Lactobacilli (probiotic): benefits, dosage, contraindications

Dermatoses
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Studies show that taking lactobacilli significantly prevents and reduces the severity of eczema or acne. rnrnA 2015 study published in the journal Clinical & Experimental Allergy showed that Lactobacillus paracasei, Lactobacillus fermentum, and a mixture of these two strains were more effective than a placebo at improving symptoms and quality of life in children with atopic dermatitis (a chronic inflammatory skin condition). rnrnA meta-analysis shows that administering probiotics such as L. rhamnosus GG to pregnant women may be beneficial in preventing atopic dermatitis in their children. rnrnL. salivarius may also be useful in the management of atopic dermatitis in both adults and children. rnrnAtopic dermatitis is allergic in origin in 70% of cases. Due to their anti-inflammatory and immunomodulatory properties, certain probiotic strains have been shown to be effective against these skin conditions. rnrnExtracts of L. plantarum are effective at reducing erythema (the most common dermatological lesion) of the skin and repairing the skin barrier. rnrn

Posologie

Orally

0.1 - 50 IU

36 - weeks

Adults, Children

Constipation
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Taking strains of Lactobacillus reduces the symptoms of constipation (abdominal pain and bloating) and facilitates intestinal transit. Some strains significantly increase stool frequency.rnrnFrom a clinical perspective, 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.rnrnSome strains may be particularly beneficial for patients with constipation associated with irritable bowel syndrome.rnrn

Posologie

Orally

0.2 - 5 IU

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. According to studies, consumption of lactobacilli can prevent and/or treat (reduce the duration of) these diarrheas.

Posologie

Orally

6 - 12 IU

5 days

Children

Synergies

Respiratory infections
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Probiotics may be effective in strengthening the immune system and fighting seasonal respiratory infections.nnA double-blind, placebo-controlled study was conducted on 479 healthy individuals for more than three months, who orally took a mixture of Lactobacillus gasseri PA 16/8, Bifidobacterium longum SP 07/3, and B. bifidum MF 20/5. The results showed a reduction in the duration and severity of cold symptoms in the group treated with probiotics. In addition, their cytotoxic T lymphocytes and CD8+ cells were significantly enhanced compared with the control group.nnThe study thus shows that L. gasseri, combined with other lactic cultures, reduces the duration and severity of symptoms of seasonal viral respiratory illnesses.nnPreliminary studies suggest that consumption of lactobacilli reduces the incidence of the common cold by about 12% in adults and reduces the incidence of respiratory disorders and infections in patients with cystic fibrosis from 37% to 3%. Some lactobacillus strains (LGG) in particular may reduce pulmonary exacerbations and hospital admissions in children with cystic fibrosis, likely via an anti-inflammatory effect.

Posologie

Oral

1 - 1 IU

12 - weeks

Adults, Children, Infants

Synergies

Oral and dental infections
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Gingivitis represents the initial (early) stage of a periodontal condition. This disease is notably manifested by inflammation of the gums, caused by bacterial plaque and often associated with irritation and bleeding. rnrnThe onset of the inflammatory reaction, and in particular the development of edema, leads to the formation of a gingival pocket. There are also a multitude of pathogenic germs belonging to the oral anaerobic microflora that are associated with gingivitis. They most often organize into a biofilm on supragingival surfaces.rnrnAccording to several clinical studies, several probiotic strains (L. rhamnosus, L. reuteri, L. salivarius...) could prove useful as an adjunct treatment to treat or prevent this infectious disease.rnrnThe strains L. acidophilus and L. plantarum have significant antifungal effects in vitro against species of oral fungi (Candida).rnrnProbiotics would be effective in reducing inflammation, gingival pockets, and pathogenic strains, resulting in a significant reduction of dental plaque.rnrnrnrn

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 consuming 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 with taking a placebo (acidified milk).

Posologie

Oral route

2 - 10 IU

12 - weeks

Adults, Children

Synergies

Candidiasis
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In a small preliminary clinical trial conducted in women with recurrent vulvovaginal candidiasis who had undergone a one-week oral treatment with fluconazole followed by intravaginal treatment with L. acidophilus LA 02 and Limosilactobacillus fermentum LF10 (at least 0.4 billion colony-forming units), it was shown that 72.4% of the patients had no clinical recurrence over a 7-month observation period.

