Wednesday, July 14, 2010

Kefir Mythology

Kefir is a yogurt-like product made by fermenting milk with cultures of several bacteria and yeast. Frankly, until recently, I had never heard of it (nor--to my short-lived, blissful ignorance--smelled the pungent stuff). However, fad, alternative remedies usually cross my path in exactly this manner; I initially catch a rumor of some new uber-cure, then see it spread, much like a virus among unvaccinated children, over weeks to years.  I had the privilege of smelling Kefir in the hands of a patient who was using it to treat abdominal pain she had suffered from for several months.  She noted if she stopped using the Kefir for even a day, she started feeling worse.

I did a little research and found a company called Body Ecology that markets a Kefir Culture Starter kit. The website touting the benefits of Kefir claims all the usual nonsense about "strengthening the immune system" and such, but goes on to specifically claim that Kefir helps patients with ADHD, flatulence, herpes, cancer, colon "strengthening," chronic fatigue syndrome, and "cleansing the whole body."  What exactly does that mean?

Another website, this one for Lifeway Foods, claims that Kefir helps with Crohn's disease and Ulcerative Colitis (UC) because those diseases are "similar to Irritable Bowel Syndrome."  In fact, Crohn's and UC are not related to Irritable Bowel Syndrome at all (other than the fact that they all affect the bowel).   Without descending too deeply into technical details, Crohn's disease and Ulcerative Colitis are inflammatory conditions of the gut that, when present, effectively rule out Irritable Bowel Syndrome as a cause of abdominal pain.

Two clicks more on my Mac took me to PubMed, the web portal of the National Library of Medicine, where I found absolutely no randomized, controlled trials supporting any of these claims. It appears, then, that Kefir is a yogurt-like food that may have some as yet poorly established benefits of a "probiotic" nature, now being promoted--with no reliable research support--as a cure-all for all sorts of symptoms and diseases.

What's the harm, one might ask. Well, in this case, Kefir is not being promoted simply as a nutritious food (which it might very well be), like cheese or yogurt. Purveyors are making health claims about this product. Some patients suffering from symptoms like chronic abdominal pain, Crohn's disease, ulcerative colitis, nausea, fatigue, colon cancer, herpes, and ADHD are listening in, and buying it. This can cause unsafe delays in actually working up, diagnosing, and treating potentially dangerous illnesses. It can also foster a false sense of security in a patient who believes he is adequately protecting himself or others from the effects of a serious infection when in fact it isn't true.

In summary, there is no reliable evidence that Kefir is anything more than a (moderately disgusting) food.  The patient with the Kefir turned out to have a Helicobacter pylori infection which I treated with antibiotics and an acid reducing medication.

18 comments:

Unknown said...

But you make it sound so, I dunno, Yummy! My bowel is falling in love with you, Dr. C. But foist, I need some kefir, pronto!

Anonymous said...

Actually in some cases placebo patients have greater healing rate than medicated patients(you can read cancer cases).

Study also says that factory made kefir contains 100 times less pro-biotic elements than homemade one.

Good luck with your medications.

Anonymous said...

If your like me, then you'd have already tried all the things the Doctors ie: conventional medicine would have you do up to and including steroids & remicaid.

When the greatest amount of relief you experience comes from knowledge outside traditional medicine, you begin to try things. Granted, failure is a given because not everything will work the way you hope- but after all is said and done, Doctors are only human and patients still need help.

The bottom line is sometimes things like this do work. I've seen it happen, hell, I've experienced it first hand. The best way to look at it is with a healthy dose of skepticism- but to give it a chance to fail or succeed BEFORE condemning it outright.

Anonymous said...

Well i disagree with you doc..I have become far healthier finding and using holistic remedies.My experience has been that most doctors are extremely limited in their healing practises, and tunnel visioned. Many refuse to even acknowledge holistic alternatives. The average doctors way is to prescribe medications and more medications.. which oftentimes do more damage. I have been using kefir for awhile now and can vouch for it's curative powers. Maybe you should try it yourself.

