KATHRYN MARSDEN
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PROBIOTIC SUPPLEMENTS

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CHOOSING PROBIOTIC FOODS 
& SUPPLEMENTS

ON THIS PAGE . . . 

  • WHAT TO LOOK FOR ON THE LABEL
  • MY FAVOURITE PROBIOTIC SUPPLEMENTS 
  • SHOPPING  GUIDE
  • STORAGE - Refrigerate or not refrigerate?


  • WHAT YOU SHOULD GET IN A GOOD PRODUCT
  • HOW MUCH TO TAKE
  • TOP TIPS
  • WHERE TO GO FOR MORE INFORMATION
CHOOSING PROBIOTIC FOODS and SUPPLEMENTS

Here are some important tips that I hope might be helpful.  First things first, it's important to understand that not all products are created equal.  Not only do they come in a wide variety of guises, as capsules, tablets or powders, there are also huge differences in strength and quality.  

I've tried a whole range of different brands over the years and again during the research for Good Gut Bugs.  What I found was that some products are extremely beneficial and provided the benefits they claimed, some were just ok (in other words, they won’t do you any harm and may be helpful) and a handful, well, to put it as politely as possible, they simply don’t pass muster.  It’s a minefield of microflora out there - so here are some guidelines to help you avoid the crap trap:

Anything that simply says it’s probiotic without providing any detail is definitely one to avoid.  And it doesn’t always follow that because a label tells you it ‘contains beneficial bacteria’ or says ‘acidophilus’ or ‘bifidus’ on the front, that it’s going to be helpful.  In particular, if your supplement label isn't telling you how many billion live bacteria are included or you can't find their names anywhere on the product, then don’t buy the product. 


HOW MUCH TO TAKE

Good quality probiotic products will be clear about the type of bacteria they contain as well as (very important) the potency.  Dosages aren’t expressed in grams or milligrams as they are in most other supplements.  Most probiotics are measured in millions or billions of microorganisms or live cells. Look for labels which tell you that the supplement has at least one billion.  If it states the quantity only in millions, then I'd avoid it. That’s because, in the vast ocean of your intestines, a mere million bacteria are, quite literally, a microscopic drop. And if you have a gut problem which is being caused or aggravated by an overgrowth of unfriendly bacteria, then you'll more than likely need far more than a million good ones to put things right.  

WHAT YOU SHOULD GET IN A GOOD PRODUCT

Although you won’t know this from reading the label, you can be confident that reliable producers of probiotics will ensure that the bacteria in your supplement:
·         Have a history of safe use, are non-toxic and non-pathogenic;
·         Are alive and kicking when administered;
·         Are stable and will survive storage for the life of the product;
·         In the case of probiotics that are used for vaginal treatment, be tough enough to resist spermicides.

DIFFERENT TYPES OF BACTERIA IN ONE PRODUCT

Remember that if your product contains more than one type of bacteria, the label will either give you an overall total of the number of friendly flora or the individual quantity alongside each of the different strains, in which case you will need to add them up.  So it might say Lactobacillus acidophilus 1 billion, Bifidobacterium bifidum 1 billion and Lactobacillus rhamnosus GG 1 billion, which means you have a probiotic supplement containing 3 billion organisms. 

While most suppliers will state the number of organisms on the label, remember independent testing has shown that several products have fallen short of their claimed targets.  That’s why is so important to (a) buy a recognized brand and (b) to make sure it’s well within date.  On some brands, you may still see the phrase ‘at the time of manufacture’ indicating the bacterial count when the product was packaged.  This reference is gradually being phased out and, before too long, best practice recommendations should have brought about a change of wording so that, instead, all products will tell you the likely potency at the expiry date.

