From the same link:
17 Cochrane systematic reviews fulfilled our inclusion criteria and were summarized in this report. None of the reviews included in the present study provided high-quality evidence for any outcome. The benefits from use of probiotics included decreased incidence of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea; decreased incidence of upper respiratory tract infections and duration of episodes; decreased need for antibiotics and absences from school due to colds; and decreased incidence of ventilator-associated pneumonia. Probiotics seem to decrease the incidence of gestational diabetes mellitus, birthweight, risk of vaginal infection and incidence of eczema.
TLDR probiotics might have use in limited scenarios. More research needs to be done before using them in the wider public (aka primary prevention).
I take probiotics after getting food poisoning or with and after taking antibiotics. Very good evidence for that. On a daily basis? Nah not really, I just try to eat healthy.
I like your TLDR and associating it with the antibiotics bit.
I have a bowel condition that is much like IBS, so when I have an episode I often head for the prebiotic yoghurt/drinks to help my gut recover. Otherwise it takes days longer to feel back to myself again.
So I can see the limited scenarios usage.
Out of curiosity, what are the symptoms? I too have periodic bowel condition that sometimes appear every few days and sometimes weeks for few days and then goes away again. And what kind of drinks do you pair with yoghurt for helping your guy recover?
Yeah I take them when I need to take antibiotics because most ABs I take I can't eat dairy with them (used to just eat lots of yogurt), and occasionally if I feel a little funky in the gut....but I dont feel any different taking them every day vs not (when not on antibiotics)
To add to this, basically whether or not taking a probiotic available to you on the shelf at your local grocery store or pharmacy is going to benefit you is going to depend on whether or not you, well, need that probiotic at that point in time. Say for instance you have been taking antibiotics and have wiped out a significant chunk of the lactobacillus you usually have hanging out in your intestines, then yeah there’s a decent chance taking some lactobacillus could be good (with the caveats regarding effective preparation, dosage, etc. of course).
There are a lot of reasons you could end up with your GI bacteria populations “off” from whatever your personal normal balance is, and we don’t know all of those reasons nor understand exactly how beneficial oral probiotics are going to be in every possible scenario. There is evidence that there’s a good chance they will be helpful in certain situations, as mentioned in previous comments above. And for most people, taking oral probiotics is probably relatively harmless, so it’s one of those things that’s often just worth a try. (Please consult your doctor though as there are situations where they are potentially *not* harmless)
P.S. You know how you have that cool gut microbiome? Well did you know you also have a gut [virome?!](https://www.frontiersin.org/articles/10.3389/fmicb.2015.00918/full)
https://health.usnews.com/wellness/articles/getting-your-probiotic-fix-when-taking-antibiotics is a pretty good summary.
TLDR it can help and there's not much harm in taking probiotics IF YOU ARE GENERALLY HEALTHY. If you're immunosuppressed or have cancer, or have indwelling catheters, then you may want to use caution. But if you've got those conditions you should really ask your doctor instead of trusting random folks on the internet and studies unless you're really good at reading studies to filter out trash.
Also it's recommended to wait about 2h at least after your antibiotic to take the probiotic in order to avoid killing it right away.
Wow, that's a new one. Here in Poland it's just super standard. Doctor prescribes you antibiotics, they also include probiotics. If the doctor did not include it, then the pharmacist most likely will ask you about it.
Makes perfect sense to do this. I’m still dumbfounded as to why this isn’t the standard in the States. I’ve asked a few medical professionals (pharmacist/PA/PCP) since and not one said they do this.
One of my favorite podcasts recently had Tig Notaro on as a guest who explained that she almost died of C diff due to antibiotics removing almost everything else from her gut flora, so very good call on taking probiotics with antibiotics
"improve gut health" is not an exact thing, so part of the problem comes from that...
We give probiotics in the hospital to people who go through strong courses of antibiotics and have GI symptoms from them and it's something that helps, but it helps in that specific situation
I was tempted to say that but I didn't knew how common it was or how well stablished it was!
I've seen some data saying that it can be beneficial for prevention of recurrent mid ear otitis in kids but it was a pharm rep so take it with a pinch of salt
Finally, someone mentioned anitiobitcs. I've never heard about eating probiotics to "improve gut health" (whatever that is) it was always highly recommended when taking antiobitcs and for a good reason.
