[0:00] I don't take probiotic supplements as a
[0:02] doctor and a scientist and if you take
[0:04] them daily, the latest science is
[0:06] telling us they're probably not doing
[0:09] much and they might even cause harm.
[0:11] I've been interested in gut health for
[0:13] many years, both during and after
[0:16] medical school, and I've recommended
[0:18] probiotic supplements in some very
[0:20] specific cases, but the supplement
[0:22] industry has turned this into a complete
[0:24] marketing gimmick. and your gut's much
[0:27] more complex than a couple bacterial
[0:30] species crammed into a pill. So, today I
[0:32] want to show you when probiotic
[0:34] supplements actually make sense versus
[0:36] when they're just a waste of money and
[0:39] when they can actually backfire. And
[0:41] we'll also talk about a much better
[0:43] option for most people. For more
[0:45] breakdowns of science and popular trends
[0:48] and different supplements with no sales,
[0:50] subscribe. When we hear probiotic, we
[0:53] usually associate that with a healthy
[0:55] gut. And there's some truth to that.
[0:58] Your gut contains trillions of microbes
[1:01] that help break down food. They talk to
[1:03] your immune system and they also nourish
[1:06] your gut wall. But the supplement
[1:07] industry wants you to make this logical
[1:09] leap that if gut bacteria are a good
[1:12] thing, then adding more bacteria in a
[1:15] pill must be good for you. And the
[1:17] scientific evidence is showing us this
[1:19] is a big mistake because probiotic
[1:21] supplements have a number of problems.
[1:24] Number one, there's almost no
[1:25] regulation. The seller doesn't need to
[1:27] show that the product works or even that
[1:30] it contains what's advertised on the
[1:32] bottle. Studies have shown that it's
[1:34] quite common for the content of these
[1:36] pills to not match what's advertised.
[1:39] Sometimes the concentration is wrong.
[1:42] Sometimes the species don't match. So,
[1:45] for anyone going for a probiotic
[1:46] supplement, it's always better to go
[1:48] with a third-party certified brand. That
[1:51] way, you know what's on the bottle is
[1:53] what's in the pill. Also, you want to
[1:55] get used to the fact that all of these
[1:56] claims on the bottles gut health, immune
[2:00] support, immune boost, that's marketing.
[2:04] It's not science. Okay. The second
[2:05] problem with probiotic pills is that a
[2:08] lot of these microorganisms are actually
[2:11] very sensitive to heat, to oxygen, and
[2:14] to the acid in your stomach. So, even if
[2:16] the pill does contain what the
[2:18] manufacturer says, by the time it's been
[2:21] stored in a warehouse and shipped and
[2:23] sits in a shelf and you take it and it
[2:26] crosses your stomach, there might be
[2:28] very little or nothing left to get to
[2:31] where it needs to be. Studies have found
[2:32] that up to twothirds of people show no
[2:36] evidence of probiotic supplements
[2:38] actually working, actually colonizing
[2:39] their gut, or reported any digestive
[2:41] benefits. And finally, these pills
[2:44] hugely oversimplify gut biology. Your
[2:47] gut contains hundreds up to a thousand
[2:49] different strains of microorganisms, all
[2:52] interacting in an equilibrium with each
[2:55] other, all with individual different
[2:57] roles. And so picking two or three or
[3:00] five random ones and cramming them into
[3:02] a pill, that might not be what you need.
[3:05] Could even be counterproductive. A
[3:06] famous study from a couple years ago
[3:08] found that the effect of probiotics
[3:10] varies enormously from one person to the
[3:13] next. Some people show colonization by
[3:16] these microbes. Other people are really
[3:18] resistant. The microbes just don't take
[3:20] hold. So you want to be careful with a
[3:22] friend or a neighbor saying, "Hey,
[3:24] probiotics worked really well for me.
