Should You Take Probiotics

Probiotics are the friendly yeasts and bacteria that populate your digestive tract. This network of microorganisms, your gut microbiome, may actually play a much larger role than simply supporting digestive health.

In fact, there are a number of other reported benefits related to:

  • Reducing toxins, infection, and inflammation
  • Healthy immune function
  • Weight loss
  • Lowering cholesterol
  • Regulating blood sugar
  • Fighting cancer

With so many potential benefits, probiotics may represent a simple dietary addition that can support wellness. But how do you know if you need them?

In this article, we’ll review some signs that your digestive and overall health could use a boost, and where to go to get help. We’ll also discuss some of the available support for the most common probiotic strains.

How Do You Know If You Need Them?

Many of the signs that your digestive health is in distress can be subtle, whereas others are more concerning for serious underlying conditions.

Mild digestive issues can include diarrhea, constipation, bloating and gas. You may also notice more general symptoms like chronic fatigue, frequent colds, or persistent allergies.

Experiencing these symptoms every once in a while is normal. Frequent occurrence or progressive worsening are red flags, however.

More serious symptoms may include sharp and sudden abdominal pain, bowel movements that are black or bright red in color, as well as vomiting blood or substances that look like coffee grounds.

These symptoms are associated with a number of different causes, so nailing down the source on your own can be challenging.

For non-emergent symptoms, it is safe to schedule an appointment with your primary care provider. The more serious symptoms can represent emergency situations, so immediate medical attention should be sought. In this case, calling 911 or getting to the emergency department is necessary.

Though probiotics may play a role in your plan of care, it is best to first identify the cause of your symptoms. Your treatment may require more than the simple addition of a supplement.

Probiotic Supplements: What’s in Them?

Once you’ve taken steps to identify the source of your symptoms, you can work with your doctor to address the treatment plan. If you’re thinking about including a probiotic supplement, this conversation may be more beneficial if you’ve already done some homework on your own.

With so many proposed benefits, it seems that adding a probiotic supplement to your plan of care would be helpful regardless of the underlying condition. But is there actually scientific research to support these claims?

In this section, we’ll review seven of the more common probiotic strains found in supplements:

Lactobacillus acidophilus

L. acidophilus are rod-shaped bacteria thought to improve diarrhea, stomach discomfort, and immune function. 

A review of more than 30 randomized trials found that L. acidophilus strains at doses ranging from 2 hundred million to 2 hundred billion colony forming units (CFU) were effective in reducing the risk for diarrhea when used alone as part of a probiotic blend.

The combination of L. acidophilus NCFM and Bifidobacterium lactis Bi-07 two times each day at 100 billion CFU reduced stomach bloating in patients with IBS and indigestion during an 8-weeks span.

Another review found that this same combination of probiotics was associated with fewer days of illness related to respiratory infections.

Lactobacillus casei 

L. casei strains are also thought to relieve diarrhea and other digestive symptoms.

These benefits were demonstrated in a randomized trial involving patients with constipation.

Those that consumed 65 mL probiotic beverage containing Lactobacillus casei Shirota on a daily basis reported greater improvement in symptoms than those that received placebo.

Consumption of a probiotic beverage that contained L. casei reduced the risk for diarrhea in hospitalized patients when compared to placebo.

Lactobacillus plantarum

Many L. plantarum species have been studied; possible benefits may include reducing toxins, fungal activity, blood pressure, and symptoms of  irritable bowel syndrome (IBS).

These effects have been investigated mainly in laboratory and animal models.

In a laboratory model, L. plantarum N14 reduced inflammation in intestinal cells.

The L. plantarum strain DSM 15313 lowered blood pressure in rats with hypertension when compared to controls.

Mice treated with 100 mg/kg injections of L. plantarum K8 experienced a reduction in the inflammatory enzymes associated with heart disease.

Lactobacillus rhamnosus

This species, in particular, the GG strain, is another common probiotic supplement ingredient.

L. rhamnosus GG may support digestion, alleviate symptoms of the stomach flu, and support your allergy response.

In mice, L. rhamnosus reduced airway inflammation and improved digestion.

This strain has also been studied in humans.

While 10 billion CFU of L. rhamnosus GG twice daily did not improve diarrhea in kids with the stomach flu, a review of 12 randomized studies found that L. rhamnosus GG at doses ranging from 400 million to 120 billion CFU prevented antibiotic-associated diarrhea.

Bifidobacterium bifidum

B. bifidum strains are thought to play a diverse role in your overall health. These trains may offer anti-inflammatory, immune-boosting, and allergy-relieving benefits.

These effects have been studied in humans, as well as the laboratory setting.

In a laboratory model, B. bifidum strains promoted the activity of white blood cells and other molecules involved in the immune response.