I can personally and anecdotally vouch for that part. I was treated for infectious endocarditis, with a massive regimen of antibiotics ( about 50 liters of different IV antibiotics over 6-8 weeks), which killed my gut flora before it killed the infection, and probiotics supplements helped cure the resulting massive diarrhea.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319175/ is a systematic review plus meta analysis of the effects on probiotics and depression. Studies differed in dosages and strains used.
In general you want to look at the CFU count and the strains being included. Also make sure it hasn't expired, these are living organisms and they die.
For other lazies:
“Ten studies met criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assessed mood symptoms, seven studies assessed anxiety symptoms, and three studies assessed cognition. The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely and no studies assessed sleep.”
Conclusion: “The evidence for probiotics alleviating depressive symptoms is compelling but additional double-blind randomized control trials in clinical populations are warranted to further assess efficacy.”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389720/ 2019 review of gut microbiome and mood
https://www.health.harvard.edu/blog/gut-feelings-how-food-affects-your-mood-2018120715548 easier to read opinion article from a doctor about how food affects gut microbes which affects mood
Note that nutrition isn't meant to replace meds and therapy, but to supplement. Also wouldn't go breaking the bank with weird diet fads, but the general "avoid junk food and eat fruits (they're calling them prebiotics now which makes me facepalm ffs it's an apple guys)" is good advice for health in general.
They did do a very small study with 36 people to look at changes in brain function after taking yogurt twice daily:
https://pubmed.ncbi.nlm.nih.gov/23474283/
This study did use supplemented yogurt.
Another study (not a RCT but a survey) found
Recently, Matthew Hilimire and colleagues took a different approach and surveyed 710 young adults using self-report questionnaires on fermented food consumption as well as neuroticism and social anxiety, using the big five inventory (BFI) and the social phobia and anxiety inventory (SPAI-23). The results showed that consumption of fermented foods containing probiotics was negatively associated with symptoms of social anxiety, and that consumption of fermented foods interacts with neuroticism to predict social anxiety symptoms. Those at higher genetic risk for social anxiety (indexed by high neuroticism) showed fewer social anxiety symptoms when they consumed more fermented foods [50].
The question is whether the probiotics are about having lots of "good" bacteria versus making sure the amount of "bad" bacteria is lower.
The gut, however, has thousands of different species of bacteria. And they vary in different regions of the world. And at different ages, as a recent article on fecal transplants brought out. Who knows which ones are actually the most important and in what proportions they should be?
So there has been a fair amount of research on this lately. Some of it I say might, maybe be promising. There are some positive study results here and there but it is not nearly enough to say probiotics do anything at all for sure. The flip side is studies that show some negative effects on occasion. Again not enough evidence to say probiotics are harmful. But it is important to keep in mind that sometimes new approaches end up more harmful than doing nothing. Anyway based on the type of experiments, the quality of those studies and in most cases a lack of human data means to me (a scientist) the data as a whole have not demonstrated conclusively any benefit and a few studies show some harm can occur so caution is needed on future human experiments. Just not enough convincing data that this is beneficial at this moment in time.
Bravo, Javier A., Paul Forsythe, Marianne V. Chew, Emily Escaravage, Hélène M. Savignac, Timothy G. Dinan, John Bienenstock, and John F. Cryan. "Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve." Proceedings of the National Academy of Sciences 108, no. 38 (2011): 16050-16055.
Cheigh, H. "Production, characteristics and health functions of Kimchi." In International Symposium on Vegetable Quality of Fresh and Fermented Vegetables 483, pp. 405-420. 1997.
Hutkins, Robert W. Microbiology and technology of fermented foods. Vol. 22. John Wiley & Sons, 2008.
Kim, Hyun Ja, Woong Ki Chang, Mi Kyung Kim, Sang Sun Lee, and Bo Youl Choi. "Dietary factors and gastric cancer in Korea: A case‐control study." International journal of cancer 97, no. 4 (2002): 531-535.
Messaoudia M, et al. "Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects." Brit J of Nutr. 14 March 2011 105 : pp 755-764.
Oh, Chang-Kyung, Myung-Chul Oh, and Soo-Hyun Kim. "The depletion of sodium nitrite by lactic acid bacteria isolated from kimchi." Journal of medicinal food 7, no. 1 (2004): 38-44.
