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Should You Take Probiotics for Acid Reflux?

probiotics for acid reflux

You have probably heard about the many benefits associated with probiotics. But can you also trust probiotics for acid reflux relief? 

In this article I will describe acid reflux, how it relates to gut health, and how taking probiotics for acid reflux may help. 

What Is Acid Reflux?

Reflux happens when acidic stomach contents flow backward into the esophagus. While this happens a bit naturally, an increase in the frequency and severity of these episodes may start to cause symptoms like heartburn, tissue damage or other complications. Then it’s known as gastroesophageal reflux disease or GERD. (1)

There are two types of GERD:

Non-erosive reflux disease (NERD) 

This is when symptoms of GERD happen without visible damage to the cells lining the esophagus. (2)

In other words, you might be experiencing symptoms of reflux but your endoscopy comes back normal. About 70% of those suffering from GERD have this NERD subtype. (3

Erosive esophagitis (EE)/Reflux esophagitis

This is a different type of GERD in which reflux episodes lead to physical damage to the mucosa or other complications. (2)  

Acid Reflux Symptoms, Diagnosis, and Standard Treatment

Symptoms of GERD can overlap with other conditions, so these might need to be ruled out before GERD is diagnosed. (1)

GERD symptoms include:

  • Heartburn
  • Regurgitation
  • Chest pain
  • Sensation of burning/pain in the esophagus 
  • Belching
  • Frequent throat clearing
  • Hoarse voice 
  • Chronic cough 
  • Nausea
  • Bloating
  • Upset stomach 
  • Early satiety 

Standard treatment of GERD is focused on managing symptoms. Treatment usually starts with a trial of medication, often proton pump inhibitors (PPIs). (4) We’ll discuss this in further detail later in this article, so hang tight. 

In addition to medication, many practitioners recommend weight loss, keeping the head of the bed elevated when sleeping, avoiding late meals, stopping the use of alcohol and tobacco, and the elimination of foods that may trigger symptoms. (4)

While these medication and lifestyle changes will certainly help in reducing symptoms, there is another aspect of reflux that is often forgotten: bacterial imbalance in the gut. 

Acid Reflux and Imbalanced Gut Bacteria

Reflux symptoms are commonly perpetuated by gut dysbiosis and/or small intestinal bacterial overgrowth (SIBO). (5)

In the case of SIBO, bacteria translocate from the large intestine to the small intestine inappropriately, where they then ferment carbohydrates. 

Both the fermentation and the presence of bacteria in the small intestine can lead to several physiological changes including decreased gastric motility, prolonged relaxation of the lower esophageal sphincter, and increased intraabdominal pressure. 

These terms might sound complicated, but ultimately all you need to know is that these physiological changes have been implicated in causing reflux episodes. (6)

PPIs for GERD

How do bacteria end up in the small intestine in the first place? 

One common cause is actually the PPIs used to treat acid reflux! The way these medications work is by decreasing the amount of stomach acid you produce and increasing your gut pH, so that you experience less pain when you do have reflux episodes. 

While this approach can be effective for improving symptoms, it may be detrimental to your gut over the long haul.

When you have an appropriate amount of stomach acid, your body naturally moderates the growth and balance of bacteria in your gut. An acidic stomach pH is also important for optimal digestion and absorption of nutrients and protection from pathogens. 

When stomach acid levels are low or pH is too high, this creates the perfect conditions for pathogenic or commensal bacteria to take over and grow to unhealthy levels or to grow in the wrong places (like the small intestine). 

If you have been taking PPIs, you could be at higher risk of SIBO and other potential imbalances. (7) Given the role microbial imbalance may play in reflux, it’s wise to talk with your healthcare practitioner about whether a PPI is right for you in the long run. 

Not sure if you have imbalanced gut bacteria? You may want to test your gut bacteria with a healthcare provider. If your healthcare practitioner determines that you may have SIBO or other gut imbalances, resolving them may greatly improve your reflux.

Best Probiotics for Acid Reflux

Given that an imbalance of bacteria in your gut can play a role in reflux, do probiotics help with acid reflux? Let’s talk about the current research on probiotics for acid reflux. 

Probiotics are the good bacteria in your gut that are vital for both your gut and overall health. Probiotics can be found in fermented foods like yogurt and kimchi as well as in supplement form, which is what we’ll discuss here.

Probiotic effects are strain-specific, meaning that one strain will have an entirely different effect from another. That means it’s especially important to pay attention to the specific strains used in research — while one strain may be really great for reflux, another could have no effect whatsoever.

Unfortunately, only recently have researchers begun to disclose the specific probiotic strains they have used into their research instead of just discussing the more general probiotic species. 

To date, only 2 strains of probiotics have been studied for their potential benefit of improving reflux symptoms in adults.

The best probiotics for acid reflux include:

  • Bifodobacterium bifidum YIT 10347. This strain, given in cultured milk to healthy adults, was shown to improve GERD related symptoms. (8) Unfortunately, this strain does not appear to be commercially available in the US just yet. 
  • Bifidobacterium lactis HN019. This strain is available in Now Foods Clinical GI Probiotic and its use has been linked to improved improved GI symptoms in those with functional GI issues, including reflux. (9)

While there may not be much research on probiotics for acid reflux symptoms quite yet, I’m confident that we’ll see more research on this in the future. I’ll be sure to put any updates I see into this post! (And if you come across any studies you’d like to share, please feel free to leave them in the comments.)

But beyond their ability to affect reflux symptoms, probiotics may play another key role when it comes to this condition: preventing the dysbiosis that goes along with PPI use.

A very interesting study done on children in 2018 showed that only 6.2% of children who were given a probiotic (Lactobacillus reuteri DSM 17938) while taking a PPI developed dysbiosis, while 56.2% of those taking the PPIs alone (without a probiotic) developed dysbiosis. 

This means that even if you need to be on a PPI to manage your symptoms, taking a probiotic could help keep your gut bacteria balanced and healthy. 

If you’re interested in the specific strain they used in this study, it can be found in the Biogaia Gastrus probiotic supplement.

Deep Breathing for Acid Reflux

Beyond taking probiotics for reflux, there are a couple other ways you can help yourself manage this condition. Let’s discuss those.

Your gut and your brain are connected, which means they talk to each other constantly. This explains why uncontrolled anxiety, depression, and stress can lead to an increase in GERD symptoms. (10) Not dealing effectively with these conditions also makes it difficult for your body to heal and respond well to reflux treatment. 

One simple strategy that can calm your mind and also help improve your GERD symptoms over time is diaphragmatic breathing. (11)

To familiarize yourself with deep breathing, you can lay on the floor with a book on top of your belly. Breathe in deeply and you should see the book rise up from your stomach. What you’re trying to avoid is breathing from your chest. Now, simply lay there and continue breathing deeply for a few minutes. 

One of my favorite recommendations to clients is to incorporate a deep breathing practice at mealtime to help relax their body before it’s time to digest. To do this, they take 1-2 minutes before eating their food to sit down, relax, and breathe deeply. Bonus point for having your food in front of you so that you can smell it — this gets the digestive juices flowing.

I have found this practice to be incredibly effective for just about all my digestive health clients, but especially those who deal with reflux.

Melatonin for Acid Reflux

Melatonin may not be the first thing you think of when it comes home remedies for acid reflux. But your gut is responsible for producing more melatonin than your brain, which might explain why researchers have found melatonin for acid reflux to be helpful. (12)

In addition to helping you get a good night’s sleep, melatonin is thought to protect the gastric mucosa from free radical damage, influence secretion of stomach acid and certain digestion enzymes, and even have positive effects on anxiety and depression. (12)

A dose of 3-6 mg melatonin for at least 8 weeks has been proven effective for relieving acid reflux symptoms. Just make sure to take melatonin at bedtime to prevent daytime sleepiness, which was the only side effect seen in clinical trials. (12, 13) You can take a supplement like NOW Foods 3mg Melatonin.

The Bottom Line

If you are suffering from acid reflux, you are probably willing to try just about anything for some relief. But for many people, the key to resolving acid reflux for good lies in testing and correcting for potential gut dysbiosis and bacterial overgrowth. 

If you want to try a probiotic to ease some of your acid reflux symptoms, I would recommend NOW Foods Clinical GI Probiotic until other strains are better studied.

If you’re on a PPI, research shows that taking a probiotic like Biogaia Gastrus may help prevent the dysbiosis associated with taking these drugs.

Deep breathing and a melatonin supplement (like NOW Foods Melatonin) may also help relieve your reflux symptoms. 

Chronic Constipation: Natural Remedies for Relief

constipated

Chronic constipation is very common. It has been estimated that up to 24% of the population struggles with chronic constipation (1). Fortunately, there are many natural constipation remedies that can help you overcome this condition. 

In this article, I’ll go over exactly what chronic constipation is, what causes it, and my best tips to help you deal with it. 

What is Chronic Constipation?

Despite the prevalence of chronic constipation, it has no exact definition because it affects everyone differently. Chronic constipation is characterized by typical constipation symptoms (like difficulty passing stool, infrequent bowel movements, etc) that have persisted for at least 6 months (2). 

Constipation definition: “a disorder in the gastrointestinal tract, which can result in the infrequent stools and/or difficult stool passage with pain and stiffness.”  (3)

There are two different types of chronic constipation: 

Primary chronic constipation: Chronic idiopathic constipation that has no clear cause.

Secondary chronic constipation: Constipation that results as a side effect or comorbidity of medications, systemic, or neurological disease. (4). 

Chronic constipation treatments vary depending on the type and root cause. Most people can manage chronic constipation by making lifestyle changes, such as adjusting their eating habits or exercise behaviors. With that said, in some instances chronic constipation may become so severe that medications or surgeries are needed to treat it (5). 

There are several complications of constipation that can result if left untreated. Perhaps the most common adverse effect is a poor quality of life from the discomfort and embarrassment that chronic constipation sufferers tend to struggle with. Complications of constipation also include hemorroids, anal fisures, pelvic floor damage, fecal incontinence, and urinary retention (6). 

Chronic Constipation Symptoms and Diagnosis 

Chronic constipation symptoms vary depending on the severity. You may have chronic constipation if you’ve been dealing with more than two of the following symptoms for more than six months (7): 

  • Less than 3 bowel movements per week 
  • Straining during bowel movements more than 25% of the time
  • Lumpy, hard stools more than 25% of the time
  • Incomplete evacuation during bowel movements more than 25% of the time
  • Feeling of blockage more than 25% of the time
  • Requiring manual stimulation to pass stool more than 25% of the time 

Additionally, those with chronic constipation commonly have secondary symptoms, such as abdominal pain and discomfort, bloating, gas, and decreased appetite. 

What Causes Chronic Constipation? 

There are many chronic constipation causes that range from your genetics, to the motility in your colon, all the way down to the foods you eat and lifestyle behaviors you engage in. Certain medications and physiological conditions, such as pregnancy, are also known to be chronic constipation causes (8). 

Some populations struggle with chronic constipation more than others. For example, women are more likely than men to have chronic constipation. In particular, premenopausal and pregnant women report chronic constipation more often, likely due to hormone fluctuations. Further, older adults are diagnosed with chronic constipation at a higher rate than younger people (9).

How to Remedy Chronic Constipation

There are many different constipation remedies that can help you overcome this debilitating condition. 

Water for Constipation

I know, I know — you’ve possibly heard this one before. But before we jump into some of the more complex issues associated with chronic constipation, let’s make sure you’re drinking enough water!

One of the most overlooked chronic constipation treatments is the simple notion of drinking more water. Since your body is made up of 60 percent water, it makes sense that it plays a role in constipation if you’re not drinking enough. 

When you’re dehydrated, water may be withdrawn from the colon to help support other parts of your body. This prevents your colon from doing what it needs to do to promote healthy bowel movements, making your stool hard and difficult to pass (10, 11). 

Low water intake has been shown to be a common chronic constipation cause. Drinking more water for constipation is an easy adjustment you can make to your lifestyle to help you deal with the condition (12, 13). 

It’s generally recommended to drink at least 8 cups of water per day, but you may need more or less depending on how much you exercise and how many water-rich foods that you eat. 

