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You’ve decided to start taking probiotics - But how do you choose? The supplement aisle can be overwhelming and you’re wondering “What do I look for in a probiotic?”. If you’ve been reading my blog this year, you know we’ve been talking about probiotics a LOT! To find out more about what probiotics are, read my blog post Probiotics 101: What Are They and Do You Need Supplements? I’m going to break down everything you need to know when looking for a probiotic, so you can be confident you are making the right choice. If you are new here: Welcome! I’m Marissa, a digestive health registered dietitian specializing in IBS, food sensitivities, and autoimmune conditions. I help clients improve their GI symptoms with food and lifestyle programs using functional nutrition and a food-as-medicine approach. Probiotics are classified as supplements which means they are not regulated by the Food and Drug Administration (FDA). This means that manufacturers can put anything into the supplement and claim that it will help a specific condition. I’m going to teach you the detective skills you need to be sure you’re making a good choice. Grab your magnifying glass and we’ll start this investigation by looking for supplements that are third-party reviewed. Photo by Daily Nouri on Unsplash Third-Party Reviewed Even though your probiotic isn’t regulated by the FDA, there are several organizations that test supplements to ensure they have the ingredients they claim to have, and do not have harmful contaminants (1). Organizations that offer this testing include: ConsumerLab.com NSF International U.S. Pharmacopeia Supplements that pass the testing will have a seal of quality assurance displayed on the label. Once you’ve found a brand of probiotics that has been tested (and passed) for quality, you can start looking for the correct strain. Let’s dive in! Strains When it comes to probiotics, there isn’t just one kind that you need. Each type of bacteria contributes differently to help your body function well. Think about your microbiome like an orchestra. You need to have the right number of flutes, violins, cellos, and french horns to make the music balanced and sound the best. If you are taking probiotics to treat a specific condition, you need to know what kind of probiotics have been researched to improve that condition. Using our orchestra example, it won’t help to improve your IBS if you are taking a supplement of french horns if flutes are the type of bacteria shown to improve IBS. Probiotic names have three parts: the genus, species, and strain designation. You need to have all 3 parts of the name to be sure you have a match. Just like mailing a letter - you need to have the right house number, street name, and zip code to have your letter get to the right destination. Let’s look at an example: Bifidobacterium bifidum MIMBb75 is a bacteria that has been shown to help with symptoms of IBS (2). In this case, Bifidobacterium is the genus, bifidum is the species and MIMBb75 is the strain. Let’s circle back to our orchestra. If you take a supplement with flutes to improve your IBS, you are helping to increase the number of flutes you have… If you continue to take a supplement with only flutes, eventually your orchestra will have too many flutes and not enough violins, french horns, or cellos. For this reason, I recommend rotating strains of probiotics every 2-3 months. This can be as easy as changing from a 7-strain probiotic to one that has 10 or 14 strains. You can also change from taking a lactobacillus and bifidobacterium strain to taking one that is more spore based. Once you’ve found the correct strain of probiotics, you need to make sure you are taking the right amount. The next clue we’re going to investigate is how to find the right dose. Dosage Probiotics are measured in colony-forming units or CFUs. This tells you the number of active bacterial cells you are getting in each dose. Maintenance doses of probiotics can range from 1 billion to 5 billion CFU. If you are looking to address a specific condition, you may need as much as 20 billion to 50 billion CFU. The label should list the number of CFU for each strain of probiotic in the supplement. Example for supplement XYZ (using the orchestra example again): Flutes 50 billion CFU Violins 10 billion CFU Clarinets 10 billion CFU If you want to improve a specific symptom, you will also want to research how many CFUs and what specific strain is needed to treat the condition. This is where a health professional familiar with the use of probiotics – that’s me! – can be helpful. The last important part of our dosage investigation is how the CFU is listed. The number of active bacteria in supplements declines over time. Make sure the CFU is listed as “prior to the end of shelf life” instead of “at time of manufacture.” You want a guarantee that the amount listed is what you’re actually getting. Now you know the strain and dose that you want. You’re ready to make your purchase! But there is another important clue to look at before you bring them home. How should you store them? Even more importantly - how are they stored in the store? Here’s a hint - You might need to be looking in