Isn’t There a Better Way?
If you grew up like I did bacteria were not our friends. They were the things that made us sick, have to go to the doctor, get shots, take yucky pink medicine, etc. I recall as a child having ear infection after ear infection, strep throat after strep throat. And what was the solution back then? Essentially the same as it is now: antibiotics, antibiotics, and more antibiotics. If those don’t work (after 4-7 rounds in 1 year!) then surgery may be recommended. I was one of the lucky few to have all the above. I had so many ear infections I had tubes placed in the ear drums, twice! I had so many strep throats I had to have my tonsils removed (which actually did resolve the strep throat issue). But what if there was another less invasive way to deal with these infections and still get resolution of the symptoms? What if this alternative strategy was something that didn’t carry serious side effect risks like those associated with antibiotics and surgery? The worst of these side effect risks being potential death! What if the issue was not necessarily that we contracted some serious bacterial infection that was floating around the community and needed to be eliminated but what if we had inadvertently changed the conditions inside our bodies which then made it easier for us to develop an infection or prevented us from adequately fighting an infection off on our own? What if for some reason whatever we were doing to our bodies or not doing hindered our immune system’s ability to react in a robust way to address the pathogenic (bad) threat? These are some very good questions I hope to offer you some insight about in this blog post.
Let’s start by sticking with the two examples I mentioned earlier, ear infections, and strep throats. Strep throat is caused by the bacteria known as Streptococcus pyogenes, thus the term, “Strep Throat”. This is the bacteria the doctor is looking for when they use that yucky throat swab that makes us all gag! Yuck! Health care providers are kean to eradicate this organism because if left untreated it can migrate from our throats to our hearts and damage the heart valves. This doesn’t always happen though. Some individuals can be colonized with this form of streptococcus in their mouths and other places on their body and never even get sick. This means the bacteria which is a form of group A streptococcus can actually live with us! How can some people have this bacteria inside them and not get sick??? Well lets start by discussing the a little bit about the bacteria living inside our mouths.
There are about 100 to 200 different types of bacteria living in our mouths at any given time.1 Individuals that brush their teeth have approximately 1,000 to 100,000 bacteria living on each tooth, while individuals that don’t brush their teeth can have between 100 million – 1 billion bacteria on each tooth! 2 While some of the bacteria in our mouths are harmful and can cause serious illness, much of our oral bacteria are actually beneficial in preventing disease. The family of bacteria known as Streptococci make up a large part of oral bacteria, streptococcus pyogenes is only being one of them which is sometimes there and sometimes not.
So what kinds of things can we do to help change our nasopharyngeal (nose and mouth) environment for the better while at the same time helping us get less sick??? Well, I am glad you asked. Here are a few very simple things we can all do each day to improve our nasopharyngeal health.
The first thing I will discuss are the elimination of dairy products. Now, now, before an army of RAW milk advocates march and lay siege to my house hear me out. Dairy products increase the thickness of phlegm or mucus. Mucus is one of the body’s natural defense mechanisms which coats the lining of our nose, mouth, throat etc. Mucus contains a protein called Mucin. Mucin binds bacteria and viruses to help prevent their entry into the cells which line our nose, mouth and gastrointestinal surfaces. The body has natural mechanisms which keep mucus in production, increase it when we get sick, and move it out of our bodies in a timely fashion so it doesn’t build up. In the nose we call this sinus drainage. Thickening of this mucus prevents the elimination of our sinus “trash”. I have noticed, anecdotally, thickening mucus delays the resolution of sinus and respiratory tract infection symptoms in adults and children. I have also noticed increased dairy consumption to be related to recurrent otits media or ear infections in children. I’m not saying to cut dairy out of your life forever, but consider giving it a strict break when you or your children are sick. You may want to consider eliminating dairy completely from you or your child’s diet and switching to an alternative like nut milk if you or your child suffer from recurrent ear, nose, or throat infections such as sinusitis or ear infections.
What about those pesky strep throat cases that seem to go through our children’s school like California wildfire? Well, remember how we discussed that there are many different types of bacteria living in our mouths? Those bacteria on the whole act like a family. They have figured out how to live in a symbiotic relationship with one another where there is a balance. This brings me to Streptococcus Salivarious K12. Streptococcus salivarius is among the most numerous beneficial bacteria in our mouths, S. salivarius is typically the first one we acquire naturally as infants. Some speculate we get it through our mother’s first kiss.
S. salivarius K12 was discovered and isolated by microbiologist Professor John Tagg at the University of Otago in New Zealand. At age 12, he experienced strep throat commonly himself. After this experience, Dr. Tagg was determined to find “a better way” to help support throat health in children. A microbiologist by training, Dr. Tagg focused on naturally occurring bacteria to create probiotics for the oral cavity that support throat health.
