Though probiotic dietary supplements may seem like a relatively new concept, using live bacteria as a food supplement is something human beings have done since about 500 BCE [6082].  Today, probiotic supplementation is big business with a predicted markYogurt(123754)Credit: Grongar at Flickret share of $32.6 billion by 2014[6083].

However…

The U.S. Food and Drug Administration (FDA) views probiotics as dietary supplements, not medicine.  Unlike drugs used for medical purposes, dietary supplements are not intended to treat, diagnose, prevent, or cure diseases. Manufacturers of these supplements, therefore, can make no claims about the effectiveness of their products [6084], even though the product may have some general health benefits.    

 Yet, the general media is abuzz with interest about probiotics. This appears to not merely be a passing fad; the sudden interest is based on reports of controlled studies. The publication of scientific findings versus media hype makes it difficult for consumers to be sure that what they’re buying is really worth the money.

 Types of probiotics

To help separate the wheat from the chaff, here’s a brief overview of what one could use and under what circumstances such preparations could be beneficial.  Although not approved by the FDA as efficacious, these micro-organisms have proven effective as health aids (based on published, double blind clinical trials).

Bacteria(123753)Credit: Bette Jensen of the CDCThe following bacterial genera are popularly used in probiotics manufacture, and are currently being used in trials: Lactobacillus; Bifidobacterium; Saccharomyces; and Streptococcus.

Each genus and species listed above can also be divided into subspecies or strains.

Clinical trials use not only a specific species, but also specific strains, so that information should be squarely tucked away in the consumer’s mind before reaching any conclusion about a probiotic substance of interest.

Probiotics selection is much like choosing a breed of dog.  Dogs are a single species that can be classified into many breeds, each with its own unique characteristics. Looking at it this way, one can imagine that some strains would be better suited than others to perform a specific task (just as one would choose a German Shepherd over a Pekinese to function as a rescue dog, for example).  

Where you might see benefits

There are several mild conditions (some more severe than others) for which probiotic supplements can perhaps provide some measure of relief.

A common problem for people who must take antibiotics frequently (for infections) is antibiotic-induced diarrhea.  This condition arises in some patients after long-term use of certain medications.  It is exactly as its name describes.  However, strains of L. rhamnosus (L. for Lactobacillus) and Saccharomyces boulardii taken as probiotic supplements (with an informed consumer decision having been made to take them) have been shown to reduce occurrences of antibiotic-induced diarrhea in children[6104][6105].  In adult patients suffering from the same side-effect of antibiotic treatment, S. boulardii and a combination of strains of L. acidophilus and L. casei, led to lowered incidences of diarrhea and shortened hospital stays[6106][6107][6108].  It was also noted that the probiotic substances should be used as one starts (and during) any long-term antibiotic treatment.

Another common problem for which probiotic supplements may be effective is the typical vaginal yeast infection.  For centuries many women have used yogurt (containing a cultured bacteria) to help treat these infections, and for many this has proven effective.  In 2009, a study confirmed the efficacy of the probiotic value of yogurt’s cultured bacteria.  Treatments with single doses of either tinidazole or fluconazole in combination with oral supplementation of two strains of L. rhamnosus and L. reuteri [6109][6110] led to reduced symptoms and a higher recovery rate, with a quicker recovery of normal vaginal flora (the vagina carries its own natural defenses in terms of bacteria and single-celled organisms that combat such infections).  This is, however, not a quick and easy cure. The study subjects took the probiotics for four weeks following drug treatment.

As probiotics are most effective for gastro-intestinal issues, it is expected that routineconstipation(123219)Credit: TipsTimes via Flikr constipation and gastro-intestinal bloating can oftentimes be alleviated with their use.  Chronic constipation sufferers can be helped by probiotic treatment. A study using the bacteria in Yakult (a fermented, probiotic beverage of Japanese origin made of skim milk and L. casei Shirota) showed positive results in 89% of the test subjects with reduced constipation symptoms (versus 56% of those taking a placebo)[6111].

 The Yakult culture, however, didn’t improve bloating or gas symptoms. A separate trial on children using a different strain of L. casei showed greater promise, treating chronic constipation as effectively as magnesium oxide [6112].  Improvements in bloating were noted in yet another study, this time using a combination of an L. acidophilus strain and a B. lactis strain (B. for Bifidobacterium) [6113].  In these, probiotics were taken for four weeks.

Again, there is another bowel problem for which probiotic supplements can be effective in treating.  Testing the efficacy of bacteria on irritable bowel syndrome (IBS) patients was promising: an L. plantarum strain administered for four weeks eliminated abdominal pain in all patients as compared to half of the patients in the placebo group.  In the end, 95% of the probiotic-treated patients reported an alleviation of their IBS symptoms [6114].  Similarly, a B. animalis strain improved symptoms in more than half of the patients treated as compared to 47.7% of those with the placebo [6115], and B. bifidum MIMBv75 was also very successful in another trial. Improvements were seen after four weeks of supplementation [6116]

Skin conditions can many times be keyed to dietary issues.  Eczema is one such disorder, and is usually treated with topical steroid creams.  Before using steroid creams, though, consideration should be given to a probiotics alternative.  L. salivarius strains, when taken for four months, led to a reduction of eczema symptoms in adults [6117].  

 Furthermore, studies were done on pregnant women to see if probiotics could inhibit eczema development in the child.  A mixture of B. bifidum, B. lactis and L. acidophilus was given to the women for 4-8 weeks before delivery and continued during breastfeeding.  Mothers fed probiotics had children with a lowered eczema incidence [6118]. A similar study using L. rhamnosus also had similar results [6119].

And during those times of year when upper respiratory infections (such as the common cold) prevail there may be benefits for which probiotics are responsible. Clinical trials investigating ways to use the supplements to prevent the common cold have been conducted with some very positive results. L. fermentum [6120], L. casei [6121] [6122] [6123] [6124], and B. animalis [6125] have all been used successfully to reduce the incidence of colds and improve recovery times. To see these positive effects, though, the user needs to be on a regimen for three or more months. 

One of the latest benefits drawn from a trial concerned dental caries (or cavities) and gum disease.  Long-term treatment of children with a strain of L. rhamnosus led to significantly reduced tooth decay [6126]. In adults, volunteers with periodontitis given L. salivarius for 8 weeks had clinical improvements [6127].

As is true with any radical change in diet or lifestyle involving intake of probiotics or any other substance it is always best to consult with a qualified nutritionist or physician before forging ahead.  The benefits await. 

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