Which Probiotics to Use?

Our gut is colonized by 10^14 microbes, ten times more than the human cells. The microbiota of the gut is quite diverse and establishes a mutually beneficial relationship with the host. Intestinal flora plays an important role in our health and nutrition by supplying essential nutrients including vitamin B-12 & vitamin K, aiding in the digestion of cellulose, and promoting angiogenesis and enteric nerve function. So, choosing probiotics is crucial for human health.

Stress, unhealthy diet, illness, antibiotics, lifestyle, and aging can affect the gut microbiome predisposing individuals to chronic diseases, such as inflammatory bowel disease, obesity, cancer, and autism. Thus the restoration of a healthy human microbiome is necessary.

Why Probiotics?

Probiotics are needed when a person has a disrupted gut microbial balance. In most cases, gut flora is restored without the use of probiotic supplements because these good bacteria are also found in various foods that we take daily such as fermented milk products (yogurt and cheese) and fermented food products (kefir, kombucha, tempeh, natto, kimchi, etc).

In some cases, doctors may prescribe microorganisms with probiotic properties to restore the normal flora. There are no official recommendations for probiotic use by healthy people. If you want to try probiotics, ask your healthcare provider for advice about which probiotic to choose, what dose to take, and how long to use the product.

A number of commercial providers are marketing various probiotic products. With so many options choosing a probiotic can be confusing.

Probiotics are identified by their specific strain, which includes genus, species, subspecies (if applicable), and an alphanumeric strain designation. For example, in the probiotic strain ‘Bifidobacterium infantis 35624’, ‘Bifidobacterium‘ is genus, ‘infantis’ is species and 35624 is alphanumeric strain designation.

Points to remember while choosing probiotics;

  1. Health benefits are demonstrated by only particular probiotic strains. Having other bacteria in the formulation besides the ones listed on their labels may not confer desired benefits.
  2. Different strains provide different benefits. Look for multiple diverse strains listed on the packaging and their probiotic benefits so you know what you are getting.
  3. Not all strains provide meaningful benefits. Looks for strains clinically studied for your specific needs.
  4. Probiotics are generally safe and beneficial for otherwise healthy individuals but consumption of probiotics by immunocompromised patients may cause infections, bacteremia, sepsis, etc.
  5. Probiotics are living cultures so make sure these organisms are live till their expiration date. Improper storage of the probiotics may kill the organism depriving the individuals of the supposed benefits.

Check product labels for the expiration or “use by” date and follow the storage instructions. Some probiotics need to be kept in the refrigerator, but others can be stored at room temperature.

Popular Probiotic Brands

Some of the most popular commercial probiotic brands for choosing probiotics are as follows;

Align probiotics

Align uses Bifidobacterium infantis 35624 as a probiotic strain in its formulation. According to the manufacturer, each capsule contains 1 x 10^9 (1 billion) (4 mg) live bacteria/CFU when manufactured, and provides an effective level of bacteria (1 x 10^7 CFU). This probiotic strain helps to promote and support a healthy digestive system. If your physician has recommended this probiotic to you, his/her plans seem to restore or build a healthy gut for you with probiotics.

Bifidobacterium is a non-spore-forming, Gram-positive, V-or Y-type branched, rod-shaped, anaerobic bacteria that belong to the family Bifidobacteriaceae and the phylum Actinobacteria. Bifidobacterium strains are being employed to prevent and treat gastrointestinal disorders, including intestinal infections and cancers. Many probiotic Bifidobacteria have shown beneficial effects on humans or animals, e.g., antiinfection, anti-depression, regulating the host immune system, and facilitating host nutrition adsorption.

Choosing probiotics
Beneficial effects of common probiotic Bifidobacterium strains.

Culturelle probiotics

Culturelle offers a range of probiotic products for gummies, babies, kids, adults, and women. Their formulation contains Lactobacillus rhamnosus GG, which is one of the most clinically studied probiotic strains which supports good digestion and immune health.

Lactobacillus rhamnosus GG (LGG) is a widely studied probiotic strain used in a variety of commercially available probiotic products. Documented health benefits of this probiotic strain include prevention and treatment of gastrointestinal infections and diarrhea, stimulation of immune responses, and prevention of certain allergic symptoms, among others.

