The Problems with Antibiotics: More Fallout from Killing Your Flora

A new study found that pediatricians are over-prescribing broad spectrum antibiotics (which target both gram-negative and gram-positive bacteria, also known as most bacteria) at an increasing rate. 21% of all pediatric visits ended with a prescription for antibiotics, 50% of which were broad spectrum. For 23% of those visits ending in antibiotics (which accounted for over 10 million visits in total), they were prescribed for conditions that don’t even respond to antibiotics, like asthma, viral infections, flu, allergies, and bronchitis. The bulk of the antibiotics prescribed in these unwarranted situations were broad spectrum, and the bulk of the patients in these situations were younger than not.

Ugh. Antibiotics clearly have therapeutic merit – a statement some would debate, I’m sure – but I think everyone would agree that prescribing broad spectrum antibiotics for non-responsive conditions to young kids is unwise.

Anyway, last week we explored the negative ramifications of antibiotics overuse, particularly on a patient’s bodyweight. The disruption of gut flora composition and diversity by antibiotic therapy has been shown to affect metabolism and body weight in both animals and humans, and the relationship appears to be causal. Today, I’ll discuss a few other potential complications related to antibiotics. I want to stress that much of this research remains exploratory and quite young  – many of the supporting studies are either in animals or in vitro situations (test tubes and such rather than live subjects) – but the hypotheses are plausible, and supporting epidemiology exists. Besides, given the chance that our gut flora may never fully recover from antibiotic therapy, it’s important to be aware of any potential fallout.

Direct and indirect effects on gut flora and host (that’s you).

A direct effect on gut flora by antibiotics is obvious: they are killed. But this can have numerous downstream effects, even on bacterial species that the antibiotics don’t target directly.

You know how I wrote that antibiotics alter makeup of bacteria in the gut last week? It turns out that even though the special ratios and diversity change, total biomass (total number of gut flora) often remains the same. So, if antibiotics eradicate one species from the gut, other species will quickly move to claim the vacancy and increase their population. Remember: even though these are microscopic organisms, they still occupy physical space, and space in the gut is limited. If one opportunistic species takes advantage of a vacancy and grows its sphere of influence (as C. diff often does following a round of antibiotics), that’s less room for another species.

Much is made of the symbiotic relationship between host and gut flora, but gut flora themselves often enjoy robust, vital relationships with other species of gut flora. One species may break down primary food components into secondary metabolites. A second species which cannot utilize primary food components must rely on the secondary metabolites from the first species. The secondary metabolites are broken down into waste products, which in turn are utilized for energy by other species. It’s a cycle, and if even one participant is missing (maybe from antibiotics), toxic metabolites can buildup and many of the flora that survived the initial onslaught will lack nutrients. Check out this cool visual of the cycle.

There’s even some (extremely limited thus far) evidence that antibiotics are linked to certain diseases and conditions, including some types of colitis, vaginal candidiasis, diarrhea, eczema, cholera, autism, and asthma.

Impaired immune function is another potential ramification. I’ve discussed the importance of the gut flora in maintaining proper immune function before, but here’s a table showing the effects of specific antibiotics courses on specific aspects of the immune system.

Loss of helpful gut bacterial metabolites.

Gut flora don’t really care about you. They’re just trying to survive, man, and survival requires sustenance. Nutrients. Food. Luckily for us, when bacteria break down some of the food we eat, they produce short chain fatty acids. Some species, like the gorilla with its cavernous gut and tendency to perpetually eat leafy fibrous things, rely almost entirely on the short chain fatty acids (SCFA) produced by gut flora. They chew and swallow ten pound Big Ass raw salads daily and derive most of their caloric energy from SCFA. Yep, those gorillas are ultimately on a high-fat diet. Anyway, we don’t house enough gut flora to live off of short chain fatty acids, but we can derive a lot of benefits from the SCFA our relatively meager flora produce.

