Bottom Line/HEALTH: Did you know that your immune system is actually right in your gut, in your stomach and your intestines? No wonder that probiotics and the bacteria that live in your intestines are all the buzz and all the rage—to help with pain, to help with digestive issues, to help with seems to be of late virtually anything that ails you. So what do you need to know about probiotics?

Bottom Line/HEALTH: Did you know that your immune system is actually right in your gut, in your stomach and your intestines? No wonder that probiotics and the bacteria that live in your intestines are all the buzz and all the rage—to help with pain, to help with digestive issues, to help with seems to be of late virtually anything that ails you. So what do you need to know about probiotics?

I’m Sarah Hiner, President of Bottom Line Publications, and this is our Conversation With the Experts, where we get the answers to your tough questions from our leading experts.

Today I’m speaking to Dr. Andrew Rubman, a leading naturopathic physician and the medical director of the Southbury Clinic in Southbury, Connecticut. Dr. Rubman is a contributing editor to Bottom Line Publications. So welcome, Andy. It’s great to see you.

Dr. Andrew Rubman: You as well, Sarah.

Bottom Line: All right, so probiotics. Sounds simple, but so incredibly complex. Let’s talk first about what it is that probiotics are doing for us, or what makes them so critical to our lives?

Dr. Rubman: They’re bacteria, but they’re special bacteria. Just a little bit of the right strains can help to organize the other bacteria that are intentionally grown in the large intestine and in the back of the nose, in the back of the throat, to protect us against foreign invaders. It’s perhaps the most important intervention that we can do to preserve our health and our longevity.

Bottom Line: So let’s talk about it. You and I have talked before—I kind of liken it to my lawn, the weeds and the grass, right? And the probiotics are the grass and the bad bacteria are the weeds. So what happens? Do the weeds overtake the lawn and we need to reseed, essentially?

Dr. Rubman: That’s part of the problem. Part of the problem is we may not be feeding our lawn well. We may be putting things on the lawn that we want to have a good effect, and they don’t really. We may be taking antibiotics…we may be having poor dietary intake…we may have chronic diseases…we may be taking polypharmacy. We may be suffering from effects of lifestyle and suffering effects of overmedication. But for all of those reasons, we may want to try to bring the bacteria back into order.

Bottom Line: All of those things—the lifestyle, the poor diet, the antibiotics, the other medications—kill the grass, kill the good bacteria?

Dr. Rubman: Make it harder for the grass to grow.

Bottom Line: Right, and then allow these other things—the bad bacteria—to go wild.

Dr. Rubman: Right. It’s always a matter of balance, too, of trying to get the right balance of organisms. That’s why sometimes general interventions don’t work for people where a specific probiotic might.

Bottom Line: Let’s talk about what somebody will experience if they don’t have enough of the good bacteria? What are some of the symptoms? I mentioned in the opening about digestion or pain. What are some of the things that somebody will experience as a result of an imbalance of the bacteria?

Dr. Rubman: Usually the first, and the most guiding, symptoms are going to be problems with the gastrointestinal tract. Intestinal gas, irregular bowel movements, so-called IBS. Secondarily, problems with the function of the stomach. Thirdly, problems with the liver. Oftentimes people will notice shifts in mood and temperament. Women will notice problems associated with hormone imbalances. There can be problems with complexion in that the skin acts as a backup organ of elimination for the liver. So, first digestion…secondarily liver…and third skin, immunity, mood and temperament, other hormonal fluctuations.

Bottom Line: There can even be things like arthritis and other inflammatory pains and allergies.

Dr. Rubman: Absolutely.

Bottom Line: I just think it’s so critical for people to understand, because those are ailments that they’re being given drugs for to suppress the pain, to stop the runny nose. But the fact of the matter is that that’s starting with the bacteria in their stomach, and all those allergy medications are fixing nothing.

Dr. Rubman: They’re at best suppressing symptoms. What people have to understand is that the current medical system is disease management. It is not health and wellness. That’s a misnomer.

