Michael Ash: Probiotics – Sorting the ‘Wheat from the Chaff’

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Michael Ash

Michael Ash BSc (Hons) DO, ND, F.Dip ION has spent over 20 years of his clinical practice exploring the role of the mucosal tissues in health and disease. This includes the use of probiotics and other natural agents to modify the local tissues, to impart benefit locally and systemically through the propagation and management of mucosal tolerance.

He has lectured all over the world on mucosal immunity and is regarded as an authority on the clinical use of probiotics.

He will explain how the role of probiotics is evolving from the traditional ‘ecological approach’ to one that is more condition specific, and will explore the changing comprehension of the immune system and how as nutritionists you are in a position to convert this into effective clinical strategies.

During this presentation he will look at the progressive science in the use of probiotics, which species and strains have been shown to have benefits in humans and present case histories to highlight potential clinical interventions.

Probiotics are defined as:  “Live microorganisms which when administered in adequate amounts confer a health benefit on the host”.

Michael Ash presented a fascinating, informed and clinically relevant presentation at The Institute of Physics on 22nd September 2009. This presentation was recorded.


Just call +44(0) 333 2414 289 to order and a link will be sent to you for the following:

  • Seminar slides used during presentation
  • Articulate version of the presentation (3 hours: slides + audio)
  • A collection of handouts provided during seminar
  • A collection of product information sheets
  • A collection of papers referenced by Michael Ash

Probiotics: The Microbial Health Factor


Topics covered will include:A panoply of functions have been attributed to probiotic bacteria, including: competitive inhibition of the growth of pathogenic bacteria in the gut, stimulation of antimicrobial peptides, improvement of digestive enzyme production, management of bio-films, repair of gastrointestinal barrier integrity, creation of substances that help fuel and reinforce the barrier defense of the gastrointestinal (GI) tract, assisting in the generation and absorption of certain vitamins, influencing the maturation and maintenance of the immune system, production of anti-inflammatory compounds, and antioxidant and cellular protection.

  1. What is mucosal immunity?
  2. How do the mucosal tissues communicate with the rest of the body?
  3. What a probiotic does and does not do – Evidence based review
  4. What is the current understanding of our microbial biome?
  5. How to select the best strain based on published data
  6. Why does, timing, duration and strain selected determine the difference between success and failure?
  7. How Nutritional Therapists are ideally placed to use these products.

Conditions looked at will include:

  • Functional Gastric Disorders, Inflammatory Bowel Disorders, Certain types of arthropathies
  • Skin and mucosal tissue health
  • Mucosal infections, post antibiotic therapy, post radiation therapy, anti inflammatory implications
  • Novel and evolving strategies
CPD Approval Credits/hours
Bant ® Final logo
British Association for Applied Nutrition and Nutritional Therapy

Traditional Ecological View

When probiotics latch on to and temporarily colonise the intestinal mucosa, they help prevent attachment of pathogenic bacteria. This ability of colonic microflora to help resist colonisation of pathogenic bacteria is now well established. Given the complexity of the intestinal ecosystem, the exact mechanisms have yet to be fully elucidated; however, several mechanisms appear to be involved and to act separately, sequentially, or together, and include:

  • exhaustion or competition for the same substrate or nutrient
  • competition for mucin adhesion receptor sites
  • production of a physiologically restrictive environment, for instance with respect to pH, redox potential, hydrogen sulfide production or production of metabolites toxic to other bacteria;
  • in vivo production of antibiotic substances such as bacteriocidins
  • improvement of the intestine’s immunologic barrier
  • alleviation of the intestinal inflammatory response
  • increased antigen (ie, foreign invader) transport across the gut mucosa, which occurs in the absence of intestinal microflora
  • the capacity of the gut-associated immune cells to generate protective immune cells, which progressively increase with gut microflora establishment

Modern Condition Specific View

The increased understanding of the relationship between bacteria deemed to be non pathogenic and us is growing at a tremendous rate. Many times the purported benefits of a probiotic exceed the evidence base. However, in this instance Michael will explain how science is both catching up on clinical experience and helping to shape a future where the humble ‘gram positive’ and ‘gram negative’ bacteria may become a clinically sophisticated ally. Michael will teach you to read through marketing hype and make judgements based on scientific evidence and patient needs.

You will never look at a probiotic in the same way again – we guarantee it!

How does gut health relate to immune health?

The gastrointestinal tract is the body’s primary immune organ with some 70-80 per cent of the body’s immune cells being localised in the gastrointestinal tract, its glands, mucosa and mucosa-associated lymphoid system. A substantial amount of research and significant scientific agreement in the literature supports the ability of various probiotic species to help support immunity.

Researchers have documented interactions between probiotics and the gut-associated lymphatic or immune tissue. For instance, experiments that compared specific germ-free and normal mice and rats have shown the strong influence of the presence of intestinal flora on the maturation and development of local and systemic immunity and on the regulation of immune functions. In humans, probiotics administered to critically ill patients have shown significant improvements in systemic immunoglobulin (ie, IgA and IgG) concentrations with a corresponding reduction in intestinal permeability.

L acidophilus and B bifidum appear to enhance nonspecific immune activity. They seem to do this by stimulating lymphocyte and macrophage activity and modulating cytokine production by mononuclear cells. They also appear to enhance synthesis of antibodies in response to microbial pathogens, particularly secretory IgA. Various other species, including L plantarum, L rhamnosus, L casei, L bulgaricus, B lactis, and L paracasei, have demonstrated a variety of immuno-regulatory effects that could help bolster an individual’s immune protection. For instance, clinical research suggests that L rhamnosus and L casei can enhance natural killer-cell activity.

