PROBIOTICS – Busting the Myths
Randolph S. Porubcan MSc
C.E.O. Master Supplements, Inc.
Myth #1: Yogurt is an effective probiotic.
RSP: False. Yogurt is an ineffective probiotic as are other functional foods that claim to contain probiotic microorganisms. In these products there is no protective delivery system to assure that probiotic cells survive stomach acid.
In addition, very few yogurt products come close to providing the minmum effective dose (M.E.D.) of 10 billion CFU recommended by leading microbiologists. And to make matters worse, most yogurt servings deliver 13-17 grams of sugar.
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Myth #2: Low strength probiotic supplements (< 5 billion CFU/dose) taken over time are as effective as high dose products ( >10 billion CFU/dose).
RSP: The answer is no if enteric protection is absent. We know the kill rate in stomach acid (1 hour at pH 1.6) for the majority of probiotic strains runs from 99 to 99.99%. This is the reason old generation probiotics did not get customers to repurchase – they didn’t work well. Market growth was slow because people could not feel them working in a time frame of days or even weeks.
High potency probiotics containing acid-resistant strains and/or new delivery technology capable of protecting the strains in stomach acid have changed this picture. People can feel them working in a short time – regularity is restored quickly.
So, well informed customers have switched to these high potency brands such as our company’s Theralac® which has a patented delivery system (see http://www.theralac.com/).
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Myth #3: Enteric coatings offer significant protection to probiotics.
RSP: No they don’t. This may sound like a contradiction to what I just said but it’s not. Enteric coatings like those used for aspirin and other drugs do not work with probiotics. For one thing the common polyacrylamide “super glue” coatings, besides having potential carcinogenic activity, actually destabilize the shelf life of probiotics because they cause moisture retention within the product.
There are now new generation delivery systems that employ polymeric carbohydrates such as alginates (used in Theralac by Master Supplements, Inc.) or pectins (used in BIO-tract caplets by Nutraceutix). But these are not enteric coatings, they are complex formulations that actually “turn on” once they contact stomach acid.
A big difference.
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Myth #4: The CFU test is the best measure of a probiotic’s strength and effectiveness.
RSP: That’s about half right. Knowing the number of CFU or colony forming units (which is the accepted measure for the live cell count at least in terms of how many colonies grow on a Petri dish) guaranteed is universally regarded as the standard measure for reporting probiotic strength.
But strength is more than just the CFU number: Activity is the other half of the equation. Specifically, it’s the rate of lactic acid production that is measured by a standardized lab test. A sample of the probiotic is inoculated into sterile broth and incubated. Lactic acid production is measured every 4 hours or so and plotted. The slope of the plot is the activity – the steeper the better. Typically, a 0.1% inoculation with an old generation probiotic produces about 1% lactic acid in 24 hours at 37C (98.6F). New generation probiotics like our Theralac produce >1.5% in 12 hours. A huge difference.
Now why is activity important? Because it’s not enough for CFUs to just show up in our G.I. Tracts, they have to do something when they get there! That something is to make metabolic byproducts and lactic acid the #1 byproduct made by these lactic acid bacteria. Lactic acid is a natural food acid found in pickles, olives, and yogurt that prevents spoilage; by this same action it prevents many pathogenic bacteria such as E. coli from overgrowing in our intestines.
So the true probiotic effect involves a significant number of CFU (preferably 10 billion CFU or more per serving) producing significant quantities of lactic acid within our intestinal tract. If you go to http://www.theralac.com/ you can read more details on this, and if you have a bottle of Theralac you can type in the lot # and get the activity analysis for that specific lot! This is leading curve stuff so don’t expect many companies to provide this analysis at this time.
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Myth #5: Single strain probiotics are as good as multi-strain products.
RSP: No, absolutely not. Let me say that again, No. A single strain product cannot colonize all the various niches in the G.I. tract, it takes a multi-strain product to do that.
For example, Lactobacillus strains are largely effective in the small intestine while Bifidobacterium strains work best in the colon. There is some overlap but a location preference exists. Also, some strains colonize the cells lining the wall of the intestines and/or their mucous surfaces better than others while some strains best colonize the cecum (that dead end sac above the appendix) while still others better colonize the food itself as it moves through the digestive tract.
I like to refer to the sum total of all these colonization events as our IPC – or Internal Probiotic Culture. It’s not rocket science that a multi-strain product will produce a more comprehensive IPC.
The reason why some companies push a single strain product is probably related to new FDA requirements that are starting to take effect now for large companies and that will be in effect by 2010 for all companies – these require that all active ingredients on a label be tested quantitatively in the product.
