Helping patients choose the best probiotics for their needs: an update
Now that flu season is in full force and there have been multiple reports of healthy, young people dying from the flu, I’m reminded of a few probiotics that have impressed me for strengthening the immune system. A few years ago I wrote an article for Pharmacy Times on choosing probiotics that had yielded good results, according to the medical literature. I also was curious to see what the literature says now, 2 years later. Is there more supporting information? Less? Other probiotics? Here’s an update:
Name of the probiotic (name brand in parenthesis when available)
Conclusions according to medical experts at Medline Plus1,2
Reduces the number of college students who experience a cold or the flu
Five days weekly for 8 weeks reduces the incidence of the flu in schoolchildren during flu season
Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect)
Children ages 1 to 6 years who attend daycare centers seem to get fewer and less severe lung infections when given milk containing Lactobacillus GG or a specific combination product containing both Lactobacillus acidophilus and Bifidobacterium (HOWARU Protect).
Lactobacillus acidophilus and Bifidobacterium bifidum (Infloran, Berna)
Reduces the risk of colds in school-aged children
Lactobacillus rhamnosus GG (Culturelle)
Taken twice daily this might reduce the incidence of pneumonia in people in the intensive care unit.
B. longum BB536
Consuming food containing B. longum BB536 for 3 weeks before getting a flu shot and 14 weeks thereafter seems to help prevent the flu in elderly patients
Lactobacillus plantarum and Lactobacillus paracasei
Taken daily for 12 weeks might reduce the risk of common cold by about 12% and reduce the number of days with symptoms from 8.6 to 6.2 in adults
Taken daily for 6 weeks does not seem to reduce the number of cold/flu days in otherwise healthy adult students. Also, drinking a beverage containing Lactobacillus brevis does not seem to reduce the risk of catching a cold
Bifidobacterium longum subsp.
Doesn't seem to work for college students who experience a cold or the flu
bifidobacteria species Bifidobacterium animalis subsp. Lactis
Does not reduce the risk of airway infections in hospitalized children and teens.
Apparently, the supporting information for using probiotics to strengthen the immune system is increasing. I was fascinated to see that B. longum BB536 was given as an adjunct to the flu vaccine. I think it was brilliant, considering that often times vaccines don’t work because the person’s immune system is too weak and debilitated to mount a response and make the necessary immunological ammunition.
In the cases of severely immune compromised patients, I don’t recommend probiotics for those patients. Keep in mind that probiotics are live bacteria that can cause sepsis in rare cases. It happens to premature babies, cancer patients and anyone in a very fragile, debilitated state.3
I think it’s very important to explain to patients that probiotics are very individual and specific in their actions. They are not interchangeable. They produce a specific effect and that is usually discovered in observational studies first, then confirmed in medical studies. When people ask me which probiotic I recommend for them, I look to see what kind of medical need they have, and then I make a recommendation for a probiotic to fill that need.
As a result of reading several studies, I realize that probiotics are very dose dependent. It’s always the highest doses that yield the best results. Therefore, I don’t recommend to patients that they skimp on doses. I don’t recommend they cut the pills in half or take half a dose to save money. I don’t recommend soon-to-expire probiotics that are on sale. I do recommend people buy probiotics that are recently manufactured and within expiration date. And never, under any circumstances, do I recommend freezing yogurt or probiotics. That could potentially kill them. I doubt anyone will ever get any probiotic benefits from frozen yogurt or frozen kefir. Technically, pill forms of probiotics are freeze dried in a laboratory and adding moisture will bring them back to life.
Probiotics can cost as much as $1.50 a pill. Considering that you can buy a 6-ounce container of yogurt for less money, I normally recommend yogurt for general health. I recommend the pills for specific actions, like strengthening the immune system during the peak cold and flu season.
I believe everyone deserves great health, and if cost is a barrier, I recommend people make their own yogurt from scratch, at home, for personal use. Follow me on Facebook, and I will share my homemade yogurt smoothie recipes that will nourish your body and soul. https://www.facebook.com/antiaging.drugs