Probiotics & Fermented Foods: The Good, The Bad, The Delicious

Probiotics & Fermented Foods:  The Good, The Bad, The Delicious


     Why are probiotics so important to our health?  It is easier to appreciate their significance if we understand what they are.  Basically, probiotics are health promoting bacteria in our intestines and other areas of our body.  In addition to bacteria, there are also probiotic yeasts.  We can think of them as good bacteria or good yeasts.  Good bacteria help break down food to make nutrients more accessible.  They also convert vitamins into forms that our body can utilize.  But they are essential to our health not only for the role they play in digestion.  Recent research has discovered that the good bacteria are also necessary in order to keep our immune system in balance.

     Science has discovered that the bacteria in our gut actually communicate with our immune system cells through chemical messengers that exchange information.  It’s a kind of language, the way they “talk” to each other.  When we don’t have enough good bacteria in our digestive system, primarily our intestines, it’s not only our digestion that can become compromised.  It’s our immune system as well. 

     The immune system’s function is to attack bacteria and yeasts (the bad ones) and viruses that can cause disease.  If it is not strong enough, it can’t do a good job of fighting them off.  So in addition to problems such as constipation, we might also be susceptible to frequent sickness.  That’s why when people have repeated courses of antibiotics without replacing the good bacteria, they can become more vulnerable to getting repeated infections in the future.

     Another problem with an imbalanced immune system is that it can attack things it’s not supposed to attack.  For example, with certain allergies, the immune system could be attacking food, pollen, dog or cat hair, or dust mites, which results in people getting allergy symptoms.  If the symptoms are serious, temporary relief may be called for.  But if the immune system can be better regulated, the allergy symptoms may not be as severe, which can reduce the need for medication.  The ultimate goal, of course, is to eliminate the allergic response altogether.

     The immune system is made up of particular kinds of white blood cells made mostly by our bone marrow.  They travel around the body through the blood and the lymph system.  The white blood cells attack the “bad guys” (disease-causing bacteria, viruses or yeast) and either destroy them at the site of the infection or carry them via the lymph system to the lymph nodes.  There the immune system works to destroy the “bad guys”. 


     Long before there were natural food stores with shelves full of probiotic supplements or grocery stores with probiotic beverages, our ancestors got theirs the old fashioned way, through their diet.  They ate fermented foods, and every culture had their own.  It was one way they preserved food before refrigeration.  Some examples are yogurt, sauerkraut, sour poi, kimchi (and other fermented vegetables), miso, tempeh, kefir, and kombucha.

      There are alternatives to kefir made from cow’s milk, including coconut water kefir and water kefir.  In addition, there are non-dairy yogurts:  coconut milk yogurt, almond milk yogurt, and soy yogurt.  With kombucha, which is typically made from black tea, most of the caffeine is consumed in the fermentation process.

     Vinegar can also be a fermented food, depending on how it’s produced and how long it’s fermented.  Tsukemono and pickles can be a source of probiotics, again, depending on how long they’re fermented and as long as preservatives are not added to them.  Most commercial products are not fermented long enough to produce probiotic benefits. Beer, wine, and liquor are also fermented, but the alcohol inhibits the growth of good bacteria.


     If you choose a food for its probiotic benefit, be sure to read the label carefully.  Preservatives such as sodium benzoate, potassium sorbate, and others are often added because they prevent bad bacteria from growing.  However, they also keep the good bacteria from growing as well.   Commercial products typically add chemical preservatives as a safeguard to extend shelf life.  But fermented foods don’t need preservatives to do that. That’s why they were fermented in the first place.  For example, I have never found preservative-free sauerkraut in regular grocery stores, but many health food stores do carry it.

     I think it is important to use both probiotic supplements and fermented foods.  Why not just take a supplement?  Many different species of good bacteria and good yeast die as soon as they are exposed to oxygen.  That makes it next to impossible to get them into a supplement because of the manufacturing and processing.  No supplements have those types of good bacteria, but they are available in fermented foods, where they are protected from oxygen within the food or the liquid.

     For treatment purposes, specific kinds of probiotics can be better for particular conditions.  In that case, supplements are helpful because a person might need a certain dose of a particular type of probiotic.  For example, C. diff is an infection in the intestines caused by a bad bacteria and there is one kind of good yeast that has been found to be helpful in its treatment, saccharomyces boulardii.


        Most picky eaters will eat yogurt.  Avoid commercial yogurts with added sugar, stick to organic plain whole milk yogurt, and then add your own fruit, honey, or 100% pure maple syrup.  If you or your child cannot have dairy, try coconut milk or almond milk yogurts and add fruits ornatural sweeteners.  If your child won’t eat that, you can spoon some yogurt into a small amount of sorbet or coconut milk ice cream. 

