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muscle bicep curlEnhancing Your Health From Within by: Colby Vorland
“Death sits in the bowels; a bad digestion is the root of all evil”
-Hippocrates, ca. 400 BC

Probiotic supplementation is one of the most under discussed topics and one of the most underrated nutraceuticals for general health, with a large body of clinical research appraising their benefits. This article will discuss a number of those benefits which include: immune system reinforcement, digestion and absorption improvement, nutrient production, blood pressure and cholesterol reduction, stress damage attenuation, suppression of inflammation, prevention of intestinal infections, pregnancy protocol and allergy prevention, a decreased risk of colorectal cancer, and some dietary suggestions to optimize gut function. A new probiotic product, Güt Health™, is introduced as an option for supplementation, showing superiority over other strains in a clinical study. An introduction to prebiotics is an inclusion as a transition to the second article in this series.

Modern diets are drastically different than in the past, with modern processing techniques destroying beneficial bacteria and enzymes which would help with digestion and absorption, and many new food products that are unnatural to the human digestion system. Coupled with an increase in pollution and stress, even a strict diet may not be optimal for promoting health. Athletes especially should look into probiotic products for advantageous recovery and improved strength and performance; however they can be extremely beneficial to anyone for general health.

An Introduction to the Intestinal Mucosal Immune System

As bacteria enter the stomach, most are destroyed because of the extremely low pH. Those that do survive pass through the pyloric sphincter to the duodenum. They are then attacked by bile salts and pancreatic secretions. Surviving through this point means they are able to increase in number as they enter the colon. From mouth to anus, the transit time for bacteria is about 55 to 72 hours, with the majority (54 to 56 hours) in the colon. They are able to colonize if they adhere to the mucus layer (73). Bacteria in the gastrointestinal tract alone amount to trillions, and can be generally divided into two categories: indigenous, and pathogenic. The average intestine holds an astonishing 1.2 kilograms (~2.6 pounds) of bacteria (2). Indigenous bacteria coexist in symbiosis with us providing many benefits, and we simply could not survive without them. Pathogenic bacteria can cause illness if not controlled by indigenous bacteria. If the balance is disrupted, many adverse effects can occur. In other words, the intestinal tract is inhabited with many bacteria, some being beneficial to the host and some harmful, forcing immune responses to maintain homeostasis. Proliferation of pathogenic bacteria leads to symptoms caused by the secretion of toxins from these bacteria.

Most estimates suggest that at least 500 species flourish in the intestine, all interacting and with different functions. No two people have the same population ratios, and diet and environment are large influential factors on this. Because the intestine is the primary interaction between outside pathogens and the immune system and the most active immune organ housing about 60% of total immunoglobulins and lymphocytes, keeping it optimized will prevent many illnesses and provide additional benefits. It is where the mucosal immune system constantly processes food and antigens and is subject to change from each nutrient or microbe it encounters. If the immune system isn’t fed by stimulating nutrients or beneficial bacteria, it becomes susceptible to the harmful bacteria trying to penetrate it by the alteration of some of its key fighting functions. The mucosal immune system is unique because it is independent of the systemic immune system, and probiotics have an influential effect on both (72). Bacteria may even have an effect on overall human growth, thus an inadequate diet may stunt growth this in this manner (74). The lactobacilli and bifidobacteria species are thought to be the most abundant and influential on health, and therefore most of the following information evaluates data on these strains.

Consuming foods containing pathogenic microbes or their toxins can cause gastroenteritis. Symptoms that accompany include vomiting, nausea, diarrhea, abdominal cramps, etc. Because many pathogenic bacteria inhabit the gut of animals too, poor slaughter practices of meat and poultry can lead to infection, even if the rest of the transportation and handling of the animal is clean. Vegetables may also become a danger from the use of animal manure as fertilizer. It is evident that different strains of bacteria have different effects on the body. For instance, Escherichia coli, Sihigella spp., salmonellae, and yersinae cause bacterial multiplication within enterocytes or colonocytes. Enteropathogenic and enterohemorrhagic strains of Escherichia coli, and shigellae are cytotoxic, causing direct cell damage. Toxigenic bacteria produce enterotoxins which alter salt and water secretion, include Vibrio cholera, and some shigellae. Another strain of E. coli can bind to the colonic mucosa which can establish infections in the gastrointestinal tract while avoiding detection from an immune system and indigenous microflora response (4).

