One of the most common questions that we at Healthy Gut Bugs get asked is, “Now that I am convinced that I should be taking probiotics, which probiotic should I choose?” While we’re fans of eating prebiotic and probiotic containing foods, probiotics supplements are another option to promote gut health. However, it can be daunting to know which ones to choose, as there are multiple factors involved in how effective a probiotic supplement can be. We’re here to help.
The word, “probiotic” is actually a very general term that describes living microorganisms that are claimed to have positive health effects for humans when taken in sufficient amount. In fact, virtually anyone can take some baker’s yeast, put the yeast into capsules, make claims about improving digestion, slap on a fancy label and market these capsules as “Probiotics.” But, health benefits from these supplements would be highly dubious.
Before selecting a probiotic supplement, is essential to identify what health concerns you are seeking to improve by taking a probiotic, and which bacteria or yeasts are likely to make a difference for your specific goal or situation. It’s also important to understand not only what the manufacturer is stating is in the pill by reading the label, but also to learn about the manufacturer’s reputation and how it has been stored, as probiotic supplements contain living creatures..
Which Friendly Microbes? How Many Strains Should I Take?
Which Microbes to Take
There is plenty of research showing that certain microbes (primarily bacteria and yeasts) can be useful to treat or cure particular conditions. However, these same studies have also shown that benefits are species and strain specific. Often, only particular strains of probiotics can improve any one concern. This makes sense if you think about it because there are between 500 to 1000 strains of friendly bacteria potentially living in the human gut alone and it’s hard to imagine that each one of these strains provides exactly same benefits to its human host. Different beneficial microbes assist in maintaining different processes in a well-functioning, healthy human body.
For example, if you have atopic dermatitis you might consider taking L. salivarius, which has been shown to improve this skin condition, but you would not want to take S. salivarius K12, which instead has been shown to improve the health of the mouth.
Before choosing a probiotic, think about what concerns you are hoping to address by taking it. Do some research on the condition you are attempting to treat, and try to find out which friendly microbes have been shown to be helpful. You can look at scientific articles as well as reviewing people’s personal experiences. At Healthy Gut Bugs, when we write about particular health conditions, we try to highlight which probiotics have shown positive effects.
The label on a bottle of commercially produced probiotics should list the genus, species and strains of the probiotic organisms that the manufacturer claims are included in the supplement.
As there may be more than one microbial strain that can be helpful, it is better to choose a probiotic formulation that has multiple strains of probiotics rather than a single strain formulation.
There are 100 trillion microbes living in the average human body – ten times as many as there are human cells! Therefore, for a probiotic supplement to provide any sort of meaningful benefit and not be immediately overwhelmed by the microbes already living in the gut, it needs to contain a very high quantity the desired live organisms.
Taking a dose containing at least 5 billion CFUs (colony forming units) is typically recommended. More is often better, but be aware that price does rise as CFUs rise.
As mentioned before, it’s preferable to choose a supplement containing multiple strains of probiotic organisms, as each provides a unique sort of potential health benefit. Look for products containing at least 5 – 7 strains of different friendly microbes.
The Importance of “Expiration Date” & “Viable through End of Shelf-Life”
Probiotics are live organisms. Over time, when they are in a capsule with limited food and exposure to variable temperatures, their numbers degrade as many of the microbes die. The CFUs (colony forming units of microbes) listed on the packaging states the number of colony forming units claimed to be present at the time the product is produced, but the CFUs start to decline soon thereafter. Therefore, it is important to ensure that the probiotic supplement that you purchase is fresh and that there is still significant time until the product expires.
Unlike some medications that can still be used (even if they are less effective) for a limited period after their expiration date, probiotics will no longer provide much benefit after they have expired or reached the end of their viable shelf-life. A significant number of the beneficial microbes will have died and the remaining numbers are likely too small to influence health.
If a probiotic does not include a statement about viability through the end of shelf-life (or include an expiry date), but instead indicates only that the probiotics were viable when manufactured, this means that the producer is not making any claims that the bacteria will still be alive when you buy them. If the manufacturer is not willing to stand behind its product, you should consider buying a different one.
Which Brand Should I Buy?