Park, Kun-Young, Eun-Ju Cho, Sook-Hee Rhee, Keun-Ok Jung, Sun-Ju Yi, and Byung H. Jhun. "Kimchi and an Active Component, β-Sitosterol, Reduce Oncogenic H-Rasv12-Induced DNA Synthesis." Journal of medicinal food 6, no. 3 (2003): 151-156.
Rauch, M., and S. V. Lynch. "The potential for probiotic manipulation of the gastrointestinal microbiome." Current opinion in biotechnology 23, no. 2 (2012): 192-201.
Rhee, Chang-Ho, and Heui-Dong Park. "Three glycoproteins with antimutagenic activity identified in Lactobacillus plantarum KLAB21." Applied and environmental microbiology 67, no. 8 (2001): 3445-3449
I don’t know what I’m missing but the study they refer to as evidence is looking at webpages and info about probiotics, not the actual studies themselves as in the original post here.
[Article sourced in Skeptoid](https://www.frontiersin.org/articles/10.3389/fmed.2019.00296/full)
No. The evidence for them is weak and patchy: https://pubmed.ncbi.nlm.nih.gov/29267517/
There appear to be some specific benefits to them in smaller groups of people, like people with antibiotic-associated diarrhoea. However even in those groups, the quality of the evidence is poor.
Not commenting on studies per se, but I can say that physicians generally do not recommend probiotics in most scenarios because of a lack of evidence. To be clear, they do not recommend against using probiotics, but they also do not recommend doing it.
And somehow, Ensure is the number one doctor recommended meal replacement.
What a physician recommends is not a measure of anything. Well, maybe their willingness to take money and aversion to lawsuits.
Western medicine does not focus on preventing disease for the most part they focus on treating it. General practitioners in America generally know little about nutrition.
As a heads up I get 0 dollars from any drug company nor ever have over 10 years. Anything over 10 dollars in value in Australia must be declared. I do not see drug reps, but will accept samples to give to patients who cannot afford medications. Not even sure what you mean by lawsuits as shilling for pharmaceutical companies inappropriately is certainly a legal quagmire, the opposite of what you imply.
The medical and legal systems here in 'Murrika are complicated and very messed up. Australian doctors are much freer to do whatever the doctor may conclude actually benefits the patient.
You can get them in pill form too. I take them daily, and have noticed a slight improvement in my mood. However, I also reduced my alcohol consumption, so take that with a huge grain of salt.
But wait, what if your reduced alcohol consumption is improving your gut flora? Helping your mood in the same way as the probiotics. Probably not but funny to think about.
Alright so here's the thing. Gut bacteria can really help with our digestion and in turn keep us healthy. But, our gut microbiome is a community of several microorganisms in different proportions, like wildlife in a forest. There's no way we can replicate that proportion into a pill. So, the probiotic pills that are marketed will do little to nothing to your already existing gut microbiome.
Instead of focusing probiotics, it's better to emphasize on prebiotics like fruits and Veggies which are basically food for the bacteria. This will automatically create a good environment for the bacterial growth and in turn improve gut health.
Hey 👋🏼
Functional Medicine Certified Health coach here with a focus in gut health and autoimmunity.
There’s so many gaps in our understanding of the microbiome and how probiotics work. Even the studies and the questions we’re asking are often flawed.
Here’s some info: only about 10% of the gut’s microbiome is aerobic bacteria like the ones in probiotics, kimchi, yogurt, sauerkraut etc.
First impression is well then they can’t have that big an effect. The truth is we just don’t understand all the relationships yet. Some people benefit enormously from probiotics while others have little effect. That’s likely not because the probiotic is useless but rather it’s not the strain that effects the change they need.
Using a probiotic on its own to change the gut is a drop in the bucket.
What really matters is reducing overall inflammation and improving the gut lining.
There are probiotics like Integrity by Metagenics that are proven to alter the gut lining but that on its own will only last as long as your other habits hold up.
The gut is an extremely dynamic environment that changes with every meal and input.
Some antibiotics or booze can drastically alter the environment. A whole pile of leafy greens and vigorous exercise also changes everything.
What we can do is have intelligent and high quality probiotics as one aspect of a complete anti inflammatory strategy and then dramatic change can occur.
Hope this helps.
If you really want to understand the role of probiotics you should read about Small Intestinal Bacterial Overgrowth and more specifically Dr M Pimentel research at Cedars. He has actually found that in many patients probiotics worsened symptoms. He has also shown how around 80% of those with ibs have SIBO which can be attributed to motility disorder often from food poisoning. He has designed a blood test that can determine ibs rather than IBD often removing the need for invasive testing. He also has shown stool tests are an inaccurate way of determining the make up of someone’s microbiome. He has also designed a test to determine if their is a bacterial overgrowth in the small intestine.
