The discussion of health-giving bacteria may make more sense if I put it in the context of a much bigger picture. I’ve listed a number of serious health concerns on the cover and indicated that they might be overcome by helpful bacteria. If that seems a bit bold, it may be in part because we have become accustomed to managing diseases and using medicine to quiet symptoms.
The conventional approach may be common, but that doesn’t make it ideal. We can obviously be fooled into complacency by what is around us constantly, but history is replete with examples of times when we did not know until too late that “the parade was out of step.”
Fortunately, there may actually be two parades from which to choose.
Modern high tech medicine is unequalled in crisis care. It excels at putting us back together after an accident and keeping us from falling off the edge with an acute disease. However, when compared to most other developed countries (and even some in the third world) our chronic disease statistics look quite grim. Medications alleviate symptoms, but often at a significant expense and reduced long term wellness. One underlying problem is that conventional medicine is thoroughly trained in those interventions that it may discount the impressive self-healing force of the human body. In fact, we’ve spent the last several decades trying to defy the laws of nature when it might have been at least as productive to invoke the power of nature. Our microorganisms are an important component of that force.
The approach I will describe in this book is more aligned with healing disciplines that are less mainstream . . . a different parade if you will. According to the Institute for Functional Medicine (functionalmedicine.org), “Functional Medicine addresses the underlying causes of disease, using a systems-oriented approach and engaging both patient and practitioner in a therapeutic partnership.” I added the emphasis because that is a key point we will come back to frequently. Although functional medicine offers specific training to practitioners, I will use the term “functional medicine” as generic shorthand to cover a broader scope of disciplines that have much in common, such as integrative medicine, complimentary medicine, naturopathic medicine, nutrition-based preventive medicine, and even alternative medicine.
These systems have in turn gained valuable insight from ancient gentle arts, such as Traditional Chinese Medicine, Ayurveda from India, and Native American Shaman healing. (Practices that have worked for thousands of years shouldn’t be discounted simply because they didn’t come out of a white coat Western laboratory.) The functional approach is gaining traction in mainstream medicine as evidenced by the fact that the prestigious Cleveland Clinic has opened a Center for Functional Medicine.
Functional medicine deals successfully with preventing and healing (curing) chronic disease in part because it is personalized. These professionals also tend to view symptoms not as the enemy, but as almost blessings which alert us to an imbalance. Identifying and correcting an imbalance can achieve a sustainable reversal or cure of disease. As a bonus, the rebalancing approach can restore health without creating further damage in the process as might often be the case with some mainstream treatments, such as surgery, radiation, and pharmaceutical drugs. An imbalance usually involves an insufficiency of one or more factors that the body needs for optimum function and/or excess of one or more factors that are interfering with normal function.
A valid treatment yardstick that applies to any style of medicine is the “risk versus benefit ratio.” Let me use a familiar example of non-steroidal anti-inflammatory drugs (NSAIDS), such as aspirin. The benefits include reduction of pain and inflammation. On the other side of the equation, aspirin’s risks include bleeding disorders, such as ulcers, intestinal bleeding, and hemorrhagic stroke. In fact, Non-steroidal Anti-inflammatory Drugs (NSAID) are blamed for over 16,000 deaths per year. That figure may be higher given that the Food and Drug Administration (FDA) recently required warning labels on non-aspirin NSAID pain killers noting that they increase the risk of heart attack, heart failure, and stroke. (The higher the dose the higher the risk.) Therefore, there is ongoing debate about the risk/benefit regarding these drugs. Tylenol is another example. The drug has been approved to reduce pain, but it is not expected to address the root cause of the pain. Under regulators’ view of the risk-to-benefit ratio, Tylenol is expected to cause side effects like liver damage (especially when it is combined with alcohol), but that is allowable as long as deaths don’t exceed the number that had been predicted.
Probiotics look fabulous when subjected to this same risk-to-benefit test.
On the risk side there are really none—probiotics are organisms that are supposed to be in our systems—they are a key part of the original plan. Probiotics often help medications work better and reduce their side effects. On the other hand, most pharmaceutical drugs have negative effects on our friendly bacteria. Probiotics are viewed by some scientists as “living drugs.”1 A rapidly developing new field of study is called “Pharmacobiotics.” Perhaps that medical sounding term will make probiotics more acceptable to mainstream docs than might be the case with quaint-sounding “fermented foods” and humble “over-the-counter probiotic supplements.” Since there is almost nothing to say about risks associated with probiotics, most of the rest of this book will be about clarifying the benefit side of the equation.
The reader may be one of the many who still have no earthly idea what probiotics are. Thanks to massive advertising especially by yogurt companies, the majority of consumers do seem to understand one tiny bit of the story—that probiotics are bacteria which help with constipation. Constipation is indeed a common concern and we will discuss it in the second part of the book. More serious clinically-diagnosed digestive diseases, such as chronic diarrhea, ulcers, and gastrointestinal (GI) cancers, are responsible for over 200,000 deaths annually in the U.S. Probiotics may be an important part of the solution to those as well. But, perhaps even more interesting are “sub-clinical” digestive issues related to an imbalance of microorganisms. (Sub-clinical means they are ones that we don’t even know we have.) They are often directly or at least indirectly responsible for many other discomforts, diseases, and deaths that at first seem unrelated to the GI tract.
