Probiotic is a term used to refer to ingested microorganisms that that offer beneficial effects to humans and animals.  The use of probiotics based on the theories of Eli Metchnikoff who suggested that “the dependence of the intestinal microbes on the food makes it possible to adopt measures to modify the flora in our bodies and to replace the harmful microbes by useful microbes”.  Basically, there are “friendly” bacteria found in the human mouth, vagina, and intestinal tract that protect us from unhealthy bacteria.  These “friendly” bacteria include L. acidophilus, B. bifidus and L. bulgaricus.  As a supplement, some of these strains help correct lactose intolerance and resolve intestinal gas, promote absorption of nutrients, and have antibacterial properties.

In a study of hospitalized seniors who suffered constipation, subjects were given a daily dessert of L. acidophilus yogurt prune whip.  Over 95 percent of the subjects no longer needed laxatives as long as they ate the special prune whip.  Other effects of probiotic treatment include improvement in overall mental outlook and in diabetic ulcers for a number of patients who also suffered from diabetes.  Other beneficial effects of probiotics include improving digestive symptoms, preventing infections, and reducing the risk of eczema.

Ideally, good bacteria should make up 90 percent of your gut microbiota (the population of microbes living in your intestines).  Diet, stress, illness, and medication can upset the balance of bacteria.  Fermented foods such as yogurt, sauerkraut, miso, and kefir all contain probiotics, but not in the same concentration as probiotic supplements.  According to Shekhar Challa, MD, president of the Kansas Medical Clinic and author of Probiotics for Dummies, ‘Many people can benefit from probiotics for general health and wellbeing.  They especially help people with immune problems, digestive problems, or yeast infections.”

Strains and Enzymes

Probiotics produce enzymes such as protease, lipase and lactase which aid the digestion of proteins, fats and milk products.  They also produce hydrogen peroxide which has a wide range of activity against yeasts, molds, and bacteria.  Probiotics adhere to the intestinal mucosa which helps prevent pathological bacteria from colonizing, and produce lactic acid which creates an acidic environment that is unfavorable for pathogens and enhance the absorption of minerals.  In addition, probiotics lower cholesterol and can inhibit the growth of 23 toxin-producing organisms (natural comp).

There are many strains of probiotics.  Some have general effects whereas some are designed to work against specific conditions.  For example, the combination of bifidobacteria and L. acidophilus has been found to reduce the incidence of cold and flu symptoms in children by 50 percent.  LGG probiotic has been found to prevent eczema in children.  Other strains have been used to treat vaginal candidiasis and reduce cancer risk.  Some probiotic products have been formulated to reduce diarrhea, improve the symptoms of lactose intolerance, and improve immune performance.

The most common indication of probiotic supplements is for those taking antibiotic drugs.  A reduction in healthy bacteria (which antibiotics can cause) can decreases digestion and absorption of nutrients.  It can increases the production of gas, bloating, and toxins.  Diarrhea, stress, and intestinal infections can also alter the bacteria balance.

The Importance of Quality

Like many natural therapies, there can be a tremendous difference in quality among various probiotic supplements.  In general, probiotics should list the genus, species and even the strain of probiotic.  The strength of probiotics is listed as CFU (colony forming units).  In general, quality products have between 1-10 billion CFU per capsule.  Sometimes, a larger quantity is not desirable.  In our clinic in Oakland, California, most people taking inferior quality probiotics notice no improvement, and occasionally people will have an increase in maldigestion after super potent probiotics–some even develop symptoms due to binder ingredients found in probiotics.  One of our patients, for example, experienced increased gas and bloating after taking a probiotic strain recommended by a doctor, a strain that listed corn as one of its ingredients.


Proper storage of probiotics is also important.  Probiotics need to be kept away from moisture and heat.  At one time, quality products could only be found in the refrigerated section of health food stores.  Today, there are excellent products which do not need refrigeration.  One must pay close attention to instructions on the label of individual products.  Expiration dates can indicate when probiotic activity may decrease or stop all together.


Rotating probiotics is one of the best ways I have found for patients to gain exposure to a wide range of microbiological organisms.  My favorite, and the best researched probiotic is Culturelle (LGG) which is the most frequently recommended probiotic in our clinic.  Other useful probiotics for the gastrointestinal tract are Florastor (S. boulardii), which is specifically for diarrhea, and Primadophilus reuteri.  Lactobacillus plantarum 200v is one of the probiotics that has been studied in IBS patients.

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