Many people with thyroid and autoimmune thyroid conditions are familiar with the health benefits of probiotics. And I’m sure many people reading this are currently taking probiotics. But just as is the case with many other supplements, many people don’t have a good understanding when it comes to different probiotic supplements. Many just choose a brand with multiple strains, but otherwise don’t know if it is the right probiotic for them. So in this post I will discuss some of the different “features” of probiotic supplements, including some of the strains, the potency, and other factors.
Just so you have a better understanding of the classification of different probiotics, the genus is the first name of the bacterium. Two of the most well known genus are lactobacillus and bifidobacterium. The species is a bacterium’s second name, such as “acidophilus” or “bifidum”. So lactobacillus acidophilus is one example of a species, while bifidobacterium bifidum is another example. However, what many people don’t realize is that members of different species will typically have different strains. So for example, some probiotic supplements I have used included L. acidophilus LA-5, whereas others have included L. acidophilus LA-14.
This is where it can get confusing, as two different strains can have two completely different functions. So for example, one strain in a given species might be able to survive passage through the upper part of the gastrointestinal tract, whereas another strain won’t be able to survive. Similarly, some strains will be able to kill pathogenic bacteria, while other strains won’t do this.
Many healthcare professionals aren’t aware of this, and I also personally wasn’t aware of this in the past. And so what frequently happens is that someone will be told to purchase a specific probiotic supplement based on the species, but if it isn’t the correct strain then it might not have the therapeutic effect you’re looking for. And of course most people who buy probiotics on their own aren’t aware of this either, and so they also aren’t receiving optimal benefits from the probiotic they’re taking.
What Are Some Of The Benefits Of Taking Probiotics?
I’d like to discuss some of the benefits of taking a good quality probiotic. Probiotics can have many beneficial effects. Here are some of the different benefits that probiotics can provide:
- Helps to improve digestion and nutrient absorption
- Modulates the immune system
- Plays a role in the synthesis of vitamins
- Can inhibit certain pathogens
- Enhances motility of the gut
- Involved in the production of short-chain fatty acids
- Certain strains (i.e. Saccharomyces boulardii) can help improve intestinal permeability
Several animal and human studies have provided strong evidence that specific strains of probiotics are able to stimulate as well as regulate several aspects of natural and acquired immune response (1) [1]. There is also evidence that taking probiotics is effective in the prevention and/or management of acute gastroenteritis and rotavirus diarrhea, antibiotic-associated diarrhea and intestinal inflammatory disorders such as Crohn’s disease and pouchitis, and pediatric atopic disorders (1) [1]. Probiotics might also be beneficial in people with allergies, cancer, AIDS, and respiratory and urinary tract infections, and they might be able to reduce the risk of developing osteoporosis, obesity, and type 2 diabetes (2) [2]. Probiotics also can enhance the nutritional content and bioavailability of certain nutrients (3) [3].
How Do Probiotics Work?
When going through my Masters in nutrition program, I took a course on “Gastrointestinal Imbalances”, which was taught by Dr. Jason Hawrelak. Dr. Hawrelak is a naturopathic doctor and western herbalist who focuses on both acute and chronic gastrointestinal conditions. Everything he taught was research-based, and the following were the mechanisms of action he discussed with regards to probiotics:
1) Competition from adhesion sites. For example, certain invading pathogens bind to receptors, but probiotics such as lactobacilli can bind to the same receptors. This will prevent the adhesion and subsequent invasion of the pathogen.
2) Modification of the microbial flora through the synthesis of antimicrobial compounds. Some strains of probiotics can synthesize substances which inactivate certain pathogens. One important thing to keep in mind is that not all strains of probiotics produce antimicrobial compounds.
3) Probiotics can stimulate the immune response and cause increased secretion of immunoglobulin A, elevated natural killer cells, or enhanced phagocytic activity of macrophages. While most people associate probiotics with gut health, many people don’t realize that approximately 70% of the immune system is in the gut. And taking probiotics can help to improve the health of the immune system.
4) Probiotics may compete for nutrients that would otherwise be utilized by pathogens. This is self explanatory, as if a specific pathogen needs certain nutrients to survive, and if certain strains of probiotics compete for the same nutrients, then having a healthy gut flora can lead to less nutrients available for the pathogens.
Which Strains of Probiotics Should You Take?
As I mentioned before, the strain you purchase makes a difference. For example, if someone is experiencing constipation then taking a probiotic supplement which has B. lactis Bb12 might be beneficial (4) [4]. If someone has gastrointestinal Candida then taking a probiotic with the strain L. rhamnosus GG would be beneficial (5) [5]. L. rhamnosus GG is also beneficial for intestinal dysbiosis. If someone has H. Pylori then taking a probiotic supplement with the strains L. acidophilus LA5 and B. lactis Bb12 can be beneficial (6) [6]. If someone has a urinary tract infection then the strains L. rhamnosus GR-1 and L. reuteri B-54 would be beneficial (7) [7].
This is not how most people choose a probiotic. What usually happens is that they visit their local health food store and ask the person working there if they can recommend a good quality probiotic. Since most healthcare professionals don’t have a good understanding of probiotic strains, it’s no surprise that many people working in health food stores don’t have a great deal of knowledge in this area either. In most cases they recommend what they feel is a good quality brand, and they might recommend a specific potency depending on one’s condition. For example, if someone is taking antibiotics and is looking for a probiotic then they might recommend a high potency probiotic that has many different strains. However, if someone has a specific condition they usually won’t have a good deal of knowledge as to which strains are the most beneficial for this condition.
You want to make sure to take well-researched probiotic strains. This will greatly improve the chances of taking a supplement which will have therapeutic actions. I can’t say that I’m an expert when it comes to all of the different probiotic strains. However, I can say that when I recommend a probiotic supplement to my patients I do try to recommend probiotics which include well-researched strains.
How Do You Choose A Good Quality Probiotic?
Choosing a good quality probiotic supplement can be a challenge. Some people simply choose a product with many different strains and a high potency. If you’re sure that this probiotic supplement is from a good quality company then it might have therapeutic value. But once again, you need to realize that specific strains will have specific functions. As a result, the same probiotic supplement that works for “patient A” might not be effective for “patient B”.
When choosing a probiotic supplement, there are two main factors you need to consider. As I just mentioned, you want to be aware of the characteristics of the strain. The second factor you need to be aware of is the viability of the microorganisms. This is where the quality of the company comes into play, as the manufacturing procedures of the company is important, as is the packaging and storage. And of course most people don’t purchase probiotics directly from the company, but they either purchase them at a health food store, retail store, online, or from a healthcare professional. And so the companies which manufacture the probiotics ship the supplements to these companies, and so the transport mechanism also has to be considered.
Some strains need to be transported with an ice pack, while others are stable (unless if the temperature is extremely hot). Some probiotic supplements don’t need to be refrigerated, although even when this is the case it’s still a good idea to refrigerate them after being purchased. Although some sources will say that probiotics should be taken on an empty stomach, you ideally want to take a probiotic supplement with meals.
What Potency Is Ideal?
As for how potent your probiotic should be, it does depend on the situation. Not everyone needs to take a probiotic with 75 billion CFU. And some people don’t do well when taking high doses, as they experience gas and bloating. On the other hand, some probiotic supplements only have a few hundred million CFU, which frequently isn’t potent enough to produce a therapeutic effect.
Once again, the quality of the probiotic supplement is important. You can purchase a probiotic supplement that has 100 billion CFU, but if the strains aren’t viable then you might only be taking something equivalent to 5 billion CFU.
Can You Get Probiotics From Eating Fermented Foods?
Fermented foods can be a good source of probiotics. Some examples of fermented foods include yogurt, kefir, sauerkraut, and kimchi. Of course if someone is trying to avoid dairy (which I commonly recommend) then they won’t want to consume fermented dairy products, such as yogurt and kefir.
As for whether fermented foods have therapeutic effects, it of course depends on which food you’re eating. For example, many brands of yogurt don’t have a sufficient number of viable microorganisms, although many yogurt manufacturers routinely add certain species of probiotics. As I mentioned earlier, the strains will make a big difference. For example, both sauerkraut and kimchi have strains of L. plantarum, which have been proven to survive exposure to gastric acid and bile salts. Certain protocols such as the GAPS diet rely heavily on the use of fermented foods to help heal the gut.
