The Probiotic Short-Course
Copyright 2001. Kd. last updated 7.14.06
What to Look for in a Probiotic
Probiotics short course and strains compiled from several sources.
1. Trillions of microorganisms live on and inside us. Most are good, some are harmful. The beneficial ones are called "probiotic microorganisms." They improve the environment of the intestinal tract.The use of good probiotics is important in healing many chronic gastrointestinal problems that are so often associated in those with ASD. Some experts feel that ASD children need several times the amount of probiotics than those without GI problems, due to the frequency of dysbiosis (overgrowth of yeast, bacteria, etc.) and "Leaky Gut" (intestinal permeability problems).
2 Scientific studies over the last 50 years show that probiotic organisms can improve the nutritional quality of foods, produce antibiotics, anticarcinogens, and substances that break down and recycle toxins for their human host.
3. The major benefits of adding probiotic organisms to the diet: boosts immune system, inhibits disease causing organisms, improved digestion, vitamin synthesis, detoxification and protection from toxins, prevents diarrhea from various causes, reduced risk of irritable bowel syndromes, cancer-protective effects, increased nutrient absorption, improves resistance to allergies, reduces yeast and other infections.
4. Lactobacillus acidophilus bacteria reside mostly in the small intestine, and Bifidobacterium bifidum are found in the large intestine (colon). Whether taking a mixed-species product or a single species is better has not been determined. There are mixed opinions. Some will decide to choose a single strain of friendly flora because of the proven effectiveness of that particular probiotic strain. Taking this strain for its specific properties can be very helpful. However, over an extended period of time, you may want to include a variety of strains.
5. Capsules are the preferred way to take probiotics because there is more protection from contamination, oxygen, and moisture, and capsules maintain organism integrity. Dairy products that contain added organisms like lactobacillus provide a mild dose of probiotics, if you can have it.
6. Generally higher more therapeutic doses of probiotics are need when first addressing GI symptoms. Probiotic strength is measured in CFUs (colony forming units) per capsule. You may want to take one or several daily. For therapeutic benefits, references varied widely from 250 million – 20 billion viable organisms/day. It is best to check with your doctor, or you can start slowly and build-up to a level you feel is most beneficial.
7. Talk to others and about quality issues, and what works best. Choose a probiotic that has been extensively researched with a great deal of scientific support behind it. Don't buy any product unless it has the manufacture date right on the bottle. Probiotic products, especially lactobacillus and bifidobacterium, lose a lot of potency after 4-10 months. Products last longer when they are refrigerated, although some product do not require refrigeration.
8. When to take probiotics varies by brand. Always check the label and follow the recommendation of the manufacturer. Some say to take on an empty stomach; some say with food so the food can buffer the organisms; some say in the morning because of stomach acid content; some can be taken anytime. The acid and salts in the gut will harm certain probiotics. Manufacturers take this into account when designing a formulation and preparing the capsules. Some capsules are specially coated so the microorganisms will safely reach their destination. Others need to be taken at certain times for optimum performance for that product. Probiotics are not adversely affected by the use of enzymes. They can both be taken during at mealtime.
Probiotic and Enzyme Interactions
or Will enzymes interfere with probiotics/probiotic foods?
The enzymes in question are usually proteases. Probiotics consist mainly of proteins so there is the thinking that protease enzymes might break down the probiotics or make it harder for them to securely attach and anchor in gut. I searched a lot of the research literature several times on this.
It depends greatly on the probiotic strain in question and how it is manufacturered. Some strains are totally unaffected by enzymes, whereas other strains are slightly affected, and others very affected. Some probiotics are destined to function in the small intestine and some in the large.
The other consideration is how it is manufacturered. Some are enterically coated, some are not. Some can be mixed with foods, some can not. Some *must* be taken with meals, some *must* be taken between meals. Some in the morning, some it doesn't matter.
If you aren't sure, the safest bet is to just give the probiotic at the end of the meal (the enzymes are given at the beginning) or between meals (unless it specifies with food). I always gave probiotics at bedtime.
