There is a TIDAL WAVE of information coming out these days about "probiotics" and the importance of having a healthy gut. Science has proven time and time again that fully functional digestive system is the key to good health.
Those people in the know have been aware of its importance for years, but only recently have probiotics found their way into the mainstream.
So, what do "microbes" and "gut bacteria" have to do with RLS?
Endless studies have shown that an unhealthy gut is a breeding ground for inflammation. If you believe that your RLS may be caused by inflammation, as I and others claim, then it is crucial that you ensure that all is healthy in the world of your digestive system. If it's not functioning properly, then any attempt you make to try and free yourself from RLS will be severely limited in its effectiveness.
For those of you like myself that are not versed in scientific things, I'm going to present some information on this page that will hopefully present the facts you need to know in a clear and simple manner.
I'll begin with a collection of key definitions that should make the rest of the information less confusing.
A food or a dietary supplement containing live bacteria that replace or add to the beneficial bacteria normally present in the gastrointestinal tract (from Greek: pro - advancing or projecting forward or outward + biotic - pertaining to life).
An extremely small living thing that can only be seen with a microscope (from Greek mi-kro- small + bíos - life).
The totality of microbes, their genetic elements, and environmental interactions in a particular environment. The term "microbiome" was coined by Joshua Lederberg, who argued that microorganisms inhabiting the human body should be included as part of the human genome, because of their influence on human physiology. The human body contains over 10 times more microbial cells than human cells (from Greek: Micro - of reduced or restricted size + Biome - a large naturally occurring community of flora and fauna occupying a major habitat, e.g. forest or tundra).
the bacteria and fungi, both normally occurring and pathological, found in or on an organ.
Gut Microbiota (formerly called Gut Flora)
The word microbiota represents an ensemble of microorganisms that resides in a previously established environment. Human beings have clusters of bacteria in different parts of the body, such as in the surface or deep layers of skin (skin microbiota), the mouth (oral microbiota), and so on.
Gut microbiota is the name given today to the microbe population living in our intestine. It contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria with more than 3 million genes (150 times more than human genes). Microbiota can, in total, weigh up to 2 kg. One third of our gut microbiota is common to most people, while two thirds are specific to each one of us. In other words, the microbiota in your intestine is like an individual identity card.
As its name states, gut microbiota is harbored in the intestine, one of the main areas in our bodies that comes into contact with the external environment (other examples are the skin and the lungs).
While each of us has a unique microbiota, it always fulfills the same physiological functions and they have a direct impact on our health:
- It helps with the production of some vitamins (B and K).
- It helps us combat aggressions from other microorganisms, maintaining the wholeness of the intestinal mucosa.
- It plays an important role in the immune system, performing a barrier effect.
- A healthy and balanced gut microbiota is key to ensuring proper digestive functioning.
"Everything you always wanted to know about the Gut microbiota..." Gut Microbiota Worldwatch
Below is a wonderful article linking gut bacteria and RLS by science writer Kristina Campbell. Kristina was kind enough to let me post her article on this website.
Kristina has written about the microbiome and digestive health since 2011. Her work as a gut bacteria science critic has appeared in newspapers, magazines and on her "Intestinal Gardener" blog
Kristina has lived and worked in Canada, Taiwan, and the U.K., and has completed degrees at the University of Toronto (B.A. Hon) and the University of British Columbia (M.Sc.). She worked as a communication clinician before training to be a journalist. Her own experience with digestive health problems first led her to investigate the science of the microbiome and its direct implications for health.
Kristina is also a frequent contributor to "The Gut Microbiota for Health" website
FLORA-KILLING FALLOUT: THE CONNECTION BETWEEN GUT BACTERIA AND RESTLESS LEGS SYNDROME Kristina Campbell, The Intestinal Gardener
According to one intriguing new study in Sleep Medicine, Restless Legs Syndrome may be another thing that is connected to gut bacteria gone haywire.
The study came about because its investigators, Weinstock and Walters, had previously noticed that many people with celiac disease and Crohn's disease happened to have a diagnosis of Restless Legs Syndrome.
They wondered: Does the reverse relationship hold between gastrointestinal problems and restless legs? That is, if we take a group of people with known RLS, would we find that they have more gastrointestinal problems than people with normal leg movement?
