Disclaimer: This article provides an overview of the research on probiotics. It is for informational purposes only and is not meant to provide any medical advice. Please talk to your doctor about your health concerns and consult them before taking any supplements or making changes to your supplement regime.
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We are going through an epidemic of digestive disorders. According to the GI Alliance, about 62 million Americans are diagnosed with a digestive disorder yearly. Skyrocketing numbers of gastrointestinal disorders among both adults and children are fueling the probiotics supplements industry.
On the bright side, the increasing need for probiotics means that new research is coming out daily.
Yet, the dark side to this trend is the rise in commercial probiotic products that have not been through clinical trials or any sort of research studies.
Some products are so poorly formulated that none of the probiotic strains listed on the label make it to the gut (Wang et al., 2020).
Consumers are left confused as to which products actually work and how to choose the right one. This isn’t surprising, since even doctors have a hard time keeping up with new evidence and formulations while making well-grounded recommendations for their patients.
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According to the National Institutes of Health (NIH), there aren’t any expert recommendations for or against probiotic use by healthy people.
However, NIH advises doctors to seek guidance in published studies and reviews when making probiotic recommendations for people with various health conditions. It’s important to choose the right probiotic species, strain, and dose that might help alleviate a person’s symptoms (NIH - Probiotics Fact Sheet).
Aside from the published research, doctors may also rely on their clinical judgment and experience. It’s key to know that probiotics often aren’t used alone. Doctors practicing within an integrative medical framework recommend probiotics alongside conventional treatment, diet, lifestyle changes, and other supplements if needed.
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With probiotics gaining popularity, many products reaching the market have not been through adequate research. Doctors need to review the evidence and recommend only safe and tested probiotics.
According to one US-based study of gastroenterologists and other doctors interested in gut health, all surveyed physicians responded that they believed probiotics to be safe for most patients.
In this study, 98% considered probiotics in gastrointestinal illnesses and 93% recommended probiotics for irritable bowel syndrome (IBS). Physicians also recommended probiotics for Crohn’s disease and diarrhea from antibiotics and bacterial infection (Clostridium difficile) (Williams et al., 2010).
Commonly used probiotics included (Williams et al., 2010; Krammer et al., 2021):
This study had another interesting finding: physicians seemed to be recommending probiotic strains they were familiar with. The probiotics that were marketed to physicians and had an affordable price were the most recommended ones despite often not being the most evidence-based choice.
For example, most physicians were familiar with the commercially marketed probiotic B. infantis (Align). Some evidence supports its use for IBS. Yet, physicians are also recommending it for other conditions that it hasn’t been tested for.
To bridge this knowledge gap, leading experts are publishing guidelines with the most up-to-date research on probiotics for specific conditions (Ciorba, 2012; Sniffen et al., 2018).
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Cardiologists are becoming increasingly aware of the link between gut health and heart health.
Integrative cardiologist, Dr. Joel Kahn, recommends probiotics and says on his blog:
“A number of studies indicate that one of the benefits of a healthier GI tract is a lower blood cholesterol level. A recent analysis of the published data found important support for this observation, and I’ve seen similar improvements in patients I have treated.”
He also notes that the increase in vitamin D from supplementation is essential to heart function.
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The way to the skin is through the gut! Skin specialists are acknowledging the role of probiotics in soothing eczema, psoriasis, acne, and other skin conditions (Navarro-Lopez et al., 2021).
Probiotics backed by evidence for eczema include various Lactobacillus and Bifidobacterium strains (including brands like Latopic) (Sodre et al., 2022, Drago et al., 2011, Drago et al. 2012):
Dermatologists also recommend probiotics to children atopic dermatitis, the most common type of eczema (Fuchs-Tarlovsky et al., 2016)
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Some OB/GYNs are embracing new research and recommending specific probiotic strains to women. Strains most commonly recommended and backed up by studies for vaginal and urogenital health include L rhamnosus GR-1 and L reuteri RC-14 (ProFem) (Griffin, 2015; Reid et al., 2004).
Many probiotics are marketed to men as well, but these are not as popular among physicians. Most probiotics targeting men support exercise performance and overall gut health. Experimental research is testing specific strains for conditions like prostate inflammation and low sperm count, but clinical trials are lacking (Chiancone et al., 2019).
There’s been a lot of hype about using probiotics for mood and mental health. Even researchers have coined the term “psychobiotics” to refer to the effects of gut bacteria on our brain and psyche (Dinan et al., 2013).
Are psychiatrists and mental health specialists on board? Or is this trend limited to biohackers?
Most doctors agree that while new research sounds promising, there are still a lot of unknowns. Several clinical trials point to the benefits of probiotics for improving mood and reducing depression and stress. The data on anxiety are mixed. Read more about the research in this post.
All in all, more trials are needed before probiotics can be widely recommended by mental health specialists.
However, probiotics seem to be a good option for healthy people who want to support their mood and stress resilience.
Most naturopathic doctors are immersed in gut microbiome research. Many recommend specialized probiotic supplements to their patients and have clinical experience with different brands (Steel et al., 2020).
Naturopaths are also ready to tackle complex and chronic health conditions—often dismissed by conventional practitioners—that are tied to gut microbiome disruption.
Specific probiotic strains may be helpful for eczema, vaginal health, heart health, and mental health. Doctors may recommend them to some patients alongside other treatments.
This is the most important factor in choosing the right probiotic: look for a strain or combination of strains that have been clinically tested. Make sure that the participants this probiotic has been tested on applies to you (e.g. adults, women, babies) (McFarland et al., 2018).
Different probiotics have different health effects. Saying all probiotics are the same is like saying all vitamins are the same. While all probiotics tend to be good for gut health and overall wellness, many probiotic benefits are highly strain-specific (Bubnov et al., 2018; McFarland et al., 2018).
For example, Microbiome Plus+ L. Reuteri NCIMB 30242 is considered a heart-healthy probiotic because it has been clinically proven to support already normal levels of LDL and total cholesterol. This health benefit does not extend to other Lactobacillus Reuteri strains (Jones et al., 2012; Jones et al., 2012).
Read more about probiotic strains and their effect on different areas of health, such as immune health, heart health, mental health, and bloating and gas.
Remember, more does not equal better when it comes to probiotic strains. Some brands will list dozens and dozens of probiotic strains. To a layperson, this may seem like a good idea: why not just up those probiotics to the max?
Let’s look at the vitamins analogy again: this would be something like a no-name supplement with untested doses of various synthetic versions of vitamins that your body can’t use or absorb. Similarly, more probiotic strains do not equal more health benefits. Untested probiotic mixtures are likely to be ineffective and may even worsen gut issues in people who are sensitive.
Not all probiotics are the same. Look for products that contain only clinically tested probiotic strains.
One extra ingredient in probiotic supplements is worth the hype: prebiotic fiber. Prebiotics act as fuel for probiotic bacteria and can boost the overall benefits.
The combination of probiotics and prebiotics that has a synergistic effect on the microbiome is called a synbiotic. It’s crucial to choose a well-researched synbiotic if you’re looking for added prebiotic benefits (Sergeev et al., 2020).
Microbiome Plus+ offers a synergistic combination of scFOS fiber that acts as a prebiotic and L. Reuteri NCIMB 30242, our clinically tested probiotic. The prebiotic in our supplements, scFOS, has also been tested in patients with IBS with good results (Azpiroz et al., 2016).
For added benefits, search for a synbiotic: a tested combination of probiotics and prebiotics.
The optimal dose of probiotics depends on the strain and product. Doctors who recommend probiotics need to understand the probiotic strains, doses, and duration of use that studies in humans have shown to be beneficial.
Probiotics are measured in colony-forming units (CFU)—the number of viable cells. Many probiotic supplements contain 1 to 10 billion CFU per dose; some contain up to 50 billion CFU (NIH - Probiotics Factsheet).
More CFUs do not equal more benefits. The safest and most effective doses are those that have been clinically tested. Different dosages of specific strains are used for various conditions.
Although manufacturers are not required to list CFUs based on the current guidelines, high-quality brands will make sure to list the CFUs for each strain (NIH - Probiotics Factsheet).
As a consumer, you should also check the labels of probiotic supplements for recommended storage conditions. Some probiotics need to be kept in the fridge, others can be stored at room temperature.
If you are in good health, you can safely take probiotics at the studied CFU level daily (WGO - Global Guide on Probiotics).
Be sure to consult your healthcare provider if you have a weakened immune system, short bowel syndrome, or any other health problems. Also, check with your provider first if you are considering probiotic supplementation during pregnancy and breastfeeding or if plan on giving it to your baby.
For a probiotic to be safe, it should be approved for human consumption by a recognized regulatory or food safety authority. In the US, probiotics labeled as GRAS (Generally Recognized As Safe) by the FDA are considered safe.
Our probiotic, L. reuteri NCIMB 30242, is one of the few probiotics with GRAS status.
For best results, go for a probiotic dosage and strain that has been through human trials and is labeled Generally Recognized As Safe (GRAS) by the FDA.
There are hundreds of probiotic products to choose from on the market, so finding the right one for you may seem overwhelming. Yet, only a fragment of these products has been through clinical trials.
More and more doctors are recommending probiotic supplements and keeping up with the latest research. If you’re unsure where to start, consult a doctor knowledgeable about probiotics to get expert advice.
To support your health goals, you should be taking the right strain and dosage for the required amount of time.
If you are looking to boost your heart and immune health, our clinically tested L. reuteri NCIMB 30242 may be a good choice.
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns and medications before taking any supplements or making drastic changes to your diet and lifestyle.
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In 2023, scientists Monica Perna and Susan Hewlings published a paper that debunks the myth that saturated fats in coconut oil are bad for your heart (Perna & Hewlings, 2023).
The paper, titled "Saturated Fatty Acid Chain Length and Risk of Cardiovascular Disease: A Systematic Review", was published in the Journal Nutrients. It included five prospective cohort studies that measured saturated fatty acid chain length intake based on diet questionnaires.
The authors discovered that short- and medium-chain saturated fatty acids like those in coconut were beneficial or neutral for heart health. On the other hand, long-chain saturated fatty acid intake was linked with an increased risk of cardiovascular disease.
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The main takeaway from the new systematic review is that we need to look at the length of fatty acids and their impact on health instead of lumping all saturated fats together. This may have implications for dietary guidelines, which still don’t take into account the differences among various saturated fats.
Yet, it’s a fact that not all saturated fats are the same—just as not all unsaturated fats are the same.
For example, we now know omega-3 fatty acids are more beneficial for heart health than omega-6 fatty acids. Yet both are unsaturated fats. A step further is to look at the types of omega-3s: EPAs support heart health while DHA is more important for brain health. Their combined intake offers the greatest heart protective effect (Djuricic & Calder, 2021).
This is exactly what we should be doing with unsaturated fats: examining their subtypes and synergistic effects on health.
The types and sources of different saturated fats include (Perna & Hewlings, 2023):
Coconut oil contains healthy saturated fats: medium-chain fatty acids. Medium-chain fatty acids seem to have a beneficial or neutral effect on heart health, based on 2023 research.
Susan Hewlings, co-author of the paper, says “Coconut contains saturated fat, but it's a medium-chain fatty acid and contains other many beneficial nutrients and therefore should not be lumped with all saturated fats."
This brings us to the second point: it’s not just about how much fats a food contains but what nutrients and beneficial compounds it boasts alongside fats.
In fact, new research highlights that we shouldn’t be looking at any nutrient in isolation. The best heart-healthy diet should emphasize whole foods and nutrient-dense natural foods. When it comes to fats, dietary fat quality is more important than total dietary fat intake (Guasch-Ferré et al., 2015).
Virgin, cold-pressed coconut oil is an overall healthy food. Aside from medium-chain fatty acids, it’s high in vitamin E, phospholipids, and antioxidant polyphenols. Coconut oil is also anti-inflammatory and antimicrobial. In moderation, it’s a great addition to a heart-healthy diet (Wallance, 2015;)
In contrast to current guidelines, new research also questions the recommendation to reduce saturated fats. A recent review of nearly 20 papers revealed there’s a lack of rigorous evidence to support continued recommendations either to limit saturated fats or to replace them with polyunsaturated fatty acids (Astrup et al., 2021).
Just counting saturated fat fails to see the bigger picture: what’s the overall dietary pattern of this person? Are they getting enough nutrients? What’s their food matrix like? (Astrup et al., 2021).
Read more about what a heart-healthy diet should actually look like based on the latest research in nutrition here.
Virgin coconut oil contains many other beneficial nutrients and antioxidants aside from fats. It’s a good addition to a heart-healthy diet that emphasizes nutrient-dense, whole foods.
Experts say that we should be looking at the entire lipid profile, not just LDL cholesterol, to understand how diet can impact heart disease risk (Ludwig et al., 2018).
A recent meta-analysis of 12 studies concluded that coconut milk and coconut oil have a net beneficial effect on the lipid profile and heart disease risk (Teng et al., 2020).
Compared to animal or plant oils, coconut oil had the strongest effect on increasing HDL cholesterol. HDL is commonly called the “good” cholesterol.
Coconut oil raised LDL cholesterol more than plant oils but less than animal fats. Overall, however, its overall effect on LDL cholesterol was so slight that it was not considered significant (average increase of 0.23 mg/dL).
However, when scientists looked at different types of coconut oil, they saw that refined coconut oil was responsible for the small rise in LDL. Extra-virgin and virgin coconut oil didn’t raise LDL. In fact, the net effect of virgin coconut oil tended toward lowering LDL cholesterol (average drop of 0.08 mg/dL).
Unlike refined coconut oil, virgin coconut oil also didn’t raise triglyceride levels.
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Virgin coconut oil is not bad for cholesterol. On the contrary, it seems to help support healthy HDL, LDL, and triglyceride levels. Refined coconut oil, however, may slightly raise LDL cholesterol and triglycerides.
The verdict is that virgin coconut oil is heart-healthy.
Although coconut oil packs medium-chain fatty acids that are classified as saturated fats, it’s not harmful.
New research published in 2023 reveals that the medium-chain fatty acids found in coconut oil have a neutral to beneficial effect on heart health.
Coconut oil also helps support healthy lipid levels. Virgin coconut oil seems to raise the “good” HDL cholesterol without increasing LDL cholesterol and triglycerides.
More research is needed, but it’s safe to say that virgin coconut oil is a great addition to any healthy diet.
If you want to improve your heart health, don’t shy away from coconut oil—just make sure you’re getting cold-pressed, virgin coconut oil. Refined coconut oil does not offer the same heart-healthy benefits and is lower in many beneficial active compounds.
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
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Access our cholesterol learning hub—it is a collection of 19 articles citing hundreds of scientific studies on the subject of cholesterol and heart health.
This hub is the result of years of research and working on creating useful and easy-to-understand articles about cholesterol and heart health. All articles are expert-curated and cite only credible, scientific resources.
Our goal at Microbiome Plus+ is to make sure you have access to the latest cholesterol science so that you can start making healthier choices today.
We link to articles on topics such as what cholesterol is, how cholesterol acts in the body, the latest stats and research on cholesterol, how to improve your heart health and cholesterol naturally, and how your gut microbiome health fits into the puzzle.
The first step to healthy cholesterol levels and good heart health is becoming informed. Once you have the right information at your fingertips, you can start making lifestyle and diet changes.
The problem is that it's hard to make sense of conflicting information from different sources, and a typical Google search will give you just that.
Here are some examples:
We cover all this and more in articles linked in our hub. And we're not afraid to delve into conflicting research and controversial topics to reach conclusions based on the latest science.
We'll keep updating the hub with new, relevant posts as they are published, so don't forget to revisit it from time to time.
If you find our resources useful, please share them and let us know how they helped you on your health journey in the comments section!
Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns and medications before taking any supplements.
The brain is the most complex organ in the human body. It contains about 100 billion neurons and as many as 1,000 trillion synapses. It’s the command center for your nervous system and controls everything from your memory to movement to mood, sleep, and energy levels (Wang et al., 2020).
Maintaining brain health throughout life is crucial in pursuing health, longevity, and overall well-being. The health of your brain even impacts your hormones and gut health (Gwak & Chang, 2021).
As we age, it's natural for cognitive function to decline. Luckily, there are steps you can take to prevent this decline and support brain health naturally (Marchand & Jensen, 2018; Crawford et al., 2021; Meeusen & Decroix, 2018).
However, keeping your brain healthy goes beyond diet and supplementation. It also involves staying physically active, having a social network, and engaging in some sort of cognitive training (Marchand & Jensen, 2018; Piolatto et al., 2018).
Race, ethnicity, gender, and genetics can also impact brain health. According to estimates, up to 60% of a person’s cognitive ability is genetic—the remaining is modifiable. By working on those 40%, you can start to unlock your brain’s full potential (Klimova et al., 2017).
In this resource-packed guide, we'll explore foods, herbs, supplements, and vitamins that may give your brain a boost and nourish your mind.
Your brain health impacts your memory, mood, and even your gut health. Keeping it in optimal shape is crucial for your wellness and longevity. Genetics, lifestyle, and diet all play in.
Eat your veggies! Or better yet, eat the rainbow.
All brain-boosting diets share the common traits of being rich in colorful fruits, vegetables, whole grains, and fish or seafood, while also being low in red meat and sweets. The most well-researched among them is the Mediterranean diet (Marchand & Jensen, 2018).
Many studies suggest that eating a healthy diet can help maintain cognitive health and maybe even prevent cognitive decline, dementia, and Alzheimer’s disease in the long term (Marchand & Jensen, 2018).
The Mediterranean diet has been associated with about 40% lower risk of cognitive impairment (including dementia and Alzheimer’s disease) in some studies. It was also linked with both a 65% lower risk of mild cognitive impairment and improved cognitive performance in one trial (Marchand & Jensen, 2018).
As its name suggests, the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) is based on the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. It was optimized to support brain health based on the latest scientific findings in nutrition (Dhana et al., 2021).
The MIND diet emphasizes brain-healthy foods that are believed to lower the risk of Alzheimer’s disease, all of which we go over below (Morris et al., 2015; Morris et al., 2015).
The MIND diet lists berries as the number one brain-boosting fruit. Blueberries, strawberries, and blackberries are packed with anthocyanin antioxidants that protect the brain from free radical damage and reduce inflammation (Kelly et al., 2018).
In one study of 16k older people, eating more berries was linked with slower rates of cognitive decline (Devore et al., 2012).
A 2022 scientific review concluded that berries have beneficial effects on brain blood flow, cognitive function, memory, executive functioning, processing speed, and attention (Bonyadi et al., 2022).
Nuts and seeds have an optimal fatty acid profile. Along with legumes and whole grains, they’re also rich in fiber, vitamin E, B vitamins, minerals, and antioxidants—all of which are essential for brain health. Some great choices are walnuts, almonds, cashews, and chia seeds (Theodore et al., 2021).
Based on a 2021 review, eating nuts on a daily basis may have a protective effect on cognition, especially in people at higher risk of cognitive decline (Theodore et al., 2021).
Fish like salmon, mackerel, and sardines are an ideal source of the brain-protective omega-3 fatty acid DHA. Fish is also a good source of vitamins D and E.
In one trial of 197 children, eating oily fish improved cognitive function, attention, and cognitive flexibility, and reduced socioemotional problems (Teisen et al., 2020).
In another study, eating fish once a week was linked to a 60% lower risk of Alzheimer’s disease in older people. Meanwhile, omega-3s enhanced cognition in mild Alzheimer’s (Morris et al., 2003).
Leafy greens—such as spinach, kale, and broccoli—are rich in brain-boosting antioxidants, minerals, and vitamins (C, E, K, and folate) (Morris et al., 2006).
In over 13k women, higher green leafy vegetable intake was linked with slower cognitive decline. Leafy greens also protected against the early onset of Alzheimer’s disease in elderly people (Kang et al, 2005; Morris et al., 2018).
It’s an essential ingredient in both the Mediterranean and the MIND diets. It’s no secret that the longest-lived people in the so-called Blue Zones of the Mediterranean consume copious amounts of olive oil (Buettner & Skemp, 2016).
Extra-virgin olive oil is anti-inflammatory, antioxidant, and brain-protective (Khalatbary et al., 2013).
In one Spanish study of 285 older people, a Mediterranean diet rich in extra-virgin olive oil led to better cognitive function and less cognitive decline (Martínez-Lapiscina et al., 2013).
Preliminary research suggests that olive oil phenols may be protective against stroke, spinal cord injury, Alzheimer's disease, multiple sclerosis, Parkinson's disease, and other neurological conditions. Clinical studies are needed to explore this further (Khalatbary et al., 2013).
The cocoa in dark chocolate boasts flavonoids, antioxidants that support cognitive function and protect the brain from free radical damage.
Dark chocolate is also a good source of magnesium, which is essential for brain health. In one study of 98 healthy young adults, eating a small dark chocolate bar improved verbal memory (Lamport et al., 2020).
Aside from boosting immunity, shiitake mushrooms may have the potential to improve cognition.
They are rich in B vitamins and anti-inflammatory compounds. However, the existing data is limited to animal studies. In rats, shiitake mushrooms prevented cognitive impairments caused by a high-fat diet. Shiitake may act on the brain-gut axis, but human research is needed (Pan et al., 2021).
Fermented foods, such as yogurt, kefir, sauerkraut, and kimchi, are rich in probiotics—beneficial bacteria that support gut health.
Research reveals that certain probiotics may improve cognitive function by preventing brain atrophy and producing neurotransmitters. Probiotics that support brain health have been termed “psychobiotics.” Some psychobiotics may be able to boost BDNF, a compound that helps “rebuild” and regenerate the brain (Kim et al., 2021; Asaoka et al., 2022; Sharma et al., 2021).
Maintaining the health of your gut microbiome is important for your brain health. A diet rich in fermented, probiotic-rich foods and prebiotic fiber can support the gut-brain axis, soothe your gut, and sharpen your mind (Mayer et al., 2022).
Eating a healthy diet can help maintain cognitive health and maybe even prevent cognitive difficulties in the long term. The Mediterranean and MIND diets are rich in fruits, vegetables, whole grains, and fish or seafood and low in red meat and sweets—common traits in diets that support brain health.
Incorporating these brain-boosting foods into your diet is not about eating large quantities of them, but rather about including them as part of a balanced diet. The focus should be on creating healthy habits in the long run while preparing nutrient-dense, delicious meals.
Look to buy local and organic and gradually introduce more of these foods into your meals. Add some of the spices we list in part II for more brain-boosting power!
Many “brain-boosting” supplements have recently spurred the market. They get a lot of hype without much research to back them up. Only a handful of supplements have been shown to support cognitive function (Block et al., 2021).
None of these supplements should be used in place of medication.
In one review, 10 out of 14 studies supported the benefits of omega-3s for cognitive function, especially in older adults. Studies used EPA, DHA, or a combination of both (Del Moral & Fortique, 2019).
Low DHA has been linked with aging-related cognitive decline. DHA helps prevent macular degeneration and Alzheimer's while enhancing memory and brain resilience (Cardosa et al., 2016).
Huperzine A is an active compound from Chinese moss. It’s often marketed as a nootropic.
In an analysis of 20 clinical trials including over 1.8k Alzheimer's patients, huperzine A seemed to improve memory, cognitive function, and behavior. More research is needed before it can be recommended (Yang et al., 2013; Ghassab-Abdollahi et al., 2021).
Acetyl-L-carnitine is a form of L-carnitine, an amino acid naturally produced by the brain and liver.
In several trials, acetyl-L-carnitine improved cognitive function and memory in elderly people with age-related cognitive decline (Cucinotta et al., 1988; Salvioli & Neri, 1994; Passeri et al., 1990).
Some studies suggested that it might slow the rate of Alzheimer's disease progression. It’s more likely to be beneficial in early-onset Alzheimer's in people under 66 years of age, but more trials should examine its effectiveness (Thal et al., 1996; Sano et al., 1992; Spagnoli et al., 1991; Brooks et al., 1998; Pettegrew et al., 1995; Rai et al., 1990; Montgomery et al., 2003; Hudson et al., 2003).
Citicoline is a natural brain compound.
In clinical trials, citicoline improved memory scores short-term in elderly patients with age-related cognitive decline (Spiers et al., 1996; Fioravanti et al., 2005; Alvarez et al., 1997; Nakazaki et al,, 2021).
L-theanine has the potential for improving mental performance, especially in people under stress. It may be more powerful when combined with caffeine (Fox et al., 2012; Hidese et al., 2019).
You can get l-theanine by having a cup of antioxidant-rich green tea!
Phosphatidylserine is a natural component of your cell membranes.
Bovine cortex-derived phosphatidylserine seems to improve attention and memory in patients with age-related cognitive decline. Plant-derived phosphatidylserine may have a similar effect (Cenacchi et al., 1993; Crook et al., 1991; Villardita et al., 1987; Palmieri et al., 1987; Schreiber et al., 2000).
Caffeine is the world’s most famous and widely used stimulant. Caffeine increases mental alertness when you’re exhausted and sleep-deprived. But this often comes at the cost of irritability, heart palpitations, and gut issues (Nehlig, 2010; Capelletti et al., 2015).
For this reason, we don’t recommend caffeine pills. If you’re not sensitive to coffee, it’s better to have an occasional cup when you need to get through the day.
Bacopa or Brahmi is an Ayurvedic herb used to support mood, memory, and mental alertness.
There’s some evidence that it may help protect the brain and improve cognition and memory recall. However, the results of studies have been inconsistent (Pase et al., 2012; Sukumaran et al., 2019).
Gingko is a Traditional Chinese Medicine herb and among the most popular supplements for brain health.
In a review of 14 clinical trials, ginkgo supplementation was linked with improved memory, cognition, and quality of life in patients with Alzheimer's and Parkinson's disease. Gingko also seems to combat oxidative stress and inflammation and improve brain blood flow, attention, and mood (Barbalho et al., 2022; Diamond & Bailey, ,2013).
Turmeric is a yellow spice that contains curcumin, one of the best-researched natural compounds.
Studies show that curcumin has brain-protective and cognitive-enhancing properties that may help delay or prevent neurodegenerative diseases like Alzheimer's (Goozee et al., 2016).
Curcumin has poor bioavailability that can be enhanced by 2000% by piperine from black pepper (Hewlings & Kalman, 2017).
So, next time you’re cooking with turmeric, don’t forget to add some black pepper in!
Lion’s mane is a medicinal mushroom that shows potential for improving cognitive function based on preliminary human data, but more clinical trials are needed (Saitsu et al., 2019).
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Certain supplements like huperzine-A, omega-3s, turmeric, and citicoline may support brain health and cognitive function when taken at the recommended dosage. More clinical research is needed before they can be recommended to people with cognitive decline.
All the listed supplements are safe when used at the recommended doses and durations. Track your response as individual reactions are always possible.
Not all supplements are created equal. Go for high-quality products and trusted brands.
When choosing a supplement for brain health, think about your specific needs and goals.
For example, if you're looking to improve memory and cognitive function, citicoline or acetyl-L-carnitine may be a good choice. If you're looking to reduce inflammation in the brain, turmeric and ginkgo may be better options. And if you’re aiming at a supplement that’s also beneficial for heart health, you can’t go wrong with omega-3s.
You may choose to supplement with one active ingredient or take a combination product. Combos may help achieve a synergistic effect.
On the flip side, some combos contain dozens of ingredients. Be sure to consult your doctor first to avoid drug interactions and side effects. Be especially cautious with supplements that contain caffeine.
Your brain needs vitamins in optimal amounts to function properly. Vitamins help the brain produce neurotransmitters and protect it from free radical damage and excessive inflammation (McCleary et al., 2018).
Studies indicate that low vitamin D levels may increase the risk of cognitive decline (Soni et al., 2012)
In one trial of 183 older people with mild cognitive problems, vitamin D (800 IU/day) over 12 months improved cognitive function by combating oxidative stress in the brain (Yang et al., 2020).
Vitamins B12, B6, and B9 (folate) are essential for brain health.
According to a 2022 review of 95 studies with 46k participants, B vitamins help slow cognitive decline when taken for at least 12 months (Wang et al., 2022).
People with lower folate levels (but not B12 or B6 deficiency) were at an increased risk of cognitive problems in this study. This means that upping your dietary folate levels is a sure way to support your brain health (Wang et al., 2022).
Retinol, the active form of vitamin A, helps protects the brain from oxidative stress and inflammation. It also maintains brain plasticity in regions involved in memory, which is key to good cognitive function (Wołoszynowska-Fraser et al., 2020).
Studies uncovered a link between vitamin A deficiency and cognitive decline and Alzheimer's disease (Wołoszynowska-Fraser et al., 2020; Palazuelos González et al., 2022).
Vitamin K2 helps brain cells grow, divide, and maintain a strong protective myelin sheath. It also helps produce sphingolipids, highly concentrated fats in the brain that help boost cognition (Maresz, 2021).
Studies reveal that people with cognitive decline, Alzheimer’s disease, and Parkinson’s disease have lower vitamin K2 levels. However, more research is needed to test whether vitamin K2 supplements are beneficial (Maresz, 2021).
The healthiest and most evidence-based way to get these brain-protective vitamins is from food.
