Talk:Probiotic

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Contents 1 Specific Organisms 2 Welcome 3 Antibiotics 4 POV? 5 Containing yeasts? 6 Lactobacillus casei 7 Skepticism 8 "Reasons for Skepticism" Dispute 9 POV 10 totallydisputed? 11 Lacking in Citations 12 "There is no published evidence that..." 12.1 Potentially useful research 13 "Side effects" 14 "Lactobacillus" 15 Research in Scandinavia 16 Blood pressure lowering 17 This article seems to contradict itself 18 Types 19 Lactus Bulgaricus 20 Article needs complete make over

[edit] Specific Organisms

I am wondering if we should refer to probiotic organisms by name in the benefits section, in addition to listing them later. The reason I would like to see this is that the benefits of some of the species have been much more well-documented than others. L. casei and L. reuteri, for example, have shown real benefits for human health after repeated effects (a lot of the assertions about preventing infection, regulating the immune system, etc is based on studies on these species). Others, such as the much more well-known L. acidophilus, have never really shown anything above placebo. --AaronM 17:25, 8 August 2006 (UTC)

[edit] Welcome

http://www.nutriwatch.org/04Foods/ff.html -- Check out the section for "Dairy Products".

This topic definitely needs to be expanded. I'll be stopping by on my journeys in researching probiotic foods.. but expertise will be warmly welcomed.

-- Sy / ^(talk) 01:27, 23 Jan 2005 (UTC)

[edit] Antibiotics

Is it true that taking probiotics while on antibiotics can be beneficial? If so, I think this should be added.

Have a look a the paper referred to in research section of article.Chris 22:40, 3 July 2007 (UTC)

[edit] POV?

"It is a common myth, even among professionals within the health care community..."
So what do you have to back up your assertions if the health care community disagrees with you?
This paragraph as well as the section on prebiotics seem distictly POV to me.
-Adjusting 21:11, August 3, 2005 (UTC)

Probiotics are healthy bacteria, not just in supplements but also in foods. The Harvard Helath Letter ran an informative article about them in the May 2005 issue, which states that "a growing body of evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of live bacteria." They go on to say that "The strains most often found in probiotic supplements and foods like yogurt are lactic acid bacteria belonging to the genera Lactobacillus and Bifidobacterium."

[edit] Containing yeasts?

I just came across this article now, and I saw this sentence:

Probiotics are dietary supplements containing potentially beneficial bacteria and yeasts.

I don't claim to have a huge knowledge of probiotics, but I know that they are very often used in the treatment of candidiasis, and people who have canidiasis are usually told to avoid all mushrooms, yeasts, truffles, etc., in their diet – in other words anything that's a fungus. I have bought probiotics regularly, and have picked up bottles from shelves in health shops to have a good look before choosing. I can't recall ever seeing one that contained yeast.

I don't pretend that I feel 100% confident taking it out, as I'm not completely sure. However, it seems most unlikely that any of the normal probiotics would have yeast, and it aslo seems unlikely that any of them at all would have it. If someone feels it should go back in, please leave a note on the talk page, so that I can be sure that this is a genuine edit. Thanks. Ann Heneghan ^(talk) 02:20, 11 November 2005 (UTC)

I agree, I know of no probiotic formulations that contain yeasts. Indeed if they did include yeast species such as Saccharomyces spp then one would expect rapid fermentation of the probiotic formulations. Velela 10:09, 11 November 2005 (UTC)

It is not common for 'commercial' probiotics to contain yeast, largely due to the public misconception about what yeast is and its role in disease and health. For example, Ann Heneghan above demonstrated the classic public misunderstanding; i.e., that people with a Candida infection should avoid all yeast. This is akin to saying that people with a bacterial infection (say for example, Helicobacter pylori) avoid all bacteria,(for example, Lactobacillus casei). Not all bacteria are the same; just as not all yeast are the same, though the common ignorance is prevalent enough to stop probiotic companies from adding yeast. See Quackwatch's entry

Many of the studies which have tested various probiotics both in animals an in human clinical trials have used certain strains of yeast such as Saccharomyces cerevisiae and Saccharomyces boulardii. Simply search PubMed for either of these two fungal species + "probiotic(s)". - Unsigned

