 Are probiotics actually useful for male health? Let's examine if probiotics help male problems like libido, erectile function, testosterone levels, heart health, and prostate. And if it matters what kinds of probiotics men specifically take. Hi, this is Dr. Ruscio, and let's jump in. There is evidence showing that probiotics can help and treat some male specific health conditions. However, with other conditions, we see more of an inferential link with gut health. The downsides are few. In fact, probiotics have side benefits, and the body of evidence supporting probiotics to improve male health is growing. And we should also be a little bit cautious regarding what to look for in probiotics. And we'll expand upon this more later, but you might not be getting your money's worth from your probiotic. Okay, so let's jump in on how, if when men can use probiotics and potentially gain some benefit from them. Regarding sexual health, there's no direct research looking at probiotics as a direct treatment for sexual health. However, there are several studies that show a correlation between sexual problems and poor gut health. Research has found a correlation between IBS and sexual dysfunction. In one study, men with IBS were three times more likely to have erectile dysfunction. And in another research review, men and women with IBS had more sexual health problems. And in yet another study, patients with inflammatory bowel disease had more erectile dysfunction. So certainly some good correlation data here. Also there's a lot of evidence finding that probiotics improve IBS or irritable bowel syndrome. This constellation of symptoms, loose stools, diarrhea, constipation, abdominal pain, bloating. In fact, there was a meta analysis or a summary of 20 randomized control trials. And probiotics were shown to significantly improve IBS symptoms. Another well-performed randomized control trial in over 300 patients found that probiotics significantly improved IBS-like symptoms. And there are many, many other studies that have found that probiotics can improve digestive symptoms. And again, these symptoms have been linked to sexual dysfunction. So the interpretation and synthesis on sexual health data sums out to those with IBS are more likely to have erectile dysfunction. Probiotics have been shown to improve IBS. Therefore probiotics may help some cases of erectile dysfunction. There was also one trial suggesting that probiotics may improve testosterone levels and sperm health. But we do want to be careful here because it's only one study and I'm not clear on the magnitude of that effect. So the conclusion here is a one-month trial on probiotics may be helpful and reasonable for men's sexual health. What about heart health? In the Journal of the American Medical Association, they have concluded, and this is probably not surprising to men, that men have a higher incidence of heart attack and heart disease. In fact, even after adjusting for confounding variables like cholesterol, blood pressure, diabetes, body mass index and physical activity, men were still shown to have more risk for heart disease and heart attacks than women. So there's something here somewhat unique to men. Now, what about this potential connection between probiotics, the gut and the heart? Well, growing evidence finds that there is a connection between the gut and the heart and this is based upon the gut hypothesis, if you will. It correlates heart conditions with poor gut health. In the Journal of Life Sciences, the gut microbiota was concluded and theorized, really theorized to affect cardiovascular disease, including clogged arteries, high blood pressure, heart failure, atrial fibrillation and myocardial fibrosis. Now continuing along this line of support for the gut-heart connection, in the journal Nature Reviews and Cardiology, they essentially concluded that an altered gut microbiota can increase susceptibility to heart disease and the gut microbiota is just a world of bacteria that live in your gut. And in another paper, they concluded and commented that leaky gut syndrome may be the cause or is likely the cause of low-grade inflammation found in heart disease patients. And what about evidence showing probiotics as direct treatment to improve heart health through the gut? So far, there's only one human clinical trial that did assess this in the internal Journal of Cardiology, but the results here were actually quite promising. In this study, the group taking probiotics showed a significant reduction in the diameter of the left ventricular artery and swelling of this artery is linked to heart failure. They also documented small improvements in metabolic markers compared to the placebo group, reduced total cholesterol and reduced uric acid levels. It's important to underscore that the effect size here or the magnitude of the benefit is small. So it's not something that if you're frankly hypercholesterolemic is going to get you back down to normal, but this is a supportive therapy that can move you in the right direction. So to summarize the gut-heart connection, there's speculative evidence, meaning it's of lower quality, that gut health and optimizing one's gut health may reduce the risk of heart failure and reduce heart disease. There's also evidence showing a small positive impact on cholesterol levels and other metabolic markers. And there's growing research establishing this gut-heart connection. We should also discuss the gut-brain connection. Regarding brain health, memory, short-term memory, working memory, processing speed, mood, these are all facets of cognition loosely stated. And it's also important to contextualize that some studies suggest men have slightly higher risk for cognitive impairment as they get older. So what does the research here say? Well, in one journal paper from the journal Nutrients, it was a clinical trial, 12 weeks on either placebo or probiotics, and they found that the probiotics was helpful for patients with mild cognitive impairment when compared to the placebo. And in a similar study, older adults were either given probiotics or placebo again for 12 weeks, and they found at the end of the 12-week intervention period, those who had poor baseline cognition saw improvements in their cognitive function, whereas healthy patients didn't see any effect. And really impressive data here, a meta-analysis or a summary of 19 clinical trials found a significantly greater improvement in depressive symptoms versus those who were receiving placebo. So the probiotics led to a significant improvement in depression symptoms as compared to