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This Is the Cold, Hard Truth About Probiotic Supplements

Melissa Matthews
·4 min read
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Supplement companies claim that prebiotics (which are one thing) and probiotics (another thing!) can strengthen your immunity, aid weight loss, and even add years to your life.

And these same companies–dangling these life-enhancing properties in the form of an easy-to-swallow pill, potion, or delicious lil’ gummy—also charge a pretty penny for their products.

First, it's important to understand that despite all the buzz around prebiotic and probiotic supplements, the scientific research behind their benefits is actually relatively new.

Photo credit: Men's Health
Photo credit: Men's Health

And, for that very reason, it's tough to draw conclusive evidence that taking a supplement can deliver any of these benefits. A lot of the lingo you’ll find on supplement labels is marketing—and not much more.

But that's not to say there isn't some promise in the scientific field about what these supplements may be able to do—"may" being the key word here. So consider biotic supplements a “space to watch.”

To reinforce this theme, and to dig into the differences between the two forms of bacteria (yes, prebiotics and probiotics are actual living bacteria), the benefits that either (or neither) may have, and whether or not you should consider taking them, we turned to the smartest experts in academic gastrointestinal research for a gut check.

For the record, that's Jack Gilbert, Ph.D., a researcher at the University of California, San Diego; Bethany Doerfler, R.D., a clinical research dietitian at Northwestern University; and David Poppers, M.D.,Ph.D., a gastroenterologist at NYU Langone.

Allow them to lead you through the small but wondrous world of (potentially) mighty microorganisms.

What are probiotics?

They’re microorganisms found in fermented foods like yogurt and kimchi, says Jack Gilbert, Ph.D., a researcher at the University of California, San Diego.

Companies claim their probiotic supplements can improve your immunity or help you lose weight. The jury is still out on those benefits, but science does show that probiotics can relieve symptoms of Crohn’s disease, inflammatory- bowel disease, and food allergies, says Gilbert.

Prebiotics, by comparison, are soluble fibers, so they attract water during digestion. They also contain oligosaccharides, sugars eaten by gut bacteria, says Bethany Doerfler, R.D., a clinical research dietitian at Northwestern University.

After your gut bacteria feast upon these oligosaccharides, they release short-chain fatty acids, which may relieve discomfort in people who have inflammatory-bowel disorders or conditions like IBS.

The bottom line: prebiotics and probiotics are not the same thing.

Do you need to take probiotic supplements?

If you suffer from chronic constipation, diarrhea, or other gastrointestinal distress— and your physician recommends taking something, says David Poppers, M.D.,Ph.D., a gastroenterologist at NYU Langone.

Photo credit: Yulia Naumenko
Photo credit: Yulia Naumenko

Everyone else can save their money, because there’s no evidence that probiotic supplements offer any benefit to already healthy people, says Gilbert

The research is "in the pipeline," but it's "not there yet," says Doerfler.

What should you look for in a probiotic supplement?

Your doctor will recommend a probiotic shown to help with your specific complaints, says Dr. Poppers. For example, one bacteria, Lactobacillus rhamnosus GG, is better for those with diarrhea, compared with other strains, Gilbert says.

Photo credit: Photographer, Basak Gurbuz Derman
Photo credit: Photographer, Basak Gurbuz Derman

Some doctors also encourage the use of probiotics if their patient is on antibiotics. Taking probiotics before, during, and after taking antibiotics could help prevent common side effects like diarrhea, Poppers says. He recommends taking probiotics containing the saccharomyces bacteria strain prior to starting antibiotics, and to continue for at least a few days after your course of treatment is done.

If you have ulcerative colitis, a chronic disease causing inflammation and ulcers in the lining of the large intestines and rectum, a doctor may also prescribe probiotics.

While people with ulcerative colitis can take anti-inflammatory medication to manage discomfort, Poppers says there is some research to suggest that the supplement VSL#3, a combination of eight different Bifidobacterium, Lactobacillus and Streptococcus bacteria strains, could help in addition to traditional treatment.

Additionally, Poppers says some people with irritable bowel syndrome (IBS), a condition that affects an estimated 7 to 16 percent of the U.S. population, have reported that taking probiotics has alleviated their symptoms, including gas, abdominal pain, and diarrhea. But he's quick to note that the data is far from conclusive, and that he doesn't recommend one type of probiotic for all IBS patients.

Photo credit: Moyo Studio
Photo credit: Moyo Studio

"IBS is very complex. What may work for your neighbor may not work for you," he explains. "A lot of trial and error is necessary, and that’s OK."

So if you have any of the above issues, it's possible that probiotic supplements, in addition to your regular course of treatment, may help manage your symptoms. But if you're in otherwise good health, taking probiotic supplements probably won't do much for you. And if you have a weakened immune system from steroid use, chemotherapy, or complications from HIV, you probably want to avoid them altogether, as they may put you at risk of bacterial infection, Poppers says.

At the end of the day, it's best to talk with your doctor to determine if taking a probiotic is right for you.

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