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How to Choose The Best Probiotic For You [E039]

Which probiotic is best for me? In today’s society, we hear more and more about gut health. This episode is all about how to choose the correct probiotic for you. Even if you are not currently feeling symptoms, your gut flora can still be affected by things you didn’t even know you were doing. Discover the do’s and don’ts when it comes to gut health probiotics to start getting your immune system and overall health on track.

Table Of Contents

Which Probiotic Is Best For Me? An Introduction

Which Probiotic Is Best For Me? An Introduction
Photographer: Daily Nouri | Source: Unsplash

Bryan Joseph: Today, we are up to episode 39, and we’re going to answer some questions that are really commonly asked in our practice with a lot of people that deal with digestive issues. But before we get into that subject matter, I just want to say thank you, as we have continued to say, for sharing the message and sharing these podcasts episodes. You know we don’t have a fee for this; we’re doing this out of the love of what we do, the passion to try to help more people, and we wholeheartedly believe that you could really make a difference and connect the world with wellness, really, one family at a time by people sharing these messages. So, thank you so much for sharing and continue to do so.

If you like what you’re hearing and you think this would be valuable to somebody else’s ears or even to help to improve their health, then take one of the platforms that we have available and just share it with them. So with that said… Dr. Olivia deals with a lot of people that are dealing with different chronic conditions, metabolic conditions, thyroid dysfunction type 2 diabetics. But really at the base of a lot of these discussions seems to be the common thread that if you don’t have a healthy gut, you’re really not going to be a healthy individual.

The need for a healthy gut

Bryan Joseph: So, I think a lot of us don’t really pay much attention to our gut until we have to. Right? Like, not until you notice that you have extensive cramping or bloating or gas or diarrhea or constipation or whatever it is that you’re dealing with. The more that I’ve actually been in healthcare and actually understand the subject matter and have paid attention, it’s kind of like planting a garden in fertile soil. The need to make sure that that foundation is really healthy or that the soil is healthy really is going to dictate what the outcome of those veggies would be in your garden, right?

Olivia Joseph: If your gut isn’t healthy, then you can eat a very healthy diet, but you’re not getting the maximum benefit from that. And I think when it comes to gut health, people assume that if I don’t have gut symptoms, then I’m good. But that’s definitely not the case, because you mentioned, we’re talking about thyroid, autoimmune disease, among many… type 2 diabetes and glucose metabolism. These things are affected when your gut isn’t functioning for you optimally. So it’s not just about gut symptoms.

And the reality is, most people do have digestive symptoms. A majority of Americans do, but we’re taught in our culture, in American culture, that because something is common, it’s normal. It’s not normal. Because when you improve these people’s gut health, they feel better than they ever have before. And what we hear over and over is, “I had no idea I could feel so good. My mental clarity is better, my skin is better, my breathing is better, my mood is better.” So, gut health really has to do with those things.

How To Keep Your Gut Healthy

How To Keep Your Gut Healthy
Photographer: Alicia Petresc | Source: Unsplash

Bryan Joseph: So let’s dive into some of this subject matter. I know there’s a lot of people that have challenges with their gut and they’re coming in and they have heard of things like a gut rebuild or a gut repair or I know I have all sorts of colitis or I know I have SIBO, and there’s all these people that are dealing with different conditions. But I overhear, often, and you hear this so frequently, people asking like, “What can I take to set the foundation to help my gut be healthy?”

Olivia Joseph: So we definitely have talked more about some of those infections. We’ve talked about autoimmune disease and gut health overall on other podcast episodes. So if we’re really going to dig deep on which probiotic is best for me. I do think people think probiotics can fix everything. It’s very beneficial for people to take some probiotics, but there’s definitely some do’s and don’ts that I want to cover.

Bryan Joseph: Hold on. Well, you were referencing one of those previous episodes; episode 20 was all about SIBO and bacteria and belly bugs. So if you haven’t heard that and you want to hear what she’s referring to, you can go and hear that episode. But what is a probiotic in the first place?

