What I Need to Know About Probiotics
What are probiotics?
Probiotics are live, “friendly” organisms that live in the intestine. They help decrease “unfriendly”
bacteria and viruses that cause diseases such as diarrhea. Examples of probiotics include Lactobacillus,
Bifidobacteria, and Saccharomyces boulardii.
For what conditions are probiotics effective?
Certain probiotics have been shown to be beneficial for preventing and treating some types of
diarrhea, including diarrhea caused by antibiotics. Probiotics also seem to help some bowel diseases such
as ulcerative colitis and irritable bowel syndrome. A specific probiotic combination. Howaru Protect, is possibly effective for preventing cold/flu-like symptoms during the winter months in children ages three to five years. But there is no proof it prevents
the flu.
What probiotic products are available, and how do I choose one?
Not all probiotic products are the same. Some do not contain what they say on the label. Others do
not contain enough live organisms to be effective. And some probiotics work better for certain conditions
than others. Clearly, product selection is important.
To prevent diarrhea caused by antibiotics, choose Culturelle (Lactobacillus GG) or Florastor
(Saccharomyces boulardii). You can also try these products for prevention of traveler’s diarrhea. Start
taking them a few days before travel, and continue them for the duration of your trip.
Yogurt is a source of probiotics, but not all yogurts contain the right kinds of organisms. Choose a
product with the National Yogurt Association’s “Live and Active Cultures” seal on the label (e.g.,
Dannon, Yoplait). You will need to eat about 8 oz twice daily to prevent antibiotic-associated diarrhea.
However, eating yogurt doesn’t seem useful for preventing vaginal yeast infections caused by antibiotics.
It is also not clear if yogurt helps prevent recurrent vaginal yeast infections.
VSL#3 is a probiotic mixture used for certain bowel conditions such as ulcerative colitis and irritable
bowel syndrome. It may help reduce bloating if you have irritable bowel syndrome with diarrhea.
What are the side effects of probiotics?
In some people, probiotics can cause stomach and intestinal upset, including gas and bloating. These
usually improve with time.
Are there any drug interactions with probiotics?
Antibiotics are used to reduce harmful bacteria in the body. They can also reduce friendly bacteria
like Lactobacillus and Bifidobacteria. If you are using these probiotics or yogurt, you should take them at
least two hours before or after the antibiotic.
The calcium in yogurt can also decrease the effectiveness of some antibiotics. You may need to allow
more than two hours between eating your yogurt and taking your antibiotic. Check with your pharmacist
for the best way to avoid this interaction.
Saccharomyces boulardii is a fungus. Medications for fungal infections help reduce fungus in and on
the body. Taking Saccharomyces boulardii with medications for fungal infections can reduce its
effectiveness. Some medications for fungal infections include Diflucan, Lamisil, Sporanox, and others.
Who should not take probiotics?
For healthy people, routine use of probiotics to maintain bowel health is unnecessary. There is a small
risk of infection with probiotics. If you have a weakened immune system you should not take probiotics
unless you’ve checked with your healthcare professional. If you are pregnant or breastfeeding, you
should get approval from your healthcare professional before taking any probiotic other than yogurt.
[September 2009]
Prepared for the subscribers of
Pharmacist’s Letter / Prescriber’s Letter to give to their patients.
Copyright © 2009 by Therapeutic Research Center
www.pharmacistsletter.com ~ www.prescribersletter.com