As labels vary so much, below are some examples 
of the types and levels of friendly bacteria 
you might find in probiotic products:

EXAMPLE 1
Lactobacillus acidophilus              5 billion live  organisms
Bifidobacterium lactis                  5 billion live  organisms
Streptococcus thermophilus          5 billion live  organisms
Count guaranteed to end of expiry 
EXAMPLE 2
Lactobacillus acidophilus                        Lactobacillus bulgaricus Lactobacillis kefir                                  Bifidobacterium lactis
Totalling 24 billion viable cells     
                          

EXAMPLE 3
Lactobacillus acidophilus LA-1       2  billion microorganisms
Bifidobacterium lactis BB-12         2  billion microorganisms
Lactobacillus paracasei 431           2  billion microorganisms
Lactobacillus rhamnosus GG           2  billion microorganisms
Quantities stated apply until end of expiry
EXAMPLE 4
Lactobacillus acidophilus LA-5        300 million organisms
Lactobacillus rhamnosus GG            300 million organisms
Lactobacillus paracasei 431            300 million organisms
Bifidobacterium lactis BB12           300 million organisms
Streptococcus thermophilus TH4    300 million organisms
EXAMPLE 5
Lactobacillus acidophilus  ½ billion CFU
Bifidobacterium bifidum   ½ billion CFU
Lactobacillus bulgaricus    ½ billion CFU
CFUs  at the time of manufacture*
*CFU stands for Colony Forming Units, the system of measurement used to calculate viable (live) bacteria.

STORAGE: KEEP THEM IN THE FRIDGE OR NOT ?

When you buy, look for information on how best to store the product.  Depending on how it was manufactured, some require refrigeration and some don't but in any case keeping the product in the fridge will always extend its shelf life.  Those that survive outside the fridge are really useful if you’re away from home and want to take your supplements with you.

BE GUIDED BY PRICE
One of the best guides to quality is price.  Although it’s a frequent groan that probiotics are expensive, it's also a truism that you do tend to get what you pay for.  The simple reason for this is that good manufacturing practice, extensive research and development, latest production techniques, effective ingredients and protective, properly vacuum sealed packaging all cost money.  When I buy probiotics, I always go for quality brands such as Bionutri, Biocare, Bio-Kult, Sweet-Cures or Viridian because they're reliable and effective. See details at the foot of this page.

OTHER TOP TIPS
  1. If you start a course of probiotics and find you’re suffering a grumble of gas in the nether regions, this doesn’t mean that what you are taking is bad for you or causing you any harm. This would be a rare occurrence.  Very occasionally, when a person alters and improves his or her diet, they might find a few not-so-nice symptoms such as flatulence, abdominal bloating, headaches or changes in bowel habit.  The same thing can happen when you introduce good gut bugs into the system. Even though it may seem like a backward step, it’s nearly always a positive sign that everything is working as it should.  
  2. If you’re affected by bloating or gas when you first begin to take probiotics, the best advice is to cut the supplements out for a couple of days and then begin again with the lowest possible dose.  Even if the pack advises you to take one or two tablets or capsules per day, ignore this for the moment and take one every other day for a week. Then increase to one daily.  If your probiotic comes as a powder, then start with a pinch per day, then two pinches, then three and so on until you reach the recommended intake.  If gas is still a problem, try changing to a brand that doesn't contain FOS. You can read more about prebiotics including FOS (fructooligosaccharide) in Good Gut Bugs.
  3. Always drink plenty of water. This increases the blood volume and encourages flushing out of the kidneys.  


WHY NOT JUST EAT YOGHURT?

A great idea and an excellent addition to any diet.  However, compared to quality probiotic supplements, the actual numbers of live organisms you're likely to get in one pot of yoghurt will make up only the tiniest blip in the bacterial vastness of your intestines.  That doesn't mean it isn't a valuable addition to the diet. Far from it. Good quality bio-yoghurt, especially if it's additive-free and full fat (yes, full fat,)  and if it's made from goat or sheep milk, or kefir rather than cow's milk, is a great food to include in your diet everyday.  Easy to digest, a super source of calcium and, hopefully blessed with a decent whack of friendly flora.   But how do you choose the best kind?

Supermarket shelves are groaning under the weight of an incredible array of ‘smart’ dairy foods.  But are they really helpful?  And are they a good enough substitute for probiotic supplements?

