A doctor’s take on probiotics

Probiotics

Probiotics are live micro-organisms that are known for helping to promote a healthy balance of bacteria in the gut. They are found naturally in some foods, such as yogurt and cheeses, but they are also becoming a growing part of the supplement market. Gastroenterologist Richard Fedorak, a specialist in inflammatory diseases, calls these health-benefit-touting supplements “designer probiotics.” As more and more of these products pop up on health food store shelves, we decided to ask Dr. Fedorak to help navigate the new world of probiotics.

Who should be using probiotics?

Everybody. Probiotics are just the normal things you have in yogurt and fermented milk. But then there are designer probiotics that we have identified have special qualities that go beyond just being food and can help treat certain disorders. So those are for people who have those disorders. The common one is that we use probiotics to treat irritable bowel syndrome. You change your diet, you introduce probiotics and you will eliminate the symptoms.

So if someone doesn’t have digestive problems, do they need to take probiotic supplements?

You want to create an underlying healthy gut bacteria by eating a diversity of foods, and then if you’re still having some problems, you need to start looking at individual probiotics to treat individual problems.

Can probiotics treat problems outside of the gut?

Probiotics, by far, are for digestive health. There are some that are being looked at to treat other disorders, but those are still really investigational. There are some probiotics people have been using to treat canidida [yeast infections], but the probiotics that are being put out there on the Internet for hair growth and increased muscle mass are false. So you need to be really careful of the claims they make.

There has been talk of a connection between probiotics and obesity. Is there any substance to that?

Probiotics cannot help with obesity. The line of research that’s being explored is that the bacteria in your gut, called the microbiome, played an important role in how your body functions. There are animal but not human experiments that show that obese mice, when you change the bacteria in their gut, can become thin. Whether all of that will extrapolate to humans, we don’t know, but research has shown us that the bacteria in our intestines are incredibly important in how we live and how we function. But giving you a probiotic is not going to make you thin.

How do you know what to look for in a probiotic?

You should be doing some research on your own, but being very careful to look for credible sources, and working with your dietitian or nutritionist who has much of this information at their fingertips.

Since probiotics are live, how do you know they’re still fresh when you consume them?

Look at expiry dates. So in general, the longer a probiotic is on the shelf, the less probiotic there is there. Probiotics ultimately die out. And so you want the freshest product possible.

Are there any risks involved in taking probiotics?

If you’re going to use probiotics to treat a disorder or disease, check with your doctor. And in general, people who are on immune-suppressing drugs or young children and infants shouldn’t be given extra probiotics unless, again, you check with your doctor.

Should you take probiotics when on antibiotics?

Most people can take antibiotics and they can recover their own bacteria naturally because they’re eating good, diverse food. But those people who might be elderly, might be a little sick, might be on antibiotics for longer, they may need to supplement with a probiotic. You can take them at the same time as the antiobiotics and for a week after you’re done.

Get more information from the Canadian Digestive Health Foundation at cdhf.ca.

(Photography: Termininja/Wikimedia Commons)