Another way to calculate how much water you need is by dividing your body weight in half. The number you get is the ounces of water to aim to drink per day. For example: 

150 pound female divided by 2 = 75 = 75 ounces of water/day 

So do a quick calculation and make sure you’re drinking enough water! And if you are, let’s jump into some other issues to look at when considering chronic constipation.

Fiber for Constipation 

Fiber is an indigestible component of plants that plays a role in your digestive health. All plant foods contain fiber in some form, which can promote regularity by bulking up your stool and making it easier to pass, as well as supporting the health of your microbiome. 

Fiber for constipation is typically categorized based on its solubility: 

Soluble fiber: As it travels through the digestive tract, soluble fiber absorbs water and is fermented by bacteria in the colon. It slows down the time it takes for food to leave your stomach and improves the consistency and form of your stool, making it easier to pass. 

Insoluble: Insoluble fiber remains intact as it travels through your digestive system. It is known for speeding up the movement of food through your digestive tract by adding bulk to your stool. 

But can too much fiber cause constipation? In my clinical experience, I have noticed that increasing insoluble fiber tends not to help constipation that much (and sometimes even makes it worse), while increasing soluble fiber tends to be very helpful for my clients.

Prebiotic Fiber for Constipation

Prebiotics, a specific type of soluble fiber, are especially helpful for those with constipation. 

Prebiotics can be described as “food” for your gut bacteria. Prebiotics fuel your healthy gut bacteria and support those bacteria in their primary functions — producing antiinflammatory compounds like short chain fatty acids (SCFAs), strengthening the lining of your gut wall, and helping to eliminate harmful bacteria and other toxins from your digestive tract. 

Without prebiotics, your gut bacteria and overall digestive health struggle to thrive. When your gut bacteria are not in healthy balance, you may develop constipation.

High Fiber Foods List for Constipation 

The best foods for constipation are typically high in prebiotic fiber. Listed below are some high prebiotic foods: 

  • Chicory root
  • Dandelion greens 
  • Jeruselem artichokes 
  • Bananas 
  • Garlic 
  • Asparagus
  • Leeks
  • Apples
  • Onions
  • Jicama root
  • Flaxseeds
  • Barley
  • Oats
  • Cocoa
  • Burdock root
  • Yacon root 

Including these foods in your diet on a regular basis may help balance your gut bacteria and prove to be beneficial for chronic constipation.

It’s worth mentioning that if you’re not used to eating high fiber foods, you should gradually introduce them into your diet. Eating too much fiber at once, especially when your body isn’t used to it, can cause symptoms such as bloating and abdominal pain. 

Prebiotic Fiber Supplements for Constipation 

Taking prebiotic fiber supplements for constipation can sometimes be useful, especially if you’re unable to consume enough high fiber foods. 

That’s where fiber supplements for constipation come into play. There are many prebiotic fiber supplements that you can try for chronic constipation, including the following: 

  • Inulin 
  • Fructooligosaccarides (FOS) 
  • Galactooligosaccarides (GOS) 
  • Partially hydrolyzed guar gum (PHGG) 

Sunfiber (partially hydrolyzed guar gum) is one of the most well-tolerated prebiotics on the market and is especially useful for those dealing with chronic constipation. 

The research on Sunfiber is particularly impressive; many studies have shown that those who take Sunfiber even at dosages as low as 5 g/day report improvements in bowel movement frequency, abdominal pain related to constipation, and stool frequency. (14)

I have found Sunfiber so useful in my own practice that I created Gut Power Matcha to make getting it into your diet even easier. Gut Power Matcha contains a blend of Sunfiber, probiotics (Bacillus coagulans GBI-30 6086), and organic matcha green tea from Japan to support the health of your gut.

In just one serving, you get 6g of Sunfiber, 1 billion CFU probiotics, and a delicious cup of matcha tea! 

If you suffer from constipation, incorporating prebiotic fiber into your diet whether it be in food or supplemental form, is a very wise idea.

The Gut-Brain Connection: Addressing Stress to Help Constipation 

Your gut and your brain are interconnected, so stress and constipation often go hand-in-hand. 

In fact, the gut is often referred to as your “second brain” because it contains over 100 million nerve endings (15). It produces neurotransmitters, including serotonin and dopamine, and has many other similarities to your true brain.

When you are stressed, your body goes into “fight or flight” mode where it focuses much more on short-term survival versus thriving long-term. This means that during these times, your body is focused on pumping blood to your muscles (in case you need to fight or run away from a threat) and pushing glucose to your brain to help you think clearly. 

What it’s not doing when you’re stressed is getting blood to your digestive system; because of this, your digestive system may not function properly. For some people, this results in diarrhea, while for others it means constipation.

Stress is also known to disrupt the balance between good and bad bacteria in your gut. This imbalanced gut bacteria is associated with a multitude of chronic health conditions, including digestive conditions like IBS, which is a common cause of chronic constipation. We’ll discuss imbalanced gut bacteria in further detail a bit later in this article, so hang tight! 

Many studies have shown a correlation between certain psychological disorders and chronic constipation. Stress and constipation are often a result of anxiety, depression, and other emotionally taxing life events (16). 

The truth is that no one has the ability to live a completely stress-free life (if you do, please share your secrets!). But working to manage your stress can make a big difference in your chronic constipation.

Remember that self care isn’t all bubble baths and pedicures…it’s more about parenting yourself to make sure you go to bed on time, schedule time for exercise, pack your healthy lunch, and do all the things you can to make sure you’re living a healthy lifestyle and taking care of yourself. 

Do some deep breathing, take a walk, talk to a friend…do what you need to do to relax and take care of yourself for at least a few minutes every day. Managing stress is important for everyone, but if you suffer from stress-induced chronic constipation, it’s especially beneficial. 

Probiotics for Constipation 

Probiotics are good gut bacteria that support your health — they can be found in both food and supplemental form. 

The research on probiotics and their effect on constipation is mixed. 

However, this is to be expected since probiotic effects are strain-specific. That means that not every strain of probiotic will be useful for a condition. Instead, you need to choose the probiotic strain that is appropriate for the condition or symptoms that you are dealing with. You can learn more about how to identify probiotic strains and why they’re important in this article.

Because of this, we see that some probiotic strains may be useful when it comes to constipation, while others make no difference at all compared to placebo.

There are a few probiotic strains that have been shown to be helpful in reducing constipation symptoms:

  • VSL #3: This is a blend of a few different probiotic strains that were studied in combination. (Please note that the probiotic blend found in VSL #3 is now found under the brand name Visiome, which is why you will see the VSL #3 link direct you to Visbiome.) (16)
  • Lactobacillus casei Shirota: This strain is found in the beverage brand Yakult, which is sadly not available in the United States. (17)

Other strains, such as Bifidobacterium lactis NCC2818, have not been found to reduce constipation symptoms any better than a placebo. (18)

Because researchers for so long have not been studying specific probiotic strains and instead focusing on probiotic species, we are really just at the beginning of finding out more about how we can use probiotics to affect our health.

It would not surprise me to find out that there are many more probiotic strains that could help alleviate constipation in the near future as we gather more research, so keep an eye out!

For the time being, you can try one of the strains listed above to see if it helps reduce your constipation symptoms.

Balancing Gut Bacteria to Relieve Chronic Constipation

If you suffer from chronic constipation, it’s a good idea to test your gut bacteria

This is because an imbalance of good and bad bacteria in your gut can play a significant role in constipation. 

Methane gas production from specific bacteria within the microbiome may play a role in constipation. When researchers give patients antibiotics like rifaximin, methane production decreases and, subsequently, constipation symptoms dissipate. (19)

Testing your bacteria to determine if you have conditions like SIBO (small intestinal bacterial overgrowth) or dysbiosis (an imbalance of bacteria in the large intestine) can help your healthcare practitioner determine if antibiotics or herbal antimicrobials may be appropriate for you.

In addition to killing off certain bacteria with antibiotics or antimicrobials, using microbiome-modulating supplements like prebiotics and probiotics can also help to rebalance your gut bacteria and potentially improve your constipation symptoms as well.

If you’re interested in testing your gut bacteria and learning more about rebalancing your microbiome, you may want to check out my 8-week online program, Build Your Biome.

The Bottom Line 

Chronic constipation is challenging to deal with, as there are many different causes that can be tricky to identify. The good news is that there are plenty of strategies to help you deal with chronic constipation. Managing chronic constipation is crucial for your overall health and quality of life. 

Strategies for managing chronic constipation range from making lifestyle and dietary changes to testing your gut bacteria and incorporating microbiome-modulating supplements.

It’s important to note that you should work with a healthcare practitioner if you are dealing with chronic constipation. They can help you to rule out underlying conditions that may be causing it, as well as help you come up with a treatment plan that makes sense for your symptoms and lifestyle. 

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Sunfiber (Partially Hydrolyzed Guar Gum PHGG): The Best Prebiotic for Digestive Problems

sunfiber partially hydrolyzed guar gum PHGG

Sunfiber (partially hydrolyzed guar gum or PHGG) is one of the most well-tolerated prebiotics on the market and is especially useful for those dealing with symptoms like bloating, gas, constipation, and diarrhea. Learn more about how Sunfiber might be helpful for you in this article.

As someone who works almost exclusively with clients with digestive problems, I get really excited about prebiotics (a substance that feeds healthy gut bacteria) that are well-tolerated even by those with issues like bloating, gas, diarrhea, and constipation.

I’m a huge fan of pretty much all prebiotics as they can all be useful for those with imbalanced gut bacteria — much like probiotics being strain-specific in their effects, each prebiotic has a slightly different effect on the beneficial bacteria colonies that live in your gut.

But the problem with many prebiotics is that they’re not particularly well-tolerated by those with digestive problems…and as you can imagine, these are often the people that need them most!

Some prebiotics cause digestive problems, especially when taken in high doses right away. The most common digestive side effect when taking prebiotics is bloating.

The Well-Tolerated Prebiotic Fiber

Sunfiber is very unique in that sense; unlike most other prebiotic fibers, it is actually very well-tolerated by most people with digestive issues. 

It’s a prebiotic I’ve used for years in my practice with much success because of how well it’s tolerated.

In fact, it’s my go-to prebiotic choice because of this — I know that it’s very unlikely that a client won’t respond well to it. Sadly, this isn’t the case with many other prebiotic choices on the market.

So let’s dig into why Sunfiber is an excellent choice for a prebiotic and how it is especially helpful for those dealing with digestive complaints.

The Scientific Evidence

Now, just because a prebiotic is well-tolerated by those with digestive issues doesn’t necessarily mean that it’s effective. That’s where looking at the research comes in handy — we want to see that taking Sunfiber provides a benefit, of course!

Partially hydrolyzed guar gum (PHGG) is very unique in that the scientific evidence supports its use in a range of digestive issues, including reducing constipation, diarrhea, abdominal pain, and more.

Sunfiber Reduces Constipation

Sunfiber (partially hydrolyzed guar gum) has been used in many studies to reduce constipation and increase bowel movement frequency. In addition to this, research shows that PHGG consumption improves stool consistency, changing it from hard to normal.

Consuming Sunfiber also seems to reduce the need for the use of laxatives and enemas, taking their use from 2 to <0.1 and 7-8 to 1-3, respectively.

Partially hydrolyzed guar gum at 5g/day increases colonic transit time (essentially the speed at which your digestive system moves food through it) by about 12 hours in constipated patients, and by about 22 hours in those with slow transit time. 

Interestingly, these benefits occurred when using a wide range of dosages of Sunfiber within these studies. Dosages from 5g/day to 36g/day were used, all with significant benefits to constipation.

This means that even at dosages as low as 5g/day, you may notice improvements in bowel movement frequency, abdominal pain related to constipation, and stool consistency.

Sunfiber Reduces Diarrhea

Acute instances of diarrhea can be disruptive and sometimes dangerous.

Sunfiber significantly reduces the incidence of diarrhea as well as the frequency of diarrhea in those with health issues that make them more prone to this condition.

In a study of healthy adults made to have diarrhea (by giving them a hefty dose of sugar alcohols), 10g of Sunfiber strongly reduced the incidence of diarrhea by a cumulative 82%.