Probiotics are healthy bacteria, not just in supplements but also in foods. The Harvard Health Letter ran an informative article about them in the May 2005 issue, which states that "a growing body of evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of life bacteria." They go on to say that "The strains most often found in probiotic supplements and foods like yogurt are lactic acid bacteria belonging to the genera Lactobacillus and Bifidobacterium." - Unsigned

There's also very useful information about probiotics at this website: http://www.usprobiotics.org/basics/ and they mention that "One yeast - Saccharomyces boulardii - also has been evaluated as a probiotic." - Unsigned

Saccharomyces boulardii is a yeast that is commercially available. It has surface receptors that interact with certain toxins from Clostridium difficile making it useful in adjunctive treatment of pseudomembranous colitis. It is useful in other settings, as well. It is unique among commercially available microorganisms in that it is the best studied. Google "Saccharomyces boulardii" for more info. Kd4ttc 17:08, 4 March 2006 (UTC)

[edit] Lactobacillus casei

Lactobacillus casei

Lactobacillus rhamnosus

Streptococcus thermophilus

Bifidobacterium breve

Lactobacillus acidophilus

Bifidobacterium longum

Lactobacillus bulgaricus

Bifidobacterium infantis

Bifidobacterium

[edit] Skepticism

I entered the section on reasons for skepticism. Probiotics sound catchy, but it really represents a fecal romanticism that if everything were just natural everything would be good and well. Studies are just coming out to suggest what roles these expensive supplements play. Kd4ttc 22:51, 3 March 2006 (UTC)

I sympathise with your concerns and have, in the past, edited out some text about good bacteria and bad bacteria from an earlier version. What I am sure that your own observations acknowledge is that severely disrupted or compromised gut flora, especially after the use of broad-spectrum anti-biotics, benefit greatly from early restitution of a more normal gut flora which helps to obviate Candida colonisation. My own scientific (but non medical) reading of the literature suggests that some modern life-style and diets are themselves the reason for a compromised gut flora and in such cases some assistance in restoring a more normal flora may be beneficial. I am however wholly with you that by far the most appropriate way to restore a normal gut flora is by adoption of healthy diet and life-style (see Prebiotic). I would suggest that your inserted text need to be re-worked and simplified to sit well with the rest of the topic or else risk a unilateral deletion (but not from me!) Velela 23:10, 3 March 2006 (UTC)

It would be amusing to see that happen. The diarrhea that results from antibiotics is due to alteration of bacterial processing of mucus, rather than a flora change. I put the skeptic part in a separate section to confirm it is rather editorial in nature. If wholesale deleted it would be best if there were a rational stated. Kd4ttc 00:31, 4 March 2006 (UTC)

"Fecal romanticsim"? Can't we leave the armchair Freudian analaysis out of this?

[edit] "Reasons for Skepticism" Dispute

This section contains a number of unsubstantiated claims regarding the purpose and function of certain bacteria in host organisms. What makes me concerned about this section is that its premise seems to contradict the entire purpose of the article. The term "probiotic" is a dichotomous term, implying that there is in fact a distinction between "good/beneficial" bacterial and "bad/harmful" bacteria. This section not only undermines that idea, but fails to provide any logical and/or factual/empirical findings to support such a broad conclusion. Furthermore, it is poorly written and contains misspellings.

If this is, in fact, an unjustified oversimplification, then why is it that certain strains of bacteria do improve the human condition? Additionally, there is nothing in the definition of probiotics which suggest that they must, and can only, act independently; that they cannot act in groups in order to achieve a positive effect.

At any rate, I would recommend that the author of this section meet a couple of requirements before deletion of this section: 1) Provide citations. 2) Revise the section.

Respectfully, articles on Wikipedia are not soapboxes; they are designed to contain factual information with citations. If this burden is not met, it does not meet Wikipedia's high quality standards, and ergo, must be deleted.

70.77.93.61 05:58, 28 March 2006 (UTC) -- I agree with the above poster, but believe deletion is required. If you feel the section is still important, rewrite it with RESEARCH. It contains no useful information and looks like nothing more than soapbox drivel. It does NOT meet Wikipedia's quality standards and is unsupported by a cursory search of many of the known research databases, including those indexed by Google Scholar.

