The microbiome is a relatively new area of study in medicine. Doctors and researchers are starting to realize how far-reaching the effects of the “gut” can be. That “gut” feeling is legtitimate and is really from all of the trillions of micro-organisms that live in your digestive tract. They are realizing that the microbiome can control mood, digestion, headaches, and a variety of other functions that you would think completely unrelated to the digestive system.
Because celiac disease does affect the small intestine or the main home of the microbiome, does that mean that we can control or eliminate celiac disease just by controlling the microbiome?
Unfortunately, the answer is no. Here are three studies that demonstrate that the probiotic pill or drink or food you put in your mouth may or may not affect what comes out the other end of your system.
In 2016, they did a double-blind, placebo controlled study of 45 celiac disease patients on a gluten free diet for longer than 12 months to see if VSL#3 probiotic would change the fecal microbiome. It didn’t. Not at all.
In 2006, they did a study to see if VSL#3 could help break down gluten proteins in the gut. It can’t.
But what was interesting in this study was that the VSL#3 could break down gluten proteins in long fermented dough, like sourdough. The VSL#3 got the dough to below 150ppm. Now, nobody would consider that celiac-safe. The promise of a probiotic being an additive to food to breakdown the gluten before consumption would be really cool!! What if they sold it in shakers, like a salt shaker, and you could sprinkle VSL#3 on your food before eating it to make it safe. I’m not sure what the food would look like at the end, but wouldn’t that be cool!
However, the sprinkle method of making food safe never panned out.
Also, this might be where the great sourdough myth started. Sprinkle some VSL#3 on the sourdough starter and ta-da, you have celiac safe bread! That isn’t the truth, but I betcha that’s where this myth started.
A note about VSL#3. The company that manufactures VSL#3 parted ways with the original creator of VSL#3 in 2016. There was a version created in America by the new company and a version created in Italy by the creator of VSL#3. Starting in 2016, the “American” version of VSL#3 was found to be clinically different from the “original” version produced in Italy. Currently, nobody is allowed to sell a probiotic under the name VSL#3. The “original” version is now sold at http://www.visbiome.com. The probiotic version at Visbiome is the formulation represented in the studies described above.
Finally, the most recent study on celiac and probiotics from 2018!! This study seems to be a study of studies. They talk about how imbalances in the microbiome could help lead to the start of celiac and the progression of the disease. They also note that, even on a strict gluten free diet that imbalances in the microbiome may remain. Specifically, in those with celiac disease, “intestinal microbiota of patients with CD that are mainly characterized by an increased abundance of Bacteroides spp. and a decrease in Bifidobacterium spp.”
In doing some other research, it seems that the Bacteroides are mainly harmless. But there is one that can cause problems. Bacteroides fragilis is the only strain of Bacteroides spp. associated with diarrhea. The Bifidobacterium seems to help with protecting the gut lining. So, we seem to have a lot of the bad bacteria and too few of the good bacteria. Anyway, back to our story.
So, the idea that the gut imbalance can contribute to ongoing symptoms starts to look like one of the reasons many of us continue to experience symptoms even on a gluten free diet. The authors conclusion on this paper is that we need to more studies on the microbiome. There might be a pattern to the microbiome of celiac patients. They might be able to create a cure harnessing the power of the microbiome. Basically, these guys think the microbiome is the holy grail in finding a solution to this disease.
What have we learned – taking probiotics does not alter the fecal microbiome, VSL#3 can break down gluten in sourdough bread dough, and a gut microbiome imbalance may explain the reason for ongoing diarrhea in celiac patients. We need to kill off the Bacteroides and get more Bifidobacterium into our bellies.
Many people talk about taking a probiotic to help with celiac symptoms and that may help, but probably not. A probiotic won’t help with a glutening episode – its too late to try to alter your microbiome when everything is already on fire. Its like pulling out a fire extinguisher for a 5-alarm fire – its too little too late.
Really, it is kind of disappointing that we don’t have as much control over our microbiome as I had hoped. I did take the VSL#3, when it was the really good stuff. It didn’t help much.
How do we improve the health of our microbiome? Eat a variety of whole foods, I think is the first place to start. And really, I think it comes down to eating a wide variety of foods in general. I know I get into ruts where I start to eat the same things over and over again. Its hard to try new things because each new thing can bring danger. I get it. But I think we have to try to branch out and do better.
It doesn’t have to be a million things it could be one or two things. Like maybe find a nice recipe for glazed carrots or a fancy up some peas with a dressing of some sort for dinner as a side instead of broccoli. Maybe homemade fried chicken on Tuesday for dinner instead of Taco Tuesday. Anything you can do to mix things up will help your microbiome to diversify. I know I get into ruts. So, I will post some recipes to help everyone maybe get out of their particular rut this week!!