It seems that a higher relative dose of partially hydrolyzed guar gum is beneficial for diarrhea — these studies used doses from 5g all the way up to 28g/day with good effect. 

Given the evidence, I suggest around 10g/day for those dealing with diarrhea.

Sunfiber Improves IBS Symptoms

Irritable Bowel Syndrome (IBS) is a condition that can lower your quality of life significantly. It also happens to be where Sunfiber really shines.

Sunfiber (partially hydrolyzed guar gum) has been shown to significantly improve a host of IBS symptoms, including:

  • Bloating
  • Abdominal Pain
  • Bowel habits
  • Flatulence (gas)
  • Abdominal spasm
  • Quality of life

In addition to this, Sunfiber decreases the concentration of methane in stool. This may be particularly helpful for those dealing with methane dominant SIBO.

The dosages used in these studies ranged from 5-10g/day, but even at the lower dosage partially hydrolyzed guar gum was highly effective in reducing IBS symptoms.

Therefore, if you suffer from IBS, just taking 5g/day of Sunfiber may help improve your symptoms.

Many of these studies had participants taking Sunfiber for at least 3 weeks, so make sure to give it some time to start working! You’ll need to take Sunfiber daily for at least this amount of time to start noticing a difference.

Sunfiber is Prebiotic

Partially hydrolyzed guar gum (Sunfiber) is a prebiotic, meaning that it increases the number of healthy bacteria in your gut microbiome.

Research shows that Sunfiber increases counts of Bifidobacteria and Lactobacillus species — two of the main beneficial bacteria present in your gut.

In addition to this, Sunfiber is highly fermentable. This means that your bacteria can “eat” Sunfiber, and when they do, they produce highly beneficial compounds called short-chain fatty acids (SCFAs).

Short-chain fatty acids fuel the cells of your digestive tract, keeping your gut (and your body as a whole) healthy.

I recommend taking at least 6g of Sunfiber per day if you’re specifically looking for prebiotic effects.

Taking Partially Hydrolyzed Guar Gum (PHGG)

As you can see, Sunfiber may be a great choice for you if you suffer from digestive issues and want help reducing your symptoms.

The dosage you may want to take ranges a bit, but in general I would recommend at least 6g/day because that is the point at which Sunfiber becomes prebiotic (meaning that we see significant increases in the counts of beneficial bacteria in the gut microbiome).

From there, we see dosages go up to 36g/day in some of these studies — clearly, you can take quite a lot of it and notice benefits!

However, it is clear from this research that a high dosage like that may not be necessary for symptom improvement.

In general, I recommend keeping your intake anywhere from 6g to 20g/day.

As mentioned above, it’s also important to be consistent with taking partially hydrolyzed guar gum in order to notice the benefits. I typically tell my clients to expect to notice symptom improvement within a few weeks of taking Sunfiber daily.

Gut Power: An Easy Source of Sunfiber

Sunfiber is one of my favorite prebiotic fibers out there, so when I wanted to create a prebiotic & probiotic drink mix, I knew I wanted to include Sunfiber in it.

Gut Power Matcha is a blend of prebiotics (Sunfiber partially hydrolyzed guar gum), probiotics (Bacillus coagulans GBI-30 6086), and organic matcha green tea from Japan.

In just one scoop, you get not only a delicious cup of matcha but also 6g of Sunfiber and 1 billion CFUs of our probiotic strain.

It’s truly the easiest, tastiest way to support your gut health!

Want to try it for yourself? Click here to order.

The Bottom Line:

Sunfiber is a well-tolerated prebiotic fiber with a lot of evidence supporting its use in those with digestive complaints. Partially hydrolyzed guar gum has been shown to significantly improve symptoms such as constipation, diarrhea, bloating, flatulence (gas), abdominal pain, and more.

For an easy way to incorporate Sunfiber on a daily basis, try Gut Power Matcha, which includes 6g of Sunfiber per serving.

Resources

This article is a summary of an excellent review article: 

Rao, Theertham Pradyumna, and Giuseppina Quartarone. “Role of guar fiber in improving digestive health and function.” Nutrition (2018). Link to article.

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Prebiotics and Probiotics…What is a Prebiotic vs Probiotic?

prebiotics and probiotics

Despite sounding very similar, prebiotics and probiotics are quite different and play different roles in the gut microbiome. So what is a prebiotic vs probiotic?

What are Prebiotics?

Prebiotic definition: “a substrate that is selectively utilized by host microorganisms conferring a health benefit.” (1)

This essentially means that the definition of a prebiotic fiber is anything that bacteria living in your gut (or elsewhere) can use to thrive. When these beneficial bacteria thrive, they help you, their host, thrive as well. Thus, prebiotics, by way of helping your good gut bacteria thrive, “confer a health benefit” to you.

Prebiotics provide health benefits by helping your healthy gut bacteria do what they’re supposed to do — produce beneficial compounds like short chain fatty acids (SCFAs), strengthen your gut integrity, and push out bad bacteria.

Prebiotics are most often non-digestible fibers, but more recent research shows that prebiotics can also be things like polyphenols (a type of antioxidant).

Types of Prebiotic Supplements

The most common prebiotic supplements you’ll find include:

  • Inulin
  • Fructooligosaccharides (FOS)
  • Galactooligosaccharides (GOS)
  • Partially hydrolyzed guar gum (PHGG)

That said, there are also many high prebiotic foods out there, too!

Prebiotic Foods

High prebiotic foods include:

  • Chicory root
  • Jerusalem artichokes
  • Dandelion greens
  • Bananas (especially green bananas)
  • Asparagus
  • Apples
  • Cocoa
  • Flaxseeds
  • Burdock root
  • Yacon root
  • Garlic
  • Onions
  • Leeks
  • Jicama root

What are Probiotics?

Probiotics definition: live microorganisms that confer a health benefit to the host. (2)

So what does this mean exactly? Well, it means that when you take probiotics, you’re consuming live bacteria or other organisms.

While that may sound a little strange, these little gut bugs are actually quite good for you! Part of the definition of a probiotic is that in order to be considered one, that bacteria must actually provide a benefit to you, their host.

That’s why harmful bacteria, like Salmonella, for example, are not considered probiotic. These bacteria cause harm instead of benefitting you. Probiotics, on the other hand, make you healthier!

You can consume probiotic supplements as well as probiotic foods to get these healthy bacteria into your body.

Probiotic Strains

When choosing a probiotic, it is very important to consider the specific strain you’re going to take. That’s because the probiotic strain dictates what kind of health benefits that probiotic might offer.

When looking at the probiotic strain level, you should see 3 different parts of the probiotic name.

Take a look at the image below to see the different parts of the probiotic name, including the probiotic strain.

probiotic strain

Because different strains of the same species may provide completely different benefits, it’s important to choose your strain carefully. This becomes especially important when you’re choosing a probiotic supplement — not all probiotic supplements tell you what strain they contain!

Probiotic Foods

Of course, you can also consume probiotics in the form of probiotic foods.

Probiotic foods include:

  • Sauerkraut
  • Kefir
  • Kvass
  • Pickles (make sure they’re fermented, not pickled in vinegar)
  • Kimchi
  • Kombucha
  • Yogurt

You can ferment all sorts of veggies yourself, too! Learn how to ferment your own vegetables here.

Prebiotic vs Probiotic

Hopefully by now, you understand the differences between a prebiotic vs probiotic.

Remember, probiotics are live organisms.

Prebiotics are anything that helps those organisms already in your gut thrive.

Both prebiotics and probiotics must be proven to provide a benefit to you, though. If a certain strain or fiber hasn’t been studied or hasn’t been shown to actually provide a benefit, it is not a probiotic or prebiotic.

Provided that you’re taking prebiotics and probiotics that have been clinically-proven to be beneficial, taking both is a really great idea!

What is a Synbiotic?

Speaking of both prebiotics and probiotics…that’s a synbiotic!

Synbiotic definition: a combination of prebiotics and probiotics.

Synbiotics make supporting your gut health easy by including both prebiotics and probiotics in one food or supplement.

But you need to choose your synbiotic supplement carefully because some of them only contain very, very small amounts of prebiotics — not enough to really provide any health benefits.

If you’re trying to choose a prebiotic and probiotic supplement, make sure it contains grams of prebiotics, not milligrams. You need a big dose of prebiotics in order to get the health benefits from it in most cases, but most prebiotic and probiotic supplements only give you tiny doses of prebiotics.

This is essentially just “marketing spin” — they want to be able to claim that their product contains prebiotics, when in reality, that tiny amount of prebiotic isn’t providing any health benefits to you. Lame!

I got so frustrated with all of the prebiotic and probiotic supplements out there that I actually created my own synbiotic product called Gut Power Matcha. I like to think it’s the best prebiotic and probiotic product out there!

gut power matcha

In every serving of Gut Power Matcha, you get 6 grams of prebiotic fiber and 1 billion CFU probiotics. All that in a delicious cup of matcha green tea, too!

Gut Power Matcha is truly the easiest, tastiest way to support your gut health and get your prebiotics and probiotics!

Have you ordered yours yet?

Why Probiotic “Strains” Are Important & The Best Probiotic Strains on the Market

best probiotic strain

Did you know that the strain of a probiotic determines its effect? And that most probiotic supplements don’t tell you what strain they contain? In order to take the best probiotic for you, you need to understand which strain will give you the benefits you’re looking for.

What is a Probiotic?

No doubt you’ve heard all the hype about probiotics.

“Probiotics will heal your gut!”

“Probiotics will prevent food sensitivities!”

“Probiotics treat IBS!”

…among others.

There’s a million claims out there and a million more probiotic supplements to buy. So how do you know what the best probiotic supplement is?

Before we jump into that, let’s quickly define probiotics:

Probiotics, at their most basic definition, are “live microorganisms which when consumed in adequate amounts as part of food confer a health benefit on the host” (according to the World Health Organization).

What is a Probiotic Strain?

Probiotic strains are where things get a bit more complicated.

You see, most of us are used to seeing probiotic names listed on labels with two parts to the name.

For example, you might see “Lactobacillus rhamnosus” on a supplement label and nothing more than that. Looks pretty legit, right? It’s a complicated name that most of us probably wouldn’t pronounce correctly.

But the truth is that it’s missing the most important part of its name — its strain.

Probiotic effects are strain specific. That means that you can’t expect Lactobacillus rhamnosus GG to do the same things as Lactobacillus rhamnosus PB01. Those third letters/numbers (e.g. “GG” and “PB01”) are the strain of the bacteria and are extremely important when you are evaluating the best probiotic supplement for you.

For example, Lactobacillus rhamnosus GG is a highly-studied strain that has a whole host of benefits, including preventing antibiotic-associated diarrhea, C.difficile treatment, and promoting intestinal barrier function.

On the other hand, Lactobacillus rhamnosus PB01 is mostly studied for urogenital infections in women, sperm motility, and pain.

So if you’re looking for a probiotic to prevent diarrhea while you’re on an antibiotic, should you really be taking a probiotic that has mostly been studied to help get rid of a urinary infection or improve sperm motility? Absolutely not!

The best probiotic for you is going to be different from the best probiotic for someone else.

heal your gut

Probiotic Naming

When it comes to probiotics, you generally need to look at 3 different parts of the name.

The first part (e.g. Lactobacillus) is the genus.

The second part (e.g. rhamnosus) is the species.

And the third — most important — part (e.g. “GG” or “PB01”) is the strain.

When looking at a probiotic supplement you’re about to buy or take, you must make sure that it lists the strain, not just the genus and species.

Why Probiotic Strain Matters

Without knowing the strain of the probiotic you’re taking, it’s impossible to know the effect that a probiotic might have on your health.

And when you’re spending your hard-earned money, don’t you want to know exactly what you’re paying for?

While your husband might benefit from the sperm-motility-enhancing effects of Lactobacillus rhamnosus PB01, you might be better served by the leaky-gut preventing aspect of Lactobacillus rhamnosus GG.

Makes a big difference, doesn’t it? 

Remember: the best probiotic for you won’t be the same for someone else.

Choosing the Best Probiotic Supplement for You

In order to pick the best probiotic supplement for yourself, you now know that you need to look for the strain of probiotic that your supplement contains.

