What Are Probiotics & Why Do We Need Them?

In this episode, Pete chats with Yuwa Astar. Yuwa is a Naturopath and is also a consultant for Australian supplement company, Activated Probiotics. During this episode, you can hear Pete and Yuwa discuss the fascinating topic of probiotics and their application not only in treating a wide range of conditions but also during different life stages. 

Research in the field of probiotics is now identifying the importance of specific strains of probiotics in treating certain conditions. Pete and Yuwa discuss how this knowledge and the wider range of strain specific products available can help practitioners when treating patients.

Click here to see my probiotic recommendations. 

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Transcript

probiotics podcast - 27:10:2022, 11Thu, Oct 27, 2022 1:11PM 1:03:52SUMMARY KEYWORDSprobiotics, bacteria, strains, antibiotics, microbiome, people, product, specific, important, terms, digestive tract, bit, question, research, biome, absolutely, impact, immune system, activated, world health organisation

SPEAKERSIntro Speaker, Yuwa Astor, Peter Williams 
IPIntro Speaker 
00:00
Welcome to functional medicine bite sized the podcast where Pete chats to experts in the field of functional medicine and health, giving you the listener, pearls of wisdom to apply on a daily basis.Peter Williams 00:19Everyone, and welcome to this new podcast. Kind of cool because I think we're going to be introducing, understanding a whole lot more about about probiotics, and you know, which ones do we get? Why do we get them? What do we do with them? How are they made, etc. And so we're going to be speaking to Yuwa Aster, this morning. Now Yuwa is the consultant for an Australian company called Activated Probiotics. It's a company we've been using for a couple of years now, we quite like them. And they've got a really nice probiotic that we use when we're dealing with people who are, who are just on the other side of antibiotic treatment. But we also use it in conjunction with antibiotic treatment and Yuwa, maybe we can talk about using probiotics with antibiotic treatment as well. And so really, today is just getting us to explore the whole area of I mean, even the simple questions, what is a probiotic, and I think this is really important. From a point of view of, you know, we get this understanding that humans are by cell, probably more bacteria than human cells. And so making sure that we have a really lovely family, particularly in our in our gastrointestinal tract of bacteria that are predominantly all good for us and all trying to do a really good job for us, it's really good to understand where that sits from a point of view of overall health. Good morning, how are you doing?Yuwa Astor 01:46Good morning, thank you so much. I'm very well, thank you so much for the invitation. And good morning to the listeners.Y

Peter Williams 01:54

This is your first one that you've wanted to do, isn't it? So I really appreciate you jumping on board with us on that one. So I really appreciate that Yuwa. So I think let's start really simply we can build into a bit more complexity and a really simple question, what are probiotics?

Yuwa Astor 02:10

So probiotics, they actually are more specific, their terminology is more specific than what we generally would think of, because I think if I was to go around with a microphone on the street and ask people what probiotics were, they'd be like, Oh, the bacteria, the good bacteria, the good bacteria, we can get from, you know, fermented foods or things like that. But actually, the World Health Organisation gives the term probiotics a very specific criteria. So for something to be called a probiotic, it actually needs to be number one alive when it's ingested. So it has to be live bacteria. Number two, it needs to contain a therapeutic dose. So we might have things with live bacteria in them but to be called a probiotic, it actually needs to have a certain amount that the research has shown that this is actually therapeutic, this conveys a positive beneficial effect. And the third part that leads directly into the third part, which is known as a probiotic, it actually has to have a health claim that's actually been supported by published research. So it's a very specific term, probiotic. And it's a little bit distinct from, you know, as I mentioned, other things we might generally associate with like live bacteria or whatever, it's not specifically a probiotic unless it follows those three, those three criteria.

Peter Williams 03:30
So let me throw a question at you. What's the difference between a probiotic that you might buy and probiotics that you get in fermented foods?

Yuwa Astor 03:41

Yes. Yes. So So strictly speaking in fermented foods, fermented foods are fermented foods, they're not, we can't, strictly speaking, call them probiotic foods. Because in fermented foods, we've got live bacterium. So these are, these are great foods, every you know, so many different cultures and traditions over the world have used them, long history of use. So they're really, really beneficial. They contain live microorganisms. But actually, if you were to, if I was to where I am here in London, and somebody else is in another part of the country, or in a different country were to ferment the exact same food, we can't be sure we can't guarantee and actually, it's unlikely that there's going to be exactly the same bacteria that are being fermented in those foods. So we don't exactly know what the bacteria are, and then we don't exactly know what it is that we're fermenting from region to region, and there's so much variability and similarly, there's nothing to count exactly what the amount is. So they're useful foods. It's important, you know, especially if we're bringing in a range of different vegetables. Absolutely, absolutely important, but it's a very different thing from using a probiotic is actually, if it's correctly identified, it's quite a precise action and a precise mechanism that you're getting from fermented foods which you would be using much more generally.

Peter Williams 05:03
It's a really good question, because what we might be saying is that sauerkraut made in. Germany might be very different from sauerkraut that might be made in Mexico if you like

Yuwa Astor 05:12
Absolutely, absolutely. And that's yeah, that's the thing. There's, there's there's a lot of

variation when it comes to just the foods. Yeah.

Peter Williams 05:20

So I think you are moving us on to it, really is a question of using the definition, about identifying strains and specifics. So can you just give us an overview with that? Because I think if I look at where we are now, maybe with the public, it's, oh, yeah, I should take a probiotic. But I think even I suppose a lot of clinicians now we're learning that, well, it's definitely not as simple as just telling people to take a probiotic. And in fact, that actually may be the complete wrong thing to say, because the strains that are involved in that, in that particular product, aren't the ones that maybe we want to be giving this patient for a specific reason. So Yuwa just expand that a bit more expand about you know that? How, well there are so many different probiotic groups and different strains, etc. And just give us a, give us a brief or a brief summary around that?