Increase your vitamin D levels through sun exposure and eating fatty fish and/or cod liver oil (Benedik, 2022; Cortese et al., 2015).
Most B vitamins are found in whole grains, nuts, legumes, and leafy greens (NHS).
Meanwhile, you can get plenty of retinol and vitamin K2 from animal foods like grass-fed butter, cheese, and chicken and beef liver. These foods also pack vitamin B12 (NIH; Schwalfenberg et al., 2017).
Vitamin D, B vitamins, retinol, and vitamin K2 help keep your mind sharp and brain healthy. The best way to get these vitamins is through a healthy diet that includes foods such as fatty fish, whole grains, leafy greens, and liver.
The first step to improving your brain health is to incorporate nutrient-rich foods like berries, fish, and leafy greens into your diet. Work to create long-term healthy diet choices over short-term dieting.
Vitamins are also essential to keeping your brain healthy. Look to get plenty of B vitamins, vitamins A and D, and vitamin K from food. Consider supplementing only if you can’t get enough of these nutrients from food.
Specific supplements, such as omega-3 fatty acids, ginkgo, and turmeric have also been shown to support cognitive function.
Think about your specific needs and health goals when choosing a supplement. Be sure to choose high-quality products and take them at the recommended dosage.
Lastly, don’t forget to consult your healthcare provider before taking any supplements to avoid disease and drug interactions.
What’s your experience with supplements for brain health? Let us know in the comments section, and share this article if you found it useful!
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post provides an overview of heart disease and cholesterol facts and statistics. It is for informational purposes only and is not meant to provide medical advice. Please talk to your doctor about your health concerns and consult them before taking any supplements or making changes to your supplement regime.
If you want to read the detailed facts and stats about cholesterol and heart disease, head over to this in-depth article. This post summarizes the key information to help you take charge of your heart health today.
Cholesterol is necessary for the body to function properly, but too much of it can lead to medical complications if it is not managed.
High cholesterol can lead to heart attack, stroke, and other cardiovascular disease complications (CDC).
Most cholesterol is produced by the body, the rest comes from diet. Dietary cholesterol absorption and production vary widely among individuals, with cholesterol hyperabsorbers at the highest risk of heart disease (Kapourchali et al., 2016; Lutjohann et al., 2019).
According to WHO, globally 39% of adults have raised total cholesterol, with 38% of US adults having total cholesterol levels higher than 200 mg/dL and 12% with levels higher than 240 mg/dL (WHO; CDC; Tsao et al., 2022).
CDC data points to a wide range of prevalence of high cholesterol across US states, ranging from 28.1% in Wyoming and North Dakota to 39.5% in West Virginia (CDC).
The prevalence of high cholesterol (over 240 mg/dL) and borderline high cholesterol (over 200 mg/dL) varies between genders and races, with Non-Hispanic White women having the highest prevalence of borderline-high cholesterol (CDC).
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In the US, 86.6% of adults have checked their cholesterol in the past 5 years, with the remaining checking less frequently (CDC; Tsao et al., 2022).
According to guidelines and studies, your total cholesterol should be between 100-200 mg/dL for optimal health, HDL should be <40 mg/dL (for men) and <50 mg/dL (for women) and LDL should be <100 mg/dL.
It is important to get your cholesterol levels checked regularly and to make healthy lifestyle changes to help keep your levels under control.
Medication is also available to help lower cholesterol levels in people who cannot control their levels through lifestyle changes alone.
High cholesterol is a serious health concern. Monitor your levels regularly and lead a healthy lifestyle to keep your levels in check and reduce your risk of cardiovascular disease.
The human heart is the size of a fist, pumps blood throughout the body, and has four chambers. Fun fact: women have an average heartbeat of 8 beats faster than men! (Cleveland Clinic)
Heart disease is the leading cause of death in both men and women in the U.S. and globally, with 1 in 5 deaths being caused by heart-related issues. Additionally, an alarming 2 million heart disease complications could be prevented each year if all adults had a high level of heart health (CDC).
Men are more likely to have high blood pressure than women. Among different races, non-Hispanic black adults have the highest prevalence while non-Hispanic white adults have the best control rate (CDC).
Hypertension or high blood pressure is considered a silent killer due to its lack of warning signs and symptoms. High blood pressure increases the risk of heart disease and stroke and costs the U.S. $131 billion annually. Sadly, only 1 in 4 adults with high blood pressure have their condition under control (CDC).
Every 40 seconds in the U.S., someone is having a heart attack, with 805,000 people having one each year and 393,872 dying from it. Most heart attacks happen at home, and the average age of having a heart attack is 64.5 for men and 70.3 for women (AHA).
Read Next:
The human heart is a fist-sized organ that pumps blood around the body and has four chambers. Heart disease leads to many deaths a year and billions of dollars in costs. Most people with high blood pressure and heart disease do not have their condition under control.
While all these statistics may sound scary, the good news is that there are many simple steps you can take to take control of your heart health.
You can reduce your risk of heart disease and stroke by eating a healthy diet, maintaining a healthy weight, getting quality sleep, exercising, and avoiding smoking, alcohol, and stress. Laughter is also beneficial - it reduces stress and strengthens immunity! (Kaminsky et al., 2022).
On the flip side, poor sleep is the number one underrecognized risk factor for heart disease. Meanwhile, copper is the number one underrated nutrient for heart health. Keeping your copper and magnesium intake high is key to optimal heart health (DiNicolantonio et al., 2018; Evers et al., 2022).
You may also consider taking supplements such as L. Reuteri NCIMB 30242, omega-3 fatty acids, CoQ10, vitamin D, and garlic (Casas et al. 2018; Bronzato & Durante, 2018).
Additionally, new research suggests that plant sterols are not a good choice for most people. Unfortunately, plant sterols are still recommended by many healthcare professionals. Read why you should avoid plant sterols and share this information with your provider (Makhmudova et al., 2021; Helgadottir et al., 2020).
It is one of the few probiotics with GRAS status and is considered a heart-healthy supplement. You can read about the complete scientific research behind L. Reuteri NCIMB 30242 here.
Eating a healthy diet, exercising, avoiding smoking, alcohol and stress, and taking supplements such as L. Reuteri NCIMB 30242, omega-3 fatty acids, CoQ10, vitamin D and garlic can help reduce the risk of heart disease and stroke. Consider avoiding plant sterols.
High cholesterol and heart disease are leading causes of death and disability worldwide and in the US.
Fortunately, healthy lifestyle changes, such as eating a balanced diet, exercising regularly, and taking supplements like L. Reuteri NCIMB 30242 can help reduce the risk of heart disease and stroke.
Be sure to monitor your cholesterol levels and heart health regularly and start making healthier lifestyle choices today.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only and is not meant to provide medical advice. Please talk to your doctor about your health concerns and consult them before taking any supplements or making changes to your regime.
Cholesterol is a fat-like substance and a vital nutrient. Your body needs cholesterol to make hormones, vitamins, cells, and digestive juices (Craig et al., 2022).
If you’re just learning about cholesterol, read this post first:
Cholesterol travels through your blood assembled into spherical lipoproteins. HDL and LDL cholesterol are types of lipoproteins.
LDL transports cholesterol from your liver to your tissues. HDL picks up cholesterol from your peripheral tissues and sends it back to your liver (Elshourbagy et al., 2013).
About a third of your total cholesterol comes from diet and the rest is made in your body—mainly in your liver. Animal foods contain cholesterol in varying amounts, while plants only contain phytosterols (Kapourchali et al., 2016).
Read Next:
Cholesterol helps your body make vitamins and hormones. Most of it is made it your liver and the rest comes from food.
The impacts of cholesterol on your health will depend on:
Also Read:
The following factors may raise cholesterol levels (NHS):
Read Next:
Based on the National Cholesterol Education Program (NCEP) and existing guidelines, high cholesterol blood levels in adults are (Ibrahim et al., 2022):
Go to this post to see the chart with normal ranges for all lipids.
HDL is usually considered the “good” type of cholesterol. HDL can pick up extra cholesterol in your tissues and transport it back to your liver. It’s also anti-inflammatory and may protect your blood vessels (Elshourbagy et al., 2013).
Slightly higher HDL levels have been linked with lower rates of heart disease. Similarly, low HDL seems to be a risk factor for atherosclerosis or hardening of the arteries (Elshourbagy et al., 2013).
LDL is typically seen as the “bad” type of cholesterol. Over decades of research, scientists kept seeing a link between high LDL levels and heart attacks and atherosclerosis. It seemed like LDL was fueling free radical damage and inflammation in the body, causing various heart disease complications (Mattiuzzi et al., 2020).
This theory rested on associations between high total or LDL cholesterol levels and increased mortality (Stamler et al., 1999; Lee et al., 2022).
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Despite the roles that HDL and LDL are said to have, therapies aimed at raising HDL cholesterol failed to live up to their expectations (Kingwell et al., 2014).
Similarly, medications that target to aggressively lower LDL failed to reduce the burden and death toll from heart disease (DuBroff & de Lorgeril, 2015).
What did scientists get wrong?
HDL cholesterol is said to be “good” and LDL cholesterol is viewed as “bad,” but this doesn’t always hold true.
New data put into question everything we thought we knew about cholesterol.
For years, scientists have been observing inconsistencies in the cholesterol theory.
This theory says that high cholesterol intake is bad for heart health and that everyone should aim to get their cholesterol down as low as possible.
Scientists now argue that this theory is based on flawed reasoning—we need to look at cholesterol through a different lens! (DuBroff & de Lorgeril, 2015)
First off, findings that suggest increased heart disease risk were based on associations. There was no evidence of causation (DuBroff & de Lorgeril, 2015).
For example, just because people with high cholesterol are more likely to have heart disease doesn’t mean that high cholesterol caused their heart problems.
Even when looking at associations, studies show that low LDL and low total cholesterol levels are just as (if not more) dangerous as high levels in the general population (Yi et al., 2019; Johannesen et al., 2020).
The new truth about cholesterol is emerging from 2022 research.
In one study, both very low and very high LDL levels were associated with increased risks of dying from heart disease. Very low LDL levels were also linked with a greater chance of dying from stroke or any cause (Rong et al., 2022).
The authors warn that we must rethink the optimal range of LDL cholesterol.
Even the protective role of “good” HDL cholesterol is under question.
People with very high levels seem to have a greater risk of mortality—suggesting that very high HDL is “the good gone bad” (Khan & Fonarow, 2022).
In a 2022 study, very high HDL cholesterol levels were linked with an increased risk of dying from any cause or from heart disease among men (but not among women) (Liu et al., 2022).
Another study voiced the same findings among both sexes in a high-risk cohort with heart disease (Liu et al., 2022).
Experts may need to determine an upper cutoff for normal HDL levels.
Both very high HDL levels and very low LDL levels have been associated with a greater risk of dying from any cause.
The first studies on cholesterol and heart disease only included White adults.
A 2022 US study of over 30k people revealed that low HDL cholesterol levels were linked with a higher risk of heart attacks in White but not in Black adults. Yet, higher HDL levels didn’t protect either group from cardiovascular disease (Zakai et al., 2022).
More research among different ethnicities is needed.
Egg yolks pack cholesterol along with many key nutrients (including choline and vitamins K2, D, and B12) (DiBella et al., 2020).
Several 2022 studies found that diets high in eggs may increase cholesterol and reduce lifespan, while others found no association (Mofrad et al., 2022; Zhao et al., 2022; Mousavi et al., 2022; Pan et al., 2022).
A 2022 analysis claims that the conflicting findings come from differences in cholesterol absorption from one person to another. Some people absorb high amounts of cholesterol from food and will not do well on a diet high in eggs and other animal foods. Others absorb tiny amounts of cholesterol and won’t experience adverse effects on a high-cholesterol diet (Schade et al., 2022).
If you’re not sure which group you belong to, experts agree that one egg per day is still a safe choice for most people.
Learn how your body absorbs and uses cholesterol in this post.
A 2022 meta-analysis revealed that statins reduce the risk of heart attacks, stroke, and dying from any cause “modestly” and “uncertainly” (Byrne at el., 2022).
Statins reduced the absolute risk by 0.4-1.3%—an effect that wasn’t linked to clinically meaningful outcomes (Byrne at el., 2022).
Also, statins don’t work well for cholesterol hyperabsorbers (Lütjohann et al., 2019).
The authors urge clinicians to discuss these findings when making informed decisions with individual patients.
It’s easy to think of cholesterol as either good or bad. Yet, new research reveals a much more nuanced truth: the health effects of cholesterol depend on factors like age, race, sex, diet, and genetics.
Even very high “good” HDL cholesterol can be harmful. Lowering “bad” LDL cholesterol with drugs won’t be beneficial for everyone. Meanwhile, eating eggs will raise cholesterol in some people and not in others.
The bottom line is that we need an individualized approach and updated guidelines on optimal HDL, LDL, and total cholesterol levels.
If you’re unsure how to interpret your levels or how to start improving your health today, consult your healthcare provider.
And if you found useful information in this post, please share!
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only and is not meant to provide medical advice. Please talk to your doctor about your health concerns and consult them before taking any supplements or making changes to your regime.
Cholesterol is a waxy, fat-like substance. All cells in your body have some cholesterol and all animal foods contain it.
Cholesterol travels throughout your bloodstream to and from tissues bound to proteins and fats.
Despite the bad rap, cholesterol has many good sides. It all depends on the type of cholesterol and how much of it you have and where in your body.
Only about a third of all cholesterol you carry comes from diet and the remaining 70% is synthesized in your body (Kapourchali et al., 2016).
This ratio is highly individual, though. Some people absorb and others produce cholesterol in excess (Lutjohann et al., 2019).
For example, cholesterol hyperabsorbers tend to absorb lots of cholesterol, produce little and are at the highest risk of heart disease (Lutjohann et al., 2019).
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When you eat a meal containing cholesterol, your gut mixes it with fats, fat-soluble vitamins, and bile to boost absorption. Your gut lining cells then assemble cholesterol into spherical particles called lipoproteins. This is how dietary cholesterol can enter your bloodstream and travel throughout your body (Zampelas & Magriplis, 2019).
Any extra cholesterol not needed by your tissues is sent back to your liver (InformedHealth.org, 2006).
Only animal foods pack cholesterol (e.g. meat, butter, eggs). Plants contain phytosterols, which resemble cholesterol but your body can’t absorb or use them similarly.
Most of the cholesterol in your body comes from your liver, the rest is from animal foods. We all vary in how much cholesterol we produce and absorb.
Unlike plants, humans and animals can make cholesterol. In fact, humans need to make cholesterol to stay alive and well.
All cells in your body can synthesize cholesterol in tiny amounts, but your liver and intestines are the main production sites (Craig et al., 2022).
The key enzyme for cholesterol production in your body is HMG-CoA reductase (Craig et al., 2022).
The activity of this enzyme determines how much cholesterol you’ll produce. Statins work by blocking HMG-CoA reductase, which reduces cholesterol production in the body (Bansal & Cassagnol, 2022).
Many factors can impact how much cholesterol your body will make, including (Zampelas & Magriplis, 2019):
It’s reassuring to know that most of these factors are modifiable. Start making healthier lifestyle and diet choices today, one step at a time.
Your liver produces most of the cholesterol in your body. Factors that influence it include your genetics, lifestyle, and diet.
Your body needs cholesterol as a building block for (Craig et al., 2022):
Sex hormones like testosterone, estrogens, and progesterone affect your fertility, energy, and reproductive health.
Among adrenal hormones, cortisol is involved in your stress response, and aldosterone in mineral balance.
Vitamin D is key for your immunity, bone health, and overall wellness.
Meanwhile, bile supports digestion and the absorption of fat-soluble vitamins A, D, E, and K.
To add, cholesterol is essential for your cellular health. Membranes of all cells in your body structurally need cholesterol to stay healthy and strong (Craig et al., 2022).
And if that’s not enough, cholesterol is also a building block for your tissues (InformedHealth.org, 2006).
Some parts of your body—such as the lens of your eyes—benefit from incredibly high amounts of cholesterol (Zampelas & Magriplis, 2019).
Your body needs cholesterol to build cells and to produce sex hormones, adrenal hormones, vitamin D, and bile.
Head over to this article to learn more about cholesterol (and uncover 100+ stats about it).
You can also read about common cholesterol myths vs. facts in this post.
Since cholesterol does not dissolve in water (or blood), your body needs to bind it to other compounds to transport it. Your body does this by creating lipoproteins–spherical droplets packed with cholesterol, proteins, and fats that can travel through your bloodstream.
As lipoproteins travel around your body, they exchange cholesterol with cells. The two main types of lipoproteins are LDL and HDL (InformedHealth.org, 2006; Huff et al., 2022)
LDL is often called “bad” cholesterol.
It holds about 60-70% of your total blood cholesterol. LDL transports cholesterol from your liver to your tissues. (Elshourbagy et al., 2013).
High levels of LDL can clog your blood vessels, create plaque, trigger inflammation, and cause a host of complications. Small, dense LDL particles are especially dangerous and are independent risk factors for coronary artery disease (Elshourbagy et al., 2013; Kapourchali et al., 2016)
HDL has been termed the “good” cholesterol. Its role is to remove unneeded cholesterol from your tissues and transport it back to your liver.
HDL is also anti-inflammatory, reduces plaque risk, and helps protect your blood vessel lining. Studies reveal that higher HDL levels are linked with better heart health (Elshourbagy et al., 2013)
LDL is the “bad” and HDL is the “good” type of cholesterol. LDL cholesterol is linked with inflammation and heart disease, while HDL is protective.
Your body is constantly working to keep the cholesterol in your body tightly regulated.
Cholesterol keeps cellular membranes strong and fluid. This helps nutrients and hormones move freely in and out of cells adapted to your body’s needs (Huff et al., 2022).
Too little cholesterol and cells become fragile and hormone levels fall out of balance (Craig et al., 2022).
Too much cholesterol and blood vessels become clogged and stiff, leading to atherosclerosis, stroke, and heart attacks (Ibrahim et al., 2022).
Blood vessel damage and high LDL can be a deadly combination.
Damaged blood vessel cells “leak” LDL cholesterol, which builds up and attracts immune cells called macrophages. Macrophages eat LDL, morphing into foam cells: highly reactive, inflammatory bubbles. At this point, inflammation is rampant (Huff et al., 2022).
Scar tissue eventually forms over the area, narrowing the blood vessel and making it rigid and constricted. This is how atherosclerotic plaque is created. If the plaque ruptures, a thrombus can break off and block blood flow, causing stroke and heart attacks (Huff et al., 2022; Elshourbagy et al., 2013).
The buildup of cholesterol in fatty tissues can also disrupt metabolism and is linked to weight gain (Ibrahim et al., 2022).
Fortunately, there are many hacks you can try today to improve your heart health quickly and naturally.
In balance, cholesterol builds cells and keeps your tissues healthy. In excess, LDL cholesterol causes plaque, inflammation, and even stroke and heart attacks.
Diet can have a major influence on your cellular makeup. The foods you eat literally become your cells.
For this reason, you do need healthy sources of fat, cholesterol, and protein. Yes, saturated fat included—as long as it’s in moderation and not from highly processed foods (Guasch-Ferré et al., 2015; Astrup et al., 2021).
Your doctor may order a lipid panel (lipid profile) to check your cholesterol levels.
A lipid panel includes:
Based on your values, your doctor will determine whether you need to make lifestyle changes or take medication (Huff et al., 2022).
Read about normal triglyceride & cholesterol levels in this post.
A novel area of diagnostics includes cholesterol absorption testing that measures blood sterols. This screening helps personalize your treatment plan and rule out ineffective therapies. Boston Heart’s Cholesterol Balance Test and Mayo Clinic Laboratories are among the few labs to run it (Lutjohann et al., 2019).
The typical lab test to check for cholesterol and other markers is a lipid panel.
Despite being framed as dangerous, cholesterol plays a vital role in the body. Without cholesterol, your body wouldn’t be able to make many hormones, vitamin D, or bile.
However, too much cholesterol is harmful. High LDL can clog your blood vessels and cause heart complications.
You can start making healthier lifestyle and diet choices today to lower your risk. Don’t forget to regularly check your cholesterol blood levels to make sure you’re on the right track.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only and is not meant to provide medical advice. Please talk to your doctor about your health concerns and consult them before taking any supplements or making changes to your regime.
The American Heart Association (AHA) now recognizes 8 lifestyle recommendations for improving heart health—also known as the “Life’s Simple 8.” (AHA; Hasbani et al., 2022).
Keeping up with these recommendations alone has been linked with a lower lifetime risk of heart disease, especially in people with high genetic risk (Hasbani et al., 2022).
We cover the “Simple 8” below while diving deeper into other natural strategies.
Making heart-healthy changes can seem overwhelming. Start with tiny steps, make one healthier choice every day, and you may find it easier to continue going.
Don’t expect changes overnight—keeping your heart healthy is a lifetime commitment.
AHA recommends 2 ½ hours of moderate or 75 minutes of vigorous physical activity per week (AHA).
You don’t have to be strict about it! The goal is to lead an active lifestyle so that you don’t have to count every minute. Spend less time sitting and more moving throughout your day. Mix up walking, running, weight training, yoga, dance, gardening—whatever feels right for you.
Look to add some strength training at least twice a week and find fun in upping the intensity.
People who regularly exercise are less likely to die from heart disease and have a lower risk of developing heart problems in the first place. They also have lower blood pressure and healthier cholesterol levels (Nystoriak & Bhatnagar, 2018).
Quick hack:
Add tidbits of physical activity into your daily routine. Make it a habit to walk to get your groceries every morning or start biking to work. Set a reminder to get up every hour to stretch. Sign up for a dance or yoga class in your neighborhood or online. Get creative!
Maintaining a healthy weight is critical for heart health. Being overweight—and especially having lots of belly fat—puts you at risk of both heart disease and diabetes (Katta et al., 2021).
You don’t have to overdo it, though. Research shows that as long as you are fit and physically active, you can have a couple of extra pounds with no adverse effects on your health. This has been termed the “obesity paradox” (Oktay et al., 2017).
Quick hack:
Instead of counting every calorie, avoid overeating. Focus on gradual weight loss by consuming healthy foods and staying active.
Vitamin D—the “sunshine vitamin”—keeps your blood pressure in check by toning your blood vessels. Its deficiency has been linked with higher mortality and heart disease risk (Guía-Galipienso et al., 2021).
The best way to boost your vitamin D levels is exposure to natural sunlight. Plus, being outdoors in nature has many other benefits for your heart—less pollution, more oxygen, more physical activity.
Taking a walk in the forest rather than in the city may even lower blood pressure and pulse rate by reducing the “fight-or-flight” response, according to recent research (Li et al., 2011; Li et al., 2016).
Quick hack:
Look up the nearest forest park or green space in your area. Go there with family and friends and turn it into a hike and picnic.
Smoking is the leading cause of preventable death in the U.S., including about a third of all deaths from heart disease. Quit smoking and look to also avoid second-hand smoke (AHA).
Quick hack:
Make a decision to stop smoking and get support. Start today by avoiding the places and things that trigger you. Explore healthier ways to cope with your urges and stress.
Drinking too much alcohol increases your risk of heart disease. Don’t go over 2 drinks per day (AHA).
There is some debate among scientists as to whether light drinking (2-3 drinks per week) protects the heart or carries some risk (Biddinger et al., 2022; Toma et al., 2017).
If you can avoid alcohol altogether, do. Otherwise, small amounts of red wine seem to be the best choice. Red wine is high in antioxidants like resveratrol and its intake has been associated with a lower risk of heart disease in some studies (Castaldo et al., 2019).
Quick hack:
If you like to have a drink every now and then, pour yourself a glass of red wine once or twice a week.
Endocrine disruptors are man-made chemicals that interfere with how hormones work in the body. Many of them are also microbiome disruptors. Exposure to these chemicals has been fueling the rise in many chronic health conditions in the past decades (Kirkley et al., 2014).
A recent meta-analysis including almost 90,000 people warns that exposure to endocrine-disrupting chemicals increases the risk of heart disease and unhealthy cholesterol levels (Fu et al., 2020).
Look to avoid the following products that contain endocrine disruptors:
Quick hack:
Buy organic whole foods and get a couple of glass or stainless-steel food containers. This way, you’ll already have reduced exposure to endocrine-disrupting chemicals by over 50%!
If you want to improve your heart health and cholesterol, diet is the first place to start.
Read this post to find out what a heart-healthy diet should look like and which foods to include, based on the latest research.
Quick hack:
Increase greens, whole grains, and legumes. Skip processed foods altogether and focus on fresh foods.
Diet quality matters more than the intake of any single nutrient. Aim for a balance of high-quality macronutrients (carbs, proteins, and fats) and micronutrients (vitamins and minerals).
Magnesium and copper are two critical heart nutrients that many people are deficient in. Higher magnesium levels have been linked with a lower risk of high blood pressure and stroke (Rosique-Esteban et al., 2018; Hill & Shannon, 2019; Wazir & Ghobrial, 2017).
Copper deficiency increases the risk of high cholesterol, heart disease, and inflammation (DiNicolantonio et al., 2018).
Good sources of magnesium and copper include (Vormann, 2016; NIH; NIH):
Quick hack:
Add organ meats and cashews to your diet.
You don’t need to take any supplements to improve your heart health.
However, certain supplements have been proven to support a healthy, strong heart and normal cholesterol levels. The ones backed up by research include:
Buy L. reuteri Probiotics with Prebiotic Fiber
Quick hack:
Make sure grains, garlic, and fish are part of your diet before considering more targeted supplements.
Certain supplements may raise blood pressure or cholesterol or interact with medications. Supplements you may want to avoid or discuss with your doctor include:
Quick hack:
Make a list of any supplements you are using or considering and take it to your next doctor or pharmacy visit. Your healthcare provider will make sure nothing is contraindicated.
Gut microbiome imbalances and inflammation play a big role in the development of heart disease (Wu & Chiou, 2021).
Read more about how to recognize gut microbiome dysbiosis and make sure your diet is high in prebiotics and probiotics.
Quick hack:
Add some yogurt, kimchi, and olives to some meals—these fermented foods are rich in probiotic bacteria that tend to your gut microbiome.
Even AHA now recognizes that good heart health relies on getting enough quality sleep (AHA).
Aim for 7-9 hours of sleep each night.
Stress can also have a huge negative impact on heart health (Steptoe & Kivimäki, 2012).
Work on reducing stress in your life and find ways to relax and stay centered.
Quick hack:
Avoid screens before going to bed and do yoga or meditation instead. Make sure to get direct sunlight in the morning and throughout the day to help sync your internal clock.
Many other conditions can affect heart health, including diabetes, kidney disease, insomnia, and others. Work with a holistically minded practitioner to better understand and manage your overall health.
Ways to keep your heart healthy naturally include:
Consult your healthcare provider before taking any supplements to avoid interactions and side effects.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
You probably know the basic definition: bloating is when gas builds up in the digestive system, often causing pain and heaviness after meals. For some people, this happens occasionally, and for others—it’s a daily struggle.
Studies suggest that between 16% and 31% of the general population experience bloating regularly. This percentage spikes up to 90% if you have other gut-related health issues, such as irritable bowel syndrome (IBS) with constipation. Also, women report higher rates of bloating than men (Lacy et al., 2021).
Doctors usually talk about so-called functional gastrointestinal (GI) disorders, an umbrella term for many disorders of the gut-brain axis including IBS and indigestion. They are called functional because there is a change in activity somewhere along the axis but no obvious damage to tissues that can be picked up with standard diagnostic tests.
A recent survey estimated that functional GI disorders are the most common gut disorder in the general population—about 40% of people worldwide are affected (Wei et al., 2021).
Symptoms include abdominal pain, burning, bloating, nausea, fullness, vomiting, and altered bowel habit (Wei et al., 2021).
Although there are many potential triggers for functional gut disorders, the main underlying culprit seems to be an imbalanced gut microbiome (Wei et al., 2021).
Individual factors like genetics, brain health, diet, lifestyle, stress, allergies, food intolerances or sensitivities, and gut conditions like SIBO, IBS, and constipation also play in (Levy et al., 2017).
Your gut microbiome becomes imbalanced or dysbiotic when it starts contributing to dis-ease. Gut bacteria become less diverse and more inflammatory and toxic. Initial gut dysbiosis is often triggered by infection, inflammation, a diet high in processed foods, certain medications, and chemicals (Levy et al., 2017; Gómez de Cedrón et al., 2020).
In a nutshell, here’s what to also pay attention to if you have bloating and gas (Serra, 2022; Levy et al., 2017):
It’s vital to understand that there is no one cause of bloating and gas. Work with a practitioner to pinpoint the cause for you. Although rebalancing the gut microbiome is key to resolving bloating and gas, taking a probiotic supplement is unlikely to help without holistically addressing all factors.
Bloating and gas are very common gut problems. Possible triggers include lifestyle, diet, genetic predispositions, and other health issues—all of which are tied to gut microbiome imbalances.
There is good evidence to claim that probiotics may improve IBS symptoms. Moderate evidence suggests that probiotics may also help relieve bloating in some people with IBS.
