Probiotics

skymningen wrote: »

JeromeBarry1 wrote: »

There's no such thing as a "best" commercial probiotic. They have features that may differ from one another and marketing pitches which try to persuade you, but you need to be aware that the state of the science of probiotics is quite shallow. We think we know that the gut biota influences the brain, we think we know what foods cause the gut biome to change. Exactly how, we don't know. We're no closer in 2017 to knowing than Chinese doctors were thousands of years ago when they mixed the feces from a healthy person in a soup which they fed to a person with symptoms of IBS, a treatment which is still being practiced with the insertion being now done from the *kitten* rather than from the mouth.

Ehm. I work with people who study the effect of probiotics on the human gut microbiota and the human host. Scientifically study, that is. I analyze their data.
While I agree with most of what you wrote, we definitely know more about them than Chinese doctors thousands of years ago. The problem though is, they work in much more complex ways than we would like.
Few commercially sold probiotics have been shown to have a significant effect. Some have. But there are generally caveats, I will collect some:

1. Only some strains of bacteria have so far been shown to have a reproducible effect
2. Even then, not every strain of bacterium works for every human
3. How well they work depends on a plethora of factors, like your diet (as in "what you normally eat" not the "trying to lose weight" kind of diet), the community of microbes already living in your gut, previous illnesses and medication you take and much more
4. Many of the probiotic strains are unfortunately having a hard time to persist, meaning, to settle in your gut and become a part of the normal community there. This is what we would like to have, but for now in most cases, your will just have to keep taking them.
5. The perfect world would allow us to study you and then suggest you the probiotics that would be beneficial for you. People work to achieve that, but we are currently collecting incredible amounts of data to gain the needed knowledge and analyzing all that will take time. I don't expect to see this solved in my lifetime, honestly.
6. People also try to understand how the treatment of the Chinese doctors works. They call it a fecal transplant. The US is actually fairly close to get a medication against persistent C. difficile infection on the market which will be based on this procedure. Don't worry, it will be inside a taste- and smell-less capsule. But the people developing this do not 100% know how it works. We (I mean "we scientists working in this area", I am not working for those people developing the fecal transplant pill, I just met them at a conference) suspect the beneficial effect is not at all based on single probiotic microbes but on some specific subset forming a healthy community. What that subset is (or more likely, what multiple subsets of this would be) is kind of a holy grail question right now and again, probably won't be answered anytime soon.
   
   In my opinion, as long as we don't have these community probiotics taking the single strains is more like a drop on the hot stone. Don't get me wrong. They don't hurt. Just save yourself from spending any horrible amounts of money on them or eating something that disgusts you. If you can find a nice, tasty yogurt with probiotic cultures in it that does not cost much more than any other yogurt there is no reason to not have that.