But more often than not, you’ll simply see up to the species level on a probiotic label. So you might see “Lactobacillus rhamnosus” on the label instead of “Lactobacillus rhamnosus GG”.

Now, I hope that these supplement companies are just ignorant instead of blatantly trying to dupe their customers.

But the truth is that you need the strain information in order to make a decision about the best probiotic supplement for yourself. And if the probiotic company that you’re trying to buy from doesn’t list it and won’t tell you, chances are that it’s a poorly-studied strain, or doesn’t do what they’re advertising it does.

If you’re looking at a probiotic supplement and the strain isn’t listed, you can contact the company and ask what strain they’re using. But don’t be surprised if they tell you that their probiotic mixture is “proprietary” (i.e. they don’t want to tell you what’s in it).

If that’s the case, I recommend steering clear. They either don’t want you to know that they’re using a poorly-researched strain of probiotics or they’re simply ignorant to the fact that the strain of probiotic really matters and determines the benefit that you’ll receive as the consumer. I usually want to give these companies the benefit of the doubt, but honestly, if you’re making a probiotic supplement you should know this stuff is important.

Let’s go through an example.

Take a look at the supplement facts for Klaire Labs Therbiotic Complete supplement below:

probiotic strain

You’ll notice that there are only two words for each type of bacteria, indicating that we’re getting to the species level, not the strain level.

We’ve talked about Lactobacillus rhamnosus strains throughout this article, and as you can see above, they just list “Lactobacillus rhamnosus” without telling us whether it’s Lactobacillus rhamnosus “GG”, “PB01”, or any other number of Lactobacillus rhamnosus strains. Who knows!

I reached out to Klaire Labs to see if they’d tell me the strains included but — surprise! — that’s “proprietary information”:

probiotic strain

I can only hope that Klaire Labs will get their act together if they want to serve their customers well.

On the other hand, take a look at the label for Florastor:

probiotic strain

We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)

Another supplement I like and use a lot, Culturelle, also lists their strain on the label (though they do so in a somewhat confusing way):

probiotic strain

Here we see “Lactobacillus GG” written, so while they’ve given us the strain (“GG”), they don’t include the species level. I am guessing this is for space concerns on the label, but I wish they’d include all three parts of the name so that people don’t get confused.

However, you can rest assured that they are actually giving you the strain name. Sometimes you might also see strains listed with their copyrighted name, like “LGG®” (that’s the copyrighted name for Lactobacillus rhamnosus GG).

heal your gut

The Best Probiotic Supplements that Actually Tell You Their Strains:

I realize that after learning this, you might feel a bit overwhelmed at the idea of finding a probiotic supplement that actually lists its strains and those strains are appropriate for you.

So here’s a list of the best probiotic supplements in my book (in no particular order), along with a few reasons why I might use them.

Someday I hope to add my own supplement to this list because, truly, we need more choices for quality probiotic supplements. Might have to step up and take things into my own hands!

Gut Power Drinks (Bacillus coagulans GBI-30 6086)

Full disclosure, this is actually my company! I started Gut Power Drinks to make the tastiest way to get prebiotics & probiotics into your diet.

The probiotic strain, Bacillus coagulans GBI-30 6086, has been researched in those with digestive problems like bloating, bowel changes, and abdominal pain.

It’s a great strain to support both digestive and immune health when combined with a healthy diet and lifestyle!

gut power matcha

Culturelle (Lactobacillus rhamnosus GG)

I use Culturelle in clients who have IBS-like symptoms (gas, bloating, diarrhea, constipation, abdominal pain, etc), as well as those who are currently on antibiotics or those who have dysbiosis.

Florastor (Saccharomyces boulardii CNCM I-745)

I use Florastor with clients who are taking antibiotics, or who have diarrhea, SIBO, giardia, candida, blastocystis hominis or H.pylori. It’s a favorite of mine!

Jarrow Ideal Bowel Support (Lactobacillus plantarum 299v)

I love Jarrow Ideal Bowel Support for those with IBS-like symptoms like excessive gas, bloating, diarrhea, constipation, abdominal pain, and more.

Now Foods Clinical GI Probiotic (Bifidobacterium lactis HN019, among others)

I use Now Foods Clinical GI Probiotic in those who have dysbiosis or who I think have slow motility. It is also useful for metabolic issues and helps your immune system.

Quick note about some formulations with multiple strains (including this one): Take a look at the label below and you’ll see that the supplement contains a mix of strains, but the label just says there is a total of 20 billion CFUs (how they measure the amount of bacteria). This does not tell us how much of each particular strain there is, and we want to know that there are at least 1 billion CFUs per strain to get a beneficial effect.probiotic strain

Given that the supplement label is not clear enough to tell us if each of these strains is present above 1 billion CFUs, I would only use this supplement if you’re looking to get the HN019 strain and consider all other probiotics “bonuses” since it’s impossible to know how much you’re getting.

Metagenics UltraFlora Synergy (Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07)

Metagenics UltraFlora Synergy is also great for preventing antibiotic-associated diarrhea, so it’s a good choice if you’re on antibiotics.

It’s also useful in dealing with bloating and abdominal pain, as well as improving the balance of your gut microbiome. In addition to this, is great for your metabolic system and insulin sensitivity.

Note: This is an example of a multi-strain probiotic that tells you how much of each strain there is, unlike the Clinical GI probiotic above. We see on the label that there are a total of 15 billion CFUs and it also tells us that it is a 50:50 split between the two strains present.

probiotic strain

Solgar Advanced Multi-Billion Dophilus (Bifidobacterium lactis Bb12, among others including L. rhamnosus GG)

Solgar Advanced Multi-Billion Dophilus is also very useful for preventing antibiotic-associated diarrhea, as well as preventing constipation. It is also helpful for improving blood glucose levels.

Note: This is another example of a multi-strain probiotic that tells you how many CFUs are present for each strain. In fact, I like this label the best since it lists the exact number of CFUs for each individual strain.

Visbiome (Lactobacillus acidophilus DSM 24735, Lactobacillus paracasei DSM 24733, Lactobacillus delbrueckii bulgaricus DSM 247634, Bifidobacterium breve DSM 24732, Bifidobacterium infantis DSM 24737, Bifidobacterium longum DSM 24736, Streptococcus thermophilus DSM 24731)

Visbiome is a highly-researched strain blend that is very potent. This probiotic supplement can be used for IBS, ulcerative colitis, antibiotic-associated diarrhea and more.

The Bottom Line

As you can see, knowing the particular strain of probiotic that you’re taking is extremely important. Without knowing it, you have absolutely no idea what benefits (or potential detriments) that strain might offer.

Probiotic effects are strain-specific meaning that one strain of a species might have completely different effects on a person than another strain.

Because of this, it is vital that you know what strains you’re buying and also that the strain you’re buying has the effect that you’re looking to get! This allows you to choose the best probiotic supplement for you.

Without knowing this, you might be throwing money down the drain by taking expensive supplements that haven’t been well-researched and don’t give you the results you’re looking for.

So consider this your PSA: Don’t buy probiotics without knowing the strain you’re buying!

,

The Best Probiotic for BV: BV Treatment Over the Counter That Works

best probiotics for bv - bacterial vaginosis

Bacterial vaginosis (BV) can be an incredibly frustrating condition to live with. More often than not, it’s something that women deal with for months or years, with little help from their doctors. Luckily, using probiotics for BV can make treating this condition much easier! In this article, I’ll go over exactly what bacterial vaginosis is, the typical BV treatment, how to address recurring BV, and how probiotics for bacterial vaginosis can help.

In doing research for this post, I came across so many stories from women all over the Internet and it really broke my heart to read them. Women who experienced extreme pain during sex, said they were embarrassed to have any sexual contact, were constantly thinking about how “fishy” they smelled, or worried if they would ever find someone who could love them. There were many women who told their stories of living with BV for years, and could not find a solution.

So this article is dedicated to you — I hope it helps you find relief.

Disclosure: Some of the links in this post are affiliate links, which means that I receive compensation when you buy from these vendors. Please note that I vet each product and do not recommend products that I do not believe in. Thank you for supporting me!

What is BV (Bacterial Vaginosis)?

Bacterial vaginosis (BV) is an imbalance of good and bad bacteria (also referred to as dysbiosis) in the vagina. BV is thought to be a sexually-transmitted disease.

Normally, the majority of the bacteria in the vagina are from the Lactobacillus genus. When Lactobacilli are in high numbers, these bacteria keep the vaginal environment acidic by producing lactic acid, which helps to prevent “bad” bacteria from taking over.

BV is the most common cause of vaginal symptoms and it is believed that ~29% of women of childbearing age have bacterial vaginosis. The rates of BV differ between ethnicities, with Black women being at the highest risk (51%), followed by Mexican women (32%), and white women (23%). (1)

When you develop BV, there is a shift away from Lactobacillus bacteria toward a more diverse mix of bacteria. This imbalance of bacteria leads to an increase in the pH of the vagina, which can cause a number of symptoms.

Men cannot get bacterial vaginosis, though they may harbor some of the bacteria (Gardnerella vaginalis) that is thought to play a role in the development of BV in women. (2)

Bacterial Vaginosis (BV) Symptoms

Despite how common BV is, it does not always cause symptoms. In fact, 84% of women with BV do not exhibit any symptoms at all. (1)

That said, there are some tell-tale signs of BV. Symptoms of BV are often chronic and usually fairly mild. They include:

  • Thin, white or grey vaginal discharge
  • A strong fishy odor, especially after sex
  • Itching, burning, or pain in or around the vagina

Bacterial Vaginosis vs Yeast Infection

Despite the fact that yeast infections are talked about much more, they are the second most common cause of vaginal symptoms, beat out only by bacterial vaginosis.

So what’s the difference between the symptoms of bacterial vaginosis and a yeast infection?

Common symptoms of a yeast infection include itchiness or burning in or around the vagina, and a white discharge that often looks like cottage cheese. This discharge is typically odorless and might have a yeasty smell (like beer or bread). (3)

This differs from the thin consistency and strong fishy odor of the discharge associated with bacterial vaginosis.

Of course, the best thing to do if you have any of these symptoms is to visit your healthcare provider who can perform an exam and testing to determine which of these infections you might have.

Bacterial Vaginosis (BV) Causes

While researchers aren’t quite sure exactly what causes BV, there are certain lifestyle factors that may make you more likely to get BV.

Factors that may increase your risk of developing BV include (4):

  • Sexual activity. Having a new sexual partner or multiple sexual partners increases your risk of BV. Women who have not had sex rarely have BV.
  • Douching. Douching disrupts the balance of bacteria as well as the pH of the vagina, putting you at higher risk of BV.

Conventional BV Treatment

Some doctors do not recommend treatment of BV, especially if you have no symptoms. This is because the typical antibiotic treatment for BV can cause you to develop a yeast infection, essentially trading one infection for another. Many cases of BV also spontaneously resolve on their own.

However, treating BV makes you less likely to contract other STDs, including HIV. In addition, you are less likely to suffer from infections after gynecological surgery like an abortion or hysterectomy if you treat BV prior to surgery.

Lastly, if you are pregnant, having BV can increase the risk of having a preterm birth or a low birth-weight baby (<5.5 pounds at the time of birth). (4)

Most practitioners will choose to treat women who complain of symptoms of BV, women with BV who are about to undergo gynecological surgery, or pregnant women with BV, especially if you’ve had a preterm birth in the past.

Typical treatment for BV is a course of antibiotics. Antibiotics for BV include metronidazole (oral or vaginal), clindamycin (oral or vaginal), tinidazole (oral), or secnidazole (oral).

Recurring BV

Many women have recurring BV infections and find pharmaceutical antimicrobial treatment ineffective over the long-term. In addition to this, the side effects of antibiotics (such as yeast infections) can often make antibiotics seem not worth it.

If rings a bell, you might want to know how to stop recurring BV infections permanently or how to get rid of BV without antibiotics.

