Probiotics Archives

Should You Take a Probiotic During Flu Season?

Everyday in the news there are updates about this year’s flu season, especially about the H1N1 virus (Swine flu). By all accounts, the infectivity rate is going to be very high.

We have all heard the recommendations:

Get the vaccine
Wash your hands
Avoid crowds
Don’t sneeze or cough into your hands
Drink lots of fluid, eat lots of fruits and vegetables, exercise and get 7 hours of sleep

Is there any other preventive therapy that is over the counter and without any adverse effects? You guessed it, PROBIOTICS!!

This month in the medical journal, Pediatrics, a study was published: “Probiotics Effects on Cold and Influenza-like Symptom Incidence and Duration in Children” ⁽¹⁾.

Method: Healthy children ages 3-5 were randomly placed in one of three groups: 104 received a placebo; 110 received a probiotic containing Lactobacillus acidophilus; 112 received a probiotic containing L acidophilus in combination with Bifidobacterium lactis. The children were given the probiotics daily for 6 months and monitored for cold and influenza-like symptoms.

Results: Compared to the placebo group, single and combination probiotics reduced the following symptoms, antibiotic usage, and reduction in days missed from school:

Conclusion: Daily intake of a probiotic supplement for 6 months during the cold and flu season was a safe and effective way to reduce the frequency of symptoms of colds and flu, reduce antibiotic usage and lessen missed days from school. A two strain probiotic in a dosage of 10 billon colonies is very beneficial.

Discussion: So I imagine you are all saying, “that is very interesting, but I am not a 3 year old.”

Well, there have been a number of studies ^(2,3,4,5,6) done over the last 4-5 years to determine if probiotics can lessen or prevent viral upper respiratory infections in not only children but also healthy adults, young and old.

One study done on healthy adults investigated the effect of long-term consumption of probiotics on viral respiratory infections during two winter/spring periods ⁽⁴⁾. The combination of a probiotic containing lactobacilli and bifidobacteriaa successfully shortened the duration of cold infections by two days and reduced the severity of symptoms. The incidence of infections, however, was not affected.

Another published paper did a systematic review of probiotics efficacy in preventing respiratory tract infections ⁽⁵⁾. Twelve controlled trials were reviewed, half reviewed adults and the other half reviewed children and infants. While the trials varied in duration of probiotic taken, dosage and type of bacterial strain, most of the trials noted a significant reduction in the severity of symptoms, but not the incidence of infection. A few did report a decrease in the frequency of infections.

There is a considerable amount of research being directed toward the mechanisms by which orally ingested probiotics can affect the immune system to lessen viral respiratory infections. Studies have shown that use of probiotics can stimulate the immune system in the gastrointestinal tract, producing more immune cells. In turn, those immune cells can stop inflammation and can also attack the viruses as they invade the lining of the respiratory tract ^{(4, 7, 8, 9)}. The stimulated immune cells can migrate from the GI tract to other areas of the body…including the respiratory tract.

Take Home Message

With these kinds of study results, it seems reasonable during the flu season to take a daily probiotic that contains a combination of lactobacilli and bifidobacteria in a serving size or dosage of 10 billon colonies or more — like EndoMune.

Thank you for your interest in EndoMune.
Eat healthy, exercise and live well!!

Larry Hoberman MD

(1)Probiotic effects on cold and influenza-like symptom incidence and duration in children.Leyer GJ, Li S, Mubasher ME, Reifer C, Ouwehand AC; Pediatrics. 2009 Aug;124(2):e172-9. Epub 2009 Jul 27

(2) Effect of a dietary supplement containing probiotic bacteria plus vitamins and minerals on common cold infections and cellular immune parameters. Winkler P, de Vrese M, Laue Ch, Schrezenmeir J; Int J Clin Pharmacol Ther. 2005 Jul;43(7):318-26.

(3)A new chance of preventing winter diseases by the administration of synbiotic formulations.Pregliasco F, Anselmi G, Fonte L, Giussani F, Schieppati S, Soletti L; J Clin Gastroenterol. 2008 Sep;42 Suppl 3 Pt 2:S224-33.

(4) Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial.de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, Ott S, Hampe J, Schreiber S, Heller K, Schrezenmeir J; Vaccine. 2006 Nov 10;24(44-46):6670-4. Epub 2006 Jun 6.

