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Allergy Articles & Updates

probiotics

4/8/2021

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Probiotics
Probiotic evidence
They are bacteria that can lead to benefits to the large bowels when taken in an appropriate amount.⁣

But are all Probiotics good?⁣

For me to have a better idea about that, I went to find the evidence behind it.⁣
  • There are over 2.5k articles focusing on 22 different probiotics.⁣
  • From those articles, I found 249 RCTs (𝘳𝘢𝘯𝘥𝘰𝘮𝘪𝘻𝘦𝘥 𝘤𝘰𝘯𝘵𝘳𝘰𝘭𝘭𝘦𝘥 𝘵𝘳𝘪𝘢𝘭𝘴), with most of them being sponsored by the company selling them.⁣
  • So take their conclusions with a pinch of salt…⁣

The most effective use for them is diarrhoea, IBD (𝘐𝘯𝘧𝘭𝘢𝘮𝘮𝘢𝘵𝘰𝘳𝘺 𝘉𝘰𝘸𝘦𝘭 𝘋𝘪𝘴𝘦𝘢𝘴𝘦) and IBS (𝘐𝘳𝘳𝘪𝘵𝘢𝘣𝘭𝘦 𝘉𝘰𝘸𝘦𝘭 𝘚𝘺𝘯𝘥𝘳𝘰𝘮𝘦).⁣

This image shows the conditions for which probiotics are helpful and the evidence's strength.⁣
(𝘊𝘩𝘰𝘰𝘴𝘪𝘯𝘨 𝘢𝘯 𝘢𝘱𝘱𝘳𝘰𝘱𝘳𝘪𝘢𝘵𝘦 𝘱𝘳𝘰𝘣𝘪𝘰𝘵𝘪𝘤 𝘱𝘳𝘰𝘥𝘶𝘤𝘵 𝘧𝘰𝘳 𝘺𝘰𝘶𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵: 𝘈𝘯 𝘦𝘷𝘪𝘥𝘦𝘯𝘤𝘦-𝘣𝘢𝘴𝘦𝘥 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘢𝘭 𝘨𝘶𝘪𝘥𝘦. 𝘩𝘵𝘵𝘱𝘴://𝘥𝘰𝘪.𝘰𝘳𝘨/𝟷𝟶.𝟷𝟹𝟽𝟷/𝘫𝘰𝘶𝘳𝘯𝘢𝘭.𝘱𝘰𝘯𝘦.𝟶𝟸𝟶𝟿𝟸𝟶𝟻 𝘋𝘦𝘤𝘦𝘮𝘣𝘦𝘳 𝟸𝟼, 𝟸𝟶𝟷𝟾)⁣





















  • This means, not all probiotics have any evidence based effect on your health.
  • And the helpful ones are disease specific.⁣
  • At least, from all of them, we know there are no absolute contraindications to their use.⁣

Other benefits found are that they:⁣
  1. Stimulate the immune system
  2. Can decrease the inflammatory response⁣
  3. Can improve vaccine response⁣

Where are they found:⁣
  1. Fermented milk drinks⁣
  2. Some yoghurts⁣
  3. Supplements⁣.
  4. Examples: kefir, kombucha, sauerkraut, pickles, miso, tempeh, kimchi, sourdough bread, some cheeses (Cheddar, Parmesan, and Swiss cheeses are soft cheeses that contain a decent amount of probiotics. Gouda is the soft cheese that delivers the most probiotics of all)


How to take them⁣⁣:
  1. There is scant evidence comparing which type of formulation may be more effective.⁣⁣
  2. The choice of formulation may be based on shelf-life, in that lyophilized capsules maintain high concentrations longer than probiotics in dairy products and enteric-coated capsules show higher survival rates than non-enteric coated capsules.⁣⁣
  3. Probiotic capsules requiring refrigeration are heat-dried (not lyophilized) and thus not stable at room temperature, limiting their portability.
  4. Besides, if the patient is lactose-intolerant, yoghurts or other types of fermented dairy products may not be advisable.

Careful with quality control, some will have less than stated.

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    Dr Costa is a Consultant Paediatrician and fellow of the Royal College of Paediatrics and Child Health.

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