Some yoghurt and yoghurt drinks can be a valuable source of probiotic bacteria but most don’t have large amounts. Just bear in mind that there's a big difference between what we call a maintenance dose of live culture in a fresh yoghurt product and the therapeutic levels that can be found in a quality probiotic supplement.  However, that doesn’t mean the beneficial bacteria in foods aren’t useful.  They’re certainly good to take on a day-to-day basis and can provide really valuable extra nourishment.  The problem lies in what to choose.  

Occasional reports have suggested that there aren't enough friendly bacteria in yoghurt products able to survive the stomach acid or to have any helpful impact on the intestines. Ten million may be about what you find in a good probiotic drink or yoghurt and although this isn't much when compared to a quality supplement, the vast majority of strains that are used in these food products are acid tolerant and are therefore likely to survive their intestinal journey. There’s also evidence in the medical literature that live yoghurt and probiotic shots can help to reduce the side-effects of antibiotics, especially diarrhoea. 

However, if you're dealing with a serious health problem or have had digestive or bowel troubles for some time, then a one-a-day yoghurt or probiotic drink is not likely to have quite enough oomph and may not always be sufficient to redress the balance where gut flora is seriously disturbed.  

A major downside of many yoghurts and yoghurt drinks is that the sugar content can be quite high, making the vast majority of them out of bounds for diabetics, for people suffering candida yeast infections, those battling obesity or folks who are just trying to avoid sugar.   I think it would be a wonderfully positive move by the manufacturers if they were to reduce the sugar levels without resorting to artificial sweeteners, especially as they continually promote their products as being healthy.   

TO HELP YOU MAKE YOUR CHOICES, HERE'S MY SHOPPING GUIDE FOR YOGHURT PRODUCTS:

  1. Scrutinise the labels and always study the list of ingredients.  This will give you a lot of valuable information. In particular, it should tell you whether or not there is any live culture. Look out for words such as ‘fermented’ or Latin names like Lactobacillus acidophilus, L. bulgaricus or L. casei. 
  2. Always make sure that the yoghurt or yoghurt drink that you buy is well within date and allow for the fact that it may be even nearer the date by the time you get to consume it.  If it is already close to expiry, then don't buy it.
  3. Take an insulated ‘cold’ bag or box with you to transport chilled foods and then put the goods straight into the refrigerator as soon as you get them home.
  4. Be wary of anything claiming to be 'sugar-free'. This hardly ever means that it's better for you. More often than not, it’s a manufacturer's euphemism for ‘We’ve stuffed it full of artificial sweeteners instead’ (don’t forget my earlier comments about chemical sweeteners and the fact that many so-called ‘diet’ products actually encourage you to crave carbohydrates).  Another confidence trick is to tell the consumer that something is 'sucrose-free', giving the impression that it has no sugar, but then to incorporate maltose, dextrose or glucose, or the ubiquitous aspartame. 
  5. You'll certainly find that most products claiming to be low calorie or zero fat will have plenty of fairly unnatural sounding things listed on the label.  My view is that it's better to buy the unadulterated full fat version and eat less of it than to load your body - and especially your liver - with a cocktail of questionable chemicals.
  6. Why not just go for plain, additive-free, yoghurt?   If you have a really sweet tooth, then stir in a small quantity of quality honey which, don't forget, is naturally prebiotic.  (If you’re dealing with Helicobacter pylori or any kind of infection, then I would very strongly recommend that you invest in a jar of high strength Comvita Manuka honey).
  7. If cow’s milk is a problem food for you, try those made from goat or sheep milk.  Or choose kefir instead. Raid the chiller cabinet in a good independent health store. It can be an Aladdin's cave of delicious cow’s milk alternatives. Soya based yoghurts are also available although they do not suit everybody.   And bear in mind that, unless you suffer from a classical Acute Allergic Reaction to dairy protein, fermented foods such as kefir and buttermilk may be easier to digest and better for your health than straight cow’s milk.  These foods are certainly a worthwhile option for anyone with lactose intolerance (see page 218-220 of Good Gut Bugs).

