If probiotics prevent atopic eczema, why are doctors not telling us?

A few years ago I was at a medical conference. At a breakout session on probiotics, the question posed was “Do they help when given alongside antibiotics?” At the time, there was nothing on eczema and there was not much evidence using probiotics did any good.

However, science is only as good as the study, and the questions asked.

I have been studying all the academic science published about atopic eczema. The field of probiotics and immunology jumps out, as being very significant. Why?

To look at the study of probiotics and medical or health benefits, one really should look back to 1908. This was the year that Ellie Mechnikoff first promoted the benefits of fermented milk products such as yoghurt on health and longevity. Born in Ivanokva, then in Russia, Mechnikoff studied natural sciences, and zoology at several universities, First Kharkiv University, then Giessen, then Gottingen, then Munich, and finally St Petersburg. However, all his significant work was carried out in Paris, at the Pasteur Institute, studying microbes, inflammation, and the immune system. He noted that white blood cells are attracted towards certain bacteria, as if zoning in one them. In the field of longevity, and ageing, he concluded that Bulgarian peasants, who drank yoghurt every day, lived longer and had better health than many other countries’ citizens. He identified Lactobacillus bulgaricus as the healthy bacteria that fermented this type of yoghurt. However he looked at many populations who also consumed fermented milk.

Now I am puzzled why a leading scientist at the Louis Pasteur institute saying something important about a natural food, and healthy and long lives, would be ignored for nearly 100 years by other medicos. After all, Mechnikoff won the Baer prize in 1867 for his doctorate, and then the Nobel prize for medicine in 1908, the Copley medal of the Royal Society in Britain in 1906. He wrote a book called “The Prolongation of Life” in 1908.

Why has no-one in medicine ever told me about this man and his work? He was decorated for his scientific advances in Paris, Germany, Sweden, and the UK. He understood something very important, which is “how to live a healthy life, and for longer”. He even wrote a book about it. In 1908. Are you surprised by this? Well I certainly was. I set about reading some of this book. One of his central doctrines is that there are “healthy” bacteria in the gut, which prevent putrefaction, and that live yoghurt containing lactic acid is one such food that contains healthy bacteria. He also lists kefir as another.

Mechnikoff states (page 171-2) “A food known as Leben raib, soured milk from buffaloes, kine, or goats, has been used in Egypt from the remotest antiquity. A similar preparation known as Yahourth (yoghurt) is familiar to the populations of the Balkan peninsula. Soured milk is consumed in great quantities in Russia in two forms, Prostokwacha (raw milk spontaneously coagulated and soured), and Varenetz (boiled milk soured with a yeast).”

“The natives south of Angola live almost entirely on milk. They employ the cream as an ointment for their skin, whilst the milk, soured and curdled, is their staple food” He goes on to state “wandering Arabs of the desert live almost wholly on the milk of camels, fresh and soured, enjoying excellent health, and some living to two or three hundred years.” P175. He does argue that these age figures are probably too high, but states that many Bulgarians live well past 100 years.

Let us jump forward now to research published 105 years later, 2008.

This is the year that Dr Kristin Wickens, and eight other academic scientists and medical doctors from New Zealand published in Clinical and Experimental Allergy. “We have shown that in a high-risk cohort (parents suffered with eczema and allergies), supplementation from 35 weeks pregnancy until 6 months if breastfeeding, and infant supplementation from birth until aged two years with Lactobacillus rhamnosus halved the incidence of eczema at age 2 and 4 years. This study provides evidence for the probiotic Lactobacillus rhamnosus prevents eczema and possibly also atopic sensitisation in high risk infants to age 6 years.”

Not only that taking a probiotic, Lactobacillus prevented around half the cases of eczema, if you look at the figures for those who continued to take Lactobacillus, by age 6 years, only five children out of 112 has developed eczema. Admittedly around 20 children developed eczema between ages 2 and 4, but the eczema settled, the longer they stayed on lactobacillus. Only 4.5% of the children taking probiotics over this time have longstanding eczema.

Let’s jump forward to present day research, still from New Zealand, from the same universities, Otago and Wellington. Professor Julian Crane and his colleagues have now published the evidence showing that Lactobacillus rhamnosus (found in live yoghurt) continues to protect children against eczema, and also asthma, hay fever, and allergies, right up to the age of eleven. Professor Crane states “it is not known why probiotics reduces the incidence of eczema, and other allergies, but they may influence the developing immune system and modify the genes that influence the skin’s barrier function”  (K Wickens et al. Effects of Lactobacillus rhamnosus HN001 in early life on the cumulative prevalence of allergic disease to eleven years. Paediatric Allergy and Immunology 14 November 2018) Lifetime prevalence for eczema was down by around half, and asthma down around three-quarters. It should be noted that another probiotic, Bifidobacterium lactis or HN019, had no discernible effect.

