Lactobacilli (probiotic): benefits, dosage, contraindications

Skin Disorders
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Studies show that taking lactobacilli significantly prevents and alleviates the severity of eczema or acne. A 2015 study published in the journal Clinical & Experimental Allergy showed that Lactobacillus paracasei, Lactobacillus fermentum, and a blend of these two strains were more effective than a placebo in improving symptoms and quality of life for children with atopic dermatitis (a chronic inflammatory skin condition). A meta-analysis shows that administering probiotics like L. rhamnosus GG to pregnant women may be beneficial in preventing atopic dermatitis in children. L. salivarius is also thought to be useful in managing atopic dermatitis in adults and children. Atopic dermatitis is allergic in origin in 70% of cases. Through their anti-inflammatory and immunomodulatory properties, certain probiotic strains have proven effective against these skin afflictions. Extracts of L. plantarum are effective in reducing erythema (the most common dermatological lesion) on the skin and repairing the skin barrier.

Posologie

Oral

0.1 - 50 UI

36 - weeks

Adults, Children

Constipation
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Taking Lactobacillus strains alleviates symptoms of constipation (abdominal pain and bloating) and facilitates intestinal transit. Certain strains significantly increase the frequency of bowel movements. Clinically, it has been observed that probiotics (3.0 × 10^8 CFU/g Streptococcus thermophilus MG510 and 1.0 × 10^8 CFU/g Lactobacillus plantarum LRCC5193) improve stool consistency in patients with chronic constipation. Some strains may be particularly beneficial for patients with constipation associated with irritable bowel syndrome.

Posologie

Oral

0.2 - 5 UI

8 - weeks

Adults, Children

Synergies

Diarrhea
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Diarrhea can be caused by infections (viruses, parasites, bacteria) including acute diarrhea (gastroenteritis) and traveler's diarrhea caused by E. coli. Studies have shown that consuming lactobacilli can help prevent and/or treat (reduce the duration of) these diarrheas.

Posologie

Oral administration

6 - 12 UI

5 - days

Children

Synergies

Respiratory Infections
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Probiotics may be effective in boosting the immune system and combating seasonal respiratory infections. A double-blind placebo-controlled study was conducted on 479 healthy individuals over more than three months, taking a blend of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, B. bifidum MF 20/5 orally. Results revealed a reduction in the duration and severity of cold symptoms in the group treated with probiotics. Additionally, their cytotoxic T lymphocytes and CD8+ were significantly enhanced compared to the control group. The study thus shows that L. gasseri, combined with other lactic ferments, reduces the duration and severity of symptoms of seasonal viral respiratory infections. Preliminary studies suggest that consuming lactobacilli reduces the incidence of colds by about 12% in adults and reduces the incidence of respiratory disorders and infections in cystic fibrosis patients from 37 to 3%. Some strains of lactobacilli (LGG) may notably reduce pulmonary exacerbations and hospital admissions in children suffering from cystic fibrosis, especially through anti-inflammatory action.

Posologie

Oral administration

1 - 1 UI

12 - weeks

Adults, Children, Infants

Synergies

Oral Infections
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Gingivitis represents the initial (early) stage of periodontal disease. This disease is particularly characterized by gum inflammation, caused by bacterial plaque and often associated with irritation and bleeding. The onset of the inflammatory response, particularly the formation of edema, leads to the creation of a gingival pocket. There is a multitude of pathogenic germs belonging to the anaerobic oral microflora associated with gingivitis. They often organize themselves into biofilm on supragingival surfaces. According to several clinical studies, several probiotic strains (L. rhamnosus, L reuteri, L. salivarius...) could be helpful as an adjunct treatment to treat or prevent this infectious disease. L. acidophilus and L. plantarum strains have significant antifungal effects, in vitro, against species of oral fungi (Candida). Probiotics would be effective in reducing inflammation, gingival pockets, and pathogenic strains, leading to a significant reduction in dental plaque.

Posologie

Oral administration

8 - weeks

Adults, Adolescents

Synergies

Allergic Rhinitis
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A small clinical trial conducted in patients with allergic rhinitis shows that the intake of 100 ml per day of fermented milk with L. acidophilus L-92 (providing 30 billion L. acidophilus cells) for 8 weeks modestly reduces nasal symptoms and mucus secretion, but not eye symptoms, compared to taking a placebo (acidified milk).

Posologie

Oral administration

2 - 10 UI

12 - weeks

Adults, Children

Synergies

Candidiasis
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In a small preliminary clinical trial conducted on patients with recurrent vulvovaginal candidiasis who underwent a one-week oral fluconazole treatment followed by intravaginal treatment with L. acidophilus LA 02 and Limosilactobacillus fermentum LF10 (at least 0.4 billion colony-forming units), it was demonstrated that 72.4% of patients did not experience clinical recurrence over a 7-month observation period.