One thing to note here is that researchers believe that treating the sexual partners of those with BV may reduce recurrence rates. Early research in the field showed that this was not effective, but it was later discovered that this early research was not up to snuff. Researchers are now diving deeper into this topic and will hopefully have a definitive answer for us soon as to whether or not treatment of sexual partners can help reduce the recurrence of BV. (2)

In the meantime, there are numerous BV over-the-counter treatments as well as home remedies for BV that can make treatment a success and decrease the likelihood of a recurrent infection. One of my favorite options is probiotics!

Let’s jump into it.

Best Probiotic for BV

probiotics for bv - probiotic supplements

Because bacterial vaginosis is an imbalance of the good and bad bacteria in the vagina, taking probiotics orally or inserting probiotic bacteria vaginally can be useful in treating BV.

Taken orally, probiotic bacteria can actually help rebalance the vaginal flora. (5)

If you are interested in inserting probiotics vaginally for BV, make sure to discuss this option with your healthcare provider.

Below are some of the best probiotics for bacterial vaginosis.

Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 for BV

One of the most studied combinations of probiotic strains for BV is Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. (Remember that knowing the strain of the probiotics you’re taking is incredibly important — you can’t just take any probiotic!)

Study 1

In a study of 32 women with BV, half the women were given metronidazole and a combination of these two probiotic strains, while the other half were given metronidazole and a placebo. They received the antibiotics for the first 7 days of the study. As for the probiotics, they took two capsules (each capsule containing at least one million bacilli per strain) for the first 30 days, and then 1 capsule per day for the remaining 30 days of the study.

For those in the probiotic group, 81% (13 women) had cured their BV by day 30. They remained BV-free until the end of the study at 60 days, as well.

This is in contrast to the placebo group (remember, they still got the conventional treatment — 7 days of metronidazole). In this group, only 31% (5 women) were free of BV by the end of the study and almost 70% of the women who only received metronidazole treatment still had BV. (6)

Study 2

In another study (double-blind, placebo-controlled, randomized) on these two strains, women who had received these probiotics in addition to conventional metronidazole treatment for BV were cured at a much higher rate than those who only received metronidazole treatment.

125 women were split into two groups, and of those on the combination of probiotics and metronidazole, 88% were cured at the 30-day follow up. Only 40% of women who received metronidazole treatment alone were cured. (7)

Study 3

Another very similar study in 2017 showed, again, that women who took these probiotic strains in addition to metronidazole antibiotic treatment were much more likely to cure their BV. 83% of those who took the combination of probiotics and antibiotics for BV had cured their BV by the end of the 30-day study, while only 37% of women who only received antibiotics had cleared their BV by the end of the study. (8)

You may have also heard milk-based drinks with Lactobacillus cultures like Yakult for BV, or Actimel for BV. They do not contain the same strains of Lactobacillus as mentioned above, and thus may not be as effective for BV. That said, I’m always open to seeing more research so if you want to share any, please do so in the comments section!

Best Probiotic for BV that Includes Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14

Clearly, these two probiotics strains have some promising results for those with BV. If you’re looking for a BV treatment over the counter to help improve the efficacy of your medical treatment, probiotics are a wonderful choice. It’s an easy remedy that you can administer at home!

Fem-Dophilus from Jarrow Formulas is a great option if you’re looking for a probiotic supplement that contains these two strains.

You can also find these same strains in RepHresh Pro B probiotic capsules.

Ideally, I would love these companies to share the exact CFU counts for each individual strain, but none of them do (opting to list it as a “proprietary blend” instead). Both of these options contain 5 billion total CFUs, but they don’t specify how much of those 5 billion is coming from each of the strains. If you know of a brand that tells you how much of each strain their supplement contains, I’d love to hear about it in the comments!

Other BV Treatments Over the Counter & Home Remedies for BV

In addition to probiotics for BV, there are some other over the counter treatments for BV that you might want to consider.

Garlic for BV

In a study of 120 women with BV, 60 women were given 500 mg capsules of garlic and 60 women were given the standard treatment of metronidazole. 63% of women who received the garlic were successful in their treatment, while 48% were successful in the metronidazole group. (9)

This shows that garlic may be a better treatment for BV than antibiotics. Perhaps combined with the probiotics listed above, we’d see even higher rates of clearance!

If you’re looking for a quality garlic supplement, Allimax is a good choice.

Boric Acid Suppositories for BV

Boric acid suppositories have long been used for vaginal infections, including BV and yeast infections. It is regarded as a simple, safe home remedy for vaginal infections. It is thought that boric acid may affect the biofilms of BV-causing bacterial. (2)

One study showed that treatment with nitroimidazole followed by 21 days of intravaginal boric acid suppositories (600 mg) and then, if in remission, metronidazole gel twice weekly for 16 weeks. BV cure rates at 12, 16, 28, and 36 weeks were 87%, 78%, 65%, and 50%, respectively. (10)

Though the BV cure was not permanent for 50% of women in the trial, this study indicates that boric acid (along with other maintenance therapies), may be useful in delaying recurrence of BV. More studies are needed to determine if ongoing use of boric acid may be helpful for BV prevention, especially for those with recurring BV.

Please note: Oral use of boric acid is toxic — vaginal use only. Pregnant women should not use boric acid.

You can purchase boric acid suppositories online quite easily.

Other home remedies for BV that are less studied include: herbal suppositories (such as this one from Dr. Aviva Romm), tea tree oil for BV, and hydrogen peroxide for BV.

If you are considering any BV treatment over the counter or home remedies for BV, talk to your doctor.

The Bottom Line:

Bacterial vaginosis is the most common vaginal infection and affects almost 1 in 3 women. It causes symptoms such as thin, white or grey discharge with a strong fishy odor, and can cause itchiness or pain in or around the vagina.

Probiotics can be a great way to improve your chances of clearing BV. The best probiotic for BV are products that include both Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 strains. These can be found in both the Fem-Dophilus from Jarrow Formulas and RepHresh Pro B probiotic supplements. Taken orally, these probiotics can help rebalance the bacteria and lower the pH of the vagina and may help prevent and treat BV.

,

Top 3 Best Prebiotic Supplements: Feeding Your Good Gut Bacteria

prebiotics

You hear a lot about probiotics these days, but what about prebiotics? What’s the difference between prebiotics and probiotics and should you be consuming both? In this article, we’ll cover everything you need to know about prebiotics and I’ll let you know about the top 3 best prebiotic supplements.

What Are Prebiotics?

Prebiotics were first defined in 1995 as “non-digestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria already resident in the colon.” (1)

That definition has been tweaked throughout the years and the latest update to the definition (decided on by the International Scientific Association for Probiotics and Prebiotics (ISAPP)) is as follows: a prebiotic is “a substrate that is selectively utilized by host microorganisms conferring a health benefit.” (2)

But let’s put this in plain English, shall we?

A prebiotic “feeds” your healthy bacteria and, as a result, benefits you and your body. Prebiotics can be found in both foods (typically high-fiber foods) and supplements.

While “classic” prebiotics such as fructooligosaccharides and galactooligosaccharides still fit this new definition, this expanded criteria now also allows some non-carbohydrate nutrition components such as polyphenols (a type of antioxidant) to be classified as prebiotics.

Prebiotic vs Probiotic

What’s the difference between prebiotics and probiotics? Prebiotics and probiotics are quite different, despite very similar-sounding names!

While a prebiotic “feeds” good bacteria in your microbiome and offers you benefits in return, a probiotic is a live organism that beneficially impacts your body. (3)

You can think of a prebiotic supplement as the fuel for probiotics, which are the live bacteria that need feeding.

Probiotics can be found in food sources like yogurt, kefir, kvass, sauerkraut, and more. Prebiotic food sources include chicory root, garlic, onion, Jerusalem artichoke, and more.You can consume both probiotic supplements and prebiotic supplements. (We’ll talk about the best prebiotic supplements in just a moment.)

Both probiotics and prebiotics are exceptionally good for you, and I highly recommend incorporating both into your routine for best results. If you’d like to learn more about probiotics, check out my article on the topic here.

Can You Take Prebiotics and Probiotics Together?

Absolutely! In fact, it’s great to take prebiotics and probiotics together. However, when you’re looking at “synbiotic” supplements that contain both prebiotics and probiotics, be aware that most of these supplements only contain a very small amount of prebiotic. It is typically not enough to be considered a therapeutic dose of prebiotic and thus won’t have much of an effect on your health (but it can help the probiotic bacteria in your supplement survive better).

We’ll talk about the best prebiotic supplements in just a moment!

What’s the Difference Between Prebiotics and Fiber?

Many prebiotics are considered a type of fiber, so you will often see the term “prebiotic fiber supplement” used.

That said, not all types of fiber are considered prebiotics. The main difference between a prebiotic and fiber is what kind of bacteria they feed.

A prebiotic must selectively feed beneficial bacteria, whereas fiber is metabolized more broadly and thus can feed non-beneficial bacteria as well as good bacteria. (Note that this doesn’t mean that fiber isn’t good for you — it just acts somewhat differently from prebiotics.)

While prebiotics and fiber are very important parts of a healthy diet, remember that not all fiber is considered a prebiotic.

Prebiotic Benefits

Prebiotic supplements are a powerhouse when it comes to improving your health.

Here are some of the benefits of prebiotics you can expect.

Prebiotics & Digestive Health

Because prebiotic supplements selectively feed healthy bacteria, they can be used to help correct “dysbiosis” or imbalanced gut bacteria.

There are two main types of dysbiosis: general imbalance, and insufficiency dysbiosis.

General imbalance is when you have too few beneficial bacteria and overgrowths of one or more commensal bacterial strains. Commensal bacteria are bacteria that are normal to find in small amounts and typically don’t cause any harm to you. However, when they start growing in high amounts, you might start developing symptoms.

Insufficiency dysbiosis occurs when you don’t have enough beneficial bacteria like Lactobacillus or Bifidobacteria hanging out in the large intestine. These should be present in high amounts, but it’s very common to see folks with very little or no growth of these beneficial microbes. In the case of insufficiency dysbiosis, you do not need to have any bad bacteria species overgrowing.

Dysbiosis has been associated with a myriad of health conditions, like allergies, eczema, metabolic syndrome, obesity, inflammatory bowel disease, autoimmunity, and more. You can learn more about dysbiosis by reading my article on the topic here.

By consuming prebiotics, you can increase your counts of beneficial bacteria which improves the balance of your microbiome. A balanced microbiome means a healthy body!

Prebiotic supplements have been shown to improve lactose tolerance in those who are lactose intolerant, as well as improve symptoms of IBS like bloating, excessive gas, diarrhea, and constipation. (4, 5)

Prebiotic supplements can also improve IBS-like symptoms even more than a low-FODMAP diet alone when combined with this approach. (6)

Prebiotics, Weight Loss & Metabolic Function

Gut bacteria play a huge role in how your metabolic system functions. When gut bacteria in the microbiome become imbalanced (i.e. you have “dysbiosis), you can develop systemic low-grade inflammation, often referred to as “metabolic endotoxemia.” This is when toxic molecules such as lipopolysaccharides (LPS) get through a “leaky gut” into your bloodstream.

Researchers believe that this inflammation is at the root of many diseases, but it can especially impact the development of metabolic disorders such as obesity and diabetes. (7, 8)

Taking prebiotic supplements has been shown to improve fasting blood sugar, HbA1c, fasting insulin levels, and inflammation markers. (9)

Prebiotic intake has also been shown to increase satiety and decrease calorie intake, which may play a role in some of the positive metabolic changes seen with prebiotic consumption. (10)

Prebiotics & the Immune System

More than 70% of your immune system is housed in your digestive tract. (11)

This makes sense when you think about it — after all, your digestive tract is exposed to the many foods, particles, bacteria, etc that make it through your mouth on a daily basis. In order to keep you healthy, it must have a robust system in place to tolerate foreign particles that pose no pathological threat, while also being able to mount an attack toward pathogens that may negatively impact the body.

Prebiotic supplements have been shown to positively impact the immune system. Prebiotic consumption increases short chain fatty acid (SCFA) production, which in turn has been shown to promote T regulatory (Treg) cells, as well as other important immune cells. (12) Treg cells have a balancing effect on the immune system because they discourage autoimmunity (the attack of your own body’s cells).