It’s uncertain if probiotics can reduce bloating and gas in people with other gut issues.
According to a recent systematic review, 8 out of 15 studies show that specific probiotics could improve overall symptoms in people with IBS, compared to the placebo (Hungin et al., 2018).
Two studies included in the review also found that certain probiotics reduced bloating in people with IBS. However, two other studies found no benefit. Those suffering from constipation-IBS were more likely to experience bloating relief, alongside more regular bowel movements (Hungin et al., 2018).
In one placebo-controlled clinical trial, probiotics improved symptoms of bloating in people with functional GI disorders (Ringel-Kulka et al., 2011).
Probiotics also reduced bloating in a study including lactose intolerant patients (Hungin et al., 2018).
In another study, probiotics didn’t affect gassiness after meals in healthy people nor did they reduce bloating in other types of gut problems unrelated to IBS (mild digestive symptoms, abdominal discomfort, hard stools) (Hungin et al., 2018).
Overall, more research is needed to assess the benefits of specific probiotics in people with bloating and gas.
Specific probiotics may help relieve bloating from IBS, but it’s not yet clear if they affect bloating caused by other gut issues.
Probiotic benefits are strain-specific! Scientific studies used different probiotics, the most common ones belonging to Lactobacillus and Bifidobacteria genera. These genera encompass dozens of species and strains with specific actions in the body.
To roughly break it down…
Lactobacillus strains have been linked to better digestion, less bloating and gas, and healthier cholesterol levels. They help rebalance and replenish the gut microbiome. Among them is Lactobacillus reuteri NCIMB 30242, which has been through 7 clinical trials for supporting normal LDL cholesterol, gut, and heart health (Agah et al., 2020; Ringel-Kulka et al., 2011; Cerbo et al., 2016).
Lactobacilli are naturally found in yogurt and fermented foods like miso and kimchi. Similar fermented foods contain Bifidobacteria such as water kefir, buttermilk, and curd (Kok & Hutkins, 2018).
Plus, Bifidobacteria are abundant in human breastmilk—this makes them the first probiotic bacteria to colonize the gut of newborns. These bacteria support healthy development, immunity, gut health, and nutrient absorption (Hidalgo-Cantabrana et al., 2017).
Bifidobacteria help move food along the digestive tract more efficiently. This encourages regular bowel movements and relieves constipation. But, bifidobacteria are less likely to specifically help with bloating and gas (Dimidi et al., 2014; Hidalgo-Cantabrana et al., 2017)
Lactobacillus strains are better for bloating and gas than Bifidobacterium strains, based on the evidence. Bifidobacteria are more likely to help with constipation. Both can support rebalancing the gut microbiome.
While fermented foods tend to have broader benefits for gut health, probiotic supplements contain specific strains and dosages for a more targeted effect.
The following probiotic strains have been adequately clinically researched for bloating (Ringel-Kulka et al., 2011; Ibarra et al., 2018; Niedzielin et al., 2001; Whorwell et al., 2006; Yuan et al., 2017; Hun, 2009; Spiller et al., 2016; Hungin et al., 2018):
It’s typically a good idea to take probiotics with prebiotics. Prebiotics act as “food” for prebiotic bacteria, helping to fuel their growth. A science-based combination of probiotics and prebiotics is called a synbiotic (Kolida & Gibson, 2011).
Synbiotics work to establish a healthy and stable gut microbiome. Secondly, they support effective digestion and gut motility. Both of these are important pieces of the puzzle if you want to get to the bottom of your bloating issues.
In one study done on children with IBS, both probiotics alone and synbiotics reduced symptoms like bloating after meals and belching/abdominal fullness. However, synbiotics offered broader benefits and increased the percentage of patients in full recovery (Basturk et al., 2016).
Another study tested different Lactobacillus and Bifidobacterium strains alongside fructooligosaccharides (FOS). This combination was beneficial for people with diarrhea-IBS, particularly for flatulence, pain, stool pressure, and diarrheal stools (Skrzydło-Radomańska et al., 2020).
Sensitive individuals may experience bloating once first taking prebiotics. This usually goes away within a couple of days, as the body adjusts. In the long run, prebiotics should help with bloating and overall gut health. Track your response and consult your healthcare provider if you experience any unwanted effects.
Consider taking prebiotics like FOS alongside probiotics for better digestion and more effective bloating and gas relief.
Research suggests that probiotics work best when taken up to 30 minutes before a light meal high in fiber or carbs. A good option is to take them shortly before or with your breakfast (Tompkins et al., 2011; Corcoran et al., 2005).
Read more here:
The time it takes to feel that probiotics are working for bloating is individual.
This may depend on your unique gut microbiome, health status, diet, and genetics. Some people experience initial relief after a couple of days while others may need to wait for several weeks before noticing any benefits.
Most clinical trials tested probiotics for at least 4 weeks.
It’s recommended to take probiotics for at least 2-3 weeks before assessing their effects.
At the same time, be sure to address any other issues that may be contributing to your bloating or gas.
Ideally, use targeted strains tailored to your needs. Consult a holistic practitioner if you’re not sure which probiotic strains might be best for you.
Bloating has many possible causes. Triggers include diet, food intolerances, toxins, stress, and other gut conditions. These are all tied to gut microbiome imbalances or dysbiosis.
Certain probiotics may help rebalance the microbiome and reduce bloating.
Several probiotic strains have been researched for relieving bloating and overall symptoms in people with IBS. A couple of studies point to benefits for bloating and gas in people with other gut issues, but more research is needed. Overall, Lactobacillus probiotic strains currently show the most promise.
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
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This article is an evidence-based overview of probiotic strains that can support your mental health and well-being based on clinical studies.
Unlike most posts on the topic, we’ll skip the animal and cell-based studies to focus on human data. Many probiotics may show effects in cells and animals but act differently in the human body.
Although the best clinically researched probiotics are listed in this article, more research is needed before any probiotic can be recommended to people with mental health disorders. It’s important to remember that probiotics and any other supplements should be a complementary strategy to, not a replacement for, standard therapy.
We now know that the gut and brain are intricately linked. Scientists call this connection the gut-brain axis. Your gut and brain communicate through neurotransmitters, hormones, and metabolic and immune activity (Ma et al., 2021).
When your brain and gut are in harmony, you digest food with ease and feel uplifted, focused, and at peace.
Any change to your gut-brain communication can cause a ripple effect in your cognition, mood, behavior, and inflammation levels. These changes can be positive or negative. A healthy diet is a positive influence. Meanwhile, the main negative trigger for most people is stress.
Image taken from Bermúdez-Humarán et al., 2019
Studies show that stress can disturb the gut microbiome, and in turn, cause mental health problems like anxiety and depression (Ma et al., 2021).
A recent study revealed that gut microbiome imbalances caused by stress mirror changes in brain activity in areas that control mood and cognition (the prefrontal cortex). As a result of high levels of stress, the gut microbiomes of healthy participants became indistinguishable from those of patients with depression. This means that subtle changes in the gut microbiome may happen well before a person starts experiencing low mood or anxiety (Yamaoka et al., 2022).
Image taken from Bermúdez-Humarán et al., 2019
The gut-brain connection explains why taking something to improve mood or reduce stress without balancing the gut microbiome often doesn’t work. It also opens up a new category of supplements that target the brain through the gut: psychobiotics.
Psychobiotics are probiotics that act on the brain. Scientists define them as live organisms that produce mental health benefits at the right dosage (Dinan et al., 2013).
Psychobiotics can deliver brain-active substances like GABA—the main “calmness” neurotransmitter, and serotonin—the “happiness” hormone. Low levels of these neurotransmitters have been linked with depression and anxiety (Dinan et al., 2013).
Psychobiotics can also activate the vagus nerve, the main branch of the parasympathetic “rest-and-digest” nervous system. Vagus nerve activity counteracts the “fight-or-flight” stress response and helps you feel calm and focused. Vagus nerve stimulation is a promising therapy for many mental health problems and inflammatory conditions (Dinan et al., 2013; Breit et al., 2018).
Lastly, psychobiotics may reduce hypothalamic-pituitary-adrenal (HPA) axis activity. An HPA axis in overdrive makes stress hormones flood the body and exhausts the adrenal glands—a possible root cause of depression and chronic fatigue syndrome (Dinan et al., 2013).
In one of the first studies in this field, a simple probiotic yogurt improved poor mood in volunteers. Further studies tested specific strains—alone or as probiotic mixtures (Benton et al., 2006).
In a study of 38 healthy volunteers, a daily probiotic mixture (containing Lactobacillus fermentum LF16, L. rhamnosus LR06, L. plantarum LP01, and Bifidobacterium longum BL04) taken for 6 weeks reduced depressed mood, anger, and fatigue and improved sleep (Marotta et al., 2019).
In another study, taking probiotics daily (L. helveticus R0052 and B. longum R0175) reduced feelings of distress, depression, anger-hostility, and anxiety and improved problem-solving in healthy volunteers (Messaoudi et al., 2011).
Another probiotic combo (containing B. bifidum, B. lactis, L. acidophilus, L. brevis, L. casei, L. salivarius, and L. lactis) reduced negative thoughts in non-depressed individuals over 4 weeks. Compared to the placebo, participants who received probiotics were less likely to have sad, ruminating, and aggressive thoughts (Steenbergen et al., 2015).
In 40 healthy volunteers, the probiotic B. longum 1714 caused brain activity changes linked with enhanced vitality and reduced mental fatigue. It also changed the brain’s response to social stress, suggesting it might help people better cope emotionally (Wang et al., 2019).
Another probiotic combination (Lactobacillus acidophilus Rosell-52 and Bifidobacterium longum Rosell-175) soothed stress-induced gastrointestinal symptoms. This probiotic mixture is being tested for potential mood benefits in further clinical trials (Diop et al., 2008; Gawlik-Kotelnicka & Strzelecki, 2021; Gawlik-Kotelnicka et al., 2021).
Best probiotics for mood:
An often overlooked contributor to low mood is low vitamin D. Vitamin D deficiency has been linked with depression and seasonal affective disorder (SAD) in dozens of studies. Aside from sunshine and food, the gut microbiome can also affect your vitamin D levels (Menon et al., 2020; Frandsen et al., 2014).
The only probiotic clinically proven to boost vitamin D levels is L. reuteri NCIMB 30242 (Jones et al., 2013).
No probiotic has yet been tested specifically in people with SAD.
Large meta-analyses of clinical studies concluded that probiotics seem to reduce depressive symptoms in patients with major depressive disorder under 60 years old (Huang et al., 2016).
In an analysis of 7 studies, both prebiotics and probiotics showed promise for anxiety and depression in adults. Patients with other health problems that probiotics also help with, like IBS, experienced greater benefits (Noonan et al., 2020).
The most commonly tested strains were Lactobacillus acidophilus (tested in three studies), Lactobacillus casei (tested in two studies), and Bifidobacterium bifidum (tested in two studies).
In 40 patients with depression, a supplement containing these 3 strains over 8 weeks improved depression scores. The potential benefits may extend beyond the brain—supplementation also improved insulin resistance, inflammation (hs-CRP), and antioxidant status (glutathione) (Akkasheh et al., 2016).
Another review came to similar conclusions but included a couple of other strains (Smith et al., 2021).
Probiotics were even tested for improving mood in pregnant and breastfeeding women. Women who took Lactobacillus rhamnosus HN001 daily from pregnancy until 6 months postpartum had less depression and anxiety postpartum (Slykerman et al., 2017).
Best probiotics for depression:
The data on probiotics for anxiety are mixed, but most studies suggest more benefits for mood and stress than for feelings of anxiety.
In an analysis including 335 people, three out of four studies reported improvements in anxiety from probiotics; one study reported improvements only in mood (Vitellio et al., 2020).
In one trial, Lactobacillus plantarum P-8 for 12 weeks reduced stress and anxiety in stressed adults. Supplementation also increased microbial diversity, gut bacteria that produce neurotransmitters, and levels of neuroactive compounds in the gut (short-chain fatty acids, GABA, arachidonic acid, and sphingomyelin)—all of which help combat stress (Ma et al. 2021).
Probiotic Lactobacillus casei strain Shirota (LcS) over 8 weeks reduced salivary cortisol spikes and symptoms of stress in healthy medical students under academic exam stress; it also improved sleep quality (Takada et al., 2016;Takada et al., 2017).
Another probiotic (Lactobacillus helveticus R0052 and Bifidobacterium longum) over 30 days reduced stress and anxiety as well as urinary levels of the stress hormone cortisol in healthy volunteers (Messaoudi et al., 2011).
In other studies, probiotics had no effects on anxiety. One analysis concluded that probiotics seem to be effective at reducing symptoms of depression in both depressed and anxious patients but that they don’t improve anxiety levels (Chao et al., 2022).
Probiotics also hold promise in specific stressful situations like impending surgery or natural disasters.
In one trial, 3 weeks of Clostridium butyricum probiotics reduced anxiety in laryngeal cancer patients anxious about upcoming surgery (Yang et al., 2016).
In another interesting study, B. infantis M-63 improved mental health in victims who developed irritable bowel syndrome (IBS) after a flood disaster (Ma et al., 2019).
Best probiotics for anxiety & stress:
Top clinically researched probiotics for mental health include B. longum, L. acidophilus, L. casei, B. bifidum, and L. plantarum P-8.
Probiotics show promise for reducing stress in healthy people and for improving mood in healthy people and in patients with mood disorders. Probiotics seem to have little or no effect on anxiety symptoms alone.
Although the existing studies are promising, larger trials are needed to determine the benefits of probiotics in people with specific mental health disorders.
Probiotics may also contribute to mental well-being by soothing inflammation and boosting key nutrients in the body. L. reuteri NCIMB 30242 is the only strain clinically proven to increase vitamin D levels in the body.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns and medications before taking any supplements or making drastic changes to your diet and lifestyle.
Buy Heart-healthy L. reuteri Probiotics
Each year, the American Heart Association AHA issues an updated document with the latest statistics on cardiovascular disease, its risk factors, and strategies to achieve cardiovascular health. Among the key strategies is diet (Tsao et al., 2022).
According to AHA, a healthy dietary pattern is made up of five primary metrics (categorized as either beneficial or harmful):
AHA also defines three secondary metrics:
Based on these eight metrics, each person’s dietary score is calculated. When a person hits most of these targets (≥80%), their score will be considered ideal. It’ll be intermediate if they somewhat meet the targets (40% to 79%) and poor if they mostly don’t (<40%).
Now, this score may seem simple enough. It was used in large scientific analyses, but only one study evaluated its effectiveness (Cacau et al., 2022).
So, what is the ideal, heart-healthy diet? And why aren’t national and international guidelines keeping track of the latest research when making recommendations?
Going only by AHA’s heart-healthy diet metrics has several limitations.
Many foods are lumped into the same categories without taking into account their quality and complex nutrient and heavy metal profiles. For example, canned tuna and wild-caught salmon don’t have the same nutrient profile or health effects. Neither does an ultra-processed vegan sausage and a fresh, organic, chickpea salad (Ohlau et al., 2022).
To add, some metrics are not based on good scientific evidence. The two most glaring examples are AHA’s recommendation to limit saturated fats and the FDA’s approval of plant sterols for reducing heart disease risk (Astrup et al., 2021; Helgadottir et al., 2020).
More holistic diet scores take into account the quality of macronutrients, the diversity of micronutrients, and the intake of ultra-processed foods (Cacau et al., 2022; Vanegas et al., 2022).
Scientific data confirms that high fruit and vegetable intake is beneficial for heart health.
The intake of 5 servings of fruit and vegetables per day (versus 2 servings) was recently linked with 13% lower total mortality, 12% lower heart disease mortality, 10% lower cancer mortality, and 35% lower respiratory disease mortality (Tsao et al., 2022).
Studies identified low fruit/vegetable intake as a major modifiable factor associated with heart attacks (Belardo et al., 2022).
Were you ever told to “eat the rainbow” as a kid? There’s valid science to back it up!
The antioxidants and other phytonutrients that are packed into fruits and veggies tend to be vividly colored. Phytonutrients have widespread beneficial health effects. Upping your intake of colorful fruits and veggies ensures good heart health and nutrient diversity. Different-colored plants tend to have phytonutrients that benefit different organ systems (Minich, 2019).
The most beneficial phytonutrients for the heart are typically colored green, for lowering inflammation red, and for the brain and blood circulation blue-purple (Minich, 2019).
Here are some fruits and vegetables to aim for every day (Minich, 2019):
According to a meta-analysis, eating cruciferous and green leafy vegetables almost every day could reduce heart disease risk by ~16% (Pollock, 2016).
Garlic is a curious case. It’s white but contains phytonutrients from all color categories. Many studies back up its benefits for heart health and cholesterol (Minich, 2019; Ried et al., 2013; Varshney & Budoff, 2016).
Greater dietary fiber intake is associated with a lower risk of cardiovascular disease and coronary heart disease. The evidence is aligned with general recommendations to increase fiber intake (Threapleton et al., 2013).
Many fruits, vegetables, and legumes covered in the previous section are also high in fiber.
Plus, fiber acts as a prebiotic, fueling your good gut bacteria. It also helps maintain healthy cholesterol levels and boosts your gut microbiome (Soliman, 2019; Oniszczuk et al., 2021).
Similarly, eating more whole grains reduces the risk of heart disease and other chronic diseases, according to a meta-analysis of 45 studies. Whole grain intake was associated with a reduced risk of coronary heart disease, cardiovascular disease, cancer, and dying from any cause (Aune et al., 2016).
Consider adding the following whole grains to your diet:
Prebiotics and probiotics help keep your gut microbiome healthy. Gut microbiome dysbiosis happens when this balance is disrupted.
Gut dysbiosis can cause many acute or chronic cardiovascular problems. Research unveils that intestinal microbiota imbalances and inflammation play a big role in the development of heart disease (Wu & Chiou, 2021).
Probiotics are found in many healthy fermented foods, such as:
Although increasing the intake of dietary probiotics is beneficial, probiotic effects are strain-specific.
L. reuteri NCIMB 30242 is the best-researched probiotic specifically for heart health and cholesterol. It supports healthy total and LDL cholesterol levels and has been through 7 clinical studies (Jones et al., 2011, Jones et al., 2012; Jones et al., 2013, Jones et al., 2013; Martoni et al., 2015; Jones et al., 2011; Jones et al, 2012).
Buy L. reuteri Probiotics with Prebiotic Fiber
The mainstream recommendations get controversial with dietary fats and dairy.
You probably think you should be eating a low-fat diet and carefully limiting your saturated fat intake to keep your heart healthy, right? And that is what most experts will tell you. Except—the data doesn’t add up.
First off, dietary fat quality is more important than total dietary fat intake (Guasch-Ferré et al., 2015).
Just counting saturated fat fails to see the bigger picture: what’s the overall dietary pattern of this person? Are they getting enough nutrients? What’s their food matrix like? (Astrup et al., 2021).
In a large randomized trial among patients with heart disease risk factors, unrestricted-calorie Mediterranean-style diets supplemented with extra-virgin olive oil or mixed nuts reduced the risk of stroke, heart attack, and death from cardiovascular causes by ~30%, compared to a reduced-fat diet (Estruch et al., 2018)
According to a recent AHA publication, people with higher intakes of total fat, polyunsaturated fatty acids (PUFAs), and monounsaturated fatty acids (MUFAs) had lower total mortality. The data on saturated fats was mixed (Tsao et al., 2022).
Whole-fat dairy, unprocessed meat, and dark chocolate are foods rich in saturated fats with a complex matrix that are not associated with an increased risk of heart disease (Astrup et al., 2020).
Research on full-fat dairy products high in saturated fat, particularly fermented dairy foods, revealed some benefits for cardiometabolic diseases (Dehghan et al., 2018).
Nearly 20 papers recently reviewed the data on saturated fats and cardiovascular outcomes. They concluded that there’s a lack of rigorous evidence to support continued recommendations either to limit saturated fats or to replace them with polyunsaturated fatty acids. Yet, these papers were not considered when making the most recent U.S. Dietary Guidelines for Americans (Astrup et al., 2021).
One study linked the replacement of animal fats, including dairy fat, with vegetable sources of fats and PUFAs with a reduced risk of cardiovascular disease. Other analyses found no link or no beneficial effects of reducing saturated fat intake on heart disease and total mortality, and instead found protective effects against stroke. Several analyses had inconsistent findings (Chen et al., 2016; Astrup et al., 2020; Heileson, 2020).
Saturated fats seem to increase low-density lipoprotein (LDL) cholesterol due to increasing levels of larger LDL particles that are less strongly related to heart disease risk (Astrup et al., 2020).
PUFA-rich vegetable oils, on the other hand, may lower total cholesterol and LDL but at the expense of more reactive LDL. The PUFAs that get incorporated into LDL are more susceptible to lipid peroxidation, which causes atherosclerotic buildup in blood vessels (Lawrence, 2021).
Despite lacking and conflicting evidence, the current guidelines still recommend limiting saturated fats to 10% or less of total energy intake (Astrup et al., 2021).
Our cells need cholesterol to function. US 2020 guidelines now state that healthy dietary patterns are “lower in cholesterol”, but a systematic review by the USDA itself says that there is “insufficient evidence” to link the intake of dietary cholesterol with cholesterol levels in the blood (Astrup et al., 2021).
Also, the all-cause death rate is higher in humans with low compared with normal or moderately elevated serum total cholesterol (Lawrence, 2021).
There are large individual differences in how each person responds to saturated fat, cholesterol, and PUFAs from food. Many of these differences have a genetic basis (Krauss & Etherton, 2020).
Polyunsaturated fats or PUFAs are a great example. PUFAs are found in diverse foods, from nuts and seeds to fish to vegetable oils (including highly processed industrial oils like canola, rapeseed, corn, sunflower, and soybean oil).
Your body uses PUFAs for nerve function, blood clotting, brain health, and more. Beneficial in the right amounts, PUFAs become toxic in excess. They can be oxidized and turned into highly reactive, inflammatory compounds (Lawrence, 2021).
Genetic variations that affect blood cholesterol levels often also affect PUFA metabolism. Some people are prone to PUFAs overload while others are more likely to be deficient. Precision nutrition looks at these genetic differences to help individualize supplements and diet (Chilton et al., 2017; Panda et al., 2022).
Healthy fats include all the following:
It may take experimentation to find out which fats work best for you and your overall health.
Plant sterols are claimed to be “safe” for people with high cholesterol. Many foods are massively fortified with high levels of plant sterols, such as margarine, and spreads. We are consuming more plant sterols than ever before in history!
Contrary to mainstream advice, new research reveals that plant sterols should not be recommended to most people. The potential harms of mass fortification with these compounds are now coming to light (Makhmudova et al., 2021; Helgadottir et al., 2020).
Scientists caution that plant sterols may build up in blood vessels and increase the risk of heart disease (Makhmudova et al., 2021; Helgadottir et al., 2021; Helgadottir et al., 2020).
Read more about the dangers of plant sterols:
The sum of all the minerals that we are taking in through our diet and that build our tissues have recently been termed the mineral matrix.
Nutrients that play vital roles in heart health but are lacking in our diet include magnesium and copper.
Most people know that magnesium is a key nutrient for the heart, with higher levels linked with better heart health. People with higher magnesium intake tend to have a lower risk of metabolic syndrome, diabetes, high blood pressure, and stroke (Rosique-Esteban et al., 2018).
Magnesium deficiency is common—about 10%–30% of the population don’t have enough magnesium in their body for optimal health. Many cases go undiagnosed (DiNicolantonio et al., 2018).
The best dietary sources of magnesium are (Vormann, 2016; NIH):
Copper is the most overlooked nutrient that many people are deficient in.
Our soil has been depleted of copper due to modern, industrialized agriculture. As a result, foods and livestock are also deficient. We are taking in far less copper than our ancestors did (Hill & Shannon, 2019; Wazir & Ghobrial, 2017).
Copper deficiency is, according to some experts, a major cause of coronary heart disease. It increases the risk of high cholesterol, chronic inflammation, high blood sugar, and oxidative stress. Eating ultra-processed foods and not getting enough copper-rich foods predisposes you to copper deficiency (DiNicolantonio et al., 2018).
The best dietary sources of copper are (NIH):
Diet quality is a complex concept, but it comes down to a balance of high-quality macronutrients (carbs, proteins, and fats) and micronutrients (vitamins and minerals). It relies on a variety of bioactive-rich, minimally-processed foods—all listed in the previous section (Vanegas et al., 2022).
In a Mediterranean population of over 18k adults, high-quality macronutrient intake was linked with a lower risk of heart disease (Vanegas et al., 2022).
Regarding energy from carbohydrates, both high and low percentages, have been associated with increased mortality. The lowest risk of mortality was between 50–55% of calories from carbs (Vanegas et al., 2022).
To ensure diet quality, avoid (Vanegas et al., 2022; Cacau et al., 2022):
Ultra-processed foods are industrial formulations made entirely or primarily of substances extracted from foods or lab-synthesized ingredients. High ultra-processed food intake is a measure of poor diet quality, and it’s been linked to heart disease (Cacau et al., 2022).
Learn how to read labels and avoid as many processed foods as possible. Many ultra-processed foods are also endocrine/microbiome disruptors. Remember, it’s not just about your heart but about your overall health and wellness.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
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Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
If you or someone you know well has suffered from eczema, you know you perplexing the search for potential triggers and solutions can be. Eczema affects up to two in 10 children and 1–3% of adults. It’s also known as atopic dermatitis and is classified as a chronic inflammatory skin condition.
Eczema is accompanied by itching, which causes painful skin irritation, soreness, and difficulty sleeping and getting about your day.
So, what can your gut microbiome have to do with it?
Thanks to new research, we now know that the bacteria in your gut can affect anything from your mental health to skin health to immunity. Imbalances in the gut microbiome can have a ripple effect on these systems. When gut health impacts the skin, we’re talking about the gut-skin axis (Hills Jr et al, 2019).
Studies reveal that gastrointestinal disorders are linked with skin diseases. For instance, people with IBD are more likely to also suffer from psoriasis. Meanwhile, many people with eczema have food allergies due to “leaky gut” or permeability of the small intestine (Pessemier et al., 2021; Sodre et al., 2022)
Scientists hypothesize that by nourishing the gut microbiome, the skin microbiome can also be improved.
Patients with eczema have a highly abnormal imbalance of skin bacteria.
The hallmarks are less microbial diversity, fewer beneficial bacteria, and an overgrowth of “bad” bacteria like Staphylococcus aureus. This causes the skin barrier to become “leaky” and vulnerable, triggering inflammation (Hrestak et al, 2022; Sodre et al., 2022).
Bifidobacterium and Lactobacillus probiotics can tighten the junctions between cells, strengthening the skin barrier (Marras et al., 2021).
It’s not just the skin—patients with eczema are prone to gut dysbiosis.
They have more “bad” gut bacteria (like Clostridium and Staphylococcus of the Firmicutes phylum) than healthy people (Sodre et al., 2022).
Eczema patients also lack the “good” gut bacteria that help produce short-chain fatty acids (SCFAs). SCFAs are anti-inflammatory and maintain gut barrier integrity (Kim & Kim, 2019).
Th1, Th2, and Th17 are important arms of the immune system.
Inflammation and increased permeability of the skin barrier in people with eczema are fueled by the Th2 immune response. That’s why new eczema drugs target IL-4 and IL-13, the main cytokines that flood the body when Th2 is overly active. This arm of your immune system is tied to allergies and infections (Sodre et al., 2022; Cukrowska et al., 2021).
Th2 tends to oppose Th1, which is usually seen as beneficial. When people talk about “immune boosting,” they are actually referring to increasing Th1. Yet, Th1 has a dark side—its activation seems to underlie eczema flareups in some cases (Brunner et al., 2018).
Lastly, Th17 gets activated on the skin in other eczema cases. This adds to excessive skin permeability and damage (Wacleche et al., 2017; Sugaya, 2020).
Therefore, the aim is not just to “boost your immune system”—it’s to balance it. Not all eczema patients are the same, so probiotic supplementation should be individualized.
Although all eczema patients would likely benefit from targeting Th2 overactivity, some may also require Th1 and Th17 lowering action. Others may tolerate boosting Th1 (Brunner et al., 2018).
In a recent animal study, a probiotic strain isolated from the feces of healthy Koreans (Lactobacillus paracasei KBL382) improved eczema symptoms by balancing the gut microbiome and lowering Th1, Th2, and Th17 cytokines (Kim et al., 2020).
Another probiotic strain isolated from kimchi (Lactobacillus sakei WIKIM30) lowered Th2 inflammation and balanced the gut microbiome (Kwon et al., 2018).
In contrast, Lactobacillus casei and Lactobacillus paracasei increased the Th1 response in blood cells from children with eczema (Gorska et al., 2016).
Clinical studies need to test how these strains might affect immunity and eczema symptoms to determine the net effect.
Eating more probiotic-rich foods or taking a probiotic supplement may have a positive effect on eczema flares by introducing “good” bacteria (Sodre et al., 2022).
However, it’s not enough to just take any probiotic. When it comes to eczema—strain specificity, timing, and dosage matter a lot.