I’ve written about prebiotics and butyric acid, or butyrate, one of the most important SCFAs. When certain types of gut flora consume certain prebiotic fibers (Melissa has a nice table detailing the butyrate production in response to various fibers), they make butyrate, which the colon uses for energy and which seems to inhibit colon tumors from forming (PDF). Additional benefits of butyrate include increased insulin sensitivity and mitochondrial function. Without the gut flora necessary to ferment fiber into butyrate, we’d be getting shortchanged (and being unable to break down the things we eat is no fun, either).

A common way to measure how many SCFAs an animal is producing is to look at the poop. If something is making a lot of SCFA, it’ll show up there. And sure enough, feces from mice given antibiotics contain fewer SCFA and related metabolites than feces from untreated mice. Oligosaccharides – what the flora ferment and turn into SCFA – appear more frequently in the feces of the treated mice, indicating that antibiotics disrupted carbohydrate fermentation (and, presumably, floral populations).

Interruption of gut bacteria signaling.

A fun thing about biology is that everything’s a multi-tasker. There are multiple levels to nearly every physiological process. For instance, reactive oxygen species are often thought of as wholly negative, but they also play important roles in signaling and maintaining cellular homeostasis. Same with the bacteria in our guts. They help digest food, they comprise the bulk of our immune systems, they produce helpful gut bacterial metabolites like butyric acid – all (relatively) well-known responsibilities – but they also act as important signaling agents in our body. More specifically, specific species of bacteria relay specific signals.

Here’s one example: a species called Saccharomyces boulardii (a common component of probiotic supplements) secretes a compound that blocks an inhibitor that normally causes a certain inflammatory cytokine to release; the result is lower inflammation. Luckily, S. boulardii isn’t targeted by antibiotics. But what happens if an important signaling bacterium is targeted by antibiotics?

Here’s an example of that: a single type of gut flora called segmented filamentous bacterium tells the body to start making CD4 T-helper cells, which in turn signal the creation of the inflammatory cytokines IL-17 and IL-22, which are crucial for certain immune responses. Those same segmented filamentous bacteria are fairly sensitive to antibiotics.

Sound confusing? It is. And those are just two examples of gut flora which act as signalers for very specific situations. One is resistant, one is not. There are undoubtedly hundreds more – most of which we can’t even culture, closely examine, nor fully understand – and they’re not all going to be resistant to antibiotics.

As you can see, the gut is complicated. We humans have evolved with the assumption that in return for hosting hundreds of species of gut flora, our guests would provide certain services. We’ve become accustomed to this arrangement. Indeed, the proper function of the human body depends on various strains of bacteria talking to each other, talking to the host cells, inducing inflammation when it’s needed, inhibiting inflammation when it’s not, (by)producing metabolites that other cells consume as energy, and helping regulate our immunity. The complexity means that a big blundering tool designed to take out a bunch of bacteria could be counterproductive – and there’s evidence that this is the case.

I’m not saying we swear off antibiotics. In fact, I’m not giving any medical advice at all. I’m just saying that caution should be exercised, that we need to weigh the known with the unforeseen and understand that there may be ramifications to antibiotics abuse, and perhaps even to normal use.

Tomorrow, I’ll discuss some possible solutions for the antibiotics problems. Stay tuned.

TAGS:  immune health

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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82 thoughts on “The Problems with Antibiotics: More Fallout from Killing Your Flora”

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  1. “They chew and swallow ten pound Big Ass raw salads daily and derive most of their caloric energy from SCFA. Yep, those gorillas are ultimately on a high-fat diet.”

    This really caught my eye! Tell this to vegans….

    1. “As you can see, the gut is complicated.”

      Uh… yeup.

      I think we need to rethink some of the antibiotics that are out there. I think its safe to say that ALL acne related antibiotics have absolutely no place on the market. I have experience myself and with helping others with acne.

      Accutane puts people into depression. Hundreds commit suicide after taking accutane. A healthy lifestyle will prevent pimples and whiteheads from popping up. Seriously folks.

      And then there is cholesterol lowering drugs…

      Some may have their place but many do nothing except cause a ton of harm.

      I’ll just do what I can…

      1. I entirely agree that Accutane has a lot of issues but just wanted to clairfy that it isn’t an antibiotic.

        1. I agree with you 100% Toad. I was on doxycycline regimen prescribed for my acne as a teen. After 6 months of unpleasant living, I nixed it altogether, but during that time, I completely changed the dynamic of my gut. Foods I normally tolerated fine weren’t sitting well with me. I never put two and two together, but it was shortly thereafter that I was diagnosed with IBS. A coincidence I do not believe to be…

    2. OMG, you know what. In an article from last year (when I first started eating primally) I mentioned that salad makes me gain weight and that I thought this is quite odd.

      I can chow down 5 strips of bacon, 2 eggs and 1 slice of liver sausage heated up in lard and not gain an ounce.
      Soon as I pick up the green stuff I’m packing on the weight…lol.

  2. “So, if antibiotics eradicate one species from the gut, other species will quickly move to claim the vacancy and increase their population.”

    This explains why me and my kids always get yeast infections after a course of antibiotics. Ugh!

    1. Further to my comment, since going Primal and having minimal sugar in our diets we very rarely now have an outbreak of thrush (yeast infection).

      In addition, we aren’t sick as often as before going Primal which means fewer trips to the doctor and fewer chances of being prescribed antibiotics. 🙂

      1. Oh, my. Sounds like you were in really sad shape! Living on Ramen? I remember being sick a lot when I lived on noodles. Ah, the good old infection days…

        Glad to hear you’re getting it figured out! I had something like ringworm growing on my leg and cutting sugar killed it. We can win this.

      2. That happened with my grand daughter. It took 2 weeks to get rid of the yeast infection. I’ve been trying to persuade my daughter to move toward primal. especially, think, before you let them prescribe antibiotics. which they will do for everything. I find it maddening.

  3. Gut flora are so astoundingly diverse, they are like animals of the rainforest — new varieties are constantly being discovered, and we probably don’t even understand half of what they do for us.

    The more I study them, the more antibiotics seem a drastic last-ditch defense. Much like chemotherapy or a neutron bomb, they wipe out good organisms as well as bad, leaving a shattered ecosystem where civilization must start all over again.

    I would have to be in seriously bad condition to consider using antibiotics, chemotherapy, or a neutron bomb.

    1. Tim,

      Buying a sledehammer tomorrow…been going to your website almost every day for the last few weeks studying…any last words of encouragment before my OCD personality take over before I become a pretend coal shoveler in my living room every day?

      1. Bubbe, that’s awesome! Sledgehammers offer strength training, aerobic training, games, or even something like a massage. They’re an underrated part of our stone-age legacy.

        My web site only scratches the surface. You will discover all sorts of things on your own just by playing around. I would love to hear how it goes for you.

        Have fun stoking the furnace!

  4. intestinal bacteria are like our inner plankton.

    People w/a diagnosis of lyme must have a rough time of it, as long-term antibiotic use is the treatment.

    1. I am one week into six weeks of treatment for Lyme with Doxycycline. Hopefully, that will nuke it early and no more will be needed. I wish I didn’t have to do this, but I need to get it before it gets me!

  5. And don’t forget the antibacterial hand soap. It strips all the bacteria off your hands, including the friendly ones. That leaves room for growth of the unfriendlies. SO don’t use antibacterial soaps. Just another link in the chain of causes of antibiotic resistant organisms.

    1. Goodness, I hear you…Before I went Primal – during the chicken flu scare – I took to using those hand sanitisers. My hands became so dry they became cracked, and bleeding. It was horrible.

    2. I once had a bad case of athletes foot. I diligently washed and disinfected and all those other microbe-killing strategies. I kept it under control, but it never went completely away.