Check the label of the probiotic and call the manufacturer of the probiotic to be sure how *their* product needs to be taken. They could comment on their own products. You can also just try giving probiotic with enzymes, and then without...and see if it makes any noticeable change.
Should enzymes be taken with probiotics or probiotic foods, such as the young green coconut kefir, cultured vegetables and nut yogurts recommended on BED and SCD diets?
This is generally fine. I hope to get more definitive information on this soon. The difference is that the probiotics in food are in a whole-food form. Probiotics 'grown' or derived in food are producing digestive enzymes anyway. So they are already there. In fact, this is one of the benefits that yogurt and other fermented foods supply: digestive enzymes to your body!
The probiotics in food are already 'established' and hard at work digesting the food as you are eating it. Probiotics in supplements are not. They are preserved in the capsule or tablet. They get to the gut, then they need to 'attach' and colonize. Then they start digesting food as it comes down the hatch.
Some of the supplement makers have the sales line: Our probiotic supplements provide much higer counts of bacteria than a cup of yogurt. You would need to eat 6 cups of yogurt to equal it. However, many of the probiotics in capsule may very well get wiped out going through the gut and attempting to colonize.
The yogurt makers will say: You don't need that high a culture count because the probiotics are already established and going in a whole-food form. So in the final tally, the yogurt culture may well outperform the supplement. In addition, the yogurt supplies other beneficial factors that a supplement does not.
Suggested Probiotic Products
There are many many probiotics on the market. Following are some that have been repeatedly recommended and produce good results by many actual real people, and have good consistent quality.
1. Culturelle (excellent for clostridia bacteria or colon problems)
___www.vrp.com (runs quarterly sales making each box about 20% off)
___www.vitacost.com (discounted supplements)
___available at more and more natural food stores
___Two varieties available:
_____Florajen (100% Lactobacillus acidophilus)
_____Florajen 3 (L. acidophilus, B. longum, B. bifidus)
___Runs about $10 a bottle at my local pharmacy.
___This site has it for about $13 www.back-to-nature-herbs.com
___available at more and more natural food stores
3. Natren probiotics
___a good line of probiotics available in most natural food stores as well as online
___Life Start is one for designed for children although adults can benefit too
___Healthy Trinity and Digesta Lac are also mentioned frequently
4. Therabiotics by Klaire Labs but requires a clinician approval
6. Custom Probiotics
___You can get some pre-mixed products (probiotic blends with more than one strain).
___OR you can buy a la carte, or have them mix the strains you want into a product.
7. Perfect Colon (was called Perfect Stool)
8. HMF www.rockwellnutrition.com
9. Houston Chewable Probiotic www.houstonni.com
___IIt has a very pleasant grape-ish flavor. Not a real sweet tart taste, or aftertaste, just
___Ilike a mild grape. Not gritty or chalky either. Worth trying especially for children
___Iwho are sensitive to taste or do not swallow capsules. Low potency, though.
10. VSL #3
It is more expensive but the activity is much higher. (so far the shipping has been free). Works very well with over 450 billion cells (that's right, 450) of 8 different strains.
11. Pro-bio by Enzymedica
Features Bacillus Subtillis which makes several digestive enzymes and a newer strain called F19. F19 is a member of the Lactobacillus acidophilus paracasei species. Has helped in some cases of serious food and supplement sensitivities where other probiotics were not tolerated.
Probiotic Strains and Descriptions
This is a list of most strains of probiotics used. The * indicates the most prevalent ones in products, both as probiotic supplements and as live cultures in probiotic foods. You can do a search by Probiotics or the species you are in terested in to find out more. Thanks to John Hedy of www.vitallifevitamins.com for much of the following information.
1. Bifidobacterium bifidum (lactis)*
B. bifidum is a prominent probiotic microorganism that takes up residence primarily in the mucous membrane lining of the large intestines and the vaginal tract. B. bifidum prevents the colonization of invading pathogenic bacteria by attaching to the intestinal wall, crowding out and taking nutrients from these unfriendly bacteria and yeast. B. bifidum produces lactic and acetic acids, which lower the intestinal pH and further inhibit the undesirable bacteria from growing. Research on Bifidobacteria has established that these organisms enhance the assimilation of minerals such as iron, calcium, magnesium and zinc.
