By in Nutrition

The Trouble with Antibiotics

The discovery of antibiotics in the first half of the 20th century changed the world. Until then, treading on a rusty nail could mean the end of you. Bacteria had been discovered in the 19th century and improved hygiene helped reduce infection, but as bacteria are everywhere, infection is not completely avoidable and once it had taken hold, there was little the doctors could do to save a patient’s life. All of that changed with the discovery of antibiotics. Countless lives have been saved since. But lately antibiotics have been losing their bite. They are becoming less and less effective. What’s going on?

In the late 18th century, European settlers introduced rabbits into Australia. Until then they did not exist down under. In the early 19th century, a small population of just 24 rabbits was released into the wild to enable settlers to hunt them. But they bred like – well – rabbits and the rabbit population in Australia rapidly increased. Before long, they spread across the entire continent and like anything that isn’t native to Australia became a serious threat to the local fauna and flora and destroyed crops. Rabbits are a pest in Australia, and there are few means to fight them. One is the myxoma virus, a virus affecting South American cottontail rabbits. This was introduced into Australia in the 1950s and it did diminish the rabbit population by killing 99% of the Australian rabbits. Success! It turned out though, that the 1% that survived was genetically resistant to the myxoma virus. Now, those immune rabbits were the only ones left and they bred like – well – rabbits.

And this is very similar to what has happened with antibiotics: They were very successful to begin with, but now and then there were some mutant strains of bacteria left over that were resistant to the drugs. Bacteria reproduce even faster than rabbits and it didn’t take very long for more and more of them to become resistant. The more antibiotics we use, the more resistant bacteria species we are producing. MRSA – the ‘hospital bug’ – is just one example of a bacterium that is extremely difficult to eradicate.

Antibiotics were so popular – and so seemingly harmless to humans – that they were used excessively, not only as medicine to treat infections, but also in animal husbandry. Factory farming means that animals are kept in very unnatural (and unhealthy) conditions, in close quarters to each other, so that infections spread easily – mixing antibiotics into the feed was meant to combat that problem. The udders of milk cows are now so large and heavy that the animals end up treading on the teats, which frequently causes mastitis – infection of the udder – which is then treated with antibiotics.

Doctors are of course aware of the problem and are trying their hardest to minimise the use of drugs, but sometimes it is just unavoidable and antibiotics still save lives. Apart from creating more resistant strains though, they are also not as harmless to the individuals’ health as once though.

Antibiotics kill bacteria, and they do not distinguish between good ones and bad ones. So, every time we take antibiotics – whether that’s for a good reason or not – our friendly bacteria are affected, too. Once the course of antibiotics is finished, our gut will repopulate in time, but we are vulnerable in the meantime and the population that grows after treatment is unlikely to be the same that we had before and it might never get there again.

While our gut flora is severely diminished, yeasts – another type of microbe naturally residing in the gut – can spread. A bit of yeast is normal and is kept in check by the commensal gut flora. Unlike bacteria, yeast is not affected by antibiotics and can have a field day while the good bacteria are struggling to get back on their feet, and it may in the end be too powerful and strong for the gut bacteria to tackle it. Yeast overgrowth can cause many health problem and make us feel really unwell, not least contributing to intestinal hyperpermeability (aka ‘leaky gut’).

So, how can you protect yourself if you really, really have to take antibiotics?

  1. Discuss with your doctor whether antibiotics are the only way forward and be aware that antibiotics do absolutely nothing to combat viruses. Colds and flu are caused by viruses – antibiotics will not help. You can only rest, drink lots of water and herbal tea, support your immune system with ginger and lemon and wait for your body to sort itself out. If you have a urinary tract infection, make sure to get tested for bacteria. Yeast can also cause UTIs, and again: antibiotics will not help, but exacerbate the problem.
  2. If it’s clear that you are experiencing a bacterial infection and you have to take antibiotics, take a supplement called Saccharomyces boulardii alongside it. This is a transient yeast – meaning that it will not settle, but travel through the digestive system and is then excreted, but it will serve as a ‘place holder’, preventing undesirable yeasts, such as Candida albicans, from spreading. (Please read the caution below!)
  3. Top up your bacteria even while taking antibiotics: Although antibiotics will affect good and bad bacteria alike, taking probiotics alongside antibiotics may help speed up repopulation after the treatment. Just make sure to not take the two at the same time, leaving at least two hours between them. Probiotics survive best if taken 30 minutes before a meal or with food (ideally containing some fat). S. boulardii can be taken at the same time as antibiotics as it is unaffected. (Please read the caution below!)
  4. Enjoy probiotic foods, i.e. fermented foods such as sauerkraut, kimchi, live natural yoghurt, kefir, and kombucha. (Please read the caution below!)
  5. After treatment, continue to take a probiotic supplement for at least another month.
  6. The best thing you can do for your gut flora is to eat a large variety of different natural (real!) foods. Different bacterial species thrive on different foods, and we know that the more diverse the gut flora, the healthier the individual. A boring diet will only serve to create a boring and rather unhelpful microbiome.

PS: Did you know that the point of the appendix – which has eluded scientists for so long – appears to be that it serves as a reservoir for the gut flora? As a dead end side road, bacteria can huddle in there, waiting for the ‘storm’ raging in the gut to pass. This could be a clearout due to food poisoning, for example, or in the modern day antibiotic treatment or an enema before a colonoscopy. Once the coast is clear, bacteria are released from the appendix to start repopulating the gut.

Caution: Both S. boulardii and probiotics (foods as well as supplements) may help alleviate the side effects of antibiotics, e.g. nausea and constipation. Although at the time of writing there are no known negative interactions of S. boulardii or probiotics with drugs, please do check with a nutritional therapist, a doctor or pharmacist if you are on any medications (other than the antibiotics). Also, avoid taking S. boulardii and probiotic supplements if you are immuno-compromised (e.g. chemotherapy or HIV patients). To be safe, check with a health practitioner first before taking any supplements at all.

Melanie
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