Gut Recovery After Antibiotics

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ANTIBIOTICS: THE GUT, THE BAD AND THE UGLY

According to a survey a few years ago, more than four out of five Americans consider antibiotic overuse a problem.¹ Even so, con­sumers’ ingestion of antibiotics and doctors’ prescriptions for them continue apace. In 2022 (and not even counting inpatient use), health care providers handed out roughly seven antibiotic prescriptions for every ten outpatients, totaling over two hundred thirty-six million prescrip­tions.² For comparison’s sake, consider that the size of the U.S. population that year was about three hundred thirty million.

An analysis of antibiotic prescribing in doc­tors’ offices and emergency departments (as of 2014–2015) determined that 28 percent of such prescriptions are unnecessary, either “overall” or because of inappropriate matching to the condition or age group.³ This is disturbing for a number of reasons, not least because, in the view of Dr. Natasha Campbell-McBride⁴—au­thor of Gut and Psychology Syndrome and Gut and Physiology Syndrome and developer of the GAPS diet—antibiotics are “by far” the most significant modern factor wreaking gut havoc.

In her 2003 book Bacteria for Breakfast,⁵ Dr. Kelly Dowhower Karpa sums up the principal reason why we should not underestimate the effects of antibiotics:

“Antibiotics kill normal flora. Antibiotics do not discriminate between ‘good’ bacteria and ‘bad’ bacteria. Any time antibiotics are used. . . they also kill ‘healthy’ bacteria. It is especially of concern when antibiotics kill bacteria that are part of the normal gastroin­testinal flora. Altered gut normal flora is the reason diarrhea occurs as a side effect in at least 25% of people taking antibiotic drugs.”

As another writer puts it, “It’s like using a bomb to destroy some of the weeds in your garden.”⁶

LONG-TERM CONSEQUENCES

Thanks to burgeoning research on the gut microbiome, people have become much more aware of how important healthy gut flora is for both mind and body. As catalogued by Campbell-McBride and others, the gut flora perform many vital functions, including providing protection from invaders and toxins, facilitating appropriate digestion and absorption of food and producing essential vitamins, hormones and neurotransmitters.⁷ When we bombard our gut flora (collectively known as the gut microbiota) with antibiotics, we interfere with those essential duties.

The increased understanding of antibiot­ics’ downside has prompted particular concern about antibiotic prescribing during pregnancy and childbirth.^8,9 Ordinarily, the first three years of life are the critical time frame when a child’s gut flora are supposed to “rapidly increase in diversity and reach an adult-like stage.”¹⁰ Antibi­otics administered during either the gestation or postpartum periods can skew that all-important process.

Studies conducted in Western nations esti­mate that antibiotics constitute some 80 percent of the drugs prescribed for pregnant women (and, by implication, for the babies they carry),8 in part due to unfounded fear-mongering about group B strep.¹¹ With the high rate of Caesarean deliveries in the West,¹² some of those women (again, with ramifications for the baby) get a double whammy, with one third to one half (or more) of mothers receiving antibiotics during childbirth.^13-15 As one researcher has comment­ed, “Most studies in the obstetrics field have focused on the benefits of antibiotics for short-term maternal and neonatal complications, but with very little (if any) interest in long-term consequences.”¹⁶ In antibiotic-exposed children, those consequences include, among others, an increased propensity to develop chronic conditions like asthma and allergies,¹⁷ obesity,¹⁸ bowel disease,¹⁹ juvenile arthritis (deemed “idiopathic” because the causes ostensibly are obscure or un­known)²⁰ and neurodevelopmental disorders.²¹

The sounding of alarm bells about the impact of antibiotics on children’s health does not mean that the adult gut microbiome is off the hook. The international research group Gut Microbiota for Health describes studies involving healthy adults whose “gut microbiome diversity was impacted as early as one day after the treatment ended”; their gut microbiome— “temporarily resembl[ing] that of a patient in the intensive care unit”—remained altered for at least six months.²² Some researchers suggest that the derangement of the microbial ecosystem can be so significant as to never return “com­pletely to baseline,”8 even with just a single or short course of antibiotic treatment.²³ It stands to reason that the antibiotic-induced pattern of “immediate perturbation. . . followed by incomplete recovery”⁸ could be even worse in individuals who take antibiotics repeatedly.

