Do You Need To Take Probiotics?

Mark Hyman, MD

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Announcer: Coming up on this episode of The Doctor's Farmacy. Dr. Mark Hyman: We live in a gut busting world. I mean our hybridized processed, high sugar, high starch diet, low fiber, low polyphenol diet is a disaster for the gut. Dr. Mark Hyman: Hey everybody, it's Dr. Hyman. Welcome to another episode of The Doctor's Farmacy, and this is a special one because it's a masterclass where we dive deep into popular health topics, including inflammation, autoimmune disease, brain health, sleep, gut, and more. Dr. Mark Hyman: And today my friend, my business partner, my podcast host Dhru Purohit and I are going to be diving deep into Part Two of our Gut Health series. And today we're talking about probiotics. Now unless you're living under a rock, you've definitely heard of these before. They're pretty famous and for a good reason. When our team decided to create a multivitamin for the gut, we knew that probiotics were going to be an essential part of the formula, right? Dr. Mark Hyman: So Dhru, really excited to have you back doing this with me and I'm excited for this conversation about probiotics. Take us down that road. Dhru Purohit: Yeah Mark. Well, I'm actually going to ask you to take us down that road. Dr. Mark Hyman: Okay. Dhru Purohit: You know, you're the expert over here, and it's a topic that a lot of people have questions about and we're very lucky that there are a lot of really great companies doing very great things. Sure, there's some poor stuff that's out on the market too, but there's been so much awareness. Generally speaking, most people have heard of the term probiotic. There's still a lot of confusion that's there and that's what hopefully this episode can get a chance to get into. Dhru Purohit: But yes, on the topic of what we've been up to with our product Gut Food, and go to gutfood.com and learn a little bit more about it and join the wait list, we thought a deep dive into the topic of probiotics would be a fantastic fit for not just chatting about our product, but answering people's questions. So Mark, I'm going to take you big picture and just say why do we need probiotics in the first place? And when was the first time that you encountered in your journey and even had heard the term probiotic? Dr. Mark Hyman: Oh wow. I mean first of all, probiotics are exactly what they sound like. They're pro-biotics as opposed to anti-biotics. They help produce a healthier gut by giving the gut the good bugs in it that it needs to thrive. And I first discovered them probably back in the beginning of my career as a doctor and began to know about them through learning about nutrition and the role of the gut way back 30-plus years ago. And studying functional medicine, they became just very obvious to me that they were critical components of rebuilding gut and rebuilding health for so many patients. Dr. Mark Hyman: So I had been using them in experimenting with different probiotics over decades and decades, and I learned so much about what they do, their role, why they're important, how they work, how they don't work, which ones are good, which ones are bad. And it's a little bit overwhelming out there for people to figure out what do I take and which one do I take and if it's cold or in the fridge, can it be on the shelf? What do I take for this condition, for that condition? And they're varied because there's literally thousands of different microbes and they all have different roles. They all do different things and they all have different benefits. So it's really about customizing and personalizing, but there are some basic ones that have really important functions, and we're going to talk about that. Dhru Purohit: And you went through the whole backstory in the last masterclass that we did on polyphenols, but just high level, what are the top insults that are going on in this world that we live in today that are destroying the microbiome and putting us in a place where we even need to be thinking about probiotics? Dr. Mark Hyman: Yeah, I mean just briefly we live in a gut busting world. I mean our hybridized processed, high sugar, high starch diet, low fiber, low polyphenol diet is a disaster for the gut. So it's a perfect storm for creating bad bugs. Second, we know we're born by C-sections, we don't breastfeed as much. We get early antibiotics. We use all kinds of drugs that screw up the gut from acid blockers to antiinflammatories to the pill, birth control, and all that is a perfect storm. On top of that, you've got all the ingredients in processed food like keragenin and gums and emulsifiers that further damage the gut and cause leaky got. And if that weren't enough, our food is often filled with pesticides and herbicides, glyphosate for example, which is a microbiome destroyer. So we basically live in a gut busting world and we have to be very vigilant about keeping our gut healthy, even if we don't have gut symptoms. Dhru Purohit: So one of the first questions that people had Mark on this topic of probiotics is store bought probiotics and things like kombucha and probiotic beverages, are they actually healthy and can they be beneficial to people? Dr. Mark Hyman: Yeah. So let's just take kombucha