      Finally, I tried simply rinsing with water and keeping my feet as dry and out in the open as possible. The athletes foot went completely away.

  6. This post hits me at the right time. My daughter was just born 3 months ago in an extremely fast labor. It took a little over an hour for her to pop out after my wife’s water broke. My daughter kept coughing up clear fluid and had trouble keeping mild down after nursing. Mind you this was merely within the first 48 hours after birth. My wife saw here cough up some fluid that was green-ish. The docs freaked out and stuck her in the NICU on broad spectrum antibiotics.

    Of course this freaked me out but I went home and looked up what was happening on the interwebs for more information. Lo and behold this is a common occurance with c-sections and quick births and clears up in 48-72 hours after birth. The docs had no idea that this is what was happening. So $2k later and my daughter pumped up with antibiotics here we are.

    I am still agitated because I could clearly see these docs looking to the nurses for approval every time they told me something. Blows my mind and makes it so I don’t trust what these overeducated individuals tell me.

    1. Oh yeah I read this recently about c-sections, that since the babies dont get pushed through the vaginal canal, they dont get a lot of the fluid in their lungs squeezed out. I could see that being a similar effect in fast labors, if theyre not compressed for long enough.

    2. Newborns have sterile guts so she didn’t lose too much. Keep breastfeeding, and try a drop of coconut water kefir on the nipple at the start of each feed.

      1. Correction: Mike and KK are right about initial innoculation. C-section babies’ guts are populated by airborne bacteria, hence their higher risk for life-long health problems. BF and coconut kefir is still the best antidote in your case!

        1. I had to take ABX when I was pregnant as I had UTI. I so wish I could have gotten around it somehow but at that time, that seemed like the best option. I hope my 14 mo, whom I birthed naturally and has been breast-fed since birth, has a good gut flora.

      2. I realize that her gut is still pristine at that point. My issue is the ignorance of the medical community and the quick draw to the antibiotics. Not to mention the impact on my wallet.

  7. I am curious about where did this gut bacteria come from in the first place? From breast milk or raw foods? That would give insight to replenishing the gut bacteria after a cycle of antibiotics. Personally, after walking in to the doctors ready to fall over several times this year, then taking antibiotics and feeling much better within 12-24 hours, I am a big fan of modern medicine and am resigned to taking antibiotics regularly over the next five years or so (I have a child in preschool and a baby and we have been a lot more sick the more daycare and schooling our oldest gets) so I am interested in keeping a healthy flora and fauna to leave no room for bad bacteria and how to replenish after taking antibiotics.

    Thanks Mark! This is an interesting series of blog posts!

    1. You are born with it. The healthier the mom is the better/ more flourishing your gut flora will be. Read into the GAPS diet about it, fascinating information; you may change your mind about *wanting* to be on antibiotics. Remember they literally mean “against life”. Find the problem/cause instead of treating just the symptom.

      1. The GAPS diet is a very valuable thing. Very close, if not identical to Primal. Dr Campbell-McBride has put together a lot of analysis regarding the increase in autism since antibiotics came on to the scene – if you read the book it is frightening how bad all of the conventional drugs are in relation to our gut flora – even the birth control pill upsets the gut flora. She also points out that a lot of other mental illness can be ‘cured’ by a change in diet where drugs are not guaranteed to make a difference and are addictive.

        GAPS is Primal with a lot of fermented products included – yoghurt, kefir, sauerkraut etc

        My autistic boy is on the GAPS diet as the rest of the family are Primal (so it is easy to maintain). Since we made the change in September there has been a lot more communication and he has become less severe in the degree of autism. It could take time, but the aim is to ‘cure’ him as Dr C-McB cured her son. He will have to stay Primal for life though (no problem there!)

