Someone asked me awhile back what I thought was the best probiotic, so here’s my answer.
Probiotics are supplements that contain bacteria that are deemed gut-friendly. People take them for a number of reasons, and they’ve been shown, in controlled trials, to have efficacy in treating antibiotic-associated diarrhea, infectious diarrhea, and inflammatory bowel disease.(1)
The scientific evidence from both humans and animals indicates, with less robust evidence, that they’re useful in treating many other illnesses, especially chronic, mysterious illnesses, such as chronic fatigue syndrome, depression, maybe even obesity.
I usually don’t take probiotics, as I don’t feel the need any longer. I took them when I had chronic fatigue, since that illness is associated with leaky gut.(2)
As I ultimately cured my chronic fatigue, probiotics were part of the solution, although I used many other interventions, so one can’t be sure of the extent of the role that probiotics played.
In leaky gut – something most doctors insist does not exist – lipopolysaccharides from gram negative bacteria in the intestines leak through the intestinal barrier. They then chronically activate the immune system, and produce inflammation and oxidative stress.
Lipopolysaccharides are very toxic and the body strives to keep them confined to the intestines and out of the circulation. In normal, healthy people, the intestinal barrier has so-called tight junctions, but in illness, these junctions can become loose, allowing bacteria and/or their cell walls into the body.
Probiotics can treat and alleviate leaky gut.(3)
Most probiotics consist of several different bacterial species in the genera Lactobacillus and Bifidobacterium. Lactobacillus species are the same bacteria that ferment yogurt. Bifidobacterium species are major constituents of the human intestinal tract.
By supplying probiotic bacteria, the intestinal contents can become more normalized and intestinal illnesses can be treated. The number and variety of bacteria in the intestines are important for health, although the science of how this all works is in its infancy.
Garden-variety probiotics, those that contain the above species of bacteria, can have limited effectiveness (it seems), because the human intestines contain many billions of bacteria of at least 400 species – and I suspect that 400 may be a serious under-counting.(4) It would seem to follow that adding a few million bacteria of limited species number might not have the desired effect of normalizing the gut.
On top of that, the bacterial contents of the gut can vary a lot between individuals.
In any case, over the past few years, a family member had to take antibiotics on a couple of occasions. When doctors prescribe antibiotics, they’re concerned lest their patient get a Clostridium difficile infection, a serious side effect of oral antibiotics which in old or debilitated people can even be fatal. Hence even the more hide-bound doctors these days often recommend a probiotic, or sometimes just live-culture yogurt, for their patients when they take oral antibiotics.
Even absent a C. difficile infection, oral antibiotics often cause diarrhea due to their effect in killing off normal gut flora. Antibiotic-associated diarrhea, when not caused by C. difficile, is less serious but still mighty annoying.
During the first instance of taking antibiotics, this family member took a standard Lactobacillus and Bifidobacteria based probiotic, and it didn’t work. No, this family member didn’t get a C. difficile infection, but was in pretty miserable shape.
During the second instance of taking antibiotics, the family member took a soil-based probiotic called Prescript-Assist. Totally worked. There were no unwanted side effects from the antibiotics.
Prescript-Assist contains 29 different species of bacteria that were originally isolated from the soil and are similar to gut bacteria. There have been some clinical trials of Prescript-Assist for irritable bowel syndrome, and it reduces symptoms.(5)
This story is of course n=1, anecdotal, but given how it worked on that one occasion, it seems well worth trying for anyone who has to take oral antibiotics. Prescript-Assist is somewhat more expensive than standard, Lactobacillus-based probiotics, but it’s money well spent if you need it. My family member told me that she wouldn’t ever take antibiotics without Prescript-Assist.
It may have also have greater efficacy than standard probiotics in treating leaky gut.
If you need to take a course of antibiotics, especially if for longer than two or three days, Prescript-Assist would be my choice of supplement to take along with it. There’s no way I want to risk a C. difficile infection, or even the lesser but miserable illness of antibiotic-associated diarrhea.
In chronic fatigue, depression, autoimmune disorders, and bowel disorders, this probiotic could prove very useful.