What’s too much? Too little? Or maybe it’s the wrong strain? How do you get it right..?
You know the saying, “If a little does a little bit of good… then a lot must do a whole lot of good…” But when it comes to probiotics, too much of a good thing can be a bad thing.
We’ve talked before about the microbiome, the ginormous collection of microbes that live in your gut.
Some of those bacteria, fungi, viruses, and other microbes maintain a thriving ecosystem of sorts that assists your body in many of its functions. And they also provide a powerful immune system to protect you from infections, cancer, and viruses from the common cold to HIV.
There are — at any given moment – -10 microbes to every single cell in the human body. So we’re vastly outnumbered from the start.
But thankfully, the majority of those microbes help us function and protect us from invaders. The rest of them are always on the attack and being destroyed or eaten by the “good” bacteria.
Until something happens that jars that system out of balance. For example:
An infection treated by antibiotics, where the good bacteria are wiped out along with the bad.
Stomach upset that results in vomiting or diarrhea, where massive evacuation of the intestine leaves behind a weakened balance of beneficial and destructive microbes.
An injury that drives you to take a heavy load of ibuprofen, and your stomach lining becomes irritated, causing pain and bleeding.
In each of these examples, ingesting probiotics can help to restore balance in your gut, and relieve symptoms.
But, there are so many probiotic products! How do you know what to take and what to avoid? How do you know you won’t cause more harm than good?
The fact is, it’s hard to know. And unless you conduct some deep research on the subject, but rather grab a bottle off the grocery store shelf, you may not know now or ever.
Since you hear all around you how probiotics make you healthy, it’s natural that so many people want to overload their systems with “good bacteria” without respecting the balance within the microbiome that keeps everything working. But, can you overdo probiotics?
Balance is The Secret to Nature’s Success
For instance, when you think about the jungle, it may be tempting to remove everything you consider unpleasant so you can enjoy an exotic hike when you’re on vacation.
So let’s say we had a way of removing all the mosquitos, spiders, and other pesky insects, as well as lions, and snakes, and gila monsters. That does make it sound like strolling through the jungle would be so much safer for us…
But.
We know, don’t we, that there is a balance in the eco system, and every creature is somewhere on the food chain? So if we removed insects… then birds and reptiles and anteaters might starve. And that would starve the larger predators and soon… well, the whole system would likely collapse.
We know we can’t do that. Balance is the key all through nature, and it’s when our body systems are balanced that we experience well-being.
Microbes in our body must be balanced too.
The same is true with the microbes in your gut. We must respect and support the balance there.
So when you get sick you may need to build up the good microbes a bit. But if you try to flood your system with good microbes that overwhelm the balance with the destructive ones, other systems can be thrown out of balance, too.
As we’ve stressed before, your microbiome is your gut-brain axis. So what goes on in your microbiome shows up in your emotions and vice versa.
There are even specific bacteria that contribute to a happier outlook, reduce anxiety, and increase wellbeing. Some of the most helpful are Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus brevis, Bifidobacterium lactis (B. animalis), and Bifidobacterium longum.
Fermented foods, like kombucha, kimchi, kefir, plain yogurt and sauerkraut introduce live bacterial cultures. They’re probiotic foods–they introduce varied bacterial strains that are so important to your health.
But sometimes, if you can’t or don’t eat these, you might choose to buy a probiotic capsule. (Yep … we’ve all been guilty.) Sometimes it’s easier, faster, or you just need or want the extra assurance of varied bacterial cultures.
If you choose a probiotic, it should include the specific bacterial strains above that help prop up and stabilize your outlook.
And your dosing should be in moderation. Researchers state that a good probiotic should have up to 10 billion colony forming units (CFU) that you take daily, and that it should have at least 5 different strains per bottle. The more variety the better.
The reason you take a probiotic is to strengthen your beneficial bacteria so they’re not overwhelmed by the destructive ones, right?