Yuwa Astor 06:19

Yeah, sure. So I like that you use the word brief, and I'm gonna keep that in mind. (It's not a brief subject is it unfortunately) it isn't, it really is it's quite big. But I think, I think the thing to, you know, the best way to describe it is to use an analogy. And just as we see, people, you know, people we've got however many billion people around. So much of us are similar, but obviously, we look at each other, and we're really quite distinct. So saying probiotics is kind of like saying, people and Pete you said at the start, you said about the fact that we've got more bacterial cells in and on us than we have human cells. So actually, there's a heck of a lot of microorganisms. So to say, probiotics, it's just so big, and it's so general, and we're not actually specifying, you know, do it. Like, what what characteristics do I want? So saying probiotics is basically saying, I want people I need people you like, okay, great, but maybe you want to define that a little bit more. So. So the easiest way is that when we're looking at the classification of living organisms, and that's biological systems all over, possibly people remember it from school biology. We know that we go from the kingdoms, order, family, etc, we go to the genus and the species, so most people are familiar with the term lactobacillus. Sometimes I even hear people using it interchangeably with probiotic term. But lactobacillus is a genus. And the species would be something like acidophilus. I think that's probably the most common probiotic that people know. But what the research has shown us is that actually the classification goes beyond the genus, and the species so beyond lactobacillus acidophilus, or lactobacillus plantarum is another particular strain that we use, actually, we the research shows us that actually, what's incredibly specific that identifies a specific type of bacteria is a genospecies. And the strain. So this third part is a part that really, it's only in the last few years, that more that the research has been kind of identifying the importance of strain that practitioners are getting involved with the importance of strains. And I'm not entirely sure that this is communicated to the general public yet, which is why a podcast like this is really brilliant, because this is what's actually defining what kind of effect that you have. So if we use lactobacillus as the Genus, Plantarum as the species, Activated Probiotics have a range of different Plantarum strains, and each of them doing slightly different, different things. So there's a Plantarum strain called to 299V, which is considered to be the most well researched Plantarum strain. And the way that you would define it, and that's different from the other strains that we have. But I think a really simple way, hopefully, if it's communicated in a really simple way of looking at this as if I were to imagine a school so as I said, that saying general probiotics, is like saying general people. If we were to imagine a school, so a primary school, like, you know, you see all over the place, so the school could be the lactobacillus school. So that's for the Genus. And then within that school, we've got different classrooms, we might have an acidophilus classroom in the lactobacillus school as a dominance classroom. We also might have a Plantarum classroom so with lots of the different Plantarum strains and then within that classroom though, so we number one can see that between different classrooms, there's different, there might be different age of students, there might be different ability. It might be based on a range of different things why these two groupings would exist. But then within a classroom, then you might find also, even though there's a lot of similarity with the students within a classroom, there's actually still quite a lot of individual distinction. So some students might be super diligent with their homework, some might be naturally talented at something else. And so even within that whole Plantarum grouping or in the Acidophilus grouping, there are particular strains. So the 299 V would be the equivalent of an actual student within that classroom within that larger group. And that's where the research has shown us that actually really pinpointing to that level of precision is what we're wanting to do in terms of actually being therapeutic to Yeah.

Peter Williams 10:39

And now, look, I think it's a really important subject, because the reality is, is that I think most of the general population and to be fair, and probably most clinicians, me included, I would say, five years ago was still probably was getting or was understanding a little bit more of this, but was still doing a bit of a blanket approach with regards to probiotics, and what clearly the, you know, we're looking at a specific strain or specific strains for specific conditions now, and I think that's what you were, you were saying there, because, as you say, I think most people still are in that thought process of oh it probably make sense I take a probiotic. And the reality is that well, actually, that might not be a good thing to do. Well, it's not that it probably isn't a good thing to do, but could be a waste of your money. So I think what we're doing now is that we are, aren't we we're sort of there's a rabbit hole, and there's a deeper rabbit hole, you want to identify something like, as you say, like, you know, a super species of bacteria like lactobacillus. And then you realise there are more sophisticated aspects that that a bit like the school analogy you've just talked about. And then we, of course, we've got to understand quality, because I think, I think the supplement industry, again, there is a misconception with regards to quality. And unfortunately, what I would say on that is that you can get a lot of supplementation that number one isn't very good quality at all has a lot of stuff in there that probably shouldn't be in there. And most of the general public population don't know the difference. So can we talk about because it's not just a question of identifying the right probiotic for the right job. There's all the other aspects with regards to whether you can expand about whether it can get to where it needs to get to, and what are the jobs that it would do once it's there as well? Because, again, I think there's a lot with regards to just because you take a probiotic doesn't mean to say It survives and gets to where it wants to get to, what are their jobs when they get there, you know, what is it that they're doing? I think, a good overview on that would be fantastic.

Yuwa Astor 12:42

Sure. Well, I think the way that you led into this question is really important, because I talk about supplement quality, a lot, ah less in my role with Activated, well, partly in my role at activated probiotics and also as a lecturer, because it is such a big subject, I think as the whole wellness and health and well being industry continues to grow. We just see a lot of things on the market that actually we really need to develop some skill around being discerning. Hugely important. And so when we're looking at probiotic number one, the discernment is about identification of the strains, seeing that that's there on the box. But there are so many things that need, from a manufacturer's perspective, a good manufacturing perspective that needs to be considered to create a viable, so viable being it's alive, and it's about it's ready to do its job. Good.

Peter Williams 13:31
It sounds a really crazy thing to say. But can you just talk about that? Because these bacteria are alive, aren't they?

Yuwa Astor 13:37

Yeah, yeah, yeah. So remember, that was part of the the first of the World Health Organisation classification to be a probiotic, it means that it needs to be live bacteria. So just as we need certain things, certain environment, certain things within the environment to help us to stay alive and viable and stable whenever you anything that's living, anything that's living. So bacteria are living organisms, they need very particular things to survive. And previously, one of the big ideas when we're looking at probiotics was that they had to be kept in the fridge, they have to be cold, cold, cold. That's the thing because they're freeze dried. So I guess the idea was, we maintain the temperature, but actually one of the big things that's involved with keeping bacteria stable, so that in the product that you have as a consumer, that you're actually able to have that up until the end of shelf life, and you still can be guaranteed and assured that there are viable live organisms there. One of the main things that probiotics need is a very dry environment. So if it's been freeze dried, everything that's going to bring in moisture is going to be a bit of a problem for that stability. So the other thing I think it's important to consider is that we think about the body. And whenever I talk about nutrition or anything I always say it's about two things. It's about the it's about the thing. So in this case of bacteria, but it's also about us because that's the interaction. And so if we look at our body, then there's so many mechanisms within our body that are designed to kill bacteria. So the most overt one being through the oral route the stomach is, you know, it's a strong well it should be a strong acid environment. And part of that design is not just from a nutritional perspective, but it is also to kill bacteria. So, if a company is making a quality, viable probiotic supplement, they have to consider what the bacteria need to survive through this quite, I guess,

Peter Williams 15:32
I like to say it's a, I always use the analogy. It's a bit like a really harsh sheep dip, you know, it's a killing zone.