In the future it would be wise to verify your facts before writing them into an article. You've made this page look worse than those new age "cure everything with magnets" pages that pop up around the net. This is a great disservice to Wikipedia, and a great disservice to its millions of users looking for FACTUAL information.

wrt "It is difficult to see how bacteria taken by mouth can survive the process of human digestion (though research shows that they do, in fact, survive [49])", if the research SHOWS that they do in fact survive, then why should this remain difficult to see? This statement should be removed or reasons for disputing the research should be cited. —Preceding unsigned comment added by 213.152.46.58 (talk) 18:37, 29 December 2007 (UTC)

[edit] POV

The lack of any mention that this entire concept is held in contempt by the scientific and medical communities is not mentioned. JBKramer 18:07, 20 September 2006 (UTC)

Maybe that's because it's not "held in contempt" by science/medicine. In large part, the research that would provide evidence for or against the claims of probiotics is being done or has not been done before. There are some in vitro results that support the hypothesis that it could be beneficial and limited animal studies. I don't see many voices shouting out against it. It's more of a waiting game as the evidence is generated. I'm not concluding that this article is neutral, only that your contention that we need to add text condemning the approach according to science/medicine isn't going to provide that neutrality (and certainly not without actual evidence of disdain from science/medicine). ju66l3r 19:29, 20 September 2006 (UTC)

The article currently states that probiotic claptrap can do the following, that it cannot do: Prevention of Colon Cancer, Cholesterol Lowering, Lowering Blood Pressure, Improving Immune Function and Preventing Infections, Reducing Inflammation, Improving Mineral Absorption and Prevents Harmful Bacterial Growth Under Stress. None of this (except for the lactose breakdown, and the repopulation of the gut for compromised individuals) has any basis in science or medicine, yet the pseudoscientific garbage studies are cited for each of them. JBKramer 19:43, 20 September 2006 (UTC)

I've changed the wording to indicate that experiments are indicating that these are potential benefits of the methods. This is more neutral and reasonable than removing the discussion entirely. This is not fortune-telling; it's a relevant and approachable scientific question with research in peer-reviewed journals. You may disagree that it will eventually lead to true medical benefits, but you can't remove the fact that people are studying it to determine if this is the case or not (just as you can't just wholesale delete the fortune telling article because you don't believe in what some think is the power of Tarot card reading). ju66l3r 19:57, 20 September 2006 (UTC)

This is one good example of why wikipedia is not highly regarded as a source of information. The studies cited are pretty much all lousy. For example, VSL#3 has only one published study of 8 patients and has never been repeated. One defender of probiotics above stated that "the research that would provide evidence for or against the claims of probiotics is being done or has not been done before". Well, that is a fair summary of the field. However, the article has no mention that research is really just beginning and that the claims should be viewed skeptically. However, when challenges are made by contributors to wikipedia they get edited out by the probiotic enthusiasts. It is really amazing that there is no section on skepticism here or any comment about the quality of the purported data. Kd4ttc (talk) 22:42, 19 February 2008 (UTC)

[edit] totallydisputed?

It is one question to wield NPOV as a weapon against an article you don't agree with. It's another item altogether to outright question the factual basis of the article. You are going to have to provide sources that dispute probiotics as a science. Good luck. ju66l3r 20:06, 20 September 2006 (UTC)

The usual standard is first to show evidence of effect rather than to demand evidence of no effect. Most of the articles in the probiotic field are poorly done. Kd4ttc (talk) 16:01, 22 February 2008 (UTC)

Lancet article added today, showing inceased fatalities in acute pancreatitis. I believe that this page should be added to the Rational Skepticism category. Pustelnik (talk) 16:41, 15 February 2008 (UTC)

[edit] Lacking in Citations

I just marked a need for citations in several places. I'm not universally questioning the validity of the claims, I'm just eager to see some actual data to back them up. Forgive me if adding this to the talk page is an unnecessary step, I'm fairly new to wiki editing. 24.220.79.116 20:20, 28 January 2007 (UTC)

[edit] "There is no published evidence that..."