the refrigerated section. Keep reading for the full scoop! Photo by Samuel Sianipar on Unsplash Storage The most common type of probiotics are lactobacillus and bifidobacterium combinations. Heat can kill these traditional probiotics and you will need to keep them in the fridge. This means they should also be refrigerated at the store where you purchase them. Spore-based probiotics are different and only become active when they reach your GI tract. They do not need to be refrigerated during storage. You can tell if a probiotic is spore-based because it will begin with “Bacillus” (for example Bacillus Indicus). Spore-based probiotics have been shown to help reduce serum triglycerides and help with inflammation (3). If traditional probiotics are all instruments in an orchestra, spore-based probiotics are like members of a band. Both types help to create balanced music, but the instruments and the way they operate are a bit different. The final piece of our investigation is the best before date - And does it matter? Let’s take a look! Best Before So you checked your cabinet (ahem, I mean the fridge) and found a bottle of probiotics from last year - Can you still take them? The CFUs in probiotics decline over time. If you use the product past the “use by'' or “best before” date, you will not be getting the listed dosage. It isn’t harmful to take the supplements past the best-before date, but you will not be getting the full benefit from taking them. This is especially important if you are trying to improve a specific condition with a targeted dose. That wraps up our investigation. Congratulations! You are now an official probiotics label detective. Keep reading for my pro tips on how to get the most out of your supplement. Pro Tips You’ve spent your hard-earned money on probiotic supplements, so let’s discuss what you can do to get the full benefit of taking them. Help the Bacteria Survive The truth is, not all the bacteria in the supplement are going to reach your intestine. Once you swallow the capsule, the probiotics must make their way through the harsh conditions in your body to successfully reach their final destination. Think about stomach acid followed by digestive enzymes. Traditional lactobacillus/bifidobacterium probiotics are vulnerable and it’s more difficult for them to make it through your digestive obstacle course. Delayed-release capsules increase the chances that the bacteria will make it to your gut to live happily ever after. Spore-based varieties (remember our band?) are dormant until they reach your GI tract. This means they are able to tolerate the harsh conditions in your body and more of the bacteria will be successful on their journey to your large intestine. Taking your probiotic with food will also help to reduce the acidic conditions in your stomach. Should you take your probiotic with your morning meal or in the evening? Take a look at my next pro tip to find out! Take Them at The Right Time of Day Starting probiotic supplements can cause some mild side effects in the beginning. The most common complaints are changes in your bowel habits including gas and bloating. This is OK and a sign that the supplement is working! Over time your body will adjust and the side effects will go away. Taking your probiotic in the evening will make these symptoms less noticeable. On the flip side, some people report feeling less rested and having vivid dreams. In this case, you might need to change and take your supplement earlier in the day. Let’s shift the conversation more towards food - and I’m not talking about food for you but rather food for your microbiome. Prebiotics are just as important as probiotics for you and your bacteria. Let’s take a look! Prebiotics and Fiber Prebiotics are a source of food for probiotics. Including prebiotics in your diet from food or supplements means that the good bacteria will have the best chance of surviving in your body. Food sources of prebiotics include (4): Whole oats Wheat bran Apples Asparagus Onions, garlic, and leeks Flax Seeds Barley Bananas Dandelion greens Prebiotics in the form of inulin are also added to some probiotic supplements. This helps the bacteria grow once it reaches your digestive tract. Imagine showing up at your Mom’s house after a long journey and she has a nice home-cooked meal already on the table. Sounds inviting doesn’t it? Sources of prebiotic fiber are often classified as high-FODMAP foods. If you need to follow a low FODMAP diet, you may not tolerate probiotics with added inulin. Food as medicine is my first-line approach and you may be wondering if you can just get your probiotics from food and ditch the supplements altogether. For many people focusing on adding probiotic foods can make a difference. In the next section, we’ll discuss the pros and cons of using food vs. supplements. Photo by Niclas Illg on Unsplash Food vs. Supplements? This is a question I get asked a lot by my clients. Is there a benefit to taking supplements or can I get the same benefit from food? As a food-first dietitian, I always recommend starting with food when possible. Probiotics are naturally found in fermented foods including (5): Yogurt Kimchi Tempeh Sauerkraut Sourdough bread Pickles Miso Some cheeses