09 November, 2018

Autism and Probiotics



There's more to gut health than Probiotics.


What if I told you to stop taking probiotics for now? Before you stop reading and conclude that I'm crazy, hear me out. You're probably wasting your money if you're taking probiotics as the first step. More effort needs to be on providing an environment for good bacteria and yeasts to thrive.

Many of us are aware of the importance of gut health, particularly when it comes to improving the lives of children with Autism Spectrum Disorder (ASD). Gut health is essential, as described in our previous post. Still, it's also important to consider what is the best approach for you and your family.

Most people dipping their toe in the area of gut health start with probiotics. It is worthwhile to consider probiotics in children with Autism Spectrum Disorder as a way to improve gut health. There are, however, other considerations when addressing gut health. Although we would love the solution to improving gut health to be a supplement or tablet, there's more to it.

We understand that more and more disorders are related to poor gut health. These disorders don't just manifest symptoms in the gut but affect many areas of the body, including the brain.

It's not that there's a lack of benefit in the diversity of microbes. There are many positive effects on the immune system and the body of adding new strains of beneficial bacteria. Probiotics can invoke a positive immune response, hovever, you may not be getting good value for money if you start with probiotics before adressing fibres and prebiotics.
 

What are Probiotics?

Probiotics are live or spore based microorganisms often taken as a supplement and referred to as good bacteria.  They are often taken to boost the immune system, aid digestion and improve gastrointestinal problems.

Probiotics are thought to be the third most commonly used dietary supplement, sitting behind vitamin and mineral supplements.
 

Many parents start with probiotics for children with autism and gut issues.

Many parents wanting to promote health in their children will provide a probiotic before they increase the amount of high-quality fibre, low fructose vegetables and fruits. The choice of a probiotic is often made without much research, and parents usually simply choose yogurt, Yakult or a less effective probiotic.

Just because there are studies suggesting links between Autism Spectrum Disorder and gut bacteria, doesn't mean the solution is probiotics. A study may link certain strains of microbes with a reduction of Autistic behaviours. Still, we need to think about how to get these strains to thrive in the gastrointestinal tract.

The role of quality foods and prebiotics must be considered. A diverse and balanced gut needs an abundance of varied and balanced food for the microbes that live there. The focus for gut healing (and related health issues), should be to provide an environment for the good microbes to thrive. The intestinal environment shouldn't provide food for individual microbes, but rather more complex diet with various nutrients and fibres that require a community of microbes working together to digest. For example, sugars can be consumed by the dominant strain without the need of help from the community. The predominant strain can then become more dominant.

Just as in the human world, dominant individuals wanting to maintain their dominance will greedily take whatever they can for themselves. They manipulate the environment to suit themselves. In the gut, certain microbes will attempt to do the same. We can, however, influence the environment to strengthen the community and weaken to dominant microbes.

Our digestive system has over 100 trillion micro-organisms at any given time. Consider that supplements with 65 billion bacteria cells are a drop in the ocean compared to 100 trillion micro-organisms already there. There are steps you should take first to give this 65 Billion a fighting chance to colonise in the colon. Many probiotics have a transient effect, and won't colonise, particularly if the environment is overrun with pathogenic microbes. If the population of bacteria don't want the probiotic to be there, colonisation is less likely. They may have small effects as they pass through, however.

We often only think of bacteria in the colon, but we have bacteria all through our digestive tract. Each tooth can have between 1000 (very clean mouth) to 1 Billion bacteria on them. The stomach and small intestine contain bacteria, but hopefully in small amounts due to the acidity.

The colon is home to the majority of digestive system bacteria. It contains about 100 trillion bacteria cells. The bacteria composition can vary widely across the population of people. If the balance is off, the symptoms can manifest in various ways (more details in our previous post).