placebo. And they did conclude, additionally, that a multi-strain or multi-species probiotic was better than a single bacterial alone. There's a little bit less research on anxiety, but there have been clinical trials that have found improvements in anxiety when using probiotics and even very recently, a meta-analysis also finding the same thing. So certainly some promising evidence here that cognition and better evidence that mood may be improved by using probiotics, kind of supporting this gut-brain connection. So in conclusion here, your brain is vulnerable to poor gut health, and I actually learned this myself. I'll share a little bit about that in a moment. And probiotics can help correct this. If your gut is healthy, probiotics may not boost your brain power anymore. And what about weight loss? The most recent high quality data finds there's no significant impact of probiotics on weight. And this is why I and we always look at the totality of the evidence and the quality of the evidence. Both of these things are very important, which is why you've heard me reference meta-analysis, which are summaries of clinical trials and clinical trials. By using this kind of filter system to not look at low quality data and only look at the best quality information, you are assured that the interventions are safe and that the interventions are effective. So continuing with the example of weight loss, we cherry-picked a couple misleading claims, but if we look at a 2019 meta-analysis, the conclusions were that there was a small effect on waste circumference, no effect on BMI, and the study concluded there was no definitive results. And four other meta-analyses have also made similar conclusions, essentially no effect on BMI, no effect on body weight, or any effect on fat mass. So again, really important that if we look hard enough, we can find a data point that reinforces what we want to believe, but we should be using science, not the footnote of prior belief, but actually inform what our positions are. In this case, unfortunately for weight loss, certainly not going to hurt you, but the degree of benefit is so small that it's essentially non-existent. So on weight loss takeaways, probiotics may have a small benefit. This really nets out to about two to four pounds max, and this is an overweight or obese individual. So if someone who's obese loses two pounds, it's not really considered clinically significant. So probiotics will not be a cornerstone of weight loss, won't hurt, but important to clarify the degree of benefit or the effect size. Now sleep is something that impacts pretty much every facet of health, from cancer risk all the way up to neurodegenerative decline. And the research here, kind of as context, has found that men have poor sleep in women. Part of this might be due to the fact that men have more muscle, and that muscle partially encroaches on the throat, the airway. And so the muscle is kind of a liability for men because you wanna have the largest airway that you can so you don't have these apnoic events or you don't snore and have labor respiration while you're breathing. So men are at higher risk, and there is actually some preliminary evidence that even though men are at higher risk for poor sleep, probiotics actually can improve sleep quality. There was one clinical trial in medical students, and it found that those taking probiotics actually slept better during times of exam stress. And in another clinical trial, participants reported that their sleep quality was better after six weeks of taking probiotics. Additionally, a study in IBS patients found that sleep improved for diarrheal type IBS. And in a group of depressed subjects, they had better sleep quality when using probiotics. So some nice benefits associated with probiotics and how they may impact the gut brain connection or the gut sleep connection. Now what about prostate health? This is coming to something that's much more squarely related to men of course. It's important to contextualize that two million men per year visit the doctor for prostatitis or prostate inflammation every year. And one study suggests that probiotics actually may be beneficial. And let's look at this, actually two studies. So in one study in the journal Prostatic Cancer and Prostatic Diseases, they concluded that the gut microbiome can influence prostate inflammation and may impact prostate cancer. And another study suggested that an imbalance of the gut bacteria may be a primary cause of chronic prostatitis and that probiotics may be a beneficial therapy. So these two papers are more so theoretical. They're looking at mechanisms that they're trying to kind of conjecture in terms of what might be a valuable therapeutic, but what about as we discussed earlier, high quality clinical trial data in humans? Well thankfully here there's two trials. One clinical trial looked at long-term treatment with refaximin and antibiotic combined with probiotics. And taking probiotics reduced the recurrence rate of chronic prostatitis. And essentially the patients who are taking refaximin plus probiotics saw no regression or no symptoms. Whereas in the group just taking the antibiotic there was a 20% rate of relapse or flaring of symptoms. It's important to mention here and tie something together that this refaximin is also used to treat IBS, irritable bowel syndrome and or small intestinal bacterial overgrowth. And people oftentimes don't appreciate the fact that there are over 20 clinical trials that have found that probiotics alone can resolve small intestinal bacterial overgrowth. So essentially there's data showing that this probiotic therapy for small intestinal bacterial overgrowth is of similar effectiveness as an antibiotic refaximin. So it's not surprising to see that when refaximin used for prostatitis was combined with probiotics, you see improvements in the prostatitis outcomes. And another very recent clinical trial in nature of use in neurology found something similar. Different antibiotic combined with a probiotic was found to be better than the antibiotic alone. So for prostate health, probiotics actually have some preliminary and exciting evidence. And to synthesize this, what's the pattern here? Well, again, the improvement seen in prostate health when using probiotics might be due to probiotics antibacterial function thus reducing bacteria potentially in the prostate. It might also be due to reduced inflammation like the heart disease studies suggested. And probiotics may help maintain a healthy balance of gut bacteria which then detoxify estrogens and this may be impacting