According to a 2022 meta-analysis of seven human studies, probiotics showed a potential to relieve the symptoms of eczema in adults compared to the placebo. However, their effectiveness varied according to the strain, period, and form of administration (Sodre et al., 2022).
“Most of the studies in this present review described effective and beneficial results with probiotic treatments,” the authors conclude.
The following probiotics were researched in clinical trials of adults with eczema (Sodre et al., 2022, Drago et al., 2011, Drago et al. 2012)
Mixed-strain probiotics best reduced eczema symptoms, followed by single Lactobacillus species. Bifdobacterium species alone seemed to worsen eczema. The added benefits of mixed-strain probiotics may be due to synergistic effects on the gut microbiome and immune system (Jiang et al., 2020).
Despite promising findings, further clinical trials are needed.
To add, low vitamin D levels increase the risk of eczema and make existing eczema more severe; children are at special risk.
The strain L. reuteri NCIMB 30242 has been clinically researched for boosting vitamin D levels. Analyses show that increasing vitamin D levels may help with eczema. Further clinical trials should test this strain in eczema patients with vitamin D deficiency (Hattangdi-Haridas et al., 2019).
Unfortunately, various probiotic products touted for eczema relief on the market lack human studies. Some strains that have not been clinically researched and are backed only by studies in animals or cells include Lactobacillus paracasei LOCK 0919, Lactobacillus casei LOCK 0908, and Lactobacillus casei LOCK 0900 (Gorska et al., 2016).
Most studies on eczema patients suggest that probiotics need to be taken for at least 8 weeks. In some studies, people took probiotics for over 6 months (Jiang et al., 2020).
The following probiotics have shown positive results in clinical trials of children and adolescents with eczema (Jiang et al., 2020; Vicente Navarro-López et al., 2018; Cukrowska et al., 2021):
Recent analyses reveal that probiotics may help prevent or relieve eczema only in children over one year (Jiang et al., 2020).
More research is needed before any of these strains they can be safely recommended.
The majority of research on probiotics for eczema tried to uncover whether supplementation during pregnancy and early infancy may stop the disease from developing in its tracks.
According to a 2020 meta-analysis, probiotics may lower the incidence of eczema in babies only if the mother took them while pregnant. Probiotics can then continue to be given to the baby after birth. Interestingly, only giving probiotics to babies after birth did not prevent eczema (Jiang et al., 2020).
The following probiotic strains have been clinically researched for helping prevent eczema prenatally (Jiang et al., 2020, Dotterud et al., 2010; Tan Lim et al., 2021; Singer et al., 2018):
Due to variable strains, dosages, and populations, additional trials are warranted.
Certain probiotics may help with eczema by rebalancing the gut and skin microbiome.
Some of the more well-known probiotic strains studied in patients with eczema include Lactobacillus rhamnosus, Lactobacillus paracasei, Lactobacillus acidophilus, Bifidobacterium lactis, and Bifidobacterium animalis.
Mixed-strain probiotics seem to have the greatest effect, followed by single Lactobacillus species, while certain Bifidobacterium species alone might worsen eczema.
More studies on specific age groups and eczema types are needed to individualize supplementation and determine the most beneficial strains and dosing regimens.
Consult your care provider if you have a weakened immune system, bowel condition, or other chronic diseases. Be sure to also consult your provider if you are pregnant, breastfeeding, or plan to give your child probiotics.
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
Your gut microbiome—also known as the human intestinal microbiota—is made up of trillions of bacteria and viruses that are considered to be beneficial to health. It plays an essential role in your (Carding et al., 2015):
Read about the science of why microbiome supplements do work here.
Homeostasis is a state of physiological balance that the body normally strives toward. Recent research reveals that the gut microbiome acts as a central hub for maintaining whole-body homeostasis. It works by encrypting messages into genes and immune cells in the gut lining. These signals are forwarded to other organs, like the brain, and then communicated back to the gut microbiome for final analysis (El Aidy et al., 2013).
Your gut microbiome is not inanimate—it’s a live, moving puzzle that adapts to your lifestyle and surroundings every day. It’s like an energy landscape. Both healthy and dysbiotic states can exist in different places. Moving from one state to another requires external energy (Levy et al., 2017).
If you feed your system healthy factors, an energetic shift toward gut microbiome health (symbiosis) starts to happen. If you add unhealthy factors in, disease-forming tendencies (dysbiosis) start grouping together.
Figure taken from Levy, M., Kolodziejczyk, A., Thaiss, C. et al. Dysbiosis and the immune system. Nat Rev Immunol 17, 219–232 (2017). https://doi.org/10.1038/nri.2017.7
What are these gut microbiome health boosters, and why is it so difficult to get enough of them?
The reality is that it’s harder than ever before in human history to maintain gut microbiome homeostasis.
Researchers even warn that we’re going through a global pandemic of gut microbiome disruption (Levy et al., 2017).
Inflammatory and metabolic chronic diseases like diabetes, obesity, allergy and asthma, neurodegeneration, and inflammatory bowel disease (IBD) have been massively on the rise over the past two centuries. We’re also seeing more food intolerances and deficiencies in digestive enzymes. Scientists argue that since this has happened over just a couple of generations, it’s unlikely to be due to genetics alone (Levy et al., 2017).
Instead, the likely culprits are changes in our lifestyle and environment. Our way of life today has become so dramatically different in a tiny period of time on an evolutionary scale that we didn’t get a chance to adapt.
Our modern, sedentary lifestyle involves increased exposure to microbiome disruptors like antibiotics, hormones, various drugs, chemical pollutants, processed food, diets low in fiber and nutrients, ultra-hygienic environments, C-sections, and artificial light and heating/cooling systems (Gagliardi et al., 2018; Rinninela et al., 2019).
Researchers further tested this hypothesis by comparing the microbiomes of tribes and rural populations that live traditionally compared to city dwellers.
European children eating a typical Western diet have fewer beneficial gut bacteria and more harmful species (like Shigella and E. Coli) than rural African Burkina Faso children consuming a diet rich in millet and local vegetables (De Filipo et al., 2010).
Compared to the urban Italian population, Hadza hunter-gatherers of Tanzania have higher microbial richness and an overall completely different gut microbiome profile (abundant Proteobacteria and Spirochaetes, no Actinobacteria) (Schnorr et al., 2014).
Although we know that certain bacteria are more likely to be beneficial than others, there’s no “one-gut-microbiome-fits-all” solution.
“There is not a unique optimal gut microbiota composition since it is different for each individual,” one group of researchers concluded (Rinninela et al., 2019).
It’s all about finding your gut microbiome health and balance. There is no perfect gut microbiome that we should all aim for.
In general, a healthy gut microbiome is rich in different probiotic bacteria, strong and resilient, and quick to return to balance even after being faced with a threat (Levy et al., 2017).
Each person’s gut microbiome is shaped early in life. Being born vaginally, at term, and getting breastmilk for as long as possible help build a strong gut microbiome that we carry into adulthood. Yet, many miss out on this initial physiological gut microbiome boost due to the rise in C-sections and declining rates of breastfeeding around the world (Rinninela et al., 2019).
Luckily, you can still take diet, weight management, exercise, stress reduction, and lifestyle into your own hands in adulthood to help rebuild or boost the gut microbiome of your infancy (Rinninela et al., 2019).
Scientists are struggling to define what makes healthy vs. unhealthy gut microbiome bacteria. There’s no clear reference point.
The range of “normal” and “healthy” is so broad that it may be completely different from one person to the next depending on geographical location, age, and dietary habits (Levy et al., 2017).
According to analysis, each person shares almost 40% of the gut bacteria with at least half of the general population. This makes up the “core microbiome,” leaving room for huge variations in the remaining 60% (Carding et al., 2015).
It’s impossible to even speak about “good” and “bad” gut bacteria because some species could be beneficial or harmful for one person but not for others (Gagliardi et al., 2018).
Gut microbiome testing companies may create their own healthy reference samples. However, this allows for almost any gut microbiome composition that’s a bit different to be classified as “dysbiotic” (Levy et al., 2017).
In short, gut dysbiosis is a stable state of the gut microbiome that contributes to the development, diagnosis, or treatment of a disease (Levy et al., 2017).
It’s a result of weak internal defense along with some outside threat. As mentioned, dysbiosis is often driven by infection and inflammation, diet and chemicals, and genetics (Levy et al., 2017).
Once these threats overcome the body’s resistance and resilience, the microbiome becomes dysbiotic. Gut microbiome bacteria reduce in diversity and proinflammatory species start dominating. Immune function weakens, triggering more inflammation and increasing the production of toxic and carcinogenic metabolites (Gómez de Cedrón et al., 2020).
It’s important to point out that dysbiosis gradually becomes a stable state, it’s not just a temporary imbalance. That’s also why it can’t be treated with just a couple of days of diet and probiotics, without addressing the underlying issue (Gómez de Cedrón et al., 2020).
The symptoms of dysbiosis are diverse and may include but are not limited to the following (Kamyar et al., Chapter 28 - Dysbiosis, The Theory of Endobiogeny, 2020):
Bloom of harmful bacteria refers to an increase in so-called “bad bacteria.” These are bacteria that are thought to have the potential to cause disease under certain conditions and include Enterobacteriaceae such as Salmonella, Shigella, and Escherichia coli (Levy et al., 2017; Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020)
In some cases, this also involves an increase in putrefying/decay bacteria—mainly a group called Bacteroides—and is called putrefactive dysbiosis. Putrefactive dysbiosis has been linked to eating too much meat and unhealthy fats and not enough fiber (Gagliardi et al., 2018).
This is the most common type of gut dysbiosis, and it involves an overall reduction of known beneficial bacterial species.
These include Lactobacilli and/or Bifidobacteria, especially Lactobacillus reuteri and Bacteroides fragilis. It may also include a reduction in butyrate-producing Firmicutes and others (Levy et al., 2017; Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020).
Gut microbiome dysbiosis almost always involves a reduction in the diversity of gut bacteria—-also called microbial richness (Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020).
A perfect analogy of loss of gut microbiome diversity is to imagine land treated with pesticides and chemicals, compared to land for organic farming or permaculture. Few vegetables and fruits can grow on chemically treated and impoverished land, while you can grow almost any combination of plants on healthy and naturally enriched soil. Our gut works in the same way.
SIBO or small intestinal bacterial overgrowth is a specific type of gut microbiome dysbiosis. The small intestine normally contains very few bacteria. The bacterial overgrowth in SIBO is thought to be due to reduced gastric acid production with an excess of bacterial fermentative activity (Gagliardi et al., 2018).
SIBO is often tricky to diagnose and causes inflammation, gut damage, nutrient deficiency, and various non-specific gut symptoms (Sorathia et al., 2021).
Fungal dysbiosis is when gut microbiome imbalances lead to yeast overgrowth. The most common type is candida overgrowth. The main triggers are a diet rich in sugar and low in fiber, as well as frequent antibiotic use (Gagliardi et al., 2018)
Gut dysbiosis has been associated with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), celiac disease, allergy, asthma, metabolic syndrome, cardiovascular disease, obesity, mood disorders, neurodegenerative disorders, cancer, and others (Carding et al., 2015; Belizário & Faintuch, 2018).
There’s no clear gut microbiome profile for any of the mentioned diseases. However, if you did microbiome testing and are curious to discuss your results and the research with your care provider, or if you’re taking a professional probiotic strain, you may find the findings outlined here relevant.
In experimental studies, the following gut microbiome profiles and diseases have been linked (Gevers et al., 2014; Rinninela et al., 2019; Levy et al., 2017; Nikolova et al., 2021):
More research is needed.
Probiotics of the Lactobacillus and Bifidobacterium species support a healthy gut microbiome. They can be used both to prevent the onset of dysbiosis in people who are exposed to triggers (prolonged antibiotic therapies, intense physical or mental stress, chronic debilitating diseases, etc.) and as part of integrative therapy to rebalance ongoing dysbiosis (Gagliardi et al., 2018).
All Lactobacilli produce lactic acid and are high in many traditionally consumed fermented foods. Lactobacillus probiotics seem to support a healthy immune system and gut and vaginal microbiome (Tannock, 2004; Mu et al., 2018).
L. reuteri (Lactobacillus reuteri) NCIMB 30242 is a unique probiotic strain in Microbiome Plus+ supplements. It has been through rigorous clinical trials published in 7 peer-reviewed scientific papers (Jones et al., 2011, Jones et al., 2012; Jones et al., 2013, Jones et al., 2013; Martoni et al., 2015; Jones et al., 2011; Jones et al, 2012). L. reuteri NCIMB 30242 may help with IBD by nourishing the gut microbiome, balancing levels of intestinal bile acids, and increasing the Firmicutes / Bacteroidetes ratio. It also supports immune function, healthy vitamin D levels, normal total and LDL cholesterol levels, and balanced plant sterol levels.
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
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Microbiome supplements are any supplements that have a potentially beneficial effect on the microbiome.
Most microbiome supplements are live probiotic bacteria or yeast. However, a broader definition of microbiome supplements also includes prebiotics, postbiotics, digestive enzymes, nutrients, and certain herbs, spices, and medicinal mushrooms that also boost microbiome health.
We don’t have only one microbiome, our whole body is made up of interconnected microbiomes—in our gut, on our skin, in our urogenital and reproductive organs, in breastmilk—that live in harmony with our cells.
Our whole-body microbiome grows with us from birth and our habits and genes continue to shape it throughout life (Rinninela et al., 2019).
The belief that our internal organs are “sterile” has long been debunked in science. In fact, living in ultra-sterile environments has a proven negative effect on our microbiome and increases the risk of chronic allergic and inflammatory disease (Levy et al., 2017; Gagliardi et al., 2018; Rinninela et al., 2019).
Out of all microbiomes in our body, the gut microbiome is the best researched. In this post, we’ll specifically focus on supplements that work on the gut microbiome.
The gut microbiome—also known as the human intestinal microbiota—is made up of trillions of bacteria and viruses that are considered to be beneficial to health. It plays an essential role in digestion, nutrient status, immunity, heart health, brain function, and overall well-being (Carding et al., 2015):
Probiotics are living beings, and they are extremely diverse. To date, there are more than 500 different kinds of probiotic species. Yet, not all are equally effective. This can create confusion when discussing their health benefits and effects on the microbiome.
To stay clear and evidence-based, any mention of the benefits of a probiotic needs to be specific. It should mention the probiotic genus, species, and strain. Many probiotic mechanisms of action are strain-specific and result in different health benefits (McFarland et al., 2018).
In line with this, clinical studies on our strain, Lactobacillus reuteri NCIMB 30242/LRC, apply only to it and not to other similar probiotics.
In one experiment, researchers screened over 127 different Lactobacillus strains and found only 3% had probiotic potential! (Domig et al., 2014).
In certain cases, studies don’t mention which strain they used, so we have to report on a probiotic species in general. This isn’t surprising as it wasn’t until 2010 that scientists realized that most probiotic benefits are strain-specific! (McFarland et al., 2018).
On the other hand, some health benefits may apply to the whole probiotic species (Lactobacillus reuteri/Limosilactobacillus reuteri) and genus (Lactobacilli).
For example, all lactobacilli produce lactic acid and are high in many traditionally consumed fermented foods. All lactobacillus probiotics seem to support a healthy immune system and gut and vaginal microbiome (Tannock, 2004; Mu et al., 2018).
Poor microbial richness—also called microbial diversity—is a common type of gut dysbiosis. It can be caused by antibiotics, toxins, bowel preparation, diet, and other lifestyle factors (Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020).
Microbial diversity can take weeks to months to recover. Probiotic and prebiotic microbiome supplements are a promising way to facilitate this process (Grazul et al., 2016).
In one recent clinical study, the probiotic Bifidobacterium Tetragenous restored normal microbial richness in people undergoing bowel preparation for colonoscopy (Grazul et al., 2016).
Olive oil and medicinal mushrooms also help boost microbial richness. Extra virgin olive oil is a nutritious fat that promotes intestinal health and increases the diversity of the gut microbiome (Marcelino et al., 2019).
Edible medicinal mushrooms help balance and enrich the gut microbiome. Mushrooms act as prebiotics and are rich in immune-boosting active compounds. Sources include lion’s mane, reishi, shiitake, maitake, turkey tail, and others (Jayachandran et al., 2017; Diling et al., 2017).
The most common type of gut dysbiosis involves an overall reduction of known beneficial bacterial species like Lactobacilli and/or Bifidobacteria, especially Lactobacillus reuteri and Bacteroides fragilis. It may also include a reduction in butyrate-producing Firmicutes and other anti-inflammatory species (Levy et al., 2017; Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020).
As live “good” bacteria, probiotics should ideally travel to your colon and integrate into your gut microbiome. However, some probiotics don’t stick around but are forced to pass through—this is called colonization resistance.
Colonization resistance is when bacteria indigenous to your colon reject the new probiotic strain. It’s a big and common problem, and if it happens, the supplemented probiotic is removed with the stool without achieving its benefits (Yao et al., 2020; Zmora et al., 2018).
Preliminary studies suggest that polyunsaturated fatty acids (PUFA) and omega-3 fatty acids may help overcome colonization resistance. They help probiotics “stick” to the gut lining. Sources include wild-caught fish walnuts, sunflower seeds, and flaxseeds (Bomba et el., 2002; Bomba et al., 2003; Han et al., 2021).
Probiotic and prebiotic microbiome supplements work to rebuild the gut microbiome, which involves getting rid of unwanted bacteria.
Probiotics help suppress possibly harmful bacteria such as Enterobacteriaceae (Shigella and Escherichia). These bacteria are present in gut dysbiosis and may cause disease given the right conditions (Grazul et al., 2016; Levy et al., 2017; Humphreys et al., 19 - Intestinal Permeability, Textbook of Natural Medicine, 2020).
Prebiotic fiber is equally important. Gut dysbiosis often also involves an increase in putrefying/decay bacteria called Bacteroides. Putrefactive dysbiosis is usually a result of eating too much meat and unhealthy fats and not enough fiber (Gagliardi et al., 2018).
Curcumin—the main active ingredient in the spice turmeric—is another great microbiome supplement. Aside from being one of the best-researched natural anti-inflammatories, curcumin helps restore gut microbiome balance. Curcumin boosts the growth of beneficial probiotics while reducing the number of pathogenic gut bacteria. Plus, it helps strengthen the gut barrier, which might be helpful for people with leaky gut (Scazzocchio et al., 2020; Di Meo et al., 2019).
Chronic inflammation is a possible underlying factor in many common diseases, including heart disease, stroke, IBD, IBS, diabetes, mood disorders, anxiety, cancer, kidney disease, non-alcoholic fatty liver disease (NAFLD), and autoimmune and neurodegenerative conditions (Furman et al., 2019).
Many probiotics have been researched for their potential to reduce inflammation, but few quality clinical trials are available. Prebiotic and herbal microbiome supplements may also help lower chronic inflammation in the body, but more research is needed.
Here, we’ll focus on clinical studies that investigated the effects of probiotics on inflammatory markers, IBD, or IBS.
In one clinical trial of 127 people, Lactobacillus reuteri NCIMB 30242 lowered C-reactive protein (CRP) and fibrinogen compared to placebo. CRP is a marker of inflammation and heart disease severity, while fibrinogen may point to excessive blood clotting and atherosclerosis. Supplementation also reduced the heart disease risk categories in 27% of people with normal or high CRP (Jones et al., 2012).
Lactobacillus reuteri also improved oral health and soothed gum inflammation in a clinical trial of 38 adult patients. It worked by lowering several pro-inflammatory cytokines (Szkaradkiewicz et al., 2014).
An analysis of 21 IBS clinical trials concluded that the probiotic strains B. infantis 35624, and L. plantarum 299v may help. Another analysis of 13 IBD trials found evidence for VSL#3 mixture and S. boulardii I-745 (McFarland et al., 2018; McFarland et al., 2018).
L. reuteri NCIMB 30242 may also hold potential for IBD. This strain increased free bile acids, total bile acids, and the ratio of Firmicutes to Bacteroidetes gut bacteria in 10 healthy people over 4 weeks. People with IBD often have a decreased Firmicutes to Bacteroidetes ratio, according to research (Martoni et al., 2015; Stojanov et al., 2020).
Most of your immune system is in your gut! Research confirms that probiotics stimulate the immune system and help maintain the normal activity of immune cells that fight off foreign invaders (Galdeano et al., 2019).
Certain probiotics may help the immune system fight off Candida, H. pylori, and viruses and bacteria that cause the common cold and flu (Yoo & Kim, 2016).
Additionally, probiotics may also help prevent immune system overactivity that can cause allergies, autoimmune problems, and food sensitivities. By reducing gut dysbiosis and intestinal leakage, probiotic supplementation may stop undigested food components from entering the blood and sending the immune system into overdrive (Galdeano et al., 2019).
Microbiome supplements like probiotics, prebiotics, and digestive enzymes support healthy levels of nutrients like vitamin D, vitamin B12, and folate.
Vitamin D deficiency is a global public health issue that has even been recognized as a pandemic. About 1 billion people or 50% of the worldwide population have vitamin D deficiency (Sizar et al., 2021).
The 25-hydroxy vitamin D test is the best way to monitor vitamin D levels. Low levels have been associated with osteoporosis, cardiovascular disease, diabetes, autoimmune disease, infectious diseases, and cancer (Holick & Chen, 2008).
Lactobacillus reuteri NCIMB 30242 increased blood levels of 25-hydroxyvitamin D by 25.5% in a study of 123 people, compared to the placebo. This was the first study to report that an oral probiotic can improve vitamin D status (Jones et al., 2013)
Several Lactobacillus species, including L. reuteri strains, are also able to produce different types of vitamins, including vitamin B12 (cobalamin) and B9 (folate). Among these strains, L. reuteri CRL1098 (isolated from sourdough) and L. reuteri JCM1112 are the most studied (Mu et al., 2018).
Additionally, digestive enzyme supplements help improve nutrient status in people with low enzyme levels. Digestive enzymes break down fats, proteins, and carbs into nutrients your body can absorb—affecting the levels of all essential nutrients in your body (Ianiro et al., 2016).
Most digestive enzymes are normally made in the pancreas. Various metabolic and inflammatory diseases, as well as genetic factors, may reduce your digestive enzyme levels (Ianiro et al., 2016).
One in three deaths in the U.S. is due to heart disease. High LDL or “bad” cholesterol can clog blood vessels and lead to atherosclerosis and heart disease—but so can plant sterols! (Gibbing et al., 2019).
You may think that margarine with plant sterols is good for you, but scientists have been warning against the mass fortification of foods with plant sterols since the 2000s. Recent research cautions that plant sterols may also build up in blood vessels, cause damage, and directly increase the risk of atherosclerosis (Makhmudova et al., 2021; Helgadottir et al., 2021; Helgadottir et al., 2020).
Therefore, the ideal microbiome supplement should aim to reduce both high cholesterol and high plant sterol levels. L. reuteri NCIMB 30242 is the only probiotic strain researched for maintaining normal levels of both cholesterol and plant sterols.
L. reuteri NCIMB 30242 is armed with an enzyme called bile salt hydrolase (BSH), which releases free bile acids from their bound or conjugated form. In the gut, free bile acids bind to cholesterol and plant sterols and reduce their absorption (Jones et al., 2012).
As a result, the liver produces more bile acids and breaks down more cholesterol. Meanwhile, the body increases the production of mucin, an anti-inflammatory gel that coats and protects the gut lining (Shirazi et al., 2000).
Lactobacillus reuteri and Lactobacillus plantarum seem to significantly reduce both total and LDL cholesterol, based on a focused analysis of 15 trials of Lactobacilli strains including close to 1k participants (Wu et al., 2017).
Lactobacillus reuteri NCIMB 30242 may also support blood sterol levels already in the normal range. In the clinical trial of 127 people, this strain decreased levels of several plant sterols in the blood (campesterol by 41.5%, sitosterol by 34.2%, and stigmasterol by 40.7%) (Jones et al., 2012).
Out of various Lactobacillus reuteri strains, only Lactobacillus reuteri NCIMB 30242 has been clinically researched for supporting markers of heart health.
One scientific review concluded that L. reuteri NCIMB 30242 best meets the requirements of a heart-healthy probiotic since it reduces cholesterol, improves inflammatory markers, and has "generally recognized as safe" (GRAS) status (DiRienzo, 2014).
In one study, Lactobacillus reuteri NCIMB 30242 yogurt taken twice a day for 6 weeks reduced LDL by ~9%, total cholesterol by ~5%, and non-HDL cholesterol by 6% compared to placebo in 114 adults with high cholesterol (Jones et al., 2012).
In another study, L. reuteri NCIMB 30242 capsules reduced LDL cholesterol by ~11.6%, total cholesterol by ~9%, and non-HDL cholesterol by ~11% compared to placebo in 127 people over 9 weeks. Supplementation also improved two other markers of heart health: the LDL-C/HDL-C ratio (by ~13%) and ApoB-100 (by ~8%) (Jones et al., 2012).
Other probiotic strains that may also support heart health include (Fuentes et al., 2013; Bernini et al., 2018; Costabile et al., 2017; Khare & Gaur, 2020)
More clinical research on the efficacy and safety of each of these strains is needed before they can be recommended to heart disease patients.
Probiotics contribute to good metabolic health, while gut microbiome dysbiosis and disruption have been linked with obesity and diabetes. Many metabolic diseases that are on the rise are thought to be a result of an impoverished gut microbiome and hormonal imbalances due to the growing number of chemicals in the environment (Aguilera et al., 2020).
Our modern, sedentary lifestyle involves increased exposure to microbiome disruptors like antibiotics, hormones, various drugs, chemical pollutants, electronic waste, processed food, alcohol, and diets low in fiber and nutrients (Gagliardi et al., 2018; Rinninela et al., 2019).
In one placebo-controlled clinical trial, taking L. reuteri JBD301 for 12 weeks significantly reduced body weight in overweight adults (Mu et al., 2018).
According to one analysis of 11 clinical trials, probiotic supplements may help maintain healthy sugar levels in people with diabetes. More research is needed, though (Sun et Bays, 2016).
Microbiome disruptors are also endocrine disruptors. They can trigger hormonal imbalances that may affect sex hormones, thyroid hormones, and other hormones in the body (Velmurugan et al., 2017).
Research suggests that probiotic microbiome supplements may help the body better detoxify endocrine-disrupting chemicals and become more resilient to them (Sevim & Kara, 2021).
A healthier gut microbiome may be more efficient at deactivating and flushing chemicals from the body. It also helps keep the gut lining strong, preventing any chemical “leaks” into the blood. Plus, a balanced gut microbiome means efficient digestion, which reduces the amount of time these toxic chemicals spend in the intestines (Snedeker & Hay, 2012).
In turn, microbiome supplements may help prevent endocrine disruption or contribute to re-establishing hormonal balance in the body.
Studies on aging mice also reveal that Lactobacillus reuteri ATCC 6475 may boost testosterone levels and restore normal testicle size. It’s hypothesized to help with male-pattern baldness and libido, but clinical trials are lacking (Levkovich et al., 2013)
Limited research suggests that probiotics and prebiotics can improve psychological well-being and cognition, but more clinical studies are needed (Ansari et al., 2020).
Probiotics and prebiotics are being researched for their potential to help with mental health disorders like anxiety, schizophrenia, depression, and autism. Scientists have even coined the term “psychobiotic” to describe their effects (Ansari et al., 2020).
Animal studies suggest that Lactobacillus reuteri probiotics may increase sociability by boosting oxytocin (the “love hormone”) in the hypothalamus. Human studies are lacking to confirm this, though (Buffington et al., 2016).
According to another animal experiment, Lactobacillus reuteri may also speed up wound healing by supporting natural oxytocin production via stimulating the vagus nerve (Poutahidis et al., 2013).
Limited research also points to the potential role of probiotic supplements in neurodegenerative diseases like Alzheimer’s. According to one theory, gut dysbiosis in the elderly can cause leaky gut, which may result in silent systemic inflammation and promote neuroinflammation that’s common in early Alzheimer’s disease (Leblhuber et al., 2018).
Lastly, probiotics are being used as an alternative and complementary therapy in children with autism, but more clinical research is needed to establish their safety and effectiveness. The results so far have been inconclusive (Sivamaruthi et al., 2020).
You don’t need to supplement your microbiome, but research strongly suggests that you may well benefit from it.
Microbiome supplements are a broad category that includes any natural compound that may beneficially affect your microbiome.
The best-researched microbiome supplements are probiotics. Microbiome supplements can also be prebiotics, postbiotics, nutrients, digestive enzymes, and even foods like olive oil, turmeric, and medicinal mushrooms.
The health benefits of probiotics are often strain-specific. Certain probiotic strains may help you achieve specific health goals, like supporting heart health, immune function, normal vitamin D levels, or mental health.
Microbiome Plus+ L. Reuteri NCIMB 30242 has been through several clinical trials for supporting already normal LDL cholesterol, total cholesterol, C-reactive protein, vitamin D, and fibrinogen levels—factors that promote cardiovascular and immune health. It also supports healthy gut microbiome diversity.
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Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Please consult your doctor before taking supplements to avoid any potential disease and drug interactions.