Emil Nicolov said...

How about this doc:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2219330/

?

Anonymous said...

I've been trying Kefir for a few weeks now as I heard of the supposed benefits, right now I am bent over with abdominal pain so severe I'm surprised I can still type. I have never previously had abdominal pain but can't find another source that could be causing it. I have no propblems with milk or yogurt but I'm done with the kefir.... now I'm just curious if anyone else has had a similar problem?

Anonymous said...

If someone is having problems that a medical doctor has not been able to help with, then I suggest trying alternative treatments. Because medical doctors are taught to treat problems with pharmaceutical drugs, that is their only source of treatment. A drug company will not give you a medication that will 'cure' your problem. They will give you medication that will help you manage your symptoms. If they cure you, then you won't need to buy their medications and they lose money. I have been making and drinking kefir for a little while and have noticed that I am feeling much better. I cannot drink the kefir plain as the taste is quite sour. However, I add a little honey and it is better. Even with the honey, it took a few days to acquire a taste for it. I find that it has a pleasantly tart taste now. It won't hurt you to try it, however I have read that you shouldn't drink kefir if you are taking insulin for diabetes. I have not researched this aspect of it, but that is the only health concern that I have found in all the research that I have done. If you have tried everything that the medical doctors have told you without relief I suggest giving it a one month trial just to see if it makes a difference. If you get the grains and make it yourself, you won't have buy it commercially. I have my son on a 4 week trial. He hated it the first few days that he drank it, but now he said it tastes pretty good. I will post later as to the results of his trial.

Anonymous said...

Yoghurt consumption regulates the immune cells implicated in acute intestinal inflammation and prevents the recurrence of the inflammatory process in a mouse model.

AuthorsChaves S, et al. Show all Journal
J Food Prot. 2011 May;74(5):801-11.
Affiliation
Centro de Referencia para Lactobacilos, Consejo Nacional de Investigaciones Científicas y Tecnológicas, Chacabuco 145, San Miguel de Tucumán, Tucumán, Argentina T4000ILC.
Abstract
Crohn's disease and ulcerative colitis, two forms of inflammatory bowel disease, are important problems in industrialized countries. The complete etiology of these two diseases is still unknown but likely involves genetic, environmental, and immunological factors. The aim of the present work was to determine whether the anti-inflammatory effects reported for yoghurt in acute trinitrobenzene sulfonic acid-induced intestinal inflammation in mice also could prevent or attenuate the recurrent intestinal inflammation, thus maintaining remission. The innate response also was evaluated through participation of Toll-like receptors (TLRs) and the analysis of T-cell populations to determine the effects of yoghurt in an acute inflammatory bowel disease model. Yoghurt exerted a beneficial effect on acute intestinal inflammation by regulating T-cell expansion and modulating the expression of TLRs, with decrease of TLR4(+) and increase of TLR9(+) cells. The anti-inflammatory effect of yoghurt also was demonstrated in a recurrent inflammation model. Yoghurt administration during the remission phase prevented the recurrence of inflammation without producing undesirable side effects. The yoghurt effect may be mediated by increased interleukin 10 production and changes in intestinal microbiota.

roadrash said...

I have suffered from colitis for many years the usual medications either did nothing or made me very ill, kefir does help me and i feel much better when taking some everyday, after 12 years of being extremely ill with not much help from the doctors or gastro i think its a good idea to explore alternative therapies.

Anonymous said...

I really like kefir as regular milk made me feel sick. I have been drinking it for a few months now and I notice my hair and nails look nice. I also noticed that when I eat legumes and cereals I don't feel sick (or get flatulant)afterward if I take the kefir with them. My husband takes it to control his acid reflux.

Anonymous said...

I have no idea, because I've never had any gastro-intestinal issues, but then again, I was brought up on drinking kefir, and have drinking it on a daily basis for over 20 years now.

I'm far from a fanatic, but feel meds should be used as a last resort, rather than the first option. Fortunately, I've rarely had to resort to pharmaceuticals, but realize, that could change.

jerlands said...

