One of the reasons our gut has so much influence over our health has to do with the 100 trillion bacteria—about three pounds worth—that line the intestinal tract. We actually have quite the symbiotic relationship with these bacterial power-houses, we give them a place to live and they help keep us alive.

It isn’t exactly novel news that we are more bacteria than we are human, in fact there is a 10 to 1 ratio of bacteria to cells in our body, meaning that the human gut contains 10 times more bacteria than all the human cells in the body.

People are beginning to really to pay attention to acquiring proper gut flora, as it influences everything from hormone secretions, immune health (80 percent of our immune system is in our gut) mood elevation (90 percent of serotonin is produced in the gut), metabolism and weight management, nutrient absorption, gene expression (our microbiome has 360 times more protein coding DNA than we do) and gastrointestinal function.

Dys-regulated gut flora has been linked to diseases ranging from autism and depression to IBS, and even type 1 diabetes.

To Each Their Own
While personalized nutrition has become a bit of a health trend, personalized probiotics can easily fall under the umbrella of customized health. Curating our personal nutrition, supplement and dietary needs is far less trending and much more omnipresent than ever before, and for good reason!

Current research is finding that each person’s bacterial profile is as unique as our individual DNA. We have about 1,000 different species of bacteria found in the human gut and each person has a unique combination of between 250-500 of these! We have roughly 1/3 shared bacteria between us, while the other 2/3 of bacteria is unique to the individual … you can imagine this makes picking a probiotic a daunting task at times.

The number and type of bacteria a person has can have an impact not only our health, but also our mood, attention and behavior. The type of bacteria we have can determine if we are lean or obese, how often and how severely we get sick, our skin health and even occurrences of allergies. Currently more than 100 million Americans have digestive problems, and there are more than 200 over-the-counter remedies for digestive disorders which include everything from irritable bowel syndrome (IBS), constipation, diarrhea, reflux and heartburn.

Who Might Need a Probiotic
Who needs to take probiotics? To put it lightly, mostly everyone! As we age our good bacteria population begins to decline, women have higher needs for certain strains of probiotics such as Lactobaccilus to support vaginal health, antibiotic use, lack of dietary fiber, smoking, stressed pregnancies, early deliveries, C-section deliveries and even formula feeding have all been shown to lower good bacteria diversity.

Changes that occur in the intestinal microflora can be alerted by the dysbosis or misbalance between good and bad bacteria. A disruption in having an optimal balance of bacteria in the gut can be caused by factors such as diet (including excessive sugars and refined carbohydrates, non-organic produce, factory-farmed animal sources and poor fiber intake), intestinal function (secretion of hormones and mobility of nutrients), lifestyle factors such as sleep and stress management and abnormal conditions related to the intestines (such as infection, inflammation, bacterial overgrowth) and medications (such as anti-acids and antibiotics).

Do I Need a Probiotic?
If you answer YES to three or more of these questions than you would likely benefit from supplementing with a probiotic.
• Do I have digestive problems?
• Do I have trouble concentrating?
• Do I feel unnecessarily stressed out?
• Do I have trouble losing weight and keeping it off?
• Do I come down with colds or allergies frequently?
• Do I eat a diet high in sugar, processed foods, refined carbohydrates?
• Have I recently taken antibiotics?
• Am I having trouble sleeping?
• Do I take birth control pills or NSAIDS?

Be Picky
Multi-strain or single strain? Refrigerated or non-refrigerated? Buying a probiotic can be confusing since there are so many different brands, strands, species and forms of this super star supplement. Certain probiotics require refrigeration, while others are shelf-stable, some are found in a capsule form, while others are in a powder, some are multi-strain, while others are single strain, and to make it even more confusing some have added pre-biotics and digestive enzymes.

Factors such as your health needs and goals, as well as your current diet and lifestyle, assessing how damaged your microbiome is and depending on the condition you are trying to combat can all play a role in picking the right probiotic for you.

