This is interesting............. | Arthritis Information

The Wall Street Journal has an assessment of Probiotics in the Jan 13, 2009 issue entitled Bug Crazy: Assessing the Benefits of Probiotics (1). For some reason when I wander around the hospital on rounds people show me articles such as this and ask, so whatcha think about this?

Probiotics are interesting. They are live bacteria given to treat and prevent diseases. It is one of those overlap areas for scientific medicine and so called alternative medicine. There are good clinical trials to suggest areas where these agents are of benefit, but other aspects of their use are blown out of proportion for the real or imagined benefit probiotics may provide. Much of alternative medicine where it overlaps with real medicine is the art of making therapeutic mountains out of clinical molehills.

The Wall Street Journal article is the kind of reporting that drives. me. nuts. It drive me nuts because the reporting acts as if the underlying assumptions of the therapies are true.

http://www.sciencebasedmedicine.org/

[QUOTE=Lynn49]

I mention all this so there is context as we explore the biologic plausibility and clinical utility of probiotics .

The reason d’etre for probiotics is inherently questionable: Normal bacteria gone, depleted, tuckered out? Take some extra bacteria and replete your ecosystem. Compared to the complexity of the GI micro environment, probiotics contain just a few bacteria, and not even the most common bowel organisms. It is safe to say that the “good’ bacteria so highly touted in probiotics are but a minor constituent of a complex flora.

Some further fine points about the probiotics
- Lactobacillus in yogurt in not necessarily lactobacillus usually found in probiotic pills. Yogurt is usually L. acidophylis or Lactobacillus bulgaricus. The yogurt bacteria turn sugar to lactic acid, making the milk curdle turning it into yogurt. The lactobacillus in probiotics contain one of more Lactobacillus casei, Lactobacillus plantarum, Lactobacillus reuteri , Lactobacillus rhamnosus, or Lactobacillus GG. As mentioned, these are not the Lactobacill found in humans.
-The Bifidobacterium found in probiotics are not necessarily the Bifidobacterium found in and on you. There are many strains of Bifidobacterium, only a fraction of which are included in probiotics.
- Saccharomyces boyardii, found in some probiotics, is not a normal part of your flora.
- Typical of the unregulated supplement industry, what is on the label may not be in the bottle of probiotic pills. In several studies that have compared what is on the label with what is actually grown, not only were the organisms misidentified, sometimes the bacteria were dead were dead. Organisms not mentioned on the label, like enterococcus, were sometimes isolated. But then enterococcus is a real constituent of the gi tract.

Probiotics, not being part of the normal flora, are cleared and cannot be isolated soon after stopping eating the probiotic. They are not normal flora and will not persist unless you keep consuming them.
If you are worried about your normal gut bacteria, be reassured. We are always consuming fecal flora in the food you eat and the water you drink. The food, your spouse, and the world, is covered in a thin patina of gastrointestinal bacteria, so you are always repleting your bacterial flora orally. Bon appetite. Families tend have similar bacterial strains. My gut flora more closely resemble my parents than my wife’s, suggesting there may be a genetic predisposition for which strains of bacteria make up your gut.
When you give probiotics to normal humans you are introducing, relative to the number and quantity of bacteria that are already there, a small amount of foreign bacteria. Continuing our metaphor, it is like trying to put a putting green in an Amazonian rain forrest. For normal people, it makes no microbiologic sense to take probiotics.
“For maximum benefit, scientists say, try to consume a variety of different bacteria, as each may contribute something slightly different.”Your best bet, with this reasoning, would be to eat a variety of human stool. That way you will get many different bacteria, all contributing something slightly different. “Probiotics are defined as “live micro-organisms which when administered in adequate amounts confer a health benefit,” according to 2002 guidelines developed by the World Health Organization and the United Nations. Exactly how this works isn’t fully understood, but scientists believe that good types of bacteria have long lived in symbiosis with humans and that the positive health effects may have evolved over time.”
Thats right. So why take large amounts of foreign bacteria and yeast that are not a normal part of your gastrointestinal flora?
“In choosing a probiotic, consumers should look for products that list a specific strain of bacteria on their label or on a Web site. Look for three names — in Lactobacillus rhamnosus GG, for example, the final two letters identify the strain. The GG strain has been well tested scientifically and has shown health benefits. A product that simply uses the first two names may include a similar, but not identical, bacterium that doesn’t have the same science behind it.”

Lynn492009-01-16 20:16:26

I didn't think much of probiotics myself until I had some major problems with my "gut" and had Florastor recommended to me by a gastroenterologist. He gives it to many patients that have IBS like symptoms and I'm telling you it does help. It's not a cure, but I will say that I've been on a few courses of antibiotics since then and don't get diarrhea from them any longer. I think probiotics are a good supplemental addition.

