First and foremost, I am beseeching you to consult, discuss, and clear everything in this protocol with your doctor before deciding to implement it. Due to the high levels of individuality between people and their specific health conditions, there are things in this protocol that could negatively impact your health or interfere with your medications. If your doctor advises you not to implement something in this protocol, or even the entire protocol, my recommendation is that you listen to your doctor’s advice. Secondly, if you start to see an increase or worsening of symptoms while following this protocol, seek medical attention if needed, err on the side of caution, and decrease the amount of, or discontinue entirely, anything that you suspect may be causing an increase in symptoms.
This may be tricky with probiotic consumption as discussed in module 3.3 due to the Herxheimer reaction. What I recommend is starting with a low dose of probiotic supplementation and consumption of probiotic foods. If there is an increase in symptoms beyond what is normal for you on a daily basis, or causes a flare, then remove the probiotics entirely until your symptoms decrease and normalize. At this point, begin again with a low amount of probiotics and remain at this same dose for one week. If symptoms do not worsen, then at the end of one week, slightly increase probiotic supplementation and food consumption and remain at this new dose for one week. If symptoms increase beyond what is normal for you or causes a flare, decrease the dose of probiotic foods and supplementation back to the level that did not cause an increase in symptoms. Remain at this lower dose until symptoms normalize. If symptoms do not normalize, seek medical attention if necessary and decrease the dose of probiotics further. When symptoms do normalize, and with your doctor’s approval, you may slowly begin to increase probiotic consumption again. Repeat this process until a therapeutic level of probiotic consumption, or the maximum recommended dose of probiotics, is reached. This is a complex game of give and take that depends entirely on how your symptoms fluctuate and what level of symptoms are normal for you while not flaring. This is why I think it is important to do everything you can to remain in consistent communication with your doctor, monitor your symptoms, and not simply grit your teeth and push through. Gritting your teeth and pushing through can result in catastrophic consequences, such as losing your colon or even your life. Do not do it. We want to slowly increase our probiotic consumption over time, taking steps backward when necessary as dictated by the level of symptoms, so that we can safely build up to a therapeutic level of probiotic consumption that will improve the composition of our GMs and begin reversing inflammation.
It is very important that you operate within the bounds of your doctor’s counsel. Your doctor needs to know what you’re doing and how you’re doing it so that they can point out any possible pitfalls or dangers that you do not see. That being said, progressing, or moving forward, is important. The goal of this program is to start with prebiotic soluble foods that are generally well tolerated, and a low consumption of probiotics, and then increase the amounts of probiotics each week if symptoms allow until the therapeutic level is reached. I have spoken to many people who have followed many, if not all, of the GM optimization strategies that are outlined in this course, and without much success. The pitfall for many of them is that they remained at low levels of probiotic consumption. They consumed the right things, just not enough to produce a therapeutic response. The therapeutic dose of probiotics will vary for each individual, however, I found that consuming about 15-20 oz (440-590 mL) of kefir per day (about 1 gallon each week), and about 1 cup of fermented vegetables per day, without supplementation, was the therapeutic level of probiotic consumption that I needed in combination with all of the prebiotics I was consuming, that allowed me to bring my GM into eubiosis and achieve the level of health I desired.
So, the following protocol will be based loosely on those numbers, but will also include probiotic supplementation for good measure. Feel free to customize the amount of probiotics you wish to build up to, it is not important that you build up to the exact numbers that are in the protocol below. What is important is continuing to increase the amount of probiotic consumption until you experience that therapeutic response or the maximum recommended dose of probiotics is reached. At that point you may stay at that level of probiotic consumption. As you get healthier, and remain healthier for longer periods of time, you may potentially require lower levels of probiotic consumption to remain in eubiosis, and so you can decrease to a lower maintenance consumption of probiotic foods and supplements.
As you are going through this process keep in mind that there is currently no standard tolerable upper intake level for the number of probiotic CFUs that can be consumed daily. However, probiotics are only one piece of the puzzle, and at a certain point, continuing to increase probiotics may not provide that therapeutic effect, and may even cause deleterious effects. Both VSL#3 and Visbiome are medical grade probiotics intended for IBS and UC that must be taken under medical supervision. Both supplements contain 450 Billion CFUs per packet, and the directions state that individuals can take up to eight packets per day. Some quick math shows that consuming eight packets of either of these supplements will come out to three trillion six hundred billion CFUs per day. I would not recommend exceeding this amount of CFUs per day from any probiotic supplement unless instructed to do so by your doctor. As for probiotics from food- I would not recommend exceeding 1 liter of kefir per day (33.8 oz) or 3 cups of fermented vegetables per day as I don’t think higher amounts will be necessary.
The probiotic supplements that I am going to use in the daily routines will be Floracor-GI and P3-OM, however, you can choose any probiotic supplement you like either from the list I provided or one that you find yourself. I recommend that the maximum dose you build up to does not exceed 8 capsules of Floracor-GI and 4 capsules of P3-OM per day, and I again recommend consulting with your doctor about this dosage beforehand.
The following 5 week program will show you how I personally think is the best way to slowly build up each week to therapeutic levels of probiotic consumption while slowly increasing the variety of prebiotic fiber as well (transitioning between phase 1 foods and phase 2). This will incorporate each major component that I think is important for GM optimization and provide meal recipes and training routines as well. The general daily routine will show how each day in the 5 week program is structured. So, if you feel comfortable, feel free to customize your own meals, training routines, and probiotic progression. Otherwise, you can follow the detailed 5 week program the way it is written. Remember, this 5 week program is a sample program and does not have to or need to be followed exactly the way it is written. Do not focus on rigidly following the program for the sake of following the program. What is more important is understanding the gut microbiome optimizing principles and concepts, and how to apply them. This 5 week program is meant to be a starting point, a roadmap for you to get your bearings, and inspiration for how to design your own eubiotic daily routine and meal plan.
Lastly, please do your due diligence and get the approval and counsel of a doctor or medical professional before you implement anything discussed in this course and program. Err on the side of caution and seek medical attention if needed. Good luck!
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