The astonishing scientific discovery paved the way for probiotics from the gut to the brain during the last two decades.

A backbreaking challenge for a doctor is pondering which patients would avail of probiotic therapy since scientific data are still not overwhelmingly positive, and patients are keenly interested in pursuing them.

Having said that, what are the signs you need probiotics?

This article will unleash the eight signs you need probiotics and crack frequently asked queries about them.

Probiotics or good bugs

Probiotics are good bugs inside your gut. 

After decades of being seen as the bad guys, microbes now have their spotlight as the good ones.

Gut Microbiome or Microbiota

Our bodies are home to trillions of microbes – bacteria, viruses, fungi, and other life forms, collectively known as the microbiome. A vast majority is colonized in the gut making up the gut microbiome. 

Most microbes are symbiotic ( relationship between the human body and microbiota where both parties are beneficial ) and some are harmful. 

Each person has a unique network of microbiomes because in our mother wombs, we started sterile, but after we came into the outside world, we developed various microorganisms depending on our environmental exposures, diet, and lifestyle.

The picture of having trillions of microbes inside and outside our bodies can be hideous, but what can we do? We bid them shelter and food, and they work for us.

What do the good guys do?

• Help us digest food and improve our gut health 

• Enable balance of good and bad bacteria to prevent the bad ones from getting out of control 

• Support the immune system

• Emerging evidence suggests that these microbes can extend beyond the gut to the brain by producing neurotransmitters ( messengers for nerve cells).

Probiotics are live microorganisms that can provide health benefits when consumed.

The eight signs you need probiotics

Glowing evidence on the benefits of probiotics makes most people fall prey to pharmaceuticals.

Therefore, I pick out the signs demanding probiotics, most of which have scientific back-up, but some still need further evidence.

SIGN 1: You are bloated

We’ve all felt that unpleasant fullness or tightness in the belly. 

Bloating happens when gas builds up in your digestive system. Gas is a natural byproduct of digestion, but too much of it means digestion goes awry, and it can be a sign of an unbalanced gut microbiome or dysbiosis.

Bloating can also be a symptom of food intolerance and digestive issues like irritable bowel syndrome (IBS).

How do probiotics debloat?

Probiotics or friendly bacteria fight off harmful bacteria and correct the imbalance in gut microbiota. 

They also help our digestion go better.

What do researchers say?

In 2011, a clinical study revealed that probiotic bacteria like Lactobacillus acidophilus and Bifidobacterium lactis quell symptoms of bloating compared to the placebo group.

Moreover, in the 2018 review, researchers looked at 34 studies where people with IBS took probiotics or a placebo, and in patients who took specific probiotics, symptoms of bloating were significantly relieved.

SIGN 2: You have diarrhea

Diarrhea is a sign of an unhealthy gut. 

Diarrhea commonly arises from bacteria or viral infections, contaminated food or water, use of antibiotics, and underlying medical conditions like irritable bowel syndrome and inflammatory bowel disease, leaky gut.

Taking probiotics not only ameliorates diarrhea but also deters it from occurring in the first place by replenishing friendly bacteria and assuring the balance of gut microbiota.

Probiotics in acute diarrhea

In 2016, researchers from the Cochrane Collaboration analyzed 63 studies, looking at the effectiveness of probiotics for acute diarrhea. They found out that probiotics can make diarrhea go away faster.

The best-known probiotics are lactic acid bacteria (lactobacilli).

Probiotics in inflammatory bowel disease

Inflammatory bowel disease (IBD) is a chronic inflammatory condition of the gut.

Patients with IBD seem to have an abnormal immunologic reaction to their bacterial flora partly contributing to the inflammation.

The rationale of probiotic therapy in IBD accounts for the fact that probiotic bacteria may correct abnormal host-microbe interaction and reduce inflammation.

The scientific evidence endorses probiotics in conjunction with standard therapies in IBD to hold the disease remission longer and prevents flare-ups.

From my experience, in patients with acute diarrhea, probiotics give better outcomes in both duration and symptoms of loose motion.

SIGN 3: You are constipated

Constipation is a common burdensome issue that negatively affects the quality of life.

Most over-the-counter remedies for constipation, such as laxatives and stool softeners, are not that helpful.