    2. The gut is sterile before birth. Rather disgustingly you get ‘innoculated’ on your way out.

      1. Which is why the healthier the mom, the healthier the baby. Internally speaking 🙂

      2. I’m not sure about that part. It just doesn’t make sense to me.

      3. That’s right, your first gut bacteria came from a vagina if that’s the way you came out 🙂

        On that note: IV penicillin during labor is rec’d for women who test positive for Group B Strep in the 3rd trimester of pregnancy. This is 10-30% of women. Though penicillin is not broad spectrum, I wonder how this affects babies’ initial inoculation during birth.

        Anyway, this whole topic is absolutely FASCINATING.

    3. I was taught we pick it from our environment and from passing chew toys around as kids. Is this wrong?

    4. Part of it comes from the mother’s skin when nursing. Breastfeeding is the original probiotic inoculation.

  8. Personally my husband and I have raised an entire brood of very healthy children. We eat natural (mostly homegrown) foods, play hard, lots of fresh air, and love life in general. No doctor visits for these guys, much less antibiotics. We have avoided daycares, nurseries, and public schools for 24 years and have NO regrets. Babies were born at home, too. The older ones are well on their way to raising their children the same way in the same small town. Don’t miss what they never had, and a good life makes up for a small budget. Highly recommended!!

    1. You. Are. Awesome. I am so greatful for people who think outside the box. Thank you!! Like, and double like.

    2. Case closed. Exactly how I envisioned on raising my offspring, when time comes. Even converted my SO from his hard-core, 36-year-streak of processed food diet since birth. Took him less than 6 months to completely embrace it and touting it to his (still) extremely skeptical workmates.

  9. There is one class of ‘antibiotics’ that has a host of serious adverse reactions associated with it – Fluroquinolones – a group of drugs that ‘unwind dna’. They are supposed to be used as a last resort option.

    I was prescribed one by mistake for a training injury Nov 2010 – prior I was a primal/paleo high intensity training guy with no health problems. It destroyed my life and crushed me for almost a year. I discovered thousands of others with the same experience, some formerly very fit like me, some are physically disabled by them. A year on and I still cannot return to the active life I had before. Hopefully in a few years it will return.

    This organisation is involved in advocacy and research to help make others aware:

    Prior to this I felt invincible and have learnt that a simple antibiotic can destroy an extremely fit body, sometimes long term.

  10. Following a stay in hospital in 2004 where I was hooked up to an antibiotic drip for 2 weeks as I had reactive arthritis in the knee, I now have Candida overgrowth which is making my life hell. I feel my good bacteria is virtually killed off for good. As a result, I have psoriasis and I’m very angry at the medical consultants who pumped this poison into my system. Over time my condition can lead to cancer. I aim to do all I can to expose the truth.


  11. Although the focus is on prescription antibiotics, what about a natural antibiotic like oregano oil? How broad spectrum is it and are the effects on gut flora similar to prescription meds?

    1. I would like to know whether natural antibiotics such as oil of oregano or olive leaf extract cause similar damage as well.

  12. I really dont think you need anything more than a symptom checker book and appropriate pill list to be a family doctor lol

  13. Just a reminder that antibiotics can save lives. I contracted hemolytic uremic syndrome when I was 18 months old. I am alive now because of them. Of course, I have had yeast issues and battled my weight my whole life, but I’d rather figure out a way to repopulate my gut with good bacteria than be dead. I now know that if I eat any kind of sugar, fruit included, my yeast flares up. I’m now incorporating raw, fermented food and bone broths to repopulate my gut. Of course, if I hadn’t weaned myself at 15 months, I would have gotten pre and pro-biotics from nursing, but what can you do?

  14. First post here on MDA after regular reading for about 3 years.

    Two points to disclose before I continue. One, I am astounded on a daily basis how Mark continues to produce articles of such a high standard and substance. Thanks Mark. Two, I work as a doctor in the NHS in the UK and felt as though I had to voice my opinion on this article and some of its comments.