Garden of life probiotics

To support a healthy microbiome for individuals, Garden of Life uses diverse probiotic strains in its formulation. Common probiotic strains found in their formulation include; Bifidobacteria, L. reuteri, and L. fermentum. They have a wide range of probiotic options to serve various health needs of an individual. Based on the nature of the product, their formulation may help in digestion, enhance the immune system or balance the ecosystem in the external genitalia of females.

Lactic acid-producing bacteria are the most commonly used probiotic strains. Lactobacillus fermentum is a Gram-positive bacterium belonging to Lactobacillus genus. Organisms of the lactobacillus genus are found to play an important role in protecting the host by strengthening the immune system, improving digestion, and reducing metabolic disorders. L. fermentum enhances the immunologic response as well as prevent community-acquired gastrointestinal and upper respiratory infections.

Beneficial roles of lactic acid bacteria (Image source: Ref-1)

Lactobacillus reuteri is a well-studied probiotic bacterium that can colonize a large number of mammals. It is also found in different body sites of humans such as the gastrointestinal tract, urinary tract, skin, and breast milk. Beneficial effects of this probiotic bacterium include inhibition of severity of enteric infections by producing antimicrobial molecules, such as organic acids, ethanol, and reuterin. Some strains of this bacteria also modulate the immune system by reducing the production of pro-inflammatory cytokines while promoting regulatory T cell development and function. Studies have found that direct
supplementation or prebiotic modulation of L. reuteri may help to prevent or treat inflammatory diseases.

ReNew life probiotics

Like any other probiotic company, RenewLife also offers different ranges of products to support digestive health, women’s health, and enhance immune response. Based on the product type, chosen probiotic strain may be Bifidobacterium, Lactobacillus, or Bacillus (such as B. coagulans, B. subtilis) or a combination of these bacteria.

GoodBelly probiotics

GoodBelly Probiotics uses Lactiplantibacillus plantarum 299v probiotic strain in its formulation. L. plantarum 299v (formerly named Lactobacillus plantarum 299v) is the most documented L. plantarum strain in the world. It was isolated from the healthy human intestinal mucosa.

In vitro, animal, and clinical studies show that this probiotic strain promotes gastrointestinal health, and reduces flatulence and abdominal pain in patients with irritable bowel syndrome (IBS). L. plantarum 299v is stable at room temperature, enabling long shelf-lives of consumer healthcare products such as capsules, tablets, or powder sachets. This strain can survive the harsh conditions of the human gastrointestinal tract thus making it an ideal probiotic strain.

Other Probiotics

Apart from the probiotics mentioned above, other popular probiotics are

  • Florastor probiotics
  • Walgreens probiotics
  • Pearl probiotics
  • Visbiome probiotics
  • Kefir probiotics, and
  • Just thrive probiotics

References and further readings

  1. Ayivi RD, Gyawali R, Krastanov A, Aljaloud SO, Worku M, Tahergorabi R, Silva RCd, Ibrahim SA. Lactic Acid Bacteria: Food Safety and Human Health Applications. Dairy. 2020; 1(3):202-232. https://doi.org/10.3390/dairy1030015 
  2. Mu Qinghui Mu, Vincent JT, Luo XM. Role of Lactobacillus reuteri in Human Health and Diseases. Frontiers in Microbiology. 2018;9.https://www.frontiersin.org/article/10.3389/fmicb.2018.00757 
  3. Chen J, Chen X, Loong HC. Recent Development of Probiotic Bifidobacteria for Treating Human Diseases. Frontiers in Bioengineering and Biotechnology. 2021;9. https://www.frontiersin.org/article/10.3389/fbioe.2021.770248 
  4. Fijan S. Microorganisms with claimed probiotic properties : an overview of recent literature. Int J Environ Res Public Health. 2014;11(5):4745-4767. Published 2014 May 5. doi:10.3390/ijerph110504745 

Acharya Tankeshwar

Hello, thank you for visiting my blog. I am Tankeshwar Acharya. Blogging is my passion. As an asst. professor, I am teaching microbiology and immunology to medical and nursing students at PAHS, Nepal. I have been working as a microbiologist at Patan hospital for more than 10 years.

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