2. Bifidobacterium infantis
Bifidobacterium infantis is an important organism shown to stimulate production of immunomodulating agents such as cytokines. Bacteriocidal activity is also observed against such pathogens as Clostridia, Salmonella, and Shigella.
3. Bifidobacterium longum*
Bifidobacterium longum is a very abundant organism found in the large intestine. It plays a role in preventing the colonization of invading pathogenic bacteria by attaching to the intestinal wall and crowding out unfriendly bacteria and yeast. Along with other microorganisms, it produces lactic and acetic acids that lower the intestinal pH and
further inhibit the undesirable bacteria. B. longum has, in clinical studies, been found to reduce the frequency of gastrointestinal disorders (diarrhea, nausea, etc.) during antibiotic use.
4. Enterococcus faecium
E. faecium has been shown to be important in the nutritional support of diarrheal diseases, especially in cases where pathogenic microbes, such as rotavirus, invade the bowel. This particular organism only transiently colonizes the GI tract. A recent study indicated that an E. faecium-containing yogurt was able to significantly lower LDL cholesterol. E. faecium is safe, and has been researched extensively by the World Health Organization. This probiotic has become so popular with health professionals over the years because of the proven therapeutic value of E. faecium. This species shows strong activity against a variety of pathogenic organisms. In several studies it has proven resistant to a wide variety of antibiotics and, in one study, proved more effective than L. acidophilus in shortening the duration of diarrheal episodes. E. faecium is a natural resident of the human intestinal tract.
5. Lactobacillus acidophilus*
L. acidophilus is one of the most important microorganisms found in the small intestines. It is known to implant itself on the intestinal wall, and in the lining of the wall of the vagina, cervix, and urethra. It performs many critical functions including inhibiting pathogenic organisms and preventing them from multiplying and colonizing.
It is well documented that L. acidophilus produces natural antibiotics like lactocidin, acidophilin, etc., which enhances resistance or immunity. L. acidophilus has known antimicrobial activity against Staphylococcus aureus, Salmonella, E.coli and Candida albicans.
6. Lactobacillus brevis
Lactobacillus brevis is a lactic acid producing organism important in the synthesis of vitamins D and K.
7. Lactobacillus bulgaricus
Lactobacillus bulgaricus is considered a transient microorganism that does not implant in the intestinal tract, but still provides an important protective role. This organism is used extensively in the commercial fermentation of yogurt. Production of lactic acid by the bacterium provides a favorable environment for the growth of other lactobacilli and bifidobacteria residing in the intestine. Studies indicate that certain strains of L. bulgaricus stimulate production of interferon and tumor necrosis factor, thus establishing a potential role in modulating the immune system.
8. Lactobacillus casei
Lactobacillus casei is closely related to the L. rhamnosus and L. acidophilus strains with some of the same immuno-modulating effects as other Lactobacilli. L. casei has several health-promoting effects provided through the production of bacteriocins, compounds that inhibit the growth of pathogenic bacteria in the small intestine. It has a few subspecies which may be written as just L. casei or one of the following:
Lactobacillus casei subspecies casei
Lactobacillus casei, subspecies paracasei
Lactobacillus casei, subspecies rhamnosus *
9. Culturelle: Lactobacillus GG
Culturelle is the only probiotic supplement containing Lactobacillus GG. In 1985, Drs. Sherwood Gorbach and Barry Golden isolated a new strain of Lactobacillus that appears to be ideal for use in humans. The strain, named Lactobacillus GG (after the surnames of its inventors), is resistant to stomach acid and bile, allowing it to survive its passage through the digestive tract and reach the large intestine intact. Once there it shows an exceptional ability to adhere to the intestinal mucosa and proliferate. There is substantial research done on this probiotic which sells under the names Culturelle, Lactobacillus GG, and ...
see Research on Culturelle
10. Lactobacillus plantarum
Lactobacillus plantarum secretes the naturally occurring antibiotic lactolin, and is also known to have the ability to synthesize the amino acid L-lysine, which has beneficial anti-viral activities. L. plantarum also produces glycolytic enzymes shown to degrade cyanogenic glycosides and is effective in eliminating nitrate while producing nitric oxide. This probiotic can preserve key nutrients, vitamins, and antioxidants, eliminate toxic components from food, and eradicate pathogens such as S. aureus from fermented food. L. plantarum-fermented oat given to healthy volunteers significantly reduced a number of potential pathogens in the gut.