Bottom Line: Let’s talk about the probiotics. If somebody is suffering from any of these kinds of symptoms, which pretty much everybody is, how do they know what supplements to take? How do they choose a probiotic to take?

Dr. Rubman: It’s a difficult choice. Most of the commercially available probiotics are dairy-derived, which means they’ll last for a few days but not too much beyond that, so you have to take more of the stuff.

Bottom Line: Are those the supplements, even in supplement form, are you talking about the Activias and the other yogurts that are promoting the probiotics in the yogurt?

Dr. Rubman: Yes, all of those virtually are dairy-derived.

Bottom Line: Even the ones on the shelf at the drugstore?

Dr. Rubman: And the health-food store. About 75% to 80% of them are dairy-derived, right. So you have to look for human-compatible strains. You might say, “All right, that’s a lot to do. Can you give me a brand? Is there a good one that most folks can take and test out the theory that a probiotic will be useful?”

The one that I usually advise people who aren’t patients and who are interested in my opinion on what might work for them is Culturelle, which is a strain of lactobacillus acidophilus called GG. It is very good. It tends to replicate, it’s human-compatible; it’s broadly available.

Bottom Line: Is there a way for somebody to know from looking at the label if something is human-derived versus dairy-derived?

Dr. Rubman: It would say human-compatible. Usually the ones that are not human-compatible don’t say anything. The ones that are human-compatible are very interested in letting the consumer know that, because as consumers get more and more educated about this, they’ll be looking more and more for that language on the label.

Bottom Line: And is it easily available on the Internet to find human-compatible?

Dr. Rubman: Yes, and in health-food stores if you ask.

Bottom Line: Because this is huge. I think that has to be—I’ve never heard anybody talk about the dairy-derived versus the human-derived. And that’s an enormous, enormous difference.

Dr. Rubman: It is, it is. It really is. Because again, the dairy-derived species look enough like the real goods in order to be helpful, but then after awhile, the immune system tires of them, moves them along, and then you have to buy more product and consume it.

Bottom Line: Let me challenge you, though, because if somebody decides they want to take it every day, it’ll work, as long as they take it every day?

Dr. Rubman: Probably. As long as they’re not overly sensitive to components in dairy protein, which usually end up working their way into the material, or the material may be present in a dairy product, which many people have some degree of sensitivity to. So there may be a downside to taking a dairy protein every day for some.

Bottom Line: Is there any risk to somebody taking probiotics on their own, without medical oversight? Is there any risk that somebody needs to watch out for if they decide to be taking probiotics?

Dr. Rubman: If they have a high degree of allergic sensitivity…if they have a very refractory or very sensitive GI tract…if they have chronic liver disease…or if they have another chronic disease and they’re on polypharmacy, they should consider it like adding an additional medication. They really should check it out with their physician before they go ahead and try something, particularly if it’s advertised as being an aggressive treatment.

Bottom Line: Are there any specific side effects that someone would notice if they take a probiotic?

Bottom Line: If it’s going to produce a negative reaction, an allergic-like phenomena that we would call an anaphylactoid reaction…or they would have increased congestion in the head, increased mucus production. They might find themselves sweating…they might find themselves rashy. But more often than not, if they’re going to have a negative reaction, it would be eight to 15 hours later, when their lower GI tract erupts.

Bottom Line: Let me ask you this, though. There’s a side effect, something bad is going on, but in this case, isn’t that kind of an effect that the probiotics are doing their job?

Dr. Rubman: Maybe. And that’s a very interesting point. When is something the result of healing taking place and going through some sort of a crisis as opposed to a negative reaction to an intervention? That’s where you seek out professional help to help you decide.

Bottom Line: Thank you, Dr. Andy. The bottom line on probiotics? Truth be told, virtually everybody probably needs them, because so many people suffer from allergies…digestive ailments… skin issues, eczema…and even arthritis or chronic pain can often be rooted in a digestive tract that’s inflamed.

Talk to your doctor about getting some probiotics that are supportive of you. Lactobacillus is probably the basic overall. Culturelle is a great brand that’s very compatible. This is Sarah Hiner with Bottom Line.