According to the National Institutes of Health, probiotics are defined as “live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods, dietary supplements, and beauty products.”
You’re probably used or been recommended traditional probiotics—multi-strain, lactobacillus and/or bifido-bacterium based formulas that have been available on retailer shelves for decades. But spore probiotics are changing the probiotics game. Let’s look at what they are, how they can help you, and who should use them.
What ARE spore probiotics?
Spore-based probiotics are probiotic supplements that contain spore-forming beneficial bacteria. Spore-based probiotic supplements contain bacteria that are known to release spores (think of them as little probiotic babies) that can flourish and multiply in the large intestine. Fun fact—mushrooms also reproduce in nature by releasing spores! The main type of spore-based probiotic in supplement form is the Bacillus species—if you see this on the strain of bacteria in your supplement, you’ve got a spore probiotic!
How are spore probiotics different from “regular” probiotics?
To contrast these to other common types of probiotics, non-spore based beneficial bacteria and yeasts can still take up residence after being ingested without releasing spores to populate the area. Some examples of these types of probiotics are lactobacillus, bifidobacteria, and saccharomyces boulardii. Their presence alone helps to increase the population.
Spore probiotics, on the other hand, recondition the gut by increasing microbial diversity and promoting the growth of health-promoting bacteria in the gut.
A lot of the recent studies published about spore-based probiotics are funded by supplement companies that make them, which can be problematic in terms of finding non-biased research regarding the topic. However, it should be noted that this is how we know a lot about medicine in general so it does not discredit the research all together.
In the medical literature, taking spore-based probiotic supplements have been shown to have positive benefit to the lining of the GI tract, improve nutrient synthesis and metabolism, decrease triglyceride levels, and decrease inflammation in the GI tract (1). They are very resistant to different temperatures and acid levels in the stomach and are said to make it all the way to the colon before releasing their spores, which is the ideal location!
Are there side effects to taking these probiotics?
Common side effects that can occur when starting probiotics are GI symptoms such as gas, bloating, and changes in bowel movements. These usually only last a couple of days and are typically caused by the (beneficial) changes that are taking place in terms of the composition of the GI flora.
These symptoms can be mitigated by decreasing the amount of the probiotic you take and building your way up slowly (example: starting with 1 capsule every other day instead of daily). If you take probiotics and your stomach symptoms do not improve or worsen over time, this could be a sign of another type of GI condition, like SIBO.
Who are spore based probiotics recommended for?
Clinically, I like to utilize spore-based probiotics in addition to other types of well-researched probiotics (such as the lactobacillus species) in those who are working on increasing the amount of beneficial flora in the GI tract. Those with inflammatory types of GI conditions, such as IBD, may also benefit. According to the research, since they also improve GI lining, those with intestinal permeability aka “leaky gut” may also benefit (2).
Spore-based probiotic supplements are an option in the market that seem to have promising data to back up their claims; however I would like to see larger studies not funded by the supplement companies to confirm the benefit of their use. While I do not believe they are the answer for everyone, the risk to trying them is low and I have seen many patients feel better after taking them.
REFERENCES:
McFarlin BK, Henning AL, Bowman EM, Gary MA, Carbajal KM. Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World J Gastrointest Pathophysiol. 2017;8(3):117-126. doi:10.4291/wjgp.v8.i3.117
Dr. Jones graduated from the National University of Natural Medicine in Portland, Oregon as a Doctor of Naturopathic Medicine and with a Master of Science in Nutrition degree. She believes that the most important part of any treatment plan is first establishing a solid foundation of health. This looks different for each patient and changes over time, and Dr. Jones’ guidance on your health journey will depend on your needs.
Going gluten free was all the rage a few years ago. But the trend masked real health conditions: celiac disease and gluten sensitivity. It’s easy to get these mixed up if you’re not in the know. So what does the difference between celiac disease and gluten sensitivity look like when played out? Let’s chat.
What is celiac disease?