Because of these effects, prebiotic supplements have been shown to improve atopic diseases such as asthma and eczema. (13, 14)

Prebiotics & The Brain

The gut and the brain are intimately connected — your brain “talks” to your gut and vice versa. At least on a subconscious level, we’ve known about this connection for a long time as evidenced by our use of phrases like “gut feeling,” “gutsy,” and “gut instinct,” but research is just starting to truly realize the extent of the connection between the brain and gut. (15)

Targeting the microbiome with microbiome-modulating things like prebiotic supplements and probiotic supplements is of great interest to researchers who study stress-related diseases such as anxiety, depression, and even conditions like irritable bowel syndrome.

Using prebiotic supplements has been shown to reduce waking cortisol response in adults. (16) In mice, prebiotic supplementation also shows antidepressant and anxiolytic effects. (17)

Because this is such a new field of study, I expect that we’ll see lots more about the effect prebiotic supplements can have on our mental health in the coming years!

Prebiotic Side Effects

There are very few side effects of consuming prebiotic supplements. That said, some people may experience slight increases in bloating when consuming large doses of prebiotics.

To avoid any digestive upset, it is best to start slow when increasing your intake of prebiotic supplements. Over time, your bacteria get used to having more and more fuel and you generally won’t experience digestive upset anymore.

Types of Prebiotics

There are many substances that act as prebiotics, and the list will surely become even longer in the coming years with the new, expanded definition of a prebiotic.

Some popular prebiotics include:

  • Inulin
  • FOS (Fructooligosaccharides)
  • GOS (Galactooligosaccharides)

With the expanded definition of prebiotics, there are some newer prebiotics available now as well, such as Sunfiber (also known as partially hydrolyzed guar gum or galactomannan fiber) and polyphenols.

Polyphenols are naturally-occurring compounds found in in plants. Some foods high in polyphenols include blueberries, coffee, strawberries, blackberries, flaxseed, tea, and wine. Recent research has shown that polyphenols act as prebiotics in the digestive system, increasing our counts of healthy gut bacteria. Learn more about polyphenols foods and their effect on gut bacteria.

Prebiotic Foods

Prebiotics can be found in both foods and supplements. Eating prebiotic foods can be a great way to get prebiotics in your diet if you’re not interested in taking prebiotic supplements.

Here is a list of foods that contain prebiotics (including polyphenol prebiotics):

  • Apples
  • Asparagus
  • Blackberries
  • Blueberries
  • Burdock root
  • Coffee
  • Chicory root
  • Chocolate (dark)
  • Dandelion greens
  • Flaxseed
  • Garlic
  • Jerusalem artichoke
  • Jicama
  • Leeks
  • Onions
  • Peach
  • Pear
  • Strawberries
  • Tea
  • Wine
  • Yacon root

Best Prebiotic Supplements

I’m a big fan of including prebiotics both from the diet and incorporating a prebiotic supplement.

Here are a few of the best prebiotic supplements on the market. Remember to start slow and ramp up your dosage over time to avoid digestive complaints, no matter what prebiotic supplement you take!

Sunfiber

Sunfiber is a new (and pretty unique) prebiotic fiber supplement. It is certified low-FODMAP by Monash University, so it’s the best prebiotic supplement choice for those who are FODMAP intolerant. It’s also been shown to improve clearance rates of SIBO (small intestinal bacterial overgrowth) when combined with the typical antibiotic treatment for this condition. (18) I generally recommend 6 grams of Sunfiber per day for best results. Sunfiber mixes in with hot or cold beverages easily and is taste-free and colorless.

I love Sunfiber so much, actually, that I use it for my products at Gut Power Drinks! Our first product, Gut Power Matcha, is a blend of Sunfiber, probiotics, and matcha green tea.

Each serving of Gut Power Matcha contains 6g of Sunfiber, as well as probiotics.

gut power matcha
Gut Power Matcha contains Sunfiber as its prebiotic. It also contains probiotics!

Bimuno (B-GOS)

Bimuno is the best prebiotic supplement that contains GOS (galactooligosaccharide). It’s generally very well tolerated, even by those with digestive issues. I typically recommend 1 stick of the powder formula (3.6g). Bimuno can be mixed into pretty much any beverage and is tasteless.

FOS

NOW’s Nutraflora FOS is the best prebiotic supplement containing FOS (fructooligosaccharides). In general, I find FOS to be slightly less well-tolerated than the others on this list, but not by much! It’s got a nice sweet taste — I generally just dump it into my mouth and let it dissolve. I recommend 5 grams of FOS for best results.

What to Avoid in a Prebiotic Supplement

As prebiotic supplements become more popular, I’ve started to see lots of products claiming to contain prebiotics when they either don’t contain a substance that actually fits the definition of a prebiotic or they contain so little prebiotic that it is almost guaranteed not to actually benefit you when you take it.

Many supplements and foods claim to contain prebiotics when in reality they just contain fiber, so keep an eye out for that. Remember that fiber is absolutely great for you, but in my opinion it’s a bit of false advertising to claim that a fiber product contains prebiotics (unless, of course, that fiber is shown to be prebiotic).

You’ll also want to watch out for prebiotic supplements that contain extremely low doses of prebiotics. This typically happens in “synbiotic” products, which means that they include both a probiotic and a prebiotic. There is usually a tiny amount of prebiotic which does absolutely nothing for you as a human being, but can possibly increase the survival of the probiotic you’re taking. If you’re taking a prebiotic to benefit you, you’ll be taking grams of the stuff, not milligrams. Prebiotics are most often powdered supplements or quite a few capsules, since you need to take a lot for a therapeutic dose.

Lastly, prebiotics do seem to be somewhat like probiotics in that different types of prebiotics may be better suited for different uses. (Remember that the effects of probiotics are strain-specific.) Further research in the area will elucidate which prebiotic supplements are most beneficial for different conditions.

The Bottom Line

Prebiotic supplements feed the beneficial bacteria in your gut, which in turn make you healthier. You can consume prebiotics both in foods and prebiotic supplements — it’s a good idea to do both to ensure you’re properly fueling your microbiome.

Be wary of supplements that contain milligrams of prebiotics — while they may benefit probiotics contained in the supplement you’re taking, it’s not a therapeutic dose for you. If you want the benefits of consuming prebiotics, you generally need to take grams of the stuff!

The best prebiotic supplements on the market are Bimuno, Sunfiber, and Nutraflora FOS.

Top 100 High Polyphenol Foods: The Best Foods for a Healthy Microbiome

polyphenols foods

One of the best things you can do for better gut health is to eat a diverse diet full of high polyphenol foods.

If you’re a pretty healthy eater and consume lots of plant matter, you might be surprised to learn that you’re already eating quite a bit of high polyphenol foods. Even so, you can always strategically increase your polyphenol intake for even more health benefits.

In this article, we’ll discuss the high polyphenol diet: what it is, how to implement it, and the massive benefits you can expect once you implement this easy, delicious diet.

Let’s jump in!

What are Polyphenols?

Polyphenols, a type of antioxidant, are naturally-occurring compounds found in plants that benefit the human body in a myriad of ways. (1) Polyphenols include things like the flavanols in chocolate, anthocyanins elderberry and currants, stillbenes in wine, and lignans in flaxseed.

Polyphenols may improve microbial balance in the gut microbiome, regulate blood sugar, and improve your heart health, among other benefits.

You’ve probably heard the term “antioxidant” before, but perhaps not “polyphenol.” While polyphenols are an important sub-category of antioxidants, they haven’t received the attention that antioxidants have gotten in the last few years in the health sphere.

Newer research now shows that polyphenols do something quite incredible: they act as a prebiotic (a substance that fuels beneficial bacteria in your gut) for the microbiome. In return, your gut bacteria transform polyphenols into health-promoting metabolites that you’re then able to absorb into the body.

Polyphenols contribute the wide array of colors you see in your food: the red in the skin of your apple, the blue in your blueberries, and the green in your matcha. These beautiful colors indicate the presence of polyphenols in your food — therefore, the more color you can include in your diet, the more polyphenols you’ll get!

Eating foods high in polyphenols and a diet with a wide array of different polyphenols (i.e. different colors) helps the bacteria in your gut become more diverse. It is thought that microbial diversity in the gut microbiome is very important, as lower diversity is seen in health conditions such as IBD, metabolic syndrome, and allergic disease, among others. (2, 3, 4)

Polyphenol Benefits

So how exactly do polyphenols benefit your body?

Polyphenols make it through the entire digestive process mostly intact, making it down to the large intestine. Here, polyphenols serve as “food” for the healthy flora in your microbiome, while your bacteria “process” the polyphenols and transform them into beneficial metabolites that you can then absorb into the bloodstream. (5) Because of this, polyphenols classify as prebiotics.

Here’s what the research has to say about the benefits of polyphenols:

  • Increases counts of Akkermansia muciniphila, a beneficial species of bacteria. (6) Akkermansia spp. counts have been found to be low in people with health conditions like diabetes, metabolic syndrome, IBD, autism, and more. (7) This bacteria is crucial for the integrity of the gut barrier (i.e. is important in preventing “leaky gut”). (8)
  • May help to prevent age-related cognitive decline. (9) This particular study looked specifically at the impact of berry polyphenols. Berry polyphenols also seem to protect against neurodegenerative disorders, as well. (10)
  • May have anti-cancer effects. A number of polyphenols have been shown to have anti-cancer effects. (11) Tea polyphenols, in particular, can do a lot to help prevent UVB-induced skin cancer. (12)
  • May delay or prevent the development of metabolic syndrome. Intakes of polyphenols have been inversely associated with metabolic syndrome (meaning, the more polyphenols you consume, the less likely you are to have metabolic syndrome). (13) In addition to this, consuming polyphenols has been shown to delay or prevent the development of metabolic syndrome and improve markers such as body weight, blood pressure, blood sugar, and lipid metabolism. (14) It is thought that these beneficial effects may be due in part to the proliferation of Akkermansia spp. in relation to polyphenol intake.

Because polyphenols act as prebiotics, they help to prevent imbalanced gut bacteria or dysbiosis.

Foods High in Polyphenols

Given the benefits of polyphenols, you’ll want to incorporate as many high polyphenol foods as possible into your diet.

Luckily, researchers have analyzed many of the foods we have access to in order to determine which foods have the highest concentration of polyphenols per serving. (15)

Below are the top 100 high polyphenol foods, separated by category, and in order of polyphenols per serving within each category.

High Polyphenol Fruits:

Fruit:Serving Size (g):Polyphenol Content Per Serving (mg):
Black elderberry1451956
Black chokeberry1451595
Blackcurrant1451092
Highbush blueberry145806
Lowbush blueberry145395
Sweet cherry145394
Strawberry166390
Blackberry144374
Plum85320
Red raspberry144310
Pure apple juice248168
Apple110149
Pure pomegranate juice15099
Black grape5491
Pure grapefruit juice15079
Pure blood orange juice15471
Prune3262
Redcurrant14462
Peach9959
Green grape5448
Pure pummelo juice15427
Nectarine9925
Pear13823
Apricot6522
Quince10019
Bilberry1457.4
Pure lemon juice156.3
Banana972.5
Pomegranate1001.1

High Polyphenol Vegetables:

Vegetable:Serving Size (g):Polyphenol Content Per Serving (mg):
Globe artichoke heads168436
Black olive1585
Spinach5970
Green olive1552
Red onion3050
Potato12836
Shallot3236
Red chicory1433
Broccoli7233
Green chicory1423
Yellow onion3022
Asparagus6522
Extra virgin olive oil1610
Carrot547.6
Red lettuce245.4
Green bean604.8
Curly endive143.4
Cauliflower382.7
Rapeseed oil162.5
Pumpkin602.5
Endive (escarole)142.5
Tomato502.1
Green lettuce241.9
White onion301.6
Sweet green pepper200.9

Nuts, Seeds, Grains, and Legumes High in Polyphenols:

Food:Serving Size (g):Polyphenol Content Per Serving (mg):
Flaxseed meal20306
Chestnut19230
Whole grain rye bread120146
Hazelnut28138
Soy yogurt125105
Soy flour2093
Pecan nut1569
Soy, tempeh4059
Soy tofu13054
Black bean3552
White bean3544
Roasted soybean1537
Soy meat4029
Whole grain rye flour2029
Almond1019
Whole grain wheat flour2014
Soybean sprout609.3
Soy cheese404.9
Peanuts, roasted dehulled402.6
Pasta602.5
Refined oat flour201.6
Refined wheat flour201.2

Other Foods High in Polyphenols:

Food:Serving Size (g):Polyphenol Content Per Serving (mg):
Coffee, filtered190408
Dark chocolate17283
Black tea195197
Green tea195173
Red wine125126
Cocoa powder3103
Milk chocolate3275
Chocolate beverage with milk18739
Soy milk18734
Beer57422
White wine12513
Rose wine12512
Dark beer57410

How to Eat a High Polyphenol Diet

For the most diverse, healthy microbiome, your diet should be as high in polyphenols as possible.

