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With the discovery of the microbiome, a new frontier in science and health care was born. While still in its infancy, there is compelling evidence suggesting numerous health benefits of taking probiotics. While the benefits of probiotics were once thought to be restricted to gut and digestive health, new research on the gut-brain axis is connecting our microbiome to the health of the brain, immunity, bone density, blood sugar, mood and even our intuition – and this is the short list. (1-2)
Transient vs. Colonizing Probiotics
One way of categorizing probiotics is whether or not they are transient or colonizing. The vast majority of all the probiotics on the market are transient probiotics, which transit through the gut but do not make a permanent or lasting home in the microbiome. There are plenty of studies supporting the numerous health benefits of transient probiotics, but once you stop taking them the microbiome generally returns to its original state before probiotic use; the health benefits gleaned are unfortunately dependent on continuous use. (3-5)
Colonizing probiotics, which are rare in the marketplace, actually adhere to the gut wall, become permanent residents, and help microbial diversity. In one study, a colonizing probiotic called Bifidobacterium lactis HN019 was shown to adhere to the gut wall and increase microbial diversity in a study group of subjects over 60 years of age. While the science studying our microbes is still in its infancy, it is clear that diversity matters. Westerners have significantly less microbial diversity than other cultures around the world. (6-8)
A Four-Step Plan
A logical strategy for a probiotic regime would be to introduce colonizing microbes into the gut and digestive tract that support microbial diversity, and ultimately promote digestive self-sufficiency. In an effort to accomplish this, I suggest a four-step comprehensive plan for perfect gut health:
Step 1: Support the intestinal mucus membranes by introducing prebiotic soluble fiber to create the best possible environment for healthy microbes to thrive.
Step 2: Introduce healthy, colonizing probiotics that will scrub undesirable microbes and simultaneously make way for new beneficial, permanent residents to proliferate.
Step 3: After the gut is primed, boost colonizing microbes to complete the process of achieving thriving microbial diversity.
Step 4: Maintain with colonizing probiotics as needed and small amounts of fermented foods and seasonal eating.
To accomplish this, I suggest using a specific progression of synergistic pre- and probiotic products, formulated to efficiently create a healthy microbiome.
Step 1: Prepare the Gut with Slippery Elm Prebiotic Formula
The journey towards optimal gut health begins with Slippery Elm Prebiotic Formula, comprised of Organic Slippery Elm Bark, Organic Marshmallow Root, and Organic Licorice Root. This formula is called a prebiotic because it helps to create an environment in the gut where good bacteria can thrive, as the probiotic cultures feed on the ingredients of this prebiotic. Each of the 3 ingredients in the Slippery Elm Prebiotic Formula naturally lubricate and calm the entire digestive tract, priming it for the introduction of healthy bacteria.
- Step 1 Directions: Begin taking Slippery Elm Prebiotic Formula and the Gut Revival in conjunction with each other for 1 month. Take the Slippery Elm Prebiotic Formula until you finish the container or for 1 month (whichever comes sooner). If you feel that the Slippery Elm Prebiotic is making a noticeable difference for you and would like to keep taking it in conjunction with more of the following steps, feel free. Sometimes it is needed for a longer period.
It is important to support elimination during this gut-preparing step:
- If you experience dry or sluggish bowels during Step 1, our proprietary blend Elim 1 in conjunction with the Slippery Elm Prebiotic Formula can support you in achieving healthy elimination. Elim 1’s formula of Organic Licorice Root, Organic Psyllium Seed Husks, Organic Triphala, and Organic Slippery Elm Bark combined with the Slippery Elm Prebiotic Formula can be a powerful way to support healthy elimination while preparing the gut for repopulation of healthy microbes.
- If you experience loose bowel movements and mucus in the stool during Step 1, our proprietary blend Elim 2 used with the Slippery Elm Prebiotic Formula can be helpful in supporting proper elimination. Elim 2 is comprised of Organic Bilva, Organic Triphala, Organic Licorice Root, Organic Slippery Elm Bark, and Organic Psyllium Seed Husks. This is a supportive formula for balancing elimination while preparing the gut flora to support a healthy microbiome.