Yuwa Astor 15:38

Yes, absolutely. So they've got to be really able to survive that digestive terrain to be able to get to where they need to get to, which is the colon, the large intestine and do their thing. So what activated probiotics do number one they are really huge on research and research again, is, you know, a big, big, big part of what this what our company is about, but research in terms of identifying the strain. But then also in terms of how the strains I mentioned, they're freeze dried and protected from moisture, they also in the encapsulation need to have the needs to be something that protects bacteria from the acid of the stomach. And different companies use different things which have variable levels of effect. But what activated probiotics do is basically use a plant based lipid coating around the bacteria. And it's so ingenious, because actually, even though it's a really strong acid part in the stomach, the stomach is designed to break down protein structures. And so if there's anything that's coated in a lipid, then that actually just bypasses the stomach and gets to the small intestine before it's worked on. So this technology that activated probiotics uses has been shown to create bacteria that almost like it's considered to be as if you've got five times more of the live microorganisms there because of this protective coating, which is really, really quite fantastic. And I think because I mentioned that research is important all the way through. Also, this technology has quite a good amount of research to support it. And and then the final thing that with activated probiotics is that we're using in terms of the actual packaging, all of the packaging is designed to protect the bacteria from moisture. So that was just answered half of your question, which is

Peter Williams 17:25

I think I'd I think that's they're perfect answers. I think that also leads into God, I can remember IFM training nearly 15 years ago now, when we were looking they were talking about when probiotic therapy was was was, I'm gonna say quite new. And they were discussing dosages, becasue think this is the other thing, and maybe that dosage is and they were whopping dosages, looking at hundreds of billions, or sometimes 1000s of billion dosages. And that doesn't seem to be the case anymore, as far as I'm aware that the dosage doesn't necessarily need to be so high as it used to. And I think that's probably because we're learning more about probiotics, but we're also delivering probiotics differently. And I think that's what you were suggesting with your technology. So I think there's quite a few subjects around here. Number one, is is more better. Number two, is that down to the technology also that you've you've just talked about. And obviously it's about delivering probiotics to the right place, which is more important. I think that's definitely something that we see in general supplementation is that you genuinely you know I think about some of the B vitamins you'll see in in daily a multivitamin minerals are absolutely enormous, you know, 10s of 1000s are normal RDA. And the reason is because they just you just don't deliver much of it, you deliver very little and of course if you're using liposomal deliveries, which sort of sounds a little bit what you were talking about. I mean, I know it's not a it's probably I don't know whether it's a liposomal delivery you're using but it sounds it doesn't sound dissimlar do is that when you use liposomal, you can use much smaller dosages because you're much more guaranteed a better delivery costs a bit more, but But it's probably long term is probably going to be more beneficial. So can we talk about that? Can we also talk about some of the terminology because I think I think you're the one who told me that we're maybe moving away from colony forming units to to a way of measuring like bacteria. So can we can we go through that?

Yuwa Astor 19:36

Great, great, so I'll start with the last point. So the CfU is a colony forming unit, when you're actually seeing that then most people if you're picking up a box of like bacteria then you're going to see the measurement of how much of the bacteria so you'll have billion number and then it will be CfU which is colony forming unit so that technology doesn't really so that's what we've been using the as an industry You know, for years, and that technology doesn't really distinguish live versus dead microorganisms it's a way for measuring open organisms, but it doesn't necessarily distinguish whether they're alive or not at the point of count. And so when I mentioned as well that the term probiotic really need the first part of that definition was they have to be alive when ingested. So companies, you know, they're still good companies that use colony forming units, but maybe the way that they get over it is to put even more in at the point of the point of manufacture so that they know that some are going to die, etc, etc. What activated probiotics do is that they use a accounting system called BLB, which is billion live bacteria. So it's in the name that it literally only measures live bacteria. So when you see a BLB count, versus a CfU count, you know that they're not actually equivalent, just in terms of the count, you can tell from the the BLB count that this is the number of live bacteria that you're going to be getting? So that's the first part of the Yeah, and

Peter Williams 21:05

I'm assuming so I think this is a key point here, isn't it? Because most people would be like, Well, surely more is better. But that actually isn't the case, I suppose what we're looking at. And I think what your company does, is that it's looking at what is the therapeutic dose to treat. And the BLB is looking at what is the live bacteria that we know gets to where it needs to get to able to therapeutically treat whatever we're treating.

Yuwa Astor 21:33

Absolutely. And I think just to extrapolate on that a little bit more is that remember that there's the third, well the second and third criteria that define the probiotic based on the World Health Organisation is that the dose needs to be based on what the research is suggesting needs to be a therapeutic dose. And also, there needs to be a health benefit associated by research. So I remember it was exactly what you said, Pete about when, you know, a decade or more ago, however long ago when there was this like, almost like race to get more into the probotics. So this is like, I believe, no temporary no 20 billion. Now there's a 50 billion 100 billion. And we all go for the more because we're obviously programmed through lots of different directions that more is better. And actually, what the research shows us is that it is about inherently it's about the specificity of strains that I mentioned at the start, because each individual student in that classroom has actually very different characteristics. So some, some strains of bacteria are better able to adhere to the digestive tract and and, you know, maybe prevent other microorganisms from proliferating there. Some microorganisms are better able to modulate the immune system in a way that that moves away from a hypersensitive, allergenic response to a more balanced response. So actually, the dose relates to number one, what that specific strain has been shown to do, and then what the research backs up, and we don't actually provide sort of a random guess as to how much, you know, is needed in the product. It's literally just based on what those clinical trials and clinical studies have been shown to do. And just on the last point to make about that is that actually, quite a few of the activated probiotics products have themselves been tested clinically been in research studies as complete products, which is a very distinct thing. So you have that added assurance, through the manufacturing, but also in terms of the actual knowing that that product has been put through a clinical trial itself.

