Synergism in Medicine

I’m settled at my laptop, green tea in hand, and I am thinking about popcorn. I am especially thinking about popcorn with butter and salt. You know how the flavour in buttered salted popcorn is elevated beyond what any of the three single ingredients has to offer? It’s an effect called synergism! The Cambridge Dictionary defines synergism as “the combined power of a group of things when they are working together that is greater than the total power achieved by each working separately.”^[1]

Complementary medicine can also involve synergism. Many botanical formulas combine herbs that work on different organ systems to produce a better total effect on a health condition than a single herb would. Probiotic combinations, rather than single strains of bacteria, can also provide a more robust effect on health. Conventional medicine also uses the idea of synergism in their pharmaceutical formulas: for example, in combining several antibiotics together to treat an infection. Now, however, there is great excitement and huge potential in the medical community, as new research is showing the effects of the synergism of using both complementary and conventional medicine together to optimize healing. Throughout my personal and professional experience, I have seen how our gentle traditional medicine works alongside conventional medicine and makes it even more effective!

I witnessed some of the most profound synergy examples in my patients with cancer when I practiced as a naturopathic doctor. The treatments recommended by the medical doctors usually worked well, but they could be very harsh on the body. There was a balancing act between using the amount of the drug necessary to stop the cancer cells, and yet not causing irreversible harm to the healthy cells. If the patient could remain strong and relatively comfortable through the chemotherapy treatment, they were less likely to need a break from it and more likely to complete the course of treatments. One of my first actions in working with a cancer patient initiating chemotherapy treatment was to learn more about the types of drugs being used and what specific side effects my patient might expect. I also needed to know what organs could be harmed by the treatment.

I then advised on herbs, supplements, and/or probiotics to work alongside the medical treatment to reduce or prevent side effects. I always encouraged the person to discuss these complementary treatments with their doctor before beginning them. Some natural remedies, properly selected, can even increase the effect of the chemotherapy: Synergism at work!

Probiotics have been widely used and studied alongside conventional cancer treatment.^[2] Thanks to the Human Microbiome Consortium Project, which was a five-year effort to map the genes of bacteria in our body,^[3] we know a lot more about where these bacteria are and how they function. When we talk about using probiotics, we are discussing a way to deliver beneficial bacteria to the body in the form of food or supplementation. Many readers will be familiar with the recommendations to use probiotics with or after antibiotic therapy, since this can help replenish the friendly gut bacteria that has been destroyed.^[4]

Replenishing the beneficial gut bacteria is vitally important, because the microbes in the gut play a major role in our immune system. It turns out that there are two important ways that probiotics can play a synergistic role in cancer. The first lies in preventing or reducing side effects from the chemotherapy. The second lies in bolstering the immune system so that the body helps prevent or fight the cancer. In a review of the use of probitoics in cancer treatment, the authors note that a gut without enough of the beneficial types of bacteria can be connected with the cause of many types of cancer.^[5] Impaired immunity associated with gut dysbiois (an unbalanced bacterial community favouring harmful over helpful bacteria), can also interfere with the ability of the body to heal from the cancer.^[6] Using probiotics throughout cancer therapy can therefore help maintain the integrity of the immune system. They can also decrease some of the effects of chemotherapy, such as diarrhea and mucositis (inflammation of the oral mucous membranes, causing sores).^[7] It is always a good idea to check with your medical doctor first, before starting any complementary therapies, such as probiotics, if you have cancer.

It’s not just in cancer treatment that probiotics can exhibit these synergistic effects. We also know that our healthy bacterial colonies live in many other places beside the gut, even in areas previously thought to be sterile, such as the lungs.^[8] The Human Microbiome Consortium Project mapped out the genes of the bacteria in the nooks and crannies of the human body and found that our health depends on maintaining adequate levels of beneficial bacteria in the gut, which then affects the bacterial populations in the other parts of our body.^[9]

For example, a healthy gut population influences a healthy lung-microbe population.^[10] The lung bacterial population in a healthy person is different than that of a person with asthma, allergic rhinitis, or chronic obstructive pulmonary disease (COPD).^[11][12] Promising work is being done showing that the long-term supplementation of probiotics can reduce the allergic potential of babies and young children.^[13] From this, we can surmise that probiotics may provide a safe way to supplement and possibly minimize the use of antihistamines and steroids used for allergic rhinitis.

