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Building a healthy gut microbiome

One of the questions I get a lot in clinic is about probiotics and antibiotics.  I always recommend that patients take probiotics along with antibiotics (please separate doses by at least 1 hour) or after they complete the course.  While antibiotics are sometimes necessary and can be lifesaving, they should not be prescribed without good reason because protecting your gut microbiome is crucial to health.  You have many microbiomes – gut, skin, mouth, mucus membranes etc.  In fact, microbes outnumber human cells by 10 to 1 and account for up to 6 pounds of your body weight.  Your gut microbiome is one of the most important in  your body, responsible for a large portion of your immune system function.  It is super important to take care of it.  Several things can impact your gut microbiome- stress, your diet, medications and of course, antibiotics which do indiscriminately kill both bad pathogenic bacteria and your good bacteria.   Medications, including both over the counter and supplements can also alter your microbiome, so it is good to be judicious with this use as well.  It is estimated that up to 40% of prescription medications alter the gut microbiome which makes sense as your gut does the major work of absorbing medications.  Since many people take both over the counter and prescription medications, supporting healthy strains can be a good way to support your overall health. 


Your bacteria need food to survive and they eat fiber.  If your diet is too low in fiber, your bacteria will auto digest your gut lining for their nutrition.  Fiber is an important part of maintaining a healthy gut.  You can also support your gut with regular probiotics- i.e. beneficial bacterial strains.  The best way to get this is again via your food- either eating or drinking probiotic foods like kefir, kombucha or other live culture containing foods.  I have been drinking the same strains of probiotic kombucha for 20 years.  If eating/drinking live cultures is not your thing, there is a multimillion dollar supplement industry that is ready to support you!


Some of the questions I get are on the best strains to have as part of a healthy diet. 

Here are some great strains to look for:


Lactobacillus rhamnosus, Lactobacillus bulgaricus, Bifidobacterium longum, Lactobacillus paracasei, Bifidobacterium lactis.


Another strain that supports weight loss by naturally boosting GLP1 (a hormone that supports your metabolic function and appetite -most commonly known as Ozempic), is Akkermansia.  There are very few companies that make a quality product and I recommend Pendulum for this strain. 


Here are supplements that can support a healthy microbiome:  You don’t need all (or any!) of these- but here are suggestions if you are interested.


Inulin, L-Glutamine, Licorice Root Extract, Berberine, Wormwood oil, Lemon balm oil, vitamin D, Watercress, Green tea catechins, riboflavin, vitamin B6, folate, vitamin B12, Milk thistle extract, alpha-lipoic acid, N-Acetyl-L-Cysteine, Boswellia


Hopefully that gives you a start on minding your microbes!

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