Posologie

Orally

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, this type of supplementation has been associated with improved glycemic control in these pregnant patients. rnrnOne study in particular reports that consumption of Lactobacillus rhamnosus HN001 would reduce the prevalence of gestational diabetes by approximately 65% compared with placebo.rnrn

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 people 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 conducted to study the efficacy of probiotics in IBS was published in 1955. Many trials have been carried out since that time.rnrnIn several randomized, controlled clinical trials, one or more probiotics were used for variable periods ranging from 2 to 24 weeks. The use of probiotics was associated with an improvement in overall IBS symptoms compared with placebo. However, the data were insufficient to draw conclusions about the most effective probiotic strains. rnrnThe following strains have been used: Bifidobacterium animalis, Bifidobacterium infantis, Lactobacillus acidophilus with Bifidobacterium lactis and Bifidobacterium bifidum, Lactobacillus plantarum.rnrnrnrn

Posologie

Oral

20 - 50 IU

12 weeks

Adults

Synergies

Gastritis
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Numerous studies have clearly established that Lactobacillus gasseri has a natural resistance, being able to survive gastric acidity and bile. It would therefore better protect against the inflammation encountered in cases of gastritis and gastric ulcers, including the ulcer associated with Helicobacter pylori infection.

Posologie

Orally

5 IU

1 - week(s)

Adults

Synergies

Weight control
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Some probiotic strains (L. plantarum) have a beneficial influence on energy metabolism in obesity.rnrnIn addition to the role attributed to L. gasseri and probiotics in general in facilitating intestinal transit and digestion, several studies have shown that consumption of Lactobacillus gasseri leads to a reduction in abdominal adiposity.rnrnA randomized, double-blind, placebo-controlled trial from a 2010 Japanese scientific study on 87 healthy overweight adults evaluated the effects of the strain L. gasseri SBT2055 on abdominal adiposity and body weight.rnrnThe researchers provided the probiotic in the form of fermented milk produced with yogurt cultures supplemented (or not for the control group) with the strain L. gasseri SBT2055. With a daily intake of 200 g, the estimated number of viable L. gasseri SBT2055 cells consumed was 5 × 1010 cfu/100g (cfu = Colony Forming Unit).rnrnThe results show that the group treated with a daily intake of L. gasseri SBT2055 for 12 weeks lost 4.6% abdominal fat and 3.3% subcutaneous fat compared with the control group. Likewise, 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.rnrnConsistently, another randomized, double-blind, placebo-controlled trial conducted on 90 volunteers aged 20 to 75 showed a significant reduction in visceral adiposity in obese adults following a 12-week intake of L. gasseri.rnrnrnrn

Posologie

Oral

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 that of healthy subjects. This is referred to as intestinal dysbiosis. In particular, there is an increase in Firmicutes (harmful bacteria) in the gut microbiota.rnrnIn several mouse models, it has been observed that a high-fat diet leads to the emergence of a less diverse microbiota, richer in Firmicutes and poor in beneficial bacteria.rnrnThus, consumption of probiotics could contribute to the treatment of metabolic diseases such as obesity, type 2 diabetes, and non-alcoholic fatty liver disease (NASH or fatty liver disease).rnrnIn patients with type 2 diabetes, regular probiotic intake improves glycemic control and reduces body weight and inflammation.rnrnDifferent species of probiotic strains would act synergistically with various effects on host metabolism:rnrn- lipid absorptionrnrn- sugar digestionrnrn- regulation of inflammationrnrn- beneficial production of short-chain fatty acidsrnrnFurthermore, hypertension is a risk factor observed in patients with metabolic syndrome.rnrnInterestingly, a supplementation (12 g/day for 4 weeks) of the probiotic strain Lactobacillus helveticus is beneficial in hypertensive subjects to normalize blood pressure.rnrn

Posologie

Oral

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 Lactobacillus species that have shown benefits in clinical research are L. gasseri, a lyophilized 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 mixture of two strains of L. reuteri.