In a before-and-after study of three healthy individuals who received the commonly used antibiotic ciprofloxacin, the investigators de­termined that there were “pervasive effects” lasting at least six months on “about a third of the bacterial taxa in the gut, decreasing the taxonomic richness, diversity, and evenness.”²⁴ On a more positive note, by four weeks post-treatment, some components of the intestinal community seemed to have recovered and “closely resembled [their] pretreatment state,” leading the researchers to urge further study of “factors promoting community resilience.”

In 2019, researchers conducted just such a study with “humanized” mice.²⁵ (“Humanized” mice are “engrafted with something from a hu­man”²⁶; in this case, that “something” was feces from a human donor.) Mice who received strep­tomycin treatment recovered more quickly when they “co-housed” with untreated mice, leading the investigators to speculate that “microbes from other hosts are an important resource for recovery after antibiotics.” Individually housed mice fared worse, exhibiting “slower and more variable recovery dynamics.” Mice fed a fiber-deficient diet also had impaired recovery. Based on multiple experiments, the investigators opti­mistically concluded that “human microbiotas may be more resilient to antibiotics than mouse microbiotas.”²⁵ Additionally, they commented that bacterial responses to antibiotics observed in vitro (that is, in a petri dish) are “not neces­sarily predictive” of what happens in vivo, that is, “within the context of a complex ecosystem in a mammalian host.”²⁵

Even if one is willing to risk the disruption to one’s gut flora, there are other reasons, of course, to be cautious about taking antibiotics. For example, other antibiotic-associated side effects—most commonly, allergic reactions, but also “neurologic or psychiatric disturbances”— are another “under-appreciated consequence” of antibiotic use.²⁷ Other “symptoms of antibi­otic toxicity” include “kidney stones, abnormal blood clotting, sun sensitivity, blood disorders and even deafness.”²⁸ In a study that looked at the “side effect” problem, the authors concluded that reducing unnecessary antibiotic use “by even a small percentage” could have a signifi­cant impact on patient welfare.²⁷ However, as a 2020 article points out, prescribers often do not recognize antibiotics’ “inevitable” adverse effects; the authors urged family physicians to prescribe the drugs “only when the probability of benefit is greater than the risk of harm.”²⁹

GUT REMEDIATION: GAPS TO THE RESCUE

As members of the public come to understand more about antibiotics’ negative impacts on gut health—both direct and indirect³⁰—they want to know what they can do in the event that circumstances, protocols or other factors compel their use. As long-time Weston A. Price Foundation members and Wise Traditions readers can probably guess, a logical answer to that question is to turn to either the GAPS diet alone or the three-pronged GAPS nutritional protocol—the GAPS diet plus judicious supplementation and detoxification measures.

Why is recovery through diet so critical? As Campbell-McBride explained in this journal a year ago (Winter 2023), “The human body is a microbial community, and food is the most powerful influence on any microbial commu­nity in Nature. This means that food is the most powerful influence on human health—there is nothing more powerful!”³¹

The GAPS diet, “designed to heal the digestive system and normalize its microbial community,” is Campbell-McBride’s adaptation of the Specific Carbohydrate Diet (SCD) first developed by Dr. Sidney Valentine Haas and later refined by Elaine Gottschall,³² and it has accrued such an extensive track record by now that typing “GAPS diet success stories” into a search engine is all that is needed to bring up a myriad of glowing testimonials. Campbell- McBride’s books³³ provide detailed guidance on all three protocol components, and Certified GAPS Practitioners are also available all over the world to provide support for those who need or desire it.³⁴