     Try coconut water kefir (e.g. Kevita) available at Safeway and health food stores – this is naturally carbonated and can be a replacement for soda.  If your child won’t drink it, you can dilute a teaspoon of the coconut water kefir in juice or a large amount of water.  Also, some parents have had success pureeing small amounts of sauerkraut or fermented beets or carrots (available at health food stores), and mixing small amounts into spaghetti sauce, soup, or stew after it’s cooked, so the heat doesn’t destroy the good bacteria.


     Some final words of advice when it comes to probiotics:  If you have sensitivity to dairy, choose non-dairy fermented foods.  If you aren’t currently eating many fermented foods in your diet, add them to your diet gradually – suddenly consuming high amounts of fermented foods can cause temporary loose stool as your body adjusts to the good bacteria.  If you have acid reflux, be careful about spicy fermented foods like kimchi. 

     If you have high blood pressure, you should use caution with salty fermented foods like sauerkraut.  If you have yeast/Candida overgrowth, limit kombucha to 1-2 times a week, as excessive consumption can sometimes aggravate bad yeast overgrowth.  Please be sure to check with your doctor.  And do eat a variety of probiotics rather than for example, just eating yogurt every day.  Each food has certain types of good bacteria, and we need a balance. 

New Understanding: How to Successfully Treat Autoimmune Diseases

New Understanding: How to Successfully Treat Autoimmune Diseases

      Autoimmune disease rates have been escalating dramatically over the past 30 years, some by up to 23%.  These diseases occur when the immune system, which is supposed to attack invaders like bacteria, viruses, fungi and yeast instead attacks one’s own body.  The medical and scientific community does not know exactly what causes autoimmune conditions like type 1 diabetes, celiac disease, lupus, multiple sclerosis, rheumatoid arthritis, and Crohn’s disease. (More than 100 autoimmune diseases have been identified). 

     The immune system is comprised of white blood cells, lymph nodes and the whole lymph system, the spleen, tonsils, and bone marrow (which makes white blood cells).  It also makes certain types of chemical messengers, while some types of white blood cells make proteins called antibodies.

     The immune system can send out cells that act like Pac-Man, gobbling up bacteria and viruses. It also makes free radicals, which act like miniature bombs to blow up the invaders. Essentially, the whole process is designed to create inflammation in the body that is targeted at killing bacteria, viruses, yeast, and other things that can cause disease.

     For example, with rheumatoid arthritis, the immune system attacks joint tissue, which can cause very bad pain and disfigured joints.  With lupus, the skin, joints, and internal organs are affected.  In multiple sclerosis, the immune system eats away at the protective coating around the nerves, preventing them from functioning properly.

     Fortunately, there are a few pharmaceutical medications that disrupt specific aspects of the autoimmune process, but for the most part, the conventional approach is usually either steroids or other medications that suppress the entire immune system.  These drugs aren’t specific, and because they affect the whole immune system, not just the area of the disease, the immune system as a whole is weaker than it should be.  This can result in the person being more susceptible to infections.

     While we don’t know exactly what causes autoimmune diseases, a critical part of treating them is healing the digestive system.  Every patient I’ve seen with an autoimmune disease has been helped to some extent by adopting a specific diet to heal the gut.  Some patients who undertook very restrictive diets, like the Autoimmune Protocol Diet, enjoyed dramatic improvement.  This is because new research is finding that the gut is very important in regulating the immune system.  Good bacteria in the gut actually communicate with the immune system cells there by exchanging chemical messages.  When the gut gets balanced and there is no inflammation there, the immune system benefits regardless of what part of the body is affected by an autoimmune disease.

     For example, researchers in Israel and Germany have noted that the increases in autoimmune diseases have occurred in too short a time to be caused by genetic changes.  Focusing instead on other causes, they discovered a strong correlation between the skyrocketing use of industrial food additives in processed food and the increase in autoimmune diseases.  The studies revealed that processed foods damage the intestinal lining, increasing the likelihood of developing an autoimmune disease.

     Other stressors on the immune system include pollution, exposure to toxins, and lack of sleep.  People who work night shifts long term have a higher risk of developing autoimmune diseases and cancer, as well.  When we don’t get enough sleep, our bodies are missing out on a major time when it repairs damaged cells or fixes mutations in DNA.

     While I have found that pharmaceutical medications are often still needed in managing autoimmune diseases, using diet and natural remedies to regulate the immune system  can bring major improvements and in some cases even lead to remission.  I typically focus on working with patients to develop a healing diet as a foundation.  I will also recommend certain types of probiotics and natural remedies to help heal the gut and regulate the immune system, along with regular acupuncture.  The acupuncture helps reduce pain and inflammation and strengthens the internal organs.  Over time, patients with an autoimmune condition are usually able to live healthier, happier lives with less dependence on medication.