THESE ARE SOME OF MY FAVOURITE PROBIOTIC SUPPLEMENTS WHICH I'VE FOUND TO BE EFFECTIVE, RELIABLE AND OF EXCELLENT QUALITY:

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TECKY STUFF: 
The letters FOS stand for fructo-oligosaccharide, a normally very healthy and helpful prebiotic substance included in some high quality probiotic products. It's really good for most of us but sometimes isn't suitable for IBS sufferers.  



I've found BIONUTRI ECODOPHILUS to be a particularly helpful formula for patients who have IBS and also diverticular disease. This could be due to the fact that it contains a particular type of bacterium known as Lactobacillus kefir which is especially helpful to an irritable gut and also because it doesn't contain any FOS. 
For more info click 
Bionutri Ecodophilus
or go to 
www.bionutri.co.uk
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 SWEET CURES PROBIOTIC BLEND is a   combination of 9 different ‘friendly’ bacteria which adds up to 15 billion live organisms per capsule. The recommended daily dose is two capsules giving 30 billion ‘good gut bugs’. 
Need more info?  Click:
Sweet Cures
Probiotic Blend

or go direct to their website 
www.sweet-cures.com
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Viridian Synbiotic Daily (High Strength) has Lactobacillus acidophilus & Lactobacillus bulgaricus and 3 strains of Bifidobacterium.  It provides 20 billion live organisms with the prebiotic known as inulin. This is the kind of level to go for when you need to repopulate the gut after antibiotics.
Viridian's 40+ Synbiotic is a high potency probiotic of 6 billion bacteria: Lactobacillus acidophilus,  Bifidobacterium lactis, Bifidobacterium bifidum and Lactobacillus salivarius which. research suggests, could be valuable to us as we age.
Contains the prebiotic FOS.
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You might also be interested in the Synbiotic Children's Powder which comes in a tasty, easy to take powder. 

For more information, click on any individual product photo or go to 
www.viridian-nutrition.com

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The Biocare Bio-Acidophilus range comes in several different strengths from 10 to 75 billion viable organisms, all with fructooligosaccharides.  I've used the lower dose 10 billion Bio-Acidophilus for everyday and the 30 billion Bio-Acidophilus Forte after antibiotics. 

Helpfully, the range includes a convenient 7 day supply of the 24 billion per dose Bio-Acidophilus Forte as well as a Bio-Acidophilus powder (20 billion bacteria per dose) for those who can't swallow capsules.

Probiotics for kids?
Try Biocare's Banana Acidophilus Plus or Strawberry Acidophilus (which are also ideal for anyone convalescing). Or the clever idea of Probiotic Straws which can be used with any cold drink.  I particularly like their specialist probiotic product called Infantis which I've used very successfully for babies and toddlers suffering colic and eczema as well as for adding to formula feed and for mums who are breastfeeding. 
For more information, click on any individual product photo or go to
www.biocare.co.uk

MORE new probiotic product recommendations 
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Bio-Kult is a multi-strain probiotic formula (meaning that it contains several different types of friendly bacteria).   It's been developed by the same company which produces the excellent psyllium fibre supplement Lepicol.   

I'd recommend Bio-Kult to anyone suffering with leaky gut syndrome, IBS (irritable bowel syndrome) and inflammatory bowel diseases such as Crohn's or Ulcerative Colitis.  And like all good probiotics, it has real value in replenishing the gut flora after antibiotics and reducing the side effects of antibiotic treatment. The Bio-Kult formulation is also suitable for travelling as it doesn't need refrigeration.  