It is always difficult to substantiate claims that begin with "There is no published evidence that...". It also borders on the absence of evidence = evidence of absence syllogism [1]. When I read this sentence (There is no published evidence that probiotic supplements are able to replace the body’s natural flora when these have been killed off; indeed bacterial levels in feces disappear within days when supplementation ceases), I went with interest to the link, which is a BBC documentary. I found the source of this claim. But I also found, couple of minutes later in the clip, a researcher, talking about the perspective of colonizing the gut of young children with protective probiotics. The enthusiam appears to be very real, because health impacts are expected to be enormous. It seems that this source has lots of useful info, but is not well balanced. As a result, these negative opening remarks, right at the beginning of this article are unjustified. I'll try and find evidence to appropriately correct this disinformation. However, a quick look at the research (it is huge) seems to indicate that probiotics have been shown to rebalance microbiota (I mean, durably). This brings me to another questionable phrasing: "to replace the body’s natural flora when these have been killed off". Syntax is not great, but the main problem is that it is assumed that we're dealing with a natural flora that could be "killed off" and should then be "replaced". First, even if it was the problem, there are researchers who focus precisely on populating the gut of infants, before the whole flora has developped. Second, doctors prescribe probiotics to balance, not to repopulate. Total destruction does not happen in real life. To summarize, weak reference, wrongly interpreted; not neutral, damaging to the rest of the article, which has good references. Pierre-Alain Gouanvic 16:50, 14 March 2007 (UTC)

Hi, a little more on this. The documentary can be found at : [2] . The exact place where we can find the reference for the "there is no evidence that" is 16 min 55 (pro); 17 min 44 (con). The BBC journalist presents the "con" section with this remark: "Maybe you need to keep on taking extra bacteria to get the benefit of them". The skeptic researcher says: "we can show that ..." (concerning the short-lived effects of probiotics). I perceive that this is biased. I think that "We can show" the opposite as well. Back to research. Pierre-Alain Gouanvic 15:53, 16 March 2007 (UTC)

There we go:

The most commonly used probiotics are strains of lactic acid bacteria (e.g., Lactobacillus, Bifidobacterium and Streptococcus). The beneficial effects of Lactobacillus and Bifidobacterium have been discussed for decades. Bacteria in these two genera resist gastric acid, bile salts and pancreatic enzymes, adhere to intestinal mucosa and readily colonize the intestinal tract.[3] Let's go a little further. Pierre-Alain Gouanvic 15:59, 16 March 2007 (UTC)

[edit] Potentially useful research

Rolfe R (2000). "The role of probiotic cultures in the control of gastrointestinal health". J Nutr 130 (2S Suppl): 396S-402S. PMID 10721914. 

Tuomola E, Salminen S (1998). "Adhesion of some probiotic and dairy Lactobacillus strains to Caco-2 cell cultures". Int J Food Microbiol 41 (1): 45-51. PMID 9631336. 

Lee Y, Lim C, Teng W, Ouwehand A, Tuomola E, Salminen S (2000). "Quantitative approach in the study of adhesion of lactic acid bacteria to intestinal cells and their competition with enterobacteria". Appl Environ Microbiol 66 (9): 3692-7. PMID 10966378. 

Naruszewicz M, Johansson M, Zapolska-Downar D, Bukowska H (2002). "Effect of Lactobacillus plantarum 299v on cardiovascular disease risk factors in smokers". Am J Clin Nutr 76 (6): 1249-55. PMID 12450890. 

Plummer S, Weaver M, Harris J, Dee P, Hunter J (2004). "Clostridium difficile pilot study: effects of probiotic supplementation on the incidence of C. difficile diarrhoea". Int Microbiol 7 (1): 59-62. PMID 15179608. 

Klarin B, Johansson M, Molin G, Larsson A, Jeppsson B (2005). "Adhesion of the probiotic bacterium Lactobacillus plantarum 299v onto the gut mucosa in critically ill patients: a randomised open trial". Crit Care 9 (3): R285-93. PMID 15987403. 

Lee Y, Puong K. "Competition for adhesion between probiotics and human gastrointestinal pathogens in the presence of carbohydrate". Br J Nutr 88 Suppl 1: S101-8. PMID 12215184. 

