Why Probiotics Sometimes Don’t Work

About 2/3 of my patients have already tried probiotics before they come to see me.  Some find them very helpful.  Most don’t feel that they do anything, however, they faithfully continue taking them, hoping to benefit from them one day.   A few people experience worsening symptoms along with other new unpleasant side effects.  The following factors can help explain the reasons for the mixed results people get from using probiotics.

The Right Fit

Probiotics help resolve symptoms when they support what the body needs.  The key is finding the right type of probiotics, and this process can be very challenging depending on what is missing from the eco-system in your gastrointestinal (GI) tract.  

Some people may lack just a few species from the Lactobacillaceae or Bifidobacteriaceae families.  This group is lucky because these are families of bacteria that we easily find in over-the-counter products.  

On the other hand, some may need a particular strain of a species.  Over the last few years, we have learned that the helpful benefits of bacteria may come from a particular strain rather than the entire species.  For example, there is a research study that shows that Lactobacillus Rhamnosus GG can help reduce diarrhea in children and is a strain of the species Lactobacillus Rhamnosus.  Some manufacturers label the strain on their products; some don’t.  If you take a product that only labels species, and it is not helping your symptoms, it could be that the product doesn’t contain the right strain. When you find the right type, you can see great improvement of symptoms even with just a small amount.  

Some may need species that unfortunately are not readily available as a commercial product.  In this case, no probiotics can provide significant relief.  We need to utilize other tools.

New Offenders

One particular ingredient in a probiotic product that can be problematic is the prebiotics.  Prebiotics are fibers that help feed the probiotics, but they can cause a lot of unpleasant symptoms for people who have trouble digesting fiber.  

The reason that probiotics can help with symptoms is because they are able to produce substances that are usually beneficial to the body, but those substances are also capable of thickening the mud.  Sometimes the new or increased symptoms can be resolved by starting at a lower dosage and titrating up with guidance or changing the diet to feed the probiotics with the right fuel.  Sometimes the body may be too sensitive to the vitamins or neurotransmitters that these probiotics produce, so probiotics are not appropriate treatments.  

With all the nuisances that one needs to consider when using probiotics, it is important for people to seek trained professionals for guidance before using probiotics to avoid potential harm and the waste of money.  

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