Probiotics – good, bad or just a waste of money? -

Our patients often ask us questions about probiotic drinks and foods. A lot of claims have been made about the benefits of probiotics in recent years. So, are they good for you? Should you spend your money on probiotic products? This week on the blog we discuss probiotics …. hoping to provide some answers.

What are probiotics?

Probiotics are live microorganisms, specifically bacteria and yeasts, which are often described as being ‘good’ or ‘friendly’ bacteria. Probiotics are found naturally in our bodies. They can also be consumed by eating or drinking products containing added probiotics (e.g. drinks, yoghurt and/or supplements in the form of capsules or powder).

Good bacteria?

Good and bad microorganisms live in harmony in our bodies and occasionally this balance becomes upset. Bad (pathogenic) bacteria can come from external sources (e.g. food, environmental toxins) or internal sources (i.e. harmless bacteria turning bad). For example, streptococcus pneumoniae bacteria (pneumococcus), can live in the nose and throat for months before triggering earaches, or more serious conditions such as meningitis or pneumonia.

How do probiotics work?

Potential benefits tend to be linked to countering the effects of things that disturb the natural balance of bacteria in the body, described above. It is believed that illness or certain treatments (e.g. antibiotics) may lead to reductions in good bacteria in the body, which probiotics may help restore, enabling the body to function normally again and/or get well.

What are the claims?

Probiotics are promoted as having various health benefits, across a range of medical problems. Studies have investigated probiotics in a number of conditions including, but not limited to, prevention of antibiotic-associated diarrhoea, treatment of infectious diarrhoea, protecting premature babies from gut disease, irritable bowel syndrome, lactose intolerance, colic, inflammatory bowel disease, boosting the immune system, vaginal infections, eczema and even weight loss. Current evidence supports the use of probiotics in only a few of the above conditions (see the NHS article).

Should I try probiotics?

Probiotics are considered to be generally safe and well tolerated by most people, provided they have no immune system problems. They are unlikely to cause unpleasant side effects.

Are there dietary sources of probiotics?

Yes. Importantly, probiotics are considered safe in the amounts normally found in food. They can be found in some yogurts and cheeses and other dairy products (e.g. Lactobacillus milk, kefir). Fermented foods such as sauerkraut and kimchi also contain probiotics. The Mayo Clinic (see below) suggests one way of getting more probiotics into your diet is to eat yogurt with probiotics. You can do this by selecting products with ‘Live and Active Cultures’ on the product label or similar words.

Should I take probiotic supplements?

While probiotics are generally safe for most people, not everyone benefits from probiotic supplements and supplements may be harmful for some people (for example people who are immunocompromised or have severe underlying illness; see MJA & other articles).

For informed decision making, we recommend discussing the potential benefits and harms of probiotic supplementation with your doctor before you take any probiotic supplements.

Good, bad or just a waste of money?

The answer to this question really depends on your circumstances and your overall health. Increasing probiotic intake from food sources will generally be safe for most people, who are well and have a healthy immune system. As stated earlier, we would recommend consulting your doctor if you are considering taking probiotic supplements.

Lastly, while a lot of research has been undertaken in the field of probiotics, particularly around pharmaceutical grade probiotics, which are different to those found in foods, there is still much that we do not know. We know that there are many different types of probiotics, which may have different effects on the body, but there is limited consensus around which types are the best ones or which ones are best for particular medical conditions.