According to a well-implemented clinical trial in 2022, probiotic compounds like Lactobacillus and Bifidobacterium alleviated the symptoms of constipation, improved the rate of gut motility, and increased the amount of stool, concluding probiotics are beneficial for the clinical treatment of constipation.

So if you’ve noticed that your bowel movements are not as regular as they should be, you might want to consider adding a specific probiotic to your daily supplement lineup. 

SIGN 4: You have taken an antibiotic

Antibiotics are designed to kill bacterial infections. Unfortunately, they do not discriminate between the bad and the good.

Even a single round of antibiotics can change the composition of the gut microbiome.

A good example is antibiotic-associated diarrhea caused by Clostridium difficile where antibiotics kill beneficial bacteria and drive the overgrowth of unhealthy bacteria leading to severe infection in the gut.

Are probiotics also prescribed in actual practice?

The finding of antibiotic-induced microbial disruption and the ability of probiotics to restore the injured microbiome makes a practice changer for clinicians.

And the final meta-analysis from PubMed Central recommended pairing antibiotics with probiotics to prevent and treat antibiotic-associated diarrhea.

So, if you have taken a round of antibiotics, consider taking a probiotic to bring the healthy flora back into your body.

SIGN 5: You have recurrent urinary or vaginal infections

Vaginal infections

If you’re suffering from recurrent vaginal infections, that is a clear sign you would benefit from a probiotic. Yeast and nasty bacteria can flourish when you do not have a good balance of bacteria in the vagina, thereby giving rise to infections down there.

It is common in women with a decline in vaginal Lactobacillus, the predominant vaginal flora that represses harmful bacteria.

Urinary tract infections (UTI)

Anything that leads to a shift in the normal urogenital bacterial flora ( the good bacteria that colonize the vagina and urethra) can result in urinary tract infections. 

In postmenopausal women, a natural drop in the number of Lactobacillus doubles the risk of UTI.

There has been promising evidence that probiotics like Lactobacillus strains can furnish valuable benefits for both vaginal and urinary tract infections without adverse effects.

SIGN 6: Your sugar cravings are out of control 

Have you ever wondered if your gut can control the brain?

The gut-brain axis makes it possible even though we are still in the middle of exploring further evidence.

Gut microbes can command your brain which food it should get by producing neurotransmitters (messengers for nerve cells).

So what makes our microbes crave sugar?

Our microbiome is very strange. Every person has unique microbiota since what a person eats can forge the evolution of the gut microbiome. If we eat healthily, we breed healthy eating bacteria. If we eat high sugars, we foster sugar-loving bacteria.

So our unhealthy eating habits are one of the reasons why sugar-loving bacteria could outnumber healthy bacteria and tell our brains to eat more and more sugar.

How do probiotics curb sugar cravings?

Probiotics fix gut bacteria imbalance and good gut bacteria like bifidobacterium help the body to produce more satiety hormones and less appetite-stimulating hormones. 

In this way, the satiety signal is transmitted to the brain via the vagus nerve in our GI tract and reduces our cravings.

A combination of taking probiotics and eating healthy foods could potentially give us control over our food cravings.

SIGN 7: You can’t control your weight 

Obesity is one of the serious health issues that are tough to manage. Lifestyle changes, weight-loss medicines, and bariatric (stomach reduction) surgery are common treatment options for obesity. However, more and more potential solutions for obesity are still being explored.

In 2015, researchers from Japan compared microbiota composition between obese and non-obese individuals in a Japanese population and concluded that gut microbiota composition is related to obesity. But the exact mechanisms are unknown.

Probiotics and weight loss

This relationship between gut microbiota and obesity has drawn the possible use of probiotics to control body weight. Probiotics can also reduce fat absorption and decrease appetite.

Are they recommended for weight loss management?

It is a pity that despite the potential benefits of probiotics on weight loss, both scientific and clinical evidence is not enough to approve the use of probiotics in

the management of weight loss.

However, considering the good safety profile, you might want to try probiotics along with conventional weight loss treatments.

SIGN 8: Difficult sleep and increased mood swings 

After getting insight into the gut-brain connection, it is no surprise that probiotics or beneficial bacteria might help with trouble sleeping and mood swings.

What is the connection between good sleep, good mood, and good guts?