that have been aged but not heat processed like swiss, provolone, gouda, and cheddar (6) In some cases though, using a supplement may be a better option. Supplements allow you to be more targeted with the strain of probiotics you are taking which can help when treating specific conditions. Other benefits of supplements include: Increased diversity of bacterial strains Accommodating food allergies and sensitivities like wheat, dairy, soy, or gluten Can be used when food sources are not tolerated Correcting an imbalance of bacteria in your body is not as simple as just adding a supplement. Many lifestyle habits common in North America make it difficult for good bacteria to survive inside your body. It’s important to ask yourself - What contributed to developing the imbalance? The population of bacteria living in your body can be affected by lifestyle habits including: Stress levels Sleep habits Processed foods high in sugar and added fat Combining daily food sources of probiotics with a variety of whole foods including vegetables, fruit, and whole grains will help to keep the probiotics growing and happy inside your body. As a digestive health dietitian, I love seeing how improvements in GI health can positively impact all areas of life. But just like with any supplement, they are not safe for everyone. Keep reading to find out if probiotics are safe for you. Can Everyone Take Probiotics? There is never a one-size-fits-all recommendation when it comes to health and probiotics are no exception. Probiotics are not recommended in these situations: Anyone who has a compromised immune system (i.e. critical illness, chemotherapy) GI infections like SIBO Pregnant women Infants If you are unsure if probiotics are the right choice for you, consult with a healthcare professional or your physician before starting any supplements. Key Takeaways Just like any supplement, probiotics are not regulated by the FDA. This means that you need to do your research and know what you’re looking for when you go to the store. The probiotics you choose should be reviewed for safety and efficacy. You should also be checking the label for the strains, dosage (measured in CFU), best-before date, and how the probiotics are stored. You can also get probiotics from food sources like yogurt, sauerkraut, tempeh, miso, kimchi, and sourdough bread. Including both probiotics and prebiotics in your diet will help to keep your microbiome balanced. If you want personalized diet and lifestyle recommendations that will help to improve your digestive health - I am here to help! Use this link to get started with me. Life is busy and I can help you do the investigative work to make sure you’re getting the right strain and dose of probiotics to help you feel better.

Have you ever wondered if you should be adding probiotics to your daily routine? If you are a regular to my blog, you know that the topic of probiotics comes up frequently. Today we’re going to explore ​​what are the signs you need probiotics. For those of you who are new here: Welcome! My name is Marissa Mekelburg, MS, RDN, CLT, HHP, and I am a Digestive Health Dietitian Nutritionist. I specialize in GI conditions like IBS, food sensitivities, and autoimmune conditions. You might be surprised to learn that digestive issues like diarrhea and constipation are only one of the signs that you may benefit from taking probiotics. In my practice, I often see that improving the health of your digestive tract can have positive effects on your entire body. What exactly is a probiotic? Probiotics are bacteria and yeast that are in some way beneficial to your body (1). You can find a detailed explanation of what probiotics are in my recent blog, Probiotics 101: What Are They and Do You Need Supplements? Digestive issues are usually the first thing that people think of when they hear probiotics - so let’s start our discussion with my favorite topic - your digestive tract! Photo by Tyler Nix on Unsplash Digestive Symptoms Probiotics can help to improve many digestive symptoms, including: Constipation Diarrhea Nausea Gas/bloating Recent food poisoning Your body has its own ecosystem that includes all the bacteria and organisms that live on your skin and in your digestive tract - these are also referred to as your microbiota (or microbiome). The number of bacteria that your body is home to has been estimated in the trillions (10). Some of these organisms can improve your health - let’s call these the “good guys”. On the flip side, some of these organisms can cause harm to your health and body - we’ll call these the “bad guys”. Just like in any ecosystem, your body has a limited amount of resources (like food) available, and the good guys and the bad guys are competing to survive. If you have too many of one type of bacteria, it can be more difficult for others to live and survive. If you have recently recovered from a bout of traveler's diarrhea or food-borne illness, your digestive tract has been out of balance with too many of the bad guys. In these cases, the bad guys are infectious bacteria that caused your illness. Non-infectious causes of diarrhea and digestive issues like inflammatory bowel disease (IBD) have also been associated with having an imbalance