Peter Williams 23:35

So that's definitely where we're going, aren't we we're definitely going back round. And again, this is something that we use all the time, it's a question of what is the strain specific or strain specific bacteria that we need. So it doesn't have to be one that is going to do the job that we know in the research. And again, that you've, you know, I think probiotics, all these different strains are doing very different jobs. And I think you've got a really nice sheet that you send out to all practitioners haven't you it just makes life so much easier to say, okay, what are you dealing with? Is it allergenic type reactions? Well, this is what we know, in the literature, you know,is it immunomodulating Well, these are the ones that we would recommend on that. And I think that makes it incredibly helpful for for clinicians, because, you know, when you're trying to deal with people, it's, you know, you need a sort of nice template that makes it easier for you to just work from. So look, here's a question then imagine that, you know, say a guy on the street, I've heard about probiotics sounds like a good thing to take. Should I just go would I be better with just getting like a really big multi strain probiotic if I was in reasonably good health. Would that make sense?

Yuwa Astor 24:45

I think whenever I hear, because people do ask me that and I'd say well, what like what, uh, what are you facing with? Do you have any particular conditions and just, you know, I think just a little bit of being a little bit more inquisitive. are a bit more curious and poking a few more questions out, would be quite useful to highlight and that would further direct you but if there was absolutely nothing, which is kind of rare because most people have something to work with. But if there's absolutely nothing, then we actually, again, as sort of a general probiotic or multi strain, again, doesn't necessarily mean anything unless we know what the strains are doing. So we at Activate Probiotics have products that just contain one strain, two strains, three strains, you know, five and six. But each of those strains, we know what they're doing. So if somebody didn't have anything going on, and they just wanted maybe now we're in autumn, we're going into winter, and we have we recognise, okay, there's nothing going on. But highly likely, my resistance, my immune resistance will be challenged, there'll be more colds and flus around. So I'm okay now, but I might want to look at supporting my immune response. Then we have a product called BIOME daily, which is it is a multi strain, it contains six different strains. And really, the research shows us all of them, again, well researched to support severity, duration, onset, even of upper respiratory tract infection. So because the bacteria always do something, I think it's best as much as possible to match the strains that we're using to whatever that person might need. And if there's nothing now then we might do it based on as I said, the seasons or

Peter Williams 26:26

refer to a lot of companies, they are starting to do that, aren't they? I mean, I know your company's very specific with regards to, you know, as you say, that one was talking about, it's almost like you're sort of, it's your bacterial version of your immune boosting vitamins and minerals, if you like, I mean, and that's what we're doing. And I think this is a really important thing to think about, because you are slightly more bacteria than human cells. In literally every lecture that I do, it's making sure that people understand what what a human is, and we are a super organism. And that simple organism is actually more bacteria than human cells. So you don't think at least 50% is well maybe I need to think about keeping my bacteria in shape. So we agree,

Yuwa Astor 27:10

Pete, I completely agree. I always say to people, students, also, you have to start thinking now nutritionally, not just about human cells, but you have to have to have to also be thinking about these microorganisms and how to look after them, because they literally impact every system of wellbeing.

Peter Williams 27:30

Yeah. And, you know, I can I can tell you from from from our practices that most, we see many people who come in who have been worked brilliantly, conventionally. You know, when you look at how they've been worked up for the condition, you just can't fault it but they've just not asked the question. And so there's maybe a little bit more than 50% that they've missed. And usually we see people who are sick, because they are multi systemically. dysbiotic. Yeah, yeah. And until you solve that, you know, these people are never going to have optimal health. Yeah. Can you give us an idea of just what they do? You know, I know. And I know, again, it will be strange specifics, and they'll do but give us give us some examples. Okay, so what happens you know, what does it do?

Yuwa Astor 28:21

I think that's really perfect, because what with what you said before about clients coming in and having been multi systemically dysbiotic? In my head, I was like, Oh, I hope he asks me this question. Because I think one of the one of the points I want to communicate with your audience is that when we're talking about, live bacteria, probiotics, or whatever term, you use gut bacteria, they don't just do their action in the gut, it's not just about if you've got a digestive issue, let's just take a probiotic, if it's a digestive issue, if I don't have a digestive issue, I don't need to think about a probiotic, because they literally, as I mentioned before, impact every system of the body. So the main interface is always through the gut. But if we were to imagine the gut as a tube, well, it is a tube from the mouth to the anus, and the bacteria would be within the in the middle of the tube. So it's still officially outside the body. It's only when things get absorbed into the lining of the tube, and then they're in the bloodstream that it has its effect. So the bacteria themselves just stay on the outside or the on the inside of the tube, so officially outside the body, but they can impact the the quality or the integrity of the cells of the intestinal tract. So whether there's holes in the tube or whether there's like, you know, good intact membrane, they can produce compounds that can mitigate any sort of or minimise any inflammation that's going on locally within the digestive tract, they could produce antimicrobial peptides that kill other bacteria. So number one thing is that they actually help the integrity of the digestive tract itself and the digestive tract, of course is important for the nutrition for the whole of the body for also managing what things come from outside of the body into and are able to challenge the immune system. All of that's happening within having a good digestive membrane and the probiotic bacteria themselves impact that. But also the bacteria because they're live, they're producing things. And some of the things that they produce, do get absorbed into the bloodstream, do impact do have an impact on the immune system. And that immune response can be communicated all over the body so we can see far reaching effects on the immune system from probiotics. So the studies, I think probably the earliest things that we saw around probiotics was around probiotics and digestive health. Then we saw probiotics in the immune system. And probably the, I would say the bulk of that was around hypersensitivity reactions, so allergies, intolerance and things like that. We saw that that was minimised where the research is going now, which completely blows my mind is that we're seeing studies not just on eczema and asthma, but we can see studies on on infant health and the rates of fertility, the rates of conception, even with IVF, looking at the reproductive microbiome, which I find is kind of wild, how could how the rate of success of IVF could be impacted by whether the tools were coated with particular like bacteria or not, I find that kind of crazy. We see that the bacteria one of the presentations I'm doing next month because we're talking about menopause and menopause awareness next month. One of the impacts I find is absolutely wild is the gain mitigated through the immune system and mitigated through the way that the probiotics can communicate with the immune system and minimise inflammation, but we know that some particular strains of bacteria can minimise bone mineral density loss in postmenopausal women. And I'm really excited that in my own private clinical practice, just a couple of days ago, I just received a two year DEXA scan report and the client that I had her bone mineral density last year was osteopenic. And now she's not anymore in her spine. And we did a number of things. But we certainly used one of the one of the activator probiotics products. So they have just very far reaching impacts. iron absorption, we can see that in terms of Candida, things that people take antibiotics for whether that's BV or candida, these recurrent infections that keep coming, there are strains of bacteria that can mitigate that. And also talking about antibiotics, we have a particular product that's really important to be used concurrently with antibiotics just to, again, mitigate a lot of the damage that can be caused through antibiotics and also hopefully prevent that level of that repetitive cycle that people often get into

