 Hi everyone, this is Dr. Ruscio and let's discuss why probiotics are important. In an ideal world, we wouldn't need probiotics, however, today there are a number of factors that congeal to create a situation in which probiotics do seem to offer benefit for many. And let's discuss the lead up, creating the factors in your gut and in the environment that create the beneficial effect that probiotics can lead to. Now I'll put a diagram up here on the screen to kind of depict what we'll talk through right now. Overuse of antibiotics is certainly one factor that does not help. Now I do feel that antibiotics are giving kind of a bad rap and so we should make a few clarifying remarks. The earlier in life antibiotics are used, the more detrimental they tend to be and the adult microbiota or the world of bacteria in the digestive tract of adults seems to be a bit more impervious to perturbations from antibiotics. Now with children and with infants, there is a time and a place for antibiotics so we want to be very careful to use them when needed but also not to be overly using them. And I do kind of outline some guidelines for this in healthy gut, healthy you. But essentially, if we can use antibiotics sparingly in infants and children, that seems to be when antibiotics have the highest degree of negative impact in adults less or so but neither of these scenarios really bode in favor for healthy intestinal bacterial function. And so this is one factor. Now another factor and many of these have to do with early life because this is when the microbiota form is developed predominantly by the second or third year of life. If one is cesarean birth or not or short term breastfed and essentially why this is important is when you pass through your mother's vaginal canal that is the first exposure or it's a major exposure to the first technically you get some while you're developing in utero. However, when passing through your mother's vaginal cavity that actually is a fairly new whopping dose of bacteria and helps the colonization of the child and breastfeeding also so if cesarean birth or short term or not breastfed, those are factors that also don't help. Now some women need to have a C-section birth that's fine and some women can't breastfeed that's also fine. There are things that we can do to help buffer that but it's important we just identify these factors so we understand why we end up in a situation where probiotics seem to be so beneficial. So continuing on our list overuse of antibacterial soaps certainly also does not help. Also diets high in sugar and low in fiber also do not help. Now the benefits of dietary fiber I do feel and the evidence suggests are overstated. They do help but it seems that cutting out processed foods and moving toward a non-processed diet is where most of the benefit occurs and some of the comparative studies looking at higher or lower fiber intakes as long as the diet is healthy there doesn't seem to be any consistent relationship showing that higher fiber leads to better health outcomes. So we want to not eat processed foods, trans fats, added sugars and aim for consumption of fruits and vegetables and other healthy fats and meats. Yes but also we don't need to obsess with a whoppingly high fiber intake so there's a little bit of a balance and nuance there to be struck. And also being sedentary and or not having good sleep habits lead to a decreased health of the microbiota. Now these are less acknowledged points that I think are also important. Sleep has been shown to impact your microbiota as has exercise in fact we see when people have disruptions of their sleep rhythm the microbiota looks to skew in an unhealthy direction and when sedentary people start exercising and we track these subjects over time we actually see improvements of their gut bacteria their microbiota just when they start exercising. So there's more to this than just antibiotics which I think oftentimes we jump on antibiotics as being fully culpable but there's a litany of factors here some of which are squarely within your control easy simple things like the level of sleep that you're getting and the amount of exercise that you're getting. So all these factors can gel together into the second part of this diagram which leads to a robbing of your intestines of the sources of healthy bacteria and reducing the food needed to feed your healthy bacteria and I should also add there's a reduction of lifestyle factors that encourage healthy bacterial growth sleep and exercise. These factors improve the health of the host the host is the soil from which the bacteria grow healthier host healthier bacteria. So all these factors can gel together and when we have a unfavorable colonization of bacteria in the gut this reduces proper development of your intestinal immune system and why this is important is because the immune system in your intestines is likely the most dense cluster of immune cells in your entire body and it's a crucially important aspect of where your immune system develops. Also the immune system in your gut needs to get along with the bacteria in your gut and so if there's this overzealous immune system that hasn't been well developed then the bacteria in the immune system often times don't get along and so all these things are starting to set the stage for the perfect storm here and what this perfect storm looks like is because your immune system is perhaps a primary source of inflammation in your body when you when we don't have proper immune system development then we can lead to a number of inflammatory conditions and so that's what we're seeing here with this lack of bullet points when you lack the bacteria to regulate your immune system the immune system becomes overactive and attacks when it shouldn't and remember point three here inflammation is the weapon your immune system uses to attack things it does not like. So kind of in recap here we have a number of factors not being breastfed or short term breastfeeding cesarean section birth early antibiotic use lack of a healthy diet poor sleep being sedentary all these factors can yield together leading to poor colonization of the intestinal microbiota that trains the immune system and this leads to a overzealous immune system which produces excessive amounts of inflammation and this leads to this vicious cycle we've discussed before poor colonization of bacteria poor immune system function excessive inflammation and a litany of modern-day inflammatory conditions and this is not a positive unique to me there have been studies published I believe the most notable one was I believe in the New England Journal of Medicine showing a correlation between hygienic practices on the one axis and increasing prevalence of autoimmune conditions on the other and so there does need to be this correlation now I should also be fair and state that with these hygienic practices that we have in the West having antibiotics having better hygiene and a cleaner environment that has reduced infant mortality infant mortality excuse me and rates of infections so there is there is a balance here and there's a trade-off but what may be happening is we may have swung too far in the hygienic direction and now we're seeing this kind of backlash of inflammatory conditions and so what we want to do is try to tip the scale back a little bit and one of the things that can help do that is probiotics because probiotics can help to train the immune system this is why we see in some of the research studies that reduced inflammatory cytokines follow the administration of probiotics as well as IBS symptoms or digestive symptoms as well as a reduction of leaky gut and even some early but promising information showing that certain autoimmune conditions the best study today is really rheumatoid arthritis may improve after the administration of probiotics part of this being due to a reduction of inflammation so probiotics are certainly not a panacea they're not a curel but they're one method that can help take this this kind of cascade of causality that we discussed and help intervene and balance out what can be one of the major underlying causes of symptoms which is this cascade of inflammation that initiates from poor bacterial balance and colonization in the gut so hopefully this helps tie together why probiotics can be important because they really do to a degree help to treat a root causative issue which is poor gut and or gut immune system health this again leads this domino rally of causation ultimately ending inflammation and symptoms and while probiotics are not a curel they certainly have been shown to help with any of conditions from joint pain to skin conditions to neurological conditions like anxiety and depression of course with IBS and to lower inflammation and even have a modest effect on things like blood pressure and cholesterol so if you have not yet used probiotics I'd recommend trying a good well-rounded probiotic protocol I will list the one that I use here in the clinic with my patients and I also recommend healthy good health to you this is a great way to start this protocol provides you essentially three different probiotics and the analogy that I use is there are essentially three different categorical types of probiotics and it appears that patients do best when they use all three together and the analogy I use is a stool if we're trying to balance we can balance on a one-legged stool or we can balance the gut on a one probiotic protocol however it does seem this is more so my inference but it does seem that people will experience higher degrees of benefit when they use all three types categorical types of probiotics at the same time they came to having a three-legged stool which is a better balance or better support to help to rectify any imbalances in the gut okay so this is Dr. Ruscio we got a little nerdy on that one hopefully this helps you better understand why probiotics are beneficial and that hinting at a good well-rounded probiotic protocol that you can execute if you're trying to get healthy and get back to your life okay we'll talk to you guys next time thanks