The Skinny on Prebiotics, Probiotics, Postbiotics and everything else in between
Knowing what each of the bacterial-balancing-related supplements does, is made of, and is intended for will change the outcome of your gut health.
Have you ever searched online “Natural supplements for (fill in the blank with below word)” ?
Gas or burping
Bloating/abdominal distention
Stomach pains
Stomach cramps
Constipation
Diarrhea
Food intolerances
Better digestion
Dysbiosis
Heartburn
SIBO, small intestinal bacterial overgrowth
Ulcerative colitis
Crohn disease
IBS, Irritable bowel syndrome
IBD, irritable bowel disease
You will likely have come across some of these supplements:
Probiotics, Spore-formed probiotics, Probiotic yeasts such as Saccharomyces boulardii
Prebiotics
Postbiotics
Bovine Immunoglobulins
Colostrum
FMT, fecal microbiota transplant therapy
Just about every human develops any number of digestive symptoms over their lifetime. Therefore, it is no surprise that there are SO many kinds of digestive supplements out on the market right now, especially bacterial balancing-related products.
The above symptoms are only symptoms and are NOT a diagnosis. This is where I stress the importance of seeing your provider for appropriate testing to help you identify the CAUSE of your symptoms instead of just blindly throwing supplements at them. Remember, as a functional medicine provider, the testing I perform in my office can and usually looks different than what conventional providers offer. If you feel stuck, reach out, I am here for you.
Bacteria and the Body
A mostly love and less hate relationship.
LESS THAN 1% of bacteria species actually create dis-ease in the human body. This 1% are the ones we fight with antibiotics and use best practices with hygiene and sanitation.
The other 99% we have a generally symbiotic relationship with. Some reside in us or have no relationship with us and live in certain soils across the globe or other living species and plants. Even still, studies have shown that some species we know to cause disease can reside in healthy, asymptomatic people!
About 10,000+ bacteria in our gut influence any given area of our health. These bacteria essentially define our gut microbiome.
Our gut microbiome has been shown to:
Be a driving factor in digestive concerns such as heartburn, gas/bloating, IBS, diarrhea, constipation, and various types of colitis.
Influence what our body absorbs from our foods (when there is inflammation, there is poor absorption)
Influence our mental health
Influence skin health such as eczema and atopic dermatitis
Influence our sex hormones and endocrine system (thyroid)
Influence our total immune system
Influence risks of certain cancers and cancer therapy
Influence risks of specific chronic diseases such as diabetes and arthritis
Influence risks of certain autoimmune and inflammatory diseases
Influence on weight (metabolism and endocrine system)
A comprehensive stool analysis (CSA) examines what good and bad bacteria exist and do not exist. Ideally, a well-rounded CSA will test for the DNA through PCR and visually through microscopy evaluation.
There are ways to influence and create a healthier microbiome, so here are some bacteria-balancing-related supplements that are worth knowing more about.
1. Probiotics
Probiotics are the beneficial bacteria we consume supplementally or through food sources that should naturally populate our gut microbiome. Probiotic species promote overall health and healthy digestion. They generally include live bacteria but also include beneficial yeasts, such as Saccharomyces boulardii, or even spore-formed species
Foods that contain a large number of probiotic species (naturally fermented, not added)
Yogurt and kefir (fermented milk)
Pickles
Kimchi
Sauerkraut
Kombucha
Kefir
Tempeh
Miso
Traditional buttermilk
Some aged cheeses
Most general probiotic supplemental products include different bacteria species in the Lactobacillus and Bifidobacterium genera. You can find hundreds of different blends or single species that target a more specific area of health. As research continues to develop, we are finding more and more information on specific strains of bacteria that benefit different areas of health.
Saccharomyces boulardii is a hardy and unique non-pathogenic ‘probiotic yeast’ that is commonly used to reduce loose stool or diarrhea. It is also commonly used to treat some cases of SIBO, small intestinal bacterial overgrowth, Clostridium difficile infections, colitis, and stomach bugs or traveler’s diarrhea. What is unique about S. boulardii is that it does not colonize the digestive tract but rather promotes Bifidobacterium species growth and it is resistant to temperature, antibiotics, and pH changes so easy for travel and on the go. S. boulardii is also known to improve immune system function and absorption of fluids and minerals/electrolytes when there are loose stool.
Spore-forming probiotics are becoming more popular and include species like Bacillus indicus, Bacillus subtilis, Bacillus coagulans, and Bacillus clausii. A specie being ‘spore-based’ means that it is encapsulated in an endospore and resistant to temperatures and stomach acid. Thus, these spore-forming species are thought to populate the digestive tract better than your traditional probiotics. Spore-based Bacillus species are toted to ‘recondition the microbiome’ and can produce enzymes, secretory proteins, antimicrobial compounds, vitamins, and carotenoids. This form can be ideal for those with absorption concerns, small intestinal issues, or during travel. They are also used in some medical conditions more effectively than regular probiotic blends.
Notes about probiotic supplementation: Some probiotics can cause the symptoms you are trying to resolve if you do not dose them appropriately. If you do not generally eat foods higher in probiotics and want to supplement, I highly recommend starting low and tapering up your dosage. Some rebound symptoms to know you are taking too much are gas/bloat, abdominal discomfort, or loose stool. It can take time to re-establish a healthy microbiome, so don’t go big at the start. Take it slow.