Bob

[QUOTE=bob_h76]

Bob

[/QUOTE]

My youngest daughter uses them too Bob when she takes an antibiotic. I just think people need to be aware that not all of them are what they say they are. Which I thought was the whole point of the article.......Just like with prescription meds, there are risks/benefits so you need to do your homework I have been having a lot of problems with my stomach lately. I mentioned it to the doctors a few months ago but haven't said anything recently because they are so busy with everything else. but every time I eat my stomach cramps violently for a few minutes, it doesn't last long but happens after eating or even after drinking water. maybe nausea is with it sometimes not.

but anyway, this article is very informative. I have been eating a lot of yogurt because I heard it is good because of the active cultures. However, not so sure about that after reading this article.

Thanks for posting.:)

There's a commercial on one of the Chicago radio stations advertising some probiotic, and they talk about various "imbalances" causing all sorts of maladies - fatigue, aches-n-pains, headaches, depression, stomach problems, weight gain, weight loss, yadda yadda yadda then they imply that THEIR probiotic (and not any of the other inferior products on the market) can make all these problems go away.

Then they give the standard "this product is not intended to treat/cure/help/etc" disclaimer.

Imagine the outrage if Motrin commercials implied that ibuprofen could brighten your mood, empty your colon, shrink your @ss AND ease your pain.

NikkiLynn - you are soooo cute! Seriously, every time it's semi- or anti natural meds you post with 'interesting' in the title. Cute...and predictable! Anyway, his beef about the claims about probiotics are interesting but he doesn't seem to up on the latest research. You seem to be quite a good Googler, have you seen the 4300+ studies on Pubmed about the benefits of probiotics? My new fave of course, is the dramatic drop in CRP levels. That should do it for us, wouldn't you think?

I love that fact that he's saying the research is paid for by probiotic companies. How is that different than the Steroid/Vitamin D research with all that conflict-of-interest-paid-for-by-the-vitamin-D-counsel-and-the-tanning-lobby exactly?

As you can see in the post itself - he says 'normal' people. We're sick people. One thing I truly wish they'd look into is probiotics and immunosuppressents. Seriously, if immunosuppressents allow previous exposure to infections to resurface, like pneumonia, and shingles as reported here on AI, you'd think that probiotics, with all the research into gut mucosa would give you guys more of a fighting chance at reaching and/or maintaining remission.

Anyway - Bob - the diarrhea with the 12 strains is normal. You have only so much water in your body. Traditional meds, if you start 'retaining water' will give you lasix (spelling) so you remove it from your body. It'll come out, usually in urine. Your body, when processing thru the GI tract, will either have the water in the stool (diarrhea) or in your cells (constipation). Some people believe that there is no difference between your optimum water level and constipation/diarrhea is actually the SAME THING. So, when starting up on probiotics, many people yo-yo between the two ends of the spectrum, so to speak, until they reach enough of a system balance and everything 'even's out' - so to speak. This is why most people starting probiotics experience gassiness, bloating etc - as the body attempts to reset. If you would have kept going, the diarrhea would have gone away. I speak from experience. :-)

Shelly - have you been tested for H. Pylori? Might you have an ulcer too?

Pip

I don't get the "logic" that if you can't get all of them you shouldn't take any of them.

In Europe Saccharomyces boyardii is sold by prescription and always prescribed along with probiotics.

So if it's a pharmaceutical in Europe is it still "woo woo cult medicine" in the US?

I can definitely tell a huge difference in well being when I use probiotics versus when I don't, and I don't need a double blind study to tell me that I do or an arrogant medical blogger to tell me that I don't.

By the way, when I asked my GP for a prescription for Nystatin, she said she'd rather I just take probiotics.

And she went to medical school.

Gimpy-a-gogo,

I notice you have minocin and a dmard in your footer. what is your daily pain level like on a scale of 1 to 10. I know it varies for all of us.

Just wishing I had done something like this in the beginning before RA sprouted into so many different conditions. I did the minocin, flagyl, and (can't remember the other antibiotic) cocktail. I herx'd the entire time and actually got worse. i am thinking I probably needed a dmard along side it. but it was never mentioned I could mix them. I see that seems to be a common thing now.

However, even though, it didn't work for me in the 11 months I was on it, I still believe it helps some. My thing is I support you for whatever you take and it helps. It doesn't have to be what I take because I haven't seen it where 2 people get the same results taking the same things. just haven't witnessed it at all. it seems this treatment therapy thing has to be tailored to the individual always and when it isn't they end up crippled by RA like me.

Hey Shelly. Yep, I took MTX for a little over 2 years. I've only been off it for about 3 weeks and before that I was taking 5mg/week for about 8 weeks.

My pain levels (on my personal scale) have been between a 0 and a 3, but 3 might be an exaggeration (I find it hard to be too precise with only 1 to 10 to work with). I have no morning stiffness, and no limitations to what I can do physically, but I am reminded on a daily basis I have RA.

I have noted that whenever I decreased mtx I would have about 8 or 12 weeks of adjustment before my RA would settle down to barely noticeable again, so I will see how having none goes.

When I started the really slow wean it wasn't done as much as it is now, but it's worked for me, so far!
Copyright ArthritisInsight.com