Olivia Joseph: So probiotic is just good bacteria: pro; good, biotic; bacteria. That’s it. That’s all it is.

Even bad bacteria is good for us

Bryan Joseph: All right. But what I’m understanding is there’s a lot of value with having the right kind of bacteria in your body. And a lot of decisions that we make, or even pills that we take, or antibiotics that we go on will kill the right bacteria and then we have a problem in our gut.

Olivia Joseph: Yeah. So even bad bugs are good for us, because by having bad bugs and bad bacteria in our gut, it allows our immune system to adapt to it. So when we do get exposed to bad bugs, we know what to do with them. So the whole thing with a probiotic is taking antibiotics, having a diet that does not allow probiotics to thrive in your gut, eating foods that are sprayed with pesticides and herbicides, eating foods that have been treated with antibiotics. Those affect gut flora.

Diet used to be very, very different 20, 30, 40 years ago. People used to eat a lot more fermented foods, a lot of foods that are considered weird now, although fermented foods are becoming more popular, paleo has become more popular. So some good things are coming back. But there’s a lot of ways to lose your good bacteria. So the most important thing is, is that there’s a balance between the good and the bad. That’s what we’re looking for.

And one thing we see a lot of or the clinical team at our office sees a lot of is stool testing, right? Well, it’s amazing. Sometimes we’ll see on a stool analysis that somebody is completely missing good bacteria or a strain of good bacteria, meaning that bacteria is not there to protect you. And something that’s becoming more popular now is fecal transfers.

Fecal Transplant For a Healthy Gut

Olivia Joseph: So they’re literally doing a fecal transfer from a healthy individual to try to get that good bacteria back in your gut because they know without that good bacteria, not only your risk for digestive disease, but your risk for autoimmune disease is higher, your risk for C.diff when you do need an antibiotic is higher. So these probiotics are extremely important.

Bryan Joseph: I can’t even imagine that they have a fecal transplant. That seems a little like off the wall. But it’s crazy. And I think the purpose is, as you’re saying, to bring in some of these people… to inoculate some people’s gut with basically the good bacteria that they don’t have anymore.

Olivia Joseph: Well, you’re right. And the fecal transfers are most commonly prescribed when someone gets C.diff after taking an antibiotic. Like, it’s your Go-to for C.diff; it really is. Another component, you mentioned ulcerative colitis. There is research, there is clinical data to support doing fecal transfers in people with ulcerative colitis has benefit. So it is more popular, and I know this sounds so gross, but they’re trying to create a supplement or a pill or a capsule that’s a fecal transfer.

Bryan Joseph: Oh my gosh.

Olivia Joseph: It hasn’t survived gastric transit yet, but I think you’ll see that come out in the next one to two years, and there are certain populations that will be so thankful for this discovery.

Bryan Joseph: Well, is that in any way, shape or form similar to the microbiome and the like gut drinks like the dirt water? Like, is that the same idea, to start reintroducing some good bugs and bacteria into the gut for people?

Prebiotics and why it’s important for probiotics

Olivia Joseph: Yeah. So what you’re talking about is really prebiotics, which I do think we should touch on, because you can’t do a whole podcast on probiotics without discussing prebiotics. So we’ll certainly cover that. But that’s one of the reasons why people are doing these dirt drinks and why people are saying which probiotic is best for me is made from dirt or with certain spores. It’s so that you get the prebiotics in there.

So let me just tell you what prebiotics are. I think people get so confused. It’s so easy. Prebiotics are food for probiotics. That’s it. You cannot have a thriving probiotic environment in your gut if they don’t have something to feed on. If there’s not food in your gut for probiotics, then they’re not going to make a cozy home in your gut. They’re going to move on, and that’s when probiotics will go right through you. So prebiotics are just food for probiotics, they are not the same thing. And you do not get the same benefit from prebiotics that you get from probiotics. They’re two separate things.

Bryan Joseph: So let’s clarify something also for everybody; there’s not just one type of prebiotic and there’s not one type of probiotic, right?

