Updated: Oct 2, 2018
The word "bacteria" doesn't always sound like a good thing, does it? Well, when it comes to probiotics, it is! Probiotics are healthy bacteria found in traditional fermented foods such as yogurt, sauerkraut and kimchi. Although these foods contain about 1 billion per serving, this is actually an incredibly small number considering there are trillions of bacteria living in gut. Crazy, right? That's why it’s important to have the "good bacteria" in your system; if too much of your gut consists of "bad" kind, it can cause a whole host of problems including constipation or diarrhea, gas, bloating, indigestion and inflammation among other things.
Most probiotics are therapeutic dosages ranging from 5 billion to 150 billion. The total number of bacteria is referred to as the CFU (or colony forming units). Additionally, many probiotics contain different types of bacteria—also known as strains. But how on earth do you know which probiotic supplement to pick? In today's post, we'll provide you with some information to ensure you're making an informed decision.
First thing's first: why do I need a probiotic?
• Have you ever taken an antibiotic?
• Do you take prescription drugs?
• Do you drink alcohol or take over the counter pain-killers?
• Do you have IBS or other digestive issues?
• Have you recently, or are you planning on travelling out of the country?
All of these factors affect the balance of healthy to unhealthy bacteria in our gut, and unless you replace them, the bad bacteria grows out of control, causing all kinds of health problems.
Eating fermented foods such as yogurt can help, but it only contains a small amount of probiotics, and usually only one or two strains.
In order to get a therapeutic dose of probiotics you need to take a supplement.
They range in amounts from 5 billion to 150 billion, so how do I know how much to take??
Before you walk into a health food store and get sticker-shock, know that the higher dose probiotics are going to be more expensive. So if budget is an issue for you, you may need to stick with a lower dose probiotic. But as a general rule, if you have any major digestive issue such as IBS, you usually need a higher dose (between 30 to 100 billion) to help manage your symptoms.
If you have recently taken antibiotics or have been very sick, you may want to try a high dose probiotic; something between 80 to 150 billion.
It’s important to note that if you have never taken a probiotic before, and especially if you have a sensitive gut, you may want to start with a low dose at first until your body has adjusted, otherwise you may experience some gas and loose stools the first day or so. My suggestion in this case would be to start with a dosage of around 10 billion or so, and as your body adjusts you can always take a double or triple dose if you feel that it’s helping. Once you have adjusted to that higher dose you may try a higher dose probiotic for your next bottle.
Why bacterial strains matter
The types of bacteria in a probiotic will be listed on the back of the bottle, and just like ingredients in a food, they are listed from highest amount to lowest amount. So, for example, if you are someone who struggles with constipation, you would want to look for a probiotic that has bifidobacteria near the top of the list.
In general, the more strains in a probiotic the better; you want to have a very diverse population of bacteria in your gut, as they all do different things for your body. This is why I always suggest to switch brands after you finish a bottle, so your body can be exposed to as many different types of healthy bacteria as possible.
Here are some common strains of bacteria and what they can be useful for:
• Lactobacillus acidophilus helps with lactose intolerance, and helps create a healthy vaginal flora for women.
• Lactobacillus rhamnosus is most important for women’s vaginal health; it can help prevent yeast infections and also helps prevent urinary tract infections (UTIs)
• Lactobacillus helveticus has been found to help with mood including symptoms of anxiety and depression.
• Bifidobacteria in general, help to maintain a healthy colon, which helps to keep you regular.
There are often other ingredients in probiotics. You may see things such as inulin, fructooligosaccharides (FOS), potato starch, skim milk powder and more. These are all food sources for the bacteria to keep them alive, and together they are called PRE-biotics.
If you have IBS or a sensitive stomach, you might want to opt for a probiotic without these ingredients, with the exception of potato starch. Inulin and FOS can cause gas and cramping in people with IBS so it is best to avoid them if possible, and get your prebiotics from food. Prebiotics are a type of fibre, so they naturally occur in many fruits, vegetables and whole grain carbs. So including high fibre foods in your diet will ensure that you are feeding your probiotics to keep them alive and keep your gut feeling great!
How long do I need to stay on probiotics?
The answer to this question depends on whether you have chronic digestive issues or not.
If you are simply recovering from a short term illness you may only need one bottle to start feeling better. However, if you have chronic digestive issues such as IBS you may need to stay on probiotics long term.
You can think of probiotics as travellers; they don’t like to move in, they would rather just visit.
Unfortunately they have not yet been able to create a probiotic that attaches to the gut permanently and stays there long-term. Many probiotics simply pass through the gut as if visiting for 14 days or so, and they head “home” (to the toilet!) so most people find they need to keep taking them continually to feel good.
I can’t tolerate dairy, are there any dairy-free options?
As some of you may know, most probiotics are grown in a dairy medium. However, once they have grown, they are isolated from the dairy and purified before being put into a capsule. As such, most probiotics do not contain dairy at all. The only dairy that you would find would be in the “non-medicinal ingredients” such as skim milk powder. Some brands use a bit of dairy to help keep the probiotics alive. So if you don’t see that listed on the bottle, it is dairy-free. So for those of us who are lactose intolerant or have a mild dairy allergy, most probiotics are safe.
Some brands actually isolate their probiotics from humans instead of dairy; one brand that is popular with naturopaths is Genestra HMF powder or capsules. So this brand would never have come in contact with dairy.
However, if you have an anaphylactic allergy to dairy I would suggest finding a probiotic that is certified dairy-free. They can be hard to find, but there are one or two brands that are available.
I’ve tried a probiotic before and it upset my stomach; I thought they were supposed to help my gut feel better, not worse!
Some people may have adverse reactions to probiotics for many reasons. It may be too high of a dose for you, or if you have IBS and cannot tolerate prebiotics you may need to find a probiotic without prebiotics.
Depending on the balance of bacteria in your gut, certain strains of bacteria may not work well for you; in that case, simply try a different probiotic with different bacterial strains. If you are unsure, consult a naturopath or staff at your local health food store.
What’s the difference between refrigerated and shelf-stable probiotics?
Contrary to popular belief, shelf stable probiotics are no less potent than refrigerated ones. They are simply processed differently, and include a food source (a prebiotic or skim milk powder) for the bacteria to survive. They also start with a dosage higher than what is listed on the box. While sitting on the shelf the bacteria will slowly die off, but will be guaranteed to still include the dosage listed on the bottle at the date of expiry.
The main advantage of shelf-stable probiotics is that if you are someone who often forgets to take their pills, and needs to have them in a visible spot on the counter you can do so. They’re also a great option for people who lead busy lifestyles or who are travelling.
This article was written by Kristina Virro & Holly Bradich (BSc, Applied Human Nutrition). Combining science with natural approaches to health, Holly's main focus is on digestive health and reducing inflammation. As someone who has struggled with IBS and Celiac disease for her entire life, she specializes in working with these disorders, along with diabetes management and weight loss.