The GAPS diet, in brief, includes an “Intro­duction Diet” (recommended in most circum­stances but somewhat challenging to implement) and the “Full GAPS Diet,” as well as other varia­tions depending on the situation, with everything homemade. Both the Introduction and Full diets emphasize meat stocks, soups, stews, high-quality fats (including dairy fats such as ghee, butter and cream; fats rendered from meat such as lard, tallow and schmaltz; and coconut oil and cream) and fer­mented foods (dairy-based and vegetable-based). Especially at the beginning, Campbell-McBride’s recommendation is that roughly 85 percent of ev­erything eaten daily “should be made out of meats (including organ meats), fish, meat and fish stock, eggs, fermented dairy and vegetables (some well cooked, some fermented and some raw),” with other items such as fruit and nut flours coming later and only in moderation.⁷

Depending on the person’s circumstances, and recognizing that “Nature designed our bodies to receive nutrition from food, not from pills,”⁷ Campbell-McBride suggests that some people may benefit from certain high-quality nutritional supplements. These might include an effective therapeutic-strength probiotic (not for­getting that the most “potent” probiotics “come in the form of homemade fermented foods”), cod liver oil, betaine hydrochloride with pepsin (not taken at the same time as probiotics) and/ or pancreatic enzymes.

To support the body’s detoxification system—the third component of the GAPS protocol—Campbell-McBride has several sug­gestions that are valuable for everyone, not just people engaged in gut healing. These include reducing one’s general toxic load (carefully scrutinize your household and personal care products!); taking detox baths with substances such as Epsom salt, apple cider vinegar, baking soda, natural salt or seaweed powder; walking barefoot (grounding); sunbathing; and doing regular enemas.

In someone who was in robust health prior to a course of antibiotics, a relatively short-term stint on the GAPS Diet might be all that is need­ed to nudge the gut flora back into diversity and homeostasis, while those who were in a weaker state to begin with might need to commit for a longer time period.

OTHER SUPPORTS FOR GUT HEALING

In her discussion of commercial probiotics, Campbell-McBride describes six components often found in commercial brands.⁷ They include five general families of bacteria—Lactobacilli, Bifidobacteria, physiological strains of E. coli, bacteria isolated from human stool (Enterococcus faecium or Streptococcus faecalis) and the soil-based microbe Bacillus subtilis—as well as the beneficial fungi Saccharomyces boulardii. Though bacteria have generally attracted more attention than fungi, she notes that the latter are extremely important for maintaining the epithelial layers in the gut, as well as perform­ing numerous other jobs, and she points out that the use of mushrooms (“larger fungi”) for gut flora rebalancing is a rising area of interest.³⁵ Celebrating five medicinal mushrooms—lion’s mane, chaga, reishi, turkey tail and shiitake— that function as “prebiotics,” one website sug­gests that the mushrooms can “reduce inflam­mation, strengthen the lining of the gut, and improve gut bacteria diversity.”³⁶

In a post titled “10 Ways to Support Gut Health after Antibiotics,” a functional medi­cine doctor offers recommendations consistent with the GAPS diet but also calls attention to “postbiotics”—the metabolic byproducts of probiotic bacteria that include short-chain fatty acids (SCFAs) as well as other constituents.³⁷ The author suggests that the SCFAs “produced by probiotic bacteria can protect against the harmful effects of antibiotics on gut health.” Discussing postbiotics as “a rather new term in the ’-biotics’ field,” researchers writing in the International Journal of Molecular Sciences in 2019 described postbiotics as a useful support for infant colic and adult diarrhea.³⁸ Both of those conditions can be the result of antibiotic treatment, either immediately or up to a couple of months later.^39,40

Australian health coach Barbara O’Neill (who, it should be noted, advocates a plant-based diet) recommends slippery elm powder as a tool for gut healing in those suffering from inflammatory bowel disease.⁴¹ According to O’Neill, slippery elm “coats, soothes and heals” the gut lining and pro­vides a growth stimulant that encourages rapid healing. Her gut healing protocol—supplemented by probiotics, incorporation in the diet of miso (for “nice microbes”) and a high-quality sea salt (for minerals)—involves taking slippery elm four times a day until the stool normalizes.⁴²

PLENTY OF ALTERNATIVES

The GAPS diet and similar gut healing diets require, as Campbell- McBride and others readily admit, home cooking and commitment. Learning about alternatives to antibiotics and prioritizing those alter­natives as much as possible can forestall the need for that investment (although home cooking should be a priority for everyone, anyway!).

