By John G. Alevizos, D.O.
Our gastrointestinal system contains more than one hundred trillion bacteria. These micro-organisms provide so many important benefits to the body that they are sometimes called a “forgotten” organ.
Our intestinal flora are responsible for fatty acid metabolism, vitamin absorption and the regulation of fats, triglycerides and cholesterol. This intestinal flora is also responsible for the breakdown of carbohydrates, detoxification, vitamin synthesis, energy production, the regulation of the immune system, and multiple other functions too numerous to list.
By performing all of these functions, including a greater metabolic activity than the liver, our intestines, along with the bacteria that live in them, are truly a very vital organ. This colonization of bacteria began at birth, beginning with breast feeding in the hospital, and continues throughout our lives, influenced by anyone or anything we came into contact with; from other people to pets to soil. The general consensus seems to be that those of us who are exposed to more bacteria in our youth tend to have a more balanced intestinal flora.
If there is an imbalance of the trillions of bacteria, we can get a condition called dysbiosis. The most prominent effect of the imbalance is seen in the digestive tract. However, it also affects the skin, lungs, mouth, nose, sinuses, vagina, ears, nails and eyes. To correct such an imbalance, many of my anti-aging colleagues add probiotics to the patient’s diet, which supply beneficial bacteria to the intestine. These good bacteria can create a “barrier effect”—essentially occupying the host receptor sites to kick out the infection.
The reason I am telling you about dysbiosis is that some of us suffer from chronic allergies, asthma and autoimmune diseases. Although we may have used multiple prescription medications, multiple tests such as CT scans and blood tests reveal that our lungs, nose, sinuses, etc. are still not functioning optimally—causing discomfort and affecting our quality of life. However, if all of these sites could be covered with beneficial colonies of bacteria that carry out very necessary and helpful functions, then penetration from a pathogen cannot occur. In fact, with the proper balance of these beneficial colonies, they compete with one another to keep one another in check.
So, what types of things cause microflora imbalance and dysbiosis? Inappropriate antibiotic exposure, alcohol misuse, poor diet, age, chronic constipation, certain drugs and stress can adversely affect the proper balance of microflora. Diet is very important. A lot of studies have been done on mice, and in one recent study, the initial bacterial colonization that the mice received from their parents was altered within 24 hours after changing their food from a plant-based diet to a high-fat, high-sugar “Western” type of diet. This caused an imbalance in the number of gut microflora and metabolites. Sci Trawl Ned 2009; 1(6):6RAI4.
How does one treat dysbiosis? The first line of treatment is with prebiotics, which are foods that support the growth of good gut microflora. Foods such as bran, onions, garlic, rye, bananas, blue-berries, chicory, artichokes, yogurt, kefir, eggplant, legumes, sugar maple, soy-beans, asparagus, leeks, honey and green tea are all prebiotics. One would need to consume an average of 2 to 8 grams per day. These foods promote the growth of beneficial bacteria, discourage the growth of bad bacteria, prevent constipation and diarrhea, have a low glycmic index (thus they do not spike insulin levels that would cause the body to make cholesterol and fat), and lower the colon pH. Lower pH in general is less inflammatory.
If you don’t like most of the above-noted foods, some commercially available supplements that would be an alternative are oligo fructose (FOS), guar lactulose and insulin. However, I do not recommend these supplements to my patients because I have read in studies that some of these products actually contain only one-tenth or less of the active substance that they claim to contain. Notice that all of the prebiotic foods are not simple sugars, as sugars and undigestive carbohydrates leave the bad bacteria in the colon, causing dysbiosis. Therefore, if we decrease our intake of sugars and carbohydrates and eat more of a vegetable, plant-based, fruit-based diet, we are replenishing beneficial bacteria that helps our entire metabolism.
Stronger than prebiotics are the actual probiotics. I recommend probiotics for women who suffer from recurrent urinary tract infections or bacterial vaginosis, and for people with irritable bowel syndrome, eczema, psoriasis, allergies, diarrhea, constipation, ulcerative colitis, Crohn’s disease, rheumatoid arthritis and dental cavities. Also, for those who suffer from certain infections, infectious diarrhea, skin infections, vagina] infections, etc.
What are probiotics? The Food and Agriculture Organization of the United Nations (FAO) defines probiotics as “live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host.” Unfortunately, we have always heard that bacteria are “bad” and drug companies work very hard to bring to market the latest super drug that kills the most bacteria. So why would we want to consume living organisms that our body has to contend with? Bacteria are everywhere in our environment and are always looking for a nice warm living host to thrive in. When harmful bacteria try to attach themselves to us, they must first fight and defeat the beneficial bacteria already residing there. However, poor diet, stress, lack of sleep, etc, give them an advantage.
When we have the right balance of good bacteria, our intestines filter out things that might damage us, such as toxins, chemicals, waste products and, once again, harmful bacteria. And at the same time, balanced intestinal flora can create the nutrients that we need and even make essential hormones for optimal health. Which probiotics should one use? Lactobacillus GG is the most common and the best studied probiotic. The combination products are not well-studied, but may work, Unfortunately, the FDA does not regulate these foods, and I have read that quality control is poor, and most of these preparations have less than 1% of the bacterial concentrations noted on their labels. Certain doctors prescribe custom probiotics, which cost $40–$50 per month, and it may take several months to see a therapeutic effect, However, if one does not modify the diet to include more prebiotics, these custom cultures are unlikely to find a permanent home. My simple recommendation is to eat yogurt. According to the National Yogurt Association, probiotics or live cultures added to yogurt must include lactobacillus bulgarious and streptococcus thermophilus. There are multiple yogurt brands that contain these cultures, and even homemade yogurt has billions of beneficial bacteria.