The Best Probiotics for Hashimotos

DR. IZABELLA WENTZ / AUGUST 18, 2017

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Note: Originally published in May 2015, this article has been revised and updated for
accuracy and thoroughness.

The Role of the Gut

When I was first searching for a healing plan for Hashimotos, I learned about the role of the
gut in autoimmune disorders.

According to research from Dr. Fasano and colleagues, every person with an autoimmune
disorder has something called intestinal permeability, also known as a leaky gut. This made
a lot of sense to me because I had many of the symptoms of intestinal permeability including
bloating, stomach pains, irritable bowel syndrome (IBS) and acid reflux, as do many people
with Hashimotos.

However, not everyone with intestinal permeability will have these symptoms. Some may
have no apparent gut symptoms at all. As awful as it was to deal with IBS for almost a decade
and acid reflux for three years, Im grateful that I had them as these symptoms were signals
from my body as to what part of the system was broken.

Autoimmunity has been determined to be a three-legged stool, needing a combination of the

right genes, the right triggers, and intestinal permeability to manifest itself. This was exciting
to me because I knew that I couldnt change my genes and wasnt sure if I would be able to
identify the exact trigger that set off the autoimmune cascade in my body, but I was hopeful
that I could fix my intestinal permeability.

I found that there are various reasons why a person may have intestinal permeability. Gluten,
the protein found in wheat products, has become a well-known producer of intestinal
permeability, and many individuals with autoimmune conditions have been able to find relief
in symptoms by following a gluten-free diet, the Paleo diet, or another elimination diet such
as the Autoimmune Paleo diet (AIP). Some people have even seen a complete remission in
their autoimmune condition after removing gluten from their diet.

Another reason why a gut may be more permeable is due to an imbalance of probiotic (good)
vs. opportunistic (bad) gut bacteria, also known as dysbiosis.
People with autoimmunity have been found to have lower amounts of the probiotic bacteria
Lactobacillus and Bifidus, and higher amounts of the opportunistic E. coli and Proteus
bacteria. E. coli and Proteus bacterial species are often referred to as opportunistic
pathogens because they only become pathogenic when the opportunity is just right. If they
are outnumbered by probiotic bacteria, they behave like good citizens of the gut and may add
value, but in times where they outnumber the probiotics, they may start to damage the gut
wall, leading to intestinal permeability.

Ive seen this pattern of low levels of probiotic bacteria with high levels of opportunistic
bacteria on my lab tests as well as the tests of many clients with Hashimotos that have had
the GI Effects Gastrointestinal Function Comprehensive Profile METAMETRIX
KIT test that quantifies the microbial flora. (You can have your functional medicine doctor
order this test for you, or you can self-order the METAMETRIX KIT or GI-MAP.)

When I first took this test, I was shocked to see that I had zero growth of Lactobacillus
bacteria, even though I was eating yogurt on a daily basis. I didnt realize at the time that the
problem with most commercial probiotics and yogurts is that they dont have enough
beneficial bacteria to make a difference.

I started to eat fermented foods and added high doses of probiotics and started to feel better
and better (I had already been gluten and dairy free and had hit a healing wall).

I retested myself with the GI Effects Gastrointestinal Function Comprehensive Profile

METAMETRIX KIT (we have also been using GI-MAP with great success as well) when
all of my Hashimotos symptoms were gone and found that my probiotic bacteria were in the
optimal range and the E. coli and Proteus species were no longer predominating my gut flora.

Thus, one of the very first recommendations I make for EVERYONE with Hashimotos
is to be sure to get enough probiotics on board.

You can do that by eating fermented foods (like my friend and mentor Donna Gates
recommends), as well as through taking probiotic supplements.

Probiotic Rich Foods

Fermented coconut yogurt: CoYo Coconut Milk Yogurt and So Delicious Dairy Free
are two potential options sold in the United States
Fermented coconut water: The Body Ecology one from Donna Gates.
Fermented cabbage (make sure you get the kind that is refrigerated, the probiotic
bacteria only survive for a couple of weeks at room temperature). Check your organic
grocery, otherwise Thirty Acre Farm ships in the US.

Probiotic Supplements
Probiotics have been widely researched for a variety of conditions including irritable bowel
syndrome, constipation, anxiety, depression, and even skin disorders. Probiotics can help
with improving digestion and nutrient extraction from the foods we eat and can also balance
the immune system.

Probiotics can help with all types of gut symptoms, some can help with treating small
intestinal bacterial overgrowth (SIBO) present in >50% of people with Hashimotos and
responsible for leaky gut, and have helped me with symptoms of anxiety and helped me with
digesting my food. (Please note, some probiotics can exacerbate SIBO.)

Types of Probiotics That I Have Used Successfully

Beneficial Yeast Probiotics

Saccharomyces boulardii (S. boulardii) is a beneficial yeast that helps to clear out
pathogenic bacteria, candida, some parasites (including Blastocystis hominis), and H.
pylori, an infection that has been implicated in ulcers and has been linked to Hashimotos.

S. boulardii does not colonize the gut wall, but instead, it causes an increase of secretory IgA,
which supports our own bodys natural defense against infections and opportunistic gut
bacteria.

While the label of the product recommends taking 2 capsules twice per day, I used higher
doses, building up to 4 capsules three times per day.

This probiotic is generally safe for SIBO and should be used whenever you are taking a
course of antibiotics (or after their use) to help rebalance the gut flora.

Lactobacillus-Based High-Dose Multi-Strain Probiotics

Most grocery stores and health food stores sell Lactobacillus-based probiotics that contain 10
billion colony forming units (CFUs) of one probiotic strain. While this seems like a really big
number, in reality, we have one trillion bacteria in our gut, and that small amount is not likely
to make a difference. In fact, most probiotic supplements only contain enough probiotics to
maintain an already healthy gut, not to restore gut microbe balance. I personally havent seen
major benefits from using Lactobacillus probiotics until we get them into really high doses.

Furthermore, as research is showing that probiotic diversity is associated with greater health
and improved gut function, I prefer probiotic blends containing Lactobacillus strains in
addition to other probiotics, instead of single strain probiotics that only contain one type of
Lactobacillus. Probiotic blends generally contain various strains of Lactobacillus,
Bifidobacteria, and in some cases, beneficial Streptococcus bacteria. Thus, I recommend
taking higher doses of multi-strain probiotics. If youve never taken probiotics, you will want
to start with the 10 billion CFU probiotic but then work your way up to a higher dose over
time.

Rather than taking multiple pills, numerous companies have created high dose probiotic
blends.

Probiotic 50B by Pure Encapsulations, which contains 50 billion colony forming units, is a
great high dose probiotic one can start with as you work your way up.

Another high dose Lactobacillus-based probiotic that I have used with great success and that
has the most research behind it is known as VSL #3 and contains 450 billion CFUs per dose.
This particular probiotic has been clinically studied for ulcerative colitis and irritable bowel
syndrome. The probiotic has been so successful in inducing remission, it has been labeled as a
medical food. Please note, this is a very expensive probiotic, but you can get it covered by
your insurance if you have the right diagnosis.

I have learned about a less expensive equally effective brand of high dose multi-strain
probiotics from my brilliant nutritionist friend, Tom Malterre, called Klaire Ther-Biotic.

High-dose, multi-strain probiotics can be very helpful for people with Hashimotos in general,
and especially for those who often show low levels of them on gut lab tests. However, they
may be problematic for people with SIBO, which can be caused by an overgrowth of various
bacteria, including Lactobacillus and Streptococcus bacteria, which are often found in
probiotics. Its important to note that up to 50 percent of people with Hashimotos may have
SIBO, and the overgrowth, in up to 75 percent, may be comprised of Lactobacillus or
Streptococcus bacteria.

Soil-Based Probiotics

Soil-based probiotics came on my radar after some colleagues reported having excellent
results using them with their clients. Soil-based probiotics are naturally occurring, spore-
based, and have a unique mechanism of action, which allows them to directly modulate the
gut microbiome. Spore-based probiotics have shown promise in various autoimmune diseases
and in reducing allergies and asthma. Spore-based probiotics also have an ability to boost
Lactobacillus colonies, so they can be used concurrently with Lactobacillus probiotics as well
as in place of them. Unlike the Lactobacillus probiotics, spore-based probiotics can reduce
SIBO and increase gut diversity by boosting the growth of other beneficial flora.

Clients and colleagues with Hashimotos have reported the following after using for thirty to
ninety days: a reduction in thyroid antibodies, an improved mood, less pain, better bowel
movements, more energy, and a reduction or complete elimination of food sensitivities.
I have had clients use MegaSporeBiotic with great success. The starting dose for
MegaSporeBiotic probiotics is one capsule every other day, and the therapeutic dose is two
capsules per day. Once the desired effect has been seen (generally three to six months in
people with Hashimotos), I recommend dropping down to a maintenance dose of one capsule
per day.

Tips for Using Probiotics

If youve never taken probiotics, you will want to start low and go slow, as you may have
increased symptoms if your gut flora changes too rapidly. If youve found that you can
tolerate that dose, but have not reached your gut health goals, you can work your way up to
higher doses.

Tips for Healing the Gut

Gut healing is a journey; you may need various interventions like removing reactive foods
and infections, taking enzymes and probiotics, and balancing nutrients. In some cases, such as
after a bout of food poisoning, antibiotic treatment, or a stressful life period, you may need to
start from scratch once more. Remember, be kind to yourself and learn to listen to your body
so that you can support and feed it properly! You are worth it!

Wishing you all the best on your journey!

P.S. To learn more about other helpful interventions, consider picking up a copy
of Hashimotos Protocol: A 90-Day Plan for Reversing Thyroid Symptoms and Getting
Your Life Backand Hashimotos Thyroiditis: Lifestyle Interventions for Finding and
Treating the Root Cause.

For continued updates and interaction, please become a part of my Facebook community and
sign up for my newsletter. I love interacting with my readers!

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FILED UNDER: GUT, SUPPLEMENTS TAGGED

WITH: BLOATING, DYSBIOSIS, GLUTEN, H. PYLORI, HEALING YOUR
GUT, IBS, LEAKY GUT, PATHOGENS, PROBIOTICS, SIBO
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eader Interactions

Comments

1. apelila says
February 15, 2015 at 8:18 PM

Thanks so much for the info about probiotics. Ive been making my own ferments but I think
Ill add probiotics now. I tried replying to the email you sent but your mailbox wouldnt
acceptjust wanted to say thank-you for all you do in your work to help and support us a
Hashis patients, it makes a difference and you are appreciated. Hope you had a beautiful
weekend with your love, the pic was great!

Reply

2. debbie says
February 16, 2015 at 8:27 AM

what do you think of Theralac and TruFlora?

Reply
3. Pam says
February 16, 2015 at 6:35 PM

What about avoiding strains of Bifidus? I have read that it should be avoided with Leaky gut (
especially with crohns and colitis) and it is in the VSL #3. I have been sticking with
Acidophilus and Lactobacillus GG with good results. Interested in your thoughts. Thanks!

Reply

4. Linda says
February 16, 2015 at 7:24 PM

I have successfully been using Enzymatic acidophilus PEARLS. They are coated to bypass
the stomach to best work in the intestines. Right now I only need one 1 billion CFU . Contains
Lactobacillus acidophilus and Bifidobacterium longum.

Reply

5. kelly says
February 16, 2015 at 7:40 PM

I sense that I am reacting to my probiotics (VSL) and bone broth and kambucha, which leads
me to believe I am Histamine inttolerant. My reactions are incredible itching. Do you have a
recommendation for how to replace healthy bacteria when you have HI?

Reply
6. Cynthia says
February 19, 2015 at 12:20 AM

Check out the Methyl Nation website and Facebook group as there are those who are finding
answers to their HI.

Reply

7. Faye Woollett says

February 16, 2015 at 8:08 PM

I use the brand Ultimate Flora. It has 30 billion of 10 diff strains and it works great! Normally
I only take one, but sometimes I will take two if I forget to take one the day before. It has
helped tremendously!

Reply

8. lisa says
February 16, 2015 at 8:59 PM

I have been on probiotics for a few years w good success with suspected leaky gut, but could
probably do better. Can I take one of these more expensive ones for a month or two to give
my gut an extra boost and then go back to my probiotics that are half the price? (All 5 of us in
the family are on probiotics that are in the billions and with a varied array of probiotics so it
gets very expensive when you add in the cost of other supplements we take as well.) Hope my
question makes sense. Also, our docs and pharmacists cant seem to tell me if we are supposed
to stay on probiotics indefinitely or give ourselves a break. Thanks So much for the great info
you put out into the world!

Reply