because that's the kind of big craze, and I'll go down the other ones. I mean kombucha is great for a lot of people. It can be fine. It's a bubbly drink, it tastes good. It actually has probiotics in it. It can be beneficial, but a lot of them all are loaded with sugar. So that's- Dhru Purohit: Most of them. Dr. Mark Hyman: Yeah. So I mean without them, they tastes pretty bad. Without sugar, it tastes pretty bad. So I'm kind of not a huge fan. I think for the right person, it can be fine. And if your gut's pretty healthy, it can be fine. But if you are struggling with weight, if you have blood sugar issues or a lot of overgrowth or yeast problems, it can be problematic. Dhru Purohit: Because the sugar's going to feed the bad bacteria. Dr. Mark Hyman: Yes. Dhru Purohit: And on top of that, liquid calories are some of the most destructive when it comes to metabolic health. Dr. Mark Hyman: Sure, right. So you don't want to drink your calories. And as far as probiotic beverages, they're little kind of bottles of probiotics. They can be very good and helpful, and I think they're not bad to try and take. And there's a lot of probiotics in the refrigerated sections of a lot of health food stores and grocery stores, and there's a lot to choose from and people are kind of confused about which one should I take for what. Dr. Mark Hyman: There are also probiotics that are in pharmacies, like lactobacillus GG or Align that are more kind of commercially available probiotics that have been well studied for treating different conditions. So there's a lot out there. I think we have to look carefully at what's in them and there's a lot of sugar, how long have they've been there, what does it say on the bottle? A lot of times you look at the bottle and it says 50 billion colony forming units, but then when you actually do look at it, they degrade very fast, they may not have what is in there. Dr. Mark Hyman: So quality matters, brand matters, how it's stored matters. And I think that's a little bit of a kind of crapshoot when you go trying to look for the stuff in the store. Dhru Purohit: So Mark, take us a little bit deeper really on the topic of why do we need probiotics and how can they be beneficial? Like what are actually the things that they make a difference on when it comes to our health? Dr. Mark Hyman: Yeah. So thank God we're in this era of microbiome research because we know now from many, many studies from many different strains of probiotics, all the beneficial effects that they have and we're still learning more and how to develop more and better probiotics. So we're growing fast in this knowledge base. But probiotics essentially are modulators of intestinal function, so they will change the immune function. They'll change the cell signaling communications. They'll compete with other bacteria that are bad bugs and get rid of those. They'll compete with yeast and help reduce those by actually helping promote more of the good bugs. Dr. Mark Hyman: They tend to be tourists. They don't exactly colonize most of the time, although they can, so they don't stay forever. But as long as you're taking them, they do their work. And then they have all these inflammatory things that they do that are antiinflammatory. They actually help you build digestive components that actually are creating vitamin K and biotin and other nutrients that your body needs. They're helping break down foods that you can absorb. They're helping create short chain fatty acids. So they really change the whole ecosystem of the gut, and it's so important because if your inner garden is unhealthy, for most of us it is, then you're more likely to get not only digestive symptoms like irritable bowel and reflux and inflammatory bowel disease, but you're more likely to gain weight, get diabetes, have allergies, have asthma, have autoimmune diseases, have depression, anxiety, ADD, dementia, and a lot of other things when your gut's not working. Dr. Mark Hyman: So we do all the things that are really bad for our gut, and even our stress is bad for our gut. Alcohol is bad for our gut, and all these drugs that we take are bad for our gut. And so, we live in a culture where we need to double down on focusing on gut health. And to date, we really haven't had a way to do that. I mean yes, take this probiotic or this probiotic, but we've created a multivitamin for the gut which really puts together all the key components, prebiotics, probiotics, and polyphenols, that the gut needs to create a healthy inner garden. Dr. Mark Hyman: And I think when we get off of the processed food, when we get off of the gut busting drugs, when we start to take probiotics and we start to take gut healing compounds like that are in Gut Food, in our multivitamin for the gut, we can really start to help rejuvenate and rebuild the gut, which then has all these downstream consequences of improving your immune system, improving your mood, improving your metabolism, reducing inflammation of the body. It's really what we want to be doing. Dr. Mark Hyman: And when you look at some of the data, and we have really good data on the product that's in our formula called LactoSpore. LactoSpore is a spore based probiotic, and when they did clinical trials, a pilot study but it was a randomized control trial, they found a 42% reduction in bloating and irritable bowel, a 47% reduction in vomiting, a 43% reduction in diarrhea, and a 68% reduction in pain. And even more remarkably, they looked at what happened to the brain because how is the gut and the brain connected? Well, they are very connected through the gut brain connection. And depression went down 57%. Sleep got better 58%, dementia symptoms went down 26%, quality of life went up 47%, along with GI discomfort going down by 62%. Dr. Mark Hyman: That's amazing just from a probiotic, right? So there are a lot of ones on the market out there. This one's shelf stable, so you don't have to refrigerate it, which is a big deal to be able to travel with it. And two, it's one that is a very unique form called Bacillus coagulans that has all these benefits. Not all probiotics are the same and not all have these benefits, but this one is really well studied and actually has these incredible benefits. Dhru Purohit: Yeah. And what's great about the formula is that it's the levels shown in the clinical trial, which we'll have the links to those below, that is the same level that's placed inside the formula. Now we're not just here to talk about the new formula that you put together, Gut Food. You've been using probiotics as part of your protocols that you've written in your book for a really long time. And one of the great things is that there's a lot of really great companies, a lot of we call them the Doctors' Brands. Metagenics, Designs for Health, Thorn, Clair Labs. I'm leaving out a few. Pure Encapsulations. They have been some of the most incredible brands and many others in that ecosystem that have really touted the benefits and educated many practitioners like yourself about how different strains of probiotics could be used to deal with patients who are struggling with various sorts of things. Dhru Purohit: Is there an example, not that you have to mention a particular product, but is there an example sometimes where you might bring in a particular strain of a probiotic because it's been shown to do really well for a patient that has a specific condition? Dr. Mark Hyman: Sure. I mean one I like to use is really great is called [inaudible 00:11:18], which is not actually a bacteria, it's a yeast, but it's called often yeast against yeast. But it is a profound effects in regulating not only the biofilm in your gut, controlling yeast overgrowth, but also helping with the deal with chronic gut issues like Clostridia like I had. So it's shown that if you take this particular strain, it helps reduce the symptoms or even get rid of clostridial bacteria, which is really great. So I really am very focused on which ones do what. Some of them are- Dhru Purohit: And by the way, if you go to Pub Med and you type in Saccharomyces Boulardii, there's a ton of research on also diarrhea. Dr. Mark Hyman: Yeah. Diarrhea, right. Dhru Purohit: People who get to go to India and they get like Delhi Belly, or they go to Mexico and they get Montezuma's Revenge or whatever people are calling it, Saccharomyces is one of the things that people are given- Dr. Mark Hyman: Always travel with it. Dhru Purohit: -To help them deal with some of the stomach upset that comes from just being introduced to bacteria that they may not typically be introduced to. Dr. Mark Hyman: Absolutely. And there's different bacteria for different things. For example for babies, often there's a particular bacteria called Bifidobacterium infantis that's really important for immune development, and it's absent in most babies because the mothers have had an antibiotic some time in their life and wiped that out, or they're born by C-section. And the 25% of calories that's in breast milk that's not digestible by babies is there to feed this particular bacteria and others called bifidobacterium infantis. And if you have low levels, it's a big problem. So you can actually give the baby probiotics when they're born in the first 100 days to help them colonize with bifidobacterium infantis and avoid the autoimmunity, the allergy, the eczema, and all these other downstream things that are going to happen if you don't have this important bacteria. So that's just another example of how different strains do different things. Dhru Purohit: Yeah. And just a little shout out, they were on your podcast previously, the name of the company that is- Dr. Mark Hyman: Evivo. Dhru Purohit: Evivo. Yeah, doing some really game changing stuff in this space. And there's plenty of others. There's our friends Kieran at Microbiome Labs. There's some friends that you're connected with at Seed that are also doing some amazing things. It really does feel like we're in this sort of golden age of people really starting to put the emphasis on probiotics. And it's less about the competition between all these different people and more about the awareness because we need a lot of different solutions for people at different levels. Dr. Mark Hyman: And we may be getting to a point soon where we get personalized probiotics where- Dhru Purohit: That'd be very exciting. Dr. Mark Hyman: -We look at your microbiome and we look at what's there, what's not there. And I do this now. I say, "Oh, you don't have enough of this or that, so I'm going to fix this or that." So I