11. Lactobacillus rhamnosus (casei)*
Lactobacillus rhamnosus is primarily found in the small bowel and vaginal tract and is beneficial in inhibiting those bacteria involved in vaginal and urinary tract infections. L. rhamnosus is very prolific in growth, has a high tolerance (resistance) to bile salts, adheres to the intestinal mucosa, and protects the intestinal tract against the invasion of harmful microorganisms. Additionally, this organism favorably affects lactose intolerance. A recent double- blinded, placebo-controlled study suggests that this probiotic bacteria may down-regulate hypersensitivity reactions and intestinal inflammation in patients with atopic eczema and food allergies. L. rhamnosus has been found to have significant benefits in the nutrition and well-being of infants and in the elderly. According to research with this strain, administration of L. rhamnosus is most helpful in inhibiting early intestinal infections in infants. This species of Lactobacillus does not only colonize, acidify and protect the small intestine, but it can quickly establish itself in the large intestine, inhibit the growth of streptococci and clostridia, create anaerobic conditions which favor the implantation of bifidobacteria, and produce biologically desirable lactic acid.
12. Lactobacillus salivarius
Lactobacillus salivarius is important in normalizing the gut flora of those dealing with chronic bowel conditions and shows potential as an effective inhibitor of H. pylori, an organism associated with the occurrence of ulcers.
13. Streptococcus thermophilus
Streptococcus thermophilus, in combination with L. bulgaricus, is used commercially to produce yogurt. This organism is known to be efficient in breaking down lactose by producing the enzyme lactase. Those who are lactose-intolerant may be greatly helped by supplementation with this particular strain. Cytokine production is stimulated in tissue cultured cells by this bacterium.
14. Other strains (I still need descriptions for)
Bifidobacterium breve subspecies breve
Combinations and Further Strain Descriptions
more individual strain descriptions here
1. L. acidophilus, L. rhamnosus
Many researchers now believe the myriad health benefits of L. acidophilus are also attributable to L. rhamnosus. These two species are perhaps the most important Lactobacilli in the small intestine.
2. L. rhamnosous, L. acidophilus, B. lactis, Streptococcus
thermophilus, L. bulgaricus
These are five extensively researched strains of friendly bacteria. These strains maintain viability in acidic environs as may be found in the stomach, and are tolerant to compounds found in the intestine such as bile. Clinical research has documented the usefulness of these probiotic strains as an adjunct to the management of gastrointestinal disorders, including: Antibiotic-associated decrease in friendly bacteria, Prevention of Clostridial colonization, Traveler's diarrhea, Diarrhea associated with rotaviral gastroenteritis, Acute non specific diarrhea, Constipation, Enhancement of immune response to rotaviral infection and adjuvant to rotavirus vaccine, Alleviation of intestinal inflammation and permeability, Amelioration of food allergies, especially lactose intolerance, Enhancement of the intestine's immunological barrier function, Intestinal production of short-chain
4. L. casei, L. rhamnosus, L. acidophilus, B. longum
Important studies have demonstrated the immune-enhancing properties of lactic acid bacteria. L. casei has been named in a significant number of these studies. L. rhamnosus, until recently, was subsumed under the heading of L. casei and likely possesses similar immune-potentiating characteristics as L. casei. A strain of L. rhamnosus was also recently shown to mitigate the effects of food allergy on infants with atopic dermatitis -- a reduction in intestinal inflammation was considered a key factor in bringing about the improvements observed. Numerous studies have shown probiotic organisms to be effective in reducing lactose intolerance, relieving constipation, preventing gastrointestinal infections, enhancing immune activity and, in some studies, reducing cholesterol.