The gastrointestinal problems they were interested in studying were irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO).
Importantly, IBS is a "functional syndrome". That means doctors diagnose it based on reported symptoms rather than a specific test that confirms or disconfirms it. So to be fair, there's no guarantee that people with IBS have anything wrong with their gut bacteria. But in recent years IBS has been linked to SIBO, a condition that is definitely associated with too many bacteria hanging out in a neighborhood where they don't belong: the small intestine.
SIBO itself is diagnosed via an indirect method called the "lactulose breath test". The attraction of this method is that it involves nothing more invasive than drinking a cup of sugar solution and blowing into a plastic tube.
The researchers wanted to investigate both IBS and SIBO because each one indicates that something is going wrong with digestion; some patients have both problems, but others have just one or the other. Smartly, the researchers ended up with one measure of gastrointestinal distress that was based on reported criteria (i.e. IBS), and one that was based on measurable biology (i.e. SIBO).
People with Restless Legs Syndrome discovered the study through ads that made no mention of gastrointestinal symptoms. Their diagnoses of RLS were confirmed by the investigators, and then each subject was assessed for both IBS and SIBO.
It turned out that IBS was diagnosed in 28% of subjects with Restless Legs Syndrome, compared to 4% of the controls. In some of the cases, the IBS symptoms had appeared before the onset of the RLS symptoms. In others, the two problems started around the same time.
As for SIBO, the breath test showed it was present in 69% of the people with Restless Legs Syndrome, compared to 28% of the controls.
The conclusion? People with Restless Legs Syndrome have a greater incidence of IBS and SIBO - that is, a greater incidence of problems in the digestive system - than people without it. And in at least some people with restless legs syndrome, the associated gastrointestinal problem was related to bacterial overgrowth in the small intestine.
The research is far from concluding that gastrointestinal problems CAUSE restless legs or vice versa. But the researchers did put forward the tantalizing idea that there may be a common mechanism that leads to both: maybe some kind of inflammatory process in the body that leads to central or peripheral nerve damage, or a change in micronutrient absorption, resulting in restless legs.
In support of this, the researchers did an informal review of conditions that tended to co-occur with RLS; 89% of these disorders had been associated with inflammation or immune system activation.
In turn, the connection between inflammation and problems with gut bacteria has strong support in the literature. But that's a topic for another day.
Lots of questions remain about Restless Legs Syndrome, but the connection that this study made between restless legs and gut troubles seems to confirm certain clinical observations - not to mention people's personal experiences. We need more information though - let's hope this area of research stays alive and... ahem... kicking.
The Intestinal Gardener, June 27, 2011
There’s a new (ancient) wrinkle to consider in the fight against chronic inflammation: the gut flora. Understanding our own bodies is difficult enough, but now we’ve also got to make sense of how the droves of foreign (but symbiotic) microbes living in our guts interact with our health.
Scientists have referred to the gut as the “second brain.” Why? Because it contains a vast network of neurons. In fact, it contains over 100 million neurons, which is more that what’s found in your spinal cord.
Just like the neurons in your brain, the neurons in your gut communicate with neurotransmitters. One particular nerve, called the vagus nerve, communicates directly to your brain. This is why your digestive system responds to stress and outside stimuli.
Researchers from the University of Michigan have published a study showing how probiotics reduce stress induced gut inflammation. Psychological stress from work, school, marriage, relationships, finances, any chronic stress, releases the stress hormone cortisol, which stops the digestive process causing inflammation and damage to the gut. Allowing large food particles and toxins to enter the bloodstream, where they are attacked by the immune system, creating inflammation in the body and brain.
Your gut can become inflamed and damaged from physical sources as well. Such as antibiotics, alcohol, diet, chlorinated drinking water, mercury, lead, GMO Food, preservatives, food additives and more.
Most people, including many physicians, do not realize that 80 percent of your immune system is located in your digestive system, making a healthy gut a major focal point if you want to maintain optimal health. Remember, a robust immune system is your number one defense system against ALL disease.