This is hard to do with multi-strain products since it’s quite difficult and expensive to separate strains once they’re mixed. At our company, Master Supplements, Inc., we are working on DNA probes for the five strains in Theralac that will allow individual strain analysis in the commercial product.
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Myth #6: Multi-strain probiotics with many strains are better than those with fewer strains.
RSP: We have not found this to be true, somewhere between 3-7 strains is about right (Theralac contains five). What happens when formulating with a large number of strains is the inability to put an efficacious amount of each strain into a 500 mg capsule (typical size for probiotics). For example, with Theralac we guarantee all five strains separately through expiration, three of them at 5 billion CFU each and the other two at 3 and 2 billion – which adds up to the 20 billion CFU/capsule guarantee.
I don’t like to see any strain used at less than 2 billion CFU. You can see where I’m going here. It’s a space problem unless you’re just adding tiny “label dressing” amounts of most strains and larger amounts of only the few that are cheaper to make – products formulated this way will not make the regulatory cuts in the future.
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Myth #7: Strain identity is critical, newer strains work better than old generation strains.
RSP: Four years ago I would have agreed with this, today we find that delivery is the number one criteria for probiotic success. We have both old and new generation strains in Theralac. Old generation meaning they have been in use for over 10 years. What we have found is that many of the older strains were condemned or discontinued because they didn’t seem to work well when actually they work quite well when delivered properly.
I need to add something important here: Delivery doesn’t just mean making it through the stomach alive, the best delivery systems keep the probiotics together in a protective gel as they move deep into the intestinal tract. The more pristine this gel state can be kept in terms of allowing only probiotics to grow the better.
The patented alginate gel system we use in Theralac stays together as a sticky biogel containing, in addition to five probiotic strains, lactoferrin (which keeps out undesirable bacteria) and LactoStim® (a patent pending prebiotic effective at milligram quantities). So we have a traveling probiotic culture where the strains are both protected and fed as they travel deep into the intestinal tract. As the biogel slowly dissolves the probiotic cells come loose and begin their search for colonization niches. Theralac is the only probiotic with this cutting edge, patented technology.
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Myth #8: Homeostatic soil organisms (HSOs) are safe probiotics.
RSP: Several companies in the USA use soil borne Bacillus bacteria in probiotic products for human consumption. This practice was spawned in Japan but is not allowed in the E.U. due to safety concerns. Usually these HSOs go by the names Bacillus subtilis and Bacillus licheniformis but there are others. They are used because they are stable since they produce spores – so refrigerated storage is not required.
I worked with agricultural probiotics for many years where we fed these same microorganisms to food animals like cattle and pigs. They work. But cattle and pigs don’t live to a ripe old age. The big worry is that HSOs can enter the blood stream in people with leaky gut syndrome and, in cases of depressed immunity, cause septicemia. True probiotics originate from the Lactobacillus and Bifidobacterium genera with only a few exceptions.
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Myth #9: Adding fructo-oligosaccharides (FOS) to probiotic
capsules is beneficial.
Currently the prebiotic FOS is under fire for not being selective enough for probiotics since it stimulates non-probiotic bacteria such as Enterococcus species. This concern aside, a number of probiotic manufacturers still include FOS in their products. Virtually all of the data on FOS as a prebiotic shows a requirement of 4-8 grams per day. So picture this: If probiotic brand X contains 100 mg of FOS per capsule (a typical amount) – to get to the 4 gram minimum requirement you would have to take 40 capsules per day. So FOS there as label dressing in these products– as a marketing story.
There is a positive point to make on FOS: Natural sources of FOS that are present in certain foods such as bananas, onions, tomatoes, rye bread, asparagus and artichokes are beneficial and quite compatible with probiotics – these are examples of true prebiotic foods. The problematic FOS is the synthetic form.
I’m a big believer in prebiotics and with Theralac the alginate we use in our delivery system is, additionally, a very good prebiotic for lactobacillus and Bifidobacteria. Alginate is one of several fiber gums (soluble fiber sources) that are proving to be better than FOS type prebiotics since they do not cause excessive intestinal gas (while FOS does).
We have just introduced a new soluble fiber product that contains partially hydrolyzed guar gum (PHGG) as a natural prebiotic; it has been clinically proven to improve regularity and is quite synergistic with high potency probiotics (visit http://www.trufiber.net/).
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Myth #10: Diet does not play a role in probiotic effectiveness.
RSP: A big myth. Even when you discount the prebiotics consumed in some foods, diet is still critical to probiotic success. The object is to eat a diet that encourages a comprehensive Internal Probiotic Culture (IPC) – like I spoke of earlier.
