Antibiotics Disrupt the Gut Microflora Resulting in Bone Loss

Gut microflora is important for bone health and bone formation. If the gut microflora is disrupted, skeletal bone loss occurs. Antibiotic therapy has been found to cause long term disruption in the gut microflora in humans. In addition, disruption of gut microflora has been linked to an increase in the risk of developing inflammatory bowel disease, obesity, and diabetes.
The Findings

Laboratory animals were given a two-week course of oral antibiotics and the gut microflora was given 4 weeks to repopulate. There was a significant disruption of the normal microflora that did not return to normal. During the 4-week time period, trabecular bone volume reduced by 30%. When the animals were given probiotics containing Lactobacillus reuteri, the bone loss was prevented.

However, Lactobacillus GG did not prevent bone loss. Lactobacillus GG is the most common bacteria found in common probiotic formulations, so simply having your patient pick up probiotics at the pharmacy is unlikely to yield the desired effect.

When medications are discussed with our patients we advise them to take the probiotics at the same time as the antibiotics, but continue taking the probiotics until gone. We know the probiotics will have no beneficial effect during antibiotic therapy, but we have found that because they have started taking the probiotics, more patients comply with continuing the probiotics for the full month. Because Lactobacillus reuteri is the only bacteria found to protect against bone loss after antibiotics, we advise the patients on where they can purchase the proper quality probiotic. For example, one supplier of a probiotic containing Lactobacillus reuteri can be found using this link: Probiotic Supplier

Probiotic Lactobacillus reuteri Prevents Postantibiotic Bone Loss by Reducing Intestinal Dysbiosis and Preventing Barrier Disruption
J Bone Miner Res. 2019 Apr;34(4):681-698. doi: 10.1002/jbmr.3635. Epub 2019 Jan 28


American Society for Bone and Mineral Research (ASBMR)

Tissue Engineering and Regenerative Medicine International Society (TERMIS)