The billions of microorganisms that reside inside of us are a major factor in how well humans operate. The microbiome, which is the collective name for these helpful microorganisms, aids in digestion, illness prevention, and even mood regulation. But not that long ago, we didn’t fully comprehend the benefits that these microbes provided for us; in fact, we’re still only beginning to appreciate how they affect our health and happiness. With the public’s increasing interest in our microflora as a result of this newfound information, the market for probiotic supplements—supplements that include either live or dead strains of helpful bacteria—naturally experienced a surge. Today, a trip to the vitamin section of the grocery store will reveal shelves stacked with a wide variety of probiotic alternatives that all promise to improve digestion, the immune system, mood, and general well-being.
However, other professionals assert that the research behind these supplements has not kept up with their promotion. Probiotics may be beneficial for a few particular gastrointestinal disorders and even improve wellbeing in otherwise healthy people, according to a solid body of research, but science has raised more concerns than it has answered.
Probiotics have been consumed by humans for up to 6,000 years in the form of fermented milk products, long before they were fashionable. Fermented milk was so highly regarded as a source of health and vigor during the Genghis Khan era, about the twelfth century C.E., that Mongolian women would practically shower warriors with it to protect them during combat.
Mongolian warriors might have been onto something when they suggested that drinking the fermenting liquid would be preferable to taking a shower in it. Irritable bowel syndrome and ulcerative colitis are just a couple of the particular gastrointestinal illnesses that probiotics have been demonstrated to help with. And in some rare circumstances, these supplements could even save lives. When researchers combined the findings from 53 trials, they discovered that preterm children who received probiotics had a 46 percent lower risk of developing necrotizing enterocolitis, a fatal condition that causes the gut tissue to inflame and most frequently affects premature newborns.
However, studies on probiotics are spread all over the place. Different probiotic strains, dosages, or therapy plans could be employed. Because of this, it is challenging to compare findings or combine data from other research and evaluate them collectively, a method that yields far stronger evidence than a single study alone. Roger Clemens, a professor of pharmaceutical sciences at the University of Southern California, adds that patients’ reactions to probiotic therapies might also differ greatly within each research. Eugene Chang, a medical scientist at the University of Chicago, adds that many probiotic research simply lack good design. They may not be in charge of or fail to declare if participants also take probiotics. Participants’ health, lifestyles, and other characteristics can vary widely in small groups and among different study populations. Of course, everyone’s microbiome is unique to begin with. This makes it exceedingly challenging to analyze the data, according to Chang.
When it comes to generally healthy people, the data is much more ambiguous. Research on probiotics’ impact on anything from mood to constipation to immune system function has produced conflicting or subpar findings. According to Chang, the data in particular for probiotics is quite speculative and tenuous. According to Chang, this discrepancy in the findings shows how much more research is needed to understand how probiotics could even function.
Consider one of the most fundamental presumptions regarding probiotics that many people have: that they magically settle in our guts and “balance” our microbiota. In fact, scientists are unsure of whether this is accurate. A gastroenterologist at the University of Washington named William DePaolo adds, “That’s a significant discussion in the field right now. This prevalent belief is “very definitely erroneous,” according to a remark published in the journal Gastroenterology. Our microbiota is mostly predetermined by the time we reach adulthood. According to Chang, the existing bacteria in our stomachs, many of which have been there since we were infants, don’t typically welcome visitors. In one research, probiotics or sugar tablets were given to 19 healthy participants over a four-week period. The researchers behind the study gave 15 of them endoscopies three weeks into the intervention, followed by biopsies of their intestinal lining. Only six of the people had altered microbiomes, according to their findings, which were published in the journal Cell. In the other four, they saw no change at all.
Clemens argues that probiotics don’t necessarily need to remain in our intestines in order to have a significant impact on our health. Even after passing through the stomach, some probiotics may alter its ecology. As it passes through our bowels, Lactobacillus, the bacteria included in yogurt and many probiotic cocktails, for instance, may create lactic acid, resulting in a more acidic environment that is unfavorable to infections but advantageous to beneficial bacteria. As they move through, DePaolo claims that probiotics may also provide us with a dosage of serotonin, which improves mood, or short-chain fatty acids, which strengthen the immune system. He continues, “I like to think that even if they’re only passing through, they could still make an impact. Although these temporary probiotics could have an impact on the body, it’s vital to remember that any positive effects would only remain as long as you continued to take the supplement.
We simply don’t know, says Chang. Although each of these processes is conceivable, they are not established. For instance, we are aware that probiotics may develop in a lab and create substances like short-chain fatty acids. However, neither their production in people nor if such substances promote better health are known. Without using more rigorous research, Chang asserts, “We won’t have solid solutions to these concerns.”
It’s possible that some probiotic strains are beneficial but not others. Perhaps, as the Cell research hypothesizes, the make-up of a person’s microbiome determines whether they stand to gain from probiotics. Even the question of whether probiotics must be living when consumed is unknown to scientists. It’s possible that even extinct bacteria release healthy chemicals. To get answers to these inquiries, more study is required.
The abundance of probiotic alternatives that fill the supplement section at the supermarket store bring us full circle. How does one choose? Can science provide healthy consumers with any advice? Chang says unfortunately not really. Not only is there minimal regulation of these supplements, but we also lack the evidence to say which bugs are good for us and which ones are bad. Probiotics do not go through the U.S. Food and Medicine Administration since they are not viewed as a drug that addresses a specific illness or condition.
The good news is that probiotics are typically harmless, according to Clemens. He still has some misgivings, though. He is concerned about items containing bacteria strains whose safety has not yet been determined because the sector is so uncontrolled. Probiotics have also incredibly infrequently caused serious infections in vulnerable individuals. However, he feels that as long as the cocktail has received scientific evaluation, there is little danger in trying them for an otherwise healthy individual (except, maybe, to your money). Consumers should double-check that the bacterial strains included in a cocktail are included on the FDA Generally Recognized as Safe (GRAS) database, according to Clemens, for a list of recommendations supported by science. He suggests probiotics.com, a site created for consumers by scientists, for a more approachable manual.