Team Work Makes the Dream Work … A Case for Multi-Strain 
It’s not the total number of bacteria in a product that is most important, it’s the number of different strains of bacteria it includes. It is important to note that different strains of probiotic bacteria have slightly different functions and are concentrated in various places along the digestive tract. Different strains of probiotics can be better for different people and often times you might have to try out a few brands or mixed strains to see what works best for you. A good strain for one person might not be the best strain for another person.

A probiotic supplement that contain multiple strains tends to be more effective for overall health, rather than a product that contains a mega dosing of just one strain; this has to due largely with the fact that many strains work synergistically to enhance health.

Mixed probiotics containing lactobacilli and bifidobacteraia are a great starting point because they work together to promote healthy levels of inflammation in the intestines, support normal GI function, stimulate immune development in children and support concentration and focus.

Lactobacillus species ferment can ferment carbs in the gut, which produce lactic acid. This is also the speicies that inhabits mostly in your small intestines. Lactic acid creates an acidic environment in digestive tract which doesn’t allow the growth of pathogenic microorganism that enjoy living in an alkaline environment. This strain is also important for healthy immune function, weight management and supporting a healthy vaginal microbiome.

Bifiodobacterium inhabit mostly in the large intestines (colon) and play a role in preventing the growth of harmful bacteria, as well as yeast. As we age the number of bifidobacterium that line the large intestinal wall begins to decline. This strain is important for supporting the production of vitamins B and K, supporting healthy digestion and bowel health as well as supporting the body’s detoxification system.

So Which Is Best?
Whichever you will take every day!

Capsules can be found both on the shelves (freeze-dried organisms) or in the refrigerated section and can be great for someone who travels often or forgets to go into their fridge every day to look for their supplements. Powders are a great option for the entire family. You can incorporate them into all kinds of things … yogurt, applesauce, smoothies, dog food, etc., and they are often shelf stable. Powdered probiotic bacteria can maintain their cell count by about 90 to 95 percent for six months to one year when they are packaged and about one to three months after they have been opened.

Depending on how damaged your gut currently is and if you are new to probiotics, start off slowly. There is actually a “die off stage” that happens as your body is getting rid of some of the pathogenic bacteria, which might cause you to actually bloat and pass gas. Start with 5 to 15 billion CFUs and work your way up to 50 billion CFUs as a maintenance phase. Bacteria are also extremely sensitive to heat, light and oxygen, so buying a probiotic with not only mixed strains (which can help keep other strains alive as certain strains are naturally compatible with other strains) look for a brand that has added digestive enzymes and pre-biotics, as these can help protect the probiotics from dying off.

Pre-biotics feed the probiotics, as well as provide a stable medium for the bacteria which will allow them to replace themselves if they find themselves in less than favorable environment (not a cool, dry place, not in a dark glass bottle etc). Digestive enzymes can help protect the bacteria from the harsh acidic environment and conditions of the stomach, which will allow them to make their way to the finish line, which is ultimately your gut!

Extra Credit: Be sure to store your probiotics in a cool dry place, ideally around 70 degrees. At 70 degrees Fahrenheit, probiotic viability decreases 10 to 15 percent per month. While if stored at above 80 degress Fahrenheit, the loss is more than doubled! Oxygen and light can cause the bacteria to go rancid and moisture can start the process of degradation of the bacteria.

References
• www.ncbi.nlm.nih.gov/pubmed/24809527
• www.nature.com/icb/journal/v78/n1/full/icb200012a.html
• www.cast-science.org/download.cfm?PublicationID=2930&File=f030d2d5777f5676ed033b112a7e65524518
• onlinelibrary.wiley.com/doi/10.1111/j.1365-2672.2005.02742.x/full
• www.sciencedaily.com/releases/2016/04/160425161324.htm
• www.hindawi.com/journals/isrn/2013/481651/

Brianna Diorio is a clinical nutritionist with an MS in human nutrition. She is also a holistic lifestyle coach and NASM CPT. Diorio advocates a holistic and naturopathic approach toward health and wellness, placing importance on proper digestive health, gluten-free living, herbal supplementation and using food as functional medicine as information for our cells. She is the director of training and education at Vitamer Laboratories in Irvine, CA.