The Truth About Probiotics (Full Report)

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The Truth About Probiotics
The Truth About Probiotics Graphic © Background Illustration – Pixabay (PD)

Should you take probiotics? Increase your expertise on this important topic with our full length free tutorial!

History of Probiotics

According to a report by Harvard University, there are an astonishing 100 trillion microorganisms that inhabit every normal, healthy bowel. [1] These microorganisms include gut-dwelling bacteria which keep pathogens or harmful microorganisms in check, aid digestion, produce vitamins, destroy disease-causing microorganisms and contribute to immune function. These bacteria and other microorganisms colonize the intestines, with a variety of strains forming an “ecosystem” that helps our bodies function properly when in proper balance. However for numerous reasons – from antibiotics to eating habits – the balance of bacterial strains may be compromised. Probiotic supplementation is one of the main ways used to address this and restore the dominance of the most beneficial bacterial strains.

Before probiotics merited a renewed popularity in contemporary culture, the concept has an ancient history in the form of fermented foods. A Roman naturalist named Pliny the Elder (AD 23/24 – 79) was astonishingly far ahead of the game and was one of the early adopters of probiotics, recommending fermented milk to treat intestinal problems. One can also find mentions of fermented foods in the Bible and the sacred books of Hinduism. The therapeutic use of probiotics has long been recognized, even before the invention of the microscope and the understanding of the science of beneficial bacteria.

Élie Metchnikoff (1845-1916) and his colleagues at the Pasteur Institute were credited for the introduction of probiotics as dietary supplements. Metchnikoff discovered that lactic acid bacteria conferred a type of protection from intestinal auto-intoxication which involves the production by less-beneficial bacterial strains of substances toxic to the human body, including ammonia, phenols, and other compounds. His team investigated why rural dwellers in Bulgaria lived to very old ages despite their poor socio-economic status and exposure to the harsh climate. They attributed the longer lifespan of these Bulgarians to fermented milk products. They published their findings in a paper titled “The Prolongation of Life: Optimistic Studies” which posited the anti-aging health benefits of ingesting microorganisms present in fermented milk products. [2] Metchnikoff won the Nobel Prize in medicine for his work.

Types of Microorganisms Present In Probiotic Supplements

Probiotic microorganisms belong to the genera Lactobacillus, Bifidobacterium, and Streptococcus which are fermentive, obligatory, or facilitative organisms that typically produce lactic acid. Each of these three broad groups includes many species of bacteria. The most common bacteria in probiotics belong to the groups Lactobacillus and Bifidobacterium. [3] Yeasts such as Saccharomyces boulardii are also used for probiotics. Here are some examples typically seen:


• L. helveticus
• L. brevis
• L. bulgaricus
• L. bulgaricus
• L. casei
• L. caucasicus
• L. fermentum
• L. lactis
• L. plantarum
• L. reuteri
• L. rhamnosus
• L. lysine, etc.


• B. infantis
• B. bifidum
• B. breve
• B. longum, etc.

The Difference Between Probiotics, Prebiotics, And Synbiotics

Note that probiotics are not the same as prebiotics or synbiotics. Prebiotics are carbohydrates that serve as food for probiotics. These carbohydrates could come from asparagus, artichokes, bananas, berries, garlic, leeks, onions, oatmeal, and legumes.

Good sources of probiotics include sauerkraut, miso soup, yogurt, fermented cheeses, and sourdough bread. Interestingly, there are no foods that have both prebiotics and probiotics in them. Meanwhile, synbiotics refer to the products that combine probiotics and prebiotics.

Prebiotics are essentially specialized fiber that nourishes the good bacteria in the bowel or colon. The role of probiotics is to introduce good bacteria into the gut while prebiotics act as a “fertilizer” for the good bacteria that is already present. Prebiotics also aid the good bacteria by improving the ratio of good-to-bad bacteria. A good bacterial balance equates with good health and – interestingly – a sense of overall wellbeing. [4] A healthy gut microbiome has been linked to good mental health.