At the same time, you don’t want to overwhelm your system with those beneficial bacteria. There are so many questions we don’t yet have answers for… like can you overdo probiotics?
Or… what happens if the yin-yang balance of tension between the two is removed? Do some of the beneficial bacteria switch sides? Do they become destructive… mimicking symptoms they have always before helped to eradicate?
In which case… maybe too much of a good thing is a bad thing?
Here is a better, more effective approach.
Balance of Power in Your Microbiome is the Ticket
But here’s where balance comes in. If your probiotic provides a great deal more than 10 billion CFU per day, you need to get your doctor’s advice. There are some products that provide 40 billion…and others even 400 billion CFUs.
And while these may be helpful in someone who has been seriously ill and may need a strong probiotic for a few days, it’s not that hard to introduce too much probiotic into your system.
Overdoing It By Over Dosing Probiotics
When this happens, side effects can emerge. It may be as simple as stomach upset and diarrhea, which can be terribly unpleasant. Or as complex as mimicking severe psychiatric symptoms like depression or anxiety or panic attacks.
We need to learn from each other, and from research, and take caution when we hear of bad experiences others have had from accidentally mismanaging their probiotics.
While research has not caught up with the widespread use of probiotics yet — we don’t have hard and fast guidelines about exactly what, how strong, how much, how often and for what, exactly — we’re learning more all the time. And there are cases of those who took a misstep and paid the price.
Here’s one example…something that could happen to anyone:
Carolyn is a 64-year-old woman in excellent health who’s always been robust and energetic.
She’s cared for pets and farm animals all her life and loves working with and riding horses. There’s nothing she’s afraid of… nothing she won’t try. In a word, she’s resilient.
Years earlier, Carolyn had suffered a knee injury that occasionally flared up. She had been taking large doses of ibuprofen that eventually irritated her stomach and led to bloating, shortness of breath, cramping, and bloody diarrhea.
She was frustrated with the misery and prolonged diarrhea, so she sought the advice of her nutritionist. He suggested a potent probiotic that provided 400 billion CFUs a day until the bottle was empty. So she followed his advice and took the whole bottle. At that point she was feeling wonderful… physically and emotionally.
She was wrapped in a sense of burgeoning wellbeing and decided if a little did a little bit of good… Her nutritionist suggested if she was to continue taking the probiotics, she should cut her dose in half.
She went to the store to buy another bottle and continued to take the original dosage without reducing them. What could it hurt?
Four days later, she awoke in the middle of the night feeling anxious. Her heart was racing, her left arm numb, and she was lightheaded. Eventually, she was able to go back to sleep, but the feelings of anxiety kept recurring.
Three more days passed. She was laying in her bed at night when gripping fear overwhelmed her. Her thoughts were racing out of control, she was lightheaded…she thought of dying, of losing her mind, felt detached and terrified.
Eventually, the terrible fear subsided, the racing thoughts slowed down, and she realized she was going to be ok.
But she was shaken.
Carolyn had never experienced anything like this before in her life. She’d always been resilient and solid…both feet firmly planted… through even the most severe crises in her life. What had happened to her?
Even though the symptoms had passed again, they recurred often and unpredictably the next few days. She researched frantically to find answers for what was happening to her.
The only thing that was different in her life was the probiotics, which had quickly healed her stomach problems. Could it have caused these new symptoms?
Then she found an article in Mental Health Daily about the side effects and adverse reactions to probiotics that people have reported. And there she found her answer.
That if you take more than 20 billion CFUs (she was taking 400 billion CFUs) per day, you can get side effects. And anxiety is listed as one of them. Who knew? She stopped the probiotics immediately. And hoped it would help.
To the Emergency Department…A Heart Attack?
Then, the next day, she woke from a sound sleep and believed she was having a heart attack. With her heart beating out of her chest, thoughts of dying in her bed overwhelmed her. She drove herself to the ED to get help. (Maybe not the best decision, but Carolyn was an independent sort.)