The home remedy website Earth Clinic lists a wide variety of natural substances with “antibiotic” and healing properties, including apple cider vinegar (ACV), astragalus, cayenne, citrus fruits, garlic, ginger, green and black tea, honey, horseradish and more.⁴³ One group of researchers has documented, in vitro, the “powerful anti-microbial effects” of ACV for both non-resistant E. coli, Staphylococcus aureus and Candida albicans as well as resistant E. coli and methicillin-resistant S. aureus (MRSA), and those authors eagerly propose that clinical research be conducted.⁴⁴ Other well-known and possibly helpful substances include coconut oil, echinacea, goldenseal, grapefruit seed extract, oil of oregano and turmeric.⁴⁵ In addition, a 2019 paper by Polish researchers describes es­sential oils as a “potential alternative to synthetic compounds,” pointing to cajuput, cinnamon, clove, eucalyptus, lavender, peppermint, sage, tea tree and thyme oils as having “high antimicrobial potential.”⁴⁶

For the types of respiratory conditions that often send people running for antibiotics, sites like Uriel Pharmacy—which produces “remedies for the body, soul, spirit” using anthroposophic and homeopathic principles and biodynamically grown medicinal herbs—might be worth exploring.⁴⁷ Uriel’s “Meteoric Iron Prunus” remedy (available in pellet or liquid form) is popular as a support during the winter season. The True Botanica company, likewise focused on holistic health “at all three levels of Body, Mind and Spirit,” offers remedies for intestinal health, lung health and a wide variety of other health concerns.⁴⁸ [Note: The Weston A. Price Foun­dation has no advertising or other relationship with these companies.]

ANTIBIOTICS AS AN INSTRUMENT OF THE FEAR AGENDA

At our current historical juncture—when officials have amped up the collective fear of “germs” and “pandemics” possibly to all-time highs—it may be wise to take a step back and reconsider the entire “war” model that underlies the use of antibiotics and most of conventional health care. As Dr. Sam Bailey suggests in a short video titled “The Truth About Antibiotics,”⁴⁹ it is entirely valid to ask whether “anti-life” antibiotics— “embedded” as they are in germ theory—are really “live-saving com­pounds, or more mythology from the pharma cartel.”

One point of evidence suggesting that antibiotics’ near-legendary success may have more to do with “pharma marketing spin” than science, notes Bailey, is the heavy hand of the Rockefeller Foundation in catapult­ing the first antibiotic—penicillin—to fame. Alexander Fleming’s petri-dish discovery might well have faded into obscurity were it not for the foundation’s concerted “big money” nudge.⁵⁰ Astonishingly, Bailey notes that there is a complete lack of studies supporting the widely repeated claim that penicillin saved the lives of thousands of soldiers during WWII.

Bailey also raises compelling questions about the fear-based narra­tive surrounding the phenomenon of “antimicrobial resistance” (AMR). In 2019, the World Health Organization (WHO) declared AMR to be one of the “top ten global public health threats facing humanity,”⁵¹ and the same cast of characters who, the following year, hyped the Covid plandemic lined up in lockstep to amplify AMR dangers. Given what we have learned about the ulterior motives that drove the engineered Covid “emergency,” it makes sense to ask questions when a scary list suddenly appears that carefully positions AMR alongside other “threats” like “vaccine hesitancy” and germ-theory bogeymen like “global influenza pandemic” and “high-threat pathogens.”