Proposed Mechanism Of Action Of Probiotics

This list outlines some of the ways in which probiotics are thought to act in the body:

• Acid and Bile Tolerance

Bile tolerance determines the ability of probiotic bacteria to survive in the small intestine as well its capacity to play its functional role as a probiotic. Studies have confirmed the capability of lactobacilli and bifidobacteria to adapt to the presence of bile salts. [5] There is a potential for probiotics to enhance their bile tolerance by displaying more robust strains of bacteria that could resist other technological or gastrointestinal factors compromising probiotics survival.

• Adhesion To Mucosal and Epithelial Surfaces

This mechanism is important for successful immune modulation, exclusion of pathogens, and prevention of pathogen adhesion and colonization. Proteins of a bacterium are significant to the physiology of probiotic bacteria in the gastrointestinal tract. They are the instruments of microbial warfare provided by probiotics. They play key roles in adhesion to host cells, enhancement of inflammatory processes, and translocation of virulence factors into host cells. [6]

• Antimicrobial Activity Against Pathogenic Bacteria

Bacteria such as Lactobacillus contain antimicrobial compounds that act as bioprotective agents to control infections. These compounds include lactic acid, formic acid, benzoic acid, organic acids, and short chain fatty acids. They contribute to the destruction of pathogens or prevention of their development. [7]

• Bile Salt Hydrolase Activity

This property may benefit a probiotic bacterium needed to survive and perform in the intestinal milieu. Microbial bile salt hydrolase plays an important role in the detoxification of bile salts which in turn increases the intestinal survival and persistence of producing strains. This activity maximizes the prospects of survival of a probiotic bacterium in the hostile environment of the gastrointestinal tract. [8]

What Science Says About the Health Benefits of Probiotics

There is increasing evidence in favor of the beneficial effects attributed to probiotics from improvement of intestinal health and cancer prevention to enhancement of the immune response and reduction of cholesterol. Here are some reports from scientific research on the benefits of probiotics. Note that some of these discoveries are still in the research phase and while highly encouraging, should not necessarily to be considered “proven beyond all doubt”.

• Action Against Antibiotic-Associated Diarrhea

Antibiotic therapy causes mild or severe episodes of diarrhea due to suppression of the normal microflora which leads to the overgrowth of opportunistic or pathogenic strains. A study published in the American Journal of Gastroenterology showed the not-too-surprising association between probiotic use and a reduced risk of diarrhea linked to antibiotic medication. [9]

• Action Against Infectious Diarrhea

Several studies have affirmed the efficacy of probiotics in the prevention of travelers’ diarrhea in adults. Research published in the journal Travel Medicine and Infectious Disease revealed the beneficial effect on travelers’ diarrhea of some probiotics including a mixture of Lactobacillus and Bifidobacterium. The study found no adverse reactions after conducting probiotics trials. [10]

• Potential Therapeutic Alternative For Lactose Intolerance

According to a study published in the American Journal of Clinical Nutrition, yogurt and other conventional starter cultures and probiotic bacteria in milk products could improve lactose digestion and mitigate symptoms of intolerance in lactose maldigesters. This study presents evidence on the positive response of individuals to probiotic bacteria. [11]

• Protection Against Allergies

A study reported in the journal Clinical and Experimental Allergy assessed the potential of probiotics to control allergic inflammation caused by atopic eczema. This study proposed the value of the probiotic approach as a new direction for the development of prevention strategies and allergy treatment. [12]

• Production of Vitamins

Probiotic treatment has been confirmed as a means of addressing disorders caused by vitamin deficiencies. A study published in the Journal of Applied Microbiology evaluated the efficacy of a Lactobacillus strain in preventing the symptoms caused by vitamin B12 deficiency in pregnant mice and their weaned offspring. The study forwarded the addition of the strain as a biotechnological alternative to complement the B12 content in deficient foods. [13]

• Abdominal Pain Relief

A 2017 review found moderate evidence on the effectiveness of probiotics in improving pain in children with recurrent abdominal pain. This study used probiotic supplements as part of a dietary intervention for the school-aged children. [14]