Readers will learn that the benefits of having a thriving and well-balanced assortment of microbes range from clearer skin and a healthier weight to better control of allergies, asthma, depression, osteoporosis, and potentially deadly diseases, such as cancer, heart disease, and diabetes. For that matter, we should consider supporting the body’s team of beneficial microorganisms as a key part of the plan to resolve virtually any type of health complaint. As I mentioned in the Preface, our collection of probiotic microorganisms is like an organ with functions every bit as health-defining and complex as that of our liver or kidneys. Our team of microorganisms creates hundreds of metabolic substances in our circulation that help direct functions all around the body. Happily, it is not as difficult to create a proper healing community of microorganisms as it would be to say . . . build a kidney from scratch. On theother hand, as we will see, it is also not as simple as buying ones favorite flavor of yogurt with its one or two strains of bacteria. Our systems are home to thousands of species and subspecies of bacteria—all with different jobs.And, to make matters even more interesting, each person’s assortment is unique to them! Obviously, no product can possibly contain a bacterial blend that matches a person’s highly complex individualized system. That’s why this book discusses how simple choices that we make each day support or harm our team of microbes. I also explain some of what is known about the various metabolic jobs that our microorganisms perform. That is not only to heighten the reader’s appreciation of their value, but also to make it easier to fathom how they can possibly have such wide-ranging health benefits. As scientists learn more about these mechanisms, they begin to connect the dots to new uses for probiotics. That expanding research will uncover exciting possibilities, but may generate some problems. With a grasp of the big picture fundamentals, the reader will be less likely to be overwhelmed by the massive amount of research data coming down the pipeline. And they may be able to make better choices among a wildly growing list of options.
These are some of the issues:
It appears that the average consumer ranks probiotic supplements based on how well they relieve constipation. While that is a worthy goal, as you will see, our friendly bacteria can improve so many other aspects of health.
Some suppliers want us to believe that all probiotic supplements are equally effective and that we should choose based on how many “bugs” you can get for a buck. We are beginning to understand that high bacterial counts are not the same thing as high potency and that there may even be questions about ingesting huge numbers of certain single bacteria.
Because the field is so new, federal regulators do not control which microorganisms are put in a pill and would only get involved if a pattern of harm emerges. An example of this concern would be a probiotic strain promoted as being “antibiotic resistant.” This could lead to trouble since bacteria swap their genetic material and a disease-causing bacterium might acquire this skill.
Food manufacturers have found that adding “probiotic” to a label is a good marketing tool. Generally speaking, more ways to obtain probiotics is usually better. However, there is a potential concern with this fad of adding probiotics willy-nilly to everything from peanut butter to wine. Probiotic label-decorating may lead to a problem similar to the one that developed when “fat free” was added to labels. The allure of probiotics might distract us from asking if the product is intrinsically healthful.
It may become increasingly difficult for consumers to become informed about probiotic benefits through the usual channel, which as noted, is the manufacturer. In addition to already strict limits enforced by the FDA on product health claims, in 2014 the Federal Trade Commission and the Department of Justice filed an action against one of Phillips’ Colon Health products. Regulators sued to stop the maker from saying that their probiotics defend against occasional constipation, diarrhea, gas, and bloating and insisted that two randomized, controlled, clinical trials be required for every single strain in a blend. To begin with it doesn’t make much sense to prove the strains individually when probiotics work best in diverse teams. Also, such studies are extremely costly. So, if such a ruling prevails, the precedent will have a chilling effect on the creation, marketing, and availability of all probiotics. This government overreach exposes its historic bias in favor of drugs. They may not be satisfied until they can classify bacteria as drugs—even though probiotics have been part of our physical makeup for all of human history.
Pharmaceutical companies see the potential profit to be gained frompatenting a particular strain of bacteria for the treatment of a specific diagnosis. They have the vast amount of funding required to do research,achieve drug approval and acquire the right to make claims. Readers of this book may be spared the unnecessary expense of a prescription product because they will have learned that, in most cases, their problem may be solved by building a well-functioning diversity of microorganisms with strains of bacteria that are already available.
The research focus on single strains may pay dividends. For example, clinical trials are under way on a bacterium that has been genetically modified to have anti-inflammatory benefits for those with Crohn’s disease. I will point out later another isolated strain that serves a unique purpose.
My goal in The Probiotic Cure is to help the reader harness the extraordinary power of their microbiome and probiotic supplements for the benefit of their short term comfort and vitality as well as their long-term health. There is a lot of ground to cover in Part One before we can get to the how-to’s of using probiotics to solve our health concerns and support wellness every day as we will do in Part Two. I first will quickly put our experience with microbes into a historical context in Chapter 1. Then in Chapter 2 I’m hoping to shock readers a bit with a glimpse of the dynamic and breathtaking world of cutting- edge research. Hopefully, an appreciation of the startling power of our microbiota will generate added enthusiasm for the important business of learning the basics of how probiotics work and how to assure that we maintain a wholesome blend of colonies. To understand what we are up against, we take a closer look at the attributes and effects of enemy microorganisms in Chapter 3. In Chapter 4 we begin to understand the extent of the skills of our ally bacteria. One serious threat to peace in our gut is antibiotics, a double-edged sword. Understanding how to use the drugs in a safer manner is covered in Chapter 5. Chapter 6 reveals other hidden threats to the stability of our microbiome. Then, in Chapter 7, we look at how to recruit additional microbes and feed them well. Chapter 8 explains how to reverse an imbalance of gut microbes and what to look for in selecting a probiotic product as well as how to use them. We can now put these fundamentals to work on basic subclinical digestive issues in Chapter 9. Part Two of the book gives strategies and tips for a variety of common health complaints. The concluding remarks reinforce probiotics’ place in the future of medicine.
To provide recommendations that are specific enough to be useful, I will mention brand names occasionally. Please know that I do not work for any of these companies. The products are ones that I know to be of high quality and effectiveness and are often what I use myself and/or give my family members. Unless noted otherwise, they are widely available. I encourage that the reader not simply jump to the “how to” sections. Understanding more fully how our body functions and how probiotics do their work will prove very useful as the reader’s future needs and the landscape change.