5. Lactobacillus Bulgaricus:
“Lactobacillus bulgaricus does not colonize in the intestinal tract, is fast growing, and
produces lactic acid; it thus promotes the growth of beneficial bacteria that establish a
balanced gastrointestinal tract environment. It contributes to digestion, lactose tolerance,
the reduction of cholesterol, and the control of intestinal infections and it also enhances
(Institute for Functional Medicine, Inc. Clinical Nutrition: A Functional Approach. Gig Harbor, WA:
The Institute for Functional Medicine; 1999) & (Bjarnason I, Williams P, Smethurst P, et al. Effect of nonsteroidal
anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine. Gut.
“Beneficial L. bulgaricus colonies form a hostile environment for pathogenic (diseasecausing)
germs and play a major detoxification role in removing potentially harmful
germs that travel through the G. I. tract. This cleansing activity also helps sweep
metabolic waste and chemical toxins from the body. L. bulgaricus helps in correcting the
condition of either constipation or diarrhea by significantly influencing the peristaltic
action of the G.I. tract...Chronic, persistent diarrhea is less common in infants fed yogurt
containing L. bulgaricus compared to milk fed infants.”
(Bergogne, E. (2000). "Treatment and prevention of antibiotic associated diarrhea." The
International Journal of Antimicrobial Agents, 16(4):521-6.FEBSLetters,57(3).) (Bryant, M. (1986). "The shift
to probiotics." The Journal of Alternative Medicine." 2: 6-9.) (Tejada-Simon, M. (1999). "Proinflammatory
cytokine and nitric oxide induction in murine macrophages by cell wall and cytoplasmic extracts of lactic acid
bacteria." Department of Food Science and Human Nutrition, Michigan State University, East Lansing
“Lactobacillus plantarum produces lactic acid, inhibits the growth of gastrointestinal tract
pathogens, and prevents flatulence. One strain of the L. plantarum species has been
tested clinically for its effect on irritable bowel syndrome (IBS). In both studies, subjects
showed a decrease in IBS symptoms and reduced pain.”
(Niedzielin, et al., in manuscript; Nobaek, S. et al., in manuscript).
“L. Plantarum appears to help preserve nutrients such as omega-3 fatty acids, but also
increase their content. L. Plantarum has also demonstrated the ability to reduce and
eliminate potentially pathogenic microorganisms both in vitro and in vivo.
(Benmark, S. Nutrition 14, nos. 7-8 (July 1998): 585-94).
“In a 4-week, double-blind, placebo-controlled trial of 60 individuals with IBS, probiotics
treatment with L. plantarum reduced intestinal gas significantly.”
(Nobaek S, Johansson ML, Molin G, et al. Alteration of intestinal microflora is associated with
reduction in abdominal bloating and pain in patients with irritable bowel syndrome. Am J Gastroenterol.
2000; 95:1231 – 1238).
“Lactobacillus rhamnosus provides mucosal support by adhering to the mucosal
membrane, inhibiting fungal or bacterial vaginal infections, and preventing infection. L.
rhamnosus GG…reduce the incidence of or lessen the severity of antibiotic-associated
(Heyman, M.J. Am. Coll. Nutr. 19: 137s, 2000.)
“According to a recent study in 10 healthy adults, cellular immune response to intestinal
microorganisms was enhanced following intake of L. rhamnosus GG for 5 weeks. This
increased the response of peripheral T. lymphocytes to intestinal bacteria and enhanced
an inflammatory response by increasing the secretion of suppressive cytokines and
decreasing secretion of pro-inflammatory cytokines.”
(Schultz, M., H. – J. Linde, N. Lehn, et al. J. Dairy Res. 70: 165, 2003)
“Administration of L. rhamnosus GG to pregnant mother weeks prior to delivery and to
their newborn babies through 6 months of age led to a 50% decrease in the infants’
incidence of recurring atopic eczema.”
(Kalliomaki, M., S. Salminen, H. Arvilommi, et al. Lancet 357: 1076, 2001).