[edit] "Side effects"

This paragraph is not justified. The claimed possible side effects of ingesting probiotics have never been documented in the scientific literature. In my opinion the paragraph should be removed, or at least the content verified. Theser 07:39, 31 July 2007 (UTC)

See Besselink, Lancet, 14 Feb 2008 for fatalities due to probiotic use. 167.73.110.8 (talk) 15:56, 15 February 2008 (UTC)

[edit] "Lactobacillus"

Many people avoid dairy products, is someone's 'dairy free gut' going to benifit from a milk based bacteria ?
I think this basic point, complicated by complex terminology, would benifit discussion. —Preceding unsigned comment added by 80.42.150.150 (talk) 12:21, 1 October 2007 (UTC)

The bacteria are not from milk, but from the intestine.Knorrepoes (talk) 19:47, 28 November 2007 (UTC)

[edit] Research in Scandinavia

There is a lot of research in Scandinavia about probiotics that is not represented in this article, not to mention the array of probiotic products that can be found in Scandinavia, such as filmjölk. This includes clinical trials with human subjects. So if someone is looking to expand the research section, looking through Scandinavian research articles may be useful. (Some articles are in English.) For example, Lactobacillus plantarum 299v was developed in a Swedish research facility and is currently marketed as ProViva products in Sweden. –panda (talk) 17:11, 28 November 2007 (UTC)

This should not be mentioned under this article, but at the appropriate species; such as for the example of L. plantarum. Or LGG for example. A lot of research has also been done in many other countries, such as the Netherlands, France, Switzerland...Knorrepoes (talk) 19:46, 28 November 2007 (UTC)

I think you've missed my point. There is text in the "Criticism" section that claims that info about probiotics comes primarily from test tube trials and not human clinical trials, for example, but they already did human clinical trials in Scandinavia some years ago. Plus the "research" section is a total of 2 sentences right now and only contains information from 2007. –panda (talk) 19:54, 28 November 2007 (UTC)

[edit] Blood pressure lowering

Lowering blood pressure by peptides produced during fermentation of milk is not a probiotic property. In such products the benefit is not due to the presence of bacteria but their metabolites. This paragraph should be removed in my opinion. Theser (talk) 08:00, 29 November 2007 (UTC)

Agreed, go ahead... Actually, the same may be true for lactose intolerance, the lactse produced is active even when the bacteria do not survive the stomach. Knorrepoes (talk) 18:09, 29 November 2007 (UTC)

The blood pressure and lactose intolerance issues are cited (by the same source) so it may be a good idea to check the reference first before removing it. I can take a look at it later if no one else does beforehand. –panda (talk) 23:18, 29 November 2007 (UTC)

No matter what Dr Sanders state in the paper it is confusing the issue to mention effects caused by peptides produced during milk fermentation in a article on probiotics. This is clearly NOT an effect of probiotics, which are per definition "Live microorganisms which when administered in adequate amounts confer a health benefit on the host".Theser 07:29, 3 December 2007 (UTC)

I haven't read the article yet since I haven't had time. That said, I don't see how the defn you've given contradicts that blood pressure decreased by peptides produced during milk fermentation is not a probiotic property unless the milk fermentation was not caused by probiotic bacteria (that obviously had to be alive). If the case is that the bacteria caused the fermentation, which produced the peptides, which then lowered blood pressure, then the bacteria did (indirectly) lower the blood pressure and conferred a health benefit on the host. –panda 17:18, 3 December 2007 (UTC)

[edit] This article seems to contradict itself

That's all i have to say.

--Z E U S (talk) 22:09, 3 January 2008 (UTC)

[edit] Types

Hi there,

I have made some additions to the types of Lactobacillus. There were serval missing that I know about. I have added the fact that ONE Group prdocues a product called MiVitality In-Liven which contains the complete Lactobacillus family. Although, some of the particular strains I'm not so sure about so I have requested more information on this so I can be 100% clear.

