Can Prebiotics and Probiotics Really Help with Exhaustion?

Can Prebiotics and Probiotics Really Help with Exhaustion? 

Written By Dr. Kristen Burris, DAcCHM

The gut-brain axis is an intricate, sophisticated,  system in our bodies that protects, feeds and heals our entire body. More critical emotional, physical,  physiological and chemical information is shared between our brain and gut than any other systems in our body. These messages influence our nervous system, endocrine system- which in turn affects our hormones, our immune function and our enteric neural network throughout our entire gastrointestinal (GI) system,  known to many of us as our "gut".  When it comes to our brian-gut-axis, there is truth about warning signs we feel physically whispering "gut feelings" and "gut instincts" to stop us from doing something. There is also  a similar notion when something good happens and we feel as though butterflies are fluttering around in our gut- this is a sign your brain is alerting your GI system and you should listen closely as it is often correct. Our brains alert our GI system to watch out for poisons, pathogens and parasites. It has a remarkable memory to help you avoid those risks in the future. With over 500 million neurons in our GI system our digestive system can work with our brain and also work independently, alluding to the possibility of our gut becoming known as our second brain in our bodies. 

Patients who have Multiple Sclerosis (M.S.) often experience unrelenting fatigue and many patients are constantly looking for ways to combat this debilitating part of their chronic disease. M.S. is a demyelinating disease of the central nervous system. Considering the intimate connection between the gut-brain-axis that has a sophisticated way of communicating with our nervous system, endocrine system and immune system, finding ways to  heal our gut in order to reduce fatigue is a critical piece of improving one's quality of life while managing M.S. 

In one promising study, The effect of probiotic supplementation on the clinical and par-clinical findings of multiple sclerosis: a randomized clinical trial, highlights the effects of probiotics for those with M.S., was published in 2023 in Scientific Reports.  Patients who took a daily probiotic containing the probiotic strain saccharomyces boulardii, for 4 months, had significant reduction in inflammatory marker high sensitivity c-reactive protein (hs-CRP) compared to placebo. Inflammation causes many health problems and can add to one's fatigue levels. Additionally, these patients reported their fatigue severity significantly reduced compared to those who were not taking a probiotic, (p=0.0004 and p=0.01), respectively. This is a tremendously promising study showing marked improvement in fatigue and quality of life for MS sufferers. 

Many treatment options for MS are exceptionally expensive, some medications cost patients over $10,000.00 a month. To have a safe, affordable, option to reduce fatigue is a welcome answer for many patients. Probiotics are extraordinarily safe for most people. The side-effects are usually very mild. Some patients will report mild digestive discomfort, bloating or gas when first starting a probiotic. For our patients we suggest starting slowly if the patient has never tried a probiotic before. One can start every other day, or take the probiotic at night before bed. They can slowly increase the frequency for which they take a pre or probiotic. this usually resolves all symptoms within a month as the body acclimates to the new, healthy microbiome growing throughout their GI tract. 

Some patients may choose to start their prebiotic and probiotic journey with a more mild approach: incorporating foods in their diet by increasing prebiotic and probiotic foods instead of taking a convenient pill. There are advantages to both. The differences between prebiotic and probiotics are simple: prebiotic food and supplements support the growth of beneficial baterias. Probiotics actually contain the wanted, beneficial bacteria. The pros of a supplement are straightforward: different strains help different conditions. Additionally, each pill has a set number of probiotics contained within each individual pill so we know what therapeutic amount is being consumed. It is easy to take orally and doesn't require incorporating daily foods, a specialized grocery list or getting bored with the same foods over and over. With food as our main source for pre and probiotics, although, we see fewer side-effects. However, we don't know the exact amount contained in each bite or serving of food. Each person needs to weigh the pros and cons for themselves. I would suggest if you are trying to combat fatigue with MS, a supplementation process would be the easiest and fastest way to see if it helps you feel more energized. Plan on trying this treatment for at least 3 months and up to one year before ditching the pre and probiotic pills. 

Prebiotics are easy to incorporate in your diet as you already should be eating these foods daily. Here are some suggestions of easy to add prebiotic foods to your diet: banana, artichoke, garlic, onion, tomatoes, berries, dark green leafy vegetables and even asparagus. You can find them in whole grains, wheat and legumes. Probiotics in food are more sparse and not everyone enjoys these foods regularly but if you find probiotic pills cause, gas or bloating try to get a least one serving a day of one or more: yogurt (with probiotics-check the label), keifer, sauerkraut, kimchi, tempeh and kombucha. 

When deciding which probiotic is best for your condition, there are many factors to consider: strength, quality, gut-stability and third-party testing. I highly suggest making a specialized appointment with a holistic doctor who has training in nutraceuticals, lifestyle adjustments, and nutrition. Doctors with credentials that read DAcCHM have the most extensive training and board exams in these areas. So do doctors of Naturopathy N.D. or N.M.D.. Some D.O.'s, D.C.'s and M.D.s, who take additional courses or earn certificates in integrative or functional medicine should have adequate knowledge as well. Traditional medical training does not usually cover dietary or nutritional supplements to these depths. 

Ask your provider about their education and expertise before making an informed decision. Not all probiotics work as well as others. Always buy straight from your doctor's online portal or from their in-office stock for the highest level of purity and quality. Randomly ordering off of the internet opens you up to all types of concerns including how they are transported, stored, temperature dysregulation and of course, fraud. Overall, supplements, particularly pre and probiotics,  have a high safety rating with very few contraindications. A few contraindications being:  a severely compromised immune system, HIV, undergoing cancer treatments, organ transplantation, severe, end-of-life illnesses in the ICU or Hospice or  patients with central venous catheters may be more susceptible to probiotic-related complications, but those are very rare. 

Dr. Kristen Burris, DAcCHM, L.Ac., M.S.T.O.M. is dual board certified in natural medicine including a doctorate in acupuncture and a doctorate in Traditional East Asian Herbal Medicine. Her training includes functional medicine, nutrition, herbal medicine, and lifestyle medicine to treat complicated medical problems. She has been in private practice for 24 years. 

Source: Asghari KM, Dolatkhah N, Ayromlou H, Mirnasiri F, Dadfar T, Hashemian M. The effect of probiotic supplementation on the clinical and para-clinical findings of multiple sclerosis: a randomized clinical trial. Sci Rep. 2023 Oct 30;13(1):18577. doi: 10.1038/s41598-023-46047-6. PMID: 37903945; PMCID: PMC10616192.