Probiotic supplement sales are booming these days. There are several reasons for this occurrence. While mainstream marketing and advertising is clearly a factor, there is also a very large database of clinical research to support probiotic supplementation. A quick search at the National Library of Medicine’s website (Pubmed) for clinical trials with probiotics shows that there are now more than 1,000 published, double-blind, clinical studies.
In addition to promoting proper intestinal environment and stimulation of the gastrointestinal (GI) tract and systemic immunity, the clinical research notes major health benefits of probiotics include the prevention and treatment of: antibiotic-induced diarrhea; urinary tract infections (UTIs); vaginal yeast infections and bacterial vaginosis; eczema; food allergies; irritable bowel syndrome (IBS); inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn’s disease; traveler’s diarrhea; and lactose intolerance.
But beyond all of those benefits, there are a number of lesser-known applications based upon recent research of which health food retailers should be aware.
In the 1940s, dermatologists John H. Stokes and Donald M. Pillsbury proposed a GI mechanism for the overlap between depression, anxiety and skin conditions such as acne. These doctors hypothesized that emotional states might alter the normal intestinal microflora, increase intestinal permeability and contribute to systemic inflammation and increased sebum production. The remedies these authors discussed as a means to cut off the stress-induced cycle included administration of Lactobacillus acidophilus cultures long before they were known as probiotics.
The ability of the gut microflora and oral probiotics to influence systemic inflammation, oxidative stress, mood and blood sugar control may have important implications in acne. In addition, probiotic supplementation is often indicated given the common use of antibiotics to treat acne as they kill off the important healthy bacteria in the intestines.
In a study conducted at the University of Alberta, administration of a probiotic was shown to produce significant benefits in women with inflammatory acne. The study was conducted on 45 women aged 18 to 35 years, who were randomly assigned to one of three arms in this prospective, open-label study. Group A received probiotic supplementation, group B received minocycline (an antibiotic) and group C was treated with both probiotic and minocycline. Though all patients demonstrated a significant improvement in total lesion count four weeks after treatment initiation, with continued improvement seen at the eight- and 12-week follow-up visits, group C experienced the best results. Two patients (13 percent) from group B failed to complete the study because they developed vaginal yeast infections.
The takeaway message is that probiotics alone may be effective in many cases and, if an antibiotic is used, probiotics can enhance the efficacy and reduce the likelihood of a yeast infection.
Non-alcoholic liver disease ranges in severity from a rather benign impairment of liver function to an inflammation of the liver referred to as nonalcoholic steatohepatitis (NASH), which may advance to severe liver disease (cirrhosis). NASH is linked to obesity and insulin resistance, as well as nutritional factors, drugs and occupational exposure to toxins.
About 20 percent of American adults show signs of impaired liver function and NASH affects roughly two to three percent of those adults. In a study published in the March 2013 issue of Annals Of Hepatology, probiotic supplementation was compared to standard medical treatment of NASH patients. The patients were given either lifestyle and dietary recommendations alone or with a probiotic formula contained Lactobacillus plantarum, Lactobacillus deslbrueckii, L. acidophilus, Lactobacillus rhamnosus and Bifidobacterium bifidum at a dosage of 200 million live bacteria three times daily.
Results showed that those subjects taking the probiotic experienced a tremendous reduction in the amount of fatty infiltration within the liver that is characteristic of NASH. The probiotic group also had greater effects in reducing the serum aspartate aminotransferase (ALT) levels—a liver enzyme associated with liver damage.
The takeaway message here is that probiotics improve liver health and may be helpful in NASH and other liver diseases.
Several studies have shown that probiotic supplementation can lower blood cholesterol levels. In the most recent study, a total of 60 patients aged 18 to 65 years were given either a placebo or one capsule daily containing 1.2 billion colony-forming units of a mixture of three strains of L. plantarum for 12 weeks. Those getting the probiotic supplement showed a 13.6 percent reduction in plasma total cholesterol levels. In those with cholesterol levels greater than 250 mg/dl, there was also a drop in LDL cholesterol and oxidized LDL-C(17. 6 and 15.6 percent, respectively).