Such a diet favors what I call cobiotics. Cobiotics, unlike prebiotics, are foods (or supplements) that both probiotics and our bodies can digest and utilize. A good example would be essential amino acids like lysine and methionine – you can get these from supplements or from easy to digest proteins such as whey protein and fish. Certain sugars like galactose have cobiotic activity as well. You will be hearing more about cobiotic diets in the future.
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Myth #11: You need to take probiotics every day – like a multivitamin.
RSP: Five years of experience with Theralac says no. Once your G.I. tract is effectively colonized you can back off to twice a week or so and save money. Everybody is different so you need to titrate yourself, meaning once you have established a good IPC (usually apparent by enhanced regularity with longer stools of less odor) you need to find a proper maintenance dose.
Our standard dose program for Theralac is one capsule daily for two weeks followed by two capsules weekly. However, some people find they can only back off to one capsule every-other-day. This is what I mean by titrating yourself.
I should add here that the one-a-day, every day recommendation came from manufacturers of low strength probiotics. High potency probiotics that deliver the minimum effective dose of 10 billion CFU or more are truly in a new world – they will save you money because you can back off on the dose once your G.I. tract is well.
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Myth #12: Probiotics do not require refrigeration.
RSP: It’s hard for me to keep a straight face on this one. Does lettuce require refrigeration? How about lunchmeat and milk? Well probiotics do too! All probiotics are perishable. If you look carefully at the labels of products that say refrigeration is not required you’ll find, in almost all cases, the CFU counts are guaranteed at time of manufacture. This is a red flag.
So if the probiotic you are looking at is not in the refrigerator at your favorite health store – forget it. Note: When probiotics are packaged in glass bottles, flushed with nitrogen to remove oxygen, kept dry with desiccant packs and hermetically sealed (Like the Totally Inert Packaging™ used for Theralac) they can withstand room temperature shipping and storage for periods up to 4 weeks. But, refrigerate upon arrival! (see http://www.theralac.com/).
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Myth #13: Probiotics dominate a balanced healthy G.I.tract.
RSP: Generally not. Probiotics are the microbial police that maintain order and peaceful cooexistance between the other 500 + microbial species in the G.I. tract. Many of these “others” have not been identified. The human G.I. tract is a very complex microbial ecosystem containing upwards of 100 trillion microorganisms. If probiotics occupy 1% of this on a CFU for CFU basis they’re doing very well.
Nobody really knows what the real percentage needs to be to create a health controlling effect. However, more is definitely better. The fact that high potency probiotics are rapidly growing in popularity over old weaker products says something.
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Myth #14: Don’t take probiotics while taking antibiotics.
RSP: Not true. This is something we had to learn by working with many doctors: Gastroenterologists and other specialists have found it’s best to co-administer high potency probiotics with antibiotics. The secret is not to take them at the same exact time. Separating the two by 3-6 hours is best. Since most antibiotics are water soluble, they absorb in the upper G.I. tract. Probiotics work mainly in the lower G.I. tract – so giving antibiotics time to absorb and get out of the way is the key.
Of course, there will be some inhibition/killing of probiotics so it is vital that you stay on high potency probiotics well after the antibiotics are finished – One month minimum.
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Myth #15: It’s best to take probiotics with water on an empty stomach.
RSP: This was always the recommendation for old generation weaker probiotics. One of our medical doctors who uses 16 cases of Theralac/mo. used to tell his patients to drink eight glasses of water prior to taking probiotics. After the 8th glass the stomach’s proton pump cells become convinced no food is coming so they stop producing acid.
In this case even weaker probiotics work if you take enough of them (8-10 capsules per dose). It was a hard sell to get people to do this. With Theralac’s delivery system you take just one or two capsules anyway you want, with or without food, on a full or empty stomach, with milk, juice, or water. How about that.
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Myth #16: Digestive enzymes do not stimulate or
RSP: False. But it depends on the enzyme supplement, most are either too weak in the enzymes that stimulate probiotics or don’t contain them at all. This is why we introduced Enzalase® in 2006 – the first high potency digestive enzyme supplement specifically designed to stimulate probiotics (see http://www.enzalase.net/).
It contains critical fiber digesting enzymes that are stimulating because they improve the microbial digestability of gum fibers found in fruits and vegetables. Our Fiberase™ enzyme complex, found in Enzalase along with nine other enzymes, contains cellulase, hemicellulase and pectinase at high activity levels. In addition, the other nine enzymes help by releasing cobiotics from various foods (see Myth # 10).
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