    All decisions in medicine (and may be in life) are made on a risk to benefit ratio. The prescription for intravenous amoxicillin and clarithromycin I wrote this morning does carry the risk of drastically and (potentially) permanently disrupting a patient’s gut flora and also opens the door for a very slim chance of C. difficile infection. However, I feel that the risk of this occurring is substantially outweighed by the benefits of these agents killing the pathogenic organism causing said patient’s severe pneumonia, which has its own good chance of killing said patient.

    We at MDA are a lucky bunch. By reading such a blog I think it’s safe to assume the average MDA reader is more willing to take responsibility for their own health than the average person, and therefore is less likely to end up in hospital due to severe chronic or even acute disease. (Which is excellent and I wish more people did this). But I don’t want people to lose perspective and focus only on the yet unsubstantiated negatives of antibiotics from this privileged viewpoint.

    When a child is in shock from meningitis a single dose of antibiotics within the 1st hour of diagnosis may save that child’s life before getting to hospital. I appreciate Mark was highlighting the over-prescription of antibiotics in non-bacterial diseases in paediatric cases, but clinicians would much rather take the risk of prescribing a medicine which may be inappropriate in that scenario (and cause a foreseeable side effect) against the benefit of curing a potentially severe illness. This is the case more so in children, where clinical condition can change drastically in a comparatively small time frame to adults, and may be a factor in antibiotic over-prescription in children in America.

    The role of the health professional is to fully inform their patient of all potential risks and benefits of a proposed treatment and allow them to make their own informed decision. Much as Mark’s penultimate paragraph in this article demonstrates.

    Many of you who have received antibiotics may counter that you have never been warned of the potential disruption to your gut flora that antibiotics may cause. Many, many more of you could say that you haven’t been warned that they may cause you to gain weight, become more susceptible to certain other infections or to suffer from asthma. And the reason for you being able to say this is thanks to people like Mark who have their finger on the pulse (couldn’t help myself) with the most cutting edge (however yet fully researched) information out there. Many doctors may have not read the articles cited here and may take notice until large scale studies are performed to confirm the proposed findings. In the end, the prescription of antibiotics will always been done with a patient’s best interests at heart with the information and knowledge available to the prescriber at that time.

    I hope I have been able to shed some light into the mind of a doctor prescribing antibiotics.

    Time to turn off the electronics, retire to the cave and rest up for lifting heavy stuff tomorrow morning. Thanks again Mark.

    Grok on!

    Adi Kumar

    1. antibiotics save lives, as an emergency measure to combat infection.

      But used to dampen the signs of underlying inflammation, like acne, or to appease a parent about their kids’ cough, is awful.

      Last time I took a kid to the doctor about a cough, they didn’t offer antibiotics…they offered an inhaler!! No underlying probs, no asthma history…WTF?!

    2. Hi Adi
      I wish the Dr’s I and dozens of others I have spoken with and met who have been seriously harmed by fluroquinolones, had considered the risk ratio before giving them. I and a number of others never had infections. And our lives have been savagely affected. I went from 180kg deadlift, sub 20min 5k and parkour, to being unable to work for 5 months, losing 16kg of muscle mass, being unable to walk and whole body peripheral neuropathy. While this is considered ‘rare’ on investigation its isn’t. The problem is the reporting system. The FDA estimates they receive 10% of the actual figures of adverse drug reactions. The UK MHRA ask you what yr Dr thinks when you contact them and of course one’s Dr says they don’t know anything about FQ ADR’s. I saw a dozen ‘specialists, all of whom knew less about the drugs than I did from online investigation (A Prof who teaches future pharmacologists was not even aware of the latest research on them, I had to provide it for him!?). I spent almost £5000 in my search for what the drug had done to me. I talk every week with new people whose lives have been wrecked by this class of antibiotic.

    3. I agree with most of what you say here. I definitely believe that doctors are trying to help their patients but due to time constraints and poor information this is not always what ends up happening.
      I just wish more medical doctors were up to date with the most current information. It would be great if more of them took to looking at different types or as you say cutting edge (non drug) treatments. I know that they all have to do continuing education but when the seminars are sponsored by pharmaceutical companies you have to question what kind of is really being presented.