Probiotic Basics

Probiotics are considered to be a “food or drug containing live microbes that confer positive physiologic changes in the host animal” (10). Most are dietary supplements that contain bacteria or yeast, but the most common are lactic acid bacteria. Currently studied, the beneficial microbial flora to the human intestinal tract include species from the genera: Lactobacillus, Bifidobacterium, and Enterococcus. The subnames of these species are: Lactobacillus acidophilus, Lactobacillus johnsonii, Lactobacillus gasseri, Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus plantarum, Bifidobacterium longum, Bifidobacterium breve, Bifidobacterium bifidum, Bifidobacterium infantis, Enterococcus faecalis, and Enterocuccus faecium (11, 12). Some of the Bifidobacterium species are only present in non human animal intestinal tracts, and may be present in animal probiotic products, including the species: Bifidobacterium thermophilum, and Bifidobacterium pseudolongum (13). Not all probiotic microbes exist in the intestinal tract, so their influence on enteric microbial balance is probably small. These species include: Lactobacillus bulgaricus, Streptococcus thermophilus, Leuconostoc, and Lactococcus (14).

Probiotic Safety

Probiotics have been proven safe through a long history of use, most especially the Lactobacillus, Leuconostoc, and Pediococcus species (15, 16). There has been some concern over whether some microbes deemed beneficial are in fact pathogenic, because of isolation from clinical infections. Lactic acid bacteria and bifidobacteria specifically have been found in this manner, but the conclusion that they are indeed infectious is nothing more than a guess. More likely is that opportunistic infection results from immunodeficiency, immunosuppression, skin injury, or drug-induced abnormality, and for the bacteria to cause a systemic infection itself is highly unlikely (19-21). Thus, the safety of probiotic strains is evaluated by considering the likelihood of these occurrences. The evidence showing the safety of probiotics is much greater, but it should be noted that probiotics may also potentiate underlying immune problems and should be considered carefully if one has a history.

Probiotics and Immune Reinforcement

Indigenous microflora and the mucosa layer can serve as barriers against pathogenic infection. Specifically, bifidobacteria and lactobacilli have been found to inhibit pathogens such as E. Coli, Campylobacter, and Salmonella spp. Some other mechanisms how lactic bacteria is speculated to strengthen resistance against pathogens include: metabolic endproducts that lower gut pH which favor friendly bacteria flourishment, competition for growth and nutrients with pathogenic bacteria, inhibitory peptides countering pathogenic microbes, and immune system enhancement by frequent cell turnover (50). Supplementing lactic acid bacteria can also increase the populations of different beneficial intestinal strains (54).

Recent research is pointing to the possibility of autoimmune disease treatment with probiotics. An increase in different types of white blood cells after probiotic consumption could be beneficial in the prevention or treatment of diseases such as diabetes, multiple sclerosis, and rheumatism. This also means that probiotics can be effective against viruses as well (62).

Probiotics shortened the average instances of the common cold by 2 days and reduced symptoms in one study (3).

Age plays a role in microbe populations, and persons above age 55 show a decrease of enteric bidifobacteria compared to younger persons (51). Comparing data from different ages affected by E. coli outbreaks, there is a very strong correlation to older age and a higher fatality rate. The importance of a healthy diet and the consideration of probiotic supplements especially as one ages is of extreme importance.