Celiac disease is a medical condition where the intake of foods containing gluten causes an immune response leading to tissue damage in the small intestine. This damage can lead to GI symptoms and other negative effects such as decreased nutrient absorption. Though celiac disease can also be asymptomatic, some common symptoms include:
GI distress such as bloating and abnormal bowel movements
Fatigue
Mouth ulcers
Skin rashes, specifically one called dermatitis herpetiformis
Anemia due to lack of absorption of nutrients
Serious reactions such as neurological symptoms
The gold standard (meaning the one deemed best by the medical society at large) for the diagnosis of celiac disease is by taking a biopsy of the tissue from the small intestine and looking at it under a microscope. There is also the option to start with a blood test to look for certain antibodies in the bloodstream (most commonly tissue transglutaminase). If those are positive, it is typically recommended to confirm the diagnosis with a biopsy.
Celiac disease treatment
The way you treat celiac disease is by avoiding gluten entirely in the diet. Without gluten, the immune system does not continue to cause damage to the intestinal lining. It is important to note that for testing, you have to be eating a diet that contains gluten otherwise you will not be able to capture signs of a heightened immune response on testing, which is why I typically recommend testing for celiac disease if indicated before cutting out gluten altogether.
Non-celiac gluten sensitivity is different from celiac disease because there is not the same immune response and subsequent inflammatory destruction of the small intestine with the intake of gluten. So, those with non-celiac gluten sensitivity will test negative for celiac disease when testing is performed.
Non-celiac gluten sensitivity often presents as having GI symptoms when eating gluten. This can be best determined by following an elimination diet for a short period of time and then reintroducing gluten containing foods and monitoring for symptoms.
While I do believe it is possible to be sensitive to foods, clinically I see food sensitivities as a symptom of sometimes bigger going on in the GI tract, such as increased intestinal permeability (aka leaky gut) or chronic unmanaged stress, leading to poor digestive function.
I do not recommend cutting out gluten from the diet unless it is medically indicated, as there are plenty of nutrient dense foods that contain gluten out there! It is best to choose organically grown whole grains and avoid conventionally farmed and processed grain products when you do partake in eating gluten to optimize nutrient intake and avoid exposure to harmful pesticides/herbicides that are used in the conventional farming process.
If you’re having GI symptoms and wonder if gluten is what you’re reacting to, give us a call. We can partner with you for better health.
Dr. Jones graduated from the National University of Natural Medicine in Portland, Oregon as a Doctor of Naturopathic Medicine and with a Master of Science in Nutrition degree. She believes that the most important part of any treatment plan is first establishing a solid foundation of health. This looks different for each patient and changes over time, and Dr. Jones’ guidance on your health journey will depend on your needs.
Trying (or struggling) to get pregnant? Integrative fertility care will look different depending on what stage of the fertility journey a patient is in. Whether you are planning on a baby in the future, currently trying for one, or have been trying for a while with no success, there are many providers out there to help.
I will be the first to say that OBGYNs and reproductive endocrinologists are amazing at what they do, and are often an essential part of the care team. Where integrative medicine shines is helping to ensure that the parent-to-be is, as a whole, as healthy as they can be while on this journey. Whether it is your first child or fifth, optimizing your health before baby is one of the greatest investments you can ever make!
The workup for fertility care will look different for everyone—but below is an example of what may be considered depending on what stage of the journey you are on.
Initial Fertility Visit
During your first visit, we will dive in to your health history. Balanced hormone health is ideal for chances of pregnancy to occur, but this does not mean that sex hormones are the only important factor! Thyroid health, adrenal health, nutrient status, and GI health are also important to assess when preparing for baby.
Lifestyle changes such as reducing environmental toxin exposure, managing stress, and increasing nutrient density through diet are ideal to start at least 3 months before becoming pregnant.
There is so much value in understanding your personal biochemistry before having a baby. Labs can give us a snapshot of your hormones, rule out conditions that may make getting pregnant difficult, and establish a baseline of health before starting the journey. Knowledge is power, and labs can also help us identify if there are any concerns that require a referral to reproductive endocrinology sooner than later depending on the patient’s fertility goals.
As you may have guessed, treatment is going to vary widely with each patient. However, some staples of fertility care for women include taking a well-formulated prenatal, a prenatal DHA, and a broad-spectrum probiotic. For men, a well-formulated multivitamin that contains zinc, selenium, and CoQ10, as well as a high quality fish oil supplement, can be supportive of healthy sperm production.