Our relationship to gut flora is confusing and rather precarious. If the right conditions are met, we exist in harmony. If good bacteria is stable, breaking down fiber (like pectin and inulin) into short chain fatty acids (like butyrate), and working harmoniously with the body, gut inflammation is suppressed, intestinal permeability is reduced, and multiple health biomarkers (lipids, insulin) improve. But we must remember – gut flora doesn’t exist for our benefit. Even if gut flora species were sentient, they’d only be acting out of self-interest. They wouldn’t “care” about us. They’re just trying to survive. It just so happens that keeping us happy by mediating immune responses and tight junction function, helping identify harmful intruders, and producing short chain fatty acids like butyrate puts the flora in good standing with our immune systems. They scratch our back, we provide room and board and don’t dispatch antibodies to destroy them.
Gut flora influences the human immune response (provides a blockade against damaging bacteria; gives a “safe word” to avoid the immune system wasting resources on attacking; influences size of the thymus). Mice without gut flora have a severely truncated immune response, for example.
Now what is the primary immune response to damaging stimuli? Inflammation. In correct doses, inflammation is a boon, necessary for healing and protection from foreign invaders. But in excess, inflammation is at the heart of many diseases. Gut inflammation especially is associated with a number of autoimmune diseases. Leaky gut, or intestinal permeability, for example, is associated with inflammation of the gut, and with small intestinal bacterial overgrowth.
Small intestinal bacterial overgrowth, or SIBO, occurs when the gut flora is compromised. Remember, normal gut flora acts as a physical barrier to foreign flora; they are stubborn tenants, old ornery relics of the neighborhood who refuse to leave and who dissuade pathogenic flora from settling in. If the good gut flora is gone or disrupted, pathogenic bacteria can populate the gut at will. The result is SIBO, and it leads to gut inflammation and intestinal hyper permeability.
It’s all a vicious cycle. Inflammation leads to disturbed gut flora (or maybe it’s the other way around – the classic chicken and the egg dilemma), SIBO, malfunctioning toll-like receptors, and leaky gut, allowing proteins to enter the body and provoke an inflammatory response by the immune system. More inflammation, more bacterial overgrowth, maybe a bout of antibiotics thrown in for good measure which wipes out the bacteria, leaving a clean slate and prompting another mad dash by microbes to fill the vacancies, and the result is – potentially – a permanently altered/disrupted distribution of gut flora both supporting and supported by chronic systemic inflammation. Where does it end? How do we fix it?
"Probiotics Reduce Gut Inflammation" from Depression Anxiety Diet, June 14, 2013
"Can Probiotics Help Reduce Anxiety?" by Maylin Rodriguez-Paez, RN, Life Extension
"Putting Out the Fire: Gut Flora and the Inflammatory Cycle" by Mark's Daily Apple
"Probiotics Found to Help Your Gut's Immune System" by mercola.com July 05, 2008
"Probiotics: One of The Most Important Supplements You Can Take" September 24, 2011 by mercola.com
If you believe that LESS INFLAMMATION = LESS RESTLESS LEGS, you can accelerate the healing process by implementing some of the probiotic foods listed below into your diet.
Science has proven without a doubt that the bacteria in your bowels determine your health. Your gut flora can make you chronically inflamed, obese, cancerous or healthy, and your diet can determine your gut flora. We return to the basic wisdom that you are what you eat, but you can change your gut flora.
If you are knowledgeable, your grocery store CAN be your pharmacy. You simply know what to buy, and what to avoid like the plague.
THE IMPORTANCE OF FERMENTED FOODS
Historically, people used cultured or fermented foods to support their intestinal and overall health, way before the invention of the probiotic supplement.
Did you know the number of bacteria in your body outnumber your cells by about 10 to 1? These bacteria in turn are comprised of both beneficial ones and harmful ones. The ideal balance is about 85 percent good bacteria and 15 percent bad. Maintaining this ideal ratio is what it’s all about when we’re talking about the importance of probiotics. It’s important to understand though that probiotics are not a new concept. The only thing that’s new is that you can take them in pill form. But historically, mankind has consumed large amounts of probiotics in the form of fermented and cultured foods, which were invented long before the advent of refrigeration and other forms of food preservation.
