The Good And the Bad – a Look at Probiotics

Over the last few weeks, we’ve seen a lot of discussions on social media about Probiotics. Many are unsure what they are, whether they are really good or helpful, and when to use them. So we thought, a more detailed look into probiotics might be a good idea.

What are probiotics?

Probiotics are live microorganisms, primarily bacteria and but sometimes also yeasts, which may help prevent some illnesses. They naturally occur in lactic acidic products such as yoghurt or buttermilk. They can also be purchased as dietary supplements or as pharmaceutical medications.

While many of us think bacteria are bad for us, we actually have a natural “flora”, population, of bacteria on and in our bodies, both good and bad. Did you know that the average adult gut is the home of about 400 different types of bacteria? It is therefore no surprise that bacteria also play an important part in keeping our gut healthy.

Probiotics are typically called the “good” bacteria.

Our gut is of particular importance for our metabolism and our immune system. It contains an entire “army” of bacteria and microorganisms.

The most important bacteria in our gut are:

  • Escherichia coli
  • Enterococcus
  • Lactobacillus
  • Bifidobacterium
  • Bacteroides

Most of the bacteria are in our large intestine and the bacteria add up to approx. 1.5 kg. Our small intestine is also the home of bacteria, especially of those producing lactic acid, Lactobacillus and Enterococcus.

These organisms are busy all day long keeping everything running smoothly. A healthy gut should contain about 85% “good” bacteria and only 15% “bad” or pathogenic bacteria. A large part of our immune system runs via our gut, thus making this an important part of our immune system.

Importance of Gut Bacteria for Our Metabolism and Immune System

Gut bacteria have multiple functions:

  • strengthen the gut barrier against “bad” germs
  • production of specific mediators to kill “bad” germs
  • strengthening of the immune system
  • producing Vitamin K and B
  • production of digestive enzymes
  • support of nutrient absorption

For a long time the significance of probiotics was underestimated. Today we know that they help in the activation of the immune response in our body by activating specific defence cells, the so-called T-cells.

Many factors can bring an imbalance to our healthy gut flora: infections, unhealthy nutrition, stress, medications. The consequence are unpleasant digestive issues from indigestion to diarrhoea.

Many discussion about the use of probiotics follow the prescription of antibiotics for a certain illness. We know today that by maintaining a healthy lifestyle, including a healthy and balanced diet and sufficient physical exercise, and such strengthening our immune system, can help to avoid the need for antibiotics. In a time of widespread antibiotics resistances, medical professionals have become more wary prescribing antibiotics. But there are occasions when they cannot be avoided like bacterial meningitis, bacterial pneumonia and a streptococcus throat infection.

“Good” bacteria – Probitotics

Three groups of probiotics can differentiated:

  • probiotics from natural foods (for example kefir, yoghurt, buttermilk, sauerkraut)
  • probiotics in “functional foods” where they are added (yoghurt etc.)
  • medicinal probiotics

Yoghurt naturally contains lactic acid bacteria and therefore is probiotic. In order to ensure sufficient numbers of lactic acid bacteria to reach the intestine, two to three container so yoghurt are recommended, best as a natural yoghurt without fruit or sugar. Since different yoghurts often contain different probiotic bacteria, changing the product may further help. Buying functional foods with added probiotics is not ideal as they often contain high amounts of sugar and other additives (and are more expensive)

Antibiotics and Probiotics

Indeed, some studies show that probiotics lessen the severity of diarrhoea as well as shorten the illness, on average by one day.

One frequently asked question is whether when having been prescribed antibiotics is actually makes sense to take probiotics at the same time.

The question arrises because if we take antibiotics, which are often indiscriminate on which bacteria they destroy, does it make sense to take probiotics at the same time, wouldn’t they also be destroyed? According to a study published in 2006, specific probiotics taken at the same time as the antibiotic medication help to prevent antibiotic-associated diarrhoea. But it is important, that probiotics and antibiotics should not be taken at the same time of the day, a couple of hours between the two are recommended for probiotics to be effective.

Probiotics are swallowed and have to pass through our digestive system. The gastric acid in our stomach usually kills potential illness causing germs. In our small intestine, bile acids from our gall bladder further inhibit microorganisms. And when finally reaching our large intestine, the “good” probiotic bacteria have to hold their ground against the existing gut flora. That is why in order to be effective, a probiotic should contain a minimum of 100 Million up to 1 billion live bacteria.

One word of “warning” at the end: probiotics do a lot of good but one study published in 2013 also showed that probiotic bacteria also contain various genes which could be responsible for developing resistances against antibiotics. Whether these genes actually cause resistances has still to be researched.