Its name isn’t sexy, and neither are its living arrangements. Probiotics, which are live microorganisms (read bacteria) that are added to your gut, sound like some sort of squirming critter you’d rather steer clear of. But because of their supposed powers to soothe stomachs and boost immunity, probiotics have become increasingly popular.
And that’s a bit ironic, because it’s hard to know if you’re getting the genuine article. According to a recent test by ConsumerLab.com, an independent laboratory that tests supplements, one-third of probiotic products have far fewer live organisms than their labels claim. Many of the supplements tested had only 1 percent of the billion or so organisms you would expect to find; some had only one-ten-thousandth. Overall, one-quarter of the probiotic products analyzed made claims their labels couldn’t support.
So how do you make sure you’re not getting stiffed? And should you even bother with probiotics? They may be selling big, but the claims take some sorting through; the evidence is stronger for some than for others.
First, a bit of Biology 101. Our intestines sport a steamy forest of bacteria, whose balance is essential to health. When the balance is upset by an external influence, mainly food-borne bacteria or antibiotics, our bodies become unhappy in any number of ways. Our digestive systems suffer, our immunity can wane, and according to many practitioners, this bacterial imbalance plays a role in ailments as wide-ranging as lactose intolerance, respiratory problems, and even heart disease. The job of probiotics is to repopulate our gut with the bacteria that have been lost.
So far, most of the research has focused on probiotics and diarrhea. In addition to reseeding the intestines with beneficial bacteria (which antibiotics typically kill off), probiotics release acids that kill harmful bacteria. This double whammy has proven so effective that many practitioners now routinely prescribe them—in supplement form or in foods like yogurt and kefir—to patients on antibiotics.
These good bacteria may also relieve the opposite problem, constipation. According to several studies, probiotics may increase acid levels, which boosts the gut’s ability to push waste through. They may also inhibit the staying power of Helicobacter pylori, a type of bacteria associated with gastritis, ulcers, and gastric cancer. In fact, many practitioners are using probiotics to treat a variety of intestinal ailments, including inflammatory bowel disease, irritable bowel syndrome, and colitis.
When Rahima Hirji, a naturopath at the Canadian College of Naturopathic Medicine in Toronto, Ontario, prescribed probiotics to an 18-year-old woman with irritable bowel syndrome, her pain and irregularity significantly improved after only three weeks.
Some research supports Hirji’s clinical experience. A 2002 University of California, Los Angeles study found that probiotics eased pain and gas and improved regularity in patients with IBS. Another study found what may be a causal link: Those with IBS tended to have low numbers of beneficial bacteria in their intestines.
And probiotics aren’t just friendly placeholders in the gut, says Alan Greene, a pediatrician at Stanford University in Palo Alto, California, and founder of www.drgreene.com. “They also help bring the immune system to a nice stable midpoint.”
In laboratory tests of cell cultures, probiotics have been shown to increase the production of immune cells that fight viral infections and tamp down antibodies associated with allergies. They also ease inflammation, which is why some experts think they can protect against respiratory infections and heart disease.
Human studies of probiotics and immunity are limited, but Greene says he sees a real improvement in the overall health of patients who take probiotics regularly. “The people who load up on the stuff have fewer colds and allergy attacks,” he says. “Kids come down with fewer ear infections, and I’m seeing evidence that probiotics help prevent urinary tract infections.”
In fact, Greene is so impressed by probiotics that he now routinely advises his patients to eat lots of yogurt. (Look for brands with the LAC seal, meaning they contain live active cultures.) But in order to treat specific conditions, he says, you’ll probably need to rely on a supplement.
Probiotics may sound creepy at first, but invite them in, and you’ll find they make very friendly houseguests.
If you have a specific ailment, such as diarrhea or lactose intolerance, most experts would advise supplements over yogurt. “You usually don’t get enough probiotics from food to have a therapeutic dose,” says naturopath Rahima Hirji. But how do you make the best choice?
Top Form: Options include capsules, tablets, powder, and liquid, but experts generally recommend the refrigerated enteric-coated capsules or tablets. The coating ensures that organisms will survive the acidy transit through the stomach to the intestines, and the refrigeration keeps organisms alive for as long as possible. The powdered form is cheaper than capsules, and it’s a great option if you want to take your dose in a smoothie. The liquid form is the least stable of all the forms, and experts tend not to recommend it.
Read the Label: Look for products that contain one billion bacteria in each daily serving. But don’t buy if the bottle guarantees the dose only at the time of manufacture; the trip from manufacturer to supermarket can seriously compromise the product’s bacteria. Check the expiration date as well, and purchase bottles as far in advance of that date as possible.
Look for a Blend: Some practitioners recommend particular strains of bacteria for different ailments, but not all strains are readily available. The simplest way to cover your bases is to buy a probiotic that contains a blend of several. “That way you’ll increase the chances that one or more of the strains will have an impact,” says Mary Ellen Sanders, food scientist and president of Dairy and Food Culture Technologies in Centennial, Colorado.
By Catherine Guthrie