All about lactobacillus

Recently lactobacillus has been found in Bronze Age cheese - and the chances are we've lived intimately with this family of bacteria for a lot longer than that. It's to be found all over our bodies. It's an important part of the gut biome and of the biofilm that protects mucus membranes in our mouths and vaginas. We now know the bladder also has a biome crucial to it's healthy functioning and that lactobacillus also protects our skin.

It's also found in cheese and yoghurt and fermented products such as sourdough bread, kefir, kombucha and sauerkraut. It's not the only microorganism involved but in many cases it seems to be the one that creates a matrix to support a symbiotic culture.

Anyone who's made sauerkraut or a sourdough starter will know that it's so ubiquitous, it will colonise any suitable medium. All you have to do with sauerkraut is add enough salt to keep out the nasties and cover it well and the lactobacillus will appear as if by magic. And farmers know that if you wrap hay in the right conditions lactobacillus will appear and start to ferment it into silage.

If it's so ubiquitous why do we have to worry about it?

Unfortunately oestrogen plays a role in helping to maintain the biome and during perimenopause and after menopause, the biome of the gut can change. Scientists at Zoe believe that these change in the gut biome might actually make some menopause symptoms worse.

As oestrogen levels drop the lactobacillus biofilm in the vagina and bladder can also become weaker. This along with changes in the tissue can leave us vulnerable to infection, irritation and genito-urinary syndrome of menopause.

We also know that some antibiotics can damage the balance of bacteria in our gut, and leave us vulnerable to diarrhoea, constipation and other digestive problems. We've probably all also experienced bouts of thrush after antibiotics as some of the lactobacillus in the biofilm die and this allow other microbes including candida yeasts to flourish.

We might also find that tight clothes, perfumed bath products, or over cleansing can leave us with thrush or bacterial vaginosis, which is caused when other bacteria such as Gardnerella start to take over.

So what do we do?

Pay attention to our diet. It's believed that prebiotics - substances that feed our lactobacillus and other beneficial bacteria - are more effective than probiotics. You can buy inulin for this purpose - but onions, garlic and artichokes in our diet are really good at feeding the right bacteria. And in fact the more plants we can eat in our diet the better for our biome.

However, it has been my experience that after a course of antibiotics, a probiotic has been very useful. And we can also experiment with fermented foods, many of which are delicious.

There's some suggestion from Zoe that a completely plant based diet might lead to a poorer biome. I think the evidence for this is still slight at the moment but I wonder if it has something to do with lactobacillus coming to us in cheese and yoghurt along with sugars that feed them.

But my suspicion maybe as much today with family lore as the evidence! My mum tells me a story of when I was a baby I had a GI infection that would not go away despite many antibiotics. In fact it was getting worse. The old doctor (and this was the late 60s so he was likely trained in the 1920s) who said, "stop the antibiotics and feed her cheese", which apparently worked. We didn't have yoghurt then. At least not in small Northern working class towns!

But like all things vegan it's not to say that vegans necessarily have more problems with lactobacillus, just that they may have to pay more attention.

What about our vaginas and bladders?

There's really good evidence that vaginal oestrogen increases the levels of lactobacillus in the vagina and bladder. Vaginal moisturisers may also be useful as they improve the condition of the underlying tissue and keep the vaginal area acidic which favours lactobacillus over other potentially more damaging bacteria.

Getting our gut biome right probably has a knock on effect on our genito-urinary system and there's some evidence that oral probiotics can help rebuild our vaginal biofilm.

And sometimes we may need medication that curbs the growth of some of the nasties in order to allow the lactobacillus biofilm space to re-establish itself.

In my experience all this can take a little time once we get into menopause!

Keeping things healthy

Prevention is always better than cure, so we do want to protect our biome and biofilm as well as we possibly can.

That means finding a routine that cares for our vaginas - with either vaginal oestrogen, non-hormonal moistures or both. It means making sure our bits can breathe because although lactobacillus doesn't need oxygen to metabolise, it thrives better in an oxygenated environment than some of it's nastier competitors.

pH matters too. The vagina is slightly acidic, thanks to the lactic acid and hydrogen peroxide produced by lactobacillus and that keeps nastier microbes in check. When the pH becomes less acid - and the presence of blood and semen as well as washing products can have an impact - then more harmful bacteria can start to dominate.

It might also mean avoiding anything that irritates the tissue, creating an opportunity for other microbes and it may mean avoiding perfumed or antiseptic bath products which could inadvertently kill some of the lactobacillus.

Sadly we can't always avoid antibiotics. Sometimes they are necessary. But different antibiotics have different profiles in terms of the bacteria that they target. So it's worth a conversation with the doctor about which one might be most appropriate if you're prone to gut or vaginal issues.

This is an ancient symbiosis. This family of bacteria has lived in our bodies and in our food system for millennia. We provide the conditions it needs to live and grow, it provides us with protection for vital tissues, and helps us make food. That's a beautiful thing and a relationship well worth nurturing.