The takeaway message here is that probiotic supplementation, especially using a product containing sufficient levels of L. plantarum (1.2 billion live cells daily), may be an effective method to lower cholesterol levels.
Oral & Throat Health
Several studies have shown beneficial effects with supplementation with Streptococcus salivarius, one of the key bacteria that resides in the mouth and throat, as well as being found in breast milk. Supplementation with these bacteria has shown beneficial effects in the relief or control of various upper respiratory tract ailments including strep sore throat, otitis media and halitosis.
In the latest study, published in the Journal of Medical Microbiology’s June 2013 issue, 100 children with dental caries (cavities) were given either S. salivaris or a placebo for three months.
Researchers looked for changes to their plaque scores. At treatment end, the plaque scores were significantly lower for children in the probiotic treated group, especially in subjects having high initial plaque scores.
In another double-blind study, researchers showed that giving another bacteria associated with oral health, Lactobacillus reuteri Prodentis, for one month improved gum (periodontal) health, including reducing plaque formation, bleeding on probing and pocket probing depths, while the placebo group showed no effects.
The takeaway message here is that probiotic supplements designed specifically for the oral flora may be quite helpful for a range of issues affecting the mouth and throat including in children (and adults) prone to cavities and plaque formation
There are so many great benefits of probiotics in children that a strong case can be made for universal supplementation to all infants and children of all ages. How soon should supplementation start? I would say before birth by giving it to the mother to promote a number of beneficial effects, including a healthy vaginal flora. Probiotic supplementation in infancy may help boost the immune system, prevent allergies and promote intestinal health. In regards to the latter, let me highlight a 2007 study in infants with colic that compared a probiotic product to the drug simethicone.
Infant colic is well known to many parents and is characterized by excessive crying/fussing for no apparent cause. It affects up to 20 percent of infants under 3 months of age and can be extremely upsetting not only to the child, but moms and dads, too. Probiotics appear to be an effective treatment.
In the comparative double-blind study, 90 breastfed, colicky infants were assigned randomly to receive either the probiotic L. reuteri (100 million live bacteria daily) or simethicone (60 mg/day) each day for 28 days. The mothers avoided cow’s milk in their diet. Parents monitored daily crying times and adverse effects by using a questionnaire.
The average minutes of “crying time” in the probiotic and simethicone groups were 51 minutes/day and 145 minutes/day, respectively, on day 28— on day 28, 95 percent of the probiotic supplemented infants were judged as responders compared to only seven percent in the simethicone group.
The takeaway message is clear here: Probiotics are an effective solution for infants with colic and show benefit within the first week of treatment, with nearly 100 percent of children experiencing significant relief after one month of supplementation. And, probiotics greatly outperform the standard medical approach.
Numerous analyses of commercially available probiotic supplements indicate there is a tremendous range of quality. The quality of probiotic supplements depends on two main factors: the characteristics of the strains contained in the supplement, and adequate viability, so that sufficient numbers of bacteria are viable at the point of consumption. Viability at consumption depends on a number of factors, such as proper manufacturing and the “hardiness” of the strain, as well as packaging and storage of the product in the right amount of moisture and at the correct temperature. What all of this means is that consumers must utilize products developed and manufactured by companies that have done the necessary work and quality control to insure the viability of their product.
The dosage of probiotic supplements is based primarily on the number of live organisms present in the product. Successful results are most often attained by taking between 5 billion and 20 billion viable bacteria per day, though it is important to note there is ample support in the medical literature for success at even lower dosages. In fact, though it is currently in vogue to go with higher dosages, there is little support for these high dosages (greater than 20 billion viable bacteria per day) showing greater effect than lower dosages.
Michael T. Murray, ND, is widely regarded as one of the world’s leading authorities on natural medicine. He is a graduate, former faculty member and serves on the Board of Regents of Bastyr University in Seattle, WA. The author of more than 30 books on health nutrition, Murray is also director of product development and education for Natural Factors Nutritional Products. For more information, visit www.doctormurray.com.