Posologie

Oral administration

2 - months

Women

Gestational Diabetes
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Clinical studies show that supplementation with different probiotic strains for 6 to 8 weeks causes a significant decrease in insulin resistance in pregnant women diagnosed with gestational diabetes. Thus, better glycemic control was observed in these pregnant patients with this type of supplementation. One study particularly reports that the consumption of Lactobacillus rhamnosus HN001 reduces the prevalence of gestational diabetes by approximately 65% compared to placebo.

Posologie

Orally

6 IU

10 - weeks

Pregnant women

Hypercholesterolemia
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The consumption of lactobacilli significantly reduces total cholesterol by up to 20 mg/dL in individuals with or without hypercholesterolemia.

Posologie

Orally

1.2 - 50 IU

9 - weeks

Men

Irritable Bowel Syndrome
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Dysbiosis has long been considered to play a role in the pathophysiology of irritable bowel syndrome (IBS) and the first trial to investigate the efficacy of probiotics in IBS was published in 1955. Many trials have been conducted since then. In several randomized controlled clinical trials, one or more probiotics were used for varying periods ranging from 2 to 24 weeks. The use of probiotics was associated with an improvement in overall IBS symptoms compared to placebo. However, the data were insufficient to draw conclusions on the most effective probiotic strains. The following strains were used: Bifidobacterium animalis, Bifidobacterium infantis, Lactobacillus acidophilus with Bifidobacterium lactis and Bifidobacterium bifidum, Lactobacillus plantarum.

Posologie

Orally

20 - 50 IU

12 - weeks

Adults

Synergies

Gastritis
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Numerous studies have clearly established that Lactobacillus gasseri has a natural resistance, capable of surviving stomach acidity and bile. It thus offers better protection against inflammation encountered in gastritis, gastric ulcers, including ulcers associated with Helicobacter pylori infection.

Posologie

Orally

5 IU

1 - weeks

Adults

Synergies

Weight Control
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Certain probiotic strains (L. plantarum) have a beneficial influence on energy metabolism in obesity. Besides the facilitative role in intestinal transit and digestion attributed to L. gasseri and probiotics in general, several studies have indicated that consuming Lactobacillus gasseri allows for a reduction in abdominal adiposity. A double-blind, placebo-controlled, randomized trial of a Japanese scientific study conducted in 2010 on 87 healthy overweight adults assessed the effects of the strain L. gasseri SBT2055 on abdominal adiposity and weight. Researchers administered the probiotic in the form of fermented milk with added yogurt cultures (or not for the control group) including the strain L. gasseri SBT2055. With a daily intake of 200 g, the estimated number of viable cells of L. gasseri SBT2055 absorbed was 5 × 1010 cfu/100 g (cfu = Colony Forming Unit). The results showed that the group treated with L. gasseri SBT2055 for 12 weeks lost 4.6% of abdominal fat and 3.3% of subcutaneous fat compared to the control group. Their body weight, waist circumference, and BMI decreased by 1.4% (1.1 kg), 1.8% (1.7 cm), and 1.5% (0.4 kg/m2) respectively. Similarly, another double-blind, placebo-controlled randomized trial conducted on 90 volunteers aged 20 to 75 showed a significant reduction in visceral adiposity in obese adults following L. gasseri intake for 12 weeks.

Posologie

Orally

5000 IU

12 - weeks

Adults, Men, Women

Synergies

Metabolic Syndrome
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It is well established that the gut microbiota is involved in the development of metabolic diseases. It has been observed that obese and diabetic patients have an altered microbiota compared to healthy subjects, known as intestinal dysbiosis. There is particularly an increase in Fimicutes (harmful bacteria) in the gut microbiota. In several mouse models, it has been seen that a high-fat diet leads to a less diversified microbiota that is richer in Fimicutes and lacking beneficial bacteria. Thus, the consumption of probiotics could contribute to the treatment of metabolic diseases such as obesity, type 2 diabetes, and non-alcoholic steatohepatitis (NASH or "fatty liver" disease). Among type 2 diabetic patients, regular intake of probiotics improves blood sugar control and reduces body weight and inflammation. Different probiotic strains may work synergistically with various effects on the host's metabolism: - lipid absorption - sugar digestion - inflammation regulation - beneficial production of short-chain fatty acids. On the other hand, hypertension is a risk factor detected in patients suffering from metabolic syndrome. Interestingly, a supplementation (12g/day for 4 weeks) with the probiotic strain, Lactobacillus helveticus, is beneficial for hypertensive subjects to normalize blood pressure.

Posologie

Oral route

1200 IU

12 - weeks

Adults, Men, Women

Synergies

Helicobacter pylori Infection
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Analyses of clinical research show that taking lactobacilli can improve Helicobacter pylori eradication rates. Among the specific species of Lactobacillus that have shown advantages in clinical research are L. gasseri, a freeze-dried and inactivated culture of L. acidophilus, a combination of L. acidophilus plus Enterococcus faecalis plus Bacillus subtilis, a combination of L. acidophilus plus Bifidobacterium bifidum, and a mix of two strains of L. reuteri.