  15. Somebody should go around collecting poop from indigenous folk who’ve not been exposed to antibiotics or modern life in general. Breed up what’s in there and let the inoculations begin. (Not sure what to do about parasites, though.) You read it here first.

  16. Adi,

    I’m not sure how you distribute drugs in the NHS system. But in America they are given much more readily if a parent or person presents even remotely with an infection symptom.

    Emergency medicine is very effective, but it gets used more than that.

    1. This is true. I work in a hospital and the usual questions are not if, but [i]which[/i] antibiotics the pt. is taking. Granted, we’re talking critical care. But my facebook people constantly talk about taking antibiotics. It’s very silly. There need to be stricter criteria.

  17. “The role of the health professional is to fully inform their patient of all potential risks and benefits of a proposed treatment and allow them to make their own informed decision”.

    Many years ago I was going to a GP who took care of our entire family – including my ex’s family as well. We all thought very highly of him. After undergoing a fairly mild procedure that supposedly usually didn’t produce any problems (if there is such a procedure), I ended up having severe pain and other complications.

    I asked the GP why wasn’t I told that these complications might arise and what I could actually expect instead of being told to believe everything would be “OK”. He told me patients were not told any more than they needed to know so as NOT TO PLANT the SUGGESTION of impending problems!

  18. Great series of posts. Thanks, Mark.

    I hope tomorrow’s post, or one in the future, will provide a concise list of what to do in the event someone chooses to or has to take some antibiotics.

    Today I just had a round prescribed for me. I won’t bore you with the details why, but I’ve decided to take it: It’s a a cephalosporin antibiotic, 30 x 500mg

    It would be super helpful to have a short list of the most helpful things I can do during and after taking this round to ward off the adverse affects detailed in your posts.

    Many thanks.

    1. You can take a good probiotic while you are taking the antibiotic. Take it a couple of hours away from the antibiotic or it will just be wiped out immediately by the drugs. Also yogurt, sauerkraut, fermented foods in general. After the antibiotics, really make sure you are taking the probiotics and lots of different fermented foods. It may take several months to repopulate your intestines with a diverse array of gut flora. You will probably never reconstitute your gut with the same population as you have before the antibiotics.

      Also — look for Saccharomyces boulardii separately — it is not a bacteria, it is a yeast, but a good one. Jarrow makes a Saccharomyces boulardii supplement. Some recommend that you take the Saccharomyces boulardii for three weeks on and three weeks off, so you avoid developing a sensitivity to it.

  19. Interesting post Mark, and surely there is a lot wrong with the way antibiotics are prescribed and taken (I saw an interesting article on the BBC site showing people failed to take the full course they were prescribed, saving some for the next time they had the flu – even though this is totally ineffective against a virus!).

    Certainly if you’ve had to take antibiotics for a reason (I took them last for an E-coli incident)then you should think carefully about the state of your gut flora afterwards…

  20. Great overview of the complex biome that exists in our guts. Scientists don’t yet know all the species present, but it’s in the hundreds, and the interconnectedness of it all is really important.

    Kids tend to get middle ear infections easily, and then doctors prescribe broad-spectrum antibiotics at the drop of a hat. I was in this loop until I got this tip from my sis (who lives in London) – when they’re little, kids’ eustacian tubes don’t drain well when they’re lying down. If you give him/her a decongestant at night before bed, you prevent the mucus (from a cold) from pooling in their eustachian tubes and providing a breeding ground for bacteria. They are much less likely to have a cold turn into an ear infection. And then once they grow up a bit, the mucus drains better naturally and you can drop the decongestant before bed when they’ve got a cold.