do that, but we're going to be more sophisticated about it and be able to make custom probiotics for people. Dhru Purohit: And you talked about this a little bit before, but there's so many Instagram ads and TikTok ads that I get, which are like, "Hey, we'll tell you exactly the diet and the probiotics to take based on your stool, so send in your stool and let's ..." Tell us, you chatted a little bit about this in the past, but just talk about how we're getting there, but maybe not exactly there. Dr. Mark Hyman: Yeah, we're getting there. I think there's sometimes overreach and over promising and under delivering on some of these tests, and they don't take in the context of patient's overall health, the other parts of their digestive function. They just look at the actual bacteria and they make all these conclusions based on the science. But that can be a lot of noise too and not actually helpful for people. So I think it's important to learn about yourself, to do the testing, but take it with a grain of salt. A lot of the recommendations that are happening now, you want to try stuff and see how it works, but you don't want to think of it as the gospel. Dhru Purohit: So one of the things that we want to chat about when it comes to eating probiotic-rich foods, which also includes some prebiotics in there as well, we'll do a whole nother episode on prebiotics, so the research shows that eating a high fermented food diet increases diversity in the microbiome and decreases inflammatory markers. So the question is what are some examples of some of the top fermented foods that many people can include on a daily basis to tap into some of these benefits that the research is showing? Dr. Mark Hyman: Absolutely. I think historically we didn't have refrigerators, and as a species, we really got good at preserving food. And we did that through making cheese or through drying meat or through creating fermented foods. And these cultures have had these for thousands of years. Dhru Purohit: Which by the way, it's another form of cooking. Dr. Mark Hyman: Yeah, exactly. So sauerkraut, kimchi, pickles, miso, [inaudible 00:15:35], tempeh, kefir, yogurt. These are all forms of bacterially generated food substances that actually are full of these beneficial compounds. And there's a great study, I love this one study, it was looking at Polish women. So they eat about 30 pounds of sauerkraut a year, which is almost a pound a week, right. It's a lot of sauerkraut. And what's amazing is when they move from Poland to America and they eat the American diet, their risk of breast cancer goes way up. Whereas with the sauerkraut eating in Poland, they have very low rates of breast cancer. Dhru Purohit: Interesting. Dr. Mark Hyman: And the same is- Dhru Purohit: Correlation study? Dr. Mark Hyman: Yes. Dhru Purohit: But still, important to pay attention. Dr. Mark Hyman: The same is true, you look across the board at longevity zones. When people leave those longevity zones like in Japan and they come to America, they get the same rates of disease as Americans. So it's not so much your genes as the environment. And so, fermented foods play a big role in keeping our microbiome healthy and regulating all sorts of things from cancer to heart disease to obesity to diabetes to mood disorders. It's kind of cool. So I think if you can tolerate them, it's fine. If you have, for example, histamine problems, or if you have a ton of yeast overgrowth or really bad dysbiosis, it can be a little bit challenging to eat those foods. But I would include those on a regular basis. Dhru Purohit: Which ones do you include on a regular basis when it comes to those fermented foods that are- Dr. Mark Hyman: Oh, I like miso. I like sauerkraut. I like tempeh, and those are my favorites. Dhru Purohit: Do you do any Kefir or things like that? Dr. Mark Hyman: I like sheep or goat yogurt, but I don't eat it that much. Dhru Purohit: And is it in the yogurt form? Because when you go to like whole foods, for example, they'll have like goat and sheep yogurt and then they'll also separately in these larger bottles have like Kefir. So there's yogurt and then there's Kefir, do you choose one over the other? Dr. Mark Hyman: I like yogurt. Kefir's liquid-y. I mean they're both fine. Dhru Purohit: Okay. There's a brand that I've been eating a lot, no affiliation with them, it's called Redwood Hill Farm, and I do not consume dairy on a regular basis because I always have dairy and I break out. I break out and it's just immediately, but I've been having this Redwood Hill Farm goat milk kefir. They have it at Whole Foods, other places. It's great. Get the one that's unsweetened. Dr. Mark Hyman: And the goat milk is important because it's A-2 casing, which is what's not causing all the inflammation, the A-A casing's what's causing your pimples. Dhru Purohit: Totally. And I don't break out. I feel good. I feel like my gut health is stronger than ever before. So just an example of we'll be writing a newsletter on this whole topic. So typically Mark, people are not making these products, although you could. And there's- Dr. Mark Hyman: My daughter makes them. I wonder how she had a whole thing of kimchi being made. Dhru Purohit: Well maybe we could all buy from her, but she's too busy being in