Olivia Joseph: Oh, absolutely. Yeah. There are so many different strands of probiotics, but we’re going to cover two of the most common ones and one that flies under the radar that’s getting a lot more attention lately that I want to discuss.

Bryan Joseph: So let’s focus on this because I think more people are familiar with probiotics and prebiotics. And that may be an advanced level for them to consider taking those type of supplements if you will.

Best Practices In Taking Probiotics

Best Practices In Taking Probiotics
Photographer: Daily Nouri | Source: Unsplash

Bryan Joseph: More and more people are aware, to my knowledge, that they should be taking some type of a probiotic right now. Even in terms of food, we’ve heard people talk about, “You need to eat more yogurt or different foods that might have some of these probiotics.” Knowing that there’s so many different strands of bacteria and probiotics, how does one decide what is right for them or what… Are there some go-tos that are saying no matter what, this is one you should have? How would you determine or advise somebody to consider the which probiotic is best for me?

Olivia Joseph: Sure. So I’m not against people eating yogurt. The only thing is… Dairy is the second most common allergy in the American population. So just be conscious of that. Many people can’t. Now, yeah, there’s dairy free yogurts. The other component with yogurt is most of them are so high in sugar, which is going to affect overgrowth of bad bugs like yeast and SIBO and things of that nature. And there’s not that much probiotic and yogurt compared to what you’re going to get in taking a probiotic.

So one thing I always recommend if you’re going to take probiotics is refrigerating it. Now, many probiotics are created to be shelf-stable. But some things just do better in cold environments and probiotics are it. So even if you buy one that’s shelf-stable, I would still keep it in a cool dark place, refrigerated optimally. You’re looking for something that the strains have numbers behind them. So if you’re reading a label, you want to make sure that every single strain of probiotic has a number after it. That’s how you monitor the quality and the quantity of a probiotic.

Under the radar probiotics

Olivia Joseph: Multi-strain means when you read the label, you’re going to see there are many different types listed. And for the purpose of this podcast, the two most common probiotics you will see are lactobacillus and bifidobacterium. Now, there are different species that may be better for one thing or another. Some probiotics have higher amounts of one than the other, and there’s definitely benefit to that depending on what you’re trying to accomplish. But those two are the most common probiotics you’re going to see.

And honestly, I don’t think it makes sense to take which probiotic is best for me as an adult if it has less than 15 billion bacteria. 5 billion is great for kids’ probiotics, but 15 billion is the minimum you want to see for a probiotic that has lactobacillus, bifidobacterium, or some combination of both or multiple strains within those two categories. The third probiotic I do want to talk about is S boulardii or Saccharomyces boulardii. This is the probiotic that has been flying under the radar for at least a decade.

S boulardii, saccharomyces boulardii, that is your go-to for someone who has diarrhea, go-to for somebody who has diarrhea after taking antibiotics, who has C.diff, who has yeast overgrowth, or even who gets diarrhea after traveling. I recommend being preventive and proactive. If you know every time you go to Mexico you get dysentery, you want to take those probiotics for two weeks before you go on your trip. If you are going to take antibiotics, take these which probiotic is best for me with the antibiotics or ideally before. So, saccharomyces boulardii is great for yeast, diarrhea, C.diff, and that does not need to be a multi-strain probiotic. So that kind of covers those three strains.

Complex Probiotics For Certain Health Conditions

A friend of mine had to do some bacteria samples during her bachelor thesis. When i saw those i was instantly fascinated by the vast range of variation within this tiny microcosm.
Photographer: Michael Schiffer | Source: Unsplash

Bryan Joseph: I guess from there if those are the most common ones, are there any probiotics that would be specific for a condition? If I was somebody that had Crohn’s or ulcerative colitis or I had… You mentioned diarrhea, but if I had a condition, are they’re a match to certain probiotics or is it a lot more complex than that?

Olivia Joseph: You’re talking about Crohn’s and colitis, it is a big deal. We’re not talking about IBS, we’re talking about IBD, which increases your risk for colon cancer, increases the risk of you going on some significant drugs that have significant side effects like biologics. You’re talking autoimmune disease, a category like that, I’m not just going to put someone on probiotics. I’m doing a stool test.