Another example of probiotic synergy deals with combating a tenacious bacteria named Helicobacter pylori. H. pylori is a main cause of ulcers and is very difficult to eradicate;^[14] the bacteria develops antibiotic resistance almost as fast as the doctors can throw antibiotics at it. Adding the probiotic Lactobacillus to an antibiotic regime increases the effectiveness of the treatment.^[15]

Enhancing the effect of synergism by using probiotics—and many other forms of complementary medicine that we have not discussed in this article—alongside conventional treatments can help give you less side effects and heal more quickly from many conditions.

Butter and salt make your popcorn taste better indeed!

Wendy Presant, RHNC, CFMP

With a background in nursing, naturopathic, and functional medicine, Wendy Presant is currently registered as a health-and-nutrition counselor. She provides virtual coaching services to individuals looking to optimize their health.

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References

1. Cambridge Advanced Learner’s Dictionary & Thesaurus, 4^th Edition. Cambridge: Cambridge University Press, 2013, s.v. “Synergy,” https://dictionary.cambridge.org/dictionary/english/synergy · Accessed 2021-⁠08-⁠11.

2. Lu, K., S. Dong, X. Wu, R. Jin, and H. Chen. “Probiotics in cancer.” Frontiers in Oncology, Vol. 11 (2021): 638148.

3. HMP Consortium. NIH Human Microbiome Project. · https://www.hmpdacc.org/ · Accessed 2021-⁠08-⁠11.

4. Vrabie, R., and F.N. Aberra. “Prescribing an antibiotic? Do not forget the probiotic.” Gastroenterology, Vol. 137, No. 5 (2009): 1846–1847.

5. Vivarelli, S., L. Falzone, M.S. Basile, D. Nicolosi, C. Genovese, M. Libra, and M. Salmeri. “Benefits of using probiotics as adjuvants in anticancer therapy (Review).” World Academy of Sciences Journal, Vol. 1, No. 3 (2019): 125–135.

6. Vivarelli et al. “Benefits of using probiotics as adjuvants.”

7. Vivarelli et al. “Benefits of using probiotics as adjuvants.”

8. Jakubczyk, D., and S. Górska. “Impact of probiotic bacteria on respiratory allergy disorders.” Frontiers in Microbiology, Vol. 12 (2021): 688137.

9. HMP Consortium. NIH Human Microbiome Project.

10. Vrabie and Aberra. “Prescribing an antibiotic? Do not forget the probiotic.”

11. Jakubczyk and Górska. “Impact of probiotic bacteria on respiratory allergy disorders.”

12. Carney, S.M., J.C. Clemente, M.J. Cox, R.P. Dickson, Y.J. Huang, G.D. Kitsios, K.M. Kloepfer, et al. “Methods in lung microbiome research.” American Journal of Respiratory Cell and Molecular Biology, Vol. 62, No. 3 (2020): 283–299.

13. Jakubczyk and Górska. “Impact of probiotic bacteria on respiratory allergy disorders.”

14. Testerman, T.L., and J. Morris. “Beyond the stomach: An updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.” World Journal of Gastroenterology, Vol. 20, No. 36 (2014): 12781–12808.

15. Konorev, M.R., T.M. Andronova, and M.E. Matveenko. “[Use of probiotics and probiotic-based immunomodulators as adjuvant therapy for Helicobacter pylori eradication]” (article in Russian). Terapevticheskii Arkhiv, Vol. 88, No. 12 (2016): 140–148.