(5) Probiotics for the prevention of respiratory tract infections: a systematic review.Vouloumanou EK, Makris GC, Karageorgopoulos DE, Falagas ME; Int J Antimicrob Agents. 2009 Sep;34(3):197.e1-10. Epub 2009 Jan 28.
Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence.
Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(6) Effect of fermented milk containing the probiotic Lactobacillus casei DN-114001 on winter infections in free-living elderly subjects: a randomised, controlled pilot study.Turchet P, Laurenzano M, Auboiron S, Antoine JM; J Nutr Health Aging. 2003;7(2):75-7.

(7) Probiotics in intestinal and non-intestinal infectious diseases–clinical evidence. Hatakka K, Saxelin M; Curr Pharm Des. 2008;14(14):1351-67. Review.

(8) Molecular and cellular basis of microflora-host interactions.Winkler P, Ghadimi D, Schrezenmeir J, Kraehenbuhl JP; J Nutr. 2007 Mar;137(3 Suppl 2):756S-72S. Review.

(9) Probiotic and prebiotic influence beyond the intestinal tract. Lenoir-Wijnkoop I, Sanders ME, Cabana MD, Caglar E, Corthier G, Rayes N, Sherman PM, Timmerman HM, Vaneechoutte M, Van Loo J, Wolvers DA; Nutr Rev. 2007 Nov;65(11):469-89. Review

Probiotics Prevent Colds in Children?

Children’s Health, Mental Health, Probiotics / By @drHoberman

“When given preventively over the winter months, probiotics reduce fever, cough, and runny noses in children, researchers said.”

This is very exciting news for parents across the country. Many parents deal with the frustration of sick children during the winter months and the many associated problems including missed school, missed work and restless nights.

A recent study evaluated 326 children ages 3 to 5 years. Two groups of these children in a childcare center in China were given “twice-daily doses of L. acidophilus or L. acidophilus in combination with Bifidobacterium animalis for six months from November 2005 to May 2006.” The third group was given a placebo.

Both the single strain and the multi-strain probiotic doses were effective at reducing fever, cough, and rhinorrhea; the combination strain, however, had a more profound, positive impact. This seems to imply multi-strain, multi-species probiotics continue to prove more efficacy for prevention rather than their single-strain counterparts.

With profound research studies, such as this study in China, physicians may be able to begin moving away from antibiotics toward other forms of prevention like probiotics. While more studies are necessary, probiotic research continues to move forward in a very exciting direction.

For the article in its entirety, visit:
http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/15251

Source reference:
Leyer GJ, et al “Probiotic effects on cold and influenza-like symptom incidence and duration in children” Pediatrics 2009; DOI: 10.1542/peds.2008-2666.

Probiotics and Irritable Bowel Syndrome

Drug interactions, Healthy Aging, Probiotics / By @drHoberman

Studies of how and which types of probiotics improve IBS symptoms have yielded contradictory results. Some studies have shown that probiotics improve IBS, while others have resulted in less promising findings. This variance reflects, in part, differences in the studies, such as trial design, the limited number of participants, and the type, dose and formulation of the probiotics used in a particular study.

The term “probiotics” refers to the beneficial bacteria that are ingested to improve intestinal health. Some probiotic supplements contain just one bacterial strain whereas others have up to 8 different strains. It is reasonable that different studies will reach different conclusions, directly dependant upon the type of strains used. Similarly, the quantity of bacteria in each probiotic supplement can vary from a low of about one million to more than 400 billon organisms per dosage – and this too will also influence results.

In order to determine whether there is a statistical benefit of probiotics in easing the symptoms of IBS, researchers will review hundreds of studies and select those that have been done following specific guidelines for creditability.

The selected studies are then evaluated using a statistical method called meta-analysis. This involves combining all the studies and measuring the outcome for a specific issue. For example, there may be 20 studies evaluating the effects of probiotics on IBS. Some studies may have positive results and others negative. Combining all the results can give an overall statistical evaluation of whether probiotics are beneficial.

Meta-Analysis Reports

Over the last 18 months there have been four major meta-analysis reports published in respected medical journals ^(1,2,3,4).

All four meta-analysis studies concluded that probiotics benefit individuals suffering with IBS. They all found that probiotics could ease the symptoms of:

Abdominal pain
Bloating
Flatulence
Improve the passage of stools

Only a few minor adverse side effects were reported, the most common being a temporary increase in abdominal bloating and flatulence. No serious health or safety issues were identified.