Here’s how to easily eat a high polyphenol diet.

Eat More High Polyphenol Foods

One of the easiest ways to get more polyphenols in your diet, of course, is to incorporate more of the high polyphenol foods on the lists above into your eating habits.

For example, if you normally eat two eggs and a smoothie for breakfast, you could choose particularly high polyphenol fruits and vegetables to add to your smoothie (and maybe even some flaxseed meal, too!) and spice up your eggs with some herbs. Drink a cup of tea or coffee on top of that and you’ve got a nice high polyphenol meal!

Instead of having some ice cream for dessert after dinner, you could instead choose a few pieces of dark chocolate to amp up your polyphenol intake.

Wherever you can, choose high polyphenol foods to incorporate into your diet and you’re bound to eat more polyphenols than you were before.

Eat at Least 40 Different Plant Foods Each Week

Gut researcher and educator Jason Hawrelak of ProbioticAdvisor.com recommends trying to eat at least 40 different plant foods each week, and I tend to agree with this advice.

When doing this, note that a purple carrot counts as a different food than an orange carrot when counting your plant foods each week. Your different herbs and spices count separately, too!

So instead of eating white potatoes each night for dinner, you’re better off eating white potatoes some nights, but also incorporating sweet potatoes, japanese potatoes, purple potatoes, etc to help you more easily reach your 40 different plant foods each week.

The easy rule of thumb to remember is: the more diverse the colors (polyphenols) in your food, the more diverse your microbiome!

Change Up Your 40 Plant Foods Each Week for Maximum Diversity

If you want to go above and beyond and really maximize your microbial diversity, you can change up your 40 plant foods each week as much as possible.

While it would be great to have an entirely different set of 40 plant foods each week, for most people that will be quite difficult. Instead, just try to change as many foods as you can from week to week!

By doing this, you help to encourage microbial diversity in your gut. This is because each different polyphenol helps to encourage the growth of different beneficial bacteria in the gut.

The Bottom Line

Polyphenols give the wide array of colors we see in our food and act as prebiotics in the gut to feed your beneficial bacteria. The more high polyphenol foods you can incorporate into your diet, the more diverse your microbiome becomes. Microbial diversity in the gut is associated with better health outcomes.

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The Role of Gut Bacteria in Fertility and Estrogen Dominance

high estrogen levels fertility

I’ve talked before about the importance of optimizing your gut health before getting pregnant in order to promote a healthy pregnancy for both you and your baby.

But what about getting pregnant in the first place… Can your gut bacteria play a role in your estrogen production and fertility?

The science suggests that it very well might!

To understand why let’s take a closer look at infertility and one of its common causes: estrogen dominance.

What is Infertility?

When you hear the term “infertility,” you likely think of a person or a couple that cannot and will never be able to have children. In the medical world, however, infertility does not refer to a permanent state at all.

A diagnosis of infertility simply means that you have not been able to get pregnant after a year of normal, unprotected sex (1).

It’s actually a diagnosis that is far more common than you might realize. According to recent statistics, between 7% and 15.5% of American women experience infertility in any given year, and the majority of women (51.8%) meet the criteria for infertility at least once during their menstruating years (2).

Infertility & Estrogen Dominance

While there are many reasons a couple might have difficulty getting pregnant, among the most common are hormone imbalances (3, 4).

Abnormally high levels of estrogen is frequently implicated in infertility in both men and women. (5, 6, 7, 8).

Let’s look at the connection between high estrogen in both men and women and how it affects fertility.

High Estrogen in Women & Infertility

Most women need little reminder that our fertility depends on a highly-coordinated 28ish-day cycle in our hormone levels. Most of us also know that one of the key players in this hormonal dance is estrogen.

Estrogen has two very important jobs in the female menstrual cycle. First, it triggers a spike in the levels of a hormone called luteinizing hormone (LH) from the pituitary gland in the brain. This spike in LH levels is what triggers the ovary to release a mature egg into the fallopian tube, where it can be fertilized (9).

After a successful ovulation, though, estrogen works together with yet another hormone called progesterone to prevent a second ovulation from occurring. Estrogen and progesterone do this by acting on the pituitary gland in the brain to make sure no more LH is made until the following cycle (or, if pregnancy occurred, until after birth). At the beginning of the next cycle (menstruation), estrogen and progesterone levels dip down, signaling to the brain that it is safe to produce another spike of LH (9).  

Constant high levels of estrogen, without a significant dip signaling the start of a new cycle, can trick your brain into thinking you’ve already ovulated, and prevent you from ovulating again (9). This is actually the logic behind hormonal birth control (the pill).

As you might imagine, this high level of estrogen can play a significant role in infertility.

High Estrogen in Men & Infertility

While we often think of estrogen as a female hormone, men also have healthy baseline levels of estrogen that are required for sexual and reproductive functions.

At moderate levels, estrogen promotes (and is necessary for) a healthy libido and the production of sperm in men. High estrogen, however, can have the opposite effect (6).

Too much estrogen in men decreases their libido. This is because, as in women, estrogen in men acts on the pituitary gland in the brain to decrease the production of LH. In men, this hormone stimulates the testes to produce testosterone. Without enough LH, there is a drop in testosterone, and low testosterone lowers male libido (6).

Too much estrogen in men can also decrease the production of sperm by the testes. This is due to the estrogen-induced decrease in LH and testosterone levels, both of which directly stimulate the testes to produce mature sperm (6).

Estrogen Dominance Symptoms

So how do you know if you’re at risk of having too much estrogen? Here are some symptoms of high estrogen levels to look out for.

High Estrogen Symptoms in Women:

  • Irregular periods
  • Breast tenderness or soreness
  • Decreased sex drive
  • Bloating
  • Increased mood swings
  • Increased symptoms of PMS (premenstrual syndrome)
  • Headaches
  • Anxiety
  • Weight gain
  • Fatigue
  • Memory issues

High Estrogen Symptoms in Men:

  • Infertility
  • Sexual dysfunction (erectile dysfunction, low libido)
  • Enlarged breasts (gynecomastia)
  • Fatigue

If you’re worried you might have high estrogen levels, the best thing to do is to have your hormones tested by your healthcare practitioner. But knowing the symptoms of high estrogen may help you determine if a visit to the doctor might be helpful.

Estrogen & Gut Bacteria

Clearly, a buildup of estrogen is not optimal for you, or your partner’s, fertility. But what’s any of this have to do with your gut bacteria?

A lot, believe it or not! There are multiple mechanisms which link your gut bacteria to your estrogen levels. This concept is often referred to as the “estrobolome,” which is defined as the bacterial genes in your microbiome that have the ability to metabolize estrogen.

Gut Bacteria and Estrogen Reabsorption

Your gut bacteria are actually an integral part of the normal regulation mechanisms your body uses to keep estrogen levels normal.   

See, every day your liver pulls estrogen out of your blood and binds it to a sugar-metabolite called glucuronic acid. This sugar-estrogen complex is then mixed with your bile, which is dumped into your digestive tract to help with digestion (10, 11, 12).

Now, this sugar-estrogen complex is bigger than estrogen by itself and it can’t be absorbed through the intestinal wall very well. Because of this, much of the estrogen gets stuck in the intestines and is eliminated from your body via bowel movements (10, 11, 12).

And this is where your gut bacteria come in. They have special enzymes that are able to cut estrogen free from the sugar, called β-glucuronidases. The freed estrogen molecule can then be easily absorbed and re-enter your bloodstream (10, 11, 12).

This is a natural part of the process and the liver binds more estrogen to bile acids than needed with the knowledge that some of it will be coming back, thanks to your gut bacteria.

This balance can be upset, however, if you have abnormal numbers, types, or ratios of bacteria in your intestines (called dysbiosis) (13).

This is because some gut bacteria have β-glucuronidases that free estrogen better than others (14). With an unhealthy mix of gut bacteria, your microbiota can free too much estrogen, allowing much greater levels of estrogen to be reabsorbed back into your body than normal, which results in excess estrogen in the blood (13).

Gut Bacteria and Estrogen from Food

In addition to the role the gut microbiota play in balancing the levels of estrogen you make yourself (called endogenous estrogen), they also regulate how much estrogen and estrogen metabolites you absorb from food sources (called exogenous estrogen).

Some gut microbes have enzymes that enable them to breakdown phytoestrogens (from plants) and polycyclic aromatic hydrocarbons (from barbequed or fried meats) into estrogens (15, 16). These estrogens can then be absorbed through the intestinal wall, raising your blood levels.

In fact, studies show that in men and postmenopausal women, the number one source of estrogen for their whole bodies is intestinal absorption from their food (17). And dysbiosis is associated with higher levels of estrogen in these populations, presumably at least partially through increasing the breakdown of dietary molecules such as phytoestrogens and polycyclic aromatic hydrocarbons (13).

Indirect Ways Gut Bacteria Affect Estrogen Levels

In addition to the direct ways dysbiosis links your gut health to higher estrogen levels, there are also several indirect links.

For example, an abnormal balance of gut bacteria has been strongly linked to constipation (18, 19), inflammation (20) and obesity (21), all of which may be able to further drive up estrogen levels in your blood (8, 22, 23).

How to Lower Estrogen Levels

If you have high estrogen levels and you’re looking to get your estrogen into the normal range, there’s a lot you can do from a dietary and lifestyle standpoint.

If you hope to get pregnant and your estrogen levels are too high, incorporating these diet and lifestyle changes may help improve your fertility.

Eat More Fiber for Lower Estrogen Levels

Research shows that one of the most beneficial things you can do to optimize your estrogen levels is increase your fiber intake.

A high fiber diet is associated with improved microbial health and decreased risk of dysbiosis (24). In fact, increasing the amount of fiber in your diet for just 2 weeks is enough to significantly improve the composition of your gut bacteria (25).  

Additionally, fiber may be able to directly bind the estrogen-sugar complex in the digestive tract, helping eliminate it from the body. In a study examining estrogen (re)absorption in women, there was a direct and significant relationship between a woman’s fiber intake, the size of her stool, and the amount of estrogen she was able to flush from her body (26).

How you choose to increase your fiber intake is up to you, but boosting your fiber intake by increasing the amount of fiber-rich foods in your diet, rather than through adding fiber supplements, may give you more bang for your buck.

This is because the dietary source of fiber — plants — are also rich in polyphenols (27, 28, 29). As I outline here, polyphenols can help boost the health of your gut bacteria, so plant-based fiber-rich foods treat dysbiosis to a one-two punch.

Supplement with Fiber

That said, for many people, incorporating a fiber supplement may be the easiest solution (in addition to a plant-rich diet, of course!). The best fiber supplement on the market (in my opinion) is Sunfiber.

Diet and Lifestyle Changes to Lower Estrogen

While fiber (and fiber-polyphenol-rich plants) is the most well established dietary tool to prevent dysbiosis and lower blood estrogen levels, other dietary and lifestyle changes may also be helpful. These include:

  • Exercising regularly (30)
  • Drinking enough water to stay properly hydrated, preventing constipation (31)
  • Taking a probiotic, which contains healthy gut bacteria that can help populate your gut with healthy microbes (32) (Want to know more about supplementing with probiotics? Check out my article on the topic here.)
  • Avoiding broiled, fried and barbecued meats that are likely to contain high levels of polycyclic hydrocarbons, which can contribute to high estrogen levels, especially if you have dysbiosis (33)

Healing Your Gut to Lower Estrogen

If you have a lot of digestive symptoms like constipation, diarrhea, bloating, or gas, you may need help beyond these simple dietary and lifestyle changes listed above.

