Probiotics: Friend or Foe?

I am a big fan of probiotics and I’m particularly fond of Kefir,

That, and live culture yoghurts play a big part in my diet and I would recommend them to you for a healthy and happy gut. But, like all good things, there can be drawbacks, and they are not suitable for everyone.

Let’s look at the benefits first, and then consider why they may not be suitable for some people. and identify who should be cautious about their use.Probiotics have garnered significant attention in recent years for their potential health benefits, so what are these little chaps?

They are live microorganisms, often referred to as “good bacteria,” and are found in various foods and supplements. While the benefits of probiotics are widely touted, it’s essential to understand both the positive and negative aspects of their consumption.

Here are some of the key advantages:

1. Enhanced Gut Health: Probiotics help maintain a healthy balance of gut bacteria, which is crucial for digestive health, where they can alleviate symptoms of gastrointestinal disorders such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) by reducing inflammation and promoting a healthy gut microbiota.
   2. Strengthened Immune System: Approximately 70–80% of the immune system is located in the gut lining, with the rest in the bone marrow and lymph glands. Probiotics can enhance immune function by stimulating the production of antibodies and modulating the activity of immune cells like T cells and macrophages.
   3. Prevention of Infections: They can help prevent infections by inhibiting the growth of harmful bacteria, as they produce substances like short-chain fatty acids (SCFAs) that create an unfavourable environment for pathogens.
   4. Allergy Prevention: Probiotics may play a role in preventing allergies by promoting the production of IgG antibodies instead of IgE, which are associated with allergic reactions.
   5. Improved Mental Health: Emerging research suggests a link between gut health and mental health, often referred to as the gut-brain axis. Probiotics may help alleviate symptoms of anxiety and depression by influencing this connection.

So that’s the good points, great as they are, but it’s not all sunshine and roses, for certain people anyway.

The downsides of Probiotics:

Despite their benefits, probiotics are not without potential drawbacks, and here are some of the negative aspects to consider:

1. Side Effects: Some individuals may experience side effects such as bloating, gas, and diarrhoea when they first start taking probiotics. These symptoms are usually temporary but can be uncomfortable.
2. Exacerbation of Certain Conditions: People with specific health conditions should be cautious with probiotics. For instance, individuals with small intestinal bacterial overgrowth (SIBO) or lactic acidosis may find that probiotics exacerbate their symptoms. SIBO is highly pro-inflammatory and can lead to severe discomfort.
3. Rheumatoid Arthritis: There is some evidence to suggest that probiotics could potentially trigger flare-ups in individuals with autoimmune conditions like rheumatoid arthritis, due to their impact on the immune system.
4. Uncertain Efficacy: While probiotics have shown promise in many areas, much remains unknown about how different strains interact with specific cells, such as mast cells and T cells. This uncertainty makes it challenging to predict their effects accurately.
5. Risk for Immunocompromised Individuals: People with weakened immune systems, such as those undergoing chemotherapy or with severe illnesses, should avoid probiotics unless advised by a healthcare provider. In these cases, probiotics could potentially cause infections.

Who should avoid Probiotics?

Given the potential downsides, certain groups of people should be particularly cautious about taking probiotics:

1. Individuals with SIBO: Probiotics can worsen symptoms of SIBO, leading to increased inflammation and discomfort.
2. People with Autoimmune Conditions: Those with conditions like rheumatoid arthritis should consult their healthcare provider before starting probiotics, as they may trigger immune system flare-ups.
3. Immunocompromised Individuals: People with compromised immune systems should avoid probiotics unless specifically recommended by a healthcare professional, due to the risk of infections.
4. Those with Severe Gastrointestinal Disorders: Individuals with severe forms of IBS or IBD should approach probiotics with caution and seek medical advice to ensure they do not worsen their condition.

Probiotics offer numerous health benefits, particularly for gut health and the immune system. But, as I said earlier, they are not suitable for everyone, and potential side effects and risks should be carefully considered.

If you are considering adding probiotics to your diet, either through Kefir, yoghurts or supplements, and especially if you have any of the medical conditions mentioned, it is essential to consult with your medical practitioner to determine if they are right for you.

References:

Frontiers | Modulation of Gut Microbiota and Immune System by Probiotics, Pre-biotics, and Post-biotics (frontiersin.org)

Understanding the health benefits of taking probiotics — Harvard Health

Subscribe to get my free weekly Newsletter, Healthwise, on Substack. All things Health, Wellness and Science

Click here: Healthwise: Exploring the Frontiers of Wellness and Science | Tom Kane | Substack