益生菌是当今健康的热门话题，这是常见的阅读probiotics are recommended for people with autoimmune diseases— including autoimmune thyroid conditions like Hashimoto’s thyroiditis and Graves’ disease. The key question, however, is how can you harness the power of probiotics? Is it enough to eat more yogurt or pop some acidophilus capsules from the grocery store aisle?
我有机会说话通过电话与基兰克里希南，著名微生物学家，与世界领先的研究人员和益生菌专家之一。他花了十多年研究各种细菌菌株，以评估其在益生菌治疗的有效性并制定专门的益生菌产品。
克里希南解释说，一个触发器autoimmune diseases- 包括桥本氏甲状腺炎和Graves’病 - 是的毒素通过发炎的肠壁，进入你的血液的能力。你的肠道内膜变得出于各种原因发炎：
- 你吃的触发过敏或敏感的食物（如面筋，例如）。
- 你吃高脂肪，高热量的食物。
- You eat foods that are genetically modified, and/or contain hormones and pesticides
- You eat high amounts of processed foods and simple carbohydrates, such as sugar.
- 你有细菌失衡与“坏”细菌和/过度生长或“好”细菌，被称为生态失调，或小肠细菌过度生长（SIBO）缺乏自己的直觉。这可能是过度使用或长期使用抗生素药物的副作用。
According to Krishnan, any sort of autoimmune disease almost always starts with dysfunction in your immune system, and 80 percent of our immune tissue is in the digestive tract. Once you have inflammation, you are at risk of developing a condition known as “metabolic endotoxemia.”
Metabolic endotoxemia is defined as the presence of endotoxins in your blood. These endotoxins can negatively affect your immune system, increase the permeability of your intestinal lining, as well as the makeup of the bacteria in your gut. Endotoxins can also raise your triglyceride levels, and increase levels of cytokines and inflammation. Metabolic endotoxemia is increasingly becoming recognized as a key trigger for obesity, type 2 diabetes, heart disease, inflammatory bowel disease, immune dysfunctions, and autoimmune disease.
Over time, chronic inflammation and metabolic endotoxemia in your intestinal lining can lead to permeability — the ability of larger toxins and particles to cross over that lining and enter your bloodstream. It’s like a window screen that has holes in it. This condition is referred to as “leaky gut.”
While some people with leaky gut have symptoms such as gas, bloating, stomach pain, and digestive issues, not everyone has these symptoms. For some people, the toxins cause免疫激活，这可以触发产生抗体和一种夸张的免疫应答该结果在自己的器官，腺体，组织或细胞的攻击 - 自身免疫性疾病的特征。
Says Krishnan: “Your gut is the largest source of sampling of the environment around you, and the decisions regarding how to react are often made in the gut. We know probiotic bacteria can affect how the immune system functions. As a result, knowing that autoimmune thyroid is immune-based, and a vast amount of control is coming from the gut, it makes sense for people with autoimmune thyroid disease to include a probiotic supplement.”
One研究表明，that people with hyperthyroidism have much lower levels of probiotic bacteria compared to healthy people. We also know that since the majority of hypothyroidism is due to autoimmunity, there is a similar immune activation component.SIBO is also common in people with hypothyroidism。
益生菌为肠漏和免疫布鲁泰克tion
许多专家建议，患有自身免疫性甲状腺疾病多吃富含益生菌发酵的食物，或采取典型的益生菌补充剂（如嗜酸乳杆菌和双歧杆菌）。
发酵食品是你的饮食健康的一部分。在发酵过程中产生的食物有利于酶和维生素，并通过基本预消化他们，使他们更易消化，营养丰富。发酵也可以产生益生菌。一些流行的发酵食品包括泡菜，泡菜，酸奶，酸牛奶，红茶菌，味噌。
我们面临的挑战，但是，根据克里希南，是大多数在发酵食品的益生菌没有生存的胃系统和胃酸，并死在到达或迅速死亡。克里希南说：“益生菌食品没有益生菌有效的输送系统。他们有一些好处，但活细菌的有效传递是不是他们的主要优势之一。”
According to Krishnan, by scientific standards most probiotic foods and supplements don’t even qualify as “probiotics,” but rather aremetabolic response modifiers。他们在促进消化，并从食品营养的吸收了一些好处，但没有一个强大的能力来抵消细菌和再平衡肠道微生态失衡的负面株，减少炎症，或有效地治愈渗透肠道。
Understanding probiotics
According to Krishnan, there are three categories of probiotic bacteria that are readily available on the market.
补种细菌：The first category is referred to as “reseeding” bacteria like the acidophilus and lactobacillus found in yogurt and many supplements. They can improve digestion and constipation, but most of them are unable to survive your stomach acid, bile salts, and pancreatic enzymes. This makes them unable to colonize your gut for any length of time, or create any significant metabolic or intestinal lining changes.
半短暂的细菌：第二类是半瞬态细菌。这些细菌被设计拓殖你的直觉一段时间，有一个代谢的效果，然后自然离开你的身体。克里希南说：“这是因为如果他们来你家，待了一会儿，解决它，清理，然后离开。”
基于孢子菌是半瞬态细菌，经过数百万年已经发展到生存的胃系统的自然能力。据克里希南：“在过去，人们得到了他们的益生菌食物，他们吃。大多数细菌的死亡，因为他们通过胃系统过去了，但有些却没有。
These strains developed protective shells, known as spores, that enabled them to survive inside and outside the body and to reach the intestines. They are typically found in the soil. Today's food, however, is highly sterilized, and our exposure to these spore-based bacteria is very limited in the modern diet.”
Spore-based strains of bacteria have the ability to kill bad bacteria and fungus and modulate your immune system. According to Krishnan, the biggest advantage of spore-based probiotics is that they are resistant to stomach acids, are stable at room temperature, don’t require special handling or refrigeration, and deliver more viable bacteria to the small intestine.
Transient bacteria:The third category is completely transient bacteria. They don't colonize, but as they pass through your system, they stimulate and upregulate the immune system and then leave the body.
Spore-based bacteria and probiotics
目前市场上大部分的益生菌正在着力打造有更多补种或瞬态细菌或细菌，被称为CFU的数字较高的补品。据克里希南，但是，对于自身免疫性疾病患者益生菌治疗的最有前途的和未充分利用区是基于孢子半短暂的细菌。孢子菌已在医药市场被用于超过50年，其中包括用于如痢疾有效治疗肠道问题一些药物。
Arecent studydone at the University of North Texas evaluated the effectiveness of spore-based probiotic supplements in combating metabolic endotoxemia. The study took a group of 100 otherwise healthy, normal-weight adults and found that a surprising half of them had an exaggerated endotoxin response to a high-calorie, high-fat meal, with levels of endotoxins five times higher than normal as long as five hours after eating.
在随机试验中，一半的团“反应者”的有安慰剂，另一半了基于孢子的益生菌为30天。结果是有希望的：
- A 42 percent reduction in the endotoxins response, reducing inflammation and helping to heal the intestinal lining
- A 24 percent reduction in triglyceride levels
- Restoration of better brain-body connection in terms of hunger and satiety hormones
- Better insulin response
This is the first time that a probiotic has been shown to significantly reduce endotoxins, leaky gut, and all the associated immune activation, in humans.
Anecdotally, some autoimmune thyroid patients who have taken spore-based probiotics have reported a reduction in their thyroid antibodies, and a reduction in food sensitivities and allergies after even one to three months of therapy.
If you want to try a probiotic
如果你有兴趣尝试益生菌，记住，而益生菌通常是安全的，副作用包括轻微的气体或腹胀。你应该总是跟你的医疗服务提供者的任何补充益生菌的使用，如果你是免疫力低下，有慢性疾病，怀孕或正在考虑在婴儿或儿童使用。
Krishnan advises that you choose a probiotic that contains verified strains of bacteria because many products do not actually contain the number of bacteria advertised. A University of California San Diegostudy published in the journalPediatrics Research2015年found that only 1 in 16 bottles of probiotics studied actually contained the strains and the potency listed on the label.
The only way to verify the strains is if the manufacturer commissions independent DNA analysis and makes that information available to the public. Look for “DNA-verified” on a product’s label or website, or contact the manufacturer.
If you want to try a spore-based probiotic, there are several brands on the market. Look for DNA-verified products that include bacteria such asbacillus indicus,bacillus subtilis,bacillus coagulans,bacillus licheniformis和bacillus clausii。克里希南也是对团队制定了两个基于孢子益生菌产品的科学家，MegaSporeBiotic,只可以通过健康professionals, and the consumer version of the product, JustThrive, which is available at health food stores and online.
资料来源：
Interview with Kiran Krishnan, October 24, 2017
麦克法林，B等。人。“口腔基于孢子补充益生菌与降低发病率餐后食物内毒素，甘油三酯和疾病风险的生物标志物。”World Journal of Gastrointestinal Pathophysiology。2017年8月15日;8（3）：117-126
Yan F, et al. “Probiotics and immune health.”目前在胃肠意见。2011;27(6):496-501.