prostatitis. This is one theory that circulates in functional and integrative medical communities. I haven't fact checked this claim, but we do know that gut bacteria detoxify estrogen so there is some plausibility to this claim. So here, a trial on probiotics to aid prostate health appears reasonable. And so this begs the question, what are the best probiotics for men? And really for men, the probiotics required are not any different than women. If you look at the research studies, you're not seeing in any of these studies for prostatitis or heart health or what have you that there's a special blend for men that's being used. Really most of the time when you see men's or women's on many formulas, not for all, but it's just marketing. So we wanna be careful about that just so that men don't think they need to buy a more expensive or unique probiotic just for them. And what I've fallen into personally in the clinic, this has not been published yet, although we are collecting data on this and we're hoping to publish on it soon, is a combination of three different probiotic formulas. Allactobacillus and Bifidobacterium blend, a sacrum mochis bilardii combined with a soil-based blend. And this is drawing or extending from the prior finding that found a single bacteria was not as helpful as a multi-bacteria probiotic. And so if we extrapolate that a little further, if we can only get so many bacteria in one formula, we could then add a couple different formulas together to get even more bacteria. And this seems to be at least in my clinical experience more effective than using one probiotic alone. And the analogy I use here is, if you consider a stool like you would sit on akin to your gut microbiota, we wanna have balance in that ecosystem. One probiotic is supportive of balance, but three probiotics are almost like having three legs of support helping to keep the gut microbiota in optimum balance. So that's what I personally use and in the clinic and we, our clinical team at the office, also use, we found it to be more effective. Again, that hasn't been published yet, but we are hoping to publish on that soon. What about buying a probiotic? Well, some cautions when buying. Research has shown that most probiotics don't meet their label claims. Of the 26 commercially assessed probiotics, according to one study, none of them fully supported their label claims. Another study found that 43% of the probiotics assessed contained less than half of the amount listed on the label. And an additional study, they found that only half of the probiotics examined had the specific strains listed on the labels. And even more shockingly, some contained harmful microorganisms. So it's really important to buy a quality probiotic. It's not to say that the most expensive probiotic is the best, but you wanna be careful of some of these shady practices that may not give you the highest quality of a probiotic. So when you shop for a probiotic, look for the following on the label. A clearly listed species, the number of colony forming units, a manufactured date or expiration date, a list of other ingredients so you can determine if there are other allergens, fillers or irritants, and that the company follows what's known as GMP or good manufacturing practices. And also evidence that the product has been tested by a third party. Regarding quality, it's not to say again that the most expensive is the best, but what I'd offer you as kind of a benchmark is if you're finding one or two products that are vastly cheaper than most of what you're seeing on the market, then they're likely doing something to cut corners and bring their costs down. So the most expensive isn't the best, but the cheapest might not be good. And so the question of, do you have to take probiotics forever? No, I would recommend you perform a trial three to four weeks seems reasonable. Re-evaluate, am I improving, am I not? If you are improving, maintain what you're doing until you plateau, then wait one or two months, make sure that the plateau, the improvement peak is consistent, and then wean yourself off and try to find your minimal effect of dose or come off completely. Some people can wean off completely and they're fine. Other people will see a gradual regression of some of their symptoms. So be careful here, not to fall into expected dependency upon probiotics or any supplement. Be objective. Don't expect them to be super helpful. Don't expect them not to help. Be objective, have a neutral expectation, listen to your body. This will prevent plus seabooing or no seabooing yourself and try to wean off and or find the minimal effective dose. And we do have a probiotic starter guide if you wanted kind of a recapping of some of these parameters. And do I take probiotics? Yes, every day. My gut was essentially a mess in college and probiotics were one of a few things that really helped turn the corner for me. And the things that I've noticed most recently, my gut health got much better after adjusting the parasite but there was still a lot of residual inflammation. And that manifested mainly as food reactive brain fog, insomnia and some fatigue. And probiotics really helped me be more impervious of things like having coffee, having wine, eating out that used to kind of trigger me with either some brain fog or some fatigue and was really frustrating. And once I got on the three probiotics that was actually a big turning point for me. So they were definitely helpful for me and I'm eager to share this with other people. And also some of the experiences that we've seen in the clinic of going on the probiotic triple therapy has been quite remarkable. So it's definitely something that I'm keen to share with people especially looking at how probiotics are relatively inexpensive. They're very safe and they have many side benefits. So if we can have someone do this and prevent them from needing to go on an antidepressant and anti-inflammatory medication and a rectile function medication then that would be a huge win. So in summary, I recommend trying probiotics for male specific health issues. They are not a panacea, they are not going to resolve everything but they are a supportive measure that may lead to improvements in many parameters of your health across the board. And probiotics can also be helpful for women and children. I should just make that quick aside. They're not something that only benefits men of course but this video is for men. Okay, well this is Dr. Ruscio and I hope this helped. And if you'd like more science-based natural health information, please click subscribe.