By Dr. Neela Sandal
Antibiotics are incredibly powerful. They’re amazing medical tools, and they have completely changed our interaction with disease. But, they also cause harm! I have met people who have been injured by antibiotic use, and never want to be treated with antibiotics again. I have also met people whose lives have been saved by antibiotics. So, we should be cautious about using antibiotics, and we should try to understand how they affect our bodies, but we shouldn’t throw the baby out with the bathwater. My goal as a physician is to help my clients carefully use antibiotics when we must, and to avoid them when whenever we can.
Antibiotics are great at killing harmful bacteria in our bodies. But, they’re indiscriminate killers: They kill the bacteria that help us just as well as they kill the bacteria that hurt us. Many antibiotics are “broad-spectrum,” meaning they kill a large variety of bacteria. These are very useful if someone is experiencing a life-threatening infection, and you have to be sure you knock out that infection as quickly as possible. Most of the time, however, we can be more careful.
A recent study suggests antibiotics may affect and slow the mitochondria in cells. Mitochondria produce the energy our bodies use. If this turns out to be supported by additional evidence, it would be shocking and alarming. At the same time, perhaps we shouldn’t be too surprised. Mitochondria were once bacteria, and still resemble bacteria in important ways, so perhaps we should expect that they would be harmed by antibiotics. And, when our mitochondria are slowed or damaged in other ways, we see chronic fatigue, chronic muscle aches, fibromyalgia, and other similar issues arise. This new evidence, and these well-established facts about mitochondria, should make us careful and conservative when deciding whether to use antibiotics.
Antibiotic use over time can cause other conditions you may not expect. It can result in gastro-intestinal issues like diarrhea, constipation, heartburn, acid reflux and food intolerances. It can cause skin issues like eczema. These are a result of the disruption of the microbiome, killing beneficial bacteria and throwing us out of balance.
Another problem: using antibiotics more makes us need antibiotics more. This is because a lot of the bacteria in our bodies actually defend us against hostile invaders or harmful overgrowth. For example, we can successfully treat a sinus infection with antibiotics. However, when we do so, we also kill bacteria that were a first-line defense against sinus infections! From then on, we may get sinus and other infections more frequently. With each use of antibiotics, we increase our vulnerability to future infections.
That is a difficult place to be, because of course we want relief from an infection, but if we want to change this cycle, we have to consider other approaches and not go straight to antibiotics again and again.
What can we do? We can create barriers to infection and make life harder for those invaders. We can encourage the growth of helpful bacteria. Regular sinus rinsing with a saline solution in a neti pot or squeeze bottle helps prevent harmful bacteria from getting established. We can use probiotics, targeted supplements, and pre-biotic and inflammation-reducing dietary changes restore and correct our body's ecology and allow us to heal from previous antibiotic use. We can use regular exercise to further reduce inflammation and illness. This is a process that takes time. Sometimes, we do need to be willing to use antibiotics, but in those instances we can find ways to use them minimally and in a targeted way.
As we build integrated and long-term health, we should be careful about when we use antibiotics and avoid them when possible. We should also work to bolster our overall bacterial health, reducing our vulnerability to infection. This whole-circle approach can help us get out of the cycle of antibiotic use.