The Conclusion: Probiotics are Promising

The general conclusion from these reports is that probiotics offer promise in the treatment of IBS. Further studies of longer duration and use of specific strains and dosages of probiotics are needed to determine which probiotics are statistically better in treating IBS.

Because the drug therapies currently available to IBS sufferers have shown limited success, a trial of probiotics certainly seems worthwhile.

Take Home Message

Probiotics are helpful in treating the symptoms of IBS. Look for one that has at least 5 billon bacteria in a serving size and contains multiple strains of lactobacillus and bifidobacteria…like EndoMune.

Eat healthy, exercise and stay well!
Dr. Hoberman

(1) A systematic review and meta-analysis: probiotics in the treatment of irritable bowel syndrome.Hoveyda N, Heneghan C, Mahtani KR, Perera R, Roberts N, Glasziou P. BMC Gastroenterol. 2009 Feb 16;9:15.

(2) Meta-analysis of probiotics for the treatment of irritable bowel syndrome. McFarland LV, Dublin S. World J Gastroenterol. 2008 May 7;14(17):2650-61.

(3) The efficacy of probiotics in the therapy of irritable bowel syndrome: a systematic review.Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein A, Brandt L, Quigley E. Gut. 2008 Dec 17

(4) Effectiveness of probiotics in the treatment of irritable bowel syndrome. Wilhelm SM, Brubaker CM, Varcak EA, Kale-Pradhan PB. Pharmacotherapy. 2008 Apr;28(4):496-505.

Probiotics and Post-Gastric Bypass Surgery Weight Loss

Disease, Healthy Aging, Probiotics / By @drHoberman

The July issue of the Journal of Gastroenterology discusses the recent findings of a post-gastric bypass surgery weightloss study. The physicians and researchers administering the study were interested in whether gastrointestinal bacteria and gut health plays an impact in the weight loss of individuals.

Both a control and a probiotic group were on the same counseling and diet regimen, with the probiotic group receiving 2.4 billion colonies of Lactobacillus daily.

At both 6-weeks and 3-months, the probiotic group had a statistically significant increase in weight loss over their counterparts in the control group. However, at 6-months, the significance had decreased.

With more research studies in the future, researchers may be able to determine if probiotics do have an impact on post-gastric bypass weight loss.

View the article at: http://www.medscape.com/viewarticle/706023

Pediatric Studies and IBS Research

Children’s Health, Probiotics / By @drHoberman

Interest in probiotics and their healthful links to gastrointestinal ailments has spurred the recent launch of the National Institute of Health’s Human Microbe Project. Baylor College of Medicine in Dallas, Texas is heavily involved in many of these studies; they received $3.7 million to map human bacteria genome.

Most recently, Dr. James Versalovic, a genetecist with the college, received a $750,000 grant to research the impact of bacteria on IBS in pediatrics. His studies are expected to explore methods of treating children without the use of invasive surgery. Dr. Robert Shulman, a pediatrics professor at Baylor College of Medicine and a practicing gastroenterologist, believes bacteria composition plays a major role in adult and child abdominal pain.

This is all very exciting and interesting news in the intestinal bacteria and probiotic front!

Read the entire article from the Houston Chronicle:
http://www.chron.com/disp/story.mpl/metropolitan/6526164.html

Study on Antibiotic-Associated Diarrhea

Disease, Probiotics / By @drHoberman

A study recently published in the Journal of Medical Microbiology further explores the potential benefits of probiotics at maintaining intestinal health while ingesting antibiotics such as Augmentin.

The study concluded probiotics, particularly Bifidobacteria, may be helpful in returning to a pre-antibiotic baseline:

This study does identify a benefit of probiotics, in part through increasing Bifidobacterium that may limit the disruption of gut microbiota by antibiotics, stabilizing concentrations of Enterobactereaceae and Bacteroides in particular. While this does not represent a clinical end point in itself this study provides important insight into the nature of the disruption of gut microbiota by antibiotics and a possible mechanism whereby probiotics limit gastrointestinal adverse events associated with antibiotics.

Further studies are necessary to assess the clinical relevance of these observations.

Engelbrektson, Anna, et al. “Probiotics to minimize the disruption of feacal microbiotia in healthy subjects undergoing antibiotic therapy.” Journal of Medical Microbiology (2009), 58, 663-670.