To find such a probiotic, Dr. Tagg followed New Zealand school children through many years, analyzing their saliva samples looking for differences. A breakthrough came when Dr. Tagg and his team isolated a unique strain of S. salivarius (K12) from a healthy child who over a six-year period exhibited remarkable throat health . Streptococcus Salivarious K12 was subsequently isolated and developed for market. Since then there has been multiple research studies on the strain of good bacteria, including its antagonistic properties towards many common childhood and adult ailments, ESPECIALY strep pyogenes, that pesky strep throat causing bug. It has also been shown to be inhibitory (prevent from growing) towards S. pneumoniae, and M. catarrhalis, both of these bacteria commonly cause ear and sinus infections, as well as pneumonia!
S. salivarius K12 has these antagonistic effects on the above mentioned potential pathogens through many ways, the greatest of these are its production of a substance called salivaricin A2 and salivaricin B. These are natural antibiotic like substances which S. salivarius K12 produces that help prevent the growth of these competitive pathogenic bacteria! In one observational uncontrolled study children with secretory otitis media (ear infections) were shown to have a statistically significant improvement when taking S. salivarius in the areas of ear infection reoccurrence, as well as increased hearing in both their ears. They were also shown to have a decrease in eustachian tube blockage, decrease in adenoid and tonsil size, and a decrease in pus like fluid behind their ear drums! 4 Other studies have demonstrated S. salivarius K12 ability to bind to the hyphae (tentable like structures) of candida albicans, which is a pathogenic (bad) type of yeast. Binding the hyphae decrease candida’s ability to have a pathogenic effect on our bodies!
S. salivarius K12 has an excellent safety profile and has been given the rating of generally regarded as safe level in the USA. As with any probiotic supplementation I always advise people with decreased immune systems to discuss taking any probiotic with their healthcare provider as these individuals are at higher risk for developing an infection from the probiotics themselves, which is incredibly rare. The good news is in these extreme circumstances probiotics are generally susceptible to most forms of antibiotics, so if there ever were an issue, it could be resolved fairly easily with treatment. As far as I know there have not been any such reports with this particular strain of probiotics, S. salivarius K12.
There is a Medscape article, please find it cited below, which also discusses S. salivarius K12’s ability effect the gene expression of approximately 660 genes (572 of which were specific to K12). Most of these were specific to decreasing inflammation such as decreasing inflammatory cytokines like IL-8, Nf-KB and TnF-a. Specifically this has been shown to be potentially beneficial in decreasing the inflammatory response in the mouth which is triggered by the bacteria that contribute to the dental condition known as Gingivitis. Not only was S. salivarius K12 shown to decrease inflammation but it also helped up regulate or turn on genes which helped prime the immune system when it was exposed to pathogenic (bad) bacteria and viruses. This helps to increase the immune systems effectiveness! 6 Last but not least S. salivarius K12 has also been shown to help decrease the amount of bad breath causing bacteria in our mouths, naturally leading to less bad breath! ☺
On that note I’ll begin to wrap up for this post. Friends, these are the types of discussions I enjoy having with my patients. This is the type of medicine I am excited to learn more about and put into practice. Ideas which help to augment our body’s own natural defensive mechanisms, while at the same time helping us to become more healthy! If you are wondering now how or where to obtain the probiotics K12, my family and I use NOW foods brand lozenges from Amazon. The lozenge can be crushed and given to children who haven’t gotten their teeth yet and it is also available I believe in fast-melt tablets, lozenges, chewing gum, and stick-pack powders that can be sprinkled directly onto your tongue and then swallowed. For those of you wanting a summary article about S. salivarius K12 I would point you to the below mentioned Medscape article as it is the best summary I’ve found on this subject. God Bless!
1. Zimmer, Carl. “How Microbes Defend and Define Us.” Science, New York Times. 12 Jul 2010.
2. Stevens, Jane E., and Jack Desrocher. “Oral ecology.” Technology Review (00401692) 100.1 (Jan. 1997): 48. Academic Search Premier. EBSCO. Brigham Young University, Provo, UT. 10 Oct. 2008.
3. “Streptococcus mutans.” Encyclopædia Britannica. 2008. Encyclopædia Britannica Online. 18 Sep. 2008.
4. Di Pierro F, Di Pasquale D, Di Cicco M. Oral use of Streptococcus salivarius K12 in children with secretory otitis media: preliminary results of a pilot, uncontrolled study. International Journal of General Medicine. 2015;8:303-308. doi:10.2147/IJGM.S92488.
5. Ishijima SA, Hayama K, Burton JP et al. Effect of Streptococcus salivarius K12 on the in vitro growth of Candida albicans and its protective effect in an oral candidiasis model. Appl. Environ. Microbiol. 78, 2190–2199 (2012).
6. Abt MC, Osborne LC, Monticelli LA et al. Commensal bacteria calibrate the activation threshold of innate antiviral immunity. Immunity 37, 158–170 (2012). Interesting article highlighting the general role probiotics can play in ‘priming’ the immune system to respond to viral or bacterial infection. Explains the idea of tonic signaling by probiotic bacteria in a mouse model.
7. Philip A Wescombe; John DF Hale; Nicholas CK Heng; John R TaggFuture Microbiol. 2012;7(12):1355-1371.