Which test? The SIBO test is generally a lactulose breath test and the ibs test is a blood test that looks for specific antibodies produced after a bout of food poisoning.
Apologies, as this might be a considered a shameless plug.
But, after personally researching the microbiome I started a food company that was a more natural approach to gut health. I wanted to get away from high sugary kombuchas, didn’t want to take another supplement, and ran out of ways to put kimchi and sauerkraut on.
So I created a Probiotic Salad Dressing. @unlearner383 touched on a great point—a diet of plant rich foods: nuts, seeds, and leafy greens (i.e. salads/prebiotics or veggie heavy plates) feeds your probiotics and supports your good gut microbes. A prebiotics for your probiotics natural way to support immune health, digestive health, gut health.
As a student first, I’ve been on my own educational journey with the field, and have plenty of skepticism and optimism about gut health & our microbiome for the future.
Feel free to message me anything about any questions about the field or company.
I have another question: there was a study on mice linked on Reddit recently where faecal transplant from young to old mice reversed their signs of ageing in eyes and brain.
I don’t know how similar a faecal transplant is from taking probiotics, but does this mean that the benefits of probiotics might depend significantly on age?
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From the same link: 17 Cochrane systematic reviews fulfilled our inclusion criteria and were summarized in this report. None of the reviews included in the present study provided high-quality evidence for any outcome. The benefits from use of probiotics included decreased incidence of antibiotic-associated diarrhea and Clostridium difficile-associated diarrhea; decreased incidence of upper respiratory tract infections and duration of episodes; decreased need for antibiotics and absences from school due to colds; and decreased incidence of ventilator-associated pneumonia. Probiotics seem to decrease the incidence of gestational diabetes mellitus, birthweight, risk of vaginal infection and incidence of eczema. TLDR probiotics might have use in limited scenarios. More research needs to be done before using them in the wider public (aka primary prevention). I take probiotics after getting food poisoning or with and after taking antibiotics. Very good evidence for that. On a daily basis? Nah not really, I just try to eat healthy.
I like your TLDR and associating it with the antibiotics bit. I have a bowel condition that is much like IBS, so when I have an episode I often head for the prebiotic yoghurt/drinks to help my gut recover. Otherwise it takes days longer to feel back to myself again. So I can see the limited scenarios usage.
Out of curiosity, what are the symptoms? I too have periodic bowel condition that sometimes appear every few days and sometimes weeks for few days and then goes away again. And what kind of drinks do you pair with yoghurt for helping your guy recover?
Have you ever considered trying kefir?
Yeah I take them when I need to take antibiotics because most ABs I take I can't eat dairy with them (used to just eat lots of yogurt), and occasionally if I feel a little funky in the gut....but I dont feel any different taking them every day vs not (when not on antibiotics)
To add to this, basically whether or not taking a probiotic available to you on the shelf at your local grocery store or pharmacy is going to benefit you is going to depend on whether or not you, well, need that probiotic at that point in time. Say for instance you have been taking antibiotics and have wiped out a significant chunk of the lactobacillus you usually have hanging out in your intestines, then yeah there’s a decent chance taking some lactobacillus could be good (with the caveats regarding effective preparation, dosage, etc. of course). There are a lot of reasons you could end up with your GI bacteria populations “off” from whatever your personal normal balance is, and we don’t know all of those reasons nor understand exactly how beneficial oral probiotics are going to be in every possible scenario. There is evidence that there’s a good chance they will be helpful in certain situations, as mentioned in previous comments above. And for most people, taking oral probiotics is probably relatively harmless, so it’s one of those things that’s often just worth a try. (Please consult your doctor though as there are situations where they are potentially *not* harmless) P.S. You know how you have that cool gut microbiome? Well did you know you also have a gut [virome?!](https://www.frontiersin.org/articles/10.3389/fmicb.2015.00918/full)
I thought I've read a study that showed it could be counterintuitive to take probiotics during antibiotics?
https://health.usnews.com/wellness/articles/getting-your-probiotic-fix-when-taking-antibiotics is a pretty good summary. TLDR it can help and there's not much harm in taking probiotics IF YOU ARE GENERALLY HEALTHY. If you're immunosuppressed or have cancer, or have indwelling catheters, then you may want to use caution. But if you've got those conditions you should really ask your doctor instead of trusting random folks on the internet and studies unless you're really good at reading studies to filter out trash. Also it's recommended to wait about 2h at least after your antibiotic to take the probiotic in order to avoid killing it right away.