Step 2: Prime the Gut with Gut Revival
Gut Revival, taken in conjunction with the Slippery Elm Prebiotic Formula, has probiotics that scrub harmful microbes and begin to seed the gut with good microbes. The immune-supportive beneficial bacteria in Gut Revival include the probiotics Bifidobacterium lactis HN019 (15 billion CFU) and a proprietary blend of Lactobacillus acidophilus LA-14, Lactobacillus plantarum LP-115, and Bifidobacterium longum BI-05 (15 billion CFU), as well as Saccharomyces boulardii (10 billion live organisms) and arabinogalactan. These components have been shown to survive the digestive tract, which few probiotics have the ability to do.
Not only do they survive the digestive tract, but they adhere to the gut wall, restore healthy flora, and support a healthy microbial environment against unhealthy microbes through the ingredients Saccharomyces boulardii (a non-pathogenic yeast) and Lactobacillus acidophilus. (11) The Slippery Elm Prebiotic Formula and the Gut Revival work synergistically to positively impact bad microbes and line the digestive tract with a supportive mucilaginous coating, so that the gut is prepared to be repopulated with the good bacteria.
- Step 2 Directions: Take 1 sachet of Gut Revival in 1-2oz of pure water, twice a day alongside the Slippery Elm Prebiotic Formula. After 1 month, begin taking Step 3, Flora Restore Max.
Step 3: Repopulate the Gut with Flora Restore MAX
After finishing the Slippery Elm Prebiotic Formula and Gut Revival and the gut is primed, it’s time to repopulate the gut with Flora Restore MAX. This will introduce 100 billion CFU per capsule into the gut, which adhere to the gut wall and proliferate new and lasting residents there. These new residents will then continue to proliferate on their own. Flora Restore MAX has been shown to establish new permanent microbial residents and microbial diversity in the gut through its combination of Bifidobacterium lactis HN019 (50 billion CFU), which is the specific probiotic strain that adheres to the gut wall, and a proprietary blend of Lactobacillus acidophilus LA-14, Lactobacillus plantarum LP-115, and Bifidobacterium longum BI-05 (50 billion CFU).
- Step 3 Directions: After finishing the combination of Slippery Elm Prebiotic Formula and Gut Revival, begin taking Flora Restore MAX. Continue taking Flora Restore MAX for 1 month. At this point, begin taking Flora Restore for optimal maintenance of the gut flora.
Step 4: Maintain the Gut with Flora Restore
After creating an optimal gut environment repopulated with healthy microbes by taking the Flora Restore MAX, the gut can still benefit from ongoing maintenance for an optimal level of gut health. This can be achieved by taking Flora Restore as necessary, which encourages a long-lasting healthy microbiome. Flora Restore contains Bifidobacterium lactis HN019 (15 billion CFU), and a proprietary blend of Lactobacillus acidophilus LA-14, Lactobacillus plantarum LP-115, and Bifidobacterium longum BI-05 (15 billion CFU), all of which support and maintain a lasting healthy microbiome in the gut.
In addition, consider introducing more fermented foods into the diet. Remember, fermented foods create heat in the body and are best consumed in the winter. Be mindful not to eat excess amounts of fermented foods in the summer. Fermented food was traditionally used as a condiment – taken in small amounts with meals – not a meal in and of itself.
Nature also supports a healthy microbiome with its seasonal harvests. Don’t miss out on our free monthly seasonal eating guide. Sign up for the free 3-Season Diet Challenge now!
- Step 4 Directions: Once you have completed Steps 1-3, begin taking Flora Restore for 1 month to maintain this new thriving level of healthy flora.
Once the microbiome has been reset and the desired health benefits have been achieved, probiotics can be weaned off and a seasonal diet of fermented foods can be continued.
*A Note Regarding How to Effectively Use Probiotics to Balance the After-effects of Antibiotics
Antibiotics, while helpful in many situations as prescribed by your primary care physician, also have the ability to wipe out the healthy bacteria of the gut. Therefore, if you have finished a course of antibiotics, it is important to take probiotics to address microbial diversity. However, it matters when you take each of them.
