Healthy Gut Basics for Mental Health (Spoiler: You Don't Need a Daily Probiotic)

By Tim Culbert, MD

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Restoring and maintaining optimal mental health requires a multi-pronged approach that supports your mind, body, and heart. A key part of that holistic approach involves caring for your gut. So, what (or who?!) lives in your gut and how can you care for it?

Your gut (AKA gastrointestinal tract) primarily includes the stomach, intestines, liver, and pancreas. A collection of micro-organisms call your gut home- a housing situation often called the "gut microbiome." I call these helpful micro-organisms "good bugs" and they include a zoo of bacteria, viruses, yeasts, and fungi. Good bugs communicate with your brain constantly via chemical messengers and nerves. Some help manufacture neurotransmitters like serotonin and GABA and also help make vitamins needed for optimal brain functioning. Good bugs also support your response to stress and contribute to healthy immune system activities. Given their big jobs, it's vital that you take good care of your bugs. Use the strategies below to help them thrive.

SHARE Model for Gut Support

A variety of factors such as stress, poor quality diet, exposure to environmental toxins, and medications like antibiotics can all negatively impact the healthy balance of good bugs that make up your microbiome. Prebiotics and probiotics are also areas of focus to care for your gut microbiome. Learn how to work with these below. 

Prebiotics and Probiotics

Prebiotics are non-digestible food ingredients that promote the growth of beneficial microorganisms in the intestines. Consider these the "chow" that good bacteria need to eat to survive and thrive in your digestive tract. For various reasons, the prebiotic material normally present in food has been reduced or even eliminated in food manufacturing processes. A prebiotic supplement can help make up for deficiencies in key nutrients normally received from food. Prebiotic supplements generally include substances like glucomannan, arabinogalactan, and inulin

Whether or not you take a supplement, look to include the most common forms of prebiotics in your diet. These fiber substances are found in vegetables, fruits, and whole grain products. Try dandelion greens, chicory root, onions, yams, garlic, asparagus, flaxseeds, jicama, bananas, and apples. Grains like oats, barley, and wheat bran are also good.

Cool side note: Prebiotics are considered to be a cross between a food and a drug since they are capable of providing health benefits while being composed of common carbohydrates. 

Probiotics are live microorganisms that have a health benefit when taken or given in adequate amounts. A probiotic substance or preparation involves a microorganism introduced into the body for its beneficial qualities.

Cool side note: Psychobiotics are live organisms that, when ingested in adequate amounts, produce a health benefit in patients suffering from psychiatric illness.

Probiotics can be found in a variety of fermented foods. Try yogurt, kefir, fermented pickles, sauerkraut, tempeh, and kimchi. They can also be taken as a supplement (like Multi-Probiotic® 40 Billion).

Different probiotic types are used to treat different medical conditions. Take the time to research what condition you are wanting to treat and identify the best probiotic microbes for that purpose.  

Good Bugs and Mental Health

Probiotics can help support mental health due to their production of various biologically active compounds like neurotransmitters. Neurotransmitters are brain chemicals that help create various emotional experiences. These chemicals include gamma-aminobutyric acid (GABA), serotonin, and acetylcholine. When these neurotransmitters are secreted in your gut, they can then communicate with the central nervous system and affect behavior and brain functions.

Good bugs also offer anti-inflammatory actions. Chronically elevated levels of inflammation throughout the body can lead to an inflamed brain (AKA neuro-inflammation). This inflammation can lead to depression and likely plays a role in ADHD, autism, and dementia. These good bugs can help cool inflammation in the digestive tract and brain. 

Probiotics can also provide a positive antioxidant effect. You can think of too much oxidation (called oxidative stress) as a "rusting" of the brain cells. Just like rust on a car, this isn't good for the structure. Individuals diagnosed with depression and anxiety tend to exhibit heightened oxidative stress which can cause neuroinflammation and lead to a host of problematic changes within the central nervous system. Probiotics can reduce this oxidative stress and improve nerve cell function in ways that support positive mental health.