If you, like most people, have an imbalance in the microbes in the colon, it's because there's a particular group of bacteria and yeasts that are in higher than wanted numbers. There are still 100's of billions of wanted microbes, but there happen to be far too many unwanted microbes and not enough of the good guys. Many of the bacteria strains in the probiotics are already in the colon. There are probably more already in the gut than in the probiotic, but they can't create balance. Adding more via a tablet or supplement will have little effect, and may not be value for money initially.

The reason the probiotic strains can't create balance is that the environment in the colon suits the unwanted microbes. Probiotics won't help until the environment the bacteria live in improves.

The reason balanced diversity isn't achieved is that the environment in the colon suits the unwanted microbes. Too often for children with Autism, they eat a narrow range of foods. They don't tend to eat many foods that are fibre rich with natural colours and promote a healthy environment for gut microbes. The bad guys have an abundance of their preferred food supply, which is usually sugars. There isn't enough fibre and prebiotic foods that the good gut microbes need.

To put it another way, the wanted microbes are starving, while the unwanted microbes are feasting.
If we provide children with probiotics for any reason, we need to take into account the whole digestive system. Yakult, for example, which is a favourite probiotic drink for kids, contains 65 Billion bacteria. When you consider there are already a few billion bacteria in the mouth, and 100 trillion in the gut, they're somewhat outnumbered. They then have to survive the acidic environment of the stomach. If they eventually reach the colon, they compete for food with the other existing bacteria residing in the colon.

For new strains of gut bacteria to colonise, they need to find a home on the colon mucosa, where they can set up a base to grow their numbers. If they can't do that, they continue through the colon and exit.
65 Billion is a drop in the ocean. Before dropping in some more bacteria to add diversity, we need to set up the environment, so that the new bacteria stands a chance of colonising.

Two main factors limit new probiotic strains' ability to colonise in most peoples colon.
  1. The current community of microbes in the gut, don't accept the new strain or crowd them out.
  2. A weak environment in the colon lacking quality foods that beneficial bacteria need, and high sugars which pathogenic bacteria love.
Some people do report side effects of using probiotics such as abdominal pain, gas bloating, overstimulated immune system, constipation and the triggering of allergies.  The reason why the side effects of using probiotics are reported may be that the environment of the gut hasn't been addressed first.
 

Can probiotics help children with autism?

A good high quality probiotic may benefit children with developmental disorders, due to their positive effects on the immune system and digestion and they pass through the body.  Probiotics also may contribute added diversity and support to the good microorganisms that have already colonised in the gut.  As discussed above, probiotics alone won't have significant long term positive effects unless the diet and environment in the colon are addressed. It is my view that before spending money on probiotics, some steps need to be taken to reduce unwanted bacteria and yeasts. Work also needs to be done to create good eating habits—more about this in future posts.

We still need more clinical trials looking at the effects of probiotics, however, multiple clinical studies showing promising results for adding diversity using probiotics.  Studies show that probiotics may improve aspects of brain function such as social behaviour and mental disorders such as depression and anxiety.  [1,2,3,4].  Probiotics have been shown to influence several neurotransmitters such as gamma-aminobutyric acid (GABA) and serotonin.

While you are working towards diet improvement, and saving your money on probiotics, look into starting to make your Kefir and fermented foods.

Once the dietary aspects are addressed, and the colon is full of the right food for good microbes, I advise quality spore-based probiotics that have superior survivability. 

Here are the probiotics I recommend.
I highly recommend Just Thrive probiotic, which was shown in a groundbreaking study to reduce intestinal permeability (leaky gut).  Intestinal permeability is very common in children with developmental disorders, and may be a significant factor in inflammation and the development of Autism Spectrum symptoms.

I recommend the above probiotics due to their survivability, and them having some important microbial strains for health. 

In addition to the above probiotics, consider finding one that contains Lactobacillus Reuteri.   Lactobacillus Reuteri is commonly found in probiotics targetting autism treatment, due to studies indicating it's postive effects on social behaviour. In future posts, we also look at other ways to improve microbe diversity more cost-effectively using fermented foods.