Probiotics

[Koalajane]

I am not sure if probiotic yoghurt drinks are to be recommended. Any thoughts please.

Thanks

[PMRpro Ambassador]

The primary downside is the amount of sugar in them. They also don't have as many "good bacteria" as maybe the salepersons would like you to think!

A good diet with plenty of prebiotics (fibre and stuff as an encouragement to the bacteria in the gut to grow well) and a good quality prebiotic capsule is probably better and cheaper in the long run although they are a bit expensive to start off.

[Rose54]

Hi

I cant say personally

However my Son suffers from Irritable Bowl and has one daily and since using does not have so many flares of IB

Could be mind over matter I dont know but he swears by them

[Blearyeyed]

I use probiotic live , unsweetened natural yoghurt with a little local or Manuka honey for my " Pred breakfast " and will , especially if I'm eating a bigger meal or have been feeling some more gastric issues , have a little serving before my main food .

The most important thing with probiotics is that they are LIVE , you want those good bacteria standing to attention and doing their job.

It's the same rule with things like Kombucha drinks , probiotic drinks and even ferments like kefir .

You can also get powdered pre and probiotic supplements , unsweetened , but I haven't used them , but people do add these to their breakfasts or homemade smoothies and homemade yoghurt drinks.

You can also make your own probiotic drinks using the LIVE yoghurt , extra milk ( normal , lactofree , or coconut) , and make them into a more nutritious or interesting part of your diet by adding in things like fruit or nuts .

Or , for more protein less sugar, nuts or unsweetened nut butter and a smidge of honey , vanilla, or natural stevia if you need more sweetness .

If you don't like the flavour , you can be naughty and add a little raw , unsweetened cocoa too .

Keep it chilled in the fridge to have little portions with your medications or just before a meal and it will help reduce stomach issues like acid and bloating that comes from the bad bacteria build up in your intestines.

[HeronNS]

Over the years I've come to quite dislike sweetened yoghurt and kefir. Takes a bit of getting used to, but straight up is the way to go, I think. We should all try to avoid added sugar because that is exactly what bad microbes thrive on, and we don't want to encourage that sort! A bit of fresh fruit, especially berries, and maybe the merest drizzle of a sweetener like real honey or real maple syrup if the berries aren't sweet enough, helps one get used to the transition from commercially flavoured products to plain.

Yoghurt is also a brilliant subsititute for sour cream in recipes, cannot remember the last time I bought sour cream, decades....

[PMRpro Ambassador in reply to HeronNS]

I like creme fraiche, different bacteria probably so a slightly different flavour.

[HeronNS in reply to PMRpro]

I suppose it's less tangy - hence fraiche as opposed to sour! Plain yoghurt is probably more sour than sour cream.

[HeronNS in reply to PMRpro]

myrecipes.com/extracrispy/w...

[Hidden in reply to PMRpro]

My neice made a lovely looking and smelling gnocchi and mushroom dish in creme fraiche sauce. I am off dairy at the moment.

I have tried those yoghurt and kefir drinks/yoghurts but cant do them on a morning or at all recently. I used to take a good quality supplement years ago that came out well in the live bacteria count but I cant remember which brand. I think prebiotics is the place to start. There are lots of sites that do it of the best foods etc.

[PMRpro Ambassador in reply to Hidden]

jinasc swears by vsl#3 which she was recommended by her gall bladder consultant when she had post op infections. It's pricey but very good.

[piglette]

I was put off probiotic yogurt when I saw a TV programme which said that the probiotic part was started using someone’s poo!

[HeronNS in reply to piglette]

All yoghurt with live culture is probiotic. The starter comes from the previous batch, ad infinitum.

These organisms are pretty tough. Apparently when people emigrated to the New World from Europe they would often bring sourdough starter with them, impregnated in a cloth, which they could reactivate when they landed and had access to new ingredients. This would have been a unique family culture.

I did find an item which says the lactobacillus in yoghurt can survive transit through the gut.

And we all must know by now that fecal transplants are saving victims of C. difficile from years of misery.

And C-section babies who skip passage through the birth canal are at risk of problems with their immune system down the line.

[PMRpro Ambassador in reply to HeronNS]

And then there is the concept of bacterial transplants for weight loss

[HeronNS in reply to PMRpro]

I know balancing the microbiome is helpful for achieving weight loss, but hadn't heard about a medical intervention. Wonder if I need something for weight gain?

[PMRpro Ambassador in reply to HeronNS]

It is claimed that faecal transplants will do that. But they don't know if you can control it. And it would be preferable to know which constellation of bacteria does what ...

[HeronNS in reply to PMRpro]

I can tell you unless I have a nasty illness like c. diff there's no way I'd be going that route. Just change the diet. Guess I need to eat more calories and stop walking so much....

[PMRpro Ambassador in reply to HeronNS]

Me neither!

[Blearyeyed in reply to HeronNS]

Yes, it's been many , many decades since bacterium was extracted from poop to start the culture used in industrial production.