In 70 patients with IBS, Those treated twice daily with a 20 billion CFU probiotic blend that included B. bifidum BGN4 experienced relief of stomach pain and discomfort with bowel movements.

Bifidobacterium lactis

Like some of the other strains mentioned, B. lactis strains may also offer support for immune function and allergy relief.

Age-related decline in immune function is common; the HN019 strain may combat this process.

In 13 elderly subjects, B. Lactis HN019 at 150 billion CFU doses twice daily over 6-weeks improved blood tests associated with immune function.

Similar effects were seen in 30 elderly subjects over a 9-week span.

Bifidobacterium longum

B. longum is a species that includes over 30 different strains that are thought to benefit immune function, allergy relief, and the inflammatory response.

The CCUG 52486 strain demonstrated anti-inflammatory effects in a laboratory model using white blood cells from elderly donors.

A randomized study with human subjects confirmed these results when BB536 increased antibody and white blood cell levels in elderly patients.

This B. longum was also associated with allergy relief when included in a probiotic blend; allergy symptoms were improved in children over the span of 4-weeks.

The Takeaway:

There are a few points that may make your decision to use a particular supplement easier.

The 7 probiotics reviewed here are commonly included likely because most offer positive results in the laboratory, animal, and human studies.

If a supplement you’re interested in doesn’t seem to have strong support, especially in human trials, you may want to search for one that does.

Keep in mind, however, that the effects are strain-specific. While a particular species of probiotic may offer similar benefits, each strain can behave very differently.

Another detail to be mindful of is the dose included in your supplement. If it is much smaller than what was successful in a research study, you may not achieve positive results.

Unfortunately, this can be problematic – oftentimes, neither the ingredient label on your supplement nor certain research studies, list specific strains. If your supplement offers a probiotic blend, then the company likely only includes the total dose for the combined ingredients.

In these instances, it is challenging to compare the dosage of your supplement to those found successful in research studies.

Your physician can play a key role in filling in any gaps in knowledge you may have; after your review, bring your questions to your appointment.

Are These Ingredients Safe?

Your supplement likely lists the most common side effects associated with their products, though your review should go beyond this information.

When possible, compare doses used in your supplements to those included in research studies. If much lower, they’re more likely to be safe but less likely to be effective. If you supplement offers a much larger dose, the risk of unwanted effects may be greater.

Part of the benefit of dietary supplements is that their safety profiles are typically better than pharmaceuticals. With probiotics, serious adverse effects are extremely rare.

The side effects you may experience are more likely to be mild. These often include abdominal pain, gas, bloating, and diarrhea.

Despite a favorable safety profile, you should always consult your doctor before using any dietary supplement. There may be risks that are less obvious. Having this information up-front can help avoid unwanted effects.

How to Take Probiotic Supplements

Be sure to review the instructions for recommended use prior to taking your supplement. Though this is often just a sentence or two, it provides information that can maximize the benefits and reduce the risk for side effects.

For example, the recommended use will typically detail the serving size and frequency of dosing. If a single serving of your supplement is 3 pills, but you’re directed to take them twice daily, you should consume 6 pills each day.

Misinterpreting this information can lead to consuming too little, or too much of your supplement.

Keep in mind, this information can differ supplement to supplement. Also, directions for consuming pills will not be the same as those provided for powder probiotics.

Our literature review did not reveal any information detailing the best time to take probiotics. However, many companies mention taking their product at the same time each day.

This does not seem to be for any medical reasons, but rather, to ensure you develop a routine so you don’t miss a dose.

The Bottom Line

While probiotics seem to benefit a variety of digestive and health-related issues, you should first identify the source of any symptoms you may be experiencing. Rule out more serious causes so the best treatment plan can be achieved.

The probiotics reviewed in this article are seven of the most common ingredients offered in probiotic supplements. They can be found alone or as part of a blend. Either way, they’re likely included because they have a laboratory, animal, and human research to support their benefits.

Nonetheless, safety and efficacy are often dose and strain-dependent. For these reasons you should always have a good idea of what you’re consuming.

Speak with your physician before use to fill in any gaps and to ensure you are on the safest plan of care.

Anthony Dugarte, M.D., C.S.C.S

Dr. Anthony Dugarte is a 2016 graduate of Case Western Reserve University School of Medicine. Passionate about health and wellness, he also has a background in collegiate athletics, exercise physiology, nutrition, and over 10-years of experience as a personal trainer. Most recently, Dr. Dugarte completed a postdoctoral Research Fellowship in Orthopaedic Trauma. At HighYa, he shares the knowledge he has obtained by blending his diverse background with his passion for relating complex health topics practically to a diverse readership. Learn more

Should You Take Probiotics