Foods that actively lower cholesterol work together. If you eat enough of the foods from this list, you’ll be targeting several cholesterol-lowering mechanisms at once!
High cholesterol levels can increase the risk of heart disease, the number one cause of death worldwide. According to estimates, the number of people with heart disease is constantly on the rise (Mannu et al., 2013).
Yet, studies suggest that most people can reduce their cholesterol levels and heart disease risk with simple dietary and lifestyle changes (Rensburg, 2018).
Aside from regular exercise and losing extra pounds, diet is the single most important factor that can help you get your cholesterol levels under control naturally (Mannu et al., 2013).
Various foods have been researched for their cholesterol-lowering effects, but they’re not all equal. In this article, we’ll focus on foods that help you actively lower your LDL or “bad” cholesterol.
So, what exactly does that mean? Let’s break down the terminology.
The standard definition of high cholesterol means that your total cholesterol is above the normal range. But that doesn’t mean much. Both excessively high and low total cholesterol increases your heart disease risk. You need to look at the type of cholesterol that’s high (Peters et al., 2016).
The most dangerous type of cholesterol is LDL cholesterol. LDL stands for low-density lipoprotein. LDL cholesterol can stick to blood vessels, team up with free radicals, and directly cause inflammation. High LDL levels directly increase your risk of heart disease and stroke (Abdullah et al., 2018).
HDL (stands for high-density lipoprotein) is the “good” cholesterol. HDL can protect your heart and blood vessels, so you want to have higher-normal levels of this type of cholesterol (Cooney et al., 2008).
The ideal diet should focus on foods that can lower your LDL cholesterol, keep your HDL cholesterol high enough, and maintain your total cholesterol levels in the optimal range.
In a nutshell, your cholesterol levels could be high because you’re either absorbing too much of it from food or your body is producing excessive amounts. Whether you’re a cholesterol “hyperabsorber” or a “hyperproducer” is affected by your genetics, diet, lifestyle, age, and other factors (Lütjohann et al., 2019).
There’s a big difference between foods that actively lower your cholesterol and those that have a passive effect.
Only following a low-cholesterol diet like the American Heart Association Step 2 diet is passive. Your cholesterol levels may drop because less cholesterol is entering your body. But, you’re not doing anything to address the potential reason why your cholesterol is high (Janapala & Reddivari, 2021).
Also, be wary of foods with “low-cholesterol” labels. Many have high levels of saturated fat or trans fat, the worst type of fat for your heart and overall health.
On the other hand, foods that block cholesterol absorption like fiber are active. So are foods that help reduce the amount of cholesterol your liver will produce, such as certain probiotics and veggies. Probiotic foods may also help your body get better at burning cholesterol and producing beneficial short-chain fatty acids (Gunness & Gidley, 2010; Kumar et al., 2012).
The best researched fiber-rich foods include:
Barley and oats have been individually found to be likely effective at reducing cholesterol in human studies. Barley helped whether it was used as a whole grain, oil, or concentrated fiber. A diet high in oats reduced high LDL cholesterol in several studies (Shimizu et al., 2008; Lupton et al. 1994; Behall et al., 2004; Braaten et al., 1994; Ripsin et al.,1992;
Both barley and oats are high in beta-glucans, immune-supportive prebiotic fiber—the key active ingredient in these grains (Shimizu et al., 2008; Braaten et al., 1994).
Rice bran oil also lowered LDL cholesterol while maintaining normal HDL levels in healthy people with slightly increased cholesterol (Most et al., 2015).
In other human studies, soluble fiber reduced LDL cholesterol by 4 to 18%. Pectin and psyllium are concentrated sources of soluble fiber (Wood et al., 2007; Bell et al., 2009; Wei et al., 2009).
Many other foods we cover in the next section—like nuts, legumes, fruits, and mushrooms—are also high in prebiotic fiber. Fruits and vegetables are especially high in soluble fiber.
Nuts that may help lower cholesterol levels include:
Nuts are rich in healthy fats, prebiotic fiber, protein, and many other nutrients that support good health.
It’s a good idea to aim for 2 to 3 servings of nuts per day. This amount decreased LDL by about 10.2 mg/dL, based on a scientific analysis of an impressive 25 human trials spanning 7 countries (Sabaté & Ros, 2010).
Nuts like walnuts and macadamia nuts boast high levels of healthy fatty acids. Adding walnuts to a typical low-fat diet seems to lower total cholesterol by up to 12% and LDL cholesterol by up to 16%, according to small clinical trials (Zambon et al., 2000; Chisholm et al., 1998).
A macadamia nut-rich diet also lowered total and LDL cholesterol in one trial of 25 people, compared to the average American diet (Sabaté et al., 1993).
Legumes like beans, chickpeas, lentils, and soy are exceptionally high in plant protein and prebiotic fiber. Increasing them in your diet may have many health benefits, as long as you are buying organic (Vendômois et al., 2010).
Eating half a cup of legumes per day may reduce LDL cholesterol by an average of 6.6 mg/dL, based on a meta-analysis of 26 clinical trials (Ha et al., 2014).
An ounce of soy per day slightly lowered LDL in another meta-analysis of almost 3k participants. It had a stronger effect in people with already high cholesterol levels (Tokede et al., 2015).
There are some potential cons to regular soy consumption to have in mind, though.
Limited research suggests that soy may be an endocrine disruptor, particularly in children (Patisaul, 2018).
Does this apply to organic soy? Possibly not.
Most soy nowadays is mass-produced using GMO crops that are treated with pesticides. One animal study reveals that the more processed soy is, the more likely it is to stimulate the growth of breast cancer tumors (Helferich et al., 2008).
Flaxseed is another well-researched heart-healthy food. It’s rich in omega-3 fatty acids, prebiotic lignans, and fiber.
Research reveals that eating 2 tablespoons of flaxseed (30g) per day may lower total cholesterol by about 7% and LDL cholesterol by 10% in postmenopausal women (Patade et al., 2008).
The same amount of milled flaxseed lowered cholesterol in another study in patients with peripheral artery disease. Peripheral artery disease is when blood vessels in the legs or lower extremities become narrowed, usually due to high cholesterol and atherosclerosis (Edel et al., 2015).
Healthy fats that may help lower cholesterol include:
Olive oil and nut and seed oils are high in beneficial monounsaturated fatty acids (MUFAs). Olive oil is also anti-inflammatory, so it’s the perfect choice for anyone looking to support cardiovascular health.
Several human studies suggest that consuming 2-10 tsp of extra virgin olive oil per day may help reduce LDL cholesterol (Violi et al., 2015; Khaw et al., 2018).
In other studies, following a diet high in olive oil, peanut oil, or peanuts and peanut butter lowered LDL by 14% on average, when compared to diets high in saturated fat (Kris-Etherton et al., 1999; Gill et al., 2003).
Black cumin oil is another anti-inflammatory, heart-protective oil. According to analyses in people with diabetes and high cholesterol, black cumin seems to lower LDL by an average of 22 mg/dL (Daryabeygi-Khotbehsara et al., 2017).
Avocados are packed with healthy fats (MUFAs), antioxidants, and prebiotic fiber (Thompson et al., 2021).
An avocado-rich diet—eating one avocado per day—lowered high total cholesterol by about 17% and LDL cholesterol by 22% in human studies. It seems to be especially beneficial in people with mildly elevated cholesterol who also have high triglycerides (Ledesma et al., 1996; Wang et al., 2020).
According to large scientific analyses, Lactobacillus probiotics may reduce LDL in healthy participants, smokers, and those with high cholesterol, diabetes, and obesity (Shimizu et al., 2015; Wu et al., 2017).
You can get your daily dose of Lactobacillus probiotics from food or supplements.
Beneficial sources include:
Like oats, mushrooms and algae contain prebiotic beta-glucans—a type of soluble fiber that boosts gut health and immunity (Akramiene et al., 2007).
Beta-glucans from medicinal mushrooms can increase your beneficial gut bacteria (Lactobacilli and Bifidobacteria) and anti-inflammatory small-chain fatty acids (SCFAs) (Cerleti et al., 2021).
According to meta-analyses, getting 3 g/day of beta-glucans reduces LDL by 8 mg/dL in people with high cholesterol (Zhu et al., 2015).
Research also suggests that spirulina, a type of blue-green algae, may reduce LDL cholesterol by up to 41 mg/dL (Serban et al., 2016).
Green tea is a powerhouse of antioxidants. Drinking green tea reduced LDL in studies of overweight or obese participants and in people at high risk of heart disease (Yuan et al., 2018; Kim et al., 2011; Zhao et al., 2015).
Eating garlic every day for at least 2 months lowers LDL cholesterol, according to findings from 39 studies that included over 2k people with high cholesterol. Studies used up to 5.6 g/day of garlic powder, 1-7 g/day of garlic extract, or 4-10 g/day of raw garlic (Ried et al., 2013).
Lastly, be sure to include enough fruits and cruciferous veggies in your diet!
These foods are rich in diverse antioxidants that help balance cholesterol, heart health, and overall wellness.
In clinical studies, drinking a small glass of juice with broccoli, cabbage, and fruit twice daily for 12 weeks reduced LDL cholesterol by 8.5% (Takai et al., 2013).
Meanwhile, berries are a concentrated source of anthocyanins, potent antioxidants that are being studied for improving LDL cholesterol, heart disease, and metabolic syndrome (Aboonabi et al., 2020).
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
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Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns and medications before taking any supplements.
Phytosterols or plant sterols are the cholesterol of the plant kingdom. Whereas cholesterol is only found in animal foods, plant sterols are found in everything else—plants, mushrooms, algae, and even seafood.
What most people know about plant sterols is an example of science and professional guidelines gone bad.
These experimental plant fats are often recommended as a “safe” health supplement or fortified food ingredient to people with high cholesterol. Yet, most international guidelines on plant sterols were put in place without valid scientific evidence.
For example, the FDA allows health claims that foods with added plant sterol/stanol esters may reduce the risk of coronary heart disease and lower blood total and LDL cholesterol levels.
Meanwhile, research published in 2020 warns that plant sterols seem to do more harm than good (Makhmudova et al., 2021; Helgadottir et al., 2020).
Does this come as a surprise? Well, once you realize that doctors learn nothing about plant sterols in med school—not so much.
Skeptical? Check out this podcast and this youtube video where the greatest experts on plant sterols in the world admit just that and caution about the dangers of mass food fortification with plant sterols.
If the leading doctors in the field are struggling, how on earth is the average person expected to keep up with the research?
Don’t worry, we’ve got you covered! This article sums up dozens of the latest scientific studies to help you understand what a handful of plant sterols experts have been passionately discussing behind the scenes.
If you’re an impatient reader, here’s the bottom line: avoid supplements and foods with added plant sterols altogether, eat a healthy and balanced wholesome diet, and consider adding a probiotic like L. Reuteri NCIMB 30242 to your daily regimen.
Unlike cholesterol, we don’t produce plant sterols—we only get them through diet. That’s why phytosterols are also called xenosterols, meaning foreign sterols (xenos—stranger). We’re exposed to over 50 types of plant sterols in our diet. Plant sterols are found in most plant foods (like fruits, vegetables, nuts, and seeds), mushrooms, algae, and seafood.
Here’s the catch: natural, whole foods contain relatively small quantities of plants that most humans can process without issues. Since plant sterols don’t play a role in our body, our physiology is adapted to getting rid of them as efficiently as possible (Makhmudova et al., 2021).
Of the phytosterols we eat, we only absorb about 5% or so in the gut. Our liver then gets rid of most of the absorbed plant sterols. As a net result, we retain less than 0.5% of the total plant sterols we take in through food (Weingärtner et al., 2015).
Phytosterols compete with cholesterol for absorption. Theoretically, the more plant sterols we eat, the less cholesterol we will absorb. Since high cholesterol is known to be a risk factor for heart disease, anything that may help reduce cholesterol levels in the whole population is usually seen as beneficial.
This led to the massive fortification of foods with plant sterols since the 2000s. A bunch of foods like margarine, dairy, juice, spreads, salad dressing, soy, and others now have extremely high amounts of added plant sterols.
In addition, vegetable oils contain high levels of plant sterols and they’re used in many processed foods. These include refined corn, sunflower, soybean, and palm oil (Klingberg et al., 2008; Yang et al., 2019).
Humans are now eating more plant sterols than ever before!
Foods fortified with plant sterols are marketed as “heart-healthy.” They were supposed to reduce your cholesterol blood levels and, subsequently, your risk of having a heart attack. However, no proper human studies support these claims. No studies have explored the long-term safety of mass fortification with plant sterols either.
In one double-blind, randomized, placebo-controlled study on healthy volunteers, eating margarine with plant sterols didn’t affect cholesterol blood levels. It only increased plant sterol blood levels and markers of cholesterol production in the body (Weingärtner et al., 2017).
Recent research cautions that plant sterols may build up in blood vessels, cause damage, and directly increase the risk of atherosclerosis (Makhmudova et al., 2021; Helgadottir et al., 2021; Helgadottir et al., 2020).
The following side effects have been reported or are theoretically possible with plant sterol supplements and fortified foods:
A 2020 Icelandic study on a huge sample finally showed that fortifying foods with phytosterols wasn't a good idea. Experts describe it as a game-changer. Dietary phytosterols intake was clearly linked with heart disease for the first time—something a handful of scientists have been warning about for a while (Helgadottir et al., 2020).
"Our results indicate that both dietary cholesterol and phytosterols contribute directly to atherogenesis," the authors of the Icelandic study conclude.
This study compared genetic variants that affect both cholesterol and phytosterols to variants that affect cholesterol only. Higher phytosterol absorption directly increased the risk of coronary artery disease in people who are high cholesterol absorbers, which is about a fourth of the population (Helgadottir et al., 2021).
The genetic variant that the study focused on is called ABCG5/8—G5/8 for short. G5/8 is a pump in the gut lining and liver that prevents both plant and cholesterol sterols from building up in the body. It kicks out 45% of the cholesterol and 95% plant sterols from food back into the gut.
If your G5/8 pump is “broken,” more dietary cholesterol and phytosterols enter your body. In turn, you’ll have higher LDL and greater heart attack risk.
There was a 40% increased risk from G5/8 phytosterol variants compared to variants that affect cholesterol only! Meaning, the extra 40% risk is just from sluggish plant sterol trafficking in the body.
Since every fourth person has a sluggish G5/8 variant, it’s safe to caution everyone against foods with added plant sterols.
These are the same genes that don’t work at all in people with sitosterolemia, a rare genetic disorder that causes massive plant sterols buildup in the body and various health issues.
Aside from genetics, aging increases the chances of the G5/8 pump becoming more leaky to cholesterol and plant sterols.
In a small German study in older patients undergoing cardiac catheterization (heart cath), poor cholesterol production was linked with an increased risk of heart complications and death. Low cholesterol producers tend to be high cholesterol and plant sterols absorbers (Weingärtner et al., 2019).
In earlier studies on mice prone to atherosclerosis (APOE- mice), supplementation did reduce blood cholesterol levels but increased phytosterol levels. Increased phytosterols in the blood were associated with damage to the blood vessels and fatty deposits in the brains of the animals (Weingärtner et al., 2011).
To sum it up, the latest research suggests plant sterols may clog arteries, increase the risk of atherosclerosis, and contribute to heart disease.
In one Japanese study, high plant sterol levels could predict heart disease complications in patients with acute coronary syndrome and high cholesterol (Yamaguchi et al., 2018).
Acute coronary syndrome is an umbrella term for heart attacks, unstable angina, and other conditions where blood flow to the heart becomes suddenly blocked.
One study showed that mainly plant sterols, not cholesterol, can build up in the heart tissue and cause narrowing of the heart’s aortic valve (Luister et al., 2015).
The study looked at 104 heart samples from patients with severe narrowing of the aortic valve. These patients also had high levels of oxidized plant sterols, suggesting that oxidative stress and inflammation also contributed.
“Stigmasterol accumulation causes cardiac injury and promotes mortality,” one animal study concluded (Tao et al., 2019).
Stigmasterol is a plant sterol commonly found in plant fats and oils. The researchers observed an increased risk of death from high plant sterols in animals despite a 50% reduction in blood cholesterol.
Animal studies warn that stigmasterol buildup may damage the heart’s ventricles, lead to excessive heart tissue scarring, and heart inflammation. This type of damage is often irreversible and greatly reduces the heart’s ability to pump blood. Researchers suggest that drugs that block plant sterol absorption may help prevent such complications (Tao et al., 2019).
Statins are the typical, first-line drugs prescribed to people with high total and LDL cholesterol and others at risk of heart disease.
But, it’s not only your total and “bad” LDL cholesterol that affects your risk of heart problems—plant sterols may be even more important! The problem is: statins don’t affect plant sterol levels.
In one famous trial, the statin atorvastatin lowered LDL cholesterol in patients with diabetes on hemodialysis but had no effect on heart attacks and increased stroke risk (Wanner et al., 2005).
High absorbers of cholesterol and plant sterols don’t respond well to statins. In the Scandinavian Simvastatin Survival Study (4S), patients with the highest absorption suffered more heart disease complications when prescribed statin therapy (Weingärtner et al., 2010).
Statins shouldn’t be prescribed as the first choice to patients on dialysis and to others at low risk of heart disease either, according to the most recent clinical research data (Olyaei et al., 2011).
New findings can help doctors personalize therapy to people who tend to absorb cholesterol and plant sterols in excess.
For example, adding Zetia (ezetimibe) to statin therapy for people who are high cholesterol absorbers seems to help. Zetia blocks cholesterol and plant sterols absorption in the gut.
Adding Zetia to statin therapy helped lower the plant sterol sitosterol and LDL cholesterol in one trial of 197 heart disease patients after 12 weeks. The combo was also more effective than statins alone in high cholesterol absorbers in two other studies (Watanabe et al., 2015; Hagiwara et al., 2017; Lütjohann et al., 2019).
Some studies also suggest that Lactobacillus Reuteri (NCIMB 30242) may help support normal cholesterol absorption in hyperabsorbers. In a placebo-controlled clinical trial of 127 people, L. Reuteri NCIMB 30242 capsules taken over 9 weeks decreased three plant sterols in the blood that act as absorption markers by up to 41% (Jones et al., 2012).
Talk to your care provider about trying L. reuteri probiotics.
Just like plant sterols can build up in blood vessels, they can latch onto heart stents and cause restenosis. Restenosis is when a part of the blocked artery the stent was placed in becomes narrowed again. In one human study, higher cholesterol and plant sterols absorption increased the risk of restenosis (Otto et al., 2019).
In a study on over 300 people, hemodialysis patients with higher markers of cholesterol and plant sterols absorption were at a greater risk of dying from any cause (Rogacev et al., 2012).
According to an analysis of 41 trials involving over 3000 people, plant sterol and stanol intake lowers blood levels of carotenoids like beta carotene, lycopene, lutein, and zeaxanthin (Baumgartner et al., 2017).
Carotenoids are antioxidants and provitamin A. They maintain immune and eye health.
In Europe, foods enriched with plant sterols must contain a warning about this side effect along with a recommendation to increase fruit and vegetable intake to help maintain carotenoid levels.
Plant sterols may also reduce the absorption and blood levels of vitamin E, but it’s uncertain to what extent. Increasing vitamin E foods is likely a good idea (Richelle et al., 2004; Baumgartner, 2017; Tuomilehto et al., 2008).
People with common mutations in the G5/8 pump are more likely to experience blood plant sterol levels way above the normal range (Patel, 2009).
Researchers have been warning that a buildup of plant sterols may disrupt hormonal balance ever since the early 2000s when massive food fortification took place. High levels of plant sterols absorbed through diet may enter reproductive tissue, bind to sex hormones, and act as endocrine and metabolic disruptors (Nieminen et al., 2002).
This is not surprising given the chemical similarity between plant sterols, cholesterol, and sex hormones.
Possible consequences of plant sterol buildup include abnormal red blood cells, anemia, giant platelets, increased bleeding, and adrenal and ovarian failure. The data are still limited, and more research is needed (Mushtaq & Wright, 2007; Patel, 2009).
The latest research suggests plant sterols may increase the risk of atherosclerosis and contribute to heart disease.
Expert analyses suggest that it’s very easy to take in excessive amounts of plant sterols with fortified products. It’s best to avoid foods fortified with plant sterols altogether. Children and pregnant and breastfeeding women should be especially cautious.
No studies have yet linked plant sterols to weight gain.
However, this is theoretically possible since plant sterols may disrupt sex hormones and metabolism. Also, consuming margarine spreads and refined oils in large amounts is not healthy and may contribute to weight gain. More research is needed.
No human studies have yet linked plant sterols to weight gain, but more safety data is needed.
Plant sterols triggered liver damage in animal experiments. Formulas with high levels of plant sterols also cause liver injury in infants and children who need to be fed through an IV (Kasmi et al., 2017; Hukkinen et al., 2017).
The latest research suggests that plant sterols may increase the risk of heart disease. People who eat foods fortified with plant sterols and are prone to high cholesterol and plant sterols absorption may be at higher risk. More research is needed.
Research suggests that plant sterols may contribute to atherosclerosis, which can lead to high blood pressure. However, additional studies need to explore whether plant sterols can directly raise blood pressure.
High cholesterol and plant sterol absorbers can’t be identified easily, but we know that they make up ~25% of the general population. Meanwhile, plant sterols are found everywhere, so cutting out otherwise healthy plant-based foods is not the solution.
For most people, the takeaway is to eat a balanced whole food diet and avoid fortified, processed foods.
The next step for some is to consider natural blockers of cholesterol absorption like L. Reuteri NCIMB 30242.
People with heart disease and those at high risk should talk about the best therapy options (like Zetia in addition to a statin) with a healthcare provider knowledgeable about phytosterols science.
Read Next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Please consult your doctor before taking supplements to avoid any potential disease and drug interactions.
People around the world have used medicinal mushrooms since at least 3000 BC. Mushrooms boast many health benefits but are best known for providing powerful immune support (Guggenheim et al., 2014).
We focus on the top three well-researched medicinal mushrooms in this guide: reishi, shiitake, and maitake.
Other sought-after medicinal mushrooms that also support the immune system are cordyceps, turkey tail, and lion’s mane. Some less commonly used immune-supportive mushrooms include matsutake, Agaricus blazei, and snow fungus (Patel et al., 2021).
Reishi mushroom (Ganoderma lucidum) provides immune support, helps reduce stress and anxiety, fight infections, and has anti-inflammatory action. Reishi or “Lingzhi” has been used for millennia in traditional Chinese medicine. Practitioners claim it’s great for balancing the immune system–boosting it if weakened and downregulating it if overactive (Sanodiya et al., 2009).
Shiitake mushrooms (Lentinula edodes) are packed with antioxidants, fiber, and important nutrients (like zinc, selenium, vitamin D, and essential amino acids). They’re purported to support immunity, longevity, liver health, and blood flow (Cassileth, 2011; USDA database).
Maitake mushrooms (Grifola frondosa) balance the stress response and support immune, liver, lung, and reproductive health. They’re a popular traditional Chinese medicine adaptogen—a remedy that helps maintain energy levels and good health under increased stress (He et al., 2017; He et al., 2019; Lindequist et al., 2010).
The first step to experiencing any potential health benefits of medicinal mushrooms is finding a high-quality supplement.
Some mushroom supplements and products contain cheap fillers like starches, artificial additives, and other ingredients you should avoid. In one analysis, 68% of tested reishi products in the US used polysaccharide fillers in place of the active ingredient; only 26% contained the labeled amount of reishi mushroom (Wu et al., 2017).
Here’s what to look out for in a quality mushroom supplement (Patel et al., 2021):
We recommend My Smart Habits Triple Immune. It contains certified-organic shiitake, maitake, and reishi mushrooms providing 1000 mg of medicinal mushrooms per serving. It’s third-party tested to guarantee high levels of beta-glucans. No starch, grains, or mycelium is added.
According to the research, medicinal mushrooms start improving antioxidant status within hours of ingestion. However, it may take weeks or months to achieve specific health benefits (Wachtel-Galor et al., 2004).
As a rule of thumb, it takes at least two weeks to notice the effects of medicinal mushrooms. It may take 4-8 weeks to feel a boost in immune function, energy levels, and stress resilience. Cognitive function, nerve repair, and metabolic support may take even longer (Tao & Feng, 1990; Mateo et al., 2015; Donatini, 2014).
Although health practitioners typically recommend taking a week off every four to six months, most medicinal mushrooms in this blend have been used consistently for longer periods of time without safety concerns.
For example, reishi mushrooms were safely used for up to one year in clinical trials as a standalone supplement and for 6 months in combination products (with vitamins and plant extracts) (Oka et al., 2010; Chiu et al., 2017; Parravano et al., 2019).
Shiitake is known to be safe in the long term when used in food amounts. However, 4 g/day of shiitake powder for 10 weeks caused abnormally high eosinophil levels (eosinophilia) in one small study of 10 people (Levy et al., 1998)
In the most recent study of 68 people, though, shiitake mushroom bars were used for 66 days without safety concerns. In another recent study, 5-10 g/day of the whole, dried shiitake mushrooms were used safely for 4 weeks to support immune function in 52 healthy men and women. More safety data are needed (Spim et al., 2021; Dai et al., 2015).
Maitake mushrooms also seem to be safe in the long run, when used appropriately. A maitake mushroom extract (3 mg/kg) twice daily has been used safely for up to 12 weeks. This is about 500mg/day for a person weighing 190 lbs. Meanwhile, 1-1.5 g/day of maitake mushroom polysaccharides were used safely for up to 2 years (Wesa et al., 2015; Konno et al., 2001).
The typical dosage for products with a combination of immune-supportive mushroom extracts is 1000-2000 mg/day.
Since medicinal mushrooms are not approved for any conditions, there is no official dose. Some clinical trials used higher doses (up to 6 g/day) in specific patient populations, but more safety and effectiveness data on optimal dosing are needed.
In general, it makes the most sense to split the daily dose into 2-3 servings throughout the day–a regimen that most clinical trials followed. This strategy helps maintain levels of active compounds in the body.
Aside from supporting immune function, dosing throughout the day may help balance the adaptogenic benefits—giving you a boost of energy in the morning and helping you wind down before going to bed.
Taking reishi, shiitake, and maitake with meals helps absorb the active compounds and boost microbiome health.
Traditionally, medicinal mushrooms are prepared in food. Research confirms that taking mushroom supplements with meals is a good idea.
Reishi, shiitake, and maitake are high in polysaccharides like beta-glucans and lentinan, which act as prebiotics and feed the good bacteria in your colon. Prebiotics work best when taken alongside light, fiber-rich meals (Bhakta & Kumar, 2013).
Beta-glucans from medicinal mushrooms can boost your gut microbiome health, beneficial bacteria (Lactobacilli and Bifidobacteria), and anti-inflammatory small-chain fatty acids (SCFAs) (Cerleti et al., 2021).
Taking medicinal mushrooms with meals also helps form a protective coating in the intestines and reduces potential side effects like stomach pain, gut discomfort, and nausea (Cerleti et al., 2021).
Taking a mushroom supplement is no miracle solution to healthy immune function and general wellness. To support your body holistically, be sure to also (Monye & Adelowo, 2020):
Consider combining medicinal mushrooms with the following supplements to boost immune and other health benefits:
Although most probiotics are good for your immune system, many have not been through human studies. L. Reuteri NCIMB 30242 is the only probiotic that has been clinically tested for supporting healthy vitamin D levels. Learn more about the clinical research behind this probiotic strain and its benefits.
Read next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please consult your doctor before taking supplements to avoid any potential disease and drug interactions.
The single most important factor in taking Lion’s mane (Hericium erinaceus) is consistency. The second one is dosage. If you’re not taking this mushroom on a regular basis or at a high enough dosage, you are likely to miss out on its benefits.
Many clinical studies back up the importance of long-term supplementation with an evidence-based dosage. Although we need more clinical studies to determine optimal dosage, the existing studies can give us a good idea of what’s likely to work.
However, if you do a quick “lion’s mane dosage” Google search, you won’t find most of these studies. The typical blog post or guide will cite one or two human studies, at best.
That’s why we’ve decided to find and sum up the complete, up-to-date scientific research. While we’re at it, we’ll also try to answer another burning question: how long does lion’s mane take to work?
Let’s dive in…
The first published double-blind placebo-controlled study used 1,000 mg of lion's mane (96% fruiting body dry powder) thrice daily over 16 weeks (3,000 mg/day). This regime improved cognitive function in thirty 50- to 80-year-old Japanese men and women with mild cognitive impairment (Mori et al., 2009).
It likely takes a couple of months of supplementation to notice results. In the above study, cognitive scores started improving after 8 weeks.
Also, you can’t expect lion’s mane to continue working on your cognition once you stop taking it. This might be especially true if you have poor cognitive function. In the mentioned study, participants started experiencing cognitive worsening again 4 weeks after they stopped supplementing with lion’s mane.
In another randomized, double-blind placebo-controlled study, cookies with lion’s mane reduced anxiety, depression, and fatigue in 30 menopausal women. Each cookie contained 500 mg of the fruiting body. The participants ate 4 cookies at any time during the day (2000 mg/day) for 4 weeks (Nagano et al., 2010).