Click here for more information about Bio-Kult 
click here 
Bio-Kult Candea is designed to help strengthen the body's natural defences against candidiasis, a condition where yeast in the gut gets out of control and produces a wide range of unpleasant symptoms including chronic fatigue, food sensitivities, bloating, thrush, recurring cystitis and hormonal problems.
For more information about Bio-Kult Candea 
click here  

Bio-Kult Pro-Cyan is new to the Bio-Kult family, and is designed to help relieve the pain and distress of urinary tract infections.   Click here to read my article on probiotics for bladder and vaginal health.
For more information about Bio-Kult Pro-Cyan
click here

NEED MORE INFORMATION ON PROBIOTICS?

  1. The article Why We Need Good Gut Bugs in the Health Notes section on this website should be of interest.
  2. Check out the full chapter on probiotic foods and supplements in my book Good Gut Bugs.  Available from UK libraries; also online from Amazon.  
  3. Go to an individual manufacturer’s website. Any good supplier or manufacturer will be happy to answer your questions without pushing their product.
Kathryn's views are completely independent. She is not employed by any pharmaceutical company, supplement supplier or food producer nor is she persuaded in any way, financially or otherwise, to recommend particular products or services.
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Amazon reviewer on Kathryn's book Good Gut Bugs:
"This book is a must-have for anyone with digestion problems or bowel conditions.Written in Kathryn's own inimitable, entertaining and quirky style, it is full of facts,anecdotes, information and useful advice on sorting out your gut problems. My partner is already well on the way to recovery after I relayed Kathryn's advice to him (you know men hate reading anything intelligent!)"

 “I am very impressed, it’s very easy to read; most enjoyable, lighthearted and fun!”

“Really like the titles and captions – they bring the subject alive.”

“Much enjoyed. Extremely clear and informative – and I’m a doctor’s son!”

“I really like the chatty, humorous style of writing. Kathryn explains complex things in a very clear way.”


"I think the writing is lovely, fresh, inspirational and most of all very readable for people who perhaps don't know a lot about their insides."

"I think this book should be heading for medical libraries across the UK - and specifically, GP surgeries- come on medics - take advice from books other than the BNF!!  Well done Kathryn!!"
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IMPORTANT NOTE FOR ALL VISITORS TO THIS WEBSITE:
This website is entirely not-for-profit and is set up and supported by Kathryn Marsden purely as a resource to provide information on matters related to health and diet. The material Kathryn has included on this website and also in her books, articles and lectures, is for information only and will have been accumulated and referenced from one or more different sources which may include published journals, meetings and discussions with a number of different practitioners, medical and surgical consultants and international experts, and from her own personal research and experience in practice over many years. From the feedback she has received, it would appear to have helped many people.  However, it is important that the reader understands that these guidelines are not intended to be prescriptive, nor are they an attempt to diagnose or treat any specific condition.

If you're concerned in any way about your health, Kathryn ALWAYS strongly recommends that you visit your own doctor or consultant without delay.  If you are suffering from any health problem, she stresses the importance of obtaining as many details about your condition as possible and asking plenty of questions about any medicines that may be prescribed to you.  Always read the pack leaflet which is included with any prescription medicine and don’t stop taking any medication without first talking to your primary health care provider.  The article ‘An Important Note About Prescription Medicines’ may be helpful to you.  Kathryn also suggests that you talk with your health care provider about any specific diets or supplement programmes you may be thinking of introducing.  In the meantime, follow a varied and sensible healthy eating plan which contains plenty of fresh, unprocessed whole foods, pulses, daily fresh fruit and vegetables, and water. Take regular exercise and try to avoid cigarette smoke.  If you suffer from any allergy, Kathryn recommends that you always check pack labels for allergen information before using any product and, if in any doubt whatsoever, contact the manufacturer or supplier directly for allergy advice.

A final note re illustrations on this website: The majority of photographs and graphics are the property of my husband who has donated them from his own collection especially for the site. However, I have used a few pictures that I already had on file and that were provided to me from other sources as being copyright-free.  If anyone believes a photograph that has been included on this basis actually is copyrighted and/or requires permission, then I apologise unreservedly to the owner of that copyright and would ask that they blog me to let me know so that I can either obtain the necessary permission or remove the picture altogether. Thank you.