of bacteria in your digestive tract (also called dysbiosis). If you suffer from IBD you may have an increased number of inflammatory bacteria (7). Your bowels (and your whole body) will function best if you have a good mix of different kinds of the good bacteria. Taking probiotics can help to restore your body’s ecosystem and help your digestive tract recover from the infectious or inflammatory bacteria. What may surprise you, is that probiotics can help with constipation too. Having the right mix of bacteria in your digestive tract can improve gut motility (how quickly food moves through your gut) and pain perception. There is research that shows taking probiotics can help to improve the frequency and consistency of bowel movements, helping to relieve symptoms of constipation (11). Antibiotics can have a big impact on your microbiome and probiotics can help to keep your system balanced. Have you ever taken antibiotics and had the unpleasant side effect of diarrhea? Keep reading to find out how probiotics can help to repair your ecosystem. Recent Course of Antibiotics Antibiotics are used to treat bacterial infections. Sometimes they are an important step in recovering from an illness. What you may not know is that antibiotics don’t discriminate against the bad guys. One of the negative side effects of taking antibiotics is they harm the good guys too. This leaves your digestive tract vulnerable. Probiotics can help to restore the population of bacteria in your digestive tract. Often we are sick from viruses like the common cold or influenza. In these cases, antibiotics are not useful to help us get better. If you find that you are often getting sick with viral infections, there is still a role that probiotics might play in restoring your health. Let’s take a look at how your digestive tract is connected to your immune system! Always Getting Sick Did you know that 70% of your immune system is in your digestive tract (18)? If you frequently get sick (even from viral infections), this may be a sign that you need probiotics. Even though the bacteria in your digestive tract are considered “good” - they’re only good if they stay in your digestive tract. Your body has several safety nets in place to make sure that the bacteria don’t travel into your body through the cells of your intestine. One of these safety nets is immune cells that recognize the good guys. Having a variety of good bacteria in your digestive tract means that your immune system is active and working hard. When you do get exposure to viral infections, your immune system is ready for the challenge. Having the right type of bacteria also helps to prevent your body from overreacting to infections. Are you familiar with the saying “too much of a good thing is bad?” If your immune system overreacts, your body will release a stress hormone called cortisol. Cortisol acts on many different areas of your body and causes inflammation. Restoring balance to your ecosystem by using probiotics has been shown to help control the immune response in some inflammatory diseases like rheumatoid arthritis and ulcerative colitis (8). Cortisol is also closely linked with mood and emotional stress. Keep reading to find out how probiotics can affect your emotional regulation! Photo by Tengyart on Unsplash Mood Swings Are you familiar with the feel-good hormones serotonin and dopamine? They help to regulate mood, sleep, food intake, and pain processing (3). Both of these chemical messengers are produced by the bacteria in your GI tract. Having an imbalance of bacteria means you won’t be producing the right amount of these messengers and that affects your mood. When you don’t have enough serotonin, your body will release cortisol. Too much cortisol leads to anxiety, depression, mood swings and irritability. This becomes a cycle because stress (from environment or emotions) stimulates more cortisol release, which worsens mood and irritability – yikes! Recent research has been looking at whether modifying your gut microflora using probiotics can help to improve mood-related symptoms and the results have been promising! Probiotics have been shown to reduce the stress-induced release of cortisol and also to improve anxiety and depression-related behavior (6) - Amazing! If you want more information on how your digestive health is related to your mood, check out my blog post, Mood Food: Cultivating Mental Health Via Gut Health. What ties in more closely to mental health than getting a good night’s sleep? Not only is serotonin responsible for regulating mood, but it also plays an important role in regulating our sleep cycle. Let’s discuss how your microbiome can help you get the sleep you need to feel your best. Difficulty Sleeping We’ve covered how serotonin can help with your mood, but it is also closely linked to sleep. Have you heard of tryptophan? It’s an amino acid found in high-protein foods, most famously in turkey. Tryptophan is digested by our intestinal bacteria to make serotonin. Serotonin is then used to make melatonin. Melatonin is a hormone that your brain produces in response to darkness and it helps to control your circadian rhythm - or your sleep/wake cycle (14). I have more information on sleep in my article: Do Pistachios Help You Sleep? Yes! Having more of the right kind of bacteria in your digestive tract (remember the good guys?) has been found to increase the amount of serotonin produced from the tryptophan you eat (3). More serotonin equals more melatonin and that means better sleep! Next, we’ll discuss the connection between your body weight and your digestive health. Let’s dive in! Weight Gain Did you know that obesity is an inflammatory condition? Remember the role of your intestinal microbiota in controlling inflammation? That means that even obesity and weight gain can be signs that you may need a probiotic supplement. Research has looked at the relationship between the type of bacteria found in the digestive tract of overweight and normal-weight study participants. Overweight individuals had more bacteria from the Firmicutes family and fewer bacteria from the Bacteroides family than the non-obese participants (8). The imbalance of bacteria leads to obese individuals releasing more energy from food and having a tendency to store more energy as fat. That means that overweight individuals with the wrong type of bacteria may eat less food than normal-weight individuals but still struggle to lose the weight (8). Overweight individuals are at greater risk for having metabolic syndrome. Metabolic syndrome describes conditions that occur together and increase your risk for heart disease, stroke, and type 2 diabetes (15). Having an imbalance of bacteria leads to elevated cortisol which contributes to metabolic syndrome (4). There are a number of factors that contribute to obesity. If you have been struggling to manage your weight, this might be a sign that you have an imbalance of bacteria. Probiotics could be a useful tool to help you on your journey to optimal health. As a digestive health dietitian, I love connecting the dots between your digestive health and your whole body! In the next section, we’re going to look at the role of probiotics on your skin. Photo by Viva Luna Studios on Unsplash Skin Conditions If you have skin conditions like acne, I’m sure you thought you’d tried EVERYTHING to improve it. But have you tried probiotics? Most people don’t realize that your gut health is even linked to your skin health. Your digestive tract isn’t the only place where bacteria live in your body. Your skin is also an important part of your microbiome. Recent research has been looking at the connection between the bacteria in your GI tract and the bacteria that live on your skin (14). One way that probiotics can help your skin is through your immune system. Remember how probiotics are important in regulating your immune response? Probiotics help to prevent your immune system from overreacting and causing inflammation. Research has been looking at the role of probiotics in helping with inflammatory skin conditions including (14): Acne Atopic dermatitis Rosacea Probiotics also help to improve your skin barrier and prevent dry irritated skin. If you are using acne treatments that cause dry skin, probiotics have been shown to increase compliance by improving this side effect (14). Probiotics are also used as a topical treatment for acne. The good bacteria in the probiotics compete with the acne-causing bacteria. The good bacteria also produce compounds that prevent the acne-producing bacteria from surviving (14). If you are taking antibiotics to treat acne, probiotics will help to restore your microbiome and prevent an imbalance in your body, including yeast infections (14). Yeast infections are another sign that you might benefit from probiotics. Yeast Infections Remember that ecosystem we were talking about? Your microbiome naturally includes yeast, but just like the bad bacteria, when you have too much yeast (also called fungus) your ecosystem is not balanced. Yeast infections include: Oral thrush Vaginal yeast infections Yeast infections on the skin It’s common to get yeast infections while taking antibiotics because your body will have fewer bacteria (good and bad) giving other organisms - like yeast - the opportunity to grow and thrive. Research shows that probiotics can help to stop the yeast from growing (17) and can be used to treat some yeast infections like thrush (16). Key Takeaways There is a role for probiotics to help with more than just digestive issues! Your GI tract is linked to your brain and immune system and this means that your digestive health can affect your mood, skin, sleep, and risk of developing chronic diseases like metabolic syndrome. Your path to recovery will likely involve more than just taking a probiotic supplement. With any ecosystem, you have to look at the whole picture. If you fertilize a plant but do not give it water - it will still not grow. BUT with the right environment including water, sun, AND fertilizer, your plant will do more than grow - it will thrive! If you think you might benefit from adding probiotics to your diet, I am ready to help! I can order specialized lab tests to get to the root cause of your inflammation and digestive issues. I can help you choose the right type of probiotics for your body and together we can make a plan to get you feeling better. Get started with an initial visit with me and let’s talk!