She told the emergency department personnel that the only thing in her life that had changed was that she was taking probiotics. The nurse sloughed it off and said, “Probiotics never hurt anyone.”
Her EKG was clear, so they gave her a medicine to calm her and sent her home.
Happily, three days after she stopped taking the probiotic supplement, the anxiety dissipated, and she felt like herself again.
She wanted to throw a party to celebrate!
Professional Nutritionist Baffled
The fact that the ED nurse had no idea probiotics could do this comforted Carolyn. She felt embarrassed to have unwittingly taken too much probiotics for too long…but apparently even some medical professionals weren’t aware there could be side effects with probiotics.
Later, she told her nutritionist what happened, and he asked her why she didn’t stop when he told her to???
She sheepishly explained.
Then he said, “In my 25 years in nutrition, I’ve never heard of side effects with probiotics!”
Carolyn told him, “Well, it sure happened to me!”
She’s been doing great ever since the whole incident and is elated to be herself again. But she learned a hard lesson. “Harmless” probiotics deserve respect for their power and impact on the human system.
From now on, she’ll ALWAYS follow directions when it comes to over-the-counter remedies. And especially probiotics!
The good news is that if probiotics can cause this much change in someone who’s healthy, they can also make a significant difference in anyone who’s not.
Along with improving health in your stomach and intestines, as well as reducing inflammation and infection throughout your body, they can also relieve symptoms of depression and anxiety.
But be aware, they’re not to be taken lightly. Experts say that since each individual is unique, there is no one-size-fits-all for probiotic supplementation.
Remember: In general terms, up to 10 billion CFUs daily. Start gently. Watch for out-of-the-ordinary symptoms. A specific strain may not be right for you, or a specific combination. Take several days or a couple weeks to test the effects of partial doses, raising the dose a little each day as long as you have no negative symptoms. Include your doctor in the process.
This story isn’t to scare you away from using a preparation that can help you become stronger and more resilient. But rather to alert you to possible risks if you use probiotics without supervision or awareness of potential side effects.
One more piece to the puzzle of health and wellbeing.
And speaking of wellbeing, how is yours?
When Nothing Else Helps, What Then?
The use of things like probiotics to strengthen your microbiome, and bioavailable curcumin to improve your health, your mood, and your wellbeing, eating a healthy diet that includes fermented dishes like kimchee, sauerkraut, and yogurt, along with frequent exercise and a good night’s sleep, can all help you to achieve wellbeing in your life and reduce stress.
But some of us are genetically predisposed to certain conditions, or find that life stressors spark symptoms or depression, anxiety, PTSD, OCD, addiction, and even suicide.
Maybe you’ve taken the medicines your doctor prescribes but don’t feel they work because you’re still not better. Maybe the wait, or the weight gain, or other side effects are all not worth it any more.
If that sounds like you, you may be a candidate for the kind of forward-thinking, innovative ketamine treatment that we offer.
Since the beginning of this century it’s been intensively studied for treatment-resistant depression, bipolar depression, suicidal thoughts, and now for other psychiatric disorders. In the last few years its use has become more and more widespread, and studies have proliferated to learn more.
For those of us in psychiatry who are treating our sickest patients with it, it’s the most extraordinary medicine we’ve seen in 50 years. In fact, in our lifetime.
Interestingly, it seems to have the most robust effects on those whose disorder is the most severe.
If that sounds like you, we may be able to help you get better.
As we say so often, ketamine isn’t for everyone… But nothing else available works so rapidly and so well for so many struggling with hopelessness.
So, if you’ve endured symptoms of a severe mood disorder way too long, call us.
We want to help you start your new year on better footing, with the power to enjoy your life and relationships, and contribute to the lives of others.
Here at Innovative Psychiatry, we see people who’ve been depressed for years walk out with joy, hope, and the energy to engage in the things that are important to them.
Give yourself the chance to really live.
To the emergence of your best self,
Lori Calabrese, M.D.
