3 Reasons Probiotics Almost Always Fail
It’s a shocking event each and every time a patient enters my office and I tell them that they can stop taking their probiotic. In fact, most patients have read so much about the “miraculous” benefits of taking probiotics that they almost immediately start to question my judgement as a physician.
So if almost all natural practitioners, naturopaths and functional medicine doctors prescribe probiotics to their patients, why am I the only doctor in town that doesn’t even sell them in the office?
Fail #1 – Paying Attention (Probiotics Not Working)
The probiotic fad is so popular right now that over the past few years, in my natural oriented health practice, the new patient that enters my office that isn’t taking a probiotic is like an endangered species. From cheap store-bought probiotics to expensive practitioner-only probiotics, I have seen them all.
As I saw the trend more and more in the office, there are 2 problems with the scenario I just laid out. The first is, if probiotics work so well and are the “cure” to so many conditions, then why are these patients still seeking me out for digestive disorders? In fact, over 80% of my patients report digestive problems and they are already taking a probiotic. So after years of seeing this, my conclusion is that probiotics simply aren’t working well enough.
The second problem I see with probiotics is that the patients that do report benefit from probiotics almost always report that if they stop taking the probiotics then all of their gut problems and/or other symptoms return. Thus, it appears that they can act as an effective temporary band-aid, but not so much as a true treatment that addresses root causes. In fact, there have been no studies to date that suggest that taking a probiotic creates long-term change in gut bacteria.
Taking a prescription medication daily for digestive tract symptoms would definitely be worse, but the goal of any supplement or medication should be to resolve an underlying root level imbalance and then to maintain your health via diet and lifestyle, not by taking the same natural pill for the rest of your life. Minus the rare genetic exception, you should be able to thrive without being required to take any supplements daily.
Fail #2 – Grasping at Straws (Probiotics Not Effective)
As of right now, most researchers believe that there are 20,000 – 30,000 different strains of good probiotics in the gut naturally. A typical probiotic ranges from 1-30 strains. This means that by taking a probiotic, we are addressing somewhere between 0.00003% and 0.0015% of the variety of strains that reside within our gut.
Given the above numbers, it is astounding that a small dosage of probiotics even helps anyone.
Secondly regarding diversity of the gut flora, it is also important to know that approximately 99 percent of our intestinal bacteria are anaerobic. This means that they are unable to process and use oxygen. This is critical because almost all probiotic pills and foods like sauerkraut and yogurt, only contain probiotics that live in oxygen.
Meaning that once again, our probiotics are affecting less than 1% of the microbial population. It’s like we are trying to change the ocean with one drop water each day. (Note that it does create change, just maybe not enough for lasting results.)
Fail #3 – Lifestyle vs. Probiotics
The most powerful way to address the keeping good bacteria in proper proportions is by lifestyle. Modifying as many of these factors as possible is the best way to develop and maintain a healthy gut. A probiotic absolutely cannot overcome the lifestyle factors that promote unhealthy gut flora.
GMOs – If you think a probiotic will eliminate the negative effects of eating GMOs 4 or 5 times a day, you are just dreaming.
High Carbs – A high carbohydrate diets feed candida and other fungal flora in your digestive tract creating gas, bloating and systemic inflammation.
High Stress – High stress in family or work relations releases high levels of cortisol and leads to imbalances in the digestive tract.
Antibiotics – Antibiotics should be avoided to the best of our abilities. There is always gut reconstruction and restoration that needs to be done afterwards. While it seems both easy and fiscally sound to run to the urgent care and pay only $30 to get a prescription, remember that you may be paying for those side effects via multiple office visits and multiple supplements over the next 6 months or so. The idea is to catch the problem quick and use powerful herbs to combat infection if possible.
Alcohol – Alcohol always causes damage to the gut. Just like other factors, taking a probiotic will not negate the fact that you killed intestinal cells via alcohol, regardless of how GMO free and organic the alcohol source is.
Gut Infections – This is the #1 reason why people don’t get results with a variety of gut protocols. These damaging pathogens are much more powerful than the capsule of probiotics you take. Taking probiotics does not directly eliminate gut infection. It is like trying to plant grass in overgrown weed infested yard. It is always prudent to remove the weeds before trying to plant new grass.
Medications – Certain medications such as acid blocker, proton pump inhibitors and NSAIDs all have negative effects on the microbiome.
This is not a comprehensive list, yet even if you are doing your best to control lifestyle factors, often times probiotics often help very little. Deeper issues that often need to be addressed in order to resolve long standing digestive problems include autoimmune disorders, food allergies and suppressed immune systems.
Summary (Probiotics …sometimes)
While I don’t sell probiotics to my patients, I realize many people have experienced at least temporary relief from their use. Temporary relief is just that, a short period of relief that buys you just enough time to look deeper at the underlying causes of your digestive disturbances. If you feel like you “have to” take your probiotic daily, it’s time to look deeper. If you are already taking a probiotic and still have gas, bloating, constipation, diarrhea, etc. then you may need to work with a practitioner to address the underlying cause of your gut imbalance.
What are your recommendations to restoring GI flora post your SIBO/SIFO regiment? Is this a case where probiotics would be helpful?
Colton, great question! The answer is that if you have your diet correct, meaning you are eating a healthy variety of clean foods, then your gut microbiome is actually genetically controlled so you don’t need to take probiotics, it will repopulate on its own if the environment is right. I have never written an article on that yet, but the idea that we can change our microbiome is an outdated idea. Now, if things aren’t perfect with diet or stress or you live next to a coal mine, then you may benefit from probiotics being something that helps to maintain a longer homeostasis.