medical school so I don't think she'll have time for that. But typically people are not going to make them and they're going to get them from the store. Just a couple of odds and ends that you want to make sure just like the kombucha, what do you want to make sure that people are looking out for when they're buying some of these things in the store? Dr. Mark Hyman: I mean if they're buying fermented, I would stick with really traditionally made fermented foods. Pickles, sauerkraut, miso, kimchi, things that have been around and been done for thousands of years, Tempeh, natto, all those are really wonderful to include in your diet and see what you like and what you enjoy. Dhru Purohit: So Mark, another thing that I found super fascinating about fermented foods that I haven't said in my show notes here is that fermented foods are shown to reduce markers like interleukin six, which is an inflammatory cytokines. So break that down. What are inflammatory cytokines and how is it, and what mechanisms that you could guess that fermented foods would play in that would reduce the overall inflammation on the body? Dr. Mark Hyman: Yeah,, yeah. So first of all, cytokines, we've heard about in the face of COVID and the cytokines storm, which kills people, essentially it's a flood of these inflammatory molecules. And cytokines are the messenger molecules of your immune system and they have all kinds of names. One class of them are called interleukins, and there's many, many different kinds. Some are anti-inflammatory, some are inflammatory. Interleukin six particularly is a very common one that's very high in belly fat and visceral fat, abdominal fat. It's quiet correlated with heart disease, dementia, cancer, obesity, diabetes, and it's really driven off of a state of low grade inflammation that comes from this visceral or belly fat on fire. Dr. Mark Hyman: The beautiful thing about our understanding about the relationship between the microbiome and our belly fat and our metabolism is that it's mediated through changes in the microbiome that drive inflammation. We talked about it earlier, the metabolic endotoxemia, the basic toxins in your gut that leak across and start to trigger immune responses. And the immune responses then generate a cascade of responses that increases certain cytokines like interleukin six. So if you have a bad gut, if you have a leaky gut, if you're eating the wrong foods, you're going to get high interleukin six, which is going to create more insulin resistance, create more weight gain, create more belly fat, and a vicious cycle. Dr. Mark Hyman: So the beautiful thing about fermented foods is that they can help reduce this process by normalizing gut function, by optimizing the gut in different ways, through optimizing healthy bacteria, reducing the bad bugs, which then reduces the leakiness of the gut, which then further limits the inflammatory cascade that results as a result of a leaky gut. So it's really kind of a beautiful story about how your microbiome plays a role in your immune system, plays a role in your weight, and how that all connects to eating the right foods and not eating the wrong foods. Dhru Purohit: If somebody's struggling with things like yeast overgrowth or histamine intolerance, are those two examples and are there any others of where fermented foods ... Because we read the articles or we read the headlines of the stuff and we say, "Okay, this food is good for everybody." But if somebody's reacting to fermented foods, one, what could that possibly be an indication of? And number two, is there anything they should be thinking about doing? Dr. Mark Hyman: Yeah. So certain people eat fermented foods and their stomachs just go crazy and blow up and they feel horrible, and that's because there's something going wrong in there. Something's rotten in Denmark as Shakespeare used to say. So we have often bad bugs growing in there, yeast overgrowth. We have something called SIFO or small intestinal fungal overgrowth, or SIBO, small intestinal bacterial overgrowth. And that means that these bugs have migrated into the small intestine. You start putting foods in there and it starts battling. So you start a war with the good bugs and the bad bugs and you get all this dangerous things that start to happen, which is more bloating, more gas production, more discomfort, more GI symptoms. Dr. Mark Hyman: So while fermented foods are good, they're good in the right person, because if your gut's not sorted, and I call it the weeding, seeding, and feeding program, if you haven't done the weeding and you got a lot of bad bugs in there, you start eating fermented foods, you're going to have a problem. So if you have yeast overgrowth, if you have small intestinal bacterial overgrowth, if you have histamine intolerance, you should be very careful. So if you don't react well to fermented foods, it doesn't mean fermented foods are bad for you. It means there's something wrong with your gut, find it and fix it. Dhru Purohit: And can you still take a probiotic for instance and get the benefits because it's not exactly like there's a clear test to say you have to go and do the weeding first, unless sometimes you're working with a functional medicine doctor they can help you interpret it. Dr. Mark Hyman: Sure. Dhru