Anyone who has travelled to another country only to spend the first few days sticking very close to a toilet knows the finicky nature of the gut. And many travellers have turned to probiotics, those friendly live microorganisms that can decimate the pathogens that cause stomach upset when things get rough.

But the more we learn about the trillions of microorganisms colonizing various parts of our body – most of which reside in our digestive system – the more we discover that keeping those microorganisms in top shape may have far greater impact on our overall health than we once thought.

“We’re just this big ecosystem host,” says Catherine Mulvale, executive director of the Canadian Digestive Health Foundation (CDHF) in Oakville, Ont.

In fact, scientists are exploring how much our microbiota (the collection of live microbes in our gut) affect a diverse range of conditions, including diseases of the gut, skin infections, obesity and psychiatric disorders such as anxiety and depression.

Scientists believe that each of us carries our own unique microbiota fingerprint. Established early in life by what we encounter (how we’re born, what we touch, what we ingest), the composition of our microbiota remains relatively consistent over our lifetime.

“Your microbiota will stay stable your whole life, changing very little unless you get sick, take antibiotics or travel,” Mulvale says. If you’re lucky enough to have a diverse and plentiful range of these organisms, you will tend to remain reasonably healthy – or so the current scientific thinking goes.

But if you’re not so lucky – or simply want to tip the balance in favour of a strong, vibrant system – probiotics can help. Supplementing your body’s natural system with some helpful little bacterial buddies is easy, mostly harmless (pregnant women and those with a compromised immune system should proceed only under medical supervision) and can, in some cases, translate into almost immediate relief of problems such as traveller’s diarrhea.

The problems with probiotics, however, are twofold. First, no one knows their own microbiota makeup (although there are two companies in the U.S. that will sequence your fecal microbiome), so determining which probiotics to take can be a guessing game. While there is some consensus that certain strains of probiotics work against specific conditions, research into more general concerns such a general immunity, obesity and anxiety is in its early stages.

The second problem is that probiotics are not medicine. While that’s a good thing in that you can’t really overdose on them (the worst that will happen is a little stomach upset if you’ve ingested too much of one kind), this also means that probiotics are not regulated in Canada. That, in turn, means there’s no proof that the probiotic you’re buying is sufficient to be effective – or is even alive by the time it reaches you.

Here are some things to keep in mind if you’re considering probiotics:

– Rely on natural sources

Probiotics can be found in several food sources. The key is fermentation. Foods such as yogurt, kefir, pickles (including kimchi), tempeh (made from fermented soybeans) and kombucha tea all carry a variety of health-maintaining probiotics.

– It’s all about the strain

Because probiotics reside in the Wild West of so-called “natural medicine,” consumers must do their homework. Mulvale recommends speaking to your doctor or pharmacist about the strains of probiotics that might make sense for you and buy only from reputable sources.

And although not all probiotics need refrigeration, you should read labels carefully. If no expiration date is listed, chances are quite high the product will die out over time. Also check out the latest information from reputable online sources, including the CDHF.

– Aim for diversity

If you’re using probiotics as a general immunity booster, the number of active microbes is less important than the variety. A multi-strain probiotic can be your insurance against any gaps in your own microbiota.

– Feed your probiotics

As with any living organism, probiotics need sustenance. In fact, they can be kind of delicate, which is why you need to follow dosage directions carefully and keep replacing the ones that you are missing. Mulvale says probiotics usually start working three days into a round of dosing and usually last about a week if you stop taking them.

Doctors have long prescribed a round of probiotics after finishing a course of antibiotics, as antibiotics wipe the system clean. If you don’t inject your flora with “good” bacteria, “bad” bacteria have more space to occupy.

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