You know, for a lot of people, antibiotics are almost routine. A sinus infection, a skin flare up, a dental procedure, a sick kid, a sick dog out comes the prescription. And while in some cases, antibiotics can absolutely be life-saving. There’s one thing almost nobody talks about the collateral damage, especially what those antibiotics may be doing to the ecosystem inside your gut. So what do antibiotics do to the gut? Well, here’s the problem. Antibiotics, when they were introduced in the late 1940s, early 1950s, were considered, you know, a godsend and let’s not beat around the bush. They saved lives every day. I was in medical school when broad spectrum antibiotics were introduced in the mid 1970s and they were absolutely a miracle because before we had to, if we could, isolate a bacteria by growing it on a Petri dish and then testing various individual antibiotics to see which on would kill or disable these bacteria.

(01:22)
And that took a long time. When broad spectrum antibiotics were introduced, as the name implies, we didn’t care really which bacteria we were treating as a general rule. We now had an AK-47 or a shotgun that could blast all the bacteria to death. And it was really fantastic, except for one thing. In those days, we didn’t know that the gut was an incredibly important part of our ecosystem, that we were a symbiotic creature. And we had no idea that the antibiotics we took to kill the infection was also decimating the bacteria that lived in our mouths, in our gut, in our sinuses. And we had no idea that was collateral damage. So antibiotics don’t just kill bad bacteria. They wipe out good bacteria too. The other thing we’ve learned through the years is that there isn’t necessarily bad bacteria and good bacteria. They should be like a tropical rainforest, a mixture of good guys and bad guys.

(02:48)
And they all actually depend on each other to keep balance. When we took a course of antibiotics, you might have killed the infection that was, you were using to treat, but you have 10,000 different species of bacteria that live in your gut. And after a course of antibiotics, you may actually be reduced to one or two bacteria that have survived. And some studies show that it may take two to three years to get those rest of the bacteria back if that ever happens. In fact, researchers at Stanford University, the Sonnenbergs, would say that we may never get that tropical rainforest back, that once we lose them, we can’t get them back. So what does that mean? The gut bacteria we now know communicate with our immune system, telling the immune system who are good guys, who are bad guys. This loss of diversity, the loss of this tropical rainforest, now we realize has a long way of telling our immune system, “Oh my gosh, I need an AK-47 and a Kevlar vest.” The other thing we didn’t know is that our ecosystem of bacteria was one of our main defense systems against plant compounds like lectins, like oxalates that were designed to damage their predators like us.

(04:35)
And this gut bacteria would eat these plant compounds and keep them from bothering us. Now, because we don’t have those guys, these plant defense system like lectins have a free shot at the wall of our gut causing leaky gut. When you have leaky gut, your immune system goes crazy and starts firing at things that should never fire out in the first place. What’s interesting is that your gut is your skin turned inside out and what happens on the inside of your gut is reflected on your skin. And so many of my patients with skin disorders like eczema, like rashes, like psoriasis, have no idea that that is merely a reflection of what’s happening on the inside of their gut. So this is just the sign of mischief inside your gut. Now, people say, “Well, what about other forms of antibiotics? What about oral antibiotics that just sit in your mouth that you’re swishing around to treat the bacteria in your mouth?” Well, here’s the bad news about that.

(06:01)
Your oral cavity is also its own tropical rainforest. And yes, there are good guys and bad guys, but they have to be in balance as well. So if you wipe out your oral flora, many things happen. You no longer can produce nitric oxide out of the food you eat because it’s dependent on oral bacteria to do that job for you. So just swishing around oral antibiotics is just as bad as swallowing them. And so yes, if it’s a topical antibiotic, it’s gonna hurt your gut. What about antibiotic eye drops? The eye does not have a good immune support system for fighting infections. So antibiotic eyedrops are actually quite useful and they usually stay where they’re put. Can they leak through your tear ducts through the back of your throat and go into your gut? Yes. But it’s such a small dose that we really don’t have to be worried about that.