This is because digestive symptoms can indicate that you have severe dysbiosis, or conditions like SIBO or parasites that need a more in-depth approach, including antimicrobials (or antibiotics) and other supplements.

That said, you can have imbalanced gut bacteria without any symptoms at all, so if you want to maximize your chances of getting pregnant or prevent estrogen dominance, it’s a good idea to test even if you don’t have digestive symptoms.

There are multiple tests to determine the health of your gut microbiota that can give you more precise information regarding your gut health. This can provide you with a roadmap to optimizing your digestive health and, in turn, your fertility.

If testing indicates you have dysbiosis, SIBO, or any other type of imbalanced gut flora, you’ll want to clear out that bad bacteria and balance your biome. If you need more help with that, check out my 8-week online program, Build Your Biome.

For women who have ever struggled with infertility, did you experience that taking care of your gut health through diet and lifestyle changes made a difference in your ability to get pregnant?

For women who are thinking about starting a family in the near future, do you think you will consider your gut health more now, before you start trying? Tell me in the comments below!

Should You Take Probiotics with Antibiotics?

What Probiotics to Take While You're On Antibiotics

In this article, you’ll learn how probiotics can prevent some of the negative side effects of antibiotics and keep your gut healthy. You’ll discover the best probiotic supplements on the market for antibiotic-associated diarrhea and other digestive problems, as well as what probiotic foods to eat. 

What are Antibiotics?

What are Antibiotics Used For?

Antibiotics are a class of drugs that kill bacteria. They are used for harmful infections in or on the body. Common antibiotics include clindamycin and amoxicillin, though there are many different types of antibiotics on the market.

How Do Antibiotics Work?

Antibiotics work by either directly killing bacteria or preventing them from replicating or reproducing, thus dwindling bacteria numbers over time.

Antibiotic drugs only kill off bacterial infections in the body, which means that they aren’t useful for illnesses like the common cold or the flu, for example, because these are viral illnesses.

Side Effects of Antibiotics

Unfortunately, antibiotics are associated with a few side effects. These include:

  • Digestive problems
  • Clostridium difficile infection
  • Altering the Microbiome
  • Antibiotic Resistance

Digestive Problems

The most common side effects of antibiotics are digestive problems. These include:

  • Nausea or vomiting
  • Abdominal pain or cramping
  • Diarrhea (commonly referred to as antibiotic-associated diarrhea)

Luckily, many of the digestive problems that are caused by antibiotics can be helped by probiotic supplementation. We’ll go over that in just a minute, but hold tight — there are a few other common side effects of antibiotics that we’ll cover first.

Clostridium Difficile Infection (C.diff)

Clostridium difficile is an infection that causes diarrhea and inflammation of the colon. It is associated with recent antibiotic use and being in a healthcare setting.

Researchers have found that during antibiotic use as well as one month after the fact, your risk of developing c.diff increases 7-to-10 fold. One month after antibiotic treatment, your risk of developing c.diff increases threefold until three months after treatment. (1)

Common antibiotics that are associated with c.diff infection include clindamycin and fluoroquinolones (such as ciprofloxacin (Cipro), gemifloxacin (Factive), and levofloxacin (Levaquin), among others).

Altering the Microbiome

While it’s easy to see how antibiotics can cause digestive upset or even serious infections like c.diff, you may not realize that taking antibiotics actually causes negative shifts in your microbiome (the bacteria in your gut). Your microbiome responsible for a number of tasks in keeping you healthy, including aiding in digestion, nutrient production, immune response and more.

This negative bacterial shift leads to a condition called “dysbiosis” — essentially, an imbalance in the proper amounts of good and bad bacteria in your gut. Dysbiosis can lead to digestive problems like bloating, excessive gas, reflux, constipation, and diarrhea, but it is also associated with a host of chronic diseases as well. If you’d like to know more about dysbiosis and the chronic diseases it is associated with, make sure to check out my article on the topic here.

Clindamycin, one of the antibiotics I mentioned above, has been shown to cause unfavorable changes in healthy gut flora even two years after treatment. (2) Clindamycin also has a lot of unpleasant side effects including gastritis, gas and bloating, diarrhea and can lead to C.diff infections, as I mentioned before. (3) For more examples of how specific antibiotics affect the gut microbiota and their related side-effects, check out this research article. Clindamycin is by far one of the worst antibiotics in terms of unfavorable bacterial changes, but it’s wise to take a look at the research on the effects of any antibiotic you’re thinking of taking.

While we know there are risks to taking antibiotics, the reality is sometimes we need them. The point of this article is not to discuss antibiotic alternatives like natural antibiotics (though that’s certainly an important discussion); rather, it is to give you advice on what probiotics are useful in reducing the side effects of antibiotics.

Antibiotic Resistance

Antibiotic resistance happens when bacteria are able to resist the effects of an antibiotic. Not good! When we take an antibiotic we want it to work, right? When bacteria start to become resistant it means that things that were once easily curable with antibiotics may no longer be killed off by these same drugs.

When antibiotics are overprescribed and overused, this can (over time) cause antibiotic resistance. There will always be a few bacteria that are resistant to an antibiotic that you take. After you’ve finished your course, any bacteria that remains are those that are resistant to the drug. They are now allowed to grow freely and you’re no longer protected by your microbiome’s good bacteria. The more you take antibiotics, the stronger those resistant bacteria get.

Now this isn’t to say that you shouldn’t take antibiotics when they are prescribed to you. Antibiotics are life-saving drugs, after all. But it means that you should have a frank conversation with your healthcare provider about whether antibiotics are necessary (some doctors are still prescribing antibiotics (often because the patient asks for them) for illnesses like the common cold, which is not affected by antibiotics since it’s a virus).

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What are Probiotics

probiotics

Probiotics are live microorganisms that have a beneficial effect on the host (that’s you!). Your microbiome contains tons of probiotics and you can also consume probiotics exogenously through the use of probiotic supplements or probiotic-rich foods.

What Do Probiotics Do?

Probiotics have a whole range of benefits. They improve the side effects of antibiotics (like diarrhea), which we’ll discuss shortly. But in addition to this, probiotics have been shown to be useful for a wide array of health conditions.

Probiotics can help with the following conditions (among others):

  • Irritable bowel syndrome (IBS) (4)
  • Depression (5)
  • Anxiety (6)
  • Cardiovascular disease (heart disease) (7)
  • Metabolic disease and diabetes (8)

Side Effects of Probiotics

The common side effect of probiotics is increased digestive discomfort, such as bloating or gas. This is typically short-lived and resolves in a few days of regularly consuming probiotic supplements or probiotic foods.

More serious side effects are possible, but extremely rare. The bacteria or yeast that is consumed as a probiotic supplement can enter the bloodstream and cause infection. Those who are at increased risk of infection include immunocompromised patients, premature infants, those with short bowel syndrome, anyone with central venous catheters, and patients with cardiac valve disease.

It is, of course, important to discuss any supplementation with your healthcare provider.

Best Probiotics to Take with Antibiotics

There are many probiotic supplements on the market, so how do you know which one to choose?

Well, the right probiotic to choose depends on what you’d like it to do. Probiotic effects are strain-specific, meaning that different strains have different effects on the body. If you want to reduce anxiety you could take a strain called Bifidobacterium longum R0175, while this strain may not be as effective if you wanted to prevent c.diff infection.

So as you can see, it’s important to choose the right probiotic strain for the job!

Best Probiotics with Antibiotics

There are a lot of myths floating out there about whether or not to take probiotics during an antibiotic course. The argument goes a little something like this: “I’m taking an antibiotic that kills bacteria – why would I take a probiotic? Wouldn’t my antibiotic just kill the probiotic?”

The answer is that probiotic supplements during antibiotic treatment has been shown to reduce the severity of antibiotic-associated diarrhea. (4) So even though your antibiotics might kill off some of those good gut bacteria, probiotics still reduce the negative side effects of antibiotics.

Here’s a list of the most researched and effective probiotic supplements for reducing the incidence and severity of antibiotic-associated diarrhea. These are some of the best probiotic supplements on the market.

  • Saccharomyces boulardii biocodex (now called Saccharomyces boulardii CNCM I-745) is found in the Florastor brand probiotic and helps to prevent C.diff infections (5) and even helps those who tend to have recurrent C.diff infections. (6). This strain does not need to be refrigerated, so it’s very easy to buy saccharomyces boulardii online.
  • Visbiome (a multi-strain probiotic) has also been shown to reduce the incidence of antibiotic-associated diarrhea.(7) Note that if you buy Visbiome online, you should choose a retailer that ships it refrigerated. (Please note: I used to recommend VSL #3 as it was the brand that use the De Simone probiotic formula. However, they have since lost access to the well-researched formula, and now Visbiome has the only rights to it. Make sure you get Visbiome and NOT VSL #3 if you’re looking for the De Simone formula.)
  • Lactobacillus rhamnosus GG (found in the Culturelle supplement) has been shown to reduce the occurrence of antibiotic-associated diarrhea, as well.(8) Like Florastor, it’s easy to buy Culturelle online since it does not need to be refrigerated.

Antibiotics also tend to cause an overgrowth in yeast (particularly candida albicans). In a study on patients provided probiotic supplementation with Lactobacillus acidophilus CUL60 and CUL21 and two species of Bifidobacterium spp., those who supplemented probiotics along with antibiotics showed less of an increase in yeasts compared to the placebo group. (9) S.boulardii, mentioned above, has been shown to help prevent some of the virulence factors related to C. albicans. (10) I have not seen any research to date on the effects of VSL #3 or Lactobacillus GG on C.albicans or other yeasts, but please chime in in the comments section if you are aware of any.

From the research, I think any of these probiotics are a good choice while taking antibiotics, but it is likely that S. boulardii has a slight advantage in that helps to deal with the overgrowth of yeast that is common with antibiotic treatment. However, research has shown that other probiotic strains can be helpful in this regard as well, so it is likely that VSL#3 and Lactobacillus can be useful in keeping yeast counts down also.

It’s not necessary to take all of these probiotics (it would be pretty expensive!), though I doubt it would hurt you in any way.

If you can’t find any of these probiotics, I still think you’re better off taking any probiotic that is available to you. Though there may not have been research on the particular strains contained in your supplement (and probiotic effects are strain-specific), it is likely that probiotics in general are helpful in preventing some of the unfortunate side effects of antibiotic treatment.

Probiotic Foods

Eating probiotic-rich foods can also be useful in preventing the negative side effects of antibiotics.

High probiotic foods include:

  • Kombucha
  • Yogurt
  • Kimchi
  • Sauerkraut (make sure to buy the kind in the refrigerated section, not off the shelf)
  • Kefir
  • Pickles (again, this should be in the refrigerated section if it has live cultures; if not, they are vinegar-based pickles and will not contain probiotics)
  • Kvass

In addition to buying probiotic foods at the grocery store, you can also make your own! They are very simple to make, and you can even buy starter cultures online to make the process easier. Check out Thrive Market who sells some of these starter cultures (in addition to tons of really healthy foods delivered straight to your door).

Lastly, I started a prebiotic and probiotic drink mix company, Gut Power Drinks — that’s an option as well! Our first product is Gut Power Matcha, a prebiotic and probiotic matcha green tea. It’s a great way to get these healthy bacteria into your routine in an easy, delicious way.

gut power matcha

I recommend taking both a probiotic supplement and consuming probiotic foods while you’re on antibiotics.

Wrapping it All Up: Should You Take Probiotics with Antibiotics?

As you can see, probiotics are a powerhouse when it comes to preventing the negative side effects of antibiotics.

If you’re looking for the best probiotic supplement to take to prevent these symptoms, choose one of the following in addition to consuming fermented foods:

Ready to learn more about healing your gut? Watch my FREE training by clicking the image below!

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How to Heal Your Gut After Antibiotics

Once you’ve finished your antibiotic course, you’ve got some damage control to do. Antibiotics certainly take a toll on the gut, so it’s important to continue babying your gut after you’re done.

Read my next article, How to Heal Your Gut After Antibiotics to learn how to do just that!