“Lactobacillus salivarius prevents flatulence and inhibits intestinal putrefaction and the
development of undesirable bacteria in the mouth and intestines. It is antibiotic resistant
and therefore helps to prevent antibiotic-induced diarrhea.”
(JMR, EB, CV, et al., unpublished data, 1997).
“L. salivarius is classified as a facultative bacterium, which means that it can survive and
grow in both anaerobic (without oxygen) and aerobic (with oxygen) environments,
although it’s main effects take place in anaerobic conditions. One unique benefit of L.
salivarius is its ability to help break down undigested protein and disengage the toxins
produced by protein putrefactions. In one study, L. salivarius was able to produce a high
amount of lactic acid and completely inhibit the growth of H. pylori in a mixed culture. L.
salivarius was found to be a potentially effective probiotics against H. pylori.”
(Aiba Y., et al. Am J Gastroenterol 93, no. 11 (November 1998): 2097-101;Kabir, A.M. Gut 41, no.
1 (July 1997): 49-55)
Inulin and Fructooligosaccharides (FOS or scFOS)
FOS and inulin are non-digestible oligosaccharides that help promote the growth and activity of friendly bacteria in the intestinal tract. These are called 'pre-biotics' because they are thought to help promote probiotic colonization and growth. These are oligosaccharides which are non-caloric compounds that can not be broken down by our digestive enzymes and therefore do not adversely affect blood sugar levels. Research has shown that both FOS and inulin enhance the growth of lactic bacteria, especially Bifidobacteria, and inhibit the growth of a variety of undesirable organisms. More at the following link.
FAQ: Are Culturelle Probiotics Casein-free?
Those on a casein-free diet (casein is one of the proteins in dairy) sometimes ask this when considering Culturelle. This has been coming up at least since spring of 2001 that I know of. I called the Culturelle company a few years ago and at that time the person said it did not contain casein but the specific strain, Lactobacillus caseii, sounded a lot like the word 'casein'. So people were confusing the two.
Since then, some other people have written saying the company told them the Culturelle organisms are 'grown' with some whey-based media but it is then purified out. But they couldn't guarantee every molecule of dairy was out.
Whey itself by definition is a protein part of dairy left over after casein is taken out (it is the casein-free protein part of dairy). Some people use the term in a general sense to mean all the non- casein parts of dairy, including such compounds as lactose milk sugar.
In actually experience, a lot of people strictly casein-free have done wonderfully with Culturelle, and I can't recall even one message about a person who is casein-free having a problem with Culturelle due to casein, but I don't know if everyone who is highly sensitive to casein has done well with Culturelle. Culturelle just excells on clostridia bacteria so perhaps the benefits far outweigh the possible problems.
This following is from the Culturelle site:
Question: Does Culturelle® contain dairy?
The Lactobacillus GG strain in Culturelle® is grown on a whey-based
media. In the cheese-making process, casein is the milk protein that
precipitates to form the cheese curds (hence the phrase, "curds and
whey"). After the Lactobacillus GG is grown on the whey-based media,
the bacterial cells are washed and freeze-dried. To test for the
presence of dairy proteins (casein and whey), Culturelle® has been
submitted to FARRP, an internationally known food allergy research
program for an enzyme-linked immuno sorbent assay (ELISA). The casein
and whey content of Culturelle® is each less than 15 ppm. Some people
can be allergic to these levels of protein.
The second to last sentence is not entirely clear. It could me there is no (zero) casein or whey in the final Culturelle product but the test wasn't sensitive enough to detect levels lower than 15 ppm. Or it could mean the level was anywhere from 00.001 to 14.999 parts per million but the test wasn't sensitive enough to find out how much exactly at such low levels. Or it could me that something was registering on the test but the researchers weren't exactly sure if it was casein and/or whey, or some base-line contamination from another source occurring as part of the test.
You can ask your doctor who knows your situation with food sensitivities and also recommended the Culturelle (if it was the same person). Ask him or her why he or she thinks it would be okay or not be okay. You might want to print off some of the whey and Culturelle information for him or her to look at too as well. Kd