[3:27] the same pill might not do anything for
[3:29] you. But the most surprising part is
[3:31] that in some contexts, probiotic pills
[3:34] can actually harm you. They can actually
[3:36] work against you. So when we take an
[3:39] antibiotic for some infection, it's very
[3:41] common for the antibiotic to wipe out
[3:44] some of our gut microbiome and then that
[3:47] will recover gradually over time
[3:49] depending on diet and other factors. But
[3:51] in a fascinating study, scientists found
[3:54] that when they gave the participants a
[3:56] probiotic, a pill containing 11 species
[3:59] of microbes that they selected, it
[4:01] actually delayed their recovery. So they
[4:04] did worse. They recovered slower than
[4:06] the folks who got nothing, who just got
[4:08] a placebo. So this was a shocking
[4:10] finding because this is exactly the
[4:12] context where you'll assume that it
[4:15] makes sense to take a probiotic. you
[4:17] just took an antibiotic, your gut
[4:18] doesn't feel right. And so you buy a
[4:20] probiotic that says gut health on it
[4:22] because you're trying to rebuild your
[4:24] gut, right? But like we said, our gut
[4:26] microbiome, it's a living organism in a
[4:29] balance. And so throwing in the wrong
[4:31] microorganism,
[4:33] can actually mess up that balance, can
[4:35] actually be worse. We're going to talk
[4:37] about which probiotic strains can help
[4:40] in that situation in specific cases.
[4:43] Just want to point out that probiotics
[4:45] can also cause some side effects. Gas,
[4:48] bloating, discomfort, although usually
[4:51] it's mild and temporary. Now, everything
[4:54] we're saying doesn't mean that
[4:56] probiotics are poison for everyone at
[4:59] all times. I'm not anti-supplements. I'm
[5:02] anti-arketing
[5:03] that's taking advantage of you. So, you
[5:05] want to take the right thing for you at
[5:08] the right time. Medicine isn't cookie
[5:10] cutter. This is why it's good that I
[5:13] reject all sponsors and I don't sell
[5:15] anything on the channel because when
[5:16] something like this comes up, I don't
[5:19] care. I can just tell you the truth,
[5:20] what works, what doesn't work. There's
[5:22] no financial pressure. So, for example,
[5:25] in people taking antibiotics, this
[5:27] specific strain of probiotic sacroyces
[5:31] bulardi, it's a type of yeast, and
[5:34] there's some evidence that that can help
[5:36] prevent cadiff infection. It's not the
[5:39] highest level evidence, but it's
[5:40] defensible. Someone in that situation to
[5:42] give that specific probiotic to prevent
[5:46] CIFF infection. That's a defensible
[5:49] medical decision. There's also some
[5:50] specific GI conditions. There's
[5:52] something called pouchitis if you have
[5:54] that. Pre-term infants sometimes are
[5:56] given probiotics as well. So, very
[5:58] specific situations. Notice how
[6:00] different that is from everybody go take
[6:03] this random probiotic pill. Healthy,
[6:05] unhealthy, doesn't matter. Also, if you
[6:07] have specific conditions, if you're
[6:09] immuno compromised, for example, if you
[6:12] have cancer and you're going through
[6:13] treatment through chemotherapy, you want
[6:15] to be especially careful with
[6:17] probiotics. In some cases, they can
[6:19] actually cause infections if the immune
[6:22] system is weakened. Okay, so we've
[6:24] covered a lot of the myths and the facts
[6:27] around probiotics, but here's a twist.
[6:30] If probiotic pills are overhyped and
[6:32] they're not needed by most healthy
[6:34] people, what about probiotic foods?