In conclusion, there are many different types of fertility care available, and integrative medicine is one option. Here at MIMC, we provide inclusive fertility care, so whether you are a single person starting the fertility journey solo, same sex couple navigating the options of having a child, or you are in a relationship with a partner of the opposite sex and planning on conceiving, we would love to support you along the way!
Dr. Jones graduated from the National University of Natural Medicine in Portland, Oregon as a Doctor of Naturopathic Medicine and with a Master of Science in Nutrition degree. She believes that the most important part of any treatment plan is first establishing a solid foundation of health. This looks different for each patient and changes over time, and Dr. Jones’ guidance on your health journey will depend on your needs.
If you’ve ever had a runny nose or itchy eyes when spring rolls around, you’re probably familiar with the term “histamine.” But what about histamine intolerance? Just like we can be sensitive to allergens in the air, we can also be sensitive to histamines taken in through the diet—this is called histamine intolerance, and it’s what we’re talking about today.
Histamine itself is a chemical messenger that plays many roles in the body, including immune defenses and gastric acid secretion. Histamine is released by the immune system (specifically mast cells and basophils) in response to allergens, such as those from the environment or foods.
Histamine is essential in controlled amounts in the body. However, when histamine levels rise, uncomfortable symptoms can occur. Allergy symptoms range from itchy, runny nose and eyes, to more severe reactions like anaphylaxis (which is a medical emergency and should not be taken lightly). Learn more here.
But histamine intolerance is less understood. Let’s dive into what it means, what symptoms to look for, and how to go about treating it.
What Is Histamine Intolerance?
Histamine intolerance is poorly understood overall, but can best be explained by malfunctioning histamine breakdown pathways in the GI tract.
Histamine is broken down by 2 main enzymes in the body, and the most active one is called diamine oxidase, or DOA. If DOA function is altered, histamines can build up in the body. Since histamine is created and released by the body, and taken in through diet, if DOA function is not working up to par, it can be common for your “histamine bucket” to overflow. This is when you’ll start to feel symptomatic after being exposed to allergens or high-histamine foods (more on what to look for in your medicine cabinet or your fridge if you’re trying to avoid high-histamine substances here).
Who is Susceptible to Histamine Intolerance?
Women with high estrogens may have a hard time with DOA enzyme function. Certain medications also alter the breakdown of DOAs, including NSAIDS and pain medications. Alcohol also alters the breakdown of histamine. Other factors that can impact DOA activity include genetic variants and microbiome imbalances.
Symptoms of Histamine Intolerance
When the body does not break down histamine from foods, it can leak through the GI lining and enter the bloodstream, causing GI symptoms and sometimes systemic symptoms, like itchy skin.
How to Diagnose Histamine Intolerance
Histamine intolerance is very challenging to diagnose and unfortunately, some of the best foods are higher on the histamine scale, such as chocolate and aged cheeses. There is no way to avoid histamines through diet at 100%, however if you are someone who tends more towards allergic symptoms and have not found success with any other treatments, reducing high-histamine foods for a period of time and seeing how you feel would be a good place to start.
For those who struggle with chronic allergy symptoms or GI concerns with no other found cause, it is worth talking with your provider about the possibility of histamine intolerance.
How to Reduce Symptoms of Histamine Intolerance
Reduce allergen exposure at home
Being aware of how to reduce your allergen exposure from the environment is a great place to start. To reduce indoor allergens, try:
wet dusting,
vacuuming,
washing curtains and bedding weekly,
and opening windows can help reduce allergens in indoor air.
Instead of blocking histamine receptors by taking antihistamines, there is also the option using mast cell stabilizers to stabilize the cells in the body that release histamine, therefore preventing the release of histamine in the first place. A few examples of mast cell stabilizers are the herb nettle, and nutrients like vitamin C, quercetin, and NAC. More of a deep dive on supplements to consider adding to your routine for histamine intolerance can be found here.
DAO support
Supplementation with an animal-derived supplement containing the enzyme DAO can help break down histamine in the GI tract in those who have poorly functioning DAO pathways. DAO is quite expensive as a supplement and isn’t indicated in everyone with general allergy symptoms,, so working with a provider to figure out if this is the best option for you is recommended. Book an appointment with us here to see if this is a good fit for you.
