There’s a lot of hope and hype about probiotics. Let’s take a look at some of the claims made, the proven benefits, as well as confront the UGLY truths, shall we?
Probiotics: What are they?
First, a definition: probiotics are tiny living bacteria that you swallow for alleged health benefits. Before you get grossed out, if you’ve eaten yogurt, soft cheese, or sauerkraut, you’ve had probiotics before.
Now, some more information: you also have bacteria living in your intestines, some 500 different kinds. Again, don’t get sick – this is completely normal, too. However, there are some bacteria strains that are considered “good” and some that are “bad.” When everything is OK, your “good” and “bad” are in perfect balance. When you start having digestive problems, including bloating and gas, it is thought that the “bad” bacteria have outnumbered the “good.”
Probiotics have billions of tiny CFUs (Colony Forming Units) comprised of different strains of living cultures that have fancy Latin names that can be hard to pronounce.
The main ones are lactobacillus (50 different species), bifidobacteria (30 species), saccharomyces boulardii, streptococcus thermophiles, enterococcus faecium, and leuconostoc. There is also something called prebiotics, which are thought to nourish the probiotic, creating a synergistic, or synbiotic effect.
Probiotics sold in supplements, foods, and liquids come in a wide variety of proprietary formulas and make claims that their particular brand can treat everything from bloating to weight loss.
Probiotics: The Good News
There have been extensive studies on many of the different strains of probiotics, and the results are quite promising. The most conclusive evidence of their effectiveness is in treating childhood diarrhea; according to The New York Times, this have been backed up by at least a dozen studies. Lactase has also been shown to allow lactose intolerant people to have milk products.
There is strong evidence it can help with irritable bowel syndrome, gut pain, and traveller’s diarrhea. Probiotics may also have a relationship to our immune system, blood pressure, and even our brain health.
Probiotics: The Bad News
But while it’s easy to understand why there is so much excitement about probiotic use, the study of probiotics is still in its infancy. Scientists still don’t understand how they really work. According to Stefano Guandalini, MD, Section Chief of Pediatric Gastroenterology, Hepatology, and Nutrition and Medical Director of the Celiac Disease Center at the University of Chicago, there is a very short list of probiotic strains that have been clinically proven effective, and an even shorter list of companies that make them.
The claim that some people are deficient in certain enzymes and that probiotics may help replenish them is a concept pushed by “profit-oriented marketers of digestive enzyme supplements,” according to Tamara Duker Freuman, a NYC-based dietician in an article for US News and World Report.
She adds that most gastroenterologists feel that those taking over-the-counter probiotics for bloating or gas are merely feeling the placebo effect, as the strains would not survive the acids in the stomach. (Prescription-based probiotics are made with a stronger coating designed to survive the journey.)
Probiotics: The UGLY Truth
The main problem, most experts agree, is that when you buy a probiotic from a store you do not really know what you are getting. The FDA considers these products safe and they do not need to provide clinical proof that they actually do what they say so long as they state they are not intended to diagnose, cure, treat, or prevent any disease.
On top of that (or possibly because of this) there are many shady companies that push these untested probiotics that may be contaminated with other organisms. There is also worry that taking probiotics can be fatal for seriously ill or immune compromised people.
Probiotics: What You Can Do
Generally speaking, however, probiotics that you buy online or in a store are considered safe. Here are some important things to look for:
- The words “contains live active cultures” or “contains probiotics”
- An expiration date – and the words “viable through end of shelf life”
- Pass on those that say “viable at time of manufacture”
- The name of the species and number of CFU
- Any clinical research supporting their claims
- Instructions if it needs refrigeration
- An independent laboratory that certified the product is pure (we recommend looking for the USP label)
We also suggest checking out probiotics.org, run by a self-proclaimed probiotics enthusiast (but not a doctor) who says he has spend thousands of hours investigating various probiotics – he lists his 10 favorite brands here.
For more balance, you may also want to read this 7-part investigation into probiotics published by The Nibble, where the author ultimately concluded taking large amounts of probiotics doesn’t make sense because of oversaturation of products and the lack of proof of their effectiveness.
Dr. Guandalini recommends Align for adults with IBS and VSL #3 which is regulated by the FDA as a medical food. Dannon Activa yogurt and Culturelle are recommended by the New York Times because of peer-reviewed research that backs their effectiveness.
On our website, BrightReviewers have given strong positive reviews for Probiotic America, with an average of 4.5 stars from more than 70 reviews. Jamie from Boston gave it a perfect score on November 24:
“… From the very first few days my symptoms abated, and after a few weeks I was symptom-free, and I am still symptom-free to this day… I can compete in road races, Spartan challenges, go on vacation, take long hikes with friends, and not worry about the horrible symptoms I was having. It truly has changed my life around.”
In conclusion: probiotics may work for certain bowel problems, but don’t spend too much money on them and only buy from reputable companies. Otherwise, you may want to stick to yogurt, miso soup, or a footlong with sauerkraut.
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