Avoid Dangers of Antibiotics With Natural Alternatives

Avoid Dangers of Antibiotics With Natural Alternatives

     It’s no secret that antibiotics are overused in the American health care system.  Often antibiotics are prescribed for viral infections or at times when they are not truly necessary.  This contributes to a worrisome spike in antibiotic resistant bacteria, as well as unwanted and even dangerous side effects from these drugs. 

     At times we all may need treatment for an infection, but thankfully many infections that are not life-threatening can be safely treated with natural remedies instead of antibiotics, under the supervision of a licensed physician trained in natural medicine.  Fortunately, naturopathic medicine has many more options for treating bacterial infections, and virus, yeast, and fungus as well.  Examples of some of these infections include simple, uncomplicated cases of colds, flu, ear infections and urinary tract infections.  Other types of infections may also be treated safely with natural remedies, but that should be determined by the physician.

     The flu and most common colds are caused by viral infections, which antibiotics cannot help, since antibiotics kill only bacteria and not viruses.  Yet many cases are treated with antibiotics because the physician and the patient want something to help the patient feel better.  I use herbs and other natural remedies to fight the virus and strengthen immune system, including alae from Hawaiian herbal medicine, and herbal cough syrups to help soothe any coughing.   

     Another common infection over treated with antibiotics are middle ear infections (otitis media) in children.  Many people don’t realize that many ear infections can be caused by viruses instead of bacteria.  When there are no signs or symptoms of complications, it is acceptable to just watch and wait.  Even the American Academy of Pediatrics guidelines state that.  In other countries, it is recommended not to use antibiotics for middle ear infections unless there are signs of complications.  Recent studies have shown that antibiotics often don’t reduce the outcome—severity or length—of a child’s middle ear infection when there are no complications. 

     I have seen good clinical success treating simple ear infections with garlic mullein oil, an herbal oil infused with garlic, which helps kill both viruses and bacteria.  This is available at health food stores, online or at lower prices from our office.  The oil goes directly into the ear and works for adults as well as children. However, before using it, a doctor does need to look in the ear to make sure ear drum is intact.  If there is a hole (perforation) in the eardrum or if it is ruptured, it is not safe to put anything into the ear.  Your child also needs to be seen by a doctor to make sure that there are no complications, because those cases often do need oral antibiotics. 

     Simple urinary tract infections (UTIs) also respond well to naturopathic treatment.  I usually recommend increasing water intake and prescribe herbs that kill bacteria and are specific for acting on the urinary tract.  I also use other natural remedies to help strengthen the immune system.  Herbs have been used for centuries and can be very powerful.  Again, however, you need to be under the supervision of a physician, as certain situations may need antibiotics.

     Antibiotics should be avoided if at all possible, because they come with many unwanted and sometimes dangerous side effects. For example, if they are used for repeated bouts of infection, good bacteria are destroyed, the immune system is weakened, and a person becomes prone to more infections. 

There are constant chemical communications going on between our gut bacteria and our immune system.  We need both to be healthy to fight off disease-causing bacteria, viruses, yeast and fungus.  That means eating fresh, whole foods, including fermented foods so our diet gives us internal strength.  Vitamins, probiotics, and supplements are also important.  However, if a patient’s infection is severe or there are signs of complications, I will certainly prescribe oral antibiotics when needed.  Then I will help the patient restore their gut bacteria and boost their immune system so, hopefully, we don’t need to use antibiotics again.


NPR Interview: Research Support for “Good Bugs”

Listen to an excellent radio interview with Susan Lynch, Associate Professor of Medicine & Director of Colitis and Crohn’s Disease Microbiome Research Core at UCSF on National Public Radio’s Science Friday.  She discusses her research on the importance of “good bacteria” in treating chronic sinusitis & inflammatory diseases.  

Research studies are now finding that these “good bugs” are important for:

  1. Digestive health
  2. Converting vitamins from our food into the active forms needed by our bodies
  3. Immune system health
  4. Cognitive/mental/emotional wellness


Take home messages:

  1. Eat fermented foods – these are the natural sources of probiotics & contain billions of aerobic & anaerobic species of “good bugs” which aren’t found in any supplement (e.g. miso, sauerkraut, kim chee, tempeh, natto, yogurt, kefir).  Many people have dairy sensitivities so I often recommend water or coconut kefir, almond or coconut yogurt.
  2. Take probiotics (at least 20 billion/day), especially if you have chronic sinusitis or inflammatory conditions (I recommend: Klaire Therbiotic Complete or Therbiotic Detox Support or probiotics from Seroyal or Kirkman).  If you are taking antibiotics or antimicrobial herbs, take at least 2 hours away from probiotics.


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