Digestion & Absorption

Intestinal bacteria use enzymes to break down nutrients and also secrete bile which aids in the absorption of nutrients, and in this way make the process more efficient. The amino acids tyrosine and tryptophan are putrefactive, meaning their metabolites, phenol and p-cresol from tyrosine and indole and skatole from tryptophan, cause a strong odor. These products are normally detoxified in the liver and excreted in the urine, however buildup in the intestine can lead to odorous gas and waste, diarrhea, liver disorders, and circulatory system malfunction. Since probiotics can help control intestinal pH, the degradation of these byproducts will be enhanced. Also, ammonia is detoxified by the liver, but if this process is preoccupied or impaired, ammonia levels will elevate and interfere with nerve impulses. Probiotics are able to inhibit urea splitting organisms (ammonia is one of the compounds in urea) and decrease ammonia levels (77). The reduction of many of these procarcinogenic and hepatotoxic compounds will promote health and reduce intestinal stress. Lactic acid bacteria can also assist in the breakdown of carbohydrates that are difficult to degrade (53). Lactose intolerance is prevalent in adults and is caused by a deficiency in the enzyme lactase which breaks down lactose. Probiotic cultures contribute lactase, shown by the reduction of hydrogen excretion in the breath. An increase in lactase activity by four times normal amounts has been demonstrated. Slowing gastric emptying may potentiate lactose digestion, which can be accomplished in many ways, the simplest being the incorporation of fatty acids or fiber into a meal. Probiotics assisting in digestion can help alleviate the symptoms of emptying that occurs too quickly (bloating, gas, diarrhea, etc) (1). Lactic acid bacteria can also convert some lactose to lactic acid, easing digestion and thus preventing the growth of pathogenic bacteria (60). Celiac disease (sprue) is a disease in the small intestine that interferes with absorption, and may be worsened by pathogenic bacteria by the interference of production and absorption of folic acid and B12 (74).

Probiotics and Nutrient Production

Not only will absorption of micronutrients be improved, probiotics can actually produce vitamins B1 (thiamine), B2 (riboflavin), B3 (niacin), B5 (pantothenic acid), B6, B7 (biotin), B9 (folic acid), B12 (cyanocobalamin), vitamin K, and various amino acids (53, 57-59, 74). When probiotics are supplemented, B1 production is shown to increase as much as 2 to 3 times greater than normal (53). Vitamin contribution by the gut is not to be overlooked, and macronutrient intake can significantly change the synthesis of especially riboflavin. High dextrose, fat, and protein decrease riboflavin synthesis, where high complex carbohydrate intake increases synthesis. Experiments in India show that the carbohydrate to fat ratio is more important than the amount consumed from foods (74).

Microflora and Obesity

Recent research suggests that the intestinal microbe populations may have a large role in body weight. Mice and humans have bacteria groups called Firmicutes and Bacteroidetes, which occur in different proportions in lean and obese subjects. Firmicutes were higher when body fat was high, and as subjects decreased body fat, the population decreased. These bacteria have genes encoding enzymes that break down polysaccharides which are normally not broken down, increasing absorption. This may be another key reason to the difficulty of weight loss. The theory is intriguing and further research can quantify the changes in humans and more possible methods for bacterial manipulation and fighting obesity (75).

Probiotics and Hypertension

Over 50 million Americans are diagnosed with hypertension, but diet and natural treatments are generally second to drugs. Probiotic dietary suggestions or supplementation are rarely discussed as options. Some research shows that probiotics are proteolytic on the milk protein casein, which results in bioactive tripeptides working as angiotensin-I-converting enzyme (ACE) inhibitors that lower blood pressure (1).

Probiotics & Cholesterol

Lactic acid bacteria convert cholesterol into coprostanol, a less absorbable form. Thus, serum cholesterol levels are reduced. Further theories of cholesterol reduction comes from data showing that dairy products with lactic acid bacteria result in reduced levels, but uncultured products result in no change (55). Certain strains can also suppress cholesterol synthesis by inhibiting the enzyme hydroxy methyl glutaryl (HMG)-CoA reductase (56). Also, because bile acids are reduced by probiotic strains, cholesterol molecules are needed to rebuild them, thus lowering circulating cholesterol. The range of effectiveness of probiotics in current research is 5.4 to 23.2% for serum cholesterol decrease and LDL from 9 to 9.8%, with varying dosages (1).

