What if you could take a pill that would treat depression, constipation and diarrhea, eczema, preterm labor, urinary tract infections and allergies, while also preventing cavities and strengthening overall immunity? And what if it promised to shield you from the impurities of the world and re-establish a right and correct balance in your body's ecology?
First of all, everybody settle down — there's no such thing as a pill that does all this, but to hear some people talk, probiotics might just come close. The popularity of these gut-friendly live microorganisms has exploded over the past decade — in 2012, 4 million Americans used them and, by the end of 2018, the global probiotics market is projected to be at nearly $7 million. At this point, you can walk into almost any grocery store and find probiotics in capsules, lozenges, gum, facial toner and, yes, even in pet products, in addition to the more traditional delivery systems: cultured dairy products like yogurt and fermented products like sauerkraut and kombucha. And somebody's making a lot of money on these little bacterial helpers, so what are they actually able to do for us, and are they safe?
Unless you have an extremely poor diet or drink alcohol to excess, there's not a lot of evidence that a probiotic dietary supplement will help your overall health, says Dr. Chris Irwin, a dietitian and lecturer in Nutrition & Dietetics at Griffith University in Queensland, Australia.
"If you're taking probiotics, you'll likely need to take them every day and it's best to feed the healthy bacteria with prebiotics, which feed the bacteria," says Irwin. "The bottom line is that healthy people are likely to get more benefit from getting regular exercise, avoiding smoking or consuming too much alcohol and having a diet rich in foods that increase fibre and natural prebiotics intake like vegetables, fruit and whole grains, than consuming a probiotic supplement."
However, probiotics might be an effective treatment for specific cases or conditions. While there's not a lot of evidence supporting the idea that probiotics could help with your eczema, allergies or dental woes — sorry — they might actually help people looking to avoid vaginal yeast infections or upper respiratory infection picked up from a cold virus. Other studies have found that probiotics can help with digestive issues like irritable bowel syndrome and may improve the frequency and consistency of your poop.
Do Your Homework
But as a consumer, what should you look for in a probiotic, if you want to get the most bang for your buck?
"Different probiotic strains have different effects, so it's important to look for a probiotic supplement that contains the strains of bacteria most likely to match your condition," says Irwin. "The dose of bacteria, called colony forming units, or CFU — is also important and should be high enough to meet benefits observed in clinical trials. The short answer here is if someone is looking for a probiotic to take, go for something that provides the greatest diversity in bacterial strains and the highest CFU."
Irwin also suggests getting advice from your doctor or dietician for the strains that might be right for you and buying probiotic brands that are reputable and have committed to transparency in scientific research. However, this is more easily said than done. A study published in the Sept. 17, 2018 issue of JAMA Internal Medicine pointed out there is very little government oversight of factories that manufacture probiotics, and the U.S. Food and Drug Administration (FDA) found 50 percent of the 650 factories that manufacture probiotic supplements in the U.S. were cited for violations, most having to do with the product not living up to what was promised on the label. The study also says probiotics may lead to infections in people with immune deficiencies.
Another study, published Sept. 6, 2018 in the journal Cell, suggests some people may be resistant to supplemented probiotic bacteria, and therefore get no benefit from it at all. The researchers also investigated whether probiotics can help the gut microbiome bounce back after a round of antibiotics, and they found that, though probiotics might have helped with diarrhea related to the antibiotic, they seem to have delayed the reconstitution of gut bacteria.
Of course, more study is needed to understand just how helpful probiotics are to our overall health, and it's important not to give them more credit than they're due.
"It's unlikely probiotic supplements are dangerous, but I don't think they're a magic bullet," says Irwin. "Healthy people are likely to get more benefit from having a diet rich in vegetables, fruit and whole grains. On the other hand, if someone has a poor diet and doesn't exercise regularly, their digestive bacteria may benefit from probiotic supplements, but they'll likely need to keep taking them to get lasting effects."