Dr. Jones graduated from the National University of Natural Medicine in Portland, Oregon as a Doctor of Naturopathic Medicine and with a Master of Science in Nutrition degree. She believes that the most important part of any treatment plan is first establishing a solid foundation of health. This looks different for each patient and changes over time, and Dr. Jones’ guidance on your health journey will depend on your needs.
There are a few supplements that stand out when thinking about what supplements I recommend most to patients. However, I do not believe that there are supplements that “everyone” should be taking.
Why? It’s at the core of what we practice at MIMC—personalized medicine! Everyone has their own unique biochemical makeup, which means just because a supplement totally changed one person’s life, doesn’t mean it will benefit the next person. People often think of supplements as harmless since they are available over the counter, but many contain potent amounts of nutrients or botanicals that require medical guidance to properly administer and reap the benefits.
How to choose high-quality supplements
When shopping for supplements, it is also important to be confident that the product you are purchasing actually contains what it says it does, as the supplement industry is not well-regulated. For this reason, I recommend sticking with supplement brands that are third-party tested for safety and purity.
While this can be difficult to navigate initially, most companies who perform this kind of testing are very transparent about their quality standards. Companies who are not are the ones I recommend avoiding. Learn more about how to evaluate supplement brands here.
What supplements should I take?
If I had to choose 3 different supplements that would benefit most people, I would recommend vitamin D3, omega-3 fatty acids, and probiotics. Let’s dive into how each of these can help.
Vitamin D3
A large percentage of the population is deficient in vitamin D, especially those who live in the midwest. Vitamin D is a fat soluble vitamin that plays a role in so many different bodily processes, including immune and mental health.
To figure out how much vitamin D3 is right for you to supplement with, I recommend having your vitamin D levels checked during a standard lab draw. While this used to be more of a specialty lab, it is becoming more commonplace because of the increasing evidence to support the importance of vitamin D in human health.
It is crucial to note that too much vitamin D can be toxic, so I recommend supplementing with no more than 4,000IU per day without knowing your personal vitamin D levels, which is the established tolerable upper intake level that is unlikely to cause harm.
Since so many of us are not eating the recommended weekly intake of fatty, cold-water fish per week (3x/week), a high-quality omega-3 fatty acid supplement can benefit most for a few reasons. The standard American diet is SUPER HIGH in omega-6 fatty acids and low in omega-3s, and this is problematic because omega-6s are inflammatory while omega-3s are anti-inflammatory.
Though both omega-6 and omega-3 fatty acids play a role in the body, the ratio should be close to 2:1, and it’s somewhere around 20:1 with the standard American diet. This doesn’t mean that you can balance the standard American diet out just by taking an omega-3 supplement. BUT, supplementing can help bring down the ratio while you are working on dietary changes.
Omega-3s are also critical during pregnancy (specifically DHA) for fetal brain development. When choosing an omega-3 supplement, it is important to make sure you are purchasing one that is free of heavy metals. Nordic Naturals is a brand that I commonly recommend for this reason.
Probiotics
Though the preferred way to support the gut microbiome is through eating a diet full of fiber and fermented foods, incorporating a well-formulated broad spectrum probiotic can be beneficial for those looking to improve GI health. I typically recommend cycling through a few different types of probiotics every year as maintenance for those who do not struggle with GI concerns.
For those who are symptomatic, advanced GI testing can help guide what type of probiotics would be best (remember that personalized medicine thing? learn more here).
While supplements are often a foundational part of treatment plans with patients, there is not a one-size fits all approach to recommendations. These are a starting place if you’re looking to support your system, but it’s merely a jumping off point. Your body might need more or less than these and the best way to figure that out is to get a full workup with a doctor you trust.
If you’re looking for a new practitioner, give us a try—we’re trained to partner with you to get to the root cause of your symptoms and create a plan that’s tailored to you.
Dr. Jones graduated from the National University of Natural Medicine in Portland, Oregon as a Doctor of Naturopathic Medicine and with a Master of Science in Nutrition degree. She believes that the most important part of any treatment plan is first establishing a solid foundation of health. This looks different for each patient and changes over time, and Dr. Jones’ guidance on your health journey will depend on your needs.
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