Article edited for scientific accuracy by Illuminate Labs Blog Editor Taylor Graber MD
More and more consumers worldwide are taking probiotics because of their proven health benefits. We know that probiotics can improve digestion and even reduce inflammation, but it’s questionable if most probiotics in supplement form are useful since they may be dead by the time you start taking them.
In this article we’ll review some of the benefits of probiotics, explain why many probiotic supplements are likely to be ineffective because they’re dead on arrival (DOA), and offer some more effective probiotic alternatives.
The importance of the microbiome (gut) for overall health is becoming more apparent every year as more research is published. We know from medical research that the balance of good and bad bacteria in our gut can influence both physical and mental health, and its dysfunction can be regulated with probiotics.
Since probiotics are beneficial strains of bacteria, they can help maintain optimal gut function in already healthy populations, and fix gut dysfunction in unhealthy individuals.
Probiotics have a proven anti-inflammatory effect, which makes sense because gut dysregulation and proliferation of bad bacteria is known to be one of the core drivers of chronic, low-level inflammation which can cause all sorts of disease states.
There is also medical research suggesting probiotics can regulate and optimize immune health, which can minimize sickness and even positively impact skin conditions like eczema which are immunogenic in nature.
Of course the benefits of probiotics will depend heavily on the strain, as there are thousands of strains of probiotics, but there is an overall positive effect in medical studies.
Dead on Arrival
Probiotics are living organisms. They’re typically measured in colony-forming units (CFU), and most supplements contain a CFU figure in the billions.
For probiotics to be effective, they must be alive when consumed. We haven’t come across any medical research suggesting that consuming dead probiotics is beneficial to human health.
Many probiotics are shelf-stable, meaning they’re stored at room temperature. This is convenient but likely to lead to dead on arrival probiotics, since many of the strains are quite sensitive to heat. A medical study on two of the most popular probiotics, lactobacillus acidophilus and bifidobacterium spp. found that their survivability was a key factor in their effectiveness.
Another medical study found that heat levels of over 45° Celsius were harmful to probiotic survival, and these temperatures are regularly achieved during supplement manufacturing.
Probiotics aren’t only exposed to stressful conditions during manufacturing, but also during storage, transit and over time.
Many supplement storage facilities aren’t adequately heat-controlled, and probiotics sitting in hot warehouses for months on end aren’t likely to be very effective. Very few freighting companies have adequate temperature-monitoring technology in our experience, and this is another vector for probiotic death.
Another core difference between probiotics in supplements and probiotics in food is that those in supplements are likely to die over time while those in food aren’t.
As discussed above, probiotics in supplements are exposed to various conditions which can cause death of the probiotics, while those in food are generally exposed to enzymes and other naturally-occurring compounds which actually encourage growth.
Naturally fermented foods like sauerkraut contain a fermentation environment that allows further growth of beneficial microbes, and it’s proven in research that these fermented foods can be grown in both warm and cold environments with similar benefits.
It’s also likely that probiotics from fermented foods have a much better survivability than probiotics from supplements, because they’re already thriving in an acidic environment. The stomach environment has a low pH, similar to the pH of fermented foods but very dissimilar to the pH of most supplements.
Probiotics From Foods
For general health, we recommend getting probiotics from foods because they’re likely to be more effective and also cheaper than those obtained from supplements.
Unless the supplement manufacturer has published independent data on the survivability of their products, we’d expect it to be very low.
There are a number of natural food products high in probiotics which also contain other beneficial nutrients:
Sauerkraut is one of the most popular probiotic foods because it’s cheap, easy to find, and effective. Because ‘kraut can be stored at room temperature it tends to be a lot cheaper than other probiotics and can be acquired in bulk at many grocery stores. Choose products with a label notice of "contains live and active cultures", because pasteurized kraut doesn't have the same probiotic benefit.
Kimchi is a fermented cabbage product similar to sauerkraut which is popular in certain Asian cultures. It tends to be more expensive than sauerkraut and also usually has other spices added. There is significant medical research backing the health benefits and probiotic benefits of kimchi just like sauerkraut.
Yogurt is one of the oldest and most popular probiotics. It tends to have less CFU than sauerkraut and kimchi, but is more tolerable and more accessible. We recommend yogurt without any added sugar. Since we know added sugar is harmful to the gut, there would be no point in consuming a health product for gut benefit that includes added sugar.
Pickles are another probiotic food that can benefit health for a low cost. It’s important to select fermented pickles, as some brands sell pickles in vinegar which aren’t truly fermented and won’t have any of the probiotic benefits.
There are many variables which can reduce the effectiveness of probiotic supplements. While supplementing targeted strains of probiotics may be useful for specific medical problems, we believe that generally probiotics from food are much more effective, and cheaper, than probiotics from supplements.
Unless a supplement manufacturer has clinical data supporting the fact that their products can survive processing, storage and time decay, we’d assume they’re dead on arrival.
We recommend that consumers get their probiotics from real foods like yogurt, pickles, kimchi and other fermented foods that have been used as effective probiotics for thousands of years.