Every traditional culture, when you look at their traditional diet, they ferment their foods. They fermented everything. You can ferment dairy, grains, beans, vegetables, fruits, meats, and fish. Everything can be fermented, and there were fermented beverages in every culture. When the cabbages were ripe in September, you made it a fermented cabbage. Perhaps for a month or two, you were eating fresh cabbage, but then for the rest of the year, 10 months of the year, you ate your cabbage in a fermented form. Quite a large percent of all the foods that people consume on a daily basis were fermented. And with every mouthful of these fermented foods you consume trillions of beneficial bacteria.
Fermented foods not only give you a wider variety of beneficial bacteria, they also give you far more of them, so it’s a much more cost effective alternative. Here’s a case in point: It’s unusual to find a probiotic supplement containing more than 10 billion colony-forming units. But when they were tested, fermented vegetables produced by probiotic starter cultures had 10 trillion colony-forming units of bacteria. Literally, one serving of vegetables was equal to an entire bottle of a high potency probiotic! So clearly, you’re far better off using fermented foods.
Mother Nature is extremely wise and extremely kind. It populated all organic fruit and vegetables, the dust on our soils, and all plant matter with Lactobacilli. The fresh cabbage leaves, if it’s organically grown (not the one from chemical farming), will be covered in Lactobacilli—lacto-fermenting bacteria. You don’t need to add anything. You just chop it up. Add some salt in the initial stages. (The salt is added in the initial stage in order to stop putrefactive bacteria from multiplying.) Then as the Lactobacillus stop working and start multiplying, they produce lactic acid. That’s why they’re called Lactobacillus. That’s just lactic acid.
If you look at the research in lactic acid, it is one of the most powerful antiseptics. It kills off lots and lots of bacteria.... So as the lactic acid starts producing, it will kill off all those putrefactive and pathogenic microbes and preserve the food. It’s a great preservative... A good batch of sauerkraut can keep for five to six years without spoiling or rotting, as long as it is covered by its own juice.”
This anaerobic process (fermentation) does more than just preserve the food, however. It also makes the nutrients inside the food more bioavailable. For example, the amount of bioavailable vitamin C in sauerkraut is 20 times higher than in the same helping of fresh cabbage!
This is because in the fresh cabbage, vitamin C is bound in the cellulose structure and various other molecules, and our digestive system is just not able to cleave it off and absorb it. Lots of it goes undigested and come out right out of you. So despite the fact that cabbage may be very rich in vitamin C, a lot of it you will not be able to absorb. But if you fermented that cabbage and made sauerkraut, all the vitamin C becomes bioavailable.
NATURAL PROBIOTIC FOODS
One of the best probiotic foods is live-cultured yogurt, especially handmade. Look for brands made from goat’s milk that have been infused with extra forms of probitoics like lactobacillus or acidophilus. Goat’s milk and cheese are particularly high in probiotics like thermophillus, bifudus, bulgaricus and acidophilus. Be sure to read the ingredients list, as not all yogurt is made equally. Many popular brands are filled with high fructose corn syrup, artificial sweeteners and artifical flavors and are way too close to being a nutritional equivalent of sugary, fatty ice cream.
Some yogurts contain the aforementioned bacteria; however, because they are sensitive to oxygen, light, and dramatic temperature changes, make sure to look for yogurts with “live and active cultures.” Many commercial yogurts are heat-treated or pasteurized, resulting in the loss of these valuable cultures. Learn more about the smart way to shop for probiotics.
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.
Similar to yogurt, this fermented dairy product is a unique combination of goat’s milk and fermented kefir grains. High in lactobacilli and bifidus bacteria, kefir is also rich in antioxidants. One of the best and least expensive ways to get healthy bacteria through your diet is to obtain raw milk and convert it to kefir, which is really easy to make at home. All you need is one half packet of the kefir start granules in a quart of raw milk, which you leave at room temperature over night. By the time you wake up in the morning you will likely have kefir. If it hasn’t obtained the consistency of yogurt you might want to set it out a bit longer and then store it in the fridge.
A quart of kefir has far more active bacteria than you can possibly purchase in any probiotics supplement, and it is very economical as you can reuse the kefir from the original quart of milk about ten times before you need to start a new culture pack. Just one starter package of kefir granules can convert about 50 gallons of milk to kefir.