(07:19)
So you don’t have to be freaking out if somebody says, “Oh, we gotta put you on some antibiotic eyedrops for a week to treat an infection in your eye.” There’s bigger things to worry about. There are cases where you absolutely do need an antibiotic. Let’s be clear about that. But what should you do if you have to take on? If your doctor gives you a broad spectrum antibiotic, first of all, you need to ask, is there an alternative? And hopefully the doctor can answer in good faith. No, there is no alternative, but there’s always a chance to get a second opinion. Are there less bad ones to take if you absolutely have to? Well, here’s the problem. If you’re gonna wipe out your gut flora, it really doesn’t matter whether it’s a good one or a bad one. For instance, we sometimes have patients that have a parasite called Giardia that is a protozoan that is a mischievous bad actor in your gut.

(08:37)
Now, there are a lot of natural remedies that we use that work 90% of the time, but occasionally we have to use what I call the nuclear option. We have to have them swallow an antibiotic to kill off these parasites when we failed these other courses. But 90% of the time we’re able to do it without the nuclear option. And that’s from what we’ve learned treating people’s infections for 20 years with natural methods. So if you have to take an antibiotic, you’ve got to try to repopulate your gut. Now, how do you do that? Well, you have to get as many bacteria in many different shapes and forms into your gut. That’s number one. So you have to take broad spectrum probiotics. Number two, most probiotics are killed by gastric acid, so they never make it into your gut where they belong. So you have to take probiotics that are enteric coated in the capsule.

(09:56)
That means they make it past gastric acid and can colonize your gut. But probably most important is if you think of probiotics as grass seed, if you plant grass seed in the desert in Palm Springs, it won’t grow. Why? Because you didn’t water it and you didn’t fertilize it. And it’s the same thing with probiotics. You have to give these probiotics something to eat to make them grow. And that’s where prebiotics and postbiotics are so important. So regrowing the gut microbiome is actually very hard to do. And I see in our patients who were starting with basically a desert wasteland in their gut after a round of antibiotics or after years and years of antibiotic exposure, that it can take a minimum of six months to really see a demonstrable change in the makeup of the bacteria in some people’s guts. And we really may take one or two years to even get close to the diversity that we want.

(11:24)
I use the example here in California we have forest fires. And yes, we could plant a bunch of new trees at the site of a forest fire, but it’s not realistic to think that we’re gona have a forest in a year or two. It may take 20, 30 years for that forest to regrow. And I think it shouldn’t surprise us now that we can look at people’s microbiome that it takes a long time and a lot of hard work to regrow that forest in people’s gut. We can do everything we can to hopefully avoid antibiotics for ourselves, but remember that antibiotics are used in conventionally raised farm animals because it makes them grow faster and it makes them get fatter. And so you can do everything you can to keep your microbiome intact by trying to avoid antibiotics and yet if you’re eating conventionally raised animals, you’re still going to be exposed to broad spectrum antibiotics.

(12:40)
In fact, recently there was a big to- do over the fact that the Chinese refused to buy American chickens from America because they found that 60% of the chicken meat that they bought from America had antibiotics even though the federal government says it’s illegal to feed antibiotics to chickens and yet 60% of them had antibiotics in their flesh. So that’s the point. Even though it’s completely illegal to give antibiotics to chickens, son of a gun, the Chinese found that 60% of our chickens had antibiotics. So when we eat these animals, we’re getting exposed to antibiotics. So what do you do? Well, you get to know your farmer, you get to know what the chicken is eating and that’s really the best way. So many of my patients, and I, 80% of my patients now have autoimmune diseases, but if somebody has a family history or a personal history of allergies, eczema, asthma, autoimmune issues, food sensitivities, I can virtually guarantee you that you either personally received antibiotics as a child or even now and you’ve got to be even more careful because when we look at your gut microbiome, it really is a desert wasteland and we’ve got to take intensive steps to rebuild that tropical rainforest.

(14:35)
The same caution also really should apply to our dogs. Dog’s microbiome is just as complex as a human microbiome and yes, you do have to sometimes use a nuclear option with dogs, particularly if dogs develop diarrhea and the nuclear option actually works remarkably well for dog diarrhea, but at the same time, owners should be asking the same questions with their vets, particularly if the vets are gonna use antibiotics for a skin issue for the dog. And I can assure you that dogs with skin issues should not be given antibiotics orally. You should be looking for why the skin is the mirror to the dog’s gut and any dog with itching or eczema, that’s a sure sign that they got gut dysbiosis and leaky gut and you should be working with your vet to eliminate that problem rather than relying on the antibiotics.