For optimal results, As soon as you have completely finished the antibiotics, take 1 packet of Gut Revival and 1 capsule of Flora Restore Max together each day for about a month (and no more than 3 months if you require support for a longer period of time). This is an excellent way to positively impact the gut’s healthy microbiome after antibiotic use.
Wishing you a wonderful journey toward establishing thriving microbial diversity in the gut!
This is a wonderful article that I’ve been in need of greatly! I was on an antibiotic 2 months ago, and sense then have been picking up colds , and a stomach bug. Would you recommend the 4 step process or the antibiotic protocol first?
Isn’t there a food that would build the colonizing? EG. Kefir??
I don’t know of a food with the colonizing probiotic in it. Bifidobacterium lactis HN019 is the strain to look for on labels. If you find it in a food please let us know about it.
Water kefir that I have fermented at home has survived my stumic and took up home in my gut.
I fermented the water kefir for 48 hours. It got to the point it was thicker then oil.
I would drink the entire pint at once. Very bad idea that one bacteria is now dominant and my stool smells horrible and is very slimy. At first my stool looked like the water kefir I was drinking then the horrible smell and slim got worse.
This was over a year ago. Now my stool has become very acidity. Burns my anus if I don’t wash after I pass stool.
I was on a antibiotic for a finger infection few months ago. Messed up my gut again of course. Thought it killed of the bacteria from the water kefir but nope it came back.
Currently doing fecal transplants with my kids stool hoping the normal gut bacteria can at least decrease the water kefir bacteria and keep it at bay.
Now that I think about it I don’t think the smell is from the water kefir bacteria. I had the same smell off and on before the water kefir.
But the slime was never there till I drank the water kefir. And it has stayed for over a year now
Wow, love this information. Thank you …. I have a question – what about fermented food triggering migraines? I get chronic migraines, and fermented food can trigger an episode. So I just do not take it. Any suggestions appreciated!
Hi Holly,
Fermented foods are heating and headaches can be triggered by excess heat. If you have excess pitta fermented foods can cause problems, particularly in summer. Check out this article https://lifespa.com/occasional-headache-support/ for more information on managing this type of headache.
I HAVE COLITIS BUT CANNOT FIND A CURE. IS THERE A PROBOTIC THAT WILL AID ME WITH THIS AILMENT? jIM
I had C Diff a couple of years ago and the two that helped me the most were: S Boulardii and Bacillus Coagulans. I also included a good multi-probiotic.
Hi Jim
I had colitis, went on a plant based gluten free diet, and I’ve never had to take medication.
I slip on the gluten, but is really makes me flare, I’m just beginning to look into the probiotics, but going plant based, was key.
Check out forks over knives documentary on Netflix, life changing, for me
Hope your better, I know how debilitating this disease can be, but it’s a sign to show you that you need to heal.
Dear Dr. Douillard,
My daughter has sensitivity to over 25 or more foods. She has a leaky gut. Her skin is red all over.
Would the above procedure help her?
Hi Ilya,
Without know more about your daughter’s situation, it is hard to say. If you would like to set up an appointment to for an Ayurvedic consultation to receive personalized recommendations from Dr. John or Tauna you can do so online or by calling 303-516-4848. With a health history and more information, they can safely offer advice.
Look into fecal transplant getting a few strains will not do much. If you or a close friend is healthy NOT over weight they can be a donair.
Google at home fecal transplant. You must do this it is the only thing that will help your child.
It is a fecal enema.
Dr. Douillard,
I’ve been browsing your website but haven’t seen IBS mentioned.
Please offer some suggestions on cause and cure. Thank you.
Hi James,
We can’t refer to specific medical conditions much on the website for FDA reasons.
I have written a lot about stress related digestive disorders so check out the Digestive Health category in my article library.
Herbs like Brahmi Brain, Happy Caps, Amalaki, Gut Revival, and Slippery Elm Prebiotic Formula are all good products to read up on for stress related digestive issues.
I hope that helps.
Be well,
John
What time of year is the best time to do this plan?