Don’t even think of using pasteurized milk, however, as pasteurized milk has its own set of negative health ramifications and should be avoided at all cost.
Made from fermented cabbage (and sometimes other vegetables), sauerkraut is not only extremely rich in healthy live cultures, but might also help with reducing allergy symptoms. Sauerkraut is also rich in vitamins B, A, E and C.
Some packaged varieties are pasteurized, which could destroy the healthy bacteria. Choose raw, unpasteurized and unheated sauerkraut to get the full benefits of its live enzymes. Look for fresh sauerkraut in the refrigerated section of your grocery store. You can also make your own sauerkraut, there are many recipes online.
This refers to super-food ocean-based plants such as spirulina, chorella, and blue-green algae. These probiotic foods have been shown to increase the amount of both Lactobacillus and bifidobacteria in the digestive tract. They also offer the most amount of energetic return, per ounce, for the human system. Sometimes called “blue algae,” microalgae is a grassy, green plant that’s often used in juices. Check your local health food store or juice bar to try this unexpectedly delicious treat.
Japanese miso paste is a form of fermented soy that is absolutely delicious. To get the beneficial probiotics from miso, however, you cannot boil the miso (as is usually the case with miso soup), because the heat kill all the bacteria.
Fortunately, miso paste makes a wonderful emulsifier in salad dressing. You can add a tablespoon of miso paste and a splash of rice vinegar to olive oil, along with salt, pepper, fresh chives and some grated ginger to make a nutritious and delicious dressing.
Beyond its important live cultures, miso is extremely nutrient-dense and believed to help neutralize the effects of environmental pollution, alkalinize the body and stop the effects of carcinogens in the system.
Believe it or not, the common green pickle is an excellent food source of probiotics. Try making your own home-made pickles in the sun. Here’s a great set of instructions for making your own probiotic-rich dill pickles .
An Asian form of pickled sauerkraut, kimchi is an extremely spicy and sour fermented cabbage, typically served alongside meals in Korea. Besides beneficial bacteria, Kimchi is also a great source of beta-carotene, calcium, iron and vitamins A, C, B1 and B2. Kimchi is one of the best probiotic foods you can add to your diet, assuming you can handle the spice, of course.
Kombucha is a form of fermented tea that contains a high amount of healthy gut bacteria. This probiotic drink has been used for centuries and is believed to help increase your energy, enhance your well being and maybe even help you lose weight. However, kombucha tea may not be the best fit for everyone, especially those that have had problems with candida.
Not all cheeses are good sources of probiotics, but certain soft fermented cheeses like Cheddar, Swiss, Parmesan and particularly Gouda contain bacteria that can survive the journey through your GI tract to benefit your health, according to Finnish research. “These cheeses start with a lactic acid bacteria that causes the milk to form curds and whey and ferment for days, weeks or even years, which helps create probiotics,” say Brown and Medina. Some cottage cheeses that list “live active cultures” on the label also contain probiotics. Work an ounce of soft cheese or a ½ cup of cottage cheese into snacks and meals for an added protein and calcium boost.
The next time you make a sandwich, pay attention to what's holding your cold cuts and cheese. San Francisco's famous sourdough bread contains lactobacilli, a probiotic that may benefit digestion.
A soy product made with fermented soybeans, tempeh has a meatier taste and texture than tofu—and almost twice the protein. Sirota advises buying brands that use organic soybeans or have the Non-GMO Project Verified seal. GMO (genetically modified organisms) foods may be linked to allergic reactions, inflammation and even an increased cancer risk. They’re also more likely to have been sprayed heavily with pesticides, Sirota says. Some brands that carry the seal include SoyBoy and Lightlife. Find them in the refrigerated section of your grocery store, and put up to 4 oz of tempeh in stir-fries, salads and tacos.
Soy naturally contains some probiotic benefits, but new soy milk products on the market have added extra live cultures. Look for labels that say “live and active cultures” to be sure.
Olives in brine have large amounts of probiotics because the brine allows the probiotic cultures to thrive. Snack on your favorite type of olive or add to a salad or pizza.
