Myths, patient management, and when to take probiotics

If you’re a patient deciding when to take probiotics, check out the guides listed and talk with your DC or health care professional

If you’ve ever taken antibiotics and had resulting digestive issues, you may have heard of probiotics. While many people take them solely for the gastrointestinal tract, these tiny organisms can also have a number of health benefits.

“Probiotics are defined as live microorganisms that, when consumed in adequate amounts, confer a health benefit,” says Eamonn M. M. Quigley, MD, FRCP, FACP, MACG, FRCPI, MWGO, professor of medicine, chief of the Division of Gastroenterology and Hepatology, and director of the Lynda K. And David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College in Houston, Texas.

Taking probiotics can also help with respiratory ailments, mental health, colic in babies, weight management, vaginal health, and more, says Dragana Skokovic-Sunjic, BScPhm, NCMP, a clinical pharmacist with Hamilton Family Health Team, Hamilton, Ontario, as well as a leader in knowledge mobilization for probiotics in both the U.S. and Canada. Skokovic-Sunjic is also the author of Clinical Guide to Probiotic Supplements Available in Canada and Clinical Guide to Probiotic Products Available in the U.S. Each year, both of these guides are updated to present the most current information.

How to choose and when to take probiotics

Selecting the correct probiotic can seem daunting. As supplements, they aren’t regulated by the FDA. So you have to know what you’re looking for — which is where the aforementioned clinical guides may come in handy.

Quigley suggests that consumers read the labels and ask themselves these questions: “What organisms does the product contain and how many? Can they guarantee that the bugs have remained alive in adequate numbers of the shelf life of the product? What does the product claim and are these claims back by evidence?”

Skokovic-Sunjic explains that the benefits of probiotics are strain-specific as well as disease-specific. So it’s not as easy as just picking one off the shelf. If you want to try using one for, say, irritable bowel syndrome (IBS), make sure that the probiotic you choose treat that. Some probiotics are also specifically designed to treat cold and flu symptoms.

What about prebiotics? These are not the same as probiotics. In fact, Quigley says, “They are food components, typically complex carbs such as some fibers, that promote the growth of ‘good’ bacteria such as lactobacilli and bifidobacterial.”

Don’t worry that you need to take prebiotics too. In a balanced diet rich in plants and fiber, Skokovic-Sunjic says, there are enough prebiotics. As a result, she says, most people don’t need to take any prebiotic supplements.

Myths of probiotics

Skokovic-Sunjic says that there are a number of myths and misconceptions associated with probiotics:

• The best probiotics are kept in the fridge. MYTH

Truth: Some probiotics need to be kept in the fridge; however, this does not mean they are better or more effective. Stability of probiotic is very strain-specific; some cannot be exposed to oxygen; others may even be baked and still provide health benefits when ingested.

• The Stronger, the better. MYTH

Truth: Some strains need to be taken in higher amounts; others will provide the benefit in 100 times smaller CFU count.

• The More strains, the merrier. MYTH

Truth: A higher number of strains present in a combination product does not always mean better outcomes. Some multi-strain products do have impressive clinical studies; others do not have the proof their strains will not ‘kill’ each other when packaged together or taken as such.

If you’re a patient selecting the right probiotic and deciding when to take probiotics, check out the guides listed and talk with your DC or health care professional.