What do yogurt, sauerkraut, and kombucha all have in common? They’re all sources of living critters called probiotics…and they can boost your health! If you suffer from irritable bowel syndrome (IBS), you may be considering taking probiotics to help ease your symptoms. But what exactly are probiotics and do you need to take them? Keep reading to find out. In this blog post, I’ll be walking you through probiotics 101: what they are, what foods and drinks you can incorporate into your usual routine, and how these habits may boost your overall health. New around here? Welcome! I’m Marissa, digestive health registered dietitian. I help clients improve their health through personalized nutrition and lifestyle programs based on functional nutrition and a "food as medicine" approach. Let’s begin this article with a quick overview of what probiotics actually are. Photo by Tiard Schulz on Unsplash Introduction to probiotics So what are these little critters? Probiotics are living microorganisms that have health benefits when consumed. Some probiotics are bacteria, others are fungi. While we might think about bacteria as being “bad” or something to squash with a dose of Purell, not all bacteria cause disease. In fact, many probiotics have very important health benefits. In your digestive system, there is an entire ecosystem of living organisms that work with you. You may have heard the term “microbiome” and that’s exactly what we’re talking about here. When things are going well, these little members of your microbiome help to digest your food, nourish your digestive tract, send and receive messages to your brain and even bolster your immune system. …if your community is out of balance, the ripple effect can be substantial. Just like a thriving city needs trash collectors, school teachers, and a librarian, your microbiome needs the right balance of different kinds of probiotics. When things get out of whack, whether because of an illness, medication, or lifestyle habit, your microbiome can suffer and in turn, you may have a variety of symptoms. How do we cultivate our microbiome? It begins when we are born! Our microbiome We start building our microbiome at birth; and your microbiome will be different based on how you were born, what you were fed, and if you ever had medications, such as antibiotics (1). As adults, everything from our usual dietary choices, exposure to pathogens (the bad guys), our usual physical activity, stress levels, and our medications influence what kinds of organisms are in our microbiome. We can continue to cultivate a healthy microbiome by having a high-fiber diet (the bacteria digest the fiber) and by eating foods that contain probiotics; this is kind of like planting fresh seeds in your garden to keep the garden healthy and thriving. Where do we get probiotics? We can get probiotics from certain foods, drinks, and supplements (2, 3). Foods that contain probiotics include: ● Yogurt ● Kefir ● Kombucha ● Sauerkraut ● Fermented pickles ● Kimchi ● Tempeh Note: not all of these products have the live probiotics in them. Pasteurized products are heated to kill the kinds of bacteria that can cause illness, but the process kills all organisms, including healthy probiotics. An exception to that is yogurt made with pasteurized milk; the milk is free from potentially harmful bugs and is then inoculated with the probiotics that turn the milk into yogurt. In addition to incorporating food sources of probiotics, you can also consider taking supplements. Probiotic supplements There are many, many different kinds of probiotic supplements. If you think about probiotics like a zoo, there are elephants, alligators, and flamingos (not to mention, lions, tigers, and bears - oh my). Certain probiotic strains are known to help with specific health goals and conditions; anything from reducing anxiety to treating diarrhea (4, 5). Common categories of probiotics include: ● Lactobacillus ● Bifidobacterium ● Yeast ● Spore based In order to have the best possible outcome with your unique goals, you have to pick 1) the right kind 2) the right dose If we continue with our zoo analogy, your symptoms might not get better if you’re taking a dose of 12 elephants when what you actually need is 50 flamingos. As for my clients, many of them are seeking relief from their digestive symptoms. Let’s talk about those potential benefits now. Probiotics and their benefits for gut health Probiotics are beneficial microorganisms that can improve gut health. When included in the daily diet, probiotics play a key role in aiding digestion, alleviating symptoms related to gastrointestinal issues such as bloating and gas, and restoring balance to the microflora in the gut. Studies have also shown that probiotics provide an array of other health benefits including improved immunity, reduced risk for certain chronic illnesses, and better mental health. Through complex metabolic machinery powered by probiotic bacteria, toxins and pathogens can be neutralized while inflammation is downregulated–resulting in improved gastrointestinal health and a happy gut! Taking probiotics regularly is a simple and often effective way to stay healthy from the inside out. I recommend working with a registered dietitian to find the best-matched probiotics for your needs and goals. But I also recommend keeping in mind that probiotic supplements are not the only factor in the overall health of your microbiome. If your microbiome has gotten out of balance, it is important to get curious about why it happened so that you can address those root causes. Photo