A recent study looked at rats eating a diet high in pectin, a component of the dietary fiber in apples. When compared to rats on a normal diet, the rats with the apple-rich diet had increased amounts of beneficial bacteria. Although researchers aren't sure if apples will have the same effect in humans, investigators did conclude that by eating apples regularly, the friendly bacteria "help produce short chain fatty acids that provide ideal pH conditions for ensuring a beneficial balance of microorganisms."
When people first started to learn how important probiotics are for proper digestion, elimination, and overall good health, many nutritional supplement manufacturers jumped on the bandwagon and flooded the market with probiotic products that may very well be worthless. The problem is that most of the beneficial bacteria in these products probably don’t survive long enough to reach you—or, more specifically, your gut. For instance:
Many probiotics are dead on arrival in your intestines. Because your stomach acids are so powerful, they kill off most probiotics well before they can reach your small and large intestines. And they won’t do you an ounce of good once they’re dead.
Most probiotics can’t survive transportation and storage. Probiotics are extremely delicate — they can’t survive exposure to light, air, or even oxygen. And if you’re taking a brand that needs refrigeration, it has got to be refrigerated 100% of the time. The truth is, by the time most probiotic products leave the manufacturer, get shipped on trucks, and sit in warehouses or on store shelves, the power of the beneficial bacteria has been significantly and in some cases completely diminished.
Manufacturers over-promise the potency of probiotics. Many may promise you one billion live acidophilus organisms—but only on the date of manufacture!
Instead, you need to take a probiotic that delivers healthy bacteria to your gut each and every time you take it, and up until its expiration date.
Here they are ...
Lactobacillus bulgaricus: can be found in many yogurts and soft cheeses. It was discovered by the Bulgarian doctor Stamen Grigorov, hence the name bulgaricus. It helps to convert lactose and other sugars into lactic acid, which may be particularly helpful for those who are lactose intolerant.
Streptococcus thermophilus: has nothing to do with strep throat, which is caused by a completely different bug. These friendly bacteria are also used to make yogurts and cheeses, and they even assist Lactobacillus bulgaricus by making nutrients that assist with growth.
Lactobacillus Acidophilus and Lactobacillus Casei: both convert lactose into lactic acid – also helping the lactose intolerant. Research has indicated that L. Acidophilus may also be helpful at reducing cholesterol levels.
Bifidobacteria: is a family of bacteria that has been studied for its ability to prevent and treat various gastrointestinal disorders, including infections, irritable bowel syndrome and constipation. In addition to making lactic acid, it also makes some important short-chain fatty acids that are then absorbed and metabolized by the body. There is also some experimental evidence that certain bifidobacteria may actually protect the host from carcinogenic activity of other intestinal flora.
If you want to supercharge your probiotic friends, you may want to feed them with prebiotics. That’s P-R-E-biotics. They nourish the good bacteria in your gut in order to keep them healthy against the bad bacteria. They should go hand-in-hand with probiotics. Prebiotics are found in many foods, including bananas, whole grains, honey, garlic, asparagus, Jerusalem artichokes, oatmeal, maple syrup, legumes and onions. Try to get two to four servings of these prebiotic-rich foods a day.
Snack alert: Popping 1.5 to 3 oz of pistachios per day increases levels of good gut bacteria, according to 2012 research in The FASEB Journal. Almonds didn’t perform as well as pistachios in the test, so it may be time to mix up your go-to snack. Opt for in-shell pistachios.
"Pre- and Probiotics" from the Cooling Inflammation Blog, September 20, 2008
"Gut Bacteria Offer New Hope for People with Celiac Disease" by drmercola.com May 27, 2010
"Probiotics Found to Help Your Gut's Immune System" by mercola.com July 05, 2008
"Fact Sheet: Probiotics" doctoroz.com June 9, 2012
"Best Types of Probiotic Supplements for Digestive Health" by Dr. David Williams drdavidwilliams.com 02/06/2014
"Probiotic Foods" Dr Edward Group III DC, ND, DACBN, DCBCN, DABFM, June 19, 2017
"The Truth About Probiotics and Your Gut" WebMD
"13 Probiotic-Filled Foods" by Readers Digest Editors
"Fermented Foods Contain 100 TIMES More Probiotics than a Supplement" by Dr. Natasha Campbell-McBride, May 12, 2012
"5 Simple Ways To Eat More Probiotics" by Darya Rose, Aug 4, 2017