Antibiotics and Probiotics

Infection occurs when bacteria cross the mucous membrane and epithelium of the intestine and is caused by a weak intestinal barrier, which can result in bacteremia (bacteria in the bloodstream). Bacteremia may progress to septicemia (bacteria along with their secreted toxins in the bloodstream) (17-19). In other words, if the immune system is compromised, infection may occur. Mucosal damage can be promoted by ethanol (alcohol) administration (22-26), NSAIDs (non steroidal anti-inflammatory drugs) (26-28), acute and chronic stress (29-31), food processing, pollution, and many other free radical causing agents. Mucosal translocation can also occur when harmful enteric bacterial flora are in an overabundance, where antibiotic prescriptions come into play. Antibiotics either kill or prevent the multiplication of bacteria, however this is detrimental to most intestinal flora. Because of this, probiotic supplementation after antibiotic use is especially important to restore health quickly. Because antibiotics are over prescribed in many unnecessary cases, some harmful pathogens may adapt and not be eliminated by antibiotics. If antibiotics are administered for long periods of time, bacteria that wouldn’t normally be infectious may be harmful because of changes in the gut ecology (74). In addition, many lactobacilli and bifidobacteria species secrete natural antibiotics, killing harmful pathogens (4). There is some concern about probiotic strains that are resistant to antibiotics because of certain genes, and they may pass those genes to pathogenic bacteria. Testing at the University of Antwerp in Belgium of over 200 commercial probiotic strains is underway to address this issue. Assisting the body’s natural defenses is the best way to achieve the strongest protection in the present and for the future.

Probiotics & Stress

Intestinal distress is linked with psychological and physical stress, impairing the defense of the mucosal layer. Probiotics can protect against stress induced intestinal disturbance. Under psychological stress, bacterial adhesion and penetration occurs in the epithelial layer, which can be completely prevented with probiotic supplementation (52). Physical stress can also induce drastic intestinal changes, which is a reason antibiotics are prescribed post operation. Intense exercise temporarily suppresses immune response, and probiotics may be useful to prevent infection during this time.

Probiotics and Inflammation

Enteral mucosal inflammation occurs when pathogens interfere with normal mucosal function. Probiotics are able to minimize this interference in a few ways. For illnesses in the category of Inflammatory Bowel Disease, such as ulcerative colitis or Crohn’s disease, probiotics show promise as a form of treatment. Tumor necrosis factor (TNF)-? and interleukin (IL)-8 are biomarkers of inflammation, and when probiotics are introduced, concentrations are decreased. Nuclear Factor kappa B (NF-?B) may be inhibited which would down-regulate cytokine secretion (61). This means a safe and effective alternative to non steroidal anti inflammatory drugs, which as discussed previously can negatively influence microbial populations.

Probiotics and Infection

The intestinal epithelial cell layer protects the homeostatic environment of the host by responding with cytokine production in the presence of invasive bacteria (6). However, there is evidence that noninvasive pathogens, such as certain serotypes of Escherichia coli (E. coli) stimulate neutrophil (7) (type of white blood cell) and cytokine translocation through the epithelial layer from the activation of NF-kB (nuclear transcription factor-kappa B) (8). Enteric pathogens, exemplified also with experiments using E. Coli, are able to negatively modulate immune response by altering lymphokine expression (chemical messengers that regulate immune response) (9). Since probiotics inhibit these pathogens, infection risk is decreased. One of the most common infectious bacteria, Helicobacter pylori, can causes ulcers and gastritis, and may be present in as many as two thirds of the world population. Probiotics, in vitro and in vivo are able to prevent H. pylori infections and reduce existing populations (76). Probiotics also have a use for treating and preventing bacterial vaginosis (63), which is the displacement of lactobacilli bacteria in the vagina by pathogens (64). Their role is further discussed below.

Probiotics, Pregnancy, and Allergy Development

Although more controversial, supplementing probiotics during pregnancy may be of benefit to a developing fetus. Healthy eating during pregnancy can decrease the baby’s long term risk of chronic diseases such as diabetes and heart disease. Lactobacilli strains enter the picture for their ability to prevent the vaginal colonization of group B streptococci, which if present during labor can be passed to the child and cause a number of serious illnesses or death (65). Probiotics may also prevent allergic reactions in babies. Supplementing probiotics during pregnancy and for the first 6 months of the newborn’s life has been demonstrated to prevent 50% of atopic dermatitis cases, which is a condition causing severe skin rash in up to 15% of babies (66, 67). Kankaanpaa, et al. suggest that the immune system is reprogrammed or there are altered levels or plasma-neutral lipids and alpha-linolenic acid with the presence of probiotics. The gut of a fetus is sterile, and at birth rapidly colonized from vaginal and fecal bacteria during birth. The complete bacterial make up of the gut is then formed by the age of two and remains this way until old age, hence the nutritional importance of this time period. If the immune system is overexposed to pathogens at an early age, certain cells can be activated thus resulting in future over response to allergens. Breast feeding is superior to formula milk which causes significantly different colonization patterns in newborns and a higher risk of hosting pathogens, and thus should be considered carefully, along with the mother’s diet to give the infant the best health (73). The introduction of probiotics may be able to alter immune response, and prevent allergies, in infants and adults. Although successful studies have been conducted, further research is needed to verify the safety of probiotics in newborns.