Purohit: So in that instance, can you still take, if you want to get some of the benefits, can you take things like probiotics and that can be one way if you're reacting to fermented foods to still get the benefits of the bacteria that you'd be introducing to your system? Dr. Mark Hyman: Yes. I mean you have to be careful. If you have a tremendous amount of bacteria overgrowth and you take probiotics, you can get worse, just like with fermented foods. But the thing is beautiful. You can start slowly and then build up and it's sort of kind of win the war over time. I'd like to do the weeding first, but you can actually start to seed and see how that works in a way that actually is a low dose initially, and then you start to build up on the dose and people can generally tolerate it. But it's often important to treat the underlying issues first. Dhru Purohit: So Mark, whether we're introducing fermented foods or not, and I hope that a lot of people are because it's a smaller part of the population that's going to have reactions to fermented foods and needs to go on a little bit more of aggressive protocol maybe with a practitioner, but whether we're about to introduce more fermented foods or start to have them on a more frequent basis or we're getting ready to include a probiotic, a high quality probiotic into our diet, there are things that we can do to get our body and our gut especially in the best shape to benefit from those things. So what are some of those lifestyle recommendations? Dr. Mark Hyman: Well, you think about it. When you put a seed in the soil, you want to prepare the soil unless you're using tons of fertilizer and pesticides and chemicals that you don't want to do. So how do you prepare the soil to plant the seed? So you have to do the same thing for your gut. Just as you're going to start your garden and you get rid of all the weeds and you dig it up and you make the soil nice, you have to do the same with your gut. And that can be done through herbs or with medications if you have bacterial overgrowth, fungal overgrowth, parasites. That's what we call the weeding phase. The other part of the weeding phase is weeding out foods that cause problems, because if you're taking probiotics but you're still eating a ton of junk food and sugar and drinking sodas and having lots of gluten and your gut's a mess, it's not going to work as well. Dr. Mark Hyman: So the key is to do a gut healthy diet, which essentially the [inaudible 00:24:37] diet or the 10-day detox diet, things I've written a lot about, then actually you can start to add these foods in because your diet's going to start to change the garden very quickly. It's going to start to get rid of the bad bugs, fertilize the good bugs, and then the probiotics tend to work better. So it's much better to actually take the probiotics in the context of a healthy diet than to try to make up for a healthy diet by eating probiotics. Dhru Purohit: Yeah, because sometimes the approach with the modern world of supplementation, this always happens, is that there's this feeling that, "Oh, this is just going to fix everything and I can just go and continue to live the lifestyle that I was living previously." But your food is always so much more of an impact than anything else that's out there, so cleaning it up over a period of time- Dr. Mark Hyman: So important. Dhru Purohit: -Is so key. So Mark, when it comes to shopping for probiotics, what are some of the things that people can be looking for when choosing the right probiotic? Dr. Mark Hyman: I mean it is difficult because it's kind of the wild west out there and the regulations are really young on not matching the need. And so the bottle might say 50 billion units, but there might be five. Or it might say there's these strains of bacteria, but they might have put them in the manufacturing but by the time they get on the shelf, they're not there. Or the cold chain might be broken, so the probiotics that are kept cold aren't cold and they degrade over time. So you got to really be careful, and then you ought to know which probiotics. So there's a bit of a science to it. With that said, there's some really good companies out there that are pretty reliable that test their products aggressively. Dhru Purohit: We mentioned a bunch in the beginning. Dr. Mark Hyman: Pure Encapsulations, Metagenics, there's others that are quite good. [inaudible 00:26:09]. There's a lot of good products that we use in the medical space, so I tend to focus on those. And I think that when people are choosing, they should really be looking at where is it coming from, who's the manufacturer, what's the process, what's their quality control measures, do they test, and how do they maintain shelf stability if it's a shelf stable product, if it's frozen what was the cold chain like? So you got to kind of do a little bit of due diligence, and I think then you can kind of come up with probiotics that are for different things. Like I said, it's not like just one size fits all, so different probiotics have different benefits for different people at different times, just like different drugs. So it's going to be that personalized. Dr. Mark Hyman: So there are some general probiotics you take like lactobacillus, bifidobacteria, and others, but there's