Beauty’s most-asked questions: should I take a probiotic?

“It’s only in the past two to three decades that we have understood the body’s microbiome, which is made up of trillions of microbes (or bacteria) on our skin and in our mouth, but mainly in our gut. Probiotics are bacteria that we take in a supplement to support the microbiome in our gut, while fermented foods, such as yoghurt and kefir, do the same but through a food source, not a pill.”

“The effect the gut has on our whole system is so much more far-reaching than we ever thought. Good digestion from a healthy, balanced gut is key to taking up nutrients from our food. Plus, the gut microbiome helps ‘train’ our immune system to recognize whether something is a ‘friend’ or ‘foe’ to our body. Between 70 to 80 percent of our immune system is in the gut, and the microbiome helps control what passes through the gut wall; if the wrong substance gets through, it can trigger an inflammatory response or autoimmune disease. Probiotics and a healthy, balanced microbiome don’t ‘boost’ the immune system, but they do support it, which is extremely important. Research [from the last four years] shows that depression can be linked to inflammation, and not just of cognitive origin, as the gut microbiome produces substances that communicate with the brain. Psycho-biotics is a new line of clinical research looking at using targeted probiotics alongside talking therapy.”

“There are quite obvious signs if your gut microbiome is out of balance, including bloating (but not after a meal, which people forget is normal), cramps, becoming sensitive to a food all of a sudden, passing an excess of gas (a sign of too much fermentation) and changes in your bowel habits. But there are also non-digestive symptoms, and psoriasis and eczema can both be linked to gut health.”

“There’s no healthy-gut panacea – it is down to a combination of diet and lifestyle and, if you need it, taking probiotic supplements. But, often, when you make a positive shift in your diet, you don’t need anything else. It’s not what you take out of your diet, but what you add to it that matters, as it’s rarely a food group’s fault. The gut needs diversity, but most of us are creatures of habit when it comes to food; our microbiome is like a pet and it needs feeding, not putting on a self-diagnosed intolerance diet. Look at upping your dietary fiber through plant-based carbs in vegetables, nuts, seeds and whole grains. Ideally aim for six to seven different types across your daily diet. It may sound like a lot, but putting nut butter on your porridge counts as two, then add nuts, seeds and some fruit to the bowl and you are up to five for breakfast alone. Garlic, leeks, onions, whole wheat, rye, spelt and asparagus are all great to eat, then add in some cheese (choose ‘uncooked’ cheeses, such as cheddar or soft cheese), sourdough bread (a pre-biotic) and yoghurt, and you have trillions of bacteria for the microbiome.”

“There’s a strong gut-brain link, and stress and anxiety can really affect the gut, as does not sitting down to eat or chewing your food properly. There has been a lot of research on the detrimental impact of artificial sweeteners on the gut, and taking the contraceptive Pill and Ibuprofen both have an effect. Like our body clock, we also have a ‘gut clock’, and it needs breaks between meals (so no snacking) to let the digestion rest and allow other microbiomes to do their job. This is also why sleep is key, as much of the cellular regeneration in the gut happens when we sleep; if we have a broken night’s sleep, it impacts the gut. Taking antibiotics wreaks havoc with your microbiome (antibiotics not only act on bacteria that cause infections, but also affect the resident microbiota), but if you are prescribed a course of antibiotics, don’t take a probiotic at the same time that you take your antibiotic medication. Instead, if you are taking the medication in the morning, take the probiotic supplement in the evening, or start taking it after you have finished your course of antibiotics.”

“A probiotic contains live bacteria and, depending on how much survives the digestive process, it works to re-balance the bacteria in your gut. A prebiotic is a type of fiber that feeds the gut bacteria. However, if you have the symptoms of a gut problem and find that upping your prebiotic intake makes it worse, then it could be because your prebiotic is feeding the bacteria imbalance.”

“First, make the changes you need through food rather than a supplement. But if you find taking a probiotic works well for you, there is no issue with taking them daily and for the long term. Look online and check for independent clinical trials and research on your specific supplement – any reputable brand should provide this. Always check the CFU number [Colony Forming Units], which should be at least in the billions; our digestion is an arduous process, so you need billions to get through the digestive enzymes and hydrochloric acid, and any good product will have testing that shows enough actually get to the large intestine.”