I have seen IBS respond beautifully by dietary change, food sensitivity testing and high dose lactobacillus bifidobacterium. So we actually use a probiotic specific to people with IBS or IB, inflammatory or irritable bowel, whether it’s syndrome or disease, it doesn’t matter. So what are those? They’re high dose lactobacillus, bifidobacterium if you have an IBS. Those two probiotics that I just mentioned, lactobacillus, bifidobacterium, they’re great for bloating and gas, great for it.

Now, if you take probiotics and your bloating gets worse, if you take probiotics and your gas gets worse, that’s a good indication that you actually have SIBO, which is small intestinal bacterial overgrowth. And again, we covered that on the SIBO podcast. But if you take a probiotic and you get more gassy, more bloated, you’ve got a bad bug overgrowth and that needs to be dealt with. You don’t have a problem with probiotics, you have a problem with bacterial overgrowth, so deal with that first.

S Boulardii for SIBO

Olivia Joseph: Yeast does great, yeast overgrowth with that saccharomyces boulardii. So yeast is going to do really good with that. People with SIBO can take S boulardii as well because S boulardii won’t feed SIBO. So, those are some categories. If you’re talking autoimmune disease, that’s a bigger can of worms. With that said, there are specific probiotics for women’s health, there are specific probiotics for daily wellness and maintenance, there are specific probiotics for immune health. And we use one called ultraflora immune that has shown to be more effective than the flu shot when taken for 90 days.

Well, in the flu shot, it kind of depends on the year, if it’s even effective. But the beautiful thing about boosting your immune system by working on gut health is you’re not just protecting against the flu, you’re protecting against a cold, you’re protecting against stomach bugs, which in my opinion are worse than influenza. So you’re getting… There’s a lot that you can get even just from lactobacillus, bifidobacterium and S boulardii.

Probiotics For Children & It’s Other Benefits

Probiotics For Children & It's Other Benefits
Photographer: Ben Wicks | Source: Unsplash

Bryan Joseph: I know with our kids, you give the kids like children, probiotics. What’s an example of a probiotic for a child?

Olivia Joseph: So the ones we give our kids are a blend of lactobacillus and bifidobacterium. It’s a blend of both

Bryan Joseph: And they’re chewable.

Olivia Joseph: Oh yeah. They’re refrigerated, they’re chewable. Yeah, probiotics are stable in powder, in a capsule or in a chewable form. So we give our kids preventively. So every day, our kids take 5 billion bacteria, and it’s a combination of lactobacillus bacteria. I’m a big proponent for dairy-free probiotics, so that’s what we give our kids.

Bryan Joseph: The question is… And this is what I’ve discovered over a period of time, is similar to a multivitamin multimineral, there’re certain supplements, if you will, that really just makes sense for all of us to consider taking as regular preventative and wellness type of supplementation. Do you believe which probiotic is best for me fall into that category?

Olivia Joseph: I absolutely do. The one thing I’ll say about that is probiotics are cumulative, meaning they build up, so it’s okay if you miss a day; it’s not the end of the world. It’s okay if you take a break from it, but I definitely recommend that as part of a protocol for prevention. And most people who do go on it, notice, “I’m not getting sick anymore. I usually get sick every fall.” Or people notice, “I didn’t even feel bloated, but my stomach is so much flatter.” Or, “I thought my bowels were regular, but staying on a probiotic, I never miss a day.”

Depression and regular bowel movement

Olivia Joseph: Last week, I literally was reading a study on probiotics preventing postpartum depression. And in the study, it’s showing how it works, is our brain hormones, serotonin, dopamine, GABA are made in our gut. So literally, the connection was that using probiotics helped to reduce symptoms of anxiety and depression because it’s working on a healthy gut.

So, I’m just reading this study and I’m like, “Oh my gosh, there’s this correlation between depression. It makes sense to me. Anxiety, it makes sense to me.” And they might have done it in a very specific demographic-like postpartum because they were trying to do a study on probiotics in pregnant women on infants that were born on breast milk. So they were using a very specific demographic, but it makes perfect sense.