In a follow-up study, lion’s mane supplements improved short-term memory and cognitive function in 31 healthy, middle-aged people over 12 weeks. They upped the dosage to 4 supplements per day, each containing 800 mg of the fruiting body (total daily dose of 3200 mg/day) (Saitsu et al., 2019).
In a Japanese pilot study of 8 undergrads, lion’s mane tablets (1950 mg/tablet fruiting body extract; 0.5% hericenones, 6% amyloban) seemed to improve sleep quality, anxiety, and wellbeing after 4 weeks. They used a high dose of 6 tablets/day (11,700 mg/day), split up into 2 or 3 takings with food (Okamura et al., 2015).
A different lion’s mane extract (1200 mg/capsule; 80% mycelia and 20% fruiting body) decreased depression, anxiety, and sleep problems in an Italian study of 77 overweight or obese people. It was dosed at 3 capsules/day for 8 weeks (3600 mg/day) (Vigna et al., 2019).
Finally, a recent study used lion’s mane mycelium capsules (350 mg/capsule; 5 mg/g erinacine A). Three capsules per day (1050 mg/day) improved cognitive scores in patients with mild Alzheimer’s Disease gradually over one year (49 weeks). Meanwhile, the placebo group experienced cognitive decline 25 weeks into the study (Li et al., 2020).
This was also the longest lion’s mane study to date, showing that this mushroom is likely safe to use over long periods of time in people who need cognitive support.
Many lion’s mane supplements are available. If you want to see results, it’s important to choose a high-quality product. Lion’s mane supplements can widely differ in their ingredients, the part of the mushroom used, purity, and extraction methods.
We recommend My Smart Habit’s lion’s mane supplement. In line with the majority of published clinical trials, it contains 1000 mg of organic lion’s mane fruiting body extract per serving (2 capsules). It’s standardized to at least 25% beta-glucans (immune support) and less than 5% of starch. Higher amounts of starch usually point to cheap, vegetable-based fillers.
Since it’s both an energy booster and a sleep aid, there are no known cons to taking lion’s mane at any time in the day. In fact, studies reveal that maintaining a steady dose of lion’s mane throughout the day helps this adaptogenic mushroom achieve its mind-body balancing effects (Okamura et al., 2015).
Indeed, a pilot study in stressed undergrads who stay up late at night revealed that lion’s mane might help sync the circadian rhythm. Plus, it decreased wakefulness in mice at the end of the day (Okamura et al., 2015; Furuta et al., 2016).
Lion’s mane may enhance nerve growth and regeneration, according to animal studies and a small human study. Our brain normally prioritizes memory consolidation and repair during sleep (Sei et al., 2000; Samberkar et al., 2015; He et al., 2017; Park et al., 2002; Wong et al., 2012; Vigna et al., 2019).
So, taking lion’s mane a couple of hours before going to bed may help you slowly start to relax and wind down. And, it might be a smart way to boost your brain’s physiological nighttime healing.
That said, everyone responds differently. If you feel that lion’s mane gives you a strong cognitive boost and makes you more alert, you might want to avoid taking it in the evening. Instead, take lion’s mane in the morning and afternoon to maintain mental clarity and stamina.
Medicinal mushrooms are traditionally prepared in food. Research confirms that taking mushroom supplements like lion’s mane with meals is a good idea.
Lion’s mane contains beta-glucans, which act as prebiotics to feed your good gut bacteria. All prebiotics work best when taken alongside light, fiber-rich meals.
In one study, beta-glucans from lion’s mane improved the gut microbiome and increased anti-inflammatory compounds (propionate, butyrate, and branched SCFAs) in the colon samples of elderly people (Mitsou et al., 2020).
Also, chemicals in lion’s mane that support brain health (hericenones and erinacines) are small, fatty molecules. That means they’re better absorbed with food. Meals stimulate the release of bile acids, which help transfer active compounds into the bloodstream (Chong et al., 2019).
What about adding lion’s mane to your coffee?
In addition to the weird flavor combination, there are no proven benefits and several risks.
Although coffee is the world’s most popular stimulant, it’s not a cognitive enhancer. By making you more alert, caffeine may help with passive listening. But, it can worsen your performance at tasks that heavily depend on working memory like decision-making and reading (Nehlig, 2010).
Plus, caffeine side effects include restlessness, headaches, dizziness, rapid or abnormal heart rhythm, dehydration, anxiety, and inflammation (Nehlig, 2010).
Green tea, on the other hand, contains l-theanine. L-theanine boosts cognition, has a calming effect, and reduces the side effects of caffeine. For this reason, taking lion’s mane with green tea or matcha may offer added benefits (Baba et al., 2021).
Consider combining lion’s mane with the following supplements to boost specific health benefits:
Read next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please consult your doctor before taking supplements to avoid any potential disease and drug interactions.
It’s crucial to choose a researched colon cleanse formulation that supports gut and whole-body detoxification. Various supplements are available on the market and their ingredients–as well as health benefits, dosing, and side effects–widely vary.
Microbiome Plus+ Colon Cleanse pills are a natural detox supplement that contains the following 16 active ingredients:
Laxatives
Herbs for natural detox
Gut-protective, digestive herbs
Prebiotics and probiotics
Colon cleanse pills are no antidote to modern living. They’re not a shortcut but rather a catalyst: they help speed up your overall detox efforts.
Each person's detox ability is influenced by environment, diet, lifestyle, health status, and genetic factors. We can’t change our genes, but most other factors are modifiable.
Have in mind that many of the tips in this guide are anecdotal or based on clinical experience and aimed at improving overall health and wellness. Nonetheless, more clinical research about colon cleansing is needed (Acosta & Cash, 2009).
If you need additional guidance, we suggest talking to an integrative health practitioner.
Taking colon cleanse pills while continuing to lead an unhealthy lifestyle might do more harm than good. Laxative active compounds aimed at detox can worsen oxidative stress and cause damage in combination with an excess of toxins that burden the liver (Liu et al., 2020).
Exposure to toxins from food, water, cosmetics, cigarettes, and air can overwhelm detoxification pathways, potentially injuring the liver and colon. These are the same factors that disrupt the gut microbiome, worsening overall health (Cline, 2015).
The first step to promoting detoxification with supplements is to remove anything that may be contributing to the total body burden of toxicants. This includes (Cline, 2015):
Alcohol and caffeine can also cause dehydration and electrolyte imbalances, making a colon cleanse dangerous.
Drugs are metabolized and removed from the body using the same detoxification pathways. Certain drugs may stress the liver more than others. Acetaminophen, a popular OTC painkiller, is particularly harsh on the liver’s main detoxification pathway–it robs the body of the “master antioxidant” glutathione. Discuss safer alternatives with your doctor or pharmacist (Nuttal, 2003).
Most detoxification programs also recommend going on an elimination diet and cutting foods that commonly trigger sensitivities like dairy, gluten, eggs, peanuts, and red meat. An elimination diet is usually done for 4 weeks, after which these foods are slowly re-introduced to observe which ones are causing health issues (Cline, 2015).
Colon cleanse pills are typically used in cycles of 7-30 days with breaks of at least 6-8 weeks in between. Most people do 2-4 cleanses per year.
Some cleanses that rely just on dietary changes and anti-inflammatory spices are safe for 30 days or more.
However, colon cleanse supplements that contain herbal laxatives should not be used for over 1 or 2 weeks at a time (Lombardi et al, 2020).
Microbiome Plus+ colon cleanse contains sugar-bound anthraquinones (found in aloe, alder buckthorn, cascara, and rhubarb), which act as stimulant laxatives. Monographs caution that products containing these actives should not be used for longer than 1–2 weeks due to the possible risk of electrolyte imbalances (Bethesda, 2012; McGuffin, 2013; Lombardi et al, 2020).
Using cascara sagrada for more than 1–2 weeks can lead to “lazy bowel syndrome” and electrolyte loss (especially low potassium levels). This can set off a vicious cycle of needing more and more laxatives to have regular bowel movements, causing dependency (Dietz & Bolton, 2007).
With this in mind, you start with one capsule per day in the morning. You may increase your daily dosage to two capsules per day if needed. Increasing the dosage too soon may trigger stomach upset, diarrhea, or even constipation. If you experience discomfort, try reducing your dosage.
If you don’t experience bowel movements after using colon cleanse pills for a couple of days, consult your care provider. You may have a more serious condition or lack hydration.
Be sure to take your colon cleanse pills with a large glass of purified water (10-12 ounces). You can also take the pills with natural fruit/vegetable juices, herbal teas, or electrolyte liquids instead of water. Taking pills containing herbal laxatives without enough liquids may cause choking and lead to dehydration and electrolyte imbalances.
Pay attention to your water and fluid intake throughout the whole day. Drink plenty of fluids before, during, and after your cleanse to ensure good hydration.
This is an important part of any colon cleanse. Colon cleanse pills, colon hydrotherapy, and colonic irrigation can all cause dehydration.
Look to get plenty of the following detox-focused, colon-cleansing, nutrient-dense foods (Simioni et al., 2018; Cline, 2015):
Most of these foods are also rich in fiber, antioxidants, and building blocks for glutathione. Maintaining healthy glutathione levels is paramount to effective detox (Hunter & Grimble, 1997).
Aim for 8 to 10 fruit or vegetable servings daily.
In addition, be sure to get enough healthy fats, nuts and seeds, lean protein, and legumes.
Image taken from Cline J. C. (2015). Nutritional aspects of detoxification in clinical practice. Alternative therapies in health and medicine, 21(3), 54–62
Exercise helps activate antioxidant pathways and circulation in the whole body (Simioni et al., 2018).
You might also want to occasionally use a sauna. Saunas encourage detoxification and boost blood flow. They’re safe for most people but check with your doctor just in case, especially if you have heart disease (Crinnion, 2007; Crinnion, 2011).
Sleep deprivation and chronic stress can trigger inflammation and burden detoxification pathways. Reducing stress in your life and getting enough quality sleep should be part of your detoxification lifestyle (Cline, 2015).
Colon cleanse pills may contain laxative, fiber-rich, and phytoestrogenic herbs that interact with many drugs, including (Brinker, 1998):
Don’t forget to consult a doctor before supplementing to avoid potentially dangerous drug interactions.
If your doctor gives you the green light, space colon cleanse pills at least 2 hours away from any medication.
You can combine colon cleanse pills with the following Microbiome Plus+ supplements for synergistic benefits:
Read next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 200+ posts, some of which reached over 1 million people. Her specialties are natural remedies, drug-supplement interactions, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Digestive enzymes break down fats, proteins, and carbs into nutrients your body can absorb. Most digestive enzymes are made in the pancreas (Ianiro et al., 2016).
Various factors can lower your production of digestive enzymes, including (Domínguez-Muñoz, 2007; Roxas, 2008; Rossi & Lentze, 1984; Kondo et al., 1988; Wydmanski et al., 2016; Kallegari & Lami, 1984):
Microbiome Plus+ Digestive Enzymes Supplement contains 18 plant-based enzymes that work synergistically (alpha-galactosidase, amylase, aspergillopepsin, beta-glucanase, cellulase, glucoamylase, hemicellulase, invertase, lactase, lipase, pectinase, peptidase, phytase, protease 1 and 2, xylanase, plus bromelain and papain).
People who struggle to make enough digestive enzymes and suffer from indigestion may choose to supplement. The rationale is to provide your body with the amount of digestive enzymes it’s lacking to function optimally. Supplemental digestive enzymes may improve digestive, gut, heart, and joint health (Ianiro et al., 2016).
Aside from supplementing with digestive enzymes, it’s important to optimize your diet and lifestyle and work with a practitioner to uncover the underlying cause of your issues.
To boost your digestive enzyme levels, keep active, add herbal bitters to your diet, and eat more foods rich in nutrients, enzymes, prebiotics, and probiotics (Koibuchi & Suzuki, 2014; McMullen, 2015; Conlon & Bird, 2015).
If you’re ready to start taking a quality digestive enzyme supplement, follow the steps outlined below for maximum results.
Digestive enzymes need to be taken with food to have an effect. Their role is to break down nutrients in food. There’s no point in taking them on an empty stomach—the enzymes will have nothing to “work on” (Roxas, 2008).
It’s best to take digestive enzymes at the beginning of the meal. This ensures that the enzymes will efficiently mix with food in the digestive system, mimicking natural enzyme secretion.
In short, yes.
To do this, you need to know what the main types of digestive enzymes are and what foods they can help you digest. Use the list of foods outlined below as a guide (Whitcomb & Lowe, 2007).
Microbiome Plus+ digestive enzymes contain all the enzymes listed.
Proteases break down proteins into amino acids.
Peptidases are involved in the final steps of protein digestion: they break down small peptides into amino acids (Kim & Erickson, 1985).
Bromelain is a type of protease from pineapple. Like all proteases, it helps digest proteins when taken with meals. However, foods like potato and soy may reduce its activity (Valueva et al., 1997).
Papain is a protease extracted from the raw papaya fruit. It boosts the digestion of high-protein foods. No wonder chefs also use it as a meat tenderizer. Papain also has many other potential health benefits (Kong et al., 2021).
Foods: meat, fish, eggs, and legumes.
Aspergillopepsin is a protease from yeast that can break down dietary gluten into short peptides (unlike animal-based pepsin) (Ehren et al., 2009).
Foods: wheat, rye, and barley.
Lipases break down fats into fatty acids.
Foods: any oil or fat.
Amylases break down complex carbs into simple sugars. They include cellulase, hemicellulase, glucoamylase, invertase, alpha-galactosidase, beta-glucanase, pectinase, and xylanase.
Alpha-galactosidase helps digest carbohydrates in beans that can cause flatulence, abdominal bloating, and stomach pain (Di Stefano et al., 2008).
Beta-glucanase works together with xylanase and cellulase to break down beta-glucan in cereal grains, wheat, and barley (Habte-Tsion & Kumar, 2018).
Pectinase breaks down pectin, a soluble fiber found in many fruits and plants.
Xylanase, cellulase, and hemicellulase also help digest high-fibrous plant foods like vegetables and whole grains (Chen et al., 2020).
Foods: potatoes, grains, beans, pears, apples, citruses, broccoli, cauliflower.
Lactase breaks down lactose, the main sugar in dairy, into simple sugars. People lacking this enzyme have lactose intolerance.
If you’re intolerant to lactose, increasing your intake of fermented milk products like yogurt may also help. Studies show that yogurt high in lactic acid probiotic bacteria helps improve lactose absorption and reduce symptoms of intolerance (Ianiro et al., 2016).
Foods: yogurt, milk, soft cheese, and most dairy products
Phytase breaks down phytic acid, a plant-based anti-nutrient that can cause digestive upset.
Foods: whole grains, beans, soy, peanuts, lentils, potatoes, beets, carrots, nuts, and seeds.
The digestive enzymes you take with a meal gradually get used up as they come into contact with food and travel down your digestive tract.
When digestive enzyme production works perfectly in the body, each meal triggers the release of the right combination of digestive enzymes. Food gets maximally digested, nutrients get broken down and absorbed, and the whole cycle starts again with the next meal (Corring, 1980).
You may not need to take digestive enzymes with every meal, depending on your food intolerances. Supplementation should mimic healthy digestion. To get into an optimal regime, you should ask yourself:
If you’re about to eat a meal that’s high in foods you don’t tolerate well, supplementing is usually a good idea.
There might be only a couple of foods that you don’t tolerate and eat only occasionally. If so, you can take digestive enzymes only with those meals.
On the other hand, you may have trouble digesting most foods that you eat on a daily basis. If that’s the case, you may want to take enzymes regularly with each meal.
There is no standard dosage for digestive enzymes. Studies often use enzyme mixtures and dosages vary widely. Also, the dosage should be adapted to each person’s individual needs and diet.
We recommend taking one capsule with each meal that contains foods you don’t tolerate well.
Clinical trials on digestive enzymes report results after 2-12 weeks, depending on health issues (Akhtar & Haqqi, 2012; Majeed et al., 2018).
We recommend regularly supplementing for at least two to three weeks if you have daily indigestion and don’t tolerate most foods.
Digestive enzymes work in synergy with probiotics and prebiotics.
Probiotic gut bacteria produce digestive enzymes, while digestive enzymes enhance the activity of probiotic bacteria. Prebiotic fiber additionally feeds your probiotic bacteria, improving the overall health of your gut microbiome (Haq & Mukhtar, 2006)
Research confirms that adding probiotics to digestive enzymes may enhance the digestive and heart health benefits (Ianiro et al., 2016; Ichim et al., 2016).
We recommend Microbiome Plus+ prebiotic and probiotic synbiotic formula as an add-on to digestive enzymes for optimal results.
Read more about the unique benefits of our pre and probiotics:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
To recap:
Prebiotics and probiotics work together in synergy, one enhancing the effects of the other. Evidence-based synergistic combinations of prebiotics and probiotics are also known as synbiotics (Markowiak & Śliżewska, 2017).
Many probiotic benefits are strain-specific. The health benefits of fiber supplements can also wildly vary depending on the type of fiber you’re taking. Not all fiber and probiotics are the same, and the combination you decide to take can make all the difference.
That’s why choosing the right product is crucial. So, be sure to pick a probiotic and prebiotic supplement combination that has been through human research and is manufactured by a trusted brand.
Microbiome Plus Prebiotic and Probiotic Combo contains the following research-based synbiotic combination:
Fructooligosaccharides (FOS) are a type of fiber that exists in about 36,000 plants. FOS have been researched for enhancing the benefits of probiotics in the large intestine (Mao et al., 2018).
Also, our probiotic has been clinically researched for resisting stomach acid and comes in delayed-release capsules. This is important since probiotics are wired to survive in your colon (pH 6 to 7) and usually don’t do well in an acidic environment.
Scientists developed L. reuteri NCIMB 30242 to be more tolerant to the hostile environment of the gastrointestinal tract than other probiotics. Our strain can increase its own survival by detoxing bile acids (being bile salt hydrolase (BSH) active). Microencapsulation ensures that freed bile acids get cleared from the body with no negative effects (Del Piano et al., 2011; Begley et al., 2006; Jones et al., 2004; Kurdi et al., 2000).
The dosage of Lactobacillus reuteri NCIMB 30242 used in clinical trials was 2.9×10⁹ CFU per capsule, twice daily (Jones et al., 2012).
Our L. reuteri NCIMB 30242 contains 3.5×10⁹ CFU per capsule. This is 21% more than the clinically researched dosage, which ensures you get the right amount of probiotics just in case some live bacteria are lost before they reach your colon.Our prebiotic contains 600 mg of concentrated short-term fructooligosaccharides (scFOS) per tablet. According to studies, the optimal and well-tolerated scFOS dose ranges from 2.5 to 10 g/day (Bouhnik et al., 2007, Bouhnik et al., 2006).
Gastrointestinal transit is how long it takes for probiotics to reach your colon from the moment you ingest them. This can be anywhere from 5 minutes to 2 hours (Han et al., 2021).
The typical advice is to take probiotics on an empty stomach because food slows down their transit—that’s what most companies and blog posts will tell you. And it’s wrong!
Here’s why: food helps probiotics survive by neutralizing stomach acid. Exposure to more concentrated stomach acid (low stomach pH) can kill probiotics before they even make it to the intestine. It’s a bigger factor than transit time (Tompkins et al., 2011; Del Piano et al., 2011).
Recent studies on non-enteric coated probiotics showed that (Tompkins et al., 2011):
Also, since Lactobacillus probiotics need glucose in an acidic environment like the stomach, they seem to survive better when taken alongside carbs (Corcoran et al., 2005).
Our probiotic is more likely to survive an empty stomach than other commercially available strains and formulations. However, taking it on an empty stomach isn’t ideal.
Traditionally, probiotic foods were an integral part of our diet. Modern animal and human studies also report benefits when prebiotics are added to meals or taken along with meals as part of a healthy, fiber-rich diet (Costa et al., 2021; Respondek et al., 2013; Hess et al., 2011).
Unlike probiotics, prebiotics are resistant to stomach acid and digestive enzymes. That means prebiotics can easily reach your colon, where all your good bacteria live. In the colon, prebiotic fiber gets broken down by probiotics, helping your microbiome diversify and flourish (Guarino et al., 2020).
Both traditional diets and modern research reveal that prebiotics work best when taken with fiber-rich meals.
Prebiotic fiber boosts the benefits of probiotics, makes live bacteria more tolerant to stomach acid, and supports the growth of a diverse gut microbiome in the colon (Markowiak & Śliżewska, 2017).
Good sources of prebiotic, fiber-rich foods you add to the meals you take your pre and probiotic with include (Davani-Davari et al., 2019; Thursby & Juge, 2017)
Resistant starch is similar to prebiotic fiber and is another great addition to a diet that boosts probiotic effectiveness and microbiome diversity (Singh et al., 2019).
Non-fiber antioxidants from fruits and vegetables such as raw cacao and green tea also act as prebiotics (Davani-Davari et al., 2019; Tzounis et al., 2019).
Here are some specific examples of light meals packed with prebiotics:
It can take a long time to digest heavy meals. Heavy food strongly increases stomach acid, bile acids, and digestive enzymes. Four to five hours can pass before the contents of heavy meals reach the colon, so even delayed-release capsules may free the probiotic too early.
For the best results, don’t take our probiotic capsules with or several hours after heavy meals.
We recommend taking L. Reuteri NCIMB 30242 probiotic capsules and scFOS prebiotic tablets with fiber-rich, light meals to boost probiotic survivability and synbiotic benefits.
Take 1-3 prebiotic tablets and 1 probiotic capsule two times per day, each with a fiber-rich meal. Adapt your prebiotic dosage to your dietary fiber intake (lower dose if your dietary fiber intake is high).
Prebiotic fiber attracts and soaks up water. Research shows that scFOS is especially good at attracting water. That’s why you should drink a glass of water along with prebiotic supplements and fiber-rich meals (Camara et al., 2020).
Always drink at least one glass of water with the prebiotic supplement.
Since prebiotic fiber isn’t digested, it can bind to medications. This may affect the absorption of prescription and over-the-counter (OTC) drugs. For this reason, it’s recommended to take prebiotic supplements at least two hours before or two hours after any medications (Canga et al., 2010).
Consult your doctor or pharmacist before adding a prebiotic supplement to your regular medications to avoid any potential interactions.
If you take any medication, do not take our scFOS supplement at least 2 hours before or after.
After all these efforts to help probiotics reach your colon, there’s one last question: how can you get the probiotic to stay there?
Colonization resistance is when bacteria indigenous to your colon reject the new probiotic strain. It’s a big and common problem, and if it happens, the supplemented probiotic is removed with the stool without achieving its benefits (Yao et al., 2020; Zmora et al., 2018).
Preliminary studies suggest that the following dietary compounds may help:
Omega 3 fatty acids and other PUFAS help probiotics “stick” to the gut lining. This is the first step to overcoming colonization resistance (Bomba et el., 2002; Bomba et al., 2003; Han et al., 2021).
Wild-caught fish is rich in omega-3 PUFAs. Plant-based sources of PUFAs include walnut, sunflower seeds, and flaxseeds. These beneficial fats also have anti-inflammatory and heart-protective properties that work in synergy with our probiotic.
Additionally, olive oil may help boost the benefits of both prebiotics and probiotics. It is a nutritious fat that promotes intestinal health and increases the diversity of the gut microbiome. Extra virgin olive oil is an especially good choice for people with high LDL (“bad”) cholesterol and heart disease (Marcelino et al., 2019).
Add moderate amounts of olive oil and foods high in healthy fats to your fiber-rich meals. This may help probiotics integrate into your gut microbiome.
Consider adding the following dietary compounds to your diet or supplement regime to help boost the benefits of our probiotic:
Curcumin is the main active ingredient in the spice turmeric. Aside from being one of the best-researched natural anti-inflammatories, curcumin helps restore gut microbiome balance. Curcumin boosts the growth of beneficial probiotics while reducing the number of pathogenic gut bacteria. Plus, it helps strengthen the gut barrier, which might be helpful for people with leaky gut (Scazzocchio et al., 2020; Di Meo et al., 2019).
You can get curcumin from food (by adding the spice turmeric to your meals) or supplements.
Lastly, edible medicinal mushrooms help balance and enrich the gut microbiome. Mushrooms act as prebiotics and are rich in immune-boosting active compounds. Some sources include Lion’s mane, reishi, shiitake, maitake, turkey tail, and others (Jayachandran et al., 2017; Diling et al., 2017).
Prebiotics are not only great for gut health, but they’re a potential strategy to overcome mineral deficiencies. That’s why we recommend combining our scFOS prebiotic supplement with mineral-dense meals or, alternatively, mineral dietary supplements (Costa et al., 2021).
According to a review of 30 articles and almost 1500 texts that included human data, scFOS may increase the absorption and/or bioavailability of (Costa et al., 2021):
Scientists think that FOS fiber works by activating bifidobacteria, which lower the pH of the colon and produce short-chain fatty acids (SCFA) and lactate. Altogether, this helps the body take in and use more nutritionally important minerals from food (Costa et al., 2021).
Here’s the good part: if you up your intake of the fiber-rich foods mentioned in the previous section, you’ll also be consuming plenty of minerals.
Some additional sources of mineral-rich nutritious foods you may want to consider adding to your diet if you’re at risk of deficiency include (Ma & Betts, 2000; NIH magnesium fact sheet; Gopalakrishnan et al., 2016; Farsi & Lee, 2008) :
If you can’t get enough minerals from food, consider adding multimineral supplements to your regime.
Avoid the following foods, they’re known microbiome disruptors (Suez et al., 2014; Singh et al., 2019):
In a nutshell, these foods reduce the effectiveness of probiotic supplementation, cause gut dysbiosis, and negatively affect your heart, immune, and overall health.
Some drugs and environmental toxins can also act as microbiome disruptors, including antibiotics, hormones, cigarettes, and many chemicals (dioxins, pesticides, pyrethroids, polychlorinated biphenyls (PCBs), flame retardants, plasticizers) (Ramirez et al., 2020; Aguilera et al., 2020).
If you’re worried about drug interactions and side effects, be sure to discuss your concerns with your care provider.
How long do prebiotics and probiotics take to work?
The answer is: the time it will take for you to experience health benefits is individual.
Clinical trials that achieved results with L. Reuteri NCIMB 30242 lasted for 6 to 9 weeks (Jones et al., 2012; Jones et al., 2012).
Studies typically report prebiotic supplement benefits after 5 to 6 weeks of supplementation (Costa et al., 2021).
Be sure to note down when you started taking prebiotics and probiotics and how you are reacting. This will help you track the results.
Also, remember that prebiotics and probiotics work best when they’re taken regularly.
Be consistent and find a time in the day to take our prebiotic and probiotic combo that you can stick to. For example, you can remind yourself to have a fiber-packed breakfast and a light early dinner at the same time each day. Take one of each with the morning meal, and one of each with the afternoon meal. Set an alarm if you need to at first. With time, your new regime will feel natural.
Get into the habit of taking your prebiotics and probiotics every day around roughly the same time. Be patient and track your response.
Read next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
Traditionally, probiotic foods were an integral part of our diet. Modern animal and human studies also report benefits when prebiotics are mixed into meals or taken in pill form with meals as part of a healthy, fiber-rich diet (Costa et al., 2021; Respondek et al., 2013; Hess et al., 2011).
Unlike probiotics, prebiotics are resistant to stomach acid and digestive enzymes. That means prebiotics can easily reach your colon, where all your good bacteria live. In the colon, prebiotic fiber gets broken down by probiotics, helping your microbiome diversify and flourish (Guarino et al., 2020).
Both traditional diets and modern research reveal that prebiotics work best when taken with fiber-rich meals.
Fructooligosaccharides (FOS) are a type of fiber that exists in about 36,000 plants. FOS have been researched for enhancing the benefits of probiotics in the large intestine (Mao et al., 2018).
The concentration of FOS in plants is low, which suggests that the effective dosage can be achieved only through supplements (Davani-Davari et al., 2019).
FOS fiber has a neutral taste, and it’s stable over a wide range of pH and temperature values. This means it’s stable on the shelf, in the gut, and even when added directly to meals (Camara et al., 2020).
Microbiome Plus+ prebiotic tablets contain 600 mg of concentrated short-term fructooligosaccharides (scFOS), a subtype of FOS prebiotic fiber with clinically proven benefits on the gut flora (Bouhnik et al., 2007, Bouhnik et al., 2006).
According to studies, the optimal and well-tolerated scFOS dose ranges from 2.5 to 10 g/day. We recommend 1-3 scFOS tablets two times per day (1.2-3.6 g/day). People with high dietary fiber intake can take a lower scFOS dose (Bouhik et al., 2007).
We’re collectively suffering from a “fiber gap.” Studies show that most people in Western societies don’t get enough dietary fiber from food. The recommended levels are 25 g/d for adult women and 38 g/d for adult men (McRorie, 2015; Barber et al., 2020).
FOS is naturally found in foods such as onions, bananas, tomatoes, garlic, and wheat. Adding these foods to our concentrated scFOS supplement can help bridge the “fiber gap” and boost health benefits (Camara et al., 2020).