  21. Mark, thank you so much for all this info! I can’t wait for tomorrow’s post on solutions! The bit with kids being prescribed antibiotics for viruses and things that dont even respond to antibiotics is outrageous. No wonder kids have such weak immune systems nowadays! Antibiotics are called for very occasionally for a very serious illness, but if used systematically they just lead to a giant viscious circle of weak immune system, illness & more antibiotics…as well as all the nasty side effects. urgh.

  22. One is forced to wonder what percentage of the prescriptions of antibiotics are due to some sort of demand from the customers who expect one. Even with lots of education and good intentions, doctors are still human and as such respond to the same incentives other human beings are subject to.

    “Ask your doctor about X!” is plastered over the airwaves several dozen times per day, so it’s not surprising that people would insist on pills they know next to nothing about and docs would cave in to pressure to “Do Something!” without fully considering how much straw they are heaping on the back of that camel.

  23. the vicious cycle begins with children being born to less-than healthy moms…and either breastfeeding ends too soon, or the baby gets a bottle from day 1. No natural immunity factors in formula! then the horrible diet (SAD) that people get used to eating and its no wonder we are so sick in the first place. antibiotics are truly just one more insult to the already injured!

  24. Yeah we get it, they are horrific. However I have yet to hear from Mark how we should be treating our raging, painful, quick spreading infections. As you say homeopathy is out, what should we turn to?

  25. This is classic. For the most part there is no longer an art to medicine, it’s all about writing prescriptions. This all comes down to time and money for medical establishments.

  26. Butyrex, which is basically butyric acid in capsule form, was very helpful in healing my gut before I found out about Paleo. I still take a couple of capsules a day, just in case, along with probiotics and digestive enzymes from Jigsaw Health. I’m not sure if I need them anymore now that I know what to eat. If you want to accelerate healing I highly recommend them. And raw sauerkraut, kefir, kombucha, and other fermented foods.

  27. This is a very interesting thread. Way back when my oldest (15) was an infant, my then-wife and I would take him to the pediatritian whenever he became sick, which wasn’t often. This was WAY before the Primal/Paleo diets came out (funny…I guess it was actually WAY after lol) Anyway, every.single.time we say this particualr Dr, we left with a prescription of some type. I knew in my gut that this wasn’t right, and we eventually stopped going to her shortly after she prescribed antibiotics for the flu, which everyone knows is a virus and therefore HAS NO CURE. The final straw was when we took him in because he bed-wetted and she wanted to prescibe a drug that would keep his body from creating urine for up to 12 hours. Insane! “So basically you are suggesting that we simply deal with the bed wetting by shutting his kidneys down for 12 hours?” “Are you ****ing insane??” That was my last conversation with that particular Dr. I pretty much hate Western medicine at this point. Save for trauma surgery, it has zero benefit.

  28. Wonderful. That was very insightful. Just wished to say thanks…
    Getting excited about the next good article. ( Please post quicker

  29. Excellent blog here! Also your site loads up very fast!

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    your host? I wish my site loaded up as quickly as yours lol

  30. I recently tested positive for e-histolytica for the 3rd or 4th time in the past few years, and my Dr once again prescribed me a heavy dose of antibiotics (paromomycin and tindamax). I have grown aware of the long-term damage these meds do to my gut flora, and so since I concluded the last dose of meds 11 months ago, have done everything in my power to fend off infection the old fashioned way. I have drastically changed my diet to more paleo-centric focused on high fat, low carb, almost eliminated gluten and grain consumption entirely, upped my intake of greek yogurt and probiotics (prescript-assist from Kresser), and exercised via crossfit 3 or 4 times a wk. This is why the most recent positive test is so frustrating; I simply don’t know what to do going fwd. Am I better off taking this round of antibiotics with the hope of another year of the modified diet/exercise program in combination with the probiotics will be enough to eliminate the problem? Or should I say no to the meds because they have done very little to fix the long-term issue, while simultaneously destroying what little good bactieria I have accumulated along the way? I recently reached out to Grace Liu with the gut institute to seek another opinion. Any advice u may have would be appreciated