# (If you don't have diarrhