Unfortunately, people with psoriatic arthritis (PsA) have lower levels of “good” bacteria in their gut than people without the condition, according to a study published in the January 2015 issue of Arthritis & Rheumatology. That’s why some healthcare practitioners recommend that patients increase their consumption of probiotics, the beneficial bacteria found in yogurt and other foods as well as in supplements. A study published in 2013 in the journal Gut Microbes found that the anti-inflammatory effects of probiotics can help combat inflammatory disorders such as psoriasis and psoriatic arthritis. Drew Sinatra, ND, a naturopathic physician with a practice called Healthy Directions in Northern California, says that probiotics can help stabilize good bacteria and crowd out harmful bacteria, restore balance in the body, and combat autoimmune diseases like psoriasis and psoriatic arthritis.
The Probiotic Plan
“One of the reasons many chronic diseases, including autoimmune diseases, are on the rise is increased intestinal permeability, or leaky gut,” Dr. Sinatra says. “This can lead to immune dysfunction, setting the stage for autoimmune diseases to develop and progress.” (Note: Leaky gut is a concept credited more by alternative-medicine practitioners than by mainstream doctors.) Probiotics can help set things right. “With any autoimmune disease, I recommend a combination of diet, herbal medicines, and supplements, including probiotics,” Sinatra says. “It can take six months or longer to see big changes, but often symptoms improve within a few weeks.” Still, Sinatra says, there are limitations in the research supporting the benefits of probiotics. “While studies show that people with certain autoimmune diseases have less microbial diversity, there is no evidence to suggest that taking a probiotic can increase that diversity.” Plus, he says, “There haven’t been any studies looking at how probiotics affect clinical outcomes or microbial diversity in people taking biologics.” (Biologics are medications that block specific immune-system activity.) Sinatra says that patients need to talk with their healthcare provider before making a decision to take a probiotic supplement with a biologic. RELATED: Can Turmeric Help Treat Psoriatic Arthritis?
Picking the Best Probiotic to Take
When you’re searching for a probiotic, look at the label to see the number of colony-forming units (CFUs). “While the optimal probiotic dose remains unknown, it’s generally recognized in the medical community that formulas should contain at least 100 million CFUs to be effective,” Sinatra says. “But doses can be as high as hundreds of billions. And for formulas that list their strength in milligrams, you want to look for one that contains at least 350 milligrams of probiotics.” There are a number of different kinds of probiotics to choose from. Some people benefit from taking lactic-acid probiotics like Lactobacillus or Bifidobacterium, while others do better with yeast-derived probiotics like Saccharomyces boulardii or soil-based organisms like bacillus. For some people, a combination of all three probiotic types is ideal. Remember that probiotics sold as dietary supplements are not regulated by the U.S. Food and Drug Administration (FDA). To ensure purity, read labels carefully, look for supplements that are rigorously screened for contaminants, and consult with your healthcare team.