Peter Williams 32:44

Yuwa can we can we jump in on this? Because this is one of the ones I'd like to talk about a little bit. Because, obviously, you know, I think if we look at I mean, obviously there's a massive problem, as you say with antibiotic resistance, I think that's gonna be a huge issue in years to come. But still as a medication, antibiotics are incredibly successful as far as, as a as a medical intervention, probably one of the most successful medications that we've ever developed. But that like every medication, they're always cost risk benefits. And and I still think where I think conventional medicine is falling down, is well, I'd say that they're much, much better because they recognise the problem with treating people consistently with antibiotics, that the less the less likely to use, but they're still not thinking about the longer term consequences. And I think this is a slight frustration for me, because it's, I've no problem with antibiotics, no problem at all. The problem realise, okay, well, okay, if we're going to use a medication that generally is very good at its job, it's going to wipe a lot of things out, it's not just going to wipe the thing we want it to wipe out, it's going to wipe everything else. And surely we would be wanting to run a strategy concurrently with that, trying to rebuild what we've just wiped out. Otherwise, we're going to be into a catch 22 situation that is going to run on and run on and run on and I see this. We see this just so often. It's unbelievable, you know, and as I say, I bring some of the you know that certainly from from our point of view of bacterial vaginosis, there's a classical one, treated, UTI, same thing treated again comes back after a few months of course it comes back because it kills the bacterial strains, but then you get a dysbiotic profile growing back and then you're into trouble again. So can you because I know because I use one of your products we we talked about this the advanced, we use this one when ever anyone is on an antibiotic. So can you just talk about that again? Because I think this is an important thing for people to understand.

Yuwa Astor 34:57

Yes, absolutely. So just, I concur with everything that you said, I think obviously antibiotics are incredibly important. And then what's scary about the idea of antibiotic resistance that age is that this incredible tool that we have, maybe because it's been overused, or maybe because the side effects are really for some individuals are so distressing that even when they start an antibiotic, there's so many side effects that they just don't feel like continuing to take them in, and then not finishing the course, which is, of course, part of the problem. So by actually having a probiotic concurrently, and it's really, really important, because we are from whatever reason we have this old thinking that if we're taking antibiotics, maybe let's wait until the antibiotics have finished before we take a probiotic, because we'll kill the we'll kill the good bacteria if we're taking it the same time with the antibiotics. But actually, it's what the research shows us is almost that it would be negligible for us not to be taking specific range of probiotics alongside the antibiotics because the effect of the antibiotics can be so disruptive to our ecosystems. So it's really, really important. It's not an optional thing. It's really, really important. So one of the things that we're seeing is that if we're taking so this particular product, we have Biome Advanced, we know that we can reduce cases of antibiotic diarrhoea, antibiotic associated diarrhoea, which is one of the side effects which you know, sometimes prevents people from finishing the course, we know when I mentioned about the the tube, the digestive tract being a tube and the bacteria being on the inside helping to kind of assist in us having like a fully integrated digestive tract. When the antibiotics are working, they might disrupt you know well they do disrupt the bacteria, they're within the digestive tract, and they can create more of an inflammation inflammatory response within the digestive tract. So when we're taking probiotics at the same time, and particularly the probiotics have been shown to actively work on repairing the intestinal epithelial membrane, so strains like lactobacillus, rhamnosus, GG, plantarum 6595, for example, these are the strains that we know that have that kind of effect, then we're putting those back in, and we're again, mitigating some of that response there. And I think that why people, maybe over the years thought to take probiotics afterwards, or thought that they couldn't take it together. Is it because the antibiotics kill bacteria? It makes no sense and is taken back to you at the same time, but actually, really, they have slightly different mechanisms. So whereas I said that the bacteria stay within the digestive tract, they stay within the tube of the digestive system. Antibiotics don't do that antibiotics like all medicines, like our foods are designed to be absorbed higher up in the digestive tract, absorbed out of the tract and into the bloodstream. And then that's why they have their effect all over the bodies because they're in the bloodstream. And so they're not actually they don't, they don't directly have an impact. The reason why antibiotics impact the digestive tract is that through the bloodstream, they can impact the blood flow to these intestinal cells. So if we're taking good bacteria at the same time, we create we create healthier intestinal profile. We also the bacteria themselves, if it's the right ones, produce antimicrobial peptides, which also help to kill whatever infections going on, support the immune system, reduce inflammation and hopefully prevent the like help to cut this recurrent cycle of antibiotics, reinfection, more antibiotics, reinfection, taking probiotics alongside not only has an impact now, but also can brake help to break that cycle?

Peter Williams 38:41

Yeah, I think that's the unfortunate thing with I think that is the story that you've got to get over to your patients with regards to, you know, again, get them to fully buy into, it's not an option. Yeah. You know, it's not an option for you to take an antibiotic, and not run a probiotic alongside it. And we're gonna have to run that pro by I mean, so what, how long would you suggest you run the probiotic for? Would you do a month? A couple of months?

