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How to Choose a Probiotic

7/20/2017

 
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A healthy gut flora is incredibly important to prevent disease and to promote a healthy body. The bacteria in your gut work for you by killing off harmful invaders, help you to absorb nutrients, enhance your immune system, and help to digest your food. However, choosing the right probiotic is tricky because there are hundreds of different types of probiotics on the market and it can be difficult to know which one to choose.
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Here is a list of 10 considerations when choosing a probiotic:
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1. Probiotic must have at least 5 billion CFU
Your gut has literally trillions of bacteria and for a probiotic to make any sort of impact you need to find a probiotic that has billions of CFU (colony forming units - aka amount of bacteria). Don't look twice at a probiotic if it has anything less than"billions CFU" listed on the nutrition facts section.

2. Multiple strain or single strain probiotic?!
One good single strain is better than multiple strains that don’t do anything. The most important thing to consider when choosing a probiotic is what type of strain(s) it contains - good brands of probiotics will list the evidence showing their strain(s) of bacteria efficacy on their website.

3. If you are constipated
One strain in particular that has shown effective in numerous studies for reducing constipation is Bifidobacterium lactis. Other strains that may help with constipation include Lactobacillus rhamnosus, Bifidobacterium animalis, Bifidobacterium longum,  and Lactobacillus plantarum.

4. If you have diarrhea or want to prevent traveler’s diarrhea
Strains that studies have shown to help with preventing diarrhea or traveler's diarrhea include Lactobacillus rhamnosus, Lactobacillus casei, and Saccharomyces boulardii.

5. If you want to lose weight
Probiotics that have shown to help you lose weight include species of Lactobacillus, specifically Lactobacillus rhamnosus and Lactobacillus gasseri. VSL# 3 is a probiotic in particular that may help with weight loss because it has been shown to promote satiety by increasing GLP-1  (satiety inducing hormone).

6. If you want to gain weight
Strains of Lactobacillus acidophilus have been shown to help you gain weight.

**Note** Before you go and throw away your probiotic that has L. acidophilus because you have been trying to lose weight, understand that there are many types of L. acidophilus and not all will necessarily promote weight gain.

7. If you are taking antibiotics
Antibiotics are sometimes necessary for large bacterial infections. Unfortunately, antibiotics will also kill off good bacteria which can lead to stomach upset and even weight gain and immune suppression. Start taking probiotics immediately when prescribed antibiotics and continue taking the probiotics for 2-3 weeks even after you have finished the course of antibiotics. Aim to take the probiotic a few hours from the antibiotic because there is the possibility of the antibiotic inactivating the probiotic - remember antibiotics kill bacteria and probiotics are bacteria.

8. If you have IBS
As of date, the best strains to treat IBS symptoms come from Bifidobacterium, particularly Bifidobacterium infantis. IBS can include alternating periods of bloating, constipation, diarrhea, gas, and stomach pain.

9. If you are prone to bacterial vaginosis
Bacterial vaginosis is often associated with low vaginal lactobacilli bacteria. Lactobacillus acidophilus and Lactobacillus rhamnosus are two strains that studies have shown to increase vaginal lactobacilli and decrease incidence of recurrent bacterial vaginosis.

10. If you get frequent urinary tract infections (UTIs)
Studies have shown that both Lactobacillus acidophilus and Lactobacillus rhamnosus can reduce and may prevent the incidence of UTIs. Studies have also shown that when antibiotics were taken with probiotics for treatment of an active UTI,  treatment outcomes were better for those who took the probiotic.

​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

The Supplements You Should Be Taking Daily

5/1/2017

 
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There are thousands of different supplements in the market today, and the efficacy is questionable for at least half of them. Let me start this first by saying that I believe diet and lifestyle are always best, but in cases where this is not enough, taking a supplement can certainly be beneficial. 

Here is a list of supplements that I get the most questions about - and which I actually recommend you take on a daily basis. I recommend after reading this post you check out Labdoor which is a company that ranks brands based on efficacy, safety, and label accuracy. 


1. Omega-3 DHA/EPA
Just about everyone could benefit from taking an omega-3 DHA/EPA supplement because most are not getting enough from the diet. There are many benefits with taking DHA/EPA, the most notable being that it decreases your overall risk of cardiovascular disease (think decreased risk of stroke, heart attack, etc) because it decreases systemic inflammation,  lowers triglyceride cholesterol, and  decreases blood pressure . Make sure your supplement contains at least 1,000mg combined DHA/EPA. 


Dietary sources: Fatty fish (salmon, sardines, mackerel) are best. Other sources include fortified foods, most notably eggs - just note that this is highly dependent on what the chickens eat. So if chickens are fed flax, this means you are not getting DHA/EPA omega-3, but instead ALA omega-3. More on this below. 

