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How to choose a Probiotic

Narinder Duggal, MD, FRCPC

Probiotics are the beneficial bacteria that live in our digestive tract. The word probiotic means “FOR LIFE”. They are live microorganisms that are similar to microorganisms found in the human gut which, when administered in adequate amounts, confer a health benefit on the host.¹ They are also called "friendly bacteria" or "good bacteria."

There is increasing evidence that probiotics have beneficial effects in preventing a wide range of conditions and improving health.² Studies have provided evidence of probiotic effectiveness for the treatment and prevention of acute diarrhea, antibiotic-induced diarrhea, traveler's diarrhea, dental caries, irritable bowel syndrome, and inflammatory bowel disease.³ Usefulness of probiotics has also been implicated in allergies, cancer, AIDS, and respiratory and urinary tract infections.⁴

It is important to understand that not all probiotics are equal.  Most probiotics are bacteria which mostly come from two groups, Lactobacillus or Bifidobacterium. Within each group there are different species, for example, Lactobacillus acidophilus and Bifidobacterium bifidum and within each species there are different strains.

Specific strains are effective in specific disease states. Probiotic strains, Lactobacillus acidophilus and Bifidobacterium provide excellent therapeutic benefits. They are able to attach to the cellular receptors of enterocytes in the intestine, and inhibit the binding of enteric pathogens (bad bacteria). Their attachment to enterocytes results in the synthesis of cytokines and bacteriocins which are responsible for inhibiting the growth of pathogens.⁵

It is extremely important to be careful when selecting a probiotics supplement. The criteria for choosing a good probiotic supplement include the functionality, safety and packaging of the probiotic along with the individual need.

Functionality:    This refers to the ability of the probiotics to survive in the product and become active when entering the consumer's gastrointestinal tract.⁶ These factors include the physiologic state of the probiotic organisms and the physical conditions of product storage such as temperature.

The functionality of a probiotic should be:

 1.  Resistant against stomach acid and bile.

 2.  Capable of growing under anaerobic conditions.

 3.  Non-toxic.

 4.  Able to adhere to human epithelial cells and cell lines.

 5.  Able to reduce pathogen adhesion.

Safety:  Some probiotics such as Lactobacillus and Bifidobacterium have been given GRAS (Generally Recognized as Safe) status.^7,8 Bifidobacterium is the most prevalent probiotic in the large intestine, and Lactobacillus is most prevalent in the small intestine.  An ideal probiotic supplement must have these strains which will insure that the probiotic needs of the small as well as large intestine are supported.

Packaging:  The number of colony forming units (CFU) or the number of living bacterial cells in each capsule refers to packaging. Dr Dash author of "A Consumer's Guide to Probiotics" has recommended that two to five billion CFU’s (2-5x 109 CFU/g) should be taken daily just before breakfast or between meals.

Individual need for any specific strain:  Different probiotic strains have been studied for their different efficacies. Choose a product which contains the specific strains your body needs to support your specific health condition or to promote the health benefits you are seeking.

If you want to buy the best probiotic supplement, Synergy Therapeutics RX Bioflora Plus DDS®-1 is the only probiotic supplement available over the counter that is physician and pharmacist formulated and approved. It fulfills the selection criteria as suggested by experts.

Bioflora Plus is the source of a special strain of Lactobacillus acidophilus, Bifidobacterium longum, Bifidobacterium bifidum, Bifidobacterium lactis and FOS (Fructooligosaccharides). Bioflora Plus DDS®-1 is free of dairy products, corn, soy and preservatives. Each gram (2 capsules) of Bioflora Plus DDS®-1 contains 12 billion viable L. acidophilus (DDS®-1 strain), B. longum, B. bifidum, and B. lactis at the time of manufacturing. It is stable at room temperature for two years. Bioflora Plus can help restore the natural balance necessary for a healthy digestive system.

References:

1.    http://nccam.nih.gov/health/probiotics/. (Open link)

2.    Minocha A. Probiotics for preventive health. Nutr Clin Pract 2009;24(2):227-41. (PUBMED Abstract)

3.    Goldin BR, Gorbach SL. Clinical indications for probiotics: an overview. Clin Infect Dis 2008;46 Suppl 2:S96-100; discussion S44-51. (PUBMED Abstract)

4.    Kaur IP, Kuhad A, Garg A, Chopra K. Probiotics: delineation of prophylactic and therapeutic benefits. J Med Food 2009;12(2):219-35. (PUBMED Abstract)

5.    Kailasapathy K, Chin J. Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp. Immunol Cell Biol 2000;78(1):80-8. (PUBMED Abstract)

6.    Heller KJ. Probiotic bacteria in fermented foods: product characteristics and starter organisms. Am J Clin Nutr 2001;73(2 Suppl):374S-9S. (PUBMED Abstract)

7.    Liong MT. Safety of probiotics: translocation and infection. Nutr Rev 2008;66(4):192-202. (PUBMED Abstract)

8.    Mattia A, Merker R. Regulation of probiotic substances as ingredients in foods: premarket approval or "generally recognized as safe" notification. Clin Infect Dis 2008;46 Suppl 2:S115-8; discussion S44-51. (PUBMED Abstract)