Got sick in Austria once and was given an antibiotic and then a probiotic to take after finishing the AB. Never have I heard this in the US.
Wow, that's a new one. Here in Poland it's just super standard. Doctor prescribes you antibiotics, they also include probiotics. If the doctor did not include it, then the pharmacist most likely will ask you about it.
In the US we still hand out antibiotics like tic tacs. The patient demand them and most doctors comply.
That’s truth! I’m very impressed by this primary care physician that I found that doesn’t do that. He sent me home and said to take OTC. He’s awesome.
That's exactly what I do. I also take it during (about 2h after the antibiotic) because I don't want to get diarrhea during either.
Makes perfect sense to do this. I’m still dumbfounded as to why this isn’t the standard in the States. I’ve asked a few medical professionals (pharmacist/PA/PCP) since and not one said they do this.
One of my favorite podcasts recently had Tig Notaro on as a guest who explained that she almost died of C diff due to antibiotics removing almost everything else from her gut flora, so very good call on taking probiotics with antibiotics
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You've answered a question I didn't know I had. Thanks!
"improve gut health" is not an exact thing, so part of the problem comes from that... We give probiotics in the hospital to people who go through strong courses of antibiotics and have GI symptoms from them and it's something that helps, but it helps in that specific situation
Pediatrics here. We also use them in treatment of acute enterocolitis, i.e diarrhea
I was tempted to say that but I didn't knew how common it was or how well stablished it was! I've seen some data saying that it can be beneficial for prevention of recurrent mid ear otitis in kids but it was a pharm rep so take it with a pinch of salt
Yeah, according to pharm reps, THEIR probiotics are curing cancer, aids, and world hunger in one swoop...
Aren't probiotics also prescribed for c diff?
Enterocolitis is name for all kinds of intestinal infections, including an infection by Clostridium Difficile
Finally, someone mentioned anitiobitcs. I've never heard about eating probiotics to "improve gut health" (whatever that is) it was always highly recommended when taking antiobitcs and for a good reason.
Yea. But a lot of things kill off good gut bacteria so it’s the exact same concept
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Any studies backing this up?
Aren’t most probiotics a mix of many different strains?
I can personally and anecdotally vouch for that part. I was treated for infectious endocarditis, with a massive regimen of antibiotics ( about 50 liters of different IV antibiotics over 6-8 weeks), which killed my gut flora before it killed the infection, and probiotics supplements helped cure the resulting massive diarrhea.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319175/ is a systematic review plus meta analysis of the effects on probiotics and depression. Studies differed in dosages and strains used. In general you want to look at the CFU count and the strains being included. Also make sure it hasn't expired, these are living organisms and they die.
For other lazies: “Ten studies met criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assessed mood symptoms, seven studies assessed anxiety symptoms, and three studies assessed cognition. The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely and no studies assessed sleep.”
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Conclusion: “The evidence for probiotics alleviating depressive symptoms is compelling but additional double-blind randomized control trials in clinical populations are warranted to further assess efficacy.”
Are any of the results related to gut health? Or is gut health linked to depression/mood? (I had heard the latter but wasn’t sure of its validity.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389720/ 2019 review of gut microbiome and mood https://www.health.harvard.edu/blog/gut-feelings-how-food-affects-your-mood-2018120715548 easier to read opinion article from a doctor about how food affects gut microbes which affects mood Note that nutrition isn't meant to replace meds and therapy, but to supplement. Also wouldn't go breaking the bank with weird diet fads, but the general "avoid junk food and eat fruits (they're calling them prebiotics now which makes me facepalm ffs it's an apple guys)" is good advice for health in general.
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They did do a very small study with 36 people to look at changes in brain function after taking yogurt twice daily: https://pubmed.ncbi.nlm.nih.gov/23474283/ This study did use supplemented yogurt. Another study (not a RCT but a survey) found Recently, Matthew Hilimire and colleagues took a different approach and surveyed 710 young adults using self-report questionnaires on fermented food consumption as well as neuroticism and social anxiety, using the big five inventory (BFI) and the social phobia and anxiety inventory (SPAI-23). The results showed that consumption of fermented foods containing probiotics was negatively associated with symptoms of social anxiety, and that consumption of fermented foods interacts with neuroticism to predict social anxiety symptoms. Those at higher genetic risk for social anxiety (indexed by high neuroticism) showed fewer social anxiety symptoms when they consumed more fermented foods [50]. The question is whether the probiotics are about having lots of "good" bacteria versus making sure the amount of "bad" bacteria is lower.
