 Hi, this is Dr. Ruscio, and let's talk about probiotics and your heart. In a previous post, we discussed some exciting research showing that probiotics can help improve markers of heart disease. And I'd like to talk with you today about two additional studies. Both of these studies showed that probiotics can improve markers associated with heart disease. Now, let's talk specifically about these study types. Both of these studies were systematic reviews with meta-analyses. What this means is a group of researchers summarized the available clinical trials using probiotics. So I'll put some notes here up on the screen and pardon me as I quote, but the first systematic review with meta-analysis examined 15 studies that included 788 subjects. And in this study, to quote, our findings suggest that probiotic supplementation use is effective in lowering the lipid level and coexisting factors associated with cardiovascular disease. So certainly we see some favorable language used there, and specifically the markers that improved according to this meta-analysis, which looked at, again, 15 studies and aggregated or summarized the findings for us, total cholesterol improved, LDL cholesterol improved, body mass index improved, waist circumference improved, as did some inflammatory markers. Now this second study also a systematic review with meta-analysis looked at 33 clinical trials and to quote this group of researchers in conclusion, this meta-analysis showed that probiotic supplementation could be useful in the primary prevention of hypercholesterolemia or high cholesterol, and may lead to reduction in risk factors for cardiovascular disease. Both of these studies are important because they attempt to summarize the available data. You can find one study that shows an unusually good or bad outcome. This is why it's important to look at multiple studies and summarize them because this is what is most likely to give you as a health care consumer or a doctor if you're treating a patient the data, the information that's going to be most likely to be what happens in the real world, right? So in this case we are looking at a large number of studies and a large number of patients in each one of these studies, and we're seeing this true effect of probiotics being able to improve markers associated with heart disease. Now I'll also put some links in this transcript for a previous post where we showed that probiotics can also improve another marker besides cholesterol known as homocysteine. Why is it that probiotics may help with these heart disease markers? Well, I don't think we know for sure, but I'd like to potentially connect a few dots. I think potentially the one or two biggest factors that make probiotics heart healthy if you will are the fact that probiotics are anti-inflammatory and specifically tend to be anti-inflammatory and somewhat reparative to the gut, and especially we think the small intestine. Now, why this is important is because the majority or the highest density of immune cells in your body are located in the small intestine, and some contemporary research is suggesting that a large part of heart disease is actually due to autoimmunity or an overzealous immune activation, and we definitely know that white blood cells and immune cells are part of the atherogenic process or part of the heart disease process, so if we can use an intervention that helps to calm down the immune system, which probiotics may through their impact on the gut and the immense connection between the gut and the immune system, then we can have a positive effect on heart disease. So probiotics improve the health of the gut. The gut has a very strong impact on your immune system, and the immune system is implicated in heart disease. And that's the way I think this all plays out. There are likely other mechanisms that are also involved in this, but I think this may be one of the primary mechanisms. Now I should say there's one thing here that we don't know, which is what sort of effect, at least not according to these studies, what we don't know is what sort of effect does taking probiotics have on your risk of death from cardiovascular disease or your risk of having a cardiovascular episode like an occlusion or a heart attack or a stroke. We don't know that. What we do know is that taking probiotics improve markers that are associated with increased risk for heart disease. Now, probiotics are fairly inexpensive, they're very safe, and taking a probiotic is not something that we need a really strong rationale to justify. You may be asking yourself what probiotic and what dose, what's nice about these summary findings that we see with the systematic reviews and meta-analyses is that different doses and types of probiotics were used, and we still seem to see this consistent relationship that probiotics as a broad class tend to have a favorable effect on risk factors associated with heart disease. I'll put some recommendations in the transcript associated with this video with some of the probiotics that I find helpful, but there are about three general classes. You have your lactobacillus bifidobacterium blends as one. You have sacrum mucous bilardi, which is a healthy type of fungus as another. And thirdly, you have what's known as spore forming or soil-based or the cillus strain probiotics as a third class. And I think for most people, taking a low dose of all three of these in the long-term can be helpful. Very, very occasionally people can experience bloating as a negative side effect from probiotics, and for those people probiotics may not be a good idea, but as a general rule probiotics seem to be very safe, very effective, and as we just covered, can improve markers that are associated with cardiovascular disease. So this is Dr. Ruscio, and I hope this information helps you get healthy and get back to your life. Thanks.