Other prebiotic foods you can combine with our supplement include (Davani-Davari et al., 2019; Thursby & Juge, 2017):
Resistant starch is similar to prebiotic fiber and is another great addition to a diet that boosts probiotic effectiveness and microbiome diversity (Singh et al., 2019).
Non-fiber antioxidants from fruits and vegetables such as raw cacao and green tea also act as prebiotics (Davani-Davari et al., 2019; Tzounis et al., 2019).
For best results, take 1-3 prebiotic tablets with your first meal of the day and 1-3 tablets with your second or third meal. Make sure your meals contain foods rich in prebiotic fiber. Adapt your prebiotic dosage to your dietary fiber intake (lower dose if your dietary fiber intake is high).
Prebiotic fiber attracts and soaks up water. Research shows that scFOS is especially good at attracting water. That’s why you should drink a glass of water along with prebiotic supplements and fiber-rich meals (Camara et al., 2020).
Always drink at least one glass of water with the prebiotic supplement.
Prebiotics work best when they’re taken regularly. Taking prebiotics with nutritious fiber-rich meals and water will work in the long run only if you follow a daily regime.
Be consistent and find a time in the day to take our prebiotic that you can stick to. For example, you can remind yourself to have a fiber-packed breakfast and a light early dinner at the same time each day. Take one tablet with the morning meal, and one tablet with the afternoon meal. Set an alarm if you need to at first. With time, your new regime will feel natural.
To get results, get into the habit of taking your prebiotics every day around roughly the same time.
Prebiotics are not only great for gut health, but they’re a potential way to overcome mineral deficiencies. That’s why we recommend combining our scFOS prebiotic supplement with mineral-dense meals or, alternatively, mineral dietary supplements (Costa et al., 2021).
Mineral deficiencies are common, especially in teenagers, the elderly, and people with gut issues and chronic health problems. The main overlooked deficiency in the modern world is subclinical magnesium deficiency. Other common ones include selenium, zinc, iodine, copper, and calcium deficiency (Vural et al., 2020; DiNicolantonio et al., 2018; Beto, 2015).
Image taken from Costa et al., 2021
According to a review of 30 articles and almost 1500 texts that included human data, scFOS (Costa et al., 2021):Scientists think that FOS fiber works by activating bifidobacteria, which lower the pH of the colon and produce short-chain fatty acids (SCFA) and lactate. Altogether, this helps the body take in and use more nutritionally important minerals from food (Costa et al., 2021).
Here’s the good part: if you up your intake of the fiber-rich foods mentioned in the previous section, you’ll also be consuming plenty of minerals.
Some additional sources of mineral-rich nutritious foods you may want to consider adding to your diet if you’re at risk of deficiency include (Ma & Betts, 2000; NIH magnesium fact sheet; Gopalakrishnan et al., 2016; Farsi & Lee, 2008) :
Supplementing with scFOS supports a healthy mineral status. We recommend taking our scFOS supplement with mineral-rich meals. If you can’t get enough minerals from food, consider adding multimineral supplements to your regime.
Since prebiotic fiber isn’t digested, it can bind to medications. This may affect the absorption of prescription and over-the-counter (OTC) drugs. For this reason, it’s recommended to take prebiotic supplements at least two hours before or two hours after any medications (Canga et al., 2010).
Consult your doctor or pharmacist before adding a prebiotic supplement to your regular medications to avoid any potential interactions.
If you take any medication, do not take our scFOS supplement at least 2 hours before or after.
Several research studies report the benefits of scFOS in combination with probiotics. The synergistic combination of a probiotic and prebiotic is called a synbiotic (Costa et al., 2021; Swanson et al., 2020)
Probiotics are most effective when taken up to half an hour before or with light, fiber-rich meals. Prebiotics work best when taken with meals. (Tompkins et al., 2011; Corcoran et al., 2005).Therefore, we recommend taking our probiotic and prebiotic supplements together with light, fiber-rich meals (check out our Prebiotic and Probiotic Combo).
Alternatively, you can take the probiotic up to half an hour before a light meal, then take the prebiotic with the meal. Both strategies are evidence-based, but the first suggestion is easier.
Read our How-to Guide to taking probiotics and probiotics together.
How long do prebiotics take to work?
This is highly individual, but most studies report results after 5-6 weeks of supplementation. Be sure to track when you started taking prebiotics and be consistent (Costa et al., 2021).
Read next:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Probiotics act in the colon, so they have a long way to go from the moment you pop a pill.
Many factors can affect if probiotics will make it to your colon or degrade beforehand. These include factors related to:
Probiotics are wired to survive in your colon (pH 6 to 7), so they usually don’t do well in an acidic environment.
Our probiotic has been clinically researched for resisting stomach acid and comes in delayed-release capsules, so you don’t have to worry about this part.
Scientists developed L. reuteri NCIMB 30242 to be more tolerant to the hostile environment of the gastrointestinal tract. Our strain can increase its own survival by detoxing bile acids (being bile salt hydrolase (BSH) active). Microencapsulation ensures that freed bile acids get cleared from the body with no negative effects (Del Piano et al., 2011; Begley et al., 2006; Jones et al., 2004; Kurdi et al., 2000).
This factor depends on whether you take probiotics on an empty stomach or with meals, and what you’re eating in general. The good news is that you can control factors related to your gut to get optimal benefits.
Image taken from Han et al., 2021
The dosage of Lactobacillus reuteri NCIMB 30242 used in clinical trials was 2.9×10⁹ CFU per capsule, twice daily (Jones et al., 2012).
Our L. reuteri NCIMB 30242 contains 3.5×10⁹ CFU per capsule. This is 21% more than the clinically researched dosage, which ensures you get the right amount of probiotics just in case some live bacteria are lost before they reach your colon.
We recommend taking two capsules per day to achieve optimal results.
Gastrointestinal transit is how long it takes for probiotics to reach your colon from the moment you ingest them. This can be anywhere from 5 minutes to 2 hours (Han et al., 2021).
The typical advice is to take probiotics on an empty stomach because food slows down their transit—that’s what most companies and blog posts will tell you. And it’s wrong!
Here’s why: food helps probiotics survive by neutralizing stomach acid. Exposure to more concentrated stomach acid (low stomach pH) can kill probiotics before they even make it to the intestine. It’s a bigger factor than transit time (Tompkins et al., 2011; Del Piano et al., 2011).
Recent studies on non-enteric coated probiotics showed that (Tompkins et al., 2011):
Also, since Lactobacillus probiotics need glucose in an acidic environment like the stomach, they seem to survive better when taken alongside carbs (Corcoran et al., 2005).
Our probiotic is more likely to survive an empty stomach than other commercially available strains and formulations. However, taking it on an empty stomach isn’t ideal.
We recommend taking L. Reuteri NCIMB 30242 shortly before or with a high-carb light meal (containing >1% fat) to boost survivability and bypass the harmful effects of stomach acid.
It can take a long time to digest heavy meals. Heavy food strongly increases stomach acid, bile acids, and digestive enzymes. Four to five hours can pass before the contents of heavy meals reach the colon, so even delayed-release capsules may free the probiotic too early.
For the best results, don’t take our probiotic capsules with or several hours after heavy meals.
Prebiotic fiber boosts the benefits of probiotics, makes live bacteria more tolerant to stomach acid, and supports the growth of a diverse gut microbiome in the colon (Markowiak & Śliżewska, 2017).
Fructooligosaccharides (FOS) are a type of fiber that exists in about 36,000 plants. It has been researched for enhancing the benefits of probiotics in the large intestine (Mao et al., 2018).
Since the concentration of FOS in plants is too low to have prebiotic effects, you need to supplement to get results (Davani-Davari et al., 2019).
Microbiome Plus+ prebiotic tablets contain 600 mg of concentrated short-chain fructooligosaccharides (scFOS). We recommend taking our fiber supplement at the same time as the probiotic.
Good sources of prebiotic, fiber-rich foods you can up in your diet include (Davani-Davari et al., 2019; Thursby & Juge, 2017)
Resistant starch is similar to prebiotic fiber and is another great addition to a diet that boosts probiotic effectiveness and microbiome diversity (Singh et al., 2019).
Non-fiber antioxidants from fruits and vegetables such as raw cacao and green tea also act as prebiotics (Davani-Davari et al., 2019; Tzounis et al., 2019).
Here are some examples of light meals packed with prebiotics:
We recommend taking L. Reuteri NCIMB 30242 up to half an hour before light, prebiotic-rich meals.
After all these efforts to help probiotics reach your colon, there’s one last question: how can you get the probiotic to stay there?
Colonization resistance is when bacteria indigenous to your colon reject the new probiotic strain. It’s a big and common problem, and if it happens, the supplemented probiotic is removed with the stool without achieving its benefits (Yao et al., 2020; Zmora et al., 2018).
Preliminary studies suggest that the following dietary compounds may help:
Omega 3 fatty acids and other PUFAS help probiotics “stick” to the gut lining. This is the first step to overcoming colonization resistance (Bomba et el., 2002; Bomba et al., 2003; Han et al., 2021).
Wild-caught fish is rich in omega-3 PUFAs. Plant-based sources of PUFAs include walnut, sunflower seeds, and flaxseeds. These beneficial fats also have anti-inflammatory and heart-protective properties that work in synergy with our probiotic.
It’s best to take L. Reuteri NCIMB 30242 about half an hour up to several hours before a meal with moderate amounts of these healthy fats.
Consider adding the following dietary compounds to your diet or supplement regime to help boost the benefits of our probiotic:
Olive oil is a nutritious fat that promotes intestinal health and increases the diversity of the gut microbiome. Extra virgin olive oil is an especially good choice for people with high LDL (“bad”) cholesterol and heart disease (Marcelino et al., 2019).
Curcumin is the main active ingredient in the spice turmeric. Aside from being one of the best-researched natural anti-inflammatories, curcumin helps restore gut microbiome balance. Curcumin boosts the growth of beneficial probiotics while reducing the number of pathogenic gut bacteria. Plus, it helps strengthen the gut barrier, which might be helpful for people with leaky gut (Scazzocchio et al., 2020; Di Meo et al., 2019).
You can get curcumin from food or take supplements.
Lastly, edible medicinal mushrooms help balance and enrich the gut microbiome. Mushrooms act as prebiotics and are rich in immune-boosting active compounds. Some sources include Lion’s mane, reishi, shiitake, maitake, turkey tail, and others (Jayachandran et al., 2017; Diling et al., 2017).
Avoid the following foods, they’re known microbiome disruptors (Suez et al., 2014; Singh et al., 2019):
In a nutshell, these foods reduce the effectiveness of probiotic supplementation, cause gut dysbiosis, and negatively affect your heart, immune, and overall health.
Some drugs and environmental toxins can also act as microbiome disruptors, including antibiotics, hormones, cigarettes, and many chemicals (dioxins, pesticides, pyrethroids, polychlorinated biphenyls (PCBs), flame retardants, plasticizers) (Ramirez et al., 2020; Aguilera et al., 2020).
If you’re worried about drug interactions and side effects, be sure to discuss your concerns with your care provider.
The time it will take for you to experience the health benefits of supplementation is individual.
Clinical trials that achieved results with L. Reuteri NCIMB 30242 lasted for 6 to 9 weeks (Jones et al., 2012; Jones et al., 2012).
Read more about the unique benefits of our probiotic:
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
]]>Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
A commonly cited 2018 review looked at the effects of various probiotic strains on total cholesterol levels. They concluded that probiotics in general lower total cholesterol better than the placebo, based on 32 clinical trials including almost 2k patients (Wang et al., 2018).
The authors discovered that Lactobacillus acidophilus, Bifidobacterium lactis, and Lactobacillus plantarum were the most commonly used probiotic strains for lowering total cholesterol levels. Yet, strong clinical evidence to support their effectiveness was lacking.
Based on the authors’ calculations, L. reuteri NCIMB 30242—the probiotic strain in Microbiome Plus supplements also known as LRC—lowered total cholesterol by about 4.4% when used in a yogurt formulation.
The original study reports that L. reuteri NCIMB 30242 lowered total cholesterol by 4.81%. This study was followed up by another study that found a 9.14% reduction with L. reuteri NCIMB 30242 capsules. The second study was not included in the review, which questions its scientific comprehensiveness (Jones et al., 2012; Jones et al., 2012).
What else is problematic about the 2018 review?
The most important flaw is that this analysis looked only at total cholesterol. This oversimplifies the heart disease risk. The impact of total cholesterol on heart disease risk is unclear and controversial, so let’s see what’s a better marker (Wang et al., 2018).
High LDL or “bad” cholesterol is a known risk factor for heart disease. Elevated levels of LDL cholesterol can clog arteries and disrupt blood flow, potentially causing heart attacks and stroke. Therefore, probiotic strains that show the potential to lower LDL cholesterol are more clinically valuable than strains that impact total cholesterol only (Gibbing et al., 2019).
A meta-analysis of 30 trials (including one Lactobacillus reuteri NCIMB 30242 trial) reported that probiotics in general lower LDL by only ~4% (Cho & Kim, 2015)
Similarly, a meta-analysis of 13 smaller probiotic clinical studies reported a mean reduction of LDL cholesterol by only ~3%. Yet, none included L. reuteri strains (Guo et al., 2011).
Lactobacillus reuteri and Lactobacillus plantarum seem to significantly reduce both total and LDL cholesterol, based on a focused analysis of 15 trials of Lactobacilli strains including close to 1k participants (Wu et al., 2017).
Scientists involved in L. reuteri NCIMB 30242 research believe that this strain has a stronger effect on LDL cholesterol and other heart-healthy factors than other probiotics that are currently being used. However, more clinical research is needed to confirm this (Jones et al., 2012)
Limited evidence suggests that Lactobacillus reuteri NCIMB 30242 may support blood sterol levels already in the normal range. In the clinical trial of 127 people, Lactobacillus reuteri NCIMB 30242 decreased levels of several plant sterols in the blood (campesterol by 41.5%, sitosterol by 34.2%, and stigmasterol by 40.7%) (Jones et al., 2012).
Normal blood sterol levels contribute to heart and blood vessel health. Scientists are just beginning to explore the potential dangers of high sterol levels.
People with a rare genetic disorder sitosterolemia have very high plant sterols, fatty growths under the skin, and heart complications. Sterol levels above the normal range may disrupt red blood cells, platelets, blood clotting, and adrenal and ovarian health (Patel, 2019; Mushtaq et al., 2007).
Based on limited research, Microbiome’s Lactobacillus Reuteri NCIMB 30242 may be a good supplement choice for supporting cholesterol balance in hyperabsorbers (Jones et al., 2012).
Not all probiotics are good for heart health. The benefits of probiotics are often specific to a certain strain (Lactobacillus reuteri NCIMB 30242). Other times, the benefits may apply to the whole probiotic species (Lactobacillus reuteri/Limosilactobacillus reuteri) or genus (Lactobacilli).
Out of various Lactobacillus reuteri strains, only Lactobacillus reuteri NCIMB 30242 has been clinically researched for supporting healthy cholesterol levels and other markers of heart health.
Proponents claim that the effects of probiotics on total and LDL cholesterol are enough to classify them as heart-healthy.
However, heart health is a lot more complex than total and LDL cholesterol levels. Other markers that increase the risk of heart disease include inflammation, increased blood clotting, low HDL cholesterol, and high levels of serum triacylglycerol and triglyceride-rich lipoproteins. Genetic factors, lifestyle, age, and other chronic diseases also play in (DiRienzo, 2014).
Adopting a healthy lifestyle helps reduce some markers of heart disease risk. General steps you can take include maintaining a healthy body weight, engaging in regular physical activity, consuming a nutritious diet, reducing trans fat intake, and avoiding tobacco. More specific and evidence-based approaches include dietary supplements like targeted probiotic strains.
In the next section, we’ll zoom in on markers of chronic inflammation, blood clotting, and blood circulation that have the potential to be modified by probiotics.
According to researchers, therapeutic lifestyle changes (TLCs) for heart disease can include the regular consumption of specific clinically tested foods or supplements, such as probiotics and fiber (DiRienzo, 2014).
One scientific review concluded that L. reuteri NCIMB 30242 probiotics best meet TLC heart-healthy requirements since they (DiRienzo, 2014):
In one study, Lactobacillus reuteri NCIMB 30242 yogurt taken twice a day for 6 weeks reduced LDL by ~9%, total cholesterol by ~5%, and non-HDL cholesterol by 6% compared to placebo in 114 adults with high cholesterol (Jones et al., 2012).
In another study, L. reuteri NCIMB 30242 capsules reduced LDL cholesterol by ~11.6%, total cholesterol by ~9%, and non-HDL cholesterol by ~11% compared to placebo in 127 people over 9 weeks. Supplementation also improved two other markers of heart health: the LDL-C/HDL-C ratio (by ~13%) and ApoB-100 (by ~8%) (Jones et al., 2012).
Other probiotic strains that may also support heart health include (Fuentes et al., 2013; Bernini et al., 2018; Costabile et al., 2017; Khare & Gaur, 2020)
More clinical research on the efficacy and safety of each of these strains is needed before they can be recommended to heart disease patients.
You may have heard about the “probiotics cardiologist warning” in the popular press. Why do cardiologists warn against probiotics in some cases?
In serious and rare cases, heart disease and certain medications used to manage heart disease may weaken the immune system causing immunocompromization.
If you suffer from weak immune system function, please consult a specialist before taking any supplements.
According to studies, probiotics containing live microorganisms should be used with caution in immunocompromised patients because they may cause infection or pathologic colonization (Anthony & Leon, 2018).
In one case, a patient with an advanced and severe heart condition (bicuspid aortic valve stenosis) developed heart inflammation or endocarditis from L. paracasei supplementation (Anthony et al., 1996).
On the other hand, one added benefit of L. reuteri NCIMB 30242 is that it supports immunity. It’s the only probiotic reported to increase vitamin D levels in clinical studies. Therefore, vitamin D and probiotics co-supplementation may be beneficial (Jones et al., 2013).
The existing evidence suggests that specific strains of Bifidobacterium lactis, Lactobacillus plantarum, Lactobacillus bulgaricus, Lactobacillus sporogenes, and Lactobacillus reuteri may support heart health and cholesterol. Of them, solid clinical evidence backs up the use of L. reuteri NCIMB 30242 (LRC), the strain in Microbiome Plus probiotics.
Read next:
Save Big on 3-Pack for Probiotics and Prebiotics
Disclaimer: This post is for informational purposes only. Please discuss your health concerns with your care provider and consult them before taking any supplements to avoid disease and drug interactions.
The short answer is yes. Taking vitamin D and probiotics together is usually a good idea. Unless you have a condition that is a contraindication for taking either vitamin D or probiotics, you can take the two together. As always, be sure to consult your doctor first.
Recent studies reveal that vitamin D and probiotics act in synergy. Their combined effects are more powerful than the effect of each active ingredient taken alone (Abboud et al., 2021).
Vitamin D deficiency can lead to poor bone health, weak immunity, inflammation, and many other health problems. We’re in need of new solutions to vitamin D deficiency, which is becoming a global health problem.
The current approaches to tackling vitamin D deficiency in people who can’t get enough natural sunlight include vitamin D supplementation, food fortification, and the use of probiotics (Gokhale & Bhaduri, 2019).
It works the other way around too: maintaining optimal vitamin D levels supports good intestinal health and gut microbiome diversity. On the other hand, an unhealthy gut microbiome or gut dysbiosis is a big risk factor for inflammatory bowel disease (IBD), obesity, diabetes, asthma, and allergies (Akimbekov et al., 2020; Butel et al., 2018).
However, not all probiotics synergize with vitamin D. We go into the science of probiotics with the highest levels of evidence in the next section.
Save Big on 3-Pack for Probiotics and Prebiotics
The only probiotic strain proven to increase vitamin D levels in clinical trials is Lactobacillus reuteri NCIMB 30242. In a Canadian study of 123 people, Lactobacillus reuteri NCIMB 30242 increased vitamin D3 blood levels by 25.5% compared to placebo (Jones et al., 2013).
Scientists suspect that Lactobacillus reuteri NCIMB 30242 can increase (Jones et al., 2013):
A study published in the prestigious journal Nature reveals that prebiotic fiber may enhance this benefit. Using a model of the human gut microbiome, researchers discovered that short-chain fructooligosaccharide (scFOS) or inulin fiber can additionally increase 7-DHC by feeding good gut bacteria (Gokhale & Bhaduri, 2019).
Low 7-DHC is a crucial but overlooked factor that contributes to vitamin D deficiency. The elderly have about 75% lower skin 7-DHC levels, which massively reduces their vitamin D production. Other factors that lower 7-DHC include having darker skin (since melanin competes with 7-DHC) and post-burn scar tissue (gets 40% less 7-DHC) (Gokhale & Bhaduri, 2019).
Our Microbiome Plus+ Gastrointestinal Combo is a science-based supplement that includes both Lactobacillus reuteri NCIMB 30242 and scFOS prebiotic fiber. Get it here today.
Probiotics may increase the activity and expression of the vitamin D receptor (VDR), according to animal experiments (Yoon & Sun, 2011).
Vitamin D achieves its effects by binding to VDR, which is found in all tissues in the body. It’s possible for someone to have normal vitamin D levels but poor VDR activity. Poor VDR activity can trigger the symptoms of vitamin D deficiency (Bouillon et al., 2008; Bikle, 2020).
Increased VDR activity may help remedy microbial dysbiosis, reduce inflammation, improve the integrity of the gut barrier, and boost the production of beneficial short-chain fatty acids (Abboud et al., 2021).
The first way in which probiotics like Lactobacillus reuteri support immune health is by boosting vitamin D absorption, production, and overall levels in the body (Jones et al., 2013)
Vitamin D deficiency is common to metabolic, inflammatory, and immune disorders. According to a recent review of scientific studies, supplementing both vitamin D and probiotics improved various inflammatory markers. Higher doses had a stronger effect (Abboud et al., 2021).
By activating VDR, probiotics protect the gut from inflammation and bacterial infection. Normal vitamin D levels also support a healthy gut microbiome and protect the gut lining. This might be especially helpful in IBD and colorectal cancer, but proper clinical trials have yet to be carried out (Shang & Sun, 2017).
Plus, vitamin D and VDR strengthen the immune system. Meanwhile, VDR also helps control gut dysbiosis and protects people with low vitamin D from IBD symptoms (Shang & Sun, 2017).
Probiotics supplementation—with Lactobacillus and Bifidobacterium species—helps the gut get rid of harmful bacteria and balances the immune response in cells that line the gut lining (Shang & Sun, 2017).
Probiotics may also increase Treg cells, which are in charge of immune balance in the body. Treg immune cells can reduce both autoimmunity and inflammation (Shang & Sun, 2017).
Polycystic ovary syndrome (PCOS) is the most common gynecological health issue in premenopausal women. It’s a complex syndrome that’s been linked with chronic inflammation, oxidative damage, and suboptimal vitamin D levels (Ostadmohammad et al, 2019).
In a placebo-controlled clinical trial of 60 women with PCOS, vitamin D and probiotics co-supplementation over 12 weeks improved (Ostadmohammad et al, 2019):
The results are promising, and more high-quality clinical trials are needed.
Vitamin D plays many roles in the brain. It protects brain cells, supports brain development, and balances neuroimmunity. It increases dopamine, a neurotransmitter that activates your centers for motivation and reward (Abboud et al., 2021).
In parallel, gut bacteria can also impact the production of neurotransmitters. They boost serotonin, known as the “happiness” neurotransmitter, and gamma-aminobutyric acid (GABA), which helps you relax and de-stress (Abboud et al., 2021).
So, the combined effects of vitamin D and probiotics may have a more powerful effect on mental health than each compound alone.
Limited evidence suggests that taking vitamin D and probiotics together may improve antioxidant status and blood lipid levels. This combo might also help increase insulin sensitivity and help reverse insulin resistance, reducing the risk of diabetes and clogged arteries. These findings are mostly limited to animal experiments (Abboud et al., 2021).
Clinical trials show that probiotics like Lactobacillus reuteri NCIMB 30242 help balance LDL and total cholesterol levels, which may also explain this benefit (Jones et al., 2012).
Some strains of probiotics have been researched in babies. Clinically studied strains include Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb-12 for diarrhea, Lactobacillus reuteri DSM 17938 for colic, among others (Martinelli et al., 2020).
These probiotics are commonly combined into drops with vitamin D since the current guidelines state that breastfed newborns need supplemental vitamin D to maintain healthy levels (CDC).
Vitamin D drops (with or without probiotics) are recommended to fully or partially breastfed infants 0–12 months of age. Consult a pediatrician before use.
Save Big on 3-Pack for Probiotics and Prebiotics
There are many benefits to taking probiotics together with vitamin D. Probiotics and vitamin D act in synergy to support your gut, immune system, and mental health. More clinical trials are needed, but most people may benefit from this combo for general well-being.
Statements made on this website have not been evaluated by the U.S. Food and Drug Administration. Information provided by this website or this company is not a substitute for direct, individual medical treatment or advice. It is the responsibility of you and your healthcare providers to make all decisions regarding your health. Microbiome Plus recommends that you consult with your healthcare providers regarding the diagnosis and treatment of any disease or condition. Products sold on this website are not intended to diagnose, treat, cure, or prevent any disease.
]]>Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns and medications before taking any supplements.
This post will go over the complete evidence on the pros and cons of foods and supplements with plant sterols and stanols. We’ll highlight some controversial research that is rarely talked about.
Pros:
Cons:
We go over the cons in more detail in this follow-up post, which reveals the findings of a ground-breaking 2020 scientific study about the dangers of plant sterols (Helgadottir et al., 2021; Helgadottir et al., 2020).
Plant sterols and stanols are fatty molecules similar to cholesterol (Patel, 2008).
Exclusively plants can produce plant sterols. Many vegetables and fruits abound in them. So far, scientists have identified over 250 plant sterols. The main ones in our diet are beta-sitosterol, stigmasterol, and campesterol (Vezza et al., 2020).
Plant stanols are found in plants in tiny amounts, but most are artificially processed (hydrogenated) plant sterols.
We absorb plant sterols in tiny amounts compared to cholesterol (~50% of cholesterol, <5% plant sterols, <0.5% plant stanols from food) (Fransen et al., 2007; Patel, 2009).
Read more about the difference between cholesterol and plant sterols in general here.
Plant sterols are absorbed by the gut in place of some cholesterol. In turn, the gut absorbs less cholesterol, which lowers its blood levels. Levels of plant sterols in the blood, however, increase (Weingärtner et al., 2009).
Plant stanols pass through the gut, mostly without being absorbed. They bind to cholesterol-rich bile on the way out, removing more cholesterol from the body and lowering its blood levels. Some fat-soluble vitamins also get flushed out, however (Weingärtner et al., 2009).
Plant sterols or stanols are usually esterified in supplements, margarine, spreads, and yogurts. This means that they are chemically processed and joined with fatty acids into esters. This makes them more soluble in water and increases their bioavailability (Fransen et al., 2007).
Ever since plant sterols were first discovered, scientists can’t seem to agree: are they essential micronutrients or potentially harmful compounds?
Advocates claim plant sterols are mostly beneficial. They’re purported to help balance the immune response and cholesterol levels, enhance mitochondrial and gut health, and reduce oxidative stress and inflammation (Vezza et al., 2020).
Skeptics warn about the lack of long-term safety research and possibly detrimental effects on heart health and nutrient status.
Regulatory health bodies across the globe are equally divided.
In 2000, the US Food and Drug Administration (FDA) allowed a health claim for reducing the risk of coronary heart disease for foods that contain phytosterols and are low in saturated fat and cholesterol. This is the 12th time the FDA has authorized a health claim for a supplement ever (Weingärtner et al., 2009).
The FDA claim is valid only for esterified plant sterols and stanols. Experts wrote to the FDA to request expanding the rule to natural (non-esterified) plant sterols. In 2010, the FDA amended this rule to apply to all conventional foods that include mixtures of esterified and non-esterified plant sterols derived from vegetable oils and tall oil (from Kraft wood pulping).
Yet, the FDA stuck to saying there’s not enough evidence that plant sterols can have notable health risks. But it’s not like that in some other parts of the world.
Health Canada now allows a limited range of foods enriched with plant sterols. The regulations eased up in 2010, after an initial ban of these foods based on a 2000 animal study reporting the negative effects of plant sterols on heart health and red blood cells (Ratnayake et al., 2000; Weingärtner et al., 2009).
The European Food Safety Authority states that the safety of plant sterols has not been adequately established. They paid special attention to studies showing plant sterols may reduce the levels of carotenoids (provitamin A) and other fat-soluble vitamins. Foods enriched with plant sterols have to carry a label that advises children, pregnant, and breastfeeding women to avoid them in the EU.
Clinical studies show that plant sterols can lower total and “bad” LDL cholesterol levels in people with familial hypercholesterolemia, a genetic condition that can cause extremely high cholesterol.
Compared to a cholesterol-lowering diet alone, taking plant sterols additionally lowers total cholesterol (by 12 mg/dL) and LDL cholesterol (by 23 mg/dL) in this population (Malhotra et al., 2014).
