DO PROBIOTICS HAVE ENOUGH STRENGTH TO REACH THE INTESTINAL TRACT?

Probiotics, meaning ‘for-life’, are “bacteria that support and enhance life” (Encyclopedia of natural healing) (2). “Dietary supplement containing potentially beneficial bacteria or yeasts”(Wikipedia) (13). Live microorganisms which when administered in adequate amounts confer a health benefit on the host” (FAO/WHO) (13). Supplementing probiotics became popular in the 1990’s as average Americans do not have a bountiful amount of fermented foods in their diet and are continuously exposed to psychological and physiological stress as well as medications which are known to deplete the intestines of friendly flora. The two topics most often referred to are; does the lack of refrigeration have an effect on the amount of living viable cells of the product, and do supplements arrive in the intestines alive and ready to colonize. These topics beg the obvious question, does bacteria need to be alive to have health promoting effects on the gastro-intestinal tract?

In order for bacteria to have health promoting effects in the intestines, must it be viable? According to the vast majority of studies, documents, papers and web sites, yes it does. There is at least one website however who begs to differ. Natural News.com state that the DNA in the bacteria alone is sufficient to reduce the effects of Inflammatory Bowel Disease (15). Upon further investigation, the information revealed was based on a clinical study done by researchers at the University of California who looked at “a synthetic form of bacterial DNA when administered to mice bred to model IBD”(14). Gastroenterology reported that the same study used gamma rays to minimalize the probiotic activity, where previous studies had used heat, which “destroyed the cellular structure and beneficial aspects”(9). Simplyvital.com states that in order “for a pro-biotic to be effective it must retain potency during storage”(6). The friendly bacteria in them (probiotics) must be alive and kicking” states candidasupport.org(16). Dr. Weiss, NMD, AACUPR agrees, “the critical key to a good quality probiotic supplement is that the bacteria must be alive to work. Only living pro-biotic bacteria can colonize in the intestines”(4).

     Is the bacteria count in supplements affected by lack of refrigeration? Many pro-biotic manufacturers guarantee the amount of living cells at the time of manufacture. Others state the quality of their product is guaranteed until expiry date if refrigerated. Many web sites and articles state that as much as 80% of beneficial bacteria are killed prior to consumption. Dr. Weiss states that “probiotics subjected to warm temperatures during shipment and storage will inevitably kill off some or all of the bacteria”(4). Simplyvital.com goes further by claiming that upon testing many products, “some 70 to 90% regularly fail to comply with even their own claims”(6). Not only is the strain labeled not always present, the bacterial count is also significantly lower than declared. A study prepared by professors and doctors of the University of Reading and King’s College of London; An Evaluation of Probiotic effects in the Human Gut: Microbial Aspects, declares that “data indicates that the products that are most known to the consumer were found to match their content in quality and content”(1). As this study took place in the UK, products world wide may differ.

     Once ingested, is bacteria capable of reaching the intestinal tract alive and ready for colonization? CEO of Master Supplements, Inc. Randolf S. Porubcan MSc declares that “the kill rate in the stomach acid (1 hour at PH 1.6) for the majority of probiotic strains runs from 99 to 99.99%. He explains that only acid-resistant strains or probiotics with a delivery system will reach the gut alive. Enteric coatings like aspirin do not work for probiotics because the “polyacrylamide coatings, besides having carcinogenic activities, actually destabilize the shelf life probiotics because they cause moisture retention with in the product”(10). Porubcan believes that delivery systems that employ polymeric carbohydrates such as alginates or pectins are the most efficient. According to Wikipedia, “Polyacrylamide is not toxic” but “some research indicates that polyacrylamide can degrade under normal conditions, releasing acrylamide, a known nerve toxin”(17). The Department of Biomedical Engineering of McGill University found that “microcapsules composed of two natural polymers, alginate and chitosan, allows delivery of a higher number of bacteria to desired targets in the GI tract” (7). The study, An Evaluation of Probiotic effects in the Human Gut, generated an entire set of data “on the ability of commercial strains to survive in vitro that mimic individual physiological environments of the intestinal tract”. Its conclusions demonstrated that not all strains of bacteria found in probiotics have the capability of surviving intestinal digestion. “Lactobacillus spp. were resistant to the gastric environment but were sensitive to upper intestinal content. Bifidobacterium spp. were more likely to be affected by stomach digesta but survived well in the upper intestine compartment”. In particular, Lactobacillus plantarum and pentosus and Bifidobacterium lactis were found to be of most resistance and “showed the best ability to colonize the three compartments of the lower digestive tract”(1).