• Reduces Risk of Necrotizing Enterocolitis and Mortality in Premature Infants

The potential of probiotics to lowering the risk of necrotizing enterocolitis and mortality in premature infants is widely studied. One meta-analysis found the effectiveness of probiotic preparations containing either lactobacillus or in combination with bifidobacterium. The probiotics used reduced the risk of necrotizing enterocolitis by more than 50% compared with controls. [15]

• Helps Control Blood Pressure

A systematic review in the journal Hypertension found the link between consumption of probiotics and improvement in diastolic blood pressure. The review clarified the effects of probiotics on BP by identifying eligible studies in Cochrane Library, PubMed, Physiotherapy Evidence Database, and databases. [16]

• Lowers Serum Cholesterol Levels

A meta-analysis that included six double-blind trials added evidence on the association between consumption of fermented yogurt and reduction in total cholesterol. The yogurt products used contain one strain of Enterococcus faecium and two strains of Streptococcus thermophilus. [17]

• Maintenance of Vaginal Health

The journal Archives of Gynecology and Obstetrics highlighted in one study the value of probiotics found in the vaginal tract in preventing various bacterial conditions including yeast infections, bacterial vaginosis, urinary tract infection, and STDs. The study noted the prevalence of lactobacilli as the dominant microorganism in the vaginal microbiota of healthy women. [18]

• Reduction of Incidence of Dental Caries in Children

In 2001, a study used milk containing a probiotic bacterium to examine its effect on caries when compared to normal milk without the bacterium. The researchers affirmed the beneficial effect of the milk containing the probiotic bacterium on the dental health of children. [19]

• Prevention Of Ventilator-Assisted Pneumonia In Critically Ill Patients

In critically ill persons, normal gut microflora may be severely compromised. Probiotics can support immune improvement, improved gastrointestinal barrier function and prevention of bacterial translocation. [20] An astonishing meta-analysis of 23 trials reported that administration of probiotics reduced the incidence of ventilator-associated pneumonia in critically ill patients by 25%. [21]

“Probiotic Killers” That May Cause Microbiome Imbalance

To improve your gut microbiome, you need to eliminate the foods and other factors that feed bad bacteria. There are also chemicals that kill off probiotics in your system and this can create conditions in which the “bad bacteria” are able to dominate. These include some prescription medications and fluoridated / chlorinated water which is thought by some to harm your digestive tract in the long term. The top “probiotic killers”, according to general thought, are:

• Chemicals and medications
• Emotional stress
• Grains
• Pesticide residues (in non-organic food)
• Unfiltered tap water (may contain chlorine, fluoride, numerous other chemicals and even medications)
• Sugar
• Prescription antibiotics

Cautions, Possible Side Effects And Contraindications Of Probiotics And Prebiotics

Probiotic products are sold worldwide and typically regulated as dietary supplements. Just like any complementary or alternative remedy, probiotics are far from perfect. There are a number of side effects that you should be cautious of. Do not assume probiotics are a cure-all despite their high regard and common use as supplements for a healthy lifestyle.

Many doctors recommend the intake of probiotics and prebiotics together. High-quality probiotics and prebiotics are safe and do not negatively interact with each other. In fact, there is a synergistic effect of probiotics and prebiotics in gut health. It is generally recommended to take prebiotics and probiotics regularly. Check out the recommendations for each supplement and seek to be consistent.

Probiotics and prebiotics are both supplements and not recommended to be used as replacements for medications. Though there is a volume of studies that support their usefulness, they are not necessarily advisable for all persons and can in certain cases cause harm: Prebiotics and probiotics could increase the symptoms and complications of certain diseases. It is likely that after diagnosis with such conditions you would have been warned about this, however it is still regarded as imperative to talk to medical experts before supplementation with prebiotics and / or probiotics.

