Antibiotics, A Necessary Evil?
Antibiotics are seen as a double-edged sword for many health-conscious people. They are lifesaving and highly effective in improving health outcomes for many bacterial (not viral) related infectious diseases and critical for healing of heart disease or cancer related surgeries. However, they have been prescribed indiscriminately which has resulted in increasing levels of antimicrobial resistance (antibiotic resistance) in the general population.
Antibiotics work by destroying microbes. In doing so, they don’t distinguish between ‘good’ and ‘bad’ bacteria. As a result, antibiotics can destroy the gut microbiota, which is the totality of the 39 trillion microorganisms like bacteria, fungi, archaea, viruses, and their genetic material which live in the gastrointestinal tract. The gut microbiome “affects the body from birth and throughout life by controlling the digestion of food, immune system, central nervous system and other bodily processes”[1]. Higher microbiome diversity is associated with good health. Just five days of ciprofloxacin wipes out about a third of gut bacteria and the gut microbiota are never quite the same. Four days of three broad spectrum antibiotics can permanently destroy nine beneficial species of bacteria [2].
When one takes antibiotics indiscriminately three adverse things happen.
● One develops a different microbiome with more antibiotic resistant microbes that leaves one vulnerable to infection, allergic conditions, osteoporosis, autoimmune diseases or obesity. This is because some of the bacteria in the gut mutate and are not destroyed by the antibiotic. They multiply and become antimicrobial resistant bacteria.
● A state of dysbiosis (an imbalance in the microorganisms in the gut) is medically induced because one is ‘choosing’ the antimicrobial resistant bacteria.
● There is a loss of diversity and richness of species in the microbiome.
Of course antibiotics are needed at some point in everyone’s lives. However, it is important to communicate with one’s doctor prior to taking them. Asking questions like whether one really needs them, asking for a less strong one or if they can be stopped if the symptoms disappear will help in preventing overuse. The caveat is for serious infections like Clostridium Difficile or Diverticulitis when one must complete the entire course.
Dietary and lifestyle strategies to heal the microbiome after antibiotics:
Maximizing plant based diversity in the diet before, during and after the course of antibiotics will help feed different species of gut microbes.
Add prebiotics to help the gut microbes bounce back faster. Sprouts and lentils are high in fiber, polyphenols, resistant starch, and prebiotics and are therefore very beneficial for the gut microbiota. When sprouted, the fiber is cranked up even further, unlocking additional nutritional benefits and amping protein content.
Plant based fermented foods increase diversity in species within ten weeks. Choosing one with live active cultures is the trick. Sourdough bread for instance has unique forms of fiber because of the fermentation process.
Avoiding chemicals, pesticides, and saturated fat in one’s food.
Avoiding alcohol.
Regular exercise and exposure to fresh air.
Going to bed early and sleeping for at least seven to eight hours.
Fasting, particularly after antibiotic use. Trying not to eat outside a 10-hour window and not eating 3 hours before bedtime helps sync mealtimes with the circadian rhythm. This helps the microbiome heal as it doesn’t have to work to digest food for at least fourteen hours..
Probiotics are known to treat antibiotic-associated diarrhea in adults. However, in two reports published in “Cell”, researchers demonstrated convincingly that probiotics slow recovery of the microbiota to stabilize and return to normal after antibiotics.[3]. Therefore, it is advisable to take probiotics as recommended by the doctor.
References:
1.Healthline: How does Your Gut Microbiome Impact Your Overall Health
2.Fiber Fuelled, Will BulsieWicz, Pg 37
3.Cell, Volume 174, Issue 6, Pages 1406-1423- Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT
