Self Care Pharmacy Blog

 

Are you “Pro” Probiotic Supplements?

December 5th, 2013

by Heather Evankow, PharmD student

In recent years, the popularity of probiotic supplements has risen. Probiotics are bacteria that help maintain the natural balance of organisms (microflora) in the intestine.1 The idea of probiotics is not a new concept. The idea was first developed around 1900 by the Nobel Prize-winning recipient Elie Metchnikoff. Metchnikoff theorized that the fermented milk products Bulgarian citizens ingested were a major factor in their longer life spans when compared with other countries.2 It was not until the year 1989 when R. Fuller popularized the term “probiotics”.3 Today, probiotics can be seen in the news claiming to improve the immune system, aid in skin health, defend against depression, clear up a bloated gut, prevent urinary tract infections, and even delay allergies.4

The Daily Herald recently released the article, Probiotics are all the rage, and experts say there are results behind the hype. The author, Gabriella Boston, Boston combines the opinions of several healthcare professionals to emphasize the health benefits behind the evolving topic of probiotics.

The first healthcare provider, Megan McCusker, is a dermatologist who believes probiotics are an important treatment therapy for treatment of anything from acne to psoriasis.4 While the Federal Drug Administration (FDA) does not approve any health claims for this supplement, McCusker could recommend 5-20 billion units per day depending on the patient’s needs. There were no clinical research references to show how McCusker developed these recommendations.

A nutritionist Boston featured, Jared Rice, also believes in the benefits of probiotics. Rice has not observed any downsides with his patients taking probiotics, but still advises patients to seek medical attention before taking high doses. Rice believes it is essential to buy the healthiest probiotic supplement. Also, he believes it is important to create a probiotic-friendly body by eating whole grains, bananas, and onions while steering clear of nondigestible carbohydrates.4 Unfortunately, there was no data referenced to confirm the benefits of Rice’s claims.

Ebeth Johnson, a nutritionist and chef, also gave her expert advice for this article. She believes this probiotic trend is here to stay. She encourages incorporating probiotics into your diet by consuming unpasteurized miso, live cultured pickles, tempeh, unsweetened kefir and yogurt, and kombucha teas.5 It is unclear how Johnson came up with these supplement sources. In addition, she also did not mention any specific research to validate the quality of these sources.

While the experts in Boston’s article seem confident in their recommendations of probiotics supplements, the clinical research is still limited for probiotics. The varieties of strains make it problematic in understanding the health benefits.

One of the most researched probiotic strains is Lactobacillus rhamnosus GG (LGG). LGG has been proven to help pediatric patients with pain-related gastrointestinal (GI) disorders in many clinical studies.5 In a 2011 meta-analysis, researchers systematically searched for randomized controlled trials assessing LGG supplementations in children with functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine and functional abdominal pain (FAP).5 The major limitations for this analysis included incomplete outcome data and the number of trials with a small sample size. The results revealed a decrease in severity in pain with the overall study population and the IBS subgroup.5 The frequency was also decreased in the IBS subgroup.

Another hopeful probiotic strain is Streptococcus thermophilus VSL #3. A multicenter, randomized, placebo-controlled, double-blind, crossover study has shown VSL #3 to be successful and safe in helping the lives of children with IBS.6  59 patients from ages 4-18 years of age completed the study with no untoward adverse effects reported. Researchers found no significant difference was found in the stool pattern of patients, but abdominal pain, abdominal bloating, and family life disruption were all significantly more effective to the placebo.6

Have you had any encounters with probiotic supplements? Comment and share your experiences. Please include the main therapy goal, specific probiotic strains, and the dosage.

If you have had no experience with probiotics, based on the information above, would you personally try probiotic supplements? Share your rational.

References

1. “Probiotics – Topic Overview.” WebMD. Healthwise, 04 FEB 2011. Web. 29 Nov 2013. <http://www.webmd.com/digestive-disorders/tc/probiotics-topic-overview>.

