The Failure of Probiotics—and the Strategy of Microbiome Synergy

The research field of the human microbiome continues to expand with groundbreaking data highlighting the complex crosstalk between our microorganisms and an increasing number of physiological systems. From directly influencing the gut-brain-immune-endocrine axis to manufacturing essential nutrients for the body and boosting chemotherapy efficacy, findings on the far-reaching functions of our microbial terrain continue to expand our understanding of this vast ecological network.

As the data continues to evolve, the importance of maintaining a healthy microbiome—particularly for long-term digestive health—has become increasingly apparent.

What is less apparent is how to get there.

Rocky Terrain

Despite the significant increase in probiotic use over the last decade, statistics nevertheless show a rise in inflammatory bowel conditions, small intestinal bacterial overgrowth (SIBO), and other chronic digestive ailments. Furthermore, an increasing number of patients report no benefits from taking probiotics.

Emerging microbiome research using new methods of analysis may help explain this contradiction. A two-part study published in the journal Cell, used endoscopy and colonoscopy evaluation (instead of just measuring stool samples as was the standard), to demonstrate that probiotic supplementation may offer no clinically-relevant benefits for a majority of patients.¹

Results from this study showed that up to two-thirds of subjects had no evidence of probiotic supplements working to colonize their digestive tract, or providing noticeable digestive benefits.

Termed “resisters” by the study authors, this majority group simply expelled the probiotics rather than successfully colonize the GI tract as intended. Only a small number of subjects, the “persisters,” showed success in probiotic colonization of the GI tract. Importantly, researchers found that they could predict whether a patient would be a “resister” or a “persister” by evaluating baseline microbial and gut gene expression profiles.

Going further, the second arm of this study demonstrated that probiotic supplementation following a round of antibiotics was unsuccessful in restoring normal, healthy gut bacterial populations in the majority of subjects.²

These findings directly reflect clinical observations that colleagues and I have made over the years when administering “high quality” probiotics to patients and seeing vastly differing clinical results. And in many cases, no results at all.

There is another issue: Preliminary research suggests that without proper intestinal motility, probiotic supplements may have the potential to contribute to an overgrowth of bacteria in the small intestines, ie. SIBO.

Probiotics supplements are designed to traverse the stomach and small intestines and reach the large intestines where they can colonize. However, when peristaltic movement is inefficient, probiotic supplements may remain in the small intestine, creating metabolic byproducts such as ammonia, and leading to bloating, discomfort, lethargy, brain fog, and other symptoms characteristic of SIBO.³

Next-Generation Results

What’s clear from this data and the growing body anecdotal evidence, is that there is an increasing need for microbiome support formulations that promote not only successful GI tract colonization (itself a challenge) but overall digestive motility and function, across a much broader patient population.

Based on the lack of success I was seeing in my practice with conventional probiotics, I stopped recommending many of the traditional clinical-grade formulas and replaced them with something very different: A unique, synbiotic pre- and probiotic formula fermented on a blend of organic digestive-and immune-supporting herbs.

The benefits of this synbiotic formula were immediately clear. For the majority of my patients and those of my colleagues, this live liquid probiotic formula worked quickly to provide relief against chronic digestive issues including constipation, diarrhea, inflammation, digestive discomfort, and other symptoms. Importantly, this unique synbiotic is shown to exert benefits in many patients for whom traditional probiotic supplements were either ineffective, or contraindicative due to an increase in digestive symptoms.

The success of this novel formula can be found in the synergy between 8 clinically-studied live lactic acid producing strains, fermented with organic digestive and immune-supporting botanicals including ginger, fennel, fenugreek, and chamomile; and patented Pectic Oligosaccharide (POS) prebiotic nutrients in a liquid delivery system.

Pharmacologically, this multitargeted formula addresses four fundamental aspects essential for establishing and maintaining a healthy internal ecosystem and microbiome vitality:

1. Proper pH balance—Insufficient acid levels in the gut are a common problem for many patients, interfering with digestive capacity, promoting the growth of harmful microbes, and creating an inhospitable environment for beneficial bacteria to survive. The fermentation byproducts in this synbiotic formula help solve the problem by promoting optimal gut pH levels—between 1.5 and 3.5—providing an ideal environment for probiotic bacteria to thrive.

2. Botanical support for motility and digestive function—Digestive and immune- supporting herbs in the formula are further activated by fermentation, providing broad-spectrum botanical support for relief of digestive discomfort, as well as support for healthy motility, nutrient absorption, immunity, and overall GI function.

3. 8 Clinically studied strains of live lactic acid bacteria—Research shows that some of the most beneficial probiotic strains include lactic acid bacteria that offer a number of essential benefits when properly established in the GI tract:

   • Bifidobacterium lactis supports nutrient absorption and defends healthy bacterial populations. B. lactis converts carbohydrates into lactic acid, vitamin B, and other key nutrients, and encourages an optimal low pH environment for healthy microbiome populations to thrive. It also protects healthy intestinal function.⁴

   • Bifidobacterium longum promotes a healthy gut environment and supports GI lining integrity; converts carbohydrates into lactic acid and prebiotic oligosaccharides into energy. B. longum also defends against pathogenic gut microbes.⁵

   • Lactobacillus acidophilus produces vitamin K and other nutrients that support a healthy microbiome. L. acidophilus also promotes metabolic balance, immune function, and other areas.⁶

   • Lactobacillus casei supports GI lining integrity, and maintains healthy colon cell behavior, supports metabolic balance, and other areas.^7,8

   • Lactobacillus rhamnosus supports digestive health, immune responsiveness, and other areas.⁹

   • Lactobacillus salivarius promotes digestive health, oral hygiene, immunity, and other areas.^10-12

   • Lactococcus lactis converts a variety of carbohydrates to lactic acid for a healthy GI environment and supports the immune system via gut mucosa interaction. It also produces nisin, which combats pathogens.¹³

   • Streptococcus thermophilus produces significant amounts of lactic acid and bacterial metabolites that promote a healthy microbiome. It also supports immunity, cardiovascular function, and other areas.¹⁴

Targeted prebiotic nutrients—In addition to the digestive-supporting botanicals, many of which also provide prebiotic nutrients, this formula also contains researched pectic oligosaccharide prebiotic fiber, PectaSol-C, (POS) to provide additional nourishment and fuel for establishing healthy microbial populations in the large intestines.

The benefits my colleagues and I continue to observe with this synbiotic formula, SynerGI^® by Clinical Synergy Professional Formulas, underscore the importance of a multi-faceted strategy for favorably modulating microbiota, particularly in gut-compromised patients.

Additional dietary measures can add significantly to this approach. Compelling data shows that people who consume diets of whole, unprocessed and fiber-rich foods have a higher number of microbes associated with specific measures of health. On the other hand, people with diets emphasizing refined carbohydrates are often shown to have microbiomes skewed toward a predominance of pathogenic species and concomitant health conditions.

Breakthrough findings in microbiome research continue to revolutionize our repertoire of targeted diagnostic and therapeutic tools that can be individualized to produce robust clinical benefits across complex patient populations.

Stay tuned.