I will assume there is one time of year that is better especially if you have a change of seasons and/or you adhere to the dosha philosophy?
Hi Dan,
Right after an Ayurvedic cleanse is a great time to embark on this pre- and probiotic plan. Cleanses are traditionally done at the change of seasons (particularly at the start of spring and at the end of summer). For folks with really compromised digestive systems, it is sometimes better to just start the plan rather than waiting for a cleanse or the ideal time of year.
The health of the microbiome is inextricably linked to immunity so the protocol is a great prep for winter.
Hello Mr.Douillard, Love all of your advice on the digestive system. I was diagnosed with gurd a year ago through an endoscopy and refuse to take the medicene because of the side effects and the fact that it makes it worse . I try to take a probiotic but I had loose stools. I am assuming my stomach is compromised from the acid and I feel like any pill I take makes me have terrible hearburn. Any suggestions to get me in healing my digestive tract slowly without inflaming it more. Thankyou
Dr. Douillard,
I’m ordering LifeSpa’s 4-Step Probiotic kit, plus a container of Elim 1, based on this article. What is the process for weaning off the Slippery Elm and Gut Revival prior to starting Flora Restore Max? I’m already trying to incorporate fermented foods into my diet and am assuming I can continue with these foods during the process of bolstering the health of my microbiome using your pre- and probiotic products.
Are the different elements of this process available for purchase?
Thank you in advance,
Susan
Hi Susan, you can view the whole recommended kit here with descriptions here, and also purchase what you need: http://store.lifespa.com/probiotics_kit.html
Be well,
Dr. John
Hi Dr.John,
Can we do this during pregnancy?
Hi Amy! Thanks for reaching out. We do recommend a probiotic protocol during pregnancy, as well as B12 and Vitamin D. All other herbs are not prescribed for woman during pregnancy. It’s best to have a consultation if you have any irregular symptoms coming up. Be well.
Hi Amy. The short answer is yes, you can support pregnancy with a healthy probiotic protocol. Getting enough B12 and Vitamin D can also helpful. No herbs are suggested during pregnancy. In Ayurveda pregnancy itself is known as medicine for the body. Be well.
I am pitta predominant, and I always have acne and these things… I try to stick to a Pitta pacifying diet to calm it down and eat seasonally (I always try to eat something compatible to pitta and the season), but despite knowing the good of fermented foods, it’s usually a no-no for pittas, right? So I really avoid it. Would having sauerkraut be okay in spite of that?
Hi Lays. Thanks for the comment. In general fermented foods are too heating for pitta dominants, if you are going to incorporate them try not to have more than 1 tablespoon daily. Be well.
Hello Dr. John,
Could you provide a link to the package of the combination of your products which will restore a Healthy Microbiome? Thank you.
Hi Marilyn. Here is where you can find our Probiotic Kit: http://store.lifespa.com/probiotics_kit.html
Very interesting article and wish I had found it sooner! Both my Mayo clinic oncologist and stem cell transplant physicians stated I should “get my Microbiom” in order to be the best condition prior to transplant but no specifics on the “how to”. This past weekend I attended a bone health workshop and asked that question – I was referred to your site. Question: transplant is in 30 days is it too late to start? And, would I continue regimen during the process? Of course, I’d consult with transplant team once I arrive as well. Appreciate your comments.
Hi Jodie, thank you so much for reaching out. As this is a sensitive matter it is really best to discuss during a consult. Please research what we offer here at the clinic: https://lifespa.com/about-lifespa/ayurvedic-clinic/ Email info@lifespa.com for more help. Be well.
Thank you for an informative and educational article. I also had a consultation, and these probiotics were recommended. However, I forgot to ask one question, for the probiotics, the Gut Revival and Flora Restore, do we need to take them on an empty stomach first thing in the morning or after a meal?
Hi Dr John,
I am in Canada so I am not able to order your supplements (expensive shipping). Any tips on how can I substitute with generally available supplements in health food stores?
Thank you.