From what I've read of Dr. Rich Charlebois comments on Kefir I get the impression he is uneducated on the immune system. It begins in the gut.. Beneficial yeast and bacteria that reside in the gut play an important role in strengthening, supporting and developing the immune system. Pro-biotics are used to strengthen the body whereas anti-biotics are used to suppress harmful elements in our body.

Anonymous said...

It is condescending attitudes like this that are driving patients away from mainstream medicine and toward charlatans. Just because medical labs have not adequately tested a treatment methodology does not mean there is no evidence for its efficacy.

What difference does it make whether the anecdotal self-reports are being published in medical journals or on amateur hobby websites? In either case you still have to take the patients' word when they say they feel better. And who cares if it's a placebo? Do they feel better or not?

By all means, critique foodsellers making untested medical claims. But don't mock the self-reports of patients who are proving more successful at treating their own illnesses than you are--especially when the treatment they have found has centuries of traditional use.

If they are saying that it works, then get in your lab and start testing.

I have been experimenting with kefir for the last two weeks. Despite the fact that I am a natural skeptic AND I hate plain yogurt, there is no question that my Crohn's, my ADHD, my chronic anxiety, and my restless limb symptoms are significantly improving, with a marked improvement in my bowel regularity. And the stuff tastes and smells absolutely delicious.

Anonymous said...

... Did you really want to ask, "Who cares if it's a placebo?" If it's placebo and a patient feels better, it means an outside variable has affected their change, or the patient is temporarily unable to objectively notice the outcome. Doctors MUST adhere to a higher level of standards than anecdotes. The problem is simply that discovery, verification, and validation of efficacy for a specific condition via statistics takes a great deal of time, and there are always people in need, so of course there will be many suitable solutions that doctors don't know about; they're only concerned with the ones that have documented, statistical evidence of working - and isn't that a good thing? The undocumented solutions will often have side effects we don't know about and thus, are only suitable for people who are at their wits' end. Doctors are always a hair trigger away from a million dollar lawsuit, are subject to investigation and subject to loss of practice, and can lose support from insurance companies if they do things their own way. It's a screwed-up system that overcharges because everyone's back is watched.
But in this case, there already is enough evidence and scientific documentation to support the idea that kefir may be good for Crohn's patients. Additionally, if you, like me have blood-in-gut issues due to your Crohn's disease, then it's highly likely that your gut problems cause a good portion of your ADHD symptoms like they do mine, and so yes, if the kefir makes any difference to your Crohn's disease, it's going to make a difference to your ADHD symptoms. However, that is a big "if".
TL;DR - Don't hate the player, hate the game.

Unknown said...

Silly. What would happen if a doctor would recommend kefir and a patient's illness wouldn't be cured or even worst?

You would surely complain about doctor's kefir. A doctor's job is not mainly to cure every single illness, it is to protect his patients.

Those drugs are tested with about all our current knowledge and shouldn't be taken so lightly. If you think kefir helps you, it's just fine but never ask a doctor for a prescription until it's benefits are fully tested. Have a quick search on how the grains are originally produced.

I drink kefir and I like it so far for it's taste, feeling and texture. In my honest opinion, it should be the only reason to consume it.

Unknown said...

Silly. What would happen if a doctor recommended kefir and a patient's illness got worst?

You would surely complain about doctor's kefir. A doctor's job is not mainly to cure every single illness, it is to protect his patients.

Those drugs are tested with about all our current knowledge and shouldn't be taken so lightly. If you think kefir helps you, it's just fine but never ask a doctor for a prescription until it's benefits are fully tested. Have a quick search on how the grains are originally produced.

I drink kefir and I like it so far for it's taste, feeling and texture. In my honest opinion, it should be the only reason to consume it.

Anonymous said...

Something about your website makes me feel decidedly skeptical... maybe its your conclusions. Go figure.

L.R. said...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4626640/ - an interesting study from October 2015 on the benefits of Kefiran present in Kefir