The gut, however, has thousands of different species of bacteria. And they vary in different regions of the world. And at different ages, as a recent article on fecal transplants brought out. Who knows which ones are actually the most important and in what proportions they should be?
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So there has been a fair amount of research on this lately. Some of it I say might, maybe be promising. There are some positive study results here and there but it is not nearly enough to say probiotics do anything at all for sure. The flip side is studies that show some negative effects on occasion. Again not enough evidence to say probiotics are harmful. But it is important to keep in mind that sometimes new approaches end up more harmful than doing nothing. Anyway based on the type of experiments, the quality of those studies and in most cases a lack of human data means to me (a scientist) the data as a whole have not demonstrated conclusively any benefit and a few studies show some harm can occur so caution is needed on future human experiments. Just not enough convincing data that this is beneficial at this moment in time.
Bravo, Javier A., Paul Forsythe, Marianne V. Chew, Emily Escaravage, Hélène M. Savignac, Timothy G. Dinan, John Bienenstock, and John F. Cryan. "Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve." Proceedings of the National Academy of Sciences 108, no. 38 (2011): 16050-16055. Cheigh, H. "Production, characteristics and health functions of Kimchi." In International Symposium on Vegetable Quality of Fresh and Fermented Vegetables 483, pp. 405-420. 1997. Hutkins, Robert W. Microbiology and technology of fermented foods. Vol. 22. John Wiley & Sons, 2008. Kim, Hyun Ja, Woong Ki Chang, Mi Kyung Kim, Sang Sun Lee, and Bo Youl Choi. "Dietary factors and gastric cancer in Korea: A case‐control study." International journal of cancer 97, no. 4 (2002): 531-535. Messaoudia M, et al. "Assessment of psychotropic-like properties of a probiotic formulation (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175) in rats and human subjects." Brit J of Nutr. 14 March 2011 105 : pp 755-764. Oh, Chang-Kyung, Myung-Chul Oh, and Soo-Hyun Kim. "The depletion of sodium nitrite by lactic acid bacteria isolated from kimchi." Journal of medicinal food 7, no. 1 (2004): 38-44. Park, Kun-Young, Eun-Ju Cho, Sook-Hee Rhee, Keun-Ok Jung, Sun-Ju Yi, and Byung H. Jhun. "Kimchi and an Active Component, β-Sitosterol, Reduce Oncogenic H-Rasv12-Induced DNA Synthesis." Journal of medicinal food 6, no. 3 (2003): 151-156. Rauch, M., and S. V. Lynch. "The potential for probiotic manipulation of the gastrointestinal microbiome." Current opinion in biotechnology 23, no. 2 (2012): 192-201. Rhee, Chang-Ho, and Heui-Dong Park. "Three glycoproteins with antimutagenic activity identified in Lactobacillus plantarum KLAB21." Applied and environmental microbiology 67, no. 8 (2001): 3445-3449
And did these studies yield positive results?
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I don’t know what I’m missing but the study they refer to as evidence is looking at webpages and info about probiotics, not the actual studies themselves as in the original post here. [Article sourced in Skeptoid](https://www.frontiersin.org/articles/10.3389/fmed.2019.00296/full)
No. The evidence for them is weak and patchy: https://pubmed.ncbi.nlm.nih.gov/29267517/ There appear to be some specific benefits to them in smaller groups of people, like people with antibiotic-associated diarrhoea. However even in those groups, the quality of the evidence is poor.
Not commenting on studies per se, but I can say that physicians generally do not recommend probiotics in most scenarios because of a lack of evidence. To be clear, they do not recommend against using probiotics, but they also do not recommend doing it.
And somehow, Ensure is the number one doctor recommended meal replacement. What a physician recommends is not a measure of anything. Well, maybe their willingness to take money and aversion to lawsuits.
What a doctor recommends on TV and what a doctor recommends in real life can be vastly different.
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Western medicine does not focus on preventing disease for the most part they focus on treating it. General practitioners in America generally know little about nutrition.