Hi Barb. It will be important to focus on seasonal eating, being as close to the cycles of nature as possible. Check out my free 3 season diet challenge: https://lifespa.com/3seasondietchallenge/
All the spices in our Gentle Digest product can be found at your local health food store. They are fennel, coriander, cumin, cardamom, and ginger. https://lifespa.com/five-spices-digestive-world/ What was fascinating is that these five spices seem to support the body’s natural ability to digest, rather than just treat its problematic symptoms. For example, studies show that they improved fat and sugar metabolism, they seemed to do so by boosting more bile acid and pancreatic enzyme flow. Digestive enzyme supplements provide the enzymes we need to digest protein and starches, while these spices amp up the body’s production of digestive enzymes and bile. This is an example of resetting digestion, rather than brewing dependency on digestive aids. *check the link to this article for references. Be well.
Hi; I have started your 4 step procedure and can’t find “Gut Revival” as the vitamin shops are
asking what it is and the brand? Also HN109 doesn’t seem to come individually. Is there are
partic colonizing probiotic with that in it that you recommend? Thanks!!! Hilary
Hi Hilary, you can always find our probiotics here: http://store.lifespa.com/Gut-Revival–Probiotic-and-Intestinal-Restore_p_908.html We do not currently have other companies to recommend! Thank you for reaching out.
Hello!
How often would you recommend to do these 4 steps (meaning lifetime). Once a year or so? Especially if I have IBS/Sibo/candida/ chronic diarheaa. Now Im working on it but Im wondering about the future.
Thank you,
Greetings from Switzerland!
Daiva
Hi Daiva,
This 4 step protocol should be done only as required. If you complete a round of antibiotics and notice poor digestion and weakness, that would be a good time. It is intended to be a recolonizing of the gut with the good micro-fauna, and is meant to last for a while. Depending on your diet, more antibiotics, or another disruptive event to your gut, you might never need it again!
Be Well.
Dear Dr Douillard–
My husband has chronic peritonitis and has to be on Bactrim DS (antibiotic) for life. I am really worried that it is going to destroy his intestinal flora but the alternative is that he can die of the peritonitis. Is there anything that we can do for his gut while he is on the antibiotics?
Thanks for your help!
I would like to try this regimine but have had awful ecperirnces with psyllium in the past as it gets stuck and causes my constipation yo become much worse. What do you suggest?
Hi Nicole,
Thanks for your question. If you know that you do not do well with psyllium, we carry products focusing on the other ingredients of our Elim formulas. Triphala and Slippery Elm would be beneficial in normalizing elimination in any case. If you are looking for help with loose movements, then you can also utilize the benefits of Bilva as well.
Slippery Elm http://store.lifespa.com/slippery_elm_prebiotic.html
Triphala http://store.lifespa.com/triphala.html
Be Well.
By following this exact formula by Dr. John Douillard I have reversed my Diabetes diagnosis. I am now feeling happy and well, and people tell me that I’ve never looked better. Am so full of gratitude.
I am just starting the protocol and have a question. If I boil this down to 1/2 quart, that is 32 Tbsp. So if I’m taking 1 Tbsp every 2 hours during waking hours, that about 8 Tbsp per day. So does 1 batch of it lasts about 4 days? And if so, do I keep it in the refrigerator? Or can it be left out? Thanks!
Thank you for the article. I would very much like to follow the protocol, but I have found I am sensitive to licorice, it can bring on heart arrhythmia, sometimes atrial fibrillation, sorry to say. Do you have a suggestion or products without licorice which would work in a similar manner? Thank you
Hi John, I’ve been following your pointings with Ayurveda and loving it. Thanks for ththe guidance.
I’ve recently done tests and Im found to have blastocystis hominis. The docotors recomm nd living with it and just Also my probiotics. My friend who is a naturopath has killed his but in this process he believes he has done a lot of damage from the technique of trying to kill these bugs which you elude to.
Is this protocol above suitable for blastocystis hominis?
Iv already started on your prebiotic tea and loving it, my life is filled with probiotic foods usually but looking at taking a structured approach as I imagine I have had blastocystis for many years.
Cheers again John, I really appreciate everything you’re doing
Sat nam 🙏