Probiotics and Cancer

Diet has a large influence on the enteric microflora population, and because of this probiotic supplementation is especially warranted for a Western diet consumer, generally on a high-fat and high-protein diet which contain high amounts of putrefactive bacteria, reductive enzymes, and therefore an increased risk for colorectal cancer (37). This is because these bacteria are able to influence metabolic activities and promote the conversion of procarcinogens to carcinogens (34-36). Bidifobacteria and lactobacilli have been linked to the reduction of reductive enzymatic activity (44-47). There is also evidence supporting positive modulation of mutagens and carcinogens by a change in positive microflora populations (48). Colon cancer incidence in Asian populations is lower than the Western diet, because of higher densities of mainly bidifobacteria and other beneficial strains. Bile acids are associated with colon cancer, and supplementation of probiotic strains can cause a beneficial shift in the metabolic characteristics of individual species or strains (34, 35). The reduction of bile acids is maximized through fiber and mineral intake (49). A decrease in enzyme activity with probiotic supplementation (also discussed below) coupled with an increase in gastric emptying frequency from fiber reduces exposure to potential carcinogens.

Commercial Product Claims

Many supplements do not meet the claims listed on the label, but probiotics seem to be especially off the mark. When ten commercial brands containing lactobacillus strains were tested from British Columbia, none of them matched label specifications. Two brands contained no bacteria whatsoever, five lacked any lactobacillus, and eight only had 10% of the number of organisms stated on the label (68). Another study on European lactobacillus strains in probiotic feed or food products tested ten products, and found that five products did not meet their claims on the number of organisms, and three had different species of lactobacilli than stated. Four of the products were found to lack any of the strains that were supposed to be in the product (69). A 1999 review looked at 52 probiotic products, and shows that an overwhelming majority are incorrectly labeled according to claims. Enterococcus faecium, a potential pathogen, was even found in nine products (70). The concern that probiotic organisms do not arrive to the consumer alive is of concern, but fortunately even dead organisms have been demonstrated in rats to generate an immune response (71). This is because only the DNA is needed to provide this benefit. However, live organisms are of more benefit because of their ability to adhere and compete with pathogenic bacteria. Quality control is a big issue when choosing a probiotic product, and research should be done on the manufacturing process.

Prebiotics & Dietary Intervention

Prebiotics are nutrients and food constituents that the gut microflora feed upon, causing their multiplication. Consuming prebiotics will provide a positive environment for good bacteria to thrive, enhancing their health benefits. These include oligosaccharides, usually studied in the fructo-oligosaccharide form, which is a naturally occurring carbohydrate in many plants, such as wheat, onions, garlic, leeks, chicory root, artichokes, asparagus, chicory, and some other soluble fibers in fruit, pulses, and some cereals. Oligosaccharides are classified as dietary fiber because they are not significantly broken down by digestion in the stomach and small intestine, and have a low molecular weight (4). A diet high in fiber is strongly linked to a reduced risk of colorectal cancer (33). Inulin, one of the most commonly sold dietary prebiotics, is a fructo-oligosaccharide and has been demonstrated to have effects on enteric bifidobacteria (32). Gibson and Wang also showed that pathogenic bacteria on the other hand, are not able to reproduce with these nutrients. Oligosaccharides, in different forms, are strongly linked to the reduction of E. coli and clostridia strains by increasing the bifidobacteria and lactobacilli populations (38-41). Galacto-oligosaccharides, present in dairy products such as milk or yogurt, have been demonstrated to be as effective as human milk at improving enteric microflora and fermentation in infants (42). This is one important reason breast feeding is vital to immune system development. Further evidence supporting the reduction of fat and protein in the diet and increasing fiber intake is beneficial to helpful bacteria populations exists, and this improvement is rapid and can occur in a matter of days, so a dietary change should be considered during periods of illness (43). However, a diet high in fiber that increases beneficial enteric microflora, although resulting in the decreased activity of carcinogenic reductive enzymes, is not sufficient by itself to sufficiently alter enzymatic activities (44). Further, the changes that occur during prebiotic supplementation are not as drastic as with probiotic supplementation (43). To conclude, a supplement (or dietary) regimen of oligosaccharides and probiotics is optimal to maintain and improve intestinal health.