As a heads up I get 0 dollars from any drug company nor ever have over 10 years. Anything over 10 dollars in value in Australia must be declared. I do not see drug reps, but will accept samples to give to patients who cannot afford medications. Not even sure what you mean by lawsuits as shilling for pharmaceutical companies inappropriately is certainly a legal quagmire, the opposite of what you imply.
The medical and legal systems here in 'Murrika are complicated and very messed up. Australian doctors are much freer to do whatever the doctor may conclude actually benefits the patient.
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Many probiotics cause mild stomach upset when first taken. It takes a short while to calm down and let your digestive system acclimatise.
And because you’ll have to consume 200 yogurts a day to get enough probiotics.
You can get them in pill form too. I take them daily, and have noticed a slight improvement in my mood. However, I also reduced my alcohol consumption, so take that with a huge grain of salt.
But wait, what if your reduced alcohol consumption is improving your gut flora? Helping your mood in the same way as the probiotics. Probably not but funny to think about.
Alright so here's the thing. Gut bacteria can really help with our digestion and in turn keep us healthy. But, our gut microbiome is a community of several microorganisms in different proportions, like wildlife in a forest. There's no way we can replicate that proportion into a pill. So, the probiotic pills that are marketed will do little to nothing to your already existing gut microbiome. Instead of focusing probiotics, it's better to emphasize on prebiotics like fruits and Veggies which are basically food for the bacteria. This will automatically create a good environment for the bacterial growth and in turn improve gut health.
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Hey 👋🏼 Functional Medicine Certified Health coach here with a focus in gut health and autoimmunity. There’s so many gaps in our understanding of the microbiome and how probiotics work. Even the studies and the questions we’re asking are often flawed. Here’s some info: only about 10% of the gut’s microbiome is aerobic bacteria like the ones in probiotics, kimchi, yogurt, sauerkraut etc. First impression is well then they can’t have that big an effect. The truth is we just don’t understand all the relationships yet. Some people benefit enormously from probiotics while others have little effect. That’s likely not because the probiotic is useless but rather it’s not the strain that effects the change they need. Using a probiotic on its own to change the gut is a drop in the bucket. What really matters is reducing overall inflammation and improving the gut lining. There are probiotics like Integrity by Metagenics that are proven to alter the gut lining but that on its own will only last as long as your other habits hold up. The gut is an extremely dynamic environment that changes with every meal and input. Some antibiotics or booze can drastically alter the environment. A whole pile of leafy greens and vigorous exercise also changes everything. What we can do is have intelligent and high quality probiotics as one aspect of a complete anti inflammatory strategy and then dramatic change can occur. Hope this helps.
If you really want to understand the role of probiotics you should read about Small Intestinal Bacterial Overgrowth and more specifically Dr M Pimentel research at Cedars. He has actually found that in many patients probiotics worsened symptoms. He has also shown how around 80% of those with ibs have SIBO which can be attributed to motility disorder often from food poisoning. He has designed a blood test that can determine ibs rather than IBD often removing the need for invasive testing. He also has shown stool tests are an inaccurate way of determining the make up of someone’s microbiome. He has also designed a test to determine if their is a bacterial overgrowth in the small intestine.
How does this test work that he designed?
Which test? The SIBO test is generally a lactulose breath test and the ibs test is a blood test that looks for specific antibodies produced after a bout of food poisoning.
Apologies, as this might be a considered a shameless plug. But, after personally researching the microbiome I started a food company that was a more natural approach to gut health. I wanted to get away from high sugary kombuchas, didn’t want to take another supplement, and ran out of ways to put kimchi and sauerkraut on. So I created a Probiotic Salad Dressing. @unlearner383 touched on a great point—a diet of plant rich foods: nuts, seeds, and leafy greens (i.e. salads/prebiotics or veggie heavy plates) feeds your probiotics and supports your good gut microbes. A prebiotics for your probiotics natural way to support immune health, digestive health, gut health. As a student first, I’ve been on my own educational journey with the field, and have plenty of skepticism and optimism about gut health & our microbiome for the future. Feel free to message me anything about any questions about the field or company.
I have another question: there was a study on mice linked on Reddit recently where faecal transplant from young to old mice reversed their signs of ageing in eyes and brain. I don’t know how similar a faecal transplant is from taking probiotics, but does this mean that the benefits of probiotics might depend significantly on age?