calming, consoling, and restorative to our energy and spirit. The gelatin in bone broth also has been shown to have numerous benefits on the cartilage in our joints, the integrity of our gut membrane, the detoxification of our livers, and the health of our skin!
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BASIC BONE BROTH MAKING

1. Bones - poultry, fish, shellfish, beef or lamb
   - cooked bones from a previous meal, with or without skin or meat
   - raw bones, with or without skin and meat (can be browned first for flavour)
   ​- use a whole carcass or just parts (good choices include feet, ribs, necks and knuckles)
2. Water - cold
   enough to just cover the bones or 2 cups water per 1 pound bones
3. Vinegar - any kind
   a splash (1-2 tablespoons), or substitute lemon juice for vinegar
4. Vegetables (optional) – skins, ends and tops or entire veggie
   traditional choices include celery, carrots, onions, garlic and parsley, but any will do

       If you suffer from chronic GI or nasal/respiratory problems, but have been unable to get a proper diagnosis; or if you have tried antibiotics and antimicrobials to treat your irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), other chronic gut/respiratory problems with little success, it may be helpful to know what a biofilm is and why it may be at the root of your problems.
​        Its estimated that a staggering 23000 people die from antibiotic resistance infections every year, and the number is increasing. If your previous attempts at getting diagnosed or treating an existing GI condition haven’t been effective, it may be time to consider alternative treatment options to disrupt the biofilms living within you.

The most common time to take a probiotic is during + following antibiotic use. Antibiotics degrade the population of our good flora, and therefore they require replacement. Some antibiotics, such as amoxicillin, ciprofloxacin, etc, have also been shown to allow for opportunistic infections from candida, or yeast. The primary concern for antibiotic use is ultimately the results of dysbiosis, which is a severe imbalance in desirable vs undesirable bacteria in our gut.
 
Some of the other benefits of a probiotic use can include:
•    Boosting your immune system
•    Improving immune dysfunction, such as in seasonal allergies, eczema, asthma, etc.
•    Improved digestive function
•    Increased absorption of nutrients, and elimination of waste
•    Fighting pathogens
 
There are many readily-available sources of probiotics, from supplements to food. Supplements usually only contain single strains of bacteria, sometimes in isolation, or other times multi-strain.
 
Unfortunately, some evidence suggests capsulated probiotics don't populate our gut long term.
If you are looking for ways to increase your probiotics consumption, it may be best to start with probiotic-rich foods like some of these:
•    Yogurt (make sure to choose a yogurt with live or active cultures)
•    Kefir
•    Sauerkraut
•    Kombucha
•    Miso
 
What to expect when you are taking probiotics?
 
Most people can tolerate probiotics fairly well; however, the most common side-effects are a temporary increase in gas and bloating, constipation, and thirst. The cause of these side-effects in some people is not entirely known, but they usually subside after a few weeks of continued use.
 
And while there may be several health benefits associated with taking probiotics, there are some people who should always seek advice before starting a probiotic. These people include individuals on immunosuppressive drugs, those with a compromised immune system, or a serious illness which predisposes them to more severe complications.
 
Can probiotics make you feel worse?
 
Our intestinal tract is a veritable colony of microorganisms. There are trillions of these little guys inhabiting our GI tracts and the exact combination and strains make for an incredibly complex interaction within us.
 
When we introduce different species into the mix, it can cause a temporary impact on our intestinal environment. The equilibrium that existed previously has been thrown off balance and needs to readjust. Once the new – and hopefully more beneficial – balance establishes itself, the symptoms should stop.
 
One primary instance where probiotic may persistently make symptoms worse is in cases of small intestinal bacterial overgrowth (SIBO). Since the root of this problem is already an overgrowth of bacteria in the wrong place (the small intestine), adding more bacteria to the mix can often aggravate symptoms. SIBO symptoms look a lot like IBS, which is why it is important to speak to your naturopath before starting a probiotic.
 
You should always introduce probiotics slowly – a process called “titrating” – and increase to a full dose gradually.
 
The Must-Knows when choosing a probiotic
 
#1: Not every probiotic is the same. L rhamnosus GG has been shown to decrease the incidence of asthma and allergies in children, L. acidophilus is helpful in preventing repeat yeast infections, and B. lactis has been shown in clinical trials to improve intestinal dysbiosis and IBS symptoms. Taking an over the counter probiotic is useless unless it contains the proper strains indicated for your concern. This is where you want to speak to your ND to choose a probiotic that's right for you.
 
#2: Most probiotics cannot survive at room temperature. Multiple consumer reports have confirmed that many probiotics taken off the shelf are no longer alive, and therefore relatively unhelpful. Many strains of probiotics must be kept at < 8 degrees C or they will degrade at roughly about 4% per day. Meanwhile, some strains of probiotics are completely safe at room temperature, such as S. boulardii, which makes it great for travel. Do your research before buying strains off the shelf, or stick to probiotics found in the refrigeration section of your health food store.
 
#3: Quantity matters. Some probiotics will claim to be over 50 billion bacteria per capsule, but in fact, contain less than 5 million colony forming units of the desired strains (this is very common with l. acidophilus). Many clinical trials show no benefit to probiotic strains until they reach a certain quantity of exposure. Always read the label, which breaks down the strains and counts of each colony. 
 
#4: Watch for fillers and Prebiotics. For those searching for probiotics for gas, bloating, IBS, IBD, etc, if a probiotic makes you feel worse, it may not be the actual bacteria. Many capsulated probiotics contain prebiotics such as inulin, pectin, potato or tapioca starches, maltodextrin, and/or fructooligosarccharides (FOS), which in and of themselves can create gas and bloating. Many are also washed in dairy, which can be a problem for those sensitive to dairy products.  
 
When is it time to call the doctor?
 
Once starting a probiotic, if you haven’t presented with an exacerbation of symptoms (suggesting potential overgrowth of bacteria in your gut), no infectious pathogens are present, and your symptoms are on the mild end of the spectrum, you can probably keep taking it. Eventually, your GI tract will settle back down to normal.
 
If you find that you cannot tolerate probiotics, it could be a sign of gut pathogens like parasites or bacterial infections, as well as potential overgrowths. Because each of these issues requires a different treatment approach, it is important to have functional GI testing done to work out exactly the root cause of the problem.
 
If you want further help, or wish to discuss ways to support optimal gut health, please feel free to contact Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule a consultation today!