Not coincidentally, as Bailey points out, a pivotal 2022 Lancet study that further promotes AMR as a “major threat to human health” used the same dubious predictive statistical modeling methods that led the world astray during Covid, with funding for the study provided by none other than the Bill & Melinda Gates Foundation and the Wellcome Trust.⁵² Implicitly raising the matter of cui bono (“who benefits”), Bailey observes how the AMR narrative serves pharmaceutical and globalist interests; while the WHO makes dramatic claims that “AMR puts many of the gains of modern medicine at risk,” it is simultaneously seeding the perception of an “urgent need” for new medicines, diagnostics and, of course, vaccines.⁵³ Under the circumstances—knowing what we now know about deceptive scientific methods, deceptive publications and “ deceptive regulatory simulations performed by FDA and drug companies,” we might do well to adopt the advice recently proffered by writer and legal researcher Katherine Watt “to become vaccine hostile” rather than “vaccine confident,”⁵⁴ and even extend that advice toward a similar skepticism about antibiotics.

In fact, there are solid grounds, say Bailey and others, for viewing antibiotics as yet another germ-theory-derived “scam.” If we can come to recognize bacteria as a crucial part of our inner and outer ecosystems— “bystanders that proliferate under certain conditions” and not scary pathogens—that realization can free us up to take greater responsibility for our health and carry out the unglamorous but far more rewarding work of strengthening our terrain, buttressed by faith that our bodies, properly supported, know how to heal.

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SIDEBARS

FULL DISCLOSURE?

According to Drugs.com,⁵⁵ there are presently ten classes of antibiotics: penicillins, tetracyclines, cephalosporins, quinolones, lincomycins, macrolides, sulfonamides, glycopeptides, aminoglycosides and carbapenems. Although the site states that antibiotics are “usually safe with few side effects,” two sentences later it tells us that the drugs “can lead to side effects that may range from being a nuisance to serious or life-threatening.”

Side effects⁵⁶ the site describes as “common” include “mild” rashes and allergic reactions, diarrhea, upset stomach, nausea and loss of appetite. Side effects described as “more severe” include “severe allergic reaction that results in difficulty breathing [and] facial swelling”; severe watery or bloody diarrhea; Clostridium difficile infection; and stomach cramps. Vaginal yeast infections and oral thrush are listed as both “common” and “more severe.”

The fluoroquinolones class of antibiotics lists potential “disabling side effects” on the “muscles, tendons, joints, heart, and metabolic or nervous system”; for this reason, Drugs.com tells us, this class “should only be considered when treatment with other, less toxic antibiotics has failed.”

The site also suggests that caution is warranted when prescribing antibiotics for infants, pregnant or breastfeeding women, the elderly, patients with kidney or liver disease and “many other people.”

WHAT’S IN A NAME? MARKETING “BROAD-SPECTRUM” ANTIBIOTICS

As recounted in Empire of Pain⁵⁷—Patrick Radden Keefe’s fascinating and colorful book about the Sackler family dynasty and its pivotal role in the opioid epidemic—the original “paterfamilias,” Arthur Sackler, almost single-handedly invented pharmaceutical advertising as we know it today.⁵⁸ One of Sackler’s ingenious marketing coups was the invention of the term “broad-spectrum” for the Pfizer antibiotic Terramycin. As Keefe puts it, though the term “sounds clinical. . . it was coined by advertisers.” Terramycin, according to Keefe, “wasn’t a particularly groundbreaking product,” but thanks to the clever marketing and fleets of “detail men,” it became a blockbuster.

Decades later, in a 1997 article in Clinical Microbiology and Infection, a disgruntled French researcher pointedly ob­served that there are no universally accepted definitions of “broad” and “narrow” spectrum antibiotics, and that “broad spectrum as an expression of greater therapeutic security has mainly been used by the pharmaceutical industry.”⁵⁹ He also commented that the most important determinant of appropriate antibiotic selection ought to be a given drug’s track record for a given condition—and that “spectrum” is an almost meaningless consideration.

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This article appeared in Wise Traditions in Food, Farming and the Healing Arts, the quarterly journal of the Weston A. Price Foundation, Winter 2024

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