by Daily Nouri on Unsplash Do you need to take a probiotic supplement? Probiotic supplementation has become increasingly popular in recent years as more people seek to take proactive steps to improve their overall health and wellness (6). While there are certainly benefits associated with opting for daily probiotics, it is important to remember that a varied diet rich in plant-based foods will already contain natural probiotics that can help maintain your gut microbiome. Therefore, if you have no known digestive problems, probiotic supplementation may not be necessary. However, for those who are dealing with specific digestion issues, probiotic supplementation may provide considerable relief. If you are uncertain whether or not you need this additional support, consulting a healthcare professional is recommended. Are there any risks of taking probiotics? There may be certain risks related to taking probiotics. Supplements are not regulated, so one risk is that you choose a product that isn’t high quality. Perhaps there are not as many probiotics present or maybe the supplement is contaminated. It is important to be an informed consumer so that you’re able to pick a high-quality product. Additionally, probiotics can interact with medications; therefore it is best to discuss their use with your doctor prior to consuming any supplements. And lastly, there can be an acclimation period with taking probiotics. It is common to experience some gas and bloating as your digestive tract adjusts to the new community members, but this tends to settle out over time. Nevertheless, when consumed correctly probiotics have been found to offer numerous health advantages and thus can be beneficial for many individuals. How to choose a quality probiotic? Choosing a quality probiotic supplement requires doing some research and due diligence. Before buying, read the label carefully to determine the type of probiotic strain it contains as well as how many billions of CFUs (colony-forming units) it provides per daily serving. Consider looking for one that provides multiple strains, as different strains offer different benefits. Additionally, look for supplements in a delayed-release capsule form: these are designed to help protect beneficial bacteria traveling through the digestive system. Finally, be sure to follow the recommendations for proper storage. Most lactobacillus and bifido strains will require refrigeration while for example, spore based products won’t. Refrigerating helps ensure that the fragile strains of probiotics remain viable and active upon consumption. Key takeaways Probiotics are beneficial bacteria that help keep your gut healthy. They work by crowding out bad bacteria, improving the barrier function of the intestine, reducing inflammation, and enhancing immunity. You can get probiotics from fermented foods such as yogurt, sauerkraut, kimchi, and kefir. You can also take a probiotic supplement. When choosing a probiotic supplement, look for one that contains multiple strains of live bacteria, has been refrigerated (if needed) to ensure potency, and is third-party tested for quality. If you’re ready to have an expert guide to optimizing your gut health and digestion, I'm ready to help! You can use this link to schedule an intial visit; we’ll discuss your health history and goals and explore how I can help you finally feel better.

Nutrition Therapy Your Journey to Digestive Wellness Starts Here Personalized Functional Nutrition Counseling Functional Nutrition considers the whole person, the root cause of symptoms, and how the body systems are interrelated and honors FOODS AS MEDICINE and the BODY'S ABILITY TO HEAL. Discovey session Nutrition Assessment Personalized Health Program Personalized Program Review Results Service Review Results Nutritional Support Services Support Health history review services Initial Functional Nutrition Assessment ​ 60- 90 min. in depth Nutrition Assessment Provide initial nutrition therapy, functional lab testing & lifestyle program recommendation ​ ​ $245 In depth nutrition assesment services Personalized Program Recommendations ​ Order lab tests: Advanced Stool Food Sensitivity Micro Nutrient Lab kits mailed to you Complete tests Mail back to lab ​ ​Fees Vary Health review labs services Review Labs / Utilize Results ​ Personalize your plan Implement the plan ​Nutrition therapy Lifestyle Supplement recommendations ​ ​ Fees Vary Professional 6 week health support service Support Package ​ 6 weeks to 3 months to start Consults tailored to your needs Messa ging support between visits Access to professional supplements and retesting as needed ​ ​ ​Fees Vary​ All CONSULTS are completed virtually ​by Phone or Video Chat in the Client Portal Retest if needed prompt Retesting if needed I would not have been able to begin to figure out my IBS triggers without Marissa. Not only does she use an established protocol, but she also uses her years of experience to guide you through the process. She took the second-guessing out of the equation. Marissa helped me keep the focus on how much I have improved and helped me easily find the supplements I needed that would not trigger my IBS. I had all these benefits, and I did not have to start by eating only broth and sauerkraut as some programs start out. We're a GOOD Match If ... You're motivated, desire to change, and are ready to invest in your health. You're ready to quit chasing symptoms. You want a Nutritional Lifestyle Plan tailored to you. You're ready to do the work and make the necessary lifestyle and food changes to heal