Do You Need To Take A Separate Prebiotic Supplement?
Examples of prebiotics include fructooligosacharides (FOSs), galactooligosaccharides (GOSs), lactulose, and inulin, and their main purpose is to help to increase the number of beneficial bacteria, while at the same time reducing the number of pathogens. They can also enhance the immune system, improve the absorption of certain nutrients such as calcium and magnesium, help with constipation, and might help with other health issues. Some argue that taking prebiotics can serve as a substrate for candida and certain pathogens, although this is controversial.
As for whether it is necessary to take a separate prebiotic supplement, it really depends on the situation. You can get prebiotics by eating certain foods, such as asparagus, onions, garlic, artichokes, and chicory root. But if someone has an imbalanced gut flora then in some cases it might be a good idea to take a separate prebiotic supplement.
Understanding The Different Species and Strains
I’m not going to discuss all of the different species, but I did want to briefly mention the benefits of some of the strains I commonly recommend to my patients:
Lactobacillus acidophilus. This is probably the most well known species, and it is resistant to gastric acid and bile salts, along with pepsin and pancreatin. The strains Lactobacillus acidophilus LA-5 and LA-14 have been shown to inhibit certain pathogens (8) [8] (9) [9].
Bifidobacterium lactis. This species produces large amounts of antimicrobial substances. It also modulates the immune system response to help against pathogens. The species Bifidobacterium lactis BB-12 and HN019 are known for their antipathogenic and immune enhancement effects (10) [10] (11) [11] (12) [12].
Lactobacillus casei. This probiotic also improves the health of the immune system, and can be effective against certain pathogens such as H. Pylori (13) [13] and Candida albicans (14) [14]. There is evidence that the strains Lactobacillus casei CRL 431 and Lactobacillus rhamnosus CRL 1224 can be effective against Aspergillus flavus (15) [15], which is a fungi.
Lactobacillus plantarum. A few strains of lactobacillus have proven to be beneficial. Lactobacillus plantarum 299v has been shown to provide effective symptom relief, particularly of abdominal pain and bloating, in patients with irritable bowel syndrome (16) [16] (17) [17]. Lactobacillus plantarum Lp-115 also can benefit people with gastrointestinal disorders (18) [18].
Saccharomyces boulardii. Saccharomyces bouldarii is another well-researched strain with many different benefits. It is well known for helping people with a candida infection (19) [19] (20) [20]. It also can be useful in the maintenance treatment of Crohn’s disease (21) [21]. It can help to improve intestinal permeability (22) [22], and also can help to reduce inflammation and dysfunction of the gastrointestinal tract in intestinal mucositis (23) [23].
VSL#3. VSL#3 is a potent probiotic supplement consisting of multiple strains, and has numerous benefits. It can help people with ulcerative colitis (24) [24], and also improves symptoms in children with irritable bowel syndrome (25) [25].
Keep in mind that there are other beneficial strains besides the ones I listed. Two others worth mentioning are Bifidobacterium longum Bl-05 and lactobacillus reuteri mm53. And there are other beneficial strains as well.
Can Taking Probiotics Help People With Thyroid and Autoimmune Thyroid Conditions?
As far as I know there is no direct effect of probiotics on thyroid health. However, most people with “thyroid” conditions either have Graves’ Disease or Hashimoto’s Thyroiditis, which are autoimmune conditions that affect the thyroid gland. And since probiotics can help to improve the health of the immune system, then one can argue that many people with these conditions can benefit from taking a good quality probiotic supplement and/or making sure they eat plenty of fermented foods. But of course there are many other benefits besides modulation of the immune system, as I mentioned in this post how certain probiotic strains can inhibit pathogens, can help with intestinal dysbiosis, and even help to repair a leaky gut. All of these can be factors in people with thyroid and autoimmune thyroid conditions.
So hopefully you have a better understanding about the benefits of probiotics, including how they work, how to choose a good quality probiotic, and some of the benefits of the different species and strains. While I commonly recommend probiotic supplements to my patients, remember that fermented foods can be an excellent source of probiotics as well. Also remember that specific strains will have specific functions, and so you can’t assume that all strains within a certain species will have the same exact function, as this usually isn’t the case.