Yuwa Astor 39:08

Yeah. So I think it depends with everything it does depend on. So as you know, with activated probiotics. We are a practitioner only company, so we only work with practitioners. And I think it's because there are so many features that do require a little bit of discernment in terms of if it's a one off if somebody else has been fine. And then maybe they happen to have like something going on with a with a tooth or some random thing. And it's a one time cause and it's one week, there may be just one box would be sufficient. But I think if somebody has had this pattern and they've been on recurring cycles for a while, then you want to keep on what the probiotics are doing is that they're coming they're coming in and they're actually repairing tissue and they're helping to rebalance the immune system. So you kind of want to be keep checking in as to what level of disarray and disrepair and imbalance were they in in the first place. And then that helps you gauge how long so it can be variable. And of course, we know sometimes people aren't on antibiotics for a really long period of time, and then they'd need even longer support. So

Peter Williams 40:12

I think in those sort of patients, that's where I suppose a degree of testing may be more helpful at some stage. I mean, I don't think we would test people. We wouldn't test people straight after, you know, we'd probably assume that they were going to be on additional probiotics for several months. And then, obviously, with their symptom changes, yes, or symptom improvement, we'd still probably maybe want to do microbiome test further down the line to make sure that we're not going to get into this cycle that you talk about, because so many people do. It's unfortunate. Can I ask some specific questions now? Because it doesn't. I mean, I look at probiotics again, is that these? Oh, that was the question I was gonna ask. Because they're not that we used to think they're not the transient helpers, aren't they, is that a good way of describing them? So can you just expand on that? Yeah. So

Yuwa Astor 41:05
I was thinking about this, when you said about doing a test and doing a microbiome test. And I was thinking about this, when you said about doing a test and doing a microbiome test. And I think, you know, I hope that the listeners are not thinking that he's going to do a test to measure the bacteria from the probiotics, because that's not what they do. So we're not taking the, we're not taking the live bacteria, because they recolonize the gut. So if you're thinking about your home as a residence, we're not having bacteria, because they're going to move in next door and kind of, you know, help to repopulate. And, you know, to improve real estate that way, what they do rather than moving in and colonising is that they restored if you're in, you know, you can think of the analogy of the house, what they do is that they come in, and they renovate, and they restore the dilapidated house, or whatever level of disarray it is, so that then by the time that they leave, because they are transient, you know, they come in, they do their thing, and then they leave again, but they leave you in a much better state. And so depending on why again, we go back to the specifics of the strain is that because each individual student, each individual strain of bacteria has slightly different features. And so some generally, most strains are within days, you know, you're taking them and then they transit, they transition out through the stool. But some might have particular features where they're actually better able to adhere so they might stay on for a week, there's very few strains that stay on for longer than a week. And even with those, they are transitional strains. So the bacteria, we're taking the bacteria not to increase directly, they actually do increase the diversity, but not directly. It's not that this bacteria, and now it's there in the gut, we swallow this capsule, we swallow this probiotic. And it helps to improve the overall health and environment of the digestive tract, helps to kill other microorganisms that are there helps with the integrity of the digestive tract. And then it makes the environment much more feasible for the beneficial bacteria to re colonise, and to be better established.

Peter Williams 43:06

So just to reiterate that point, I think the research shows that our microbiomes are pretty much set by the time we're about three or four, that would be right, wouldn't it so you're sort of you get sort of you get born, and then you're sort of microbiome more or less as you say, super kingdoms of bacteria are getting established by the time you about three and from that it stays reasonably settled throughout life. But of course, it depends what happens, you know, gastrointestinal disorders, if you've, you know, had significant food poisoning, you know, stress could slightly alter that change so that it becomes dysfunctional. But what you're saying is that probiotics in general become like, helpers for a period of time, and maybe that, you know, some are brick layers, and they're just refronting the house. Some of them are cleaning the windows, some of them, making sure that, you know, I always think of it bit like a border control, you know, they are they're just additional numbers on the borders, making sure that for many, they're allowing things in that they want to allow in the crosstalk into the immune system, which is there as well. And also the reducing the amount of bad things that want to cross the border, but they're also almost like giving your microbiome, again, which is essentially set by about three, and it does change a little bit throughout your lifestyle, but not a bit, not much. But it does allow that microbiome to sort of have a break, regroup and start to proliferate better that would that be a correct analogy for

Yuwa Astor 44:41

it? I would say yes, up until the if I just got could ask you to clarify that last bit, the microbiome to have a break and then regroup? Well.

Peter Williams 44:49

I mean, generally what happens is what I look at it is that you're making. If you're needing to take a probiotic, it's maybe because your microbiome has got out of shape for some reason and Whether that's you've had food poisoning or something, and when you take the probiotics, what they're doing is a specific job to try and help you out. And it sort of allows your own microbiome to sort of, not take a rest, but try to get back on its own two feet. So it gets better would that be a good way of looking at it. Or

Yuwa Astor 45:19

I'd say I'd say in part because like, say, for example, last week, we I was talking about, we've got a new product called Biome Baby, which is really we talked about Biome Baby and Biome Kids, because it is so important, what's going on with the microbiome in infancy for neonates in infancy and early childhood as exactly as you said, because we want to get it set and established and hopefully have a very viable a really good quality immune response going. But actually, for lots of different reasons, that might not happen. So even though it's set, you know, when we're younger, we might be set in a way that slightly (Absolutely). So we even if you're an adult, you might want to take a probiotic if you still have presentation of eczema or asthma or allergic rhinitis, hay fever, then these the even though it's been set, and we know that there's a strong family history, we know that we see more prevalence in childhood, lots and lots of lots of people expressing with hay fever. So actually, it's maybe not allowing your microbiome to regroup, but it's allowing the immune response to be altered a little bit. In the main, I think what you said, Absolutely, I would agree. But I think there's a lot of things that happen throughout life, even hormonally, we've got a product that's specifically looking at a new product actually around acne. And so there might be even though you're fine, but there might be that period of time around adolescence and lots of hormonal changes, or later on in a woman's life, maybe in that perimenopausal period, a period where there's lots of hormonal changes that then impact the microbiome, that then might indicate some probiotic use,

Peter Williams 46:58

I think you've articulated that much better than I did, I suppose the way to think about it is that we all get born with the house, if you like, but for many people, that house might not be perfect. And I think the great example of that is vaginal birth, as opposed to C section births. We know that that C section babies are more at risk of having a microbiome that may not be as well established and as healthy and therefore, the risk of atopic diseases are much more profound in that, and I think if you, I can remember, many immunologists saying, you know, these kids may need to be on a specific probiotic for the rest of their life, because that part of the house was never built that well and might always suffer. So I think that's what you're saying aren't you and at different timeframes through your life, you may always need a sort of strain specific to do the job that it needs to do.