Bryan Joseph: Well, you said something about regular bowel movements, and it made me think of… It’s amazing to me when you hear people say that they… Some people don’t have a bowel movement every two days, every three days, once a week.

So because of that, we hold it in and then we train our body that it’s only able to eliminate maybe one time in the morning or at night when I’m in my own environment. But you’re creating a breakdown to that system in your body, your digestive system doing that. And so just pay attention to that. You’re supposed to be able to eliminate, and it’s part of… It’s natural to be able to have a bowel movement.

Olivia Joseph: It’s part of your detoxification system and your detox pathways. And when you don’t eliminate daily… Like I would love for someone to have a bowel movement after every meal. That would be awesome. That would be ideal.

Preventing colon cancer with probiotics

Olivia Joseph: So one thing we see clinically, I see every day with our clinical team at the office is calprotectin is a marker of inflammation in your intestines. When levels are really high, it’s an increased risk for IBD, which is Crohn’s, colitis, things of that nature. But it’s an increased risk for colon cancer, right? When you give someone a probiotic, you see calprotectin levels go down. So you can think about it is that it is a preventive against colon cancer. You know what else is a preventive against colon cancer? Pooping every day.

So we know that… Like, it’s a no brainer. You’ve got to have a healthy gut, because when it’s not healthy, you do see things not just like GI symptoms, gas, bloating, constipation, diarrhea, pain, cramping; you see depression, anxiety, you see brain fog, you see increased risk for every autoimmune disease, inflammation, aches and pains. All of the above. You see problems with skin conditions. It’s going to show up in some way and usually you can trace it back to the gut.

Bryan Joseph: It’s all related. Everything’s connected, it’s all connected. Let’s end on this. If you liked what you heard, first of all, you can find this episode, livingonthewellnessconnection.com/e39, and you can share this. Obviously, there were some big words like usual when we get into clinical conversation, so if you didn’t really understand what we were saying or couldn’t write it down, then you could find that there and use it as a resource.

Closing Thoughts

Olivia Joseph: I just want to just circle back for one minute on a prebiotic because it’s not as complex as people think. Prebiotics are in fermented foods, things like sauerkraut, kombucha is becoming very trendy, kimchi, even sour cream, which I get is dairy. I’m not contradicting what I was saying earlier. I’m just saying any fermented food as a source of prebiotics. And you don’t need a lot, you need as little as one tablespoon a day. And the original prebiotics are sources of fiber. Fruits and vegetables are still your best source of fiber that exists.

So, when people say, “Oh, take Metamucil,” fruits and vegetables, right? Minerals help absorb water into the bowel. Eating a few fermented foods, ideally, a tablespoon a day will help with that good healthy gut. And again, if you eat fermented foods and they make you more bloated, that’s probably an indication of bad bug overgrowth. And when you talk about bad bug overgrowth, as we said on our SIBO podcast, I’m a huge proponent of getting rid of the bad guys and then working on rebuilding the good guys. But you’re not going to hurt yourself taking a which probiotic is best for me, ever.

So take one, try one. And if you find you feel worse, the problem isn’t the probiotic, the problem is you probably have bad bugs that need to be eliminated before you can really rebuild the good bugs. So remove the bad, rebuild the good or reinoculate. And we also talk about rebuilding the mucosal integrity of the gut. That’s a whole different story and we’ll talk about that on a different podcast.

Get started taking probiotics

Bryan Joseph: Well, I think my closing thoughts would be very simple. Number one is consider a which probiotic is best for me as a place to start if you’re not on anything. Second thing, and probably the last thing is just to imagine if we all had x-ray vision and we can actually see under our skin what was actually truly happening in our organs, in our digestive track, I think we may make different decisions with the choices that we make on a daily basis.

Bryan Joseph: Rather than waiting until you experience symptoms or breakdown and then you see those things, why don’t you consider being on the front end of all those things and actually prevent these things from happening? And that’s what we’re hoping to share with you. So, till next time, this is the Wellness Connection show.

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