Posologie

Oral administration

5 IU

1 - weeks

Adults

Synergies

Ulcerative colitis
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Some research suggests that taking probiotics containing lactobacilli may increase remission rates in patients with ulcerative colitis. Indeed, L. rhamnosus, for example, is capable of colonizing the colonic mucosa while reducing the expression of pro-inflammatory cytokines (TNFα and IL-17). In addition, some probiotic strains exert an anti-polymicrobial biofilm effect that may be beneficial in the treatment of inflammatory bowel diseases. However, meta-analyses of randomized controlled trials evaluating the impact of probiotics in ulcerative colitis conclude that using probiotics as an adjunct to standard care did not significantly change remission rates. The results were, however, highly heterogeneous.

Posologie

Oral administration

112 IU

VSL#3

Synergies

Vaginal infections
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Most clinical research shows that intravaginal application of various strains of Lactobacillus may be helpful in the treatment of bacterial vaginosis. In addition, certain species of Lactobacillus, given intravaginally and orally, have demonstrated effectiveness in preventing bacterial vaginosis. A clinical trial shows that intravaginal suppositories containing L. acidophilus, administered twice daily for 6 days, improve remission rates compared with placebo. Another clinical trial shows that the use of 1 to 2 vaginal tablets containing viable L. acidophilus and 0.03 mg of estriol per tablet per day for 6 days increases cure rates compared with placebo. However, using this product in combination with metronidazole 400 mg twice daily for 7 days does not improve outcomes compared with metronidazole alone. Another clinical trial shows that using vaginal capsules containing L. gasseri and L. rhamnosus, after a standard 10-day treatment for three consecutive menstrual cycles, increases the time between cure and relapse compared with placebo. Moreover, after vaginal metronidazole treatment, vaginal administration of a formulation of L. crispatus CTV-05, 2 billion CFU per day for 4 days, then twice weekly for 10 weeks, reduces bacterial vaginosis recurrence by 34% at 12 weeks and by 27% at 24 weeks, compared with placebo. The oral Lactobacillus has also been evaluated. Preliminary clinical research shows that daily consumption of 125 ml of yogurt fortified with L. acidophilus for 2 months may slightly reduce the incidence of recurrent bacterial vaginosis. However, oral Lactobacillus may not be beneficial during pregnancy. A clinical trial shows that daily intake of 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 the rate of bacterial vaginosis compared with placebo.

Posologie

Orally

Infant colic
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Clinical research shows that administration of L. reuteri (the L. reuteri DSM 17938 strain) at a dose of 100 million CFU per day for 21 to 28 days can improve colic in breastfed infants within the week following treatment. In some clinical trials, taking this strain reduced colic symptoms more effectively than simethicone 60 mg once or twice daily over a 28-day period. Some data suggest this specific strain is also effective at reducing daily crying time in formula-fed infants when administered for 28 to 90 days.

Posologie

Oral

0.1 IU

Rheumatoid arthritis
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Research shows that consumption of the Lactobacillus casei strain reduces joint stiffness 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 some clinical studies. However, longer clinical trials including a variety of parameters (age, sex, diet, individual microbiota variation) are needed to validate the therapeutic use of probiotics in this type of musculoskeletal condition.

Posologie

Oral

0.1 IU

8 weeks

Women

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

Posologie

Oral

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 of 40 patients randomized to either 3 months of treatment with rifaximin followed by 9 months of treatment with a specific product containing a high concentration of eight strains of lactic bacteria (Bifidobacterium breve, B. longum, B. infantis, Lactobacillus acidophilus, L. plantarum, L. casei, L. bulgaricus and Streptococcus thermophilus) or to 12 months of treatment with mesalamine (an anti-inflammatory used to treat certain inflammatory diseases of the colon and intestine), a reduction in relapse rate was demonstrated in the patients treated with the probiotics. However, a Cochrane systematic review did not recommend a role for probiotics in Crohn's disease based on the available evidence. Most studies had a relatively small number of participants with different treatment protocols and different probiotic strains used, which makes comparison between studies difficult.

Posologie

Orally

112 IU

VSL#3

Synergies