Probiotics Health Article

Dosage and administration

Some practitioners distinguish between a therapeutic dose of probiotic products, which is given for 10 days, and a maintenance dose, which is used afterward. One source gives 2–5 level tsp (5–10 g) of powdered supplement as the daily therapeutic dose if the patient is taking L. acidophilus or B. bifidum, 1–3 tsp (3–6 g) if the patient is using L. bulgaricus. The maintenance dose of L. acidophilus is given as 0.5 tsp (1 g) daily; of B. bifidum, 2 tsp (4 g) daily; of L. bulgaricus, 0.5 tsp (1 g) with each meal. The recommended dose of LGG capsules is once daily. A dose two or three times daily may also be used initially to overcome acute symptoms.

Patients are advised to take these supplements with spring water, but not with juice or broth. These fluids are thought to stimulate the secretion of stomach acids that will destroy the friendly bacteria.

Preparation

The fact that probiotic products include some ordinary dairy and grocery items means that most people who use them do not think of them as medications and see no need to consult a health professional. Persons who are taking prescription medications and persons with compromised immune status, however, are advised to consult their doctors before using probiotic dietary supplements. These products often influence the bulk and frequency of bowel movements, thus increasing the elimination rate of some medications and necessitating a dose adjustment.

Some practitioners of nutritional therapies recommend cleansing the lower digestive tract with an enema or colonic treatment before beginning a course of probiotic supplements. Conversely, use of probiotics may be particularly recommended following colonic therapy as it is following antibiotic therapy.

Precautions

Although the bacteria in probiotic supplements are human-friendly, some persons may have food allergies or a digestive tract that is sensitive to miso, other fermented foods, or the milk powder that may be in some products.

Vegetarians or persons who cannot digest milk-based products may prefer probiotic supplements with a rice base.

Product reliability is a concern because probiotic dietary supplements are not regulated by the Food and Drug Administration (FDA) and because study after study demonstrates the difficulty of maintaining a live probiotic culture, in or out of the body. One study of the microorganisms in 25 dairy products and 30 powdered products found that more than one third of these products contained no living microorganisms, and only 13% of the products contained all of the bacteria types listed on the label. One practitioner suggests the following guidelines for evaluating the effectiveness of probiotic products:

• Number of viable organisms. A number lower than 1 billion organisms per gram is considered inadequate for a therapeutic dosage.
• Type of organism. Single-strain products are considered more useful than multi-strain products on the grounds that the different bacteria in multi-strain products may compete with each other.
• Processing method. Products that have been put through a centrifuge or ultra-filtration system are thought to have fewer viable bacteria.
• Additives. Products that do not have hormones or other chemicals added to stimulate the growth of the bacteria are considered more effective.
• Form. Powdered supplements are considered preferable to liquids. Encapsulated powders are second-best, except in the case of LGG capsules.
• Storage. Probiotic products that are not refrigerated are thought to lose much of their effectiveness.

Side effects

The side effects of treatment with probiotics may include a condition called excessive drainage syndrome, which includes headache, diarrhea, bloating, or constipation. Another commonly reported side effect is intestinal gas. These side effects are attributed to the cleansing of toxins from the body and may last for some days. Practitioners recommend lowering the supplement dosage to reduce the side effects, or pretreating with colonic therapy, or stool softeners and fiber as tolerated or advised by a healthcare professional.