I also made a change to Lactobacillus caucasicus as it previously stated that it was a 'fantasy name'. This is incorrect, it is also named Lactobacillus kefiri. I have also modified Lactobacillus sporogenes as this is also an originator of Lactobacillus and not a made up name. It seems the section on Lactobacillus was taken from this website http://www.food-info.net/uk/ff/probiotics.htm and not much post-editing work was done. 'Fantasy name' really isn't the right thing to be putting as an entry in Wiki. 0s1r1s (talk) 07:54, 11 January 2008 (UTC)

The InLeven product contains only a few species, not the whole family, that is impossible. Sporogenes and caucasicus are not recognised names, thus invalid and cannot be used.Knorrepoes (talk) 08:06, 11 January 2008 (UTC)

Sporogenes is a recognized name. It is produced by both Thorne Research and Pure Encapsulations. Both are professional only grade product lines and are always well reasearched before porduction. Lactobacillus Sporogenes is a strain that is viable without refrigeration. Great for travelling. KK 13 January 2008 —Preceding unsigned comment added by 68.184.39.217 (talk) 14:33, 13 January 2008 (UTC)

See here to get some more information on why this name is illegal and should be Bacillus coagulans.Knorrepoes (talk) 16:16, 13 January 2008 (UTC)

[edit] Lactus Bulgaricus

I have some info that 10% of lactus Bulgaricus population does indeed survive stomach acid making their way to intestines. So L.Bulgaricus should indeed have some therapeutic characteristics. —Preceding unsigned comment added by 79.101.14.6 (talk) 21:41, 18 March 2008 (UTC)

[edit] Article needs complete make over

This article brings more confusion than clarity to the reader. The introduction is poorly written and does not explain clearly what probiotics are. E.g. the lengthy paragraph on LAB should be replaced by a link to the lactic acid bacteria article. For those of you being able to read German, take a look at the German Wiki on probiotics (probiotikum) which is much more in the encyclopedia format – short and concise.
Further, to avoid the discussion of pro/con probiotics, which should not take place in an encyclopedia, a historical, descriptive perspective should be taken. The table of “proven probiotic strains” is useless as the claims are not documented by scientific references. Links to companies/probiotic producers are not proper documentation. Some keywords on the claimed effects could, however, be extracted from the table, e.g. immune stimulation, lactose intolerance, alleviates atopic eczema…
My suggestion to an outline of this article would be:

1 Introduction/definition
2 History of probiotics
3 Probiotic foods
4 Probiotic food supplements
5 Potential benefits (short list), emphasizing that scientific documentation is often scarce and that mode of action is poorly understood
6 References and links (non-commercial if any).

- What do you think ?? —Preceding unsigned comment added by Theser (talk • contribs) 08:03, 22 February 2008 (UTC)

Sounds good to me - the current version is a mess and I suspect the hand of some major probiotic suppliers at work here. Go for it. Velela (talk) 09:39, 22 February 2008 (UTC)

Agreed. The article has no coherence as it currently exists.--AaronM (talk) 14:14, 22 February 2008 (UTC)

As a physician this article is an example of a problem with wikipedia. The references often are to small uncontrolled studies or references that are followed say something like the findings are preliminary and need to be followed up, but the only thing that gets in here is the optimistic bit. Since there is no discussion of the quality of the data it reads as if probiotics have major health utility when practical experience has not borne that out. Even the phrase probiotic is jaded - the implication is that the germs are good, when in reality they are just germs. There is no discussion on the field being unregulated and having resisted regulation. Safety concerns are not throughly addressed. Strain drift and strain differences are not discussed. There isn't even any mention that the subspecies are probably important. The work it would take to go through each reference and debunk it or to elevate it (in the few cases where that is warranted) is major. There is also a pervasive POV here on promoting probiotics and I have seen criticism against probiotics whittled out of the article. Also, I say someone revert a set of additions to the table of proven probiotics because they were felt to be ads, when to my reading the claims added had as much justification as anything already in the article.

The Germans are probably the most sophisticated in their use of whole bacterial products. Perhaps the German version of this article should just be translated. Kd4ttc (talk) 15:15, 22 February 2008 (UTC)

While the German version may be more concise, it also only contains 6 references + 2 books. I don't know if all of the references in the English version should be kept or not, but a complete literature review may be warranted to determine what should go vs what should stay. A note on links to companies/probiotic producers as not proper documentation -- this may be true for the majority of the world but in Sweden, I believe that all medical claims made by Swedish companies must be approved by the Medical Products Agency (Läkemedelsverkets, a Swedish governmental agency) or else the company can be reported for false claims and fined until the claim is removed. So even if something is published on a company's website in Sweden, it can be considered a reliable reference. –panda (talk) 01:18, 27 March 2008 (UTC)