Probiotics are getting more and more press these days and they are good for just about everybody to take in order to obtain and maintain optimal health. Many people ask us, “How do I choose a good probiotic?”, and with good reason: the gastrointestinal (GI) tract contains more bacterial organisms (trillions) than there are cells in the entire human body.

Once more, researchers are finding more evidence every day that those intestinal bacteria do a lot more than help us digest and absorb nutrients. In fact, research has shown that probiotics can:

  • Reestablish healthy bacterial balance following microflora imbalance (i.e., after antibiotic use, illness, etc.)
  • Support healthy bowel function
  • Increase the production of important short chain fatty acids that provide energy to the GI lining
  • Create a strong immune barrier and boost immune function
  • Aid in the digestion of difficult to break down compounds like lactose and casein
  • Increase the detoxification of harmful compounds.
  • Provide protection from carcinogens
  • Lower cholesterol levels
  • Alter brain chemicals (neurotransmitters) which can impact mood and behavior

Therefore, choosing a good probiotic is very important in order to obtain and maintain optimal health. Unfortunately, marketers have picked up on the increased demand and flooded the market with inferior products. Here are some things to look for in a probiotic that can help you choose a probiotic that is right for you.

How to Choose a Good Probiotic

  1. Potency – There are over 300 different strains of bacteria competing for space in the gastrointestinal tract. Strains that promote health (probiotics), as well as those that cause disturbances in GI (potentially pathogenic microorganisms) compete for space and nutrients. You need to get a probiotic that has sufficient potency to obtain and maintain balance in the system. Look for a product that has at least 20 billion CFU (colony forming units) at expiration (see below).
  2. Bacterial Strains – each bacterial strain provides specific benefits to specific parts of the GI tract. Once more, only specific strains of bacteria have been studied. When choosing a good probiotic, it is wise to focus on those strains that have been shown to be beneficial, rather than taking a product containing numerous strains of untested bacteria. In my opinion, a desirable product would contain the following strains:
    1. Lactobacillus acidophilus (La-14): L. acidophilus has been shown to protect the GI tract from invasion of E. Coli, decrease the risk of colon cancer and increase overall immune function. The L. acidophilus La-14 strain shows strong adherence in the GI tract and can tolerate exposure to stomach acid, bile salts and has the ability to withstand antibiotics.
    2. Lactobacillus plantarum (Lp-115): L. plantarum has been shown to decrease inflammation (in the GI tract and throughout the body), help improve immune function and improve overall GI function, even in those with IBS.
    3. Lactobacillus rhamnosus (Lr-32): L. rhamnosus has been shown to increase Natural Killer (NK) cell activity (which helps protect you from viruses and cancers), maintain optimal GI health and inhibit the adhesion of Salmonella.
    4. Bifidobacterium bifidum (Bb-02): B. bifidum has been shown to effectively inhibit E. coli and Staphylococcus aureus in the GI tract and improve overall immunity.
    5. Bifidobacterium lactis (Bl-04): B. lactis has been shown to inhibit pathogens from adhering to and invading the GI tract and may help prevent allergies.
    6. Saccharomyces boulardii: S. boulardii is a brewer’s yeast. It has been approved in Germany for the treatment of chronic acne, boils, acute and traveler’s diarrhea. It has also been shown to displace other (potentially pathogenic) yeasts and bacteria, increase the levels of secretory IgA and reduce inflammation in the GI tract.
  3. Product Viability – probiotics don’t do you much good if their dead. Unfortunately, the vast majority of probiotics out there aren’t processed or stored properly, which can dramatically decrease how well the product works. As an example, one study measured 52 probiotic products for microbiological content (dose and strains of microorganisms) and compared those to what was listed on the label; only 5 (less than 10%) accurately described their bacterial content.

Probiotics are living organisms and are sensitive to light, heat and moisture. Most probiotics need to be refrigerated in order to remain viable for any length of time; unfortunately, keeping probiotics in the fridge is expensive and cuts down on compliance. If probiotics are not refrigerated, they need to be manufactured very carefully in order to maximize viability at room temperature. Very few products have undergone the processing necessary to remain viable at room temperature – if they do, they will tell you (because it’s expensive).

  1. Expiration Date – If a probiotic product doesn’t have an expiration date, put it back. In fact, the product expiration date should be at most one year after the product was manufactured and the manufacturer should guarantee the number of CFUs per capsule at the time of expiration (at least 20 billion CFUs).

Use these criteria to help you choose a good probiotic. You will find, as we did, that most probiotics on the market won’t measure up. However, we have found that Ortho Biotic meets all these criteria and have been using it for years in practice. For overall health and maintenance, we generally use 1 capsule/day taken on an empty stomach (usually first thing in the morning or before bed). For more targeted GI support, 1-2 capsules 2x/day often works well.

References:

  1. Lipski E. (1996) Digestive Wellness. New Canaan, CT: Keats Publishing.
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  12. McClemens J, Kim JJ, Wang H, Mao YK, Collins M, Kunze W, Bienenstock J, Forsythe P, Khan WI. Lactobacillus Rhamnosus (JB-1) Ingestion Promotes Innate Host Defense in an Enteric Parasitic Infection. Clin Vaccine Immunol 2013; Mar 27.
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