Posologie

Oral route

5 IU

1 - weeks

Adults

Synergies

Ulcerative Colitis
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Certain research shows that taking probiotics containing lactobacilli could increase the remission rate among patients with ulcerative colitis. L. rhamnosus, for example, is capable of colonizing the colon's mucosa while reducing the expression of pro-inflammatory cytokines (TNFα and IL-17). Additionally, some probiotic strains exert an anti-polymicrobial biofilm effect, which may be beneficial in treating inflammatory bowel diseases. However, meta-analyses of randomized controlled trials evaluating the impact of probiotics in ulcerative colitis conclude that complementary use of probiotics in addition to standard care did not significantly alter remission rates. Nevertheless, the results were highly heterogeneous.

Posologie

Oral route

112 IU

VSL#3

Synergies

Vaginal Infections
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Most clinical research shows that the intravaginal application of various lactobacillus strains can be useful in treating bacterial vaginosis. Additionally, certain species of lactobacilli, through intravaginal and oral routes, have demonstrated efficacy in preventing bacterial vaginosis. A clinical trial shows that intra-vaginal suppositories based on L. acidophilus, administered twice a day for 6 days, improve remission rates compared to placebo. Another clinical trial shows that using 1 to 2 vaginal tablets containing viable L. acidophilus and 0.03 mg estriol per tablet per day for 6 days increases healing rates compared to placebo. However, the use of this product alongside metronidazole 400 mg twice daily for 7 days does not improve outcomes compared to metronidazole alone. Another clinical trial shows that using vaginal capsules containing L. gasseri and L. rhamnosus, after conventional treatment for 10 days during three consecutive menstrual cycles, increases the interval between healing and relapse compared to placebo. Additionally, after vaginal treatment with metronidazole, the vaginal administration of a L. crispatus CTV-05 formulation, 2 billion CFU per day for 4 days, then twice a week for 10 weeks, reduces the recurrence of bacterial vaginosis by 34% after 12 weeks and by 27% after 24 weeks, compared to placebo. Oral lactobacilli have also been evaluated. Preliminary clinical research indicates that daily consumption of 125 ml of yogurt fortified with L. acidophilus for 2 months could slightly reduce the incidence of recurrent bacterial vaginosis. However, oral lactobacilli may not be beneficial during pregnancy. A clinical study shows that taking daily capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 from the 9th to the 14th week of gestation until delivery does not affect bacterial vaginosis rates compared to placebo.

Posologie

Oral route

Infant colic
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Clinical research shows that administering L. reuteri (the DSM 17938 strain of L. reuteri) at a dose of 100 million CFU per day for 21 to 28 days can improve colic in breastfed infants, within a week after treatment. In some clinical studies, taking this strain reduced colic symptoms more effectively than simethicone 60 mg once or twice daily over a 28-day period. Some data suggest that this specific strain is also effective in reducing daily crying time in formula-fed infants when administered for 28 to 90 days. Some research has evaluated L. reuteri in combination with L. rhamnosus. A clinical study conducted on infants aged 4 to 12 weeks suffering from colic showed that taking this combination of 250 million CFU with 3.33 mg of fructo-oligosaccharides and 200 IU of vitamin D3 per day for 28 days reduced the average duration of crying and fussiness by 2.7 hours at the end of the study, compared to a reduction of 1.9 hours in the group receiving only vitamin D.

Posologie

Oral route

0.1 IU

Rheumatoid arthritis
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Research shows that consuming the Lactobacillus casei strain reduces joint tension and swelling and improves the condition of patients with osteoarthritis. A significant reduction in perceived pain by patients with rheumatoid arthritis has been reported by a few clinical studies. However, longer clinical studies including a variety of parameters (age, gender, diet, individual microbiota variety) are needed to validate the therapeutic use of probiotics in this type of osteoarticular condition.

Posologie

Oral route

0.1 IU

8 weeks

Women

Urinary tract infections
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Certain probiotic strains (L. crispatus...) could prevent recurrent urinary tract infections in women. More scientific evidence supporting the usefulness of probiotics in combating all urological diseases is needed.

Posologie

Oral route

40 IU

Adults, Women

Synergies

Crohn's disease
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Only a limited number of studies have indicated a role for probiotics in the remission of Crohn's disease. In a study involving 40 patients randomly assigned to 3 months of treatment with rifaximine followed by 9 months of treatment with a specific product containing a high concentration of eight strains of lactic acid bacteria (Bifidobacterium breve, B. longum, B. infantis, Lactobacillus acidophilus, L. plantarum, L. casei, L. bulgaricus, and Streptococcus thermophilus) or followed by 12 months of treatment with mesalazine (an anti-inflammatory used to treat certain inflammatory bowel diseases), a reduction in the relapse rate was demonstrated in patients treated with probiotics. However, a Cochrane systematic review did not advocate a role for probiotics in Crohn's disease based on available evidence. Most studies had a relatively small number of participants with different treatment protocols and different probiotic strains used, making study comparison difficult.

Posologie

Oral route

112 IU

VSL#3

Synergies