Most side effects are likely to be mild issues such as gas or bloating. However more serious adverse risk events related to probiotics intake are high for people with immunodeficiency, short bowel syndrome, and cardiac valve disease. People with inflammatory bowel disease are potentially prone to the passage of bacteria from the gastrointestinal tract to the intestinal organs and for those with conditions with any type of bowel perforation, probiotics may be very dangerous and are typically a strongly contraindicated. Sepsis or fatal disease, could affect children with lowered immune system function following consumption of probiotics. [20] A wrong decision could lead to infections, unhealthy metabolic activities or too much stimulation of the immune system.

Ways To Get More Probiotics In Your System

• Consumption of sour foods like apple cider vinegar and fermented vegetables like sauerkraut is one step to reap the benefits of probiotics. The growth of probiotics in your system is enabled by a certain type of pH in your body that is made by possible by certain types of acids contained in some probiotics.

• Start eating more probiotic-rich foods like goat milk yogurt, kefir, and other fermented foods. One serving of probiotic-rich food a day is ideal. You can use kefir or yogurt for your morning smoothies. The inclusion of fermented foods in your diet is a must!

• Probiotics in your body increases if you get good, high-quality fiber in your diet. Some of the high-fiber foods include chia seeds, flaxseeds, organic fruits, vegetables, and sweet potatoes.

• You can also boost the good probiotics in your system by taking a quality probiotic supplement. When buying a supplement, you need to consider several things including brand quality, strain diversity of the product, and high probiotics content.


[1] Harvard Medical School. December 1, 2015. Health benefits of taking probiotics.

[2] Ilya Ilyich Metchnikoff. The Prolongation of Life: Optimistic Studies (1908).

[3] Reuter G. September 2001. Current Issues in Intestinal Microbiology. Lactobacillus and Bifidobacterium.

[4] American Association of Cereal Chemists. Przemyslaw Jan Tomasik and Piotr Tomasik. 2003. Probiotics vs Prebiotics.

[5] Ruiz L et al. December 24, 2013. Frontiers in Microbiology. Bile resistance mechanisms in Lactobacillus and Bifidobacterium.

[6] Annick Gauthier and B. Brett Finlay. October 22, 1998. Current Biology. Protein translocation: Delivering virulence into the host cell.

[7] Sabina Fijan. July 13, 2016. Probiotics and Prebiotics in Human Nutrition and Health.

[8] Begley M et al. March 2006. Applied and Environmental Microbiology. Bile Salt Hydrolase Activity in Probiotics.

[9] McFarland LV. April 2006. Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease.

[10] McFarland LV. March 5, 2007. Meta-analysis of probiotics for the prevention of traveler’s diarrhea.

[11] de Vrese M et al. February 2011. Probiotics–compensation for lactase insufficiency.

[12] Isolauri E et al. November 2000. Probiotics in the management of atopic eczema.

[13] Molina VC et al. January 7, 2009. Lactobacillus reuteri CRL 1098 prevents side effects produced by a nutritional vitamin B12 deficiency.

[14] Newlove-Delgado TV et al. March 23, 2017. Dietary interventions for recurrent abdominal pain in childhood.

[15] Khalid AlFaleh and Jasim Anabrees. April 10, 2014. Cochrane Library. Probiotics for prevention of necrotizing enterocolitis in preterm infants.

[16] Khalesi S et al. July 21, 2014. Effect of Probiotics on Blood Pressure.

[17] Agerholm-Larsen L et al. November 2000. European Journal of Clinical Nutrition. The effect of a probiotic milk product on plasma cholesterol:a meta-analysis of short-term intervention studies.

[18] Borges S et al. March 2014. The role of lactobacilli and probiotics in maintaining vaginal health.

[19] Nase L et al. Caries Research. Effect of Long-Term Consumption of a Probiotic Bacterium, Lactobacillus rhamnosus GG, in Milk on Dental Caries and Caries Risk in Children.

[20] Sunit C. Singhi and Suresh Kumar. March 29, 2016. Probiotics in critically ill children.

[21] Probiotics in the critically ill: a systematic review of the randomized trial evidence. (2012)

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