As a United States board certified, board eligible rural Family Physician, I am continually mystified by many of my patients preferring pills to food.

I don’t get it.

Today I will discuss probiotics. I have tons of patients taking probiotic pills. I ask all patients to bring in all pills, prescribed or not, fda approved or “natural”, when they come for their first visit. Many people arrive with a shopping bag. People say, “I am not on any medicines.” Then they pull seven “herbal” medicines out of the bag. A pill is a pill to me. I have never seen one growing on a tree. It’s as natural as a shoe, in my opinion. Shoes don’t grow on my feet, but sometimes I wear them. I feel the same about pills.

I hold up the probiotic bottle. “How long have you been taking this?” I ask.

“For a year,” says my patient.

I then get this internal vision. The probiotic leader in my patient’s stomach speaks, “Another load of refugees. I just don’t know where we’ll put them. Everyone is starving as it is. And dehydrated and dessicated with many dead again. Call the burial team and the grief counselors. I swear, it’s like clockwork. We had a forty eight hour break last Saturday, remember? But then we had to handle all that alcohol….”

“Have you thought of stopping it?” I ask.

“Probiotics are good for the digestion,” says my patient.

“Ok,” I say and try to gently introduce the idea of as few pills as possible. Also if they are taking four preparations with vitamin A, I total it up and ask them to consider lowering their dose a bit……

Why don’t people eat their probiotics as food? I am not talking about the expensive advertised yogurt. Live culture yogurt has always had probiotics, but now they’ve standardized, advertised and raised the price. All of the pickled things are sources of probiotics: Kimchi, dill pickles, sauerkraut and all of those interesting pickles that one gets with sushi. I am not so sure about the sweetened pickles, though my mother used to make watermelon rind pickles in a crock, and I am sure there were very many interesting organisms in them. Delicious, too. A friend said that he first got interested in fungi perusing leftovers in my parents’ refrigerator, and he ended up with a PhD. My digestion has been really really healthy, though my recent strep A was hard on it.

I got live kimchi at the Farmer’s Market recently, and hard cider. Both contain love, I mean live cultures. If you make your own beer, that has live cultures when it’s brewing.

The best thing you can do for your intestinal health is stop. eating. sugar. Quit all the junk food and anything with sugar or corn syrup and make your own food. I have some really dark chocolate or two table spoons of really good ice cream most days. I did eat one donut in the last five months. Perfection is silly, boring and stifling.

Another overlooked cheap source of probiotics that anyone can find: dirt. Yes. Dirt from your yard. It contains all manner of live microscopic things and you are focusing on local bacteria. Don’t wash that carrot quite so carefully and you will be adding to the probiotic culture in your body. If you are in a CSA (community supported agriculture) and get a box from a local farmer once a week, you are getting local probiotics. Do be sure to get your tetnus vaccine updated every ten years, too.

Lastly, think about your food. Would you rather have local probiotics from a local farm or attempt to wash the pesticides off of vegetables that have had pesticide genes added to their genome?