a lot of strains and things that are now coming out that are a more research based strain. So it depends on what you're dealing with. If you're dealing with immune issues or hormonal issues or brain issues, I mean there's probiotics for depression now, for blood sugar, for all kinds of stuff. Literally, I'm going to be doing an Instagram Live with a famous actress who had diabetes and started taking a particular probiotic that helped balance her blood sugar. And I've seen this in other patients when they get the gut healthy, their blood sugar gets better. So there's really very much a future of customized and personalized probiotics. Dhru Purohit: No, absolutely. There's ton of great companies that are doing stuff in the space. And I think through education and digging in a little bit and asking the companies how they approach it, that's a big part of the process. Talk a little bit more about LactoSpore, which is the probiotic that you put in your formula. Dr. Mark Hyman: Yeah. I mean the reason we picked this is because of the level of data on this. This is a probiotic that's been well researched in randomized clinical trials, looking at efficacy across a broad range of health issues, digestive symptoms, mood issues, and more. And it's quite amazing when you look at it. It's a spore-based probiotic, which is quite different. It's shelf stable, so you don't have to worry about keeping it in the fridge. And the data actually is quite amazing because it shows that it has dramatic reductions in GI symptoms. Dr. Mark Hyman: So for example, the LactoSpore cuts down on irritable bowel symptoms by 42%, bloating by 47%, vomiting by 47%, diarrhea by 43%, overall GI pain by 68%. But also there are other physiologic problems like depression and mood issues like reduction depression by 57% and improvement in quality life scores by 47%. These are quite amazing data. Sleep improvements by 58%. So we've got data showing that these kinds of probiotics work, and then I tend to rely more on the ones that are research-based that are used in the clinical studies that I can rely on and I know the manufacturer. So that's why we tend to pick these probiotic for our formula as opposed to just some random product. Dhru Purohit: So a couple last things on the topics of probiotics. Almost everybody in the world has taken an antibiotic at some point in time, and people are always curious about that. On one extreme, there's this deep, deep, deep fear that, "Oh my gosh, I've heard so much about the gut microbiome from functional medicine doctors and experts like yourself and I'm just worried to take an antibiotic ever." And on the other side it's like, "The data's way overblown. We're fine, antibiotics, the body's resilient." Tell us where you lie on that spectrum of things. Dr. Mark Hyman: I mean look, antibiotics have been the huge benefit to humankind for sure. And without that, many of us would be dead right now. No question about it. But there's a downside, which is they wipe out a lot of Keystone species in our gut, in our microbiome, that leads me to kind of wonder about how we can actually kind of reset our system after antibiotics. So I'm very aggressive with my patients if they've taken antibiotics to rebuild their gut after. I always put them on the Saccharomyces while they're on antibiotics because that helps prevent antibiotic-associated diarrhea and also changes. And then afterwards, I make sure they take a good three to four months of a good multi complex probiotic after. And it's really important because if you don't, you're just kind of going back to having these altered microbiomes that never reset, and you want to reset them. And you also want to use diet to reset them too, that's really important. So the diet is the best way to create a sustained change in the population of your microbiome, and the probiotics really help regulate your immune system and leaky got all along the way. Dhru Purohit: All right Mark, well we talked about a bunch of companies that you love and use and trust on a regular basis. We'll have a link to those. We're all about lifting everybody up and highlighting and putting the spotlight on companies that you love and that you use in your clinic and they use at the Cleveland Clinic as well too in some cases. So we'll have a link to those in Show Notes, as well as some of the studies that we mentioned, we'll put those in the show notes as well. And with that, I think we can go ahead and conclude today's episode. Dr. Mark Hyman: Well, thanks Dhru. It's been a fun class. I think we really always have more to learn about the microbiome, about probiotics, about how to fix the gut, and the exciting part about this era is we're learning more every day and I'm learning more every day. And I've been doing this for 30 years, so it's pretty exciting. So if you like what you heard on this podcast and you want to learn more about our new multivitamin for your gut called Gut Food, just visit gutfood.com to sign up for the wait list and be sure to share this podcast with your friends and family and we'll see you next week on The Doctor's Farmacy. Announcer: Hi everyone. I hope you enjoyed this week's episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who's trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.