Specific bugs may also impact mental health in specific ways. A handful of studies have suggested that these bugs may be particularly helpful for mental health: 

• Lactobacillus Helveticus  
• Lactobacillus Plantarum
• Lactobacillus Rhamnosus
• Bifidobacterium Longum  
• Lactobacillus Casei
• Bifidobacterium Animalis
• Bifidobacterium Infantis
• Lactobacillus Acidophilus

As you probably guessed, if there are good bugs, there are also bad ones. There is some evidence that the bacteria listed below may contribute to mental health problems:

• Camylobacter Jejuni
• Citrobacter Rodentium
• Clostridium Species
• Enterococcus Faecalis
• Streptococcus Sanguinis

So, how do you get the good ones in and keep the bad ones out? One strategy to optimize this balance is to take a high dose probiotic as discussed in the next section. This practice can support the good bugs while essentially squeezing out the bad bugs. 

Tips for Using Probiotics and Prebiotics

As you've probably heard from just about everyone (and discussed above), probiotic supplementation can help your good bug balance. They can help reinoculate the GI tract with healthy bacterial strains and can crowd out unhelpful bacteria in the short term. What you may not know is that probiotics can't do it all and you likely don't need to take them daily. Here are some tips for using probiotics:

• For general health and wellness purposes, people can typically take 1-20 Billion CFU’s of a probiotic for a few days or weeks. Consider this a boost to bring your gut back to balance. That means you likely don't need to take a probiotic daily, but you may want to repeat this boost dose a few times each year for a few days or weeks.
• Probiotics don't have to be taken with food for benefit, but they may be more effective when taken with food or up to 30 minutes prior to a meal.
• Some probiotics require refrigeration to remain potent. Adhere to that requirement if needed and be sure to use your probiotics before the expiration date.
• Antibiotics kill off bacteria- the bad and the good. If you are taking a probiotic as a way to rebalance the gut after taking prescription antibiotics, then aim to take it at least two hours away from the antibiotic dose.
• There are a variety of probiotic types available and the type may impact the dose, so read the recommendations on the product carefully. The different strains of bacteria contained in a given probiotic and the strength (number of “colony forming units” or CFU’s) are typically listed clearly on the label.
• Larger doses may be recommended (25-300 billion CFUs daily) when using probiotics to treat a specific medical condition. This is still likely to involve a high-quality multi-strain blend and should be done under the advice of a qualified healthcare provider.
• A prebiotic can also be taken to help feed and maintain the helpful bacterial strains. In general, any time is a good time to take a prebiotic, though it may be safest to take it at least two hours before or two hours after any other medication so there is no interference with absorption. You can take a prebiotic with food or without.

Your Guts, Bugs, and Brain Need Well-Rounded Care

Remember, building an optimal microbiome isn't just about supplementation. It requires a healthy diet full of variety, healthy fibers, and some fermented items. Stress must also be decreased and avoidance of exposure to environmental toxins is helpful. 

Probiotic Supplements from Fullscript, our partner store

^{Please note: The product links in this blog go to our partner store, Fullscript (with an ongoing 10% discount for you + free shipping on orders over $50). You must have an account to view products and shop. Create your free account at: https://us.fullscript.com/welcome/nmh/signup. Learn more about Fullscript here.}

Multi-Probiotic 40 Billion

Multi-Probiotic® 40 Billion contains 16 beneficial strains of Lactobacillus, Bifidobacterium and Streptococcus cultures, including the clinically researched Bifidobacterium lactis HN019 that supports gastrointestinal and immune function. Also included in the synbiotic blend is scFOS® prebiotic fiber, which is well tolerated and works synergistically with probiotics to flourish in the intestinal tract.These probiotics are resistant to both acid and bile and undergo a patented cryoprotectant stabilization process for shelf stability.*

*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. Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms.

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