Probiotics: The Powers of Supermicrobes

AUGUST 07, 2014
Yvette C. Terrie, BSPharm, RPh
Often used to promote digestive health, probiotics may have several protective health effects.
In the past decade, there has been great interest in the possible health benefits associated with the use of probiotics. Research is ongoing to find out more about these “super” microbes.

As a result, multiple probiotic supplements have been introduced to the dietary supplement market. Pharmacists are likely to encounter questions from patients regarding the use of probiotics, and can provide patients with pertinent information to make informed decisions.

According to the National Institutes of Health National Center for Complementary and Alternative Medicine and the World Health Organization, probiotics can be defined as “live microorganisms (eg, bacteria) that are either the same as or similar to microorganisms found naturally in the human body and when administered in sufficient amounts may be beneficial to health.”1-5 Classification of probiotics is typically based on the genus, species, and strain, and a range of studies have investigated various strains of probiotics to explore different health effects.2-7

While probiotics are often used to promote digestive health, various studies have postulated that the use of probiotics may have several protective health effects (Table 11-10). Examples of potential proprotective effects associated with probiotics include gastrointestinal barrier function, inhibition of the growth of potential pathogens, alteration of epithelial cell cytokine production, enhancement of antiviral activity, and regulation of T cell induction.1-4 Ongoing research has also provided compelling evidence regarding the role of probiotics in decreasing the incidence of certain diarrheal illnesses, enabling those with lactose intolerance to better digest the enzyme lactose, and enhancing immune function.1-7 Results of a study published in May 2013 showed a moderate amount of evidence that probiotics were safe and effective for preventing Clostridium difficile–associated diarrhea.8

Probiotic Supplements
Probiotics are often present in fermented products such as dairy products (eg, yogurt, yogurt drinks, buttermilk), some juices and soy beverages, and plants (sauerkraut and miso), as well as in dietary supplements, which are available in various dosage forms, such as capsules, tablets, and powders. In probiotic foods and dietary supplements, the bacteria may be present already or added during the preparation process.1-7

Probiotic supplements may contain 1 or more species of Lactobacillus, Bifidobacterium, or Saccharomyces.7 Within the Lactobacillus genus, Lactobacillus reuteri is the most prevalent in the human body; however, supplements on the market may contain the following Lactobacillus species: rhamnosus GG, reuteri, acidophilus, bulgaricus, or fermentum.3,7 Species of Bifidobacterium found in supplements include longum, bifidum, breve, infanti, or lactis. Saccharomyces boulardii, which is yeast, is the only Saccharomyces species used in dietary supplements.1 Lactobacillus and Saccharomyces products are recommended for antibiotic-associated diarrhea, and L rhamnosus GG is recommended for atopy and dermatitis.

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