There are many mixed messages when it comes to probiotics: When to take them? What kind to take? Is the whole thing a scam?
Probiotics are generally accepted as a safe way to build up the ‘good bugs’ in your digestive tract, by inoculating our intestines with large numbers of beneficial bacteria. Berkley Wellness states probiotics play a role in keeping our immune systems balanced, absorbing nutrients in the food we eat, and may have an anti-cancer effect. The claims different probiotic companies use range from immune boosting, to weight loss, to help with serious conditions like ulcerative colitis and irritable bowel syndrome. They come in capsules, powders and liquids to suit your preference.
Probiotics are an area where you get what you pay for. The mixture of bacteria types, the fillers, efficacy testing in the packing facility, and the storage techniques between the factory and your mouth all make a drastic difference in the results you experience. A probiotic may be packaged with 50 billion organisms per dose, but if exposed to heat at any time during the shipping or storage process, many of those organisms will die and be worthless to your gut. The bacteria need food to eat while they are being stored. If the capsule/bottle/packet has a low quality food, or contain multiple strains of bacteria that eat the same food, many of the organisms will die during storage and again be worthless. You need to store them away from light and heat when you get them home, and use them before the ‘use by’ date on the package.
The strains of bacteria included in the capsules make a huge difference as well. The World Journal of Gastroenterology stated in 2010 that very particular strains of B. lactis and L. casei aid in reducing constipation, but one would not want a huge influx of these strains when experiencing diarrhea.
Taking probiotics while taking prescription antibiotics is often a heated debate between health professionals. Some believe a large influx of good bacteria while the drugs are targeting bad bacteria is like hitting two birds with one stone. Others believe having a large influx of any bacteria into your system, good or bad, creates more work for the antibiotic drug and therefore decreases its effectiveness. In 2012 Journal of the American Medical Association (JAMA) concluded in their study that taking probiotic supplements while taking antibiotics reduced the incidence of antibiotic-induced diarrhea by 42%. I like those odds, and therefore suggest my patients use high quality probiotics while on an antibiotic course.
When purchasing probiotics, use the advice of your healthcare providers. Your symptoms and goals play a large role in deciding which supplement to use. Generally speaking, you want to purchase probiotics that have the highest number of organisms per dose you can find, the package states the bacteria strains are non-competitive, and the product has been properly stored. This most-often means they are shipped in refrigerated packaging, are stored in a refrigerator at the store, and you store them in your refrigerator at home. Occasionally I see a probiotic claim it does not need to be refrigerated, but I feel it is better to be safe than sorry.
It is generally accepted that is it best to take probiotics just before or with a meal, to give the organisms something to chew on, and aid in your nutrient absorption. If taking while on antibiotics, take them at opposite times of day from each other.
When considering using food products such as yogurt or kefir as a probiotics, remember that pasteurized products will not contain live bacteria. The ‘live and active cultures’ label from the National Yogurt Foundation refers to active cultures being used during the fermentation process, and does not guarantee that any certain number of the bacteria survived any freezing or heat-treating the product went through after fermentation. Reading your labels and applying common sense will ensure you are making good purchases.
Probiotics come with little risk, the most common side effects being temporary bloating and gas. Berkeley Wellness states in rare cases, immune compromised patients have experienced increased side effects.
The take-home message with probiotics, like many dietary supplements, is if you use a quality product and are thoughtful about when you use it, it is very likely to help you. Consult your healthcare provider to help you choose which supplements are best for you.
Sources:
http://www.berkeleywellness.com/supplements/other-supplements/article/probiotics-pros-and-cons
http://www.ncbi.nlm.nih.gov/pubmed/17897389
http://aboutyogurt.com/index.asp?bid=28
http://www.medscape.com/viewarticle/719654_12