2. Parvez, S. and Kang S. “Probiotics and their fermented food products are beneficial for health.” Volume 6. Web. 29 Nov. 2013. <http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2672.2006.02963.x/pdf>.

3. Ouwehand, A., S. Salminen, and E. Isolauri. “Probiotics: an overview of beneficial effects.” Vol 82.Issue 1-4 (2002): 279-289. Web. 29 Nov. 2013. <http://link.springer.com/article/10.1023

4. Boston, Gabriella. “Probiotics are all the rage, and experts say there are results behind the hype.” Daily Herald. N.p., 28 Oct 2013. Web. 29 Nov 2013. <http://www.dailyherald.com/article/20131028/entlife/710289977/>.

5. Horvath, A., P. Dziechciarz, and H. Szajewska. “Meta-analysis: Lactobacillus rhamnosus GG for abdominal pain-related functional gastrointestinal disorders in childhood.” Alimentary Pharmacology & Therapeutics. Vol 6.Issue 12 (2011): 1302-1310. Web. 29 Nov. 2013. <http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2036.2011.04665.x/full>.

6. Guandalini S., G. Magazzu, and A. Chiaro. “VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study.” J Pediatrics Gastroenterol Nutr. 2010 Jul;51(1):24-30. Web. 04 Dec. 2013. http://www.ncbi.nlm.nih.gov/pubmed/20453678.

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4 Responses to “Are you “Pro” Probiotic Supplements?”

  1. Caleb Lyman Says:

    I have not heard too much about probiotics but I think this article is a good introduction for me. Initially I am a little skeptical about the use of probiotics. The list of conditions that probiotics can aid in remedying is impressive and seems like quite a tall order for just one thing to take care of. The experts and studies appear to be lacking basic scientific understanding and while that does not disqualify the effect of probiotics, it does make me wary. Since probiotics can come from natural sources, however, it does not sound like there is too much danger in trying it out. Until they are better understood I think I will refrain from recommending them.

  2. Cara Toms Says:

    I, as well, am not familiar with the use of probiotics. Theoretically, it seems like a good solution to many diseases. It would make sense that if you had a disease that hindered your ‘good bacteria’ a probiotic would be a good option. I know that if you have inadequate amounts of ‘good bacteria’ in your body, foreign particles are more likely to invade and for infections to arise. Also, antibiotics can deplete the amount of good bacteria. In these situations I would recommend probiotics. However, in a normal semi healthy person I do not think I would recommend these products. I would like to see some more clinical studies and tests being done that show effectiveness and benefits. I agree with Caleb that the lack of scientific understanding makes me hesitant.

  3. Chelsae Ward Says:

    With all the probiotic hype nowadays, especially with the yogurt commercials, I have often wondered how effective these products are toward their claims. It is slightly concerning that the experts had no evidence to support their claims but I feel like we, as readers might not be getting the whole story. Maybe they chose not to share it thinking it was not important for the purpose of the article or perhaps the author did not include such evidence due to her reading audience. Either way, I do not want to discredit their information but it would make me more confident in their claims.
    Whether it is just hype or not, it does not seem like much harm can be done from using probiotics. If it encourages people to eat healthier food options in order to obtain the probiotics then I see no harm in people using it.
    I have always thought that this would be a “fun” supplement to try out to see if a noticeable difference was observed as the media hype claims. Maybe now I will give it a try! Have any of you tried a probiotic?

  4. Gina Mattes Says:

    I personally have no experience with Probiotics, but I also think that there is not a lot of research about them. I wouldn’t feel comfortable taking them because of all the misconceptions. I feel like with Probiotics they may be effective if taken appropriately, but the body also makes these so I don’t know if they are doing nay good. The body can make a sufficient amount of antioxidants, which I believe is enough. I feel like taking a high amount of Probiotics might do more arm than good. Personally I would recommend any patient to talk with their doctor about it before taking them no matter what the reason. I would also want more research done on the harm they could cause in the body and how they are really working to be fully confident about these products.

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