2. Prebiotics
Prebiotics are the FOOD for the microbiome. They are complex carbohydrates such as insoluble dietary fibers and resistant starches that are the food to the bacteria in our microbiome. The bacteria need these constituents to proliferate and continue to survive and overcome the less favorable bacteria we are exposed to often.
There are MANY types of prebiotics in the foods we eat, primarily in fruits and vegetables. As the name ‘insoluble fiber’ implies, most prebiotics are bulking agents and make up much of what is in our poop!
Some of the most common prebiotic forms you will come across in natural supplements include:
Galacto-oligosaccharides, xylo-oligosaccharides, and/or fructo-oligosaccharides
Kiwi fruit extract
Pomegranate fruit extract
Citrus bioflavonoids
Modified apple pectin
Inulin from Chicory root
Notes about prebiotic supplementation: Since prebiotics are fiber, you must ensure you consume PLENTY of water when you take them in supplement form. At least half your body weight in ounces per day and at least 8-10oz consumed with the supplement. Not adding water and consuming it in adequate quantities can cause constipation, hard stool, gas, and bloating. Again, just like probiotics, start lower and slowly work your way up if necessary.
3. Postbiotics
Postbiotics are the bioactive compounds a probiotic bacteria makes when they consume a prebiotic. It is essentially the ‘poop’ of the bacteria when they eat their food (fiber).
Some postbiotic compounds include:
Short-chain fatty acids such as butyrate (magnesium butyrate, butyric acid Tributyrin)
Lipopolysaccharides and exopolysaccharides
enzymes
cell wall fragments and cell-free supernatants
bacterial lysates
And various other metabolites, such as vitamins and amino acids
Some benefits of particular postbiotics that are currently being researched include immunomodulation, anti-inflammation, antioxidant, and anti-cancer properties. They are also studied to show benefits for those with IBD, chronic diarrhea, Crohn's disease, and ulcerative colitis.
Some supplements include these compounds, but they are not always necessary to supplement if you consume dietary or supplemental beneficial bacteria and fiber. Many great products on the market are 2-in-1 probiotics and prebiotics that essentially increase postbiotic production. Currently, a leader in the field is Thaena. We will talk more about this therapy below in fecal microbiome transplant.
4. Serum-derived Bovine Immunoglobulins and Bovine Colostrum
I mention these two products together because they are commonly combined in supplements. Colostrum contains immunoglobulins, so there is a significant overlap between these products. You cannot acquire them through regular dietary food intake, and they are only found supplementally unless you acquire bovine colostrum from a dairy farm.
Now, this topic goes much further than just the digestive tract. At a basic level, immunoglobulins (Ig) are antibodies. At a more scientific level, they are glycoproteins that plasma cells make to protect the body against viruses, bacteria, fungi, or other pathogens. There are different types of Immunoglobulins, such as Immunoglobulin A (IgA), Immunoglobulin G (IgG), and Immunoglobulin M (IgM). We can test for the number of immunoglobulins in someone’s blood to identify acute and chronic illnesses. In a digestive health setting, I want to discuss the supplementation of serum-derived immunoglobulins and colostrum.
Much like human milk colostrum, bovine colostrum is the milk that a birthing cow produces in the first two-four days after giving birth. Colostrum contains high levels of immunoglobulins, antimicrobial peptides, and growth factors. The immunoglobulins in colostrum are acquired via milk where as serum-derived immunoglobulins are derived from cow blood serum. The immunoglobulins are the same regardless of the source, but research shows the level of immunoglobulins in colostrum is higher than that of the serum.
Immunoglobulins are researched to repair and maintain gut barrier integrity. These products are used in cases of ‘leaky-gut’ to support gut barrier function and in other diseases that cause loss of integrity of the gut lining. Conditions in which we see benefit include SIBO, IBS, mucositis, and colitis, and indirectly any condition in which the patient’s digestive tract has been altered through medication or disease. Immunoglobulins can also neutralize some bacterial infections in the GI tract. These supplements generally improve the absorption of nutrients in the diet and reduce inflammation.
Notes about Immunoglobulins and Colostrum: These are not products for those with dairy or cow meat allergies or sensitivities. These are not vegan products. While most companies that sell bovine colostrum state that it is not being taken from a new calf, it still poses an ethical question of human consumption of bovine colostrum.
5. Fecal Microbiota Transplant (FMT)
This therapy is essentially the ingestion or rectal insertion of a specially-processed donated fecal specimen to re-establish a healthy gut microbiome. Yes, I know it sounds gross, but to be honest, this is one of the very best therapies we use today to heal chronic diseases in the digestive tract. It is basically directly introducing a healthy individual’s gut microbiome into a less healthy individual’s gut microbiome to re-establish systemic health.
Some clinics and facilities administer this therapy; there are ‘at home’ methods (NOT to be used without the supervision of your doctor) and hybrid products such as ThaenaBiotic.
FMT is an ideal therapy for those with debilitating complex illnesses and immunodeficiency. It’s far more potent than taking a prebiotic, probiotics, and postbiotic and usually works faster. Studies show its positive effects on Clostridium difficile infection and irritable bowel disease. Ongoing research is looking into its impact on autism and obesity.
Notes on FMT: Do not perform oral FMT therapy at home unless you have doctor supervision. For rectal FMT, this is done in a clinical setting. Like many other digestive aids, start slow and low and work your way up, as this therapy can transiently cause the symptoms you are trying to eliminate.
Here to empower you with the knowledge of health,
