Are Probiotics Money Down the Toilet? Or Worse?
Albeit with a provocative title destined to be click-bait, this January 2019 article in Journal of American Medical Association looks seriously at the science. It dissects the two recent studies from Israel which raised questions about probiotic use. Author Jennifer Abbasi does a good job of teasing out implications of the work published in the journal Cell last October.
The first study
As may be recalled, in the first study a probiotic supplement didn’t colonize in everyone’s intestines. Preexisting microbiomes determined whether these participants were permissive or resistant to probiotics. Extrapolating from the results, it is not imprudent to suggest that some will benefit from supplements but others will not.
Rob Knight, PhD, who directs the Center for Microbiome Innovation at the University of California, San Diego, told Abbasi that he wasn’t surprised because “ different people respond differently to the same foods, medications, and pathogens.”
Thus rather than supporting the scatological “waste of money” position, the findings lend credence to a more personalized approach when it comes to probiotic therapy.
The second study
In the second controversial study which also solicited only healthy volunteers, doses of supplemented bacteria colonized intestines after a course of antibiotics but appeared to delay the return of the native microbiota. The key here is whether a delay in return to “native microbiota” is a bad thing—could dysbiosis and resultant problems result? Or on a positive note, senior researcher Eran Elinav of the Weizmann Institute of Science in Rehovot, Israel said it could potentially present an ideal time to reset gut microbes to reverse microbiome-associated disorders.
Nevertheless, Knight said it is important to find out if probiotics delay the return of native microbes in sick people taking antibiotics, because after all, healthy people—whom the study used—are not taking antibiotics.
Other professionals in the field—gastroenterologists who see their fair share of probiotic-popping patients– weigh-in on their handling of pertinent treatments.
And perhaps most interestingly, the article takes a look at the future of personalized probiotic therapy: sophisticated algorithms may remove the guesswork.
The article is a must-read.