Serotonin (happy hormone) regulates your mood and makes you feel more focused, emotionally stable, gleeful, and calmer.

Serotonin is also the precursor to melatonin (sleep hormone) that controls your sleep-wake rhythm.

About 80% of serotonin comes from your gut, and an unhealthy community of gut microbes can affect both serotonin and melatonin production.

What do clinical trials suggest?

Recently, a research team conducted an 8-week clinical trial in Korea to evaluate the effects of a probiotic mixture ( Lactobacillus reuteri NK33 and Bifidobacterium adolescentis NK98 ) on mental health and sleep in healthy adults, and the outcome was probiotics helped alleviate depression and anxiety and improve sleep quality.

It is encouraging that probiotics could help if you are struggling to get a good sleep or stabilize your mood swings.

How can I get probiotics?

You can build up more good bacteria in your gut through fermented foods and dietary supplements.

Top foods high in probiotics 

Yogurt, kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, green olives, sourdough bread, and some cheeses are good sources.

Yogurt is the finest source of probiotic foods. The taste and texture are also satisfying to Western palates. 

Be aware that not all yogurt contains live probiotics because they can be killed during processing. So, find the words “live and active cultures” on the label.  Also, the number and strain of bacteria differ depending on the yogurt brand.

Probiotic supplements

Not everyone needs to take a probiotic supplement, but if you may benefit from taking one, there are two noteworthy issues to be aware of with probiotic supplements.

• Read the label for types of bacteria, amount of bacteria, and storage instructions
• Choose pharmaceutical-grade probiotics that show promise in clinical trials as most products do not contain the same composition as claimed on the bottle.

Do probiotics enter the bloodstream?

Since probiotics are live microorganisms, the concern is that they may translocate from the gut into the bloodstream, resulting in bacteremia and sepsis (a life-threatening reaction to infection).

They don’t enter the bloodstream. But the tables are turned when you have a fragile immune system or are taking medications that suppress your immune system.

There is scientific evidence of bacterial transmission from probiotic capsules to blood in ICU patients. The study examined the rates of Lactobacillus bacteremia among ICU patients at Boston Children’s Hospital. The rate of bacteremia is higher in the patients receiving probiotics that contain the same type of lactobacillus as those found in bacteremia patients.

Caution!

You should not take probiotics if your immune system is very weak or suppressed by drugs.

How can I know if my probiotics are working?

The signs of a good response depend on why you consume probiotics in the first place and which probiotics you are taking.

However, here are some signals that they are working.

• Less bloating
• More regular bowel movement
• Less stomach pain
• Fewer sugar cravings
• Fewer vaginal infections
• Better sleep
• Improved mood and memory

Can I have too many good bacteria/ probiotics in my gut?

It is tricky to define “Too many”,  as there is no recommended dosage value for probiotics.

Generally, having more good bacteria is exemplary. But you can’t consume them to the point you suffer from side effects. Common side effects of taking too many probiotics include bloating, gas, and nausea.

A quote from Roman philosopher, Marcus Tullius Cicero is “Never go to excess, but let moderation be your guide”. It is also a practical fact of medical science.

Take-home message

• The benefits of probiotics on gut health are promising.

• There are also other potential benefits but neither scientific nor clinical evidence is enough to prove.

• You can naturally get probiotics from food, but supplements are profitable if you have the eight signs I’ve described.

• A single probiotic can’t be a solution to all the different health conditions. Probiotics for diarrhea differ from the ones used to reduce sugar cravings.

• Probiotics are not for people with immunocompromised conditions.

• Besides probiotics, a healthy diet will give you a healthy microbiome.

My final say is if you’re thinking of taking probiotics, be sure to talk to your doctor first to ensure the safety and effectiveness of probiotics.

References

• https://pubmed.ncbi.nlm.nih.gov/31700189/
• https://pubmed.ncbi.nlm.nih.gov/21436726/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5900870/
• https://www.ncbi.nlm.nih.gov/books/NBK373095/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8838973/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601687/
• https://pubmed.ncbi.nlm.nih.gov/26261039/
• https://pubmed.ncbi.nlm.nih.gov/26261039/
• https://pubmed.ncbi.nlm.nih.gov/34444820/
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6236028/