Yuwa Astor 47:53

That's exactly how I'd look at it, that's exactly how I look at it. Because I think that there's so many, you know, like, you know, lots of people we think about, like ideal scenarios or perfect circumstances, I just don't believe that exists really like, who has a perfect anything. And so all circumstances, I just don't believe that exists really like, who has a perfect anything. And so all of us have an Achilles heel. And we might find that depending on, you know, maybe in our regular day to day it's fine, but there might be a period of excess stress it might be when it's dark, and it's cold, it might be you know, for women around their menstrual cycle or different stages in their menstrual cycle that, that whatever that sort of tendency towards weakness might express. So yes, I think

Peter Williams 48:30
that's can we get into some specifics then? So what would you Is there a probiotic that you would utilise for pain disorders?

Yuwa Astor 48:40

Oh, that's a good one. So for pain, that's a really good one because actually, in my own clinical practice, I'm seeing more clients with pain. I think that there's, again, it depends on what is going on. So with I've got quite a few clients who have migraines, my own private clients who have migraines, and so that's a pain disorder. But here we're looking at a lot in terms of what's going on with particularly with the hormones and the detoxification. So not necessarily for all of those conditions would I put a probiotic or one of our products in the mix, but I have with women who are postmenopausal and there's a lot of sort of pelvic pain I have added in our Biome Her which is a probiotic, specifically around female genital urinary health, with recurrent cystitis, particularly within interstitial cystitis, or, you know, bladder pain syndromes.

Peter Williams 49:33

Just to confirm on that they that those conditions seem to get worse, don't they, as they become pre and postmenopausal? Yes, yeah. oestrogen seems to have a pretty large effect on trying to keep the UTI vaginal area in really good health, doesn't it? Yeah, women really do suffer once they've, once they've gone through those phases.

Yuwa Astor 49:53

Absolutely. So in the same way that we see topically on the skin the changes and the atrophy and the dryness is basically what is happening with all of our mucous membranes, particularly genital urinary mucous membranes as well. So exactly right. With some with some individuals with pain, then if there's more indication towards like if there's, you know, with interstitial cystitis as well, there's also for some individuals, there might be kind of more of an irritable bowel syndrome type presentation, and then that would indicate a slightly different probiotic products. So we've got biome relief, which is a specific one for IBS, so that I would incorporate it into a pain management programme. But again, it kind of requires I can't pinpoint and say, Okay,

Peter Williams 50:39

I'm probably asking you very difficult questions. So no

Yuwa Astor 50:42
No no question. I've actually never asked that question before. I thought it was brilliant. So thank you for that.

Peter Williams 50:47

What I'm doing is I'm just thinking about patients at the moment, and questions that I'm struggling with. And so I'm going to ask you another one then, is there anything you would recommend for gastroparesis, and just obviously, Gastro precesses, is where basically, the GI tract seems to sort of almost shut down, it seems to not work as well as it should do.

Yuwa Astor 51:08

I would say Biome Advance and that was Biome Advance was going to be the other one that I would consider in a pain scenario. But Biome Advance contains Well, it's actually the same strains as in the biome daily, but there's a particular bacterial strain in there Bifidobacterium Animalis, subspecies lactus, BSO1. So that strain has been independently studied for evacuation disorders, or whenever there's any kind of stasis within the GI tract. That strain particularly does that. The other strains in Biome Advance have been shown to not only promote the overall integrity and restoration of the GI tract, but generally motility once once we improve overall structure, then we have better function. So Biome Advance is the one that you know, we kind of would use that in cases of autoimmune, that would be probably one of the one of this one, that would be the product that we'd use with lots of different autoimmune conditions, for cases that that's a strain that you use for the antibiotic resistance, but beyond the antibiotic co prescribing, I'd use it for antibiotics, sorry for autoimmune conditions and I'd use it for cases where you could see that there's a need for for specific microbial support, but it wasn't necessarily clear the picture, I think Biome Advance bringing that in can sometimes you know how it is where you sometimes need to kind of clear a layer before you can see a little bit you know, what else is going on and Biome Advance would be the product for that

Peter Williams 52:40
Have you noticed any research with regards to probiotic use and long COVID?

Yuwa Astor 52:46

Yes, so we haven't you know, it's more like as a company, there hasn't been stuff that we've been sharing publicly. So I'm mindful what I'm saying on a on a public podcast. But of course within the industry, then for sure that that's what we have been seeing for sure. And the original product that I mentioned that if we're looking at this time of year, we're thinking about immune support it's Autumn, it's winter, so by BIOME daily. So it's actually similar strains, well the same strains that are in the Biome Advanced, but Biome Daily, those a couple of strains that have been really, really well studied to manage and mitigate upper respiratory tract infections. And so that would be a strain that I'd be using, or that is the strain that I suggested to my private clients over the last couple of years as support for this for this season. I think also because we know that we're wanting to have some cases of COVID, were not just impacting the respiratory system, but they're also impacting the GI. So that, again, is a product that has both a gastrointestinal and an overall immune modulatory. Action

Peter Williams 53:51

What's quite interesting about that is that it does look like the virus is actually. So there's a couple of things, the thing I think, many researchers are looking at the virus still seems to be surviving. And it's surviving in the in the GI tract, but also pointing to the fact that it seems to they believe the virus is actually infecting the bacteria. So it's acting as so which I find fascinating. Because if it's affecting the bacteria, then you're really going to have to make a decision about well, how do we change the microbiome? Because of course, you know, if that most microbiome is dysbiotic, which I think in most COVID patients who have got one COVID, that seems to be their primary area where it's actually doing the damage, you're still hanging out, which I find fascinating, then you've got that whole systemic, I suppose they're an outflow from there. And I think this is the importance of probiotics, isn't it important here is that they're, they're not just defending you from the outside world, they're sorting out the sorting the barriers, making sure they're secure. They're communicating all the way up the up the nervous system, particularly to the brain and you know, having conversations there as well. Should we talk one more? One more? I know, I know, I'm taking a lot of your time.