Other Dietary Suggestions

Because pathogenic intestinal bacteria can use monosaccharides or short-oligosaccharides as nutrients, simple sugars (fructose, glucose, and galactose) should be limited (4). Consumption of yogurts with live and active cultures contain probiotics. Low antioxidant levels have been observed in patients with gastritis and peptic ulcer disease, and the addition of antioxidants can decrease gastric inflammation. Fish oil is also beneficial by the reduction of pro-inflammatory conditions. Glutamine and arginine promote T cell response and are backed by much research in subjects with illness. The more active the immune system is, the more glutamine will be used and reduced availability results in an inhibited immune response. Zinc and vitamin A deficiency promote infection. Dietary nucleotides also are potent immune strengtheners. Milk may be beneficial because of immune system activation from cow insulin. Malnutrition is frequent in non industrialized countries, but also affects industrialized. The recent obesity epidemic is representative of nutritional ignorance and results in a greater risk of illness. Dieting can also lead to this increased risk if not balanced, but luckily refeeding or the emphasis on nutrients that stimulate the mucosal immune system have been demonstrated to positively alter the protective functions, and the administration of single nutrients is well documented to bring out these changes, showing merit for over the counter cold products (72). The administration of large doses of vitamin C is a popular remedy, and can spare other vitamin requirements and may be used as an energy source by the microflora (74). Increasing fat intake in research decreases lactic acid bacteria, which can be increased by protein (73). A balanced diet is clearly necessary to complement any supplemental additions.

Güt Health™

One specific strain of the Lactobacillus casei species, dubbed KE99, sold now under the name Güt Health™, has been demonstrated to be particularly effective in maintaining a positive intestinal environment. KE99 displayed excellent sulfide/ammonia reduction, ability to colonize, and E.coli O157:H7 removal (the deadliest strain in humans). Compared to other strains of lactobacilli: casei ssp. casei ATCC393, casei ssp. rhamnosus ATCC7469, and reuteri ATCC23272, KE99 was superior at sulfide reduction, a carcinogen which can cause liver damage if it builds up.


KE99 is superior at sulfide reduction at various pH environments compared to reference strains.

Sulfide reduction peaked at around hour 24 and stayed elevated through hour 72.


KE99 reduces sulfide for an extended time period.

When sodium and ammonium sulfide salts were added, KE99 was again very effective at sulfide reduction.


KE99 effectively reduces sulfide against sodium and ammonium sulfide salts.

The binding of the probiotic strains to synthetic layers were tested to check the ability to colonize in the intestine, and the results suggest that KE99 is very effective at colonization and would result in flourishment, overpopulating pathogenic strains and holding position during the emptying of the gut.


KE99 displayed a better ability to bind to synthetic layers.


KE99 also successfully detached E. coli O157:H7 binding with a 55-76% effectiveness.

Because sulfide and ammonia are odorous and toxic in waste, the importance of their reduction is significant. In vitro, the lactic acid bacteria strain Lactobacillus casei KE99 is more effective than three other strains at sulfur and ammonia reduction. The ability of probiotic bacteria to survive the gut by binding to the enteric epithelium is important to its effectiveness. KE99 displays exceptional ability to do this in vitro with synthetic layers. Through experimentation, KE99 shows competitive binding characteristics versus various salts and sugars, suggesting lectin-type interaction. This means that KE99 binds in place of nutrients that would be used to fuel pathogenic bacteria growth. KE99 also detached five different strains of E.coli O157:H7 in the in vitro model. E.coli attaches to collagen anchoring sites, for which KE99 shows a stronger affinity. Güt Health™ is a powerful probiotic supplement that will help maintain optimal intestinal health (77).


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