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How to Pick a Probiotic!

Did you know that more strains in your probiotic does not = a better effect…

Common advice when picking a probiotic includes…

The more strains the better!

Anything with Lactobacillus/Bifidobacteria in it!

Supplement bacteria you want more of in your gut!

Let's go through this step by step to bust some probiotic myths…


  1. More strains are not better.

The probiotics strain = the numbers and/or letters appearing after the name.

A good example is Lactobacillus rhamnosus GG and Lactobacillus plantarum 299V.

Lactobacillus is the genus of bacteria.

Rhamnosus or plantarum are the species.

And GG or 299v are the strains.

Each strain has a different action in the gut!

For example Lactobacillus rhamnosus GG (LGG) interacts with the gut microbiome to positively influence your immune system. It is well known for reducing allergies such as hay fever and is frequently prescribed during pregnancy or breastfeeding to reduce atopy in infants. (Capurso, 2019)

Whereas Lactobacillus plantarum 299v reduces gut pain in conditions such as irritable bowel syndrome (IBS). IBS is commonly characterised by a heightened response to pain in the gut known as visceral hypersensitivity. This probiotic helps to dampen down this over-reactive pain response. (Ducrotté et al., 2012)

Commercial companies are not required to create formulas including only useful strains. Unresearched strains can be used to reduce cost, and some companies don't even include the strain name on the bottle!

It is much more beneficial to find specific probiotic strains which targets your own specific symptoms. The best way to do this is with the help of a professional, however I will provide a short list of evidence based strains at the end of this document and their key uses.

2. Anything with (insert genus name e.g. lactobacillus) in it…

The information above alone discounts this myth. We now know that the strain denotes the action, so focusing on the genus alone is not an effective way to supplement!

3. Supplement bacteria you want more of in your gut!

Did you know that probiotics do not permanently colonise in the gut? Instead they have a beneficial role as they pass through the gut. (Bezkorovainy, 2001)

This could be regulating your immune response, reducing bowel sensitivity to pain, producing antibacterial molecules to kill off pathogens or helping with gut motility (e.g. reducing constipation).

We supplement probiotics for their specific action in the gut, and prebiotics to build up a variety of healthy bacteria in the gut.

Prebiotics = plant compounds such as fibre and polyphenols which feed up beneficial gut bugs.

If you are looking to increase specific gut bugs, the best way to go about this is to feed them the fibre they need to thrive! For example, polyphenols in the skin of red apples help to feed up Akkermansia muciniphila which is known for its positive effects on metabolic health. (Hills et al., 2019)

A quick probiotic guide:

Probiotic name

​What does it do?

What conditions is it helpful for?

Saccharomyces boulardii

Acts as a crowd controller i.e. helps prevent/reduce overgrowth of opportunistic gut bugs.

Overgrowth of opportunistic microbes, particularly candida.

Antibiotic use (during/post).

Candida/thrush.

Diarrhoea.

Food poisoning.

Small intestinal bacterial overgrowth (SIBO).

Lactobacillus plantarum 299v

Reduces digestive pain. Reduces digestive inflammation. May reduce cortisol/an over active stress response.

Irritable bowel syndrome (IBS). SIBO. Antibiotic associated diarrhoea.

Bifidobacterium lactis HNO19

Speeds up gut transit time i.e. speeds up the movement of food through the digestive tract.

Constipation/slow transit time.

Lactobacillus rhamnosus GG (LGG)

Immune modulation: helps prevent an over-active immune response to common allergens e.g. grass, dust mites, pollen.

Seasonal allergies/hayfever. Eczema. Eczema and allergy prevention in infants (taken by parent during pregnancy/breast feeding). Preventing/reducing severity of respiratory tract infections. Reducing diarrhoea with antibiotic use.

Lactobacillus acidophilus NCFM

Significantly reduces pain and bloating in IBS. Has an analgesic effect in the gut. Reduces changes to the gut microbiome with antibiotic use. Supports a healthy immune response.

IBS. Gastrointestinal pain and bloating. Immediately post antibiotic use.

Escherichia coli Nissle 1917

Improves the gut barrier integrity. Modulates immune function. Inhibits the overgrowth of pathogenic E coli strains.

Acne, rosacea and seborrheic dermatitis. Ulcerative colitis Diverticular disease Management of liver cirrhosis Preventing upper respiratory tract infections in infants.

References:

Bezkorovainy, A. (2001). Probiotics: determinants of survival and growth in the gut. The American Journal of Clinical Nutrition, 73(2), 399s-405s. https://doi.org/10.1093/AJCN/73.2.399S

Capurso, L. (2019). Thirty Years of Lactobacillus rhamnosus GG A Review. In Journal of Clinical Gastroenterology (Vol. 53, pp. S1–S41). Lippincott Williams and Wilkins. https://doi.org/10.1097/MCG.0000000000001170

Ducrotté, P., Sawant, P., & Jayanthi, V. (2012). Clinical trial: Lactobacillus plantarum 299v (DSM 9843) improves symptoms of irritable bowel syndrome. World Journal of Gastroenterology : WJG, 18(30), 4012. https://doi.org/10.3748/WJG.V18.I30.4012

Hills, R. D., Pontefract, B. A., Mishcon, H. R., Black, C. A., Sutton, S. C., & Theberge, C. R. (2019). Gut microbiome: Profound implications for diet and disease. Nutrients, 11(7). https://doi.org/10.3390/nu11071613

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