In clinical trials, margarine spreads or yogurt with plant sterols (reaching 1.6-2.3 g/day) reduced total cholesterol by up to 11% and LDL cholesterol by up to 14% in patients with familial hypercholesterolemia. But, plant sterols did not reduce triglyceride levels or increase “good” HDL cholesterol levels in most of these trials (Amundsen et al., 2004; O'Neill et al., 2005; Guardamagna et al., 2010; Vásquez-Trespalacios & Romero-Palacio, 2014).
Similarly, clinical studies show that plant sterols (alone or with plant stanols) reduce total and LDL cholesterol in people with high cholesterol or hypercholesterolemia.
According to clinical trials and systematic reviews, adding plant sterols to a cholesterol-lowering diet additionally reduces total cholesterol by 3-8% and LDL cholesterol by about 5-15% (Weststrate & Meijer, 1998; Kabral & Clein, 2017; Gylling et al., 2013).
A study of 63 people revealed that plant sterols have the greatest cholesterol-lowering effect in people who do not produce a high amount of cholesterol. These responders are cholesterol hyperabsorbers—they have high cholesterol because they absorb it in excess. Every fourth person is a hyperabsorber (Mackay et al., 2015).
Genetics
The above study reveals a strong genetic component to plant sterols response. Common genetic variations (like CYP7A1-rs3808607 and APOE ε4) that increase cholesterol absorption and bile acid production in the body have been linked to a better response to plant sterols (Mackay et al., 2015; Mackay et al., 2015).
Another study confirmed that people with markers of low cholesterol synthesis and high cholesterol absorption were more likely to see LDL cholesterol drops on plant sterols (Casas-Agustench et al., 2011).
Statins Response
Interestingly, these are the same people for whom statins—the main drug therapy—are less likely to work and more likely to trigger heart complications (Miettinen et al., 1998; the Scandinavian Simvastatin Survival Study (4S), 1994).
Studies suggest that adding plant sterols to statins may additionally lower cholesterol levels. However, there’s a lot we don’t know about how this therapy can be individualized and who will respond. It’s theoretically possible that only hyperabsorbers would see a benefit (Scholle et al., 2009).
In Combination with Zetia
Zetia (ezetimibe) is a drug alternative to statins for hyperabsorbers. It works by blocking cholesterol absorption. In a study of 41 heart disease patients, adding plant sterols to statins lowered LDL by ~ 17%, adding ezetimibe ~19%, while the ezetimibe-plant sterols combination cut LDL by ~27% (Gomes et al., 2017).
Hyperabsorbers are also the same people for whom L. Reuteri NCIMB 30242 shows promise since it was clinically investigated for lowering cholesterol absorption (Jones & Prakash, 2012). We covered that research and how to find out if you are a hyperabsorber in a separate post.
Plant Stanols vs Sterols for Hyperabsorbers
Although one review concluded that plant sterols and stanols have similar effects on cholesterol, some studies suggest that plant stanols might be more relevant for hyperabsobers. (Talati et al., 2010)
Plant stanols seem to reduce plant sterol blood levels and cholesterol absorption dose-dependently (Hallikainen & Gylling, 2014).
Plant stanols also reduced plant sterol levels in the carotid arteries in statin-treated patients without changing the walls of the arteries. So, plant stanols might be less likely to cause side effects to the heart and blood vessels, but more research is needed (Miettinen, 2011).
Evidence suggests that plant sterols and stanols may help lower LDL cholesterol in people who absorb too much cholesterol, in addition to diet and drug therapy. Plant stanols likely block absorption better than plant sterols.
In the US, foods containing at least 0.65 g of plant sterols and foods and supplements containing at least 1.7 g of plant stanols per serving are allowed to be labeled with a health claim for lowering heart disease risk. These foods must also meet low saturated fat and cholesterol requirements (fda.gov).
The health claim can say "Diets low in saturated fat and cholesterol that include two servings of foods that provide a daily total of at least 3.4 grams of plant stanol esters may reduce the risk of heart disease" (efcr.gov).
Yet, experts stress that lowering LDL cholesterol doesn’t equal reduced heart disease risk. It’s more complex than that.
Studies investigating the link between plant sterol blood levels and heart health had conflicting results. The largest trials and genome-wide association studies found an association with increased heart disease risk. Others have reported no such association (Vergès & Fumeron, 2015).
Overall, the available data can’t confirm an increased or decreased heart disease risk from plant sterols, nor can it rule out either. Large trials are needed to properly test this.
According to limited research, eating plant sterols does not affect the risk of rectal cancer in women or colon cancer in both men and women. One study found a link between higher dietary plant sterols intake and an increased risk of rectal cancer in men, but more research is needed (Normén et al., 2001).
There is not enough evidence to support the use of plant sterols for any of the conditions listed below.
In one Uruguayan study, people who ate at least 82.5 mg of plant sterols per day through food had slightly lower odds of gastric cancer compared to those who ate less than 45.5 mg (De Stefani et al., 2000).
The effects of plant sterols on metabolic syndrome have been mixed.
In one clinical study, yogurt mini-drinks with plant sterols reduced total and LDL cholesterol in 108 people with metabolic syndrome on a typical Western diet (Sialvera et al., 2010).
In a smaller study of 9 men with metabolic syndrome, plant sterols in breakfast cereal and margarine didn’t improve blood cholesterol (Ooi et al., 2007).
More research is needed.
According to limited research in the Swedish population, men who take in ~340 mg of plant sterols daily have a 29% lower risk of suffering a heart attack for the first time compared to men who take in ~150 mg daily. This association didn’t stand in women. Additional research needs to confirm it (Klingberg et al., 2013).
In one clinical study of 24 overweight people, diet and rice bran snack bars fortified with a plant sterols and stanols mix did not improve weight loss, LDL cholesterol, or blood sugar better than diet and unfortified snack bars (Hongu et al., 2014).
In this study, plant sterols snacks lowered total cholesterol ~10% more than regular snacks. It’s unclear if this is meaningful.
Since plant sterols reduce cholesterol absorption, they may cause gut-specific side effects like diarrhea and excess amounts of fat in the stool (steatorrhea).
One child also experienced abdominal discomfort in a clinical trial (Patel & Salen, 1998).
Sitosterolemia or phytosterolemia is a rare genetic disorder that causes a massive buildup of plant sterols in the body and blood. It affects fewer than one per 1 million people, although it might be underdiagnosed.
Plant sterols are dangerous for people with sitosterolemia.
In sitosterolemia, a person will absorb plant sterols in extreme excess because their body can’t tell apart cholesterol from plant sterols. Sitosterolemia is associated with fatty growths underneath the skin, heart complications, and the breakdown of red blood cells (Patel, 2009).
The FDA concluded that no cautionary statement about plant sterols sensitivity is necessary and that consumers aware of their sensitivity should consult their medical practitioner.
However, some people may be unaware of their sensitivity, which can be subtle.
Common genetic mutations (ABCG8, ABCG5) can make people slightly sensitive to plant sterols. A diet enriched with plant sterols will still raise their blood plant sterol levels way above the normal range (Patel, 2009).
The consequences of high plant sterols in this population may include abnormal red blood cells, anemia, giant platelets, increased bleeding, and adrenal and ovarian failure. Some researchers believe that a buildup of plant sterols may disrupt hormonal balance (especially of sex and steroid hormones), but more research is needed (Mushtaq & Wright, 2007; Patel, 2009).
An analysis of 41 trials involving over 3000 people concluded that plant sterol and stanol intake lowers blood levels of carotenoids like beta carotene, lycopene, lutein, and zeaxanthin. Carotenoids are antioxidants and provitamin A. They maintain immune and eye health (Baumgartner et al., 2017).
In Europe, foods enriched with plant sterols must contain a warning about this side effect along with a recommendation to increase fruit and vegetable intake to help maintain carotenoid levels.
Plant sterols may also reduce the absorption and blood levels of vitamin E, but it’s uncertain to what extent. Increasing vitamin E foods is likely a good idea (Richelle et al., 2004; Baumgartner, 2017; Tuomilehto et al., 2008).
One woman experienced allergic skin rash on the hands and feet and face swelling while taking plant sterol supplements. The culprit isn’t completely clear, though (Hussain, & Roberts, 2008).
In another woman with high cholesterol, plant sterol-enriched margarine increased blood plant sterols and led to fatty growths under the skin (Vergès et al., 2009).
Several studies point out that plant sterols may trigger heart disease by gradually building up in small blood vessels. They point to a link between higher blood plant sterol levels and a narrowing of arteries that deliver oxygen-rich blood to the retina of the eye (Kelly et al., 2011).
Blockage of retinal arteries can lead to vision loss. It’s also been linked with high blood pressure. However, additional research is needed to explore if plant sterols are part of the problem.
Stigmasterol blocked a receptor that’s important for transporting bile in liver cells (FXR) (Scolaro et al., 2020).
Scientists are investigating whether beta-sitosterol can be toxic to cells in test tubes (Rubis et al., 2008).
We can’t know if plant sterols will have these effects in live animals (let alone humans).
According to one theory, only mega doses of certain plant sterols have toxic potential. Natural food sources contain a mix of plant sterols and may be less likely to cause imbalances, but this hasn't been confirmed (Lizard, 2008).
Here is a list of healthy foods with plant sterols (Kabral & Clein, 2017; Vezza et al., 2020; Shin et al., 2010; Schepers et al., 2020):
Foods with plant stanols (Klingberg et al., 2008; Yang et al., 2019):
Unhealthy sources of plant sterols include:
A typical western diet contains ~300 mg of sterols and 30 mg of plant stanols in a day. Vegetarians tend to have a higher intake (300 - 500 mg/day) (Kabral & Clein, 2017).
The recommended daily intake of phytosterols for LDL-cholesterol reduction is ~2 g/day, but the optimal intake is unknown (Kabral & Clein, 2017).
Plant sterols have now been added to spreads, salad dressing, milk, soy, yogurt, cheese, fruit drinks, and even sausages and bread. Analyses suggest that it’s very easy to take in excessive amounts with all these new types of fortified products.
Be sure to always check the label. Children and pregnant and breastfeeding women should be extra cautious.
Recent studies reveal that plant sterols can interact with the gut microbiome (Cuevas-Tena et al., 2018; Kübeck et al., 2016).
Different sources and types of plant sterols may have different effects. Compared to olive or safflower oil, palm oil increased weight gain, lowered microbial diversity, and increased the ratio of “bad” to “good” probiotic bacteria (Firmicutes to Bacteroidetes) (de Wit et al., 2012).
Plant sterols may act also in symbiosis with probiotics, but clinical research is needed to confirm this. In a rat study, probiotics were more effective at lowering total and LDL cholesterol than plant sterols. However, their combination had the greatest effect on lowering LDL (Awaisheh, 2013).
Increasing healthy food sources of prebiotics, probiotics, and plant sterols at the same time is the best way to go.
Read about prebiotic and probiotic food sources here.
Lactobacillus Reuteri NCIMB 30242 is a reasonable alternative for people who want to avoid plant sterols. In a clinical trial of 127 people, this probiotic strain reduced LDL cholesterol, total cholesterol, and plant sterol blood levels (Jones & Prakash, 2012).
Find out how L. Reuteri affects cholesterol and plant sterols here.
The typical plant sterols dosage for lowering cholesterol is 1.6-1.8 grams daily, usually accomplished by eating fortified spreads.
The dosage in clinical trials varied from 200 mg to 9 g/day. Most research shows that there is no benefit to going above 2-3 grams daily.
According to the FDA, at least 3.4 g/day of plant stanol esters or 1.3 g of plant sterol esters has been linked with reduced heart disease risk, in addition to a low-fat, low-cholesterol diet. This approach is controversial.
We advise caution since there is a lack of safety data on going over 3 g per day (Weingärtner et al., 2009).
Ana is an integrative pharmacist and scientist with many years of medical writing, clinical research, and health advising experience. She loves communicating science and empowering people to achieve their optimal health. Ana has edited 800+ and written 150+ posts, some of which reached over 1 million people. Her specialties are natural remedies, women’s health, and mental health. She is also a birth doula and a strong advocate of bridging scientific knowledge with holistic medicine.
Disclaimer: This post is for informational purposes only. Other causes that are beyond the scope of this article may also affect cholesterol levels. Ask your doctor if you should have a cholesterol test. If your cholesterol levels are high, your doctor may run more tests to determine the underlying causes and suggest treatment. Be sure to consult your doctor before making any major changes to your lifestyle, diet, or supplements regimen.
✔ Fact: A Nutrient-Dense Diet Supports Cholesterol Balance
Eating a diet rich in fruits, vegetables, whole grains, nuts, seeds, and fish supports healthy cholesterol levels. Getting plenty of prebiotics and probiotics also helps (R, R).
✖ Myth: Foods High in Saturated Fat Cause High Cholesterol
Foods that contain cholesterol are usually high in saturated fat, such as fatty meat, full-fat dairy, and eggs.
However, the research on their health effects thus far has been controversial (R, R).
A 2019 study that analyzed data from 29,615 US participants reported a link between eating more dietary cholesterol or eggs with heart disease and deaths from any cause. Researchers are still debating whether their findings are scientifically robust (R).
Other published analyses of clinical trials concluded that saturated fats do not increase the risk of heart disease. One large study even reported lower heart disease risk with increased intake of energy from saturated fat (R, R, R).
✔ Fact: Not All People Respond in the Same Way to a High-Cholesterol Diet
Individual differences can help explain some of the controversies around high-saturated-fat diets.
According to clinical studies, most people see no or only a mild increase in cholesterol blood levels in response to a high-cholesterol diet. They are classified as hypo-responders (R).
On the other hand, about a third of people are hyper-responders and see a dramatic increase in their cholesterol levels on a high-cholesterol diet (R).
All in all, the amount of cholesterol in your food does not equal the amount of cholesterol in your blood. Exactly how food impacts your blood cholesterol levels possibly comes down to genetic tendencies, which we cover further below (R).
✔ Fact: Trans Fats Increase Cholesterol and Heart Disease Risk
Data undoubtedly reveal that trans fats are harmful. According to studies, a trans fats intake above 4%–6% increases blood LDL cholesterol (the “bad” cholesterol) (R).
The FDA states that removing trans fats from processed foods could prevent thousands of heart attacks and deaths each year.
✔ Fact: Smoking, Obesity, and Lack of Exercise Increase Cholesterol
High cholesterol is often tied to unhealthy lifestyle choices. Smoking, being inactive, drinking too much alcohol, and obesity put people at risk of high cholesterol (R).
✖ Myth: Age Doesn’t Affect Cholesterol Levels
Cholesterol levels tend to increase with age. But scientists have yet to define an optimal range for older people since excessively low cholesterol may be as dangerous as high levels (R).
✔ Fact: Chronic Health Problems and Medications Can Raise Cholesterol
Diabetes increases the risk of high cholesterol, damage to the arteries, and heart disease (R).
Stress is another factor that has been linked to free radical damage, inflammation, chronic health problems, and high cholesterol (R, R, R).
Many medications can also raise cholesterol levels (R).
✖ Myth: If High Cholesterol Doesn’t Run in Your Family, Your Genes Don’t Matter
When someone says that they have a family history of high cholesterol, they are usually referring to genetic disorders called familial combined hyperlipidemia or familial hypercholesterolemia (R, R).
However, this is just the tip of the genetics iceberg.
At a basic level, there are three main potential reasons for high cholesterol levels:
Have in mind that these are not mutually exclusive. Genetic factors interact with other genetic factors, diet, and lifestyle. Plus, other genetic factors (including ApoE4) that are beyond the scope of this article can also impact cholesterol levels (R).
✔ Fact: Some People Can Have High Cholesterol Because They Have a Genetic Tendency to Absorb It in Excess (Hyperabsorbers)
About 25% of people are cholesterol hyperabsorbers. They tend to absorb lots of cholesterol and produce little. Hyperabsorbers are more likely to have heart disease despite similar HDL and LDL cholesterol levels (R, R).
Identifying hyperabsorbers can make a big difference to doctors when it comes to treatment (R).
Interestingly, research reveals that most people with familial hypercholesterolemia are hyperabsorbers (R).
Aside from genetics, age increases the chance of being a hyperabsorber, especially in postmenopausal women (R, R).
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Save Big on 3 Pack of the Prebiotics
Disclaimer: This post is for informational purposes only. Please consult your doctor about your health-related concerns before taking any supplements.
Prebiotics are indigestible food ingredients that feed your good gut bacteria. While indigestible for you, the good bacteria in your colon can digest and ferment prebiotics. In turn, prebiotics boost the number or activity of your good gut bacteria (R).
Although prebiotics are usually a specialized type of fiber (such as fructooligosaccharides or oligofructose, beta-glucans, and resistant starch), that isn’t always the case. For example, scientists discovered that some non-fiber antioxidants from cocoa also act as prebiotics (R, R).
Probiotics are good bacteria. They’re living microorganisms that normally reside in your body. Their diversity and number can have a large impact on your health (R).
So, probiotics and prebiotics only sound similar enough—and that’s only because both terms refer back to the gut microbiome. The “biotic” part comes from Greek and means “life.” In modern science, your gut’s “biota” or “biome” is its entire living network of microbes (R).
To sum it up, probiotics boost your gut microbiome by supplying living bacteria, whereas prebiotics are what your gut bacteria use as fuel.
Save Big on 3 Pack of the Prebiotics
Here’s a breakdown of the main benefits prebiotics and probiotics have been linked to (R, R, R, R, R, R, R).
Prebiotics help reshape your gut microbiome. Your gut bacteria break them down to various short-chain fatty acids. This lowers your colon’s pH, making it a more friendly environment for specific beneficial bacteria. Some of these bacteria can produce butyrate, an anti-inflammatory fat that boosts antioxidant levels (R, R).
It’s important to remember that probiotic effects are very strain-specific and cannot be generalized. Just because one strain carries certain benefits doesn’t mean another similar-sounding strain will have the same effect.
For example, L. reuteri NCIMB 30242 supports cholesterol balance, based on clinical studies. But L. reuteri DSM 17938 hasn’t been researched for this purpose.
Save Big on 3 Pack of the Prebiotics
More clinical studies are needed to confirm many of the potential health benefits of both probiotics and prebiotics. All in all, probiotics are better researched than prebiotics (R).
Studies reveal it’s likely best to take certain probiotics and prebiotics together. They can act in synergy—one enhancing the effect of the other (R).
Combinations of prebiotics and probiotics that act in synergy are called synbiotics. An effective synbiotic should contain a prebiotic that selectively increases the growth or activity of a beneficial probiotic strain (R).
If you’re eating a balanced, healthy, and diverse diet on a daily basis, you’re probably getting plenty of prebiotics and probiotics.
Here are some good sources of each (R, R, R):
In case you're struggling to get enough fermented and fiber-rich foods in your diet, adding supplements to your regimen might be a good idea.
Have in mind that there are countless probiotic and prebiotic supplements on the market. You can choose from many probiotic strains, formulations, and dosages. However, some products lack proof of efficacy.
For a supplement to be beneficial, it needs to contain a well-researched synbiotic combination at the correct dosage. It’s also important to find a product that reaches the large intestine before getting broken down by stomach acid.
As always, consult your healthcare provider first if you’re considering supplementation.
Microbiome Plus+ has research-based synbiotic supplements that combine L. reuteri NCIMB 30242 with short-chain fructooligosaccharides (scFOS) prebiotic fiber.
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These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
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These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
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A study published in the journal Globalization and Health estimated that 31.9% of our fellow citizens are experiencing anxiety specifically. That means almost one in three people have ongoing symptoms like excessive fear, catastrophizing and an inability to let go of negative thoughts. Panic attacks can strike. A racing heart may be accompanied by hot or cold flushes. Breathing can quicken. A sense of restlessness, tension or edginess can settle in. These unpleasant signs and symptoms can lead to avoidance of situations that could trigger stress. This can lead to work, relationship or social avoidance and isolation.
So, what can you do to calm anxiety; to get back on a level footing?
Probiotics may offer an unexpected, safe and effective answer.
Probiotics and anxiety: The gut and the brain talk
While we tend to imagine that anxiety occurs strictly in the brain, the incredible human body and mind are far more complex. In fact, you might have experienced this in your own life. If you’ve developed an upset tummy or a queazy feeling when you feel anxious, you’ve already felt the intricate link between your gut and your brain in action.
A study published in the journal PLoS One stated, “The severity and duration of abdominal pain are associated with elevated anxiety.” This might be what you’ve personally noticed, too?
In scientific terms, this amazing connection is called the microbiota-gut-brain axis. In short, it means that the gut bugs, the digestive system and the brain “talk”.
Can probiotics act as therapy for anxiety?
The impact of anxiety on quality of life can be significant. Therefore, finding safe and effective remedies is key to successful treatment and living well. Which begs the question, “Can probiotics act as therapy for anxiety?”
A study published in the journal, Nutrients, investigated the effects of probiotic supplementation in adults exposed to chronic stress; students prepping for the national medical practitioners exam. The researchers found that ongoing probiotic supplementation significantly lowered both anxiety and sleep disturbance, a symptom of anxiousness. They concluded that probiotics “may improve mental state, sleep quality, and gut microbiota of healthy adults under stressful conditions.”
A further study was published in the journal, Nutritional Neuroscience. The researchers investigated patients who had a diagnosis of generalized anxiety disorder, or GAD. Each participant took the medication, sertraline, a member of the selective serotonin re-uptake inhibitor family. Half also took a probiotic, while the other half also took a placebo. After only eight weeks, those who had taken both sertraline and the probiotic experienced a larger drop in anxiety symptoms than those who had taken the sertraline-placebo combination.
A third study published in the journal Frontiers in Neurology concluded that, “Probiotics had a significant effect on the scores of patients with… anxiety, suggesting that probiotics may be adjunct therapies for deep mental illness.”
Anxiety can be difficult to treat and its signs and symptoms can gouge away quality of life. Yet the research suggests probiotics might be a missing piece in the mental illness puzzle; an evidence-based way to find solace and calm in our crazy, overwhelming world.
If you are a cholesterol hyperabsorber, L. Reuteri NCIMB 30242 probiotics may help to balance your cholesterol levels – here’s how.
If you're already taking L. Reuteri NCIMB 30242 or want to start, head on over to this post:
Disclaimer: This post is for informational purposes only. Please discuss your medications with your doctor.
If you have high cholesterol, your doctor will probably order the standard blood work. Most people will only be tested with a lipid panel, which measures your levels of certain fats in the blood (triglycerides and total, HDL, and LDL cholesterol) (R).
Scientific studies reveal that there are two main categories of people: those who produce too much cholesterol, and those who absorb more than they need in the gut. Finding out which one you are can make a world of a difference when it comes to treatment (R).
According to one study, people with high cholesterol absorption are more likely to have heart disease despite similar HDL and LDL cholesterol levels (R).
A lipid panel doesn’t tell you your absorption status. However, there is a simple blood test that can tell your doctor which group you belong to: the sterols test (R).
Related:
Sterols are a family of small fatty molecules humans and plants produce. The main sterol in animals and humans is cholesterol, while plants abound in plant sterols (phytosterols) (R).
The typical diet contains similar amounts of cholesterol from animal foods and plant sterols from vegetables and fruits. Yet, the human body values cholesterol more, while mostly discarding plant sterols. When you eat an omnivorous meal, cells in your gut will absorb about 50% of cholesterol and only 5% of plant sterols (R).
Cholesterol has a bad reputation, but it’s essential to health. Our body uses it to build all cells in the body, tissues, sex hormones, vitamin D, and bile (R).
On the other hand, the body has no use for plant sterols. Moreover, plant sterols appear to be toxic at lower levels than cholesterol, according to some studies (R, R, R). That’s why nobody had paid much attention to them, until recently. That is, until researchers realized that sterols are key blood markers of cholesterol absorption!
Bear with the science: after a meal, cells in your gut take in plant sterols and cholesterol at the same time. Since cholesterol can be stored or used, as well as produced in the liver, we can’t know how much was absorbed from the gut based on its blood levels. However, all absorbed plant sterols are left to float in the bloodstream (R).
Therefore, the amount of plant sterols you have in your blood directly reflects how much cholesterol you absorb (R).
Sterols testing measures the following markers that will tell you how much cholesterol you absorb on a daily basis:
If your levels of these markers are high, you are a hyperabsorber. About 25% of people fall into this category. They usually absorb lots of cholesterol and produce little, don’t respond to standard statins drug therapy, and are at the highest risk of heart disease complications (R).
Whereas most people absorb 50% of cholesterol, hyperabsorbers take up 60-80% and hypoabsorbers only about 20-30% (R).
In addition, sterols testing may measure the following compounds, which tell you how much cholesterol you are producing (R, R):
If your desmosterol or lathosterol are high, you are likely a hypersynthesizer.
Intestinal cells have transporters (labeled NPC1L1) that act as a generous host--they take sterols from food to the inside of cells. But intestinal cells also have transporters that work as bouncers, which can kick sterols--especially plant sterols--back out soon after they enter (ABCG5 and ABCG8). Liver cells have the same transporters to remove sterols from the body with bile (R).
To continue this metaphor, everyone is invited to the party, but only a select few sterols get to stay.
Plus, cells have a way of transforming sterols to make them easier to move into the blood (called esterification), sort of like a VIP pass. Intestinal cells that give away this pass use an enzyme called ACAT (acyl-cholesterol acyltransferase) (R).
Microbiome’s L. Reuteri 30242 strain works, in part, by taking this VIP pass away from cholesterol-carrying bile (via activating an enzyme called bile salt hydrolase). In turn, more bile packed with cholesterol, sterols, and other fats is removed from the body (R, R, R).
The amount of sterols that will reach the blood depend on all these factors, which often have a genetic basis. For example, you may have a more active sterols host (NPC1L1) or a lazy bouncer (ABCG5 and ABCG8). The latter has been linked with high cholesterol absorption and heart disease. Other genetic factors, like your APOE genotype, can also play in (R, R, R, R, R).
Additionally, being older can make you more likely to be a hyperabsorber, especially if you are a post-menopausal woman (R, R).
Although scientists have demonstrated that sterols testing can go a long way in individualizing therapy, it’s still not commonly ordered. Only a few labs run this test, like Boston Heart’s Cholesterol Balance Test and Mayo Clinic Laboratories. In turn, many people may be prescribed drugs that work against their physiology: statins (R, R).
Exactly why are statins alone bad for hyperabsorbers?
The answer ties into how statins work. Statins block an enzyme (called HMG-CoA reductase) responsible for producing cholesterol (R).
If the reason why your cholesterol is high is that you are absorbing too much and producing too little, then it becomes obvious that prescribing statins is a bad idea. To make matters worse, the body tries to compensate by increasing cholesterol absorption, which accomplishes the exact opposite of what hyperabsobers need (R).
In a subgroup of 868 patients included in a larger clinical trial, a statin called simvastatin increased heart disease complications in hyperabsorbers. The more cholesterol patients absorbed and the less cholesterol they produced, the more complications they suffered. Meanwhile, hypoabsorbers—aka low absorbers— responded well to statins and experienced fewer complications (R, R).
So, what should doctors be prescribing to hyperabsorbers? The typical answer is Zetia (ezetimibe), a pharmaceutical that lowers cholesterol absorption. People who don’t respond to high doses of statins are usually additionally put on Zetia (R).
Adding Zetia to statin therapy helped lower the plant sterol sitosterol and LDL cholesterol in one trial of 197 heart disease patients after 12 weeks. However, hyperabsorbers (with high sitosterol levels) were still described as poor responders to aggressive cholesterol-lowering drug therapies in this study (R).
Some studies also suggest that Microbiome’s strain of Lactobacillus Reuteri (NCIMB 30242) may be a good supplement choice for supporting cholesterol balance in hyperabsorbers (R). If you’re not responding to statins, you may talk to your care provider about trying Lactobacillus reuteri probiotics.
In a placebo-controlled clinical trial of 127 people, L. Reuteri NCIMB 30242 capsules taken over 9 weeks decreased three plant sterols in the blood that act as absorption markers (R):
L. Reuteri has yet to be further tested in larger clinical trials.
Nonetheless, existing studies are promising. Importantly, L. Reuteri is a natural compound and one of the few probiotics designated GRAS (Generally Recognized as Safe) status by the FDA. It also has other health benefits (like supporting gut health, vitamin D levels, immune balance, and good digestion).
Given its good safety profile and the promising possible benefits of L. Reuteri for maintaining normal cholesterol levels, physicians are now trialing L. Reuteri for their patients who are hyperabsorbers. This approach rests on clinical judgment and experience.
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Every fourth person has high cholesterol due to increased absorption in the gut as is classified as a hyperabsorber.
The health of hyperabsorbers can worsen on typical cholesterol-lowering drugs like statins. Sterols testing can help your doctor determine if you are a hyperabsorber, so you can get adequate diagnosis and treatment such as L. Reuteri NCIMB 30242.
Can probiotics lower your cholesterol? Not all probiotics, but there is evidence that Lactobacillus Reuteri probiotics may help hyperabsorbers since it may support cholesterol balance,possibly by helping lower cholesterol absorption,while aiding gut health.
You can buy probiotics with L. Reuteri here.
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