[6:36] Kafir, yogurt, kombucha. You've heard me
[6:39] talk about these foods in many videos in
[6:42] the past. I've told you that I eat them
[6:44] on a regular basis. So, am I just a
[6:46] hypocrite? So, there's a number of
[6:48] fundamental differences between a
[6:50] probiotic pill and a probiotic food like
[6:53] some fermented foods. Fermented foods
[6:56] contain an entire ecosystem of
[6:58] microorganisms. Kafir, for example, has
[7:01] been shown to contain dozens of
[7:03] bacterial strains and yeast strains. And
[7:05] we know that one key feature of a
[7:07] healthy microbiome is diversity. So
[7:11] these fermented foods already come with
[7:13] that diversity built in that natural
[7:16] ecosystem. You can't get that. You can't
[7:18] replicate that with a pill that has
[7:21] three or four strains in it. But also
[7:23] the types of strains that you're getting
[7:25] in the fermented food are the ones that
[7:27] survived and that evolved in that
[7:30] ecosystem, right? interacting with each
[7:32] other. Not a couple strains that were
[7:35] artificially chosen because they're
[7:37] easier to manufacture at scale or to
[7:39] ship or something like that. But also
[7:41] the concentration and the proportion of
[7:43] the microbes to each other that's
[7:45] already built in because a fermented
[7:48] food is a living organism. It's
[7:51] literally fermenting all the way up and
[7:54] growing all the way up to you consuming
[7:56] it. That's assuming it's not killed by
[7:58] heat, right? That's a common question
[7:59] and that can happen if it's heated then
[8:02] the microbes are killed. So this depends
[8:04] on the food. Kafir for example it's done
[8:06] from pasteurized milk but the
[8:08] pasteurization happens before the
[8:11] fermentation process. So it doesn't kill
[8:14] the bunks. Make sense? And one last
[8:16] point I want to make with the fermented
[8:18] food with the probiotic food you're also
[8:21] getting the entire food matrix. It's not
[8:23] just the microbes by themselves. You're
[8:26] also getting in addition to the
[8:28] probiotics, you're getting the
[8:30] prebiotics. So that's specific types of
[8:33] fiber and specific types of starch that
[8:36] the microbes consume. Those come in
[8:38] there as well. You're also getting the
[8:40] postbiotics. So those are fermentation
[8:43] products, metabolites of the microbes
[8:46] that are in there as well that have all
[8:48] kinds of physiological effects on your
[8:50] body and many other compounds like fatty
[8:52] acids and amino acids. So they're
[8:54] fundamentally different products. A pill
[8:57] with two or three species crammed in,
[9:00] concentrated, isolated versus this
[9:04] complex ecosystem of the fermented food.
[9:06] So this goes back to a principle we've
[9:08] talked about in many previous videos,
[9:10] which is we don't just want to get
[9:13] microbes in there. We also want to feed
[9:16] them properly. It's like planting a
[9:17] seed, but then you got to water it and
[9:19] give it light. Otherwise, it doesn't
[9:22] sprout. It's useless. So, if you're new
[9:23] to the channel, we have a lot of content
[9:25] covering all of this, all the
[9:26] actionables, how to maintain a healthy
[9:28] microbiome. Also, notice that the this
[9:30] matrix, this food matrix wraps the
[9:33] microbes so that they're not directly
[9:35] exposed to the acidity of the stomach,
[9:37] not as much as they are in a pill where
[9:40] they're isolated. And so, there's a
[9:41] landmark trial that showed that
[9:43] generally healthy people given fermented
[9:46] foods, their microbiome diversity
[9:48] improved and their inflammation came
[9:50] down as well. So, this is the twist.
[9:53] People get these probiotic pills to have
[9:55] a healthier gut, a healthier microbiome.
[9:58] But for most people, there are actual
[10:00] foods that are much more likely to
[10:02] deliver that result. Now, bear in mind,
[10:04] fermented foods also have some caveats.
[10:06] So, for example, people with a weakened
[10:09] immune system, people with specific
[10:11] sensitivities like histamine
[10:12] intolerance, talk to your doctor before
[10:14] you start fermented foods. Okay, so
[10:16] let's make this actionable. How do you
[10:17] actually make that decision? You're
[10:19] standing in the store. Look at the shelf
[10:21] with all the probiotics. This is what I
[10:23] tell a friend of mine if they ask me
[10:25] about this. If you're healthy
[10:26] individual, you just heard the
[10:28] probiotics are good for your gut. Save
[10:30] your money. Spend it on some yogurt with
[10:33] probiotic cultures or some kafir or some
[10:36] kombucha or something like that. If you
[10:38] have a specific health condition or a
[10:41] gut issue, then it's possible that
[10:43] probiotics might be right for you. But
[10:46] don't grab a random strain. You want to
[10:48] look up the exact strain and the dose
[10:51] that was shown to help your situation
[10:53] and ideally talk to a
[10:55] gastroenterenterologist. And remember,
[10:56] for specific medical issues, weakened
[10:59] immune system, cancer, going through
[11:01] treatment, talk to your doctor before
[11:02] you start probiotics. For more
[11:04] evidence-based breakdowns of common
[11:06] questions with no sponsors and no sales,
[11:09] subscribe and I'll see you on the next
[11:10] video. Actually, I'll link one right
[11:12] here.