In the Beginning – Early formulations of probiotics contained friendly microbes that offered general microbiome support for improved gut health including better digestion and elimination. These commonly included lactic acid producing strains of Bifidobacterium or Lactobacillus as well as the yeast Saccharomyces boulardii without specific attention to individual strain strengths and the level of synergies between them. Based on deeper insights from ongoing research, we now understand that different probiotic strains perform different functions in the management of health and specific disease (Visconti, A. et al, 2019). This information can help inform focused formulations to support individual needs.
Investigators are also exploring unique bacterial species including Christensenella minuta, Faecalibacterium prausnitzii, Anaerobutyricum soehngenii and Akkermansia muciniphila as well as active metabolic byproducts of various probiotics for targeted applications (so-called post-biotic products like short chain fatty acids, for example). Unfortunately, however, to date the challenges associated with extremely limited human clinical study data and the manufacturing difficulties posed by strictly anaerobic organisms has hampered the potential clinical utility of these “next generation” probiotics. But manufacturers dedicated to evidence-based probiotic formulation have already taken the next steps toward a personalized approach to microbiome support. You can take advantage of these high performance, precision probiotics by evaluating brands with the following 3 characteristics in mind:
1. Informed Strain Selection
When selecting the best probiotic for specific health conditions or your stage of life, the first step is to identify what microbe-modulated function you wish to support, meaning: what symptoms you are trying to address or prevent. In a review published in the journal Nutrients, the authors emphasize the importance of this process in formulation development: “It is important to select probiotics strains that can influence the disturbed physiological processes in the health condition that is targeted by the respective probiotic product” (Grumet, L., et al 2020).
For example, many mental health symptoms including depression, anxiety, and rumination are due, at least in part, to system-wide inflammation caused by damage to the cells of the intestinal wall. Unchecked, the tight junctions that normally separate the contents of the gut from general circulation are impaired leading to “leaky gut.” As a result, microbes and toxins that enter the bloodstream can cause inflammation of, and damage to, the blood brain barrier. In such cases, the best results are likely to come from a probiotic that contains strains of bacteria that are anti-inflammatory, repair intestinal wall tight junctions, and restore the integrity of the blood brain barrier.
Quality manufacturers interested in developing indication-targeted formulations will examine the unique healing effects of individual probiotic strains – often publishing the results. For example, strains including Lactobacillus casei W56, Lactococcus lactis W19, Lactobacillus acidophilus W22, and Bifidobacterium lactis W52, are directly associated with improved gut barrier function, healing of intestinal wall tight junctions, and the reduction of related mood disorders (Moser, A.M., et al, 2019). While in another study, the same formulation also demonstrated the ability to shift (fMRI) brain activity from the default mode network (DMN), associated with inward analysis and rumination, to the salience network (SN), associated with increased perception, attention, and cognition (Bagga, D., et al, 2019).
2. Demonstrated Strain Synergies
While single probiotic strains have been shown to be beneficial to health, multi-strain probiotics have the potential to be significantly more effective due to multi-microbe synergies and additive functional activity (Kwoji, I.D., et al, 2021). But it is important to realize that not all strains collaborate. Some healthful strains will actually compete with each other resulting in changes in the metabolic activity of the probiotics, which is certainly not what you want. Therefore, the most reliable method of demonstrating strain synergies is through human clinical trials. Although expensive, a high quality manufacturer will invest in this type of evidence using the exact commercial formulation available to consumers. Any brand worth consideration will have this data available for review.
3. Quality Manufacturing Processes
By definition, all probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. The live part is very important, but also one of the most challenging aspects of manufacturing. Because small factors can make a big difference in the viability of a probiotic formulation, quality processes are vital.
All ingredients in a probiotic formulation should support the health and activity of the probiotics without introducing unnecessary additives and potential allergens. A quality manufacturer will be pleased to detail the function of each component should you have questions. Probiotic manufacturers also take different approaches to stabilizing their formulations. But the highest quality manufacturers will share the analytical data to demonstrate that their probiotics survive the harsh gastric acid environment and deliver the number of metabolically active microbes stated on the package right up until the date of expiration. You can dramatically reduce the potential of consuming dead probiotics by asking the manufacturer for viability and stability data and purchasing your probiotics through a reliable channel such as your healthcare provider, direct from the manufacturer, or through manufacturer-managed distribution channels. Without proper oversight, probiotics may be shipped or stored improperly which can impact their efficacy.
Today’s targeted probiotic interventions offer a valuable complementary health solution that is effective, safe to use alongside conventional therapies, and can be fast-acting, especially when supported by microbiome-friendly foods (whole foods rich in prebiotic fibers). In fact, according to a 2019 publication in Nutrients, “manipulation of macronutrient intake can consistently shift the composition of the gut microbiota within the span of a day” (Leeming, E.R., 2019).
A daily probiotic can be a great addition to bolster the gut-brain axis and mental well-being, liver detoxification and metabolic support, and microbiome restoration especially when being treated with an antibiotic. But not all formulations are the same. Doing the diligence to ensure quality and efficacy will make all the difference to your health.