I have a live sour dough starter for savoury and for sweet bread , one of them is nearly 20 years on, but yoghurt starters and sour dough starters are probably like people and the amount of cells left in it from the original would be negligible.

Fecal transplants seem amazingly effective , if it turns out that it is 94% in reducing IBS symptoms as it was in the initial trials I would be willing to give it a go.

[PMRpro Ambassador in reply to Blearyeyed]

Sort of homeopathic levels ...

[Blearyeyed in reply to PMRpro]

Yep, 0.00005 of a cell of prehistoric yeast per loaf!😂😂😂😂

[PMRpro Ambassador in reply to Blearyeyed]

As much as that?

[Blearyeyed in reply to PMRpro]

😋😂😂😂😘😘😍

[Louisepenygraig]

As HeronNS as says any yoghurt is probiotic as long as it's not pasteurized. There's no need to buy fancy stuff.

[Galloping]

But is it ok to take probiotics when on steroids?

I've read on one of these forums that because steroids suppress the immune system it's dangerous to encourage an increase in bacteria.

I'm due for o start Predisilone and as I take probiotics I'd like to know.

[PMRpro Ambassador in reply to Galloping]

Lots of us do/have taken them. I don't really think it is dangerous at PMR doses - the jury is still out on the amount the immune system is suppressed at the lower doses of steroids anyway.

[Blearyeyed in reply to Galloping]

There some specific severe immunosuppression treatments that you are told to avoid the use of pro and prebiotics with , and after certain types of major surgery when particular treatments are used and your overall bacteria level needs to be kept low when you are told not to take them.

However , there are also some surgeries when they give them to you.

If you are taking antibiotics you are not meant to have probiotics within two hours of taking the medication but are encouraged to increase good bacteria in your diet to replace those killed by your drug and maintain the gut flora.

On antifungal treatments the same two hour rule applies but they do suggest you limit yourself to only bacteria based probiotics not fungal ones.

The debate with use of steroids is very, very, grey , no definitive argument exists against , unless it has to do with you having one of a group of immunodeficiency conditions.

The only consistent suggestion I have seen for a time to reduce probiotic usage while on long term steroids is during surgery or infections.

It seems, as ever , to have more to do with the individual and all of their health issues than a specific contraindication or rule. The same is true of prebiotics.

It's good to remember , that these bacteria are there to increase the good bacteria in the gut and help reduce the increase of bad bacteria that could occur as your sugar levels change with long term steroid use. Many other foods that you consume could have worse bacteria in them than those of probiotics .

Many people advise that you should have more probiotics from your food and not take pre or probiotic supplements if you take steroids in the long term.

Yet , there are also some doctors who prescribe the supplements with the steroids in certain illnesses and individual circumstances.

Many patients find , especially probiotic yoghurt , to be beneficial in the long term and help them cope with steroids in the stomach and reduce gastric reflux instead of using PPIs.

The bacteria that you get from yoghurt and other products is not considered to be harmful in general in most studies , in fact in one NIH study there conclusions were that the use of probiotics made no significant difference in the amount of good or bad bacteria in the gut based on no increase in them in stool samples.

There are some rare cases, as ever, which saw other health issues from use of high dose steroids and other drugs with probiotics arise .

The only common intolerance from probiotic foods seems to be an increase of gas and bloating for some with intolerances , but that has often been corrected with use of only bacteria probiotics , dairy free alternatives or a reduction in sugar in the diet.

It seems , therefore, that it has to be based on a personal decision and what benefits you feel you will gain , or lose , by taking them , or, if you have side effects as you go along.

I hope that helps with your decision .

[Galloping in reply to Blearyeyed]

Thank you Bleary. Lots to think about

[Koalajane in reply to Blearyeyed]

Thanks, I am thinking I will save my money!

[Janstr]

I started getting acid reflux about 6 weeks ago & noticed it was a lot worse after my AA medication day. I am taking fosamax which requires you to take it with a glass of water (before other food or drink) in the morning, & then stand or sit up right for 30 mins before eating.

I was reluctant to take omezaprole that I know my doctor would give me to solve the problem so did a bit of research.

1. I am now avoiding raw onion & uncooked tomatoes ( mostly) & chilli

2. I am now remaining up right for 1 hour instead of 30 mins

3. I used to have unsweetened porridge to eat after this period. Now to the point of my post.. I have replaced this with my home made smoothy consisting of unsweetened pro biotic yohurt, 1 tbsp crunchy peanut butter, spirulina powder, 1/3 of a banana, unsweetened soya milk. ( I know we should avoid banana, but just have 1 a week, unlike my 1 a day pre PMR)

This has solved my acid reflux problem

[misspops in reply to Janstr]

Janstr, why should we avoid bananas?

[PMRpro Ambassador in reply to misspops]

Lots of carbs if you are on a reduced carb diet!

[Koalajane]

Thanks everyone. I think I will save my money

[gtate1914]

I drink at least 1 cup kefir everyday, no sugar. I make it myself.