 Hi, this is Dr. Ruscio and let's discuss if probiotics can actually help make vaccine specifically the flu vaccine work more effectively. And I'd like to answer an audience question, I'm going to use my super high-tech method here of playing her question. Hi, Dr. Ruscio. My name is Kelly. I listen to your podcast all the time and thank you so much for making sure that they are understandable by the way of a person such as myself. I am in the process of healing my leaky gut and I am curious to know your thoughts on the flu shot and how that impacts gut health and your thoughts on if it's worth getting the flu shot or not. I have read a lot of research both positive and negative in terms of getting the flu shot and I was just curious about your opinion. Thank you so much. Okay, so good question by Kelly and certainly this time of year an understandable question. Now in adults, in immunocompetent adults, I'm not highly concerned about the flu vaccine in either direction. The benefit seems to be minimal but the risk also seems to be minimal. So what I tell my patients is I'm not highly concerned about this one way or the other. Now in higher risk populations like children and those who are elderly, it's a different conversation but in immunocompetent or adults with normal immune systems there does seem to be some benefit but that benefit seems to be minimal. It does not mean that benefit is necessarily non-existent but it does appear to be minimal at least the best of my knowledge but the risk also seems to be minimal because in an immunocompetent and well-formed adult there's not the same potential risk that there may be in other populations. Now I should also mention that I have not performed a comprehensive review of the literature here so that recommendation I'm making or that comment I'm making may be shown to be not the most accurate or most reflective of what the evidence shows but I think it's a pretty reasonable recommendation that it doesn't seem to make a huge difference detrimental or beneficial one way or the other in immunocompetent adults so I wouldn't be too worried about it. However, there is some interesting information that may be able to help you mitigate any potential damage to your gut that you're describing your leaky gut and that may be with probiotics and the probiotics may actually be able to help not only with helping to keep your gut healthy but also to enhance the effectiveness of the vaccination and I'd like to share with you a study. The study entitled the influence of probiotics on vaccine response a systematic review. Now remember a systematic review reviews all the literature so in a sense this is a semi comprehensive review of the literature on the relationship between probiotics and the and vaccines as a general class. So to quote we found 26 studies involving 3,812 patients investigating the effects of 40 different probiotics and response to 17 different vaccines so a pretty good review. A beneficial effect of probiotics was reported in about half of these studies so again not bad and the strongest evidence was actually found for the influenza vaccination and also for other vaccinations that were administered orally. And they conclude the studies in our review suggest that probiotics offer a relatively cheap intervention to improve vaccine efficacy and duration of protection. So that's pretty interesting information. We see that vaccines may help or I'm sorry probiotics may help vaccines to work more effectively and the duration of the response may be prolonged from using probiotics and they may also help any negative gut consequences that may be secondary to the flu vaccine. There was another paper I couldn't find it that I recently read that also showed that probiotics may when co-administered along with vaccines may help to reduce any negative side effects and I searched for it I couldn't pick that one out. But essentially if you're going to use a vaccine as an adult that doesn't have any other frank immune issues then I don't think you're going to garner a huge benefit but I also don't think there's going to be much in the way of detriment. So you can really go either way and if you have your general practitioner or someone who's leaning on you to get one again you know it's not a huge deal in my opinion either way using a probiotic may help protect the gut not that I think there's a lot negative that's going to occur in the gut anyway from a vaccine but it may help protect from any potential negative gut side effects and may actually help the vaccine work more effectively. So just a few thoughts for you there Kelly and a few thoughts on the relationship between vaccines and probiotics at large and gut health and hopefully this information helps you get healthy and get back to your life. Thanks.