your body. You believe food can be used as medicine. You can cook or are willing to learn. You're willing to try new foods. You're ready to feel better than you have in years. GET STARTED NOW I am no longer guessing about how to feel better. I have control over my health and am free of constant bathroom awareness and worry of food roulette! Marissa is so knowledgeable, cheerful, and positive. Working with her has been amazing; I highly recommend her! testimonial quote 2 We're NOT a Good Match If ... You want a quick fix or "magic pill" to make your symptoms go away. You don't care to know your health concerns' underlying root causes. You're easily frustrated and/or tend to give up too quickly. (I can't do the work for you.) You're unwilling to cook, learn to cook, or don't have a friend or family member to help you with your dietary changes. You're not willing to make necessary diet and lifestyle changes. You're unwilling to keep a food diary for a few weeks. Your body needs to heal from the inside out. It takes time. You didn't get to where you are now overnight. With our support and guidance we're here to support you. What Makes Us Different? YOU'RE NOT JUST ANOTHER PATIENT plus-icon NEVER GET CHARGED BY THE HOUR OR VISIT plus-icon YOUR PROGRAM IS 100% PERSONALIZED TO YOU plus-icon YOU'LL SAVE TIME, MONEY AND ENERGY plus-icon A COMPREHENSIVE APPROACH WITH THE MOST IMPORTANT TESTING INCLUDED plus-icon A TRIED AND TRUE SYSTEMATIC APPROACH WITH UNLIMITED SUPPORT plus-icon You CAN Trust Us !!! Personalized, Compassionate Care helps to meet your needs and goals for BETTER HEALTH. DOUBLE the Convenience DOUBLE the Options Connect with Us number-one-icon HAVE A QUESTION? Check the FAQ section. Still have a question? Let's CHAT. CHAT NOW number-two-icon SCHEDULE A CONSULT You're ready to start feeling better and get to the "ROOT CAUSE" of your symptoms. Book an initial consult with us. BOOK NOW calander icon

My Favorites Marissa's FAVs enjoy ! My Helpful links, tips, and ideas to help you on your path to Better Health. Heading 6 select ... Category arrow&v pink-shopping-cart Store-coupon shopping-bag-icon Shop LMNT Electrolytes FREE Sample Pack with first order. Electrolyte Drinks Shop Perfect Amino Essential Amino Acids Shop Joi WHOLISTICWORKS | 10% OFF Plant Based Milk Concentrates Shop ImAware MARISSAMEKELBURG10 | 15% OFF At Home Lab Testing Shop Modify Health Premade Low FODMAP & Mediterranean Meals Shop Hungryroot First Order | $50 OFF Personalized Grocery Service - Making it easy to SHOP, COOK, and LOVE healthy food. Shop Golden Ratio Coffee Shop Fullscript Supplements Shop doTERRA High Quality Essential Oils and Products Shop FODY Low FODMAP Foods These are Affiliate Links , which means we may earn a commission if you purchase through a link. By using these affiliate links, you are helping to support our business, and we genuinely appreciate your support. We only recommend products and services that we have personally used or thoroughly researched. We do not accept free products or services in exchange for sharing the links. You can trust that our opinions are unbiased and not influenced by any company, product, or service. If you have any questions about our affiliate links or our recommendations, please don't hesitate to contact us at support@wholisticworks.com. DOUBLE the Convenience DOUBLE the Options Connect with Us HAVE A QUESTION? Check the FAQ section. Still have a question? Let's CHAT. CHAT NOW SCHEDULE A CONSULT You want to feel better and get to the "ROOT CAUSE" of your symptoms. Book an initial consult with us. BOOK NOW calender icon I am walking away with confidence and an understanding of what causes my symptoms, how much of my trigger foods I can or cannot handle, and what to expect if I eat something I am sensitive to. I can manage this on my own and feel SO MUCH BETTER! quotes-icon

TeleHealth or TeleMedicine A HIPAA-compliant video call or phone call that allows practitioners to meet with their clients virtually. Why TeleHealth? Calls from the comfort of your own home. Convenience Flexibility One less appointment to travel to (especially in inclement weather or not feeling well) Access to a Digestive Health Dietitian - even in remote areas. Ability to provide top-quality care to our clients - no matter where they are. WORK WITH US What is a Client Portal ? A secure communication platform for our clients to create an account to contact us, schedule appointments, share important documents, and forms with us. Practice Better - Our Client Portal arrow-icon Platform ease of use. Easily fill out and submit forms. Upload documents Receive handouts Host video consults Works on any device- computer, phone, or tablet 1 easy step to join a video call - log into your Practice Better account at your scheduled time - That’s it! You're in. Reliable and secure Ensures that all consultations are conducted with the utmost privacy and confidentiality. GET STARTED RATES & INSURANCE Marissa is reliable and responsive. She always schedules appointments around your availability- even across time changes. She is always available to respond quickly to questions between appointments. Marissa is enthusiastic and encouraging. She is genuinely invested in helping you achieve your goals. quotes-icon DOUBLE the Convenience DOUBLE the Options Connect with Us number-one-icon HAVE A QUESTION? Check the FAQ section. Still have a question? Let's CHAT. CHAT NOW number-two-icon SCHEDULE A CONSULT You are ready to get to the "ROOT CAUSE" of your symptoms. Book an initial consult with us. BOOK NOW calander-icon