Now I have a few serious questions: “Why has it taken medicine over 100 years to develop what was already known in 1908, that soured fermented milk, or yoghurt, containing lactobacillus species, has health benefits amongst users in populations that extends right up to and over the age of 100 years?” And another: “Why have we not picked up on the difference between milk from African cows, Arabian camels, Asian cows, and those from Egypt, and Bulgaria, and those bred in the UK and USA for better milk yields?”

We now know that cows from Africa, Asia, New Zealand and the islands of Guernsey and Jersey still produce A2 protein, which is much more similar to human breast-milk (A2), than A1 milk or infant milk formula. We get most of our milk from Holstein, Ayrshire, Milking Shorthorn, which are all A1 protein milk producers. Although we do get some milk from Guernsey, and Jersey and Brown Swiss cattle, these are much smaller herds, and much of their milk is made into cheese. These cattle herds vary from around 70% A2 (Brown Swiss) to the Jersey, Guernsey, and Normande French cows, which make around 100% A2 milk. These cows are generally smaller, and brown with white markings. A1 cows are generally black and white.

Other species that we get A2 milk from include; sheep, goat, donkeys, yaks, camel, and buffalo. Despite Mechnikoff’s work over 100 years ago, it seems that milk producers were happy to breed dairy herds from cows that produced larger quantities of milk, even though the milk protein was entirely different.

The major difference in the milk protein is that A1 milk breaks down in the gut or in the circulation to a peptide known as BCM-7. This peptide is implicated in the following diseases, some with greater evidence than others:

  1. Type 1 diabetes (very strong evidence)
  2. Behavioural disorders in children (very strong evidence)
  3. Autism (weak evidence)
  4. Asperger’s syndrome (weak evidence)
  5. Sudden Infant Death Syndrome (weak evidence)
  6. Schizophrenia (weak evidence)
  7. Endocrine and auto-immune disorders (weak evidence)
  8. Leaky gut syndrome (weak evidence)
  9. Coronary heart disease (weak evidence)
  10. Irritable bowel syndrome (strong evidence)
  11. Inflammatory conditions including eczema (weak evidence)

If you are not yet convinced about using live yoghurt for their healthy bacteria, and preventing eczema let me tell you something else. The incidence of atopic eczema in “western countries” where dairy herds are generally A1 is about 15-16% of the population. Yet in Iran, and Albania, and rural Turkey, the incidence of eczema is around 1%. We have 15 times the incidence of eczema. What do they do differently there? They consume liquid yoghurt in vast amounts. In Turkey it is the national drink. Known variously as kefir, doogh, Ayran, Dhalle or Kaskh, depending on how it is drunk, and with what flavourings. All from fermented A2 milk.

You may ask, why do we get A1 milk then in UK?

The answer is that a spontaneous mutation occurred in cattle breeding programmes several hundred years ago in northern Europe. The Holstein breed originated from the Netherlands for example, and a mutation occurred in the main milk protein, casein. A single amino acid in the chain that makes up milk, occurred in position 67, where histidine occurs in A1 milk in place of proline in A2 milk. This single change results in a completely different chain of 7 amino acids, called a peptide being broken down from A1 milk. This is what we call BCM-7. It is biologically active, meaning that this small piece of protein is able to interact with important receptors in the body, both in the gut, in the brain, and in the skin for example. We know that it causes inflammation and can cause irreversible damage.

Perhaps like me you are asking why farmers still use other breeds?

I don’t know the answer to this, but I suspect it comes down to money. Farmers don’t make much money from producing milk. Supermarkets have ensured that the profit margin is extremely small. If a Holstein or Friesian cow produces more milk in a season, then the farmer will generally use this breed. There may be other reasons based on temperament and handling. However, I was shocked to discover that there has been a huge drive to export embryos of the Indian Desi cow (which is A2) to Europe and USA, to try and breed out the A1 milk protein mutation.

So here it is; my understanding of why Arab camel drivers and Bulgarian peasants, and Egyptian aristocracy, and other nations lived so long and were apparently so healthy.

Firstly, they drank fermented or soured milk, kefir or yoghurt. Secondly, they drank milk only from A2 producing cows.

For those of you suffering from eczema, and other allergies such as asthma, and hay fever, or conditions such as glue ear, there are some very important things that you can do, that will dramatically cut the chance of these conditions occurring in your children.

  1. Drink fermented or soured milk or live yoghurt from 36 weeks pregnancy
  2. Breast feed your child for as long as you can, ideally for 6 months (A2 protein)
  3. If bottle feeding, choose a hydrolysed formula which minimises A1 protein
  4. Introduce live yoghurt as soon as you commence weaning foods, sourced from France or outside UK or from Guernsey cows
  5. Buy a good probiotic capsule such as BioKult, and either have your child take this every day, or use it as a starter to make your own yoghurt from A2 milk
  6. Keep up the live yoghurt or lactobacillus-based probiotic until at least age 4, longer if possible.

As to why doctors are not telling us all this, I think this boils down to how science is funded, and what get published and where attention is drawn. Doctors do not appear to teach this, either at medical school, or in post-graduate education. And I for one, am genuinely puzzled about the reasons why they do not know.