Yuwa Astor 55:07 To share with

Peter Williams 55:08

I think what we should do is we should do another one, which is really sort of really digging into more specifics. You know, I mean, the stuff that we're talking about about menopausal women and you know, the use of bacterial species that I think would be a brilliant subject

Yuwa Astor 55:21
It blows my mind, I'd love to that's my,

Peter Williams 55:24

Let's get that one organised. Because, as you say, I think there's just I think my wife would, would probably appreciate that one as well. So, can I just talk about psycho biotic revolution? That's regards to how we're manipulating bacteria for mood and what what influence gut bacteria is having on mood. Wow,

Yuwa Astor 55:50

What what influence, like where is there not an influence with gut bacteria and mood, I think so this whole, and I think it's such a brilliant subject to discuss, like literally, every, it's what I mentioned before that every single system of our body, nervous system, skeletal system, reproductive, every system has been impacted but this field of the gut brain access and how the digestive system and what's going on with the digestive system and the or more specifically, the gut microbiome brain access, and how that's communicating from the nervous system. So we know that mental and emotional health is a really, really big subject. And I believe that the World Health Organisation is again, kind of categorised it as a predominant area of focus for us. And then we also know that we have this, you know, full range of the different tools that we have. And I'm not a I'm not a medical practitioner, I can't comment about medicines. But we know that there's certain or I'd imagine for many of us, it's common knowledge that there's certain shortages in terms of how effective solely medication sole medication can be. So we know that with mental health conditions as social aspects, a range of different things that are going on. So it's a big, big, big area that we're not saying that just one thing is the fix. So there's a number of yes, yeah, so we need medications for some of the individuals we need social intervention. But when it comes to looking at the gut microbiota, I think again, it's incredibly fascinating, because we are recognising that there are particular compounds that are produced within the no actually, let me go back. So we know that we have a very clear, semi autonomous nervous system, within the digestive system, the enteric nervous system, so has about you know, 10th of the of the neurons that are in the central nervous system. So that's biology, that's well known. But we also recognise that there's a very direct communication through the cranial nerves, cranial nerve 10, the vagus nerve, to that enteric nervous system. And we know that there's this bi directional communication that goes on. And actually, whereas normally, we think of the brain being the one that sends most of the communication to different parts of the body, because it's organising and directing to the enteric nervous system, we know that we've got more communication coming back from the enteric nervous system to the brain. So what's going on in the digestive system, simply just based on biology is that if we've got a sort of a healthier, better digestive system, we've got the communication that's been sent up to the brain is, you know, less inflammatory, for example. So where the microorganisms come into places that we know that they not only in terms of what we've been talking about, that it's improving the health of the, of the intestinal tract, etc. But there are particular strains that and because it's new, I have to I have to put this caveat in not all of the pathways have been like, clearly identified, not all of them, like because it's a really new area, but it's a huge, huge, huge area of growth. But there's like, you know, proposed mechanisms in terms of serotonergic signalling for example, we know that we produce lots of serotonin in the gut not that it's been communicated back up to the brain but that's been used locally to promote things like motility and overall health in the digestive system. So this our overall area of psycho biotics and we also at Activated Probiotics have a product that's been clinically trial is done through one clinical trial. And now it's an another clinical trial, it's has been shown to reduce the incidence and the severity of stress and improve sleep outcomes and a range of other outcomes, including anger, surprisingly, was one of the minor outcomes in this study. So we know that depending on how we are modifying the immune system from particular bacteria, and probably the mechanism is a pro inflammatory, whether it's pro inflammatory or anti anti inflammatory, probably that's a mechanism but it's not super clear, but we know that we can see actually different results from people taking well this particular strain these particular strains of bacteria from them not doing clinically significant results in those mental and emotional So gain I think that's a really big, big, big. Let's explore I think

Peter Williams 1:00:05

it's a hugely growing area. And I think the key the key for this, like everything is that the safety aspects. With regards to taking probiotics, it just means that you're getting clinically validated products that really aren't going to have any side effects at all. Really? Yeah. Absolutely no, no knock on so you know, when you're talking about so when I say this is not a question of Pooh poohing medicines, it's not that at all. But whenever you use the medicine, you have to recognise that, number one, it's always you're always looking at cost risk benefits, because you know, there's going to be side effects. And when you're, and although they may be stronger, they're never going to, you know, the safety aspects of them are, you know, sometimes the problem later on when people have been using them, because they're actually causing more, more damage than they were for what they originally used for. And I think this is a, I think this is the way we've got to go is the safety profile on probiotics is pretty spectacular.

Yuwa Astor 1:01:11

Absolutely. I love that you said that. I think that's such an incredibly important point. And I guess, particularly with this area, because it's the same as when we're describing and talking about antibiotics. And I mentioned that the way antibiotics absorbed in the same way as with foods and with other medicines, and that sort of dance to the the movement of drugs through the body is through absorption into the bloodstream, and then doing whatever effect that you have them because probiotics stay within the digestive tract within the hollow part of this tube, and they're officially always out of the body is that you just don't see interactions with drugs, you know, obviously, you always have to check that. That's what practitioners always going to do. So I'm not saying to your listeners, just take them. But if you're on lots of medications, a practitioner always checks but you just don't see probiotic bacteria coming up. And I have a client that has pretty severe immunodeficiency condition, and we have to check literally everything. Everything that's going into her body has to be checked both by me and then obviously her consultants beforehand, and the probiotics come up as they're generally okay for her to be taking. And so it's in that case with the medications that this person is taking. We have an incredibly high safety profile. So we've got really potent therapeutics with, you know, we don't see negative side effects, potentially for some individuals, a little bit of bloating and gas. short lived until it clears and then that's it. That's so it's incredible.

Peter Williams 1:02:40

All right, let's end it there. Because we are well over the hour. I could quite easily go on all morning and it's kind of cool. So So look, I think this is this has been the sort of probiotics, taking probiotics. 101 I think, I think I would love to get you back on and we would definitely talk about that. And again, this is just an area, I'd say it's probably not one of my strengths. Certainly, DD Despina would be much better with regards to perimenopause or menopausal women but, you know, we just see so much work, that microbiome seems to be affected, you know, because of those hormonal changes. And obviously, you know, the microbiome and the bodies moving into a different stages of their life. I think that'd be awesome just to have a chat, because then we can give some clinical outcomes and maybe some ways forward for people on that one. Yuwa absolute pleasure. Thanks so much.

Yuwa Astor 1:03:34
Thank you. And have a good day.

Peter Williams 1:03:37
And we'll speak to you soon. Yeah, yes.