Probiotics are regulated as a dietary supplement and not as a medicine by the US Food and Drug Administration (FDA). Therefore, unlike medications that require their manufacturer to demonstrate that they are safe and effective, sellers of probiotics need merely to notify the FDA of their intent to sell them. Dietary supplements have a lower standard of oversight than medications do.
Consumer protection agencies have tested multiple brands of probiotic products on the market and determined that many of them do not in fact contain all of the probiotic strains listed on the packaging by their manufacturer. Additionally, less than half of those tested contain the probiotics in the numbers claimed by the manufacturer.
Because of the reduced government supervision for probiotics and the known concern over false labelling on some products, as a consumer it is important to choose a reputable manufacturer.
Many probiotic manufacturers submit their products to independent third parties that verify the types and quantities of friendly microbes in the supplements. This is a good thing. Try to choose a manufacture that is willing to do this for increased confidence that you are getting what you have selected and paid for.
There is an independent third party organization, Consumer Lab, which purchases dietary supplements, such as probiotics, and sends them to an independent lab for testing. They have evaluated the contents of many major brands of probiotics to see which species of microbes they contain and to count the number of viable/living organisms. If you are concerned about purchasing a high-quality probiotic supplement, you might consider purchasing the full report that they have prepared on forty-one probiotic products they tested. You can see which manufacturers’ products were tested and can obtain the report here.
To be effective, the probiotic microbes in a supplement must survive the hostile environment of the small intestine and make it alive to the large intestine, where they do their good work.
Probiotics come in different forms. I have seen powdered probiotics, either loose or in individual sachets. Others are in tablet form. Most commonly, probiotics supplements are in a capsule.
Some capsules or tablets are advertised as having an enteric coating. The stated purpose of the enteric coating is to protect the probiotics as they move through the small intestine and only later to open up and release the friendly microbes when they have reached the large intestine. However, many friendly, well-tested strains can survive the small intestine without an enteric coating. Probiotics surviving the small intestine can also be seen in probiotic-containing fermented foods such as miso, kimchee, sauerkraut and kefir. Additionally, some researchers claim that the enteric coating can actually reduce the shelf life of the probiotic by exposing the microbes to heat during processing and locking in moisture into the capsule. Current scientific consensus is that the enteric coating for probiotics is unnecessary at best and harmful at worst, if it’s made from a synthetic ingredient.
If you choose to take a supplement without the enteric coating, be sure take it just before or with a meal. In this way, the beneficial microbes will be “protected” by the food that is also moving through the digestive tract.
As mentioned, probiotics are living organisms that provide a health benefit to their host. To be effective, they have to remain viable / alive. Temperature can affect their life span. Higher temperatures increases the microbes’ metabolism, which causes them to use up available food and energy more quickly and die faster while in encapsulated form.
The probiotic packaging will provide storage instructions. Be sure to read it and follow instructions to prolong the useful life of your purchase.
Some products state that refrigeration is required. If you are purchasing a product requiring refrigeration, make sure that it has been refrigerated while at the store or supplier where you are getting it from, otherwise product effectiveness may have already been reduced. If it is being shipped, consider the length of time required for shipment as well as the likely temperatures during transit. A product ordered during the heat of summer in Arizona may sit on a hot truck and in your mailbox for days.
Other probiotics are labelled as being “shelf-stable.” This means that the probiotic is supposed to remain viable at room temperature. If you are in a warm climate, this is a good choice.
Personally, living in tropical Singapore I always refrigerate my own probiotics, regardless of whether or not they are shelf-stable. I believe that the product will remain effective for longer if kept at a lower temperature because of the slowing-down effect of the on the microbes’ metabolisms.
Before purchasing a probiotic, be sure to research your symptoms or what you are trying to accomplish by taking the probiotic. Learn which species and strains are most likely to be effective.
Once you have located a supplement that contains strains that you believe will be helpful, do your research on the manufacturer. A more reputable manufacturer whose product has been independently tested is a safer bet to ensure you’re getting living microbes in the quantities and species that you are paying for. When in doubt, select supplements with higher CFUs of probiotics.
Double check that the product is fresh and that it has been stored in accordance with manufacturer recommendations. Follow manufacturer instructions for storing and taking the supplement, but consider refrigerating them in any case.
Unless your probiotics are enteric coated, take them with a meal.
If you have found a supplement that you have found to be helpful, please consider sharing your knowledge with us below in the comment section.