This article is part 2 of a 2 part series. For Part 1, click here.

Fibromyalgia (FM) management requires a multi-dimensional approach, of which nutrition plays a BIG role. Last month, we discussed the importance of keeping an accurate food journal and grading the reaction that certain foods, vitamins, herbs, etc. have on you. This month, let’s discuss the nutritional use of probiotics.

Probiotics can be defined as the “good guy,” or friendly bacteria, that we need and have in our gastrointestinal (GI) tract. Certain “strains” or types of probiotics have been linked to many health benefits ranging from calming IBS (irritable bowel syndrome) to stimulating the immune system.  As a result, probiotics can help “fight off” MANY conditions, including bacterial and/or viral infections and related conditions. Probiotics may also benefit those suffering from autoimmune diseases such as rheumatoid arthritis, MS, lupus, and more. Common questions surrounding the use of probiotics include:

1) Are these FDA regulated? ANSWER: In 2001, the FAO (Food and Agriculture Organization – NOT the FDA or Food and Drug Administration) defined probiotics as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.” At this time, the FDA has NOT approved any specific health benefit related to probiotics. This may be because the amounts of probiotic that studies have reported to be beneficial vary from strain to strain and condition to condition. In 2007, the FDA placed regulations requiring all dietary supplements to be a) produced in a quality manner, b) to be free of contaminants / impurities, and c) accurately labeled. Probiotic researchers are hoping this will improve the quality of the probiotic supplements and research quality in the United States.

2) Which probiotic strain does what? ANSWER:  According to probiotic microbiology consultant Dr. Mary Ellen Sanders, strains that help modulate and support the immune system include: Bifidobacterium lactis HN019 – this helps older people in particular (sold as an active ingredient for dairy and supplement products); Lactobacillus reuten ATCC55730 (available in BioGaia Gut Health products); Lactobacillus casei DN-114 001 (in DanActive products); and d) Bifidobacterium lactis Bb-12 (available in Yo-Plus yogurt, LiveActive cheese) –  best used uncooked. To help combat diarrhea associated with antibiotic use, consider: S. cerevisiae (S. boulardii) (found in Florastore powder and Lalfor capsules); Lactobacillus rhamnosus GG (LGG) (found in Danimals drinkable yogurt and Culturelle capsules); Lactobacillus casei DN-114 001 (in DanActive products); Lactobacillus acidophilus CL1285 and Lactobacillus casei Lbc80r (found as BioK + CL1285 fermented milk, BioK + CL1285 soy milk, and capsules).

3) What information should be looked at on the label of probiotic foods? ANSWER: a) Look for the full probiotic name, which includes the genus, species followed by the strain, as many only list the genus/species (such as “Bifidobacterium lactis” found in Kraft’s LiveActive Cheddar Cheese Sticks). b) Find out how much probiotic is contained in each serving, and what research supports the health benefit and the amount they used (search the website of each individual product to find these answers).

4) Are probiotic supplements worthwhile? ANSWER: When consumed in food or pill form, YES! Dr. Sanders says food sources are more nutritious, but pills are more convenient and may have greater amounts of probiotic. Most important, You MUST receive adequate amounts of Probiotics for your needs!

5) Are Probiotics safe? ANSWER: Usually, but those acutely ill or those with a compromised immune system should be cautious, as this area is currently being researched with unknown answers. A Tufts University expert writes that no harm has been reported in healthy people – BUT those with terminal cancer or leaky bowels, including acute pancreatitis, should NOT consume probiotics. Work with your doctor of chiropractic and your primary care physician for guidance.