     Unless specifically irradiated by gamma ray, which is not a product currently available to consumers, probiotics must be alive to bring any benefit to the host. If a retailer can guarantee a product is shipped cold from a short distance than look for specific strains such as Lactobacillus plantarum, L. pentosus as well as Bifidobacterium lactis. These strains will be most successful to reach the intestines alive. A little help from studies would be of use to determine whether the product indeed carries the strains and potency labeled. Shelf stable probiotics may be the easiest choice. When purchasing, look carefully at packaging to determine what type of coating is used. Alginate, chitosan and pectin are most effective and non-toxic. It is possible that products do not reveal this information, so once again, a little research could be extremely helpful.

References

1 Gibson, G.R., Rouzaud, Dr.G., Brostoff, Prof.J.,Rayment, Dr.N. “An evaluation of probiotic effects in the human gut: microbial aspects.” Publication date unknown; visited July 22, 2008: http://www.food.gov.uk/news/archive/2005/mar/probiotics

2 Gursche, Siegfried MH., Rona, Zoltan, MD.MSc. Encyclopedia of Natural Healing, second edition. British-Columbia: Alive Publishing Group Inc., 1997, page 220.

3 Weiss, Decker, NMD, AACVPR. “Effective Probiotics for Digestive Health.” Ask the Doctor date of publication unknown,

4 Weiss, Decker, NMD, AACVPR. “Gastric Stable Acidophilus.” Ask the Doctor date of publication unknown

5 Murray, Micheal, Dr. “InnerSync- The Ultimate Probiotic” Natural Factors, Continuing Education Series Publication date unknown; 4 (7)

6 Wison, J. B. Pharm.”What Shape Are You In?” Simply Vital 2008; visited July 17 2008: http://simplyvital.com/story.php?NewsID=25&TypeID=1&PHPSESSID=348db3c7e

7 Urbanska AM, Bhathena J, Prakash S. “Live encapsulated Lactobacillus acidophilus cells in yogurt for therapeutic oral delivery: preparation and in vitro analysis of alginate-chitosan microcapsules.” Pub Med 2007; visited July 22, 2008; http://www.ncbi.nlm.nih.gov/pubmed/18066134?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

8 Wawrezinieck A, Péan JM, Wüthrich P, Benoit JP. “Oral bioavailability and drug/carrier particulate systems.” Pub Med 2008; visited July 22, 2008; http://www.ncbi.nlm.nih.gov/pubmed/18601886?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

9 Author Unknown. “Probiotics, dead or alive, can relieve gut disease” Nutra Ingredients 2004; visited July21, 2008; http://www.nutraingredients.com/news/ng.asp?n=49552-probiotics-dead-or

10 Porubcan, Randolph, S. MSc. “Probiotics- Busting the Myths.” Probiotic Myths 2008; visited July 21, 2008; http://probioticmyths.com/

11 Author unknown. “Bacterial Count Discussion Endorsing A Five-Year, Natural Temperature Fermentation Japanese Probiotic Product.” Omx2u.com publication date unknown; visited July 21, 2008; http://www.omx2u.com/articles/baccount.asp

12 Johnson, Shirley. “Results Of Review Of Probiotic Research.” Medical News Today 2007; visited July18, 2008; http://www.medicalnewstoday.com/articles/85642.php

13 Author unknown. “Probiotic.” Wikipedia  publication date unknown; visited July 12, 2008; http://en.wikipedia.org/wiki/Probiotics

14 Author unknown. “Researchers Show Beneficial Role of Bacterial DNA
In Fighting Inflammatory Bowel Disease.” UCSD School of Medicine News, Health Sciences Communications 2002; visited July 22, 2008; http://health.ucsd.edu/news/2002/04_29_Raz.html
15 Adams, Mike. “Probiotics Work Even When They’re No Longer Alive.” Natural News.com 2004; visited July 22, 2008; http://www.naturalnews.com/000888.html
16 Author unknown. “Comparing Candida Products, The History of Candida Remedies.” Candida Support publication date unknown; visited July 20, 2008; http://www.candidasupport.org/RESOURCES/comparing-candida-products/?gclid=CPWsqubxx5QCFRYcagodjFmvlg
17 Author unknown. “Polyacrylamide.” Wikipedia publication date unknown; visited July 22, 2008; http://en.wikipedia.org/wiki/Polyacrylamide