9 Comments. Leave new

  • Ivana Manrique
    February 25, 2015 9:40 am

    Dear Dr Ash:
    I have read several of your articles and am very interested in your opinion.
    I am a woman of 44 years, from adolescence with panic and anxiety problems, which have been added autoimmune problems such as rosacea, dry eye, Raynaud, s …
    After understanding the importance of a healthy intestinal flora, dysbiosis conduct a test that showed an invasion of Blastocystis hominis in large quantity. I think I have intestinal permeability, because I have 47 food intolerances, always fetid gases …
    After 2 rounds of antibiotics I have not gotten more than increase the number of Blastocystis.
    I have read about Sacaromicis Boulardi. Taking probiotics ¿I can eliminate Blastocystis? Can I get my taking glutamine mucosa, bone broth and grated apple?
    It would be so kind as to give me a recommendation?
    You can treat me as a professional in private?
    A million thanks for your time

  • Thank you so much for allowing everyday people to access your absolutely invaluable information on gut health and probiotics. This information helped me so much when recovering from a nasty case of post-infectious irritable bowel syndrome (brought on by over-use of antibiotics, infection with a virus and with Blastocystis hominis). I followed the probiotics (and the Monash University low FODMAP diet) religiously and made a fantastic recovery. :0)

  • I watched Episode #3 of the “Betrayal Series” with Dr. Tom O’Bryan. I did my best to write down what you explained about plants and their different impacts on our GI’s. I truly learned a lot. Thank you.

  • Teresa Moussa
    June 21, 2022 4:49 pm

    I am following up with Michael Ash explanation about functional gastric disorders inflammatory bowel disorders . My question is . What is the best probiotic and prebiotic to take? I am being struggling for years , don’t know what to do ? Lost my hope. Everything I eat , right away I feel bloated , release tons of gas ,,is extremely uncomfortable., can’t keep my weight. I am trying to be positive about it , I really need help please . Dr Michael please help me out .
    Thanks a lot
    Teresa Moussa

    • Leah Jamieson
      June 22, 2022 12:58 pm

      Dear Teresa

      Probiotics are well defined in terms of their genetic structure and strains, but this still leaves uncertainty in regard to a specific application.

      It is also important to reflect that inflammatory tissues have more than one trigger and may require a number of simultaneous interventions to achieve resolution or management.

      Prebiotic foods are a good place to start, selecting soft fibre foods to begin with can be safe place to undertake a steady reduction in IBD pathophysiology. I have written about this in this allied piece.


      In terms of specific bacteria – I have indicated in the article above the use of LGG and Saccharomyces Boulardii. But since I wrote this pece 11 years ago another species has shown positive early outcomes for IBD.

      It is called Clostridium butyricum and is understood to be a producer of butyric acid, as short chain fatty acid known to reduce inflammation in the colon and small intestine.

      I see you are US based and there is a US company called http://www.PendulumLife.com that may provide you with their product accordingly.

      Otherwise if you are finding the journey too complex to manage on your own, do visit the IFM site https://www.ifm.org/find-a-practitioner/ to track down a clinician to assist.

      Michael Ash DO. ND. BSc. RNT

  • Dr. Ash, I have taken Butyricum after seeing your recommendation and the results are amazing! I have suffered from IBS for years, and the only thing anyone found was Blastocystis Hominis (which was impossible to eradicate). I have been on Butyricum for only two weeks and my stools are completely normal, back to what they were many years ago. I don’t have any more bloating, pain, or discomfort. My question to you is: Can I use this product indefinitely? I contacted the company and they told me to ask my doctor, but he doesn’t know this product at all. Could you please help me by telling me if Butyricum can be taken long-term? Thank you!

    • Hi Simonetta

      Thank you for the feedback on your experience.. It is very gratifying to learn of your improvement. I hope that it continues and allows you to recover all of the advantages you will likely have had to put to one side with the IBS.

      Butyricum, as with all commensal organisms may be taken on an ongoing basis, but in part its performance is to reset the sensitivity of the GI receptors that were in part responsible for the IBS.

      I suggest that you continue to utilise the product for a few months -3-6 on an ongoing basis, this is long enough to reset and repair many receptors. Then look to reduce the frequency to every other day for a month or so – and reduce further if you feel stable. At some point you may feel confident to discontinue, and know you have a solution if you need it.

      Best of health.

      Michael Ash

      • Thank you for your reply. Actually, I now have some symptoms again of a condition that doctors could only diagnose as blastocystis. No medication has ever helped. I normally use your protocol but the results are never permanent. Is there any new finding on this issue? Thank you!

        • Ailsa Reed
          May 2, 2023 3:13 pm

          Thank you for asking and sorry to hear that B Hominis (parasite) remains present in your GI tract. Its important to recall that not all B Hominis create symptoms, but will expand in areas where the immune system remains compromised.

          I wonder if you have ever checked to see if you have an immunoglobulin A deficiency because of genetics? https://primaryimmune.org/about-primary-immunodeficiencies/specific-disease-types/selective-iga-deficiency

          It may be worth exploring as a recurring infection indicates a problem with securing efficient immune defences and the treatment is designed to enhance IgA production.

          Otherwise, check water supplies, hand washing practices, peel vegetables and fruits.

          If you do have a selective IgA deficiency then the protocol will need to be followed on an ongoing basis to accommodate the absence, and care must be taken to avoid re-infection risk.

          Michael Ash


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