Note: The most common and easily absorbable forms of omega 3 are DHA/EPA. Plant based sources of Omega-3 contain ALA and not DHA or EPA. ALA must be converted to DHA/EPA which your body has a hard time doing. So yes, flax and chia are a "good source of omega-3," but this is highly deceiving because your body has a hard time absorbing any of it.
 
2. Magnesium
One of the most important minerals, magnesium is essential for bone formation and adequate vitamin D absorption. Magnesium can help with many ailments, but the most common everyday uses include prevention of headaches and migraines, constipation, pre-menstrual syndrome, and muscle aches. If you suffer from any of the above, a 400mg daily magnesium supplement may help, I recommend magnesium citrate.

Dietary sources: Almonds, sesame seeds, black beans, leafy greens, and cashews.  
 
Note: There are many different types of magnesium and most are readily absorbable, but a few that you should avoid include magnesium oxide – this formulation is not easily absorbable by the body and unlikely to give you any benefit. Also avoid magnesium glutamate and aspartate which are linked to the artificial sweetener aspartame.
 
3. Vitamin D
Vitamin D also promotes calcium absorption and is therefore a necessary factor for keeping bones strong. Very few foods contain much Vitamin D, so the best way to get is from UV light – which most of us will not get especially with the winter and with the use of sunscreen. Low levels of vitamin D are linked to headaches, depression, dizziness, and fatigue. Make sure you take Vitamin D3 and not Vitamin D2 because Vitamin D3 is much more absorbable by your body. Take at least 1,000mg per day and make sure to take with a fatty meal because Vitamin D is a fat soluble vitamin and needs fat to be absorbed.

Dietary sources: Fatty fish contain the highest amount. Other foods that contain minimal amounts include eggs, cheese, and beef liver.
 
4. Biotin
For those of you who want strong, healthy hair and nails (who doesn't?) this is a  supplement worth trying. Studies have shown that getting adequate biotin helps brittle nails become stronger and firmer and makes hair stronger thereby preventing hair loss.  

Dietary sources: Eggs, fatty fish, meat, almonds, and beans. 
 
5. Folate
If you are a woman of child bearing age and there is a chance you could become pregnant make sure you are taking at least 600mg of folate daily. Folate protects against major birth defects (i.e. neural tube defects) because it is essential for proper brain and spine development of a growing fetus - additionally it helps protect you from developing a folate induced anemia.
 
Folate (aka L-methlyfolate, L-5-Methyltetrahydrofolate) is the natural form found in foods and is preferred over folic acid. Folic acid is a synthetic version of folate and it must be broken down via several different steps into a compound that can be absorbed (aka its active form). This means when you take folic acid rather than folate there is a higher risk of buildup of folic acid derivatives and less vitamin being absorbed. Read more about this here.

Dietary sources: Eggs, green leafy vegetables, beef liver, and fortified foods.

Note: If you have the MTHFR mutation you should definitely be taking folate rather than folic acid, because this mutation means that you cannot fully break folic acid down to its absorbable form and this can lead to dangerous buildup of folic acid derivatives. 
 
6. Probiotics
There are many benefits of taking a probiotic, but the most common everyday benefits include decreasing chronic gas, bloating, diarrhea, constipation, as well as improving immune function, absorbing nutrients, and for a healthy weight.


Fun fact: Microbes in your gut will eat up some that food you put into your system meaning this prevents you from absorbing calories – another reason to skip antibiotics if you can. 

Your gut has trillions of bacteria so aim to get a probiotic that has at least 5 billion CFU (ideally 30-50 billion), because anything less is not going to do much for you . I recommend Ultimate Flora by Renew Life.

Dietary sources: Kimchi, kombucha, sauerkraut, pickles, and miso.


Note: I always recommend taking a probiotic when taking antibiotics, just keep in mind there is a chance of the antibiotic deactivating the probiotic when taken together. To prevent this from happening, take your probiotic on an empty stomach and make sure it has been a couple hours since you took your antibiotic or are going to take it.

7. Lysine
If you are someone who gets cold sores regularly, this may be a good option for you. Studies have shown that taking 500-1000mg of lysine daily can decrease cold sore outbreaks as well as decrease severity and duration of the outbreak.  I've heard great success from many patients who take lysine, and I recommend trying if you get cold sores regularly. 

Dietary sources: Eggs, beans, meat, cheese, fish, and nuts.

Note: At the first sign of a cold sore, contact your provider immediately to get a prescription of anti-viral medication. Prescription anti-virals, such as Valtrex, work best when taken within the first 24-48 hours of an outbreak.


​Sarah-Kate Rems, NP
Co-founder, The Mindful Tech Lab - Check out all of our amazing apps to help improve your life here

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