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									PROBIOTICS by Dr. Kris Peña

Background: Normally we have over a trillion bacteria or “flora” in our bowel, consisting of over 500 species. These
bacteria help us to digest our food, fight infection, produce vitamins and maintain a healthy immune system.
Alterations in these normal bacteria occur from:
  Stress                                      Hormones                                  Delivery by C/section
  Formula feeding as infants                  Stomach infections (stomach flu,          Diet
  Antibiotic use                              food poisoning)

Alterations in these normal bacteria can cause:
         Changes in stool habits Bowel disease Recurrent Infections Obesity             Vitamin deficiencies

What are probiotics? Probiotics are “good bacteria” given in the form of foods, drinks, pills or liquids that can help
replace the normal gut flora.

When are probiotics used? Probiotics may help the following conditions:
 Antibiotic or infection-induced diarrhea, including C. difficile, rotavirus and tube-feeding associated infections
 Irritable bowel syndrome and Inflammatory Bowel syndromes such as Crohns and Ulcerative Colitis
 Recurrent vaginal infections from Candida (yeast) or Bacteria vaginosis
 Recurrent bladder infections
 Obesity and bacterial overgrowth related to bariatric surgery
 Prevention of infant Necrotizing Enterocolitis (a condition seen in premature infants)
 Eczema and other allergic conditions
 Anxiety and other mood disorders                               Helicobacter pylori infection
 Possibly fibromyalgia, chronic fatigue syndrome                Vitamin deficiencies
 Autism                                                         Lactose intolerance
 May prevent certain forms of cancers

What to look for in a probiotic: There are many different forms of probiotics. When choosing a probiotic the
following are important:
 The amount of bacteria that survive into the gut (those that are not killed by normal stomach acid)
 The species or type of bacteria present
 The amount of bacteria - usually at least 10 billion units (CFU) per dose
 The quality of the supplement. Unfortunately these are not regulated and there are many poor products out there.
     Look for brands that have clinical studies or that display the stamp “Good Manufacturing Process” or GMP.

Some reputable brands include:
 VSL #3 (By VSL Pharmaceuticals)
 Klaire Lab formulations including Vital 10 and Ther-Biotic
 Fem-dophilus (by Jarrow)
 Yakult
 In general, products that are refrigerated and that contain more than one species are likely more effective

Are there safety concerns with probiotics? No. They have been tested in adults, and kids, including preterm infants,
and no ill effects have been demonstrated.

How should they be taken? In general, take probiotics by mouth with food at the end of a meal. If taking antibiotics,
take probiotics at least 1 hour before or two hours after an antibiotic or after you have completed the course of
antibiotics. Most are taken twice a day; follow manufacturer instructions. In the treatment of vaginal infections,
tablets can also be given vaginally. For treatment of bowel disorders, they can also be given rectally via special enemas.

What can I do to make the probiotic more effective? Good bacteria live off fibers called “pre-biotics”. Getting
sufficient amounts of prebiotic foods (such as onions, leeks, garlic, bananas, artichokes, asparagus) or taking a pre-
biotic in addition to the probiotic (called a „synbiotic‟) may be helpful. Supplement forms of pre-biotics are usually in
the form of inulin from chicory root. Some studies also suggest taking or eating significant amounts of Omega-3 fatty
acids can enhance the effects of probiotics.
What other foods are helpful? Fermented foods such as yougurt, sauerkraut, kimchi, fermented cheeses, naturally
fermented pickles (without vineagar) and miso may be helpful but probably don‟t have as much effect as a pill or other

CONDITION                               BACTERIA                                 PRODUCT
Allergies                               Bifidobacterium bifidum                  Ther-Biotic Infant Formula (Klaire)
                                        Lactobacillus rhamnosus                  Vital-Plex (Klaire)
Antibiotic associated diarrhea          Bifidobacterium bifidum                  ABx Support (Klaire)
                                        Bifidobacterium breve                    Saccharomyces boulardii
                                        Bifidobacterium infantis                 Ther-Biotic Complete (Klaire)
                                        Lactobacillus casei
                                        Lactobacillus gasseri
                                        Lactobacillus paracasei
                                        Lactobacillus plantarum
                                        Lactobacillus rhamnosus
                                        Saccharomyces boulardii (yeast)
                                        Streptococcus thermophilus
Candidiasis                             Saccharomyces boulardii (yeast)
Chronic Fatigue Syndrome                Bifidiobacterium
                                        Lactobacillus casei
Crohns Disease                          Bifidobacterium infantis                 Saccharomyces boulardii
                                        Lactobacillus rhamnosus                  VSL#3 (VSL Pharmaceuticals)
                                        Saccharomyces boulardii
Helicobacter Pylori                     Lactobacillus casei
Irritable Bowel Syndrome                Lactobacillus plantarum                  Ther-Biotic Complete (Klaire)
                                                                                 Vital-10 (Klaire)
Lowering Cholesterol                    Lactobacillus bulgaricus                 Ther-Biotic Complete (Klaire)
Necrotizing Enterocolitis               Bifidobacterium bifidum
                                        Lactobacillus acidophilus
Ulcerative Colitis                      Bifidobacterium infantis                 Ther-Biotic Complete (Klaire)
                                        Bifidobacterium longum                   VSL#3 (VSL Pharmaceuticals)
                                        Lactobacillus rhamnosus
                                        Streptococcus thermophilus
Urine infections                        Lactobacillus reuteri                    Fem-dophilus (Jarrow)
                                        Lactobacillus rhamnosus                  Ther-Biotic Complete (Klaire)
                                                                                 Vital-Dophilus Plus (Klaire)
Vaginal infections                      Lactobacillus brevis                     Fem-dophilus (Jarrow)
                                        Lactobacillus paracasei                  Ther-Biotic Complete (Klaire)
                                        Saccharomyces boulardii (yeast)          Vital-Dophilus Plus (Klaire)

Ordering information:
VSL #3 - or call 1-866-GET-VSL3
Klaire products - – physician code 743 (and no, we do not make any profit from sales)
Fem-dophilus – – this is now over the counter

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