Probiotics
Probiotic species already live in your body, along with many others. Probiotic supplements increase your existing supply of friendly microbes. They help fight off less friendly species and boost your immunity against infections.
Probiotics are live microorganisms used for their purported health benefits when administered, which is most commonly done to improve the gut microbiota.
Even though generally thought to be safe for ingestion, probiotics sometimes cause some interaction between the bacteria and their host leading to undesirable effects in an infrequent scenario. It is also said that probiotics have been known to reduce symptoms of some cases of irritable bowel syndrome among others. Nonetheless, its efficacy in conditions such as treating eczema has a basis on rather weak scientific evidence.
The first known probiotic was a special bacterium found in Bulgarian yogurt, called Lactobacillus bulgaricus. It was first isolated in 1905 by the Bulgarian physician and microbiologist Stamen Grigorov. The current hypothesis is largely attributed to Russian Nobel laureate Elie Metchnikoff, who suggested around 1907 that Bulgarian peasants ate yogurt and therefore lived longer.
Source of Probiotic
Food
Probiotic foods are manufactured through the growth and metabolic activity of various live microbial cultures. Many of these foods are good sources of live and potentially beneficial microbes. Some fermented foods, such as sourdough bread and most commercial pickles, are processed after fermentation and do not contain live cultures in the form in which they are consumed.
Live microorganisms, such as those used in the preparation of many fermented foods, such as yogurt, are generally stable throughout the life of the product. They do not generally survive passage through the stomach and cannot tolerate digestion by intestinal hydrolytic enzymes and bile salts and thus cannot even reach the distal intestine. However, legitimate probiotic strains provided with yogurt or other food matrices survive passage through the gastrointestinal tract.
Fermented foods containing but generally not living cultures Probiotics themselves are many types of cheese, kimchi – a Korean dish made from fermented cabbage, fermented kombucha tea, fermented cabbage with sauerkraut, fermented soybean paste miso, raw salami, and vinegar, unfiltered apple cider made from fermented sugar from the apple.
Some non-fermented foods also have added microorganisms, such as milk, juices, smoothies, cereals, snack bars, and formulas for babies and children. What is a probiotic is determined by the amounts of microorganisms it contains at the time of consumption, the survival of microorganisms that pass through the intestines, and the health effects of specific types and strains.
Supplements
Other than ready-to-consume foods, probiotics can also be taken through dietary supplements in the form of capsules, powders, liquids, and many others, with different strains and dosages. Most of these products are constituted as mixed cultures of live microorganisms rather than a single strain. Most commercial probiotic products have not been scientifically investigated, and it can be quite challenging for anyone who does not follow studies on probiotics to identify what is supported by evidence. However, some organizations have systematically reviewed the available evidence and have given recommendations on specific probiotics regarding which products, doses, and formulations are appropriate to use for the prevention and treatment of several diseases.
Current labeling regulations only require that manufacturers list the total weight of microorganisms on dietary supplement labels of probiotic products, this cell mass may be comprised of both live and dead microorganisms and therefore bears no relation to the number of viable microorganisms in the product. Manufacturers may now voluntarily list the CFUs of a product in addition to the total weight of the microorganism on dietary supplement labels. Since probiotics must be taken live to produce health effects and may die during the life of a bacteria, the consumer needs to look for a product labeled with the CFU count at the end of the product’s life, not at the time of manufacture.
Effects of Probiotics
Alterations in the gut microbiota are intricate and may produce interactions between bacteria and the host. Although bacteria are considered safe, some raise safety issues regarding the use of particular bacteria. People with immunodeficiency, short bowel syndrome, central venous catheters, heart valve disease, and premature babies may be at more risk for developing adverse effects.
In critically ill patients with inflammatory bowel disease, there is a risk that viable bacteria may migrate from the gastrointestinal tract to internal organs and that bacterial translocation may occur due to bacteremia, which can adversely affect health. In rare cases, probiotics taken by children with weakened immune systems or already seriously ill can result in bacteremia or fungemia, where bacteria or fungi are introduced into the bloodstream and can potentially cause sepsis, a potentially fatal condition.
Usually, bacteria supplements contain between one and ten billion colony-forming units (CFU) per dose. An increased amount of CFU does not enhance the effect of probiotics but might produce adverse side effects, like gastrointestinal discomfort, including bloating, gas, and diarrhea.
Safety for probiotics
Most probiotic strains are isolated from species used in foods for thousands of years and microorganisms found living well in healthy gastrointestinal tracts. Common bacteria species, therefore include Lactobacillus acidophilus, casei, fermentum, gasseri, johnsonii, paracasei, plantarum, rhamnosus, and salivarius, while the animals, bifidum, breve, and longum species are classified under Bifidobacterium adolescentis, which will less likely harm the healthy man.
The side effects of probiotics are usually minor and consist of self-limited gastrointestinal symptoms, such as the newspapers.
However, some clinical trials of bacteria are not devised to meet the needs in terms of safety, and there is a gap concerning the safety evidence available. On the other hand, it has been evidenced that certain populations are adversely affected by bacteria, including premature babies and patients who are severely ill or immunocompromised. Some bacterial products are utilized in hospitals to minimize the risk of necrotizing enterocolitis, a fatal gastrointestinal disease mainly involving newborns.
A 2023 systematic review of 106 trials in premature infants concluded that multispecies bacteria reduce morbidity and mortality in premature infants but a Cochrane review recommended further research. In 2023, the FDA issued a press release alerting the public, including healthcare providers, of the risk that bacteria given to premature infants may lead to life-threatening infections or invasive diseases. According to the FDA, bacteria have been linked with deaths of infants and more than two dozen adverse events over recent years, but the agency noted these products have not undergone its premarket process aimed to evaluate safety, effectiveness and quality for medical use.