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Friday, December 22 2017

Understanding Priobotics

Probiotics have become an accepted protocol in the treatment of many health problems.  In an age when antibiotic overexposure has become commonplace, we often turn to probiotics to replace the good bacteria that most certainly has been lost for this reason and to help with a variety of gastrointestinal, skin or other problems.  Usually we rely upon yogurt or lactobacillus supplements towards that goal.  However, not all lactobacillus is the same.  Since the discovery of the first lactobacillus in early part of the 20th century, there have been dozens of species discovered within the genus of lactobacillus and over 180 different strains identified within those species.  Here is a timeline on the discovery of the different species of Lactobacillus.


The diagram below also should help explain how multiple strains are classified from the Genus Lactobacillus and each species.

To quote a NY Times article on probiotics, simply looking at a probiotic and seeing that it had Lactobacillus rhamnosus is akin to “saying you had George Clooney at your house yesterday”. “It could mean you had the famous actor George Clooney or it could have been your uncle George Clooney by the same name is visiting you from Atlanta”.  Using the species above of rhamnosus R0011 as an example, it might be useful for treating fatty liver (the famous George Clooney), however another strain, rhamnosus W71 might be helpful for women with constipation who are pregnant (your uncle named George Clooney). 


This nomenclature system isn’t perfect.  Scientists are using DNA analysis to identify strains and sometimes realize later that it is a new species.  Then to make things more confusing, there are circumstances where the same strain has multiple names.  Ultimately scientists are trying to connect what each species and strain are best for treating which health issue.

This chart composed by Mary Ellen Sanders PhD, the founder and president of ISAPP, the International Scientific Association for Probiotics and Prebiotics offers a good synopsis of information towards that end.  Dr. Sanders has authored over 110 peer-reviewed scientific publications on efficacy substantiation, microbiology and regulatory issues pertaining to probiotics.


 Single Strain and human data

L. rhamnosus GG                        Immune enhancement, infectious diarrhea
                                                    in children and
                                                    prevention of atopic dermatitis

B. Lactis BB-12                           Immune enhancement, diarrhea in children

L. reuteri SD2112                        Reduced absences from work, diarrhea

B. infantis 35624                         Irritable bowel syndrome (IBS)

L. casei DN114-001                     Immune enhancement

B. longum BB536                        Allergy symptoms, intestinal micro-ecology

L. acidophilus NCFM                   Symptoms of lactose intolerance, reduced
                                                     small bowel overgrowth

B. Lactis HN019 (DR10)              Immune enhancement, especially in the elderly

B. animalis DN173-010                Normalizes intestinal transit time

L. plantarum 299V                       IBS, post-surgical gut nutrition

L. casei Shirota YIT9029             Superficial bladder-cancer recurrence, intestinal

                                                     Microbiota, immune enhancement

L. salivarius UCC118                   Inflammatory bowel disease

L. johnsonii La1 (Lj1)                   Immune function, heliobactor pylori eradication

Escherichia coli Nissle 1917        Immune function, intestinal health

Saccaromyces Cerevisiae           Antibiotic associated diarrhea

Saccaromyces boulardii              Clostridium difficile infection

S. thermophilus (most strains)     Symptoms of lactose intolerance


Additional combination strains and human data

L. rhamnosus GR-1 + L. reuteri RC-14   Oral consumption leads to colonization
                                                               of  vaginal tract and improved therapeutic

                                                               outcome for women being treated for bacterial vaginosis. 

VSL#3 (8 strain blend of S. thermophilus)  Inflammatory bowel conditions

4 strains of lactobacillus and 3 strains of


L. Acidophilus (CUL60) +                       Reduction of C. difficile toxin in feces

B. Bifidum (CUL20)

L. Helveticus R0052+                            H. Pylori eradication, diarrhea in children

L. rhamnosus R0011



Probiotics are live bacteria living synergistically with humans since the beginning of time.  They comprise a percentage of the ten trillion bacteria in our gut and without them life would be impossible.  For at least 7,000 years humans have been using bacterial fermentation as a way of preserving foods.  Foods such as yogurt and kefir, (avoid if label says heat treated), raw sauerkraut, pickles, kimchi, miso, tempeh, Natto, sour dough bread, kombucha, and even beer and wine are examples of this.  Cultures around the world that regularly use fermented foods seem to have increased longevity. 


In recent years the discovery of enteric coated delivery systems for probiotics have increased therapeutic options for delivery and survivability of probiotics. This is important because according to some researchers only about 6% of the bacteria ingested get delivered to the intestinal area.  Spore based probiotics have a better survivability profile; up to 100% absorbability. There are several strains of these probiotics that have value too.  These include Bacillis Lichinformis, Bacillus Indicus HU 36, Bacillus Subtilis HU 58, Bacillus Clausii, and Bacillus Coagulans.  These bacteria produce B vitamins, antioxidants, vitamin K, and help the immune and digestive system in many ways.  They all are part of a formula called MegaSporBiotic.  I use this in my office along with a half dozen other probiotic formulas.  


There are numerous probiotics in the marketplace.  Many are sold even though the bacteria are no longer living or viable enough to reproduce in our digestive tracts.  Many have no enteric coating to survive the acidity of the stomach acids.  As with any product if it works stick with it, but if you continue to have issues, other bacteria strains may hold the answer to your problems.  You should be able to see the strain of bacteria on the label or be able to call the company and get that information if it isn’t listed.  In many cases simply having a probiotic with billions of total bacteria may not be as important as the species and strain and whether it can be delivered intact to the gut.



Posted by: Dr. Goldstein AT 09:00 am   |  Permalink   |  0 Comments  |  Email

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