SAY HELLO to My Little Friend

Bacteria have a PR problem.

Almost all of the press for these ubiquitous single-celled creatures seems to focus on the bad actors. And to be fair, there are nefarious germs out there that can cause damage to our health and our bodies. So it’s understandable that modern society has waged a war against bacteria. We see it in the ads for wipes or cleaners pleading with us to sanitize every surface we might encounter. Or in the development of antibiotics, an arms race that began with the discovery of penicillin in 1928. For the most part the message has been clear: When it comes to bacteria, it’s us versus them.

As we continued to wage this war, however, we began to learn that our relationship to bacteria is not so simple. It turns out that our bodies are a permanent host for billions of bacteria. They can be found on the skin, but where most of our bacterial guests live is in our gastrointestinal tract, or gut. And, within the gut, the vast majority take up residence in the large intestine. What is fascinating is that these bacteria are not just mooching tenants along for the ride. Health scientists are learning more and more about the crucial role this collection of microorganisms plays in our health and well-being. It appears that humans and these "good bacteria” didn’t just nd each other by chance. We evolved together. Our fates have likely been intertwined for eons. We need each other to live and we were made for each other. Pretty romantic, huh? We provide food and shelter, and these good bacteria help us with vitamin and nutrient absorption, immune regulation, digestive health and more.

Having a robust population and a robust variety of good bacteria living in our intestine seems to be the key to getting the most health bene ts out of this relationship. Balance is crucial, but unfortunately for many people this balance seems to be fading. The intestines of many of us appear to have fewer bacteria overall, and less variety in the types of bacteria that are there. Not only are we potentially losing out on the critical health functions of the good bacteria, but not having a robust microbe army can actually provide bad bacteria the opportunity to muscle in and cause disease. This depletion of good bacteria in our bodies may have been caused by our well-intentioned ght against bacterial disease through the use of antibiotics. It also could be due to increased sanitation, a western diet, some other factor we don’t understand yet, or a combination of all these. Regardless of the cause, the result has been a correlation between having fewer good bacteria in our guts and an increase in digestive and immune disorders. And as we learn more about how interconnected our immune system and digestive system is with our overall health, we can see why appreciating and understanding our bacterial selves is more important than ever.

What can be done to reverse this trend and restore our army of good bacteria? A common strategy is to simply ingest some good bacteria through supplements called probiotics. Probiotics are simply shelf-stable strains of good bacteria, most o en freeze-dried and dosed in a capsule. Some foods such as certain yogurts, sauerkraut or kombucha naturally contain healthy strains of bacteria and can be considered probiotics. Despite the prevalence of probiotic supplements, scientists are still nailing down many of the details. Probiotic supplements usually di erentiate their products based on the speci c strain or species of bacteria that they are using as well as the number of live bacteria, (o en written as cfu or colony forming units) in each pill. Unfortunately, research is not yet clear about which strain or what dose is most e ective for restoring a good bacteria population. There are also logistical issues that can in uence a probiotic supplement’s usefulness. The supplement can only work if the bacteria in the pill are alive or viable from the time it is manufactured until the time it reaches someone’s medicine cabinet. And even if the bacteria are viable in the bottle, they have to stay that way all the way from the patient’s mouth to their nal destination in the large intestine. The maker of the probiotic needs to have considered how their manufacturing, shipping and formulation processes could a ect these factors.

These uncertainties about probiotics, however, should not discourage someone from considering a probiotic supplement for their health. When a person is ready to start a probiotic, they should work with their doctor or pharmacist to nd a high quality, reliable product. Then, a er adding a probiotic to their routine, they should continue to listen to their body to see if any adjustments need to be made to the regimen. It is also very important for anyone taking a probiotic supplement to strive for a healthy diet that is high in ber and low in re ned sugars. Our little friends are eating what we’re eating! The role our good bacteria play in our health is an emerging frontier and we will continue to learn more and better ways to keep this relationship strong for the bene t of our bodies and our lives.

InHealth Specialty Pharmacist

Jason Cossette, PharmD, RPh is a 2007 graduate of the NDSU College of Pharmacy. He has 15 years of experience in community pharmacy and five years specializing in compounding pharmacy. Cossette is a passionate patient care advocate who enjoys teaming with patients and providers to achieve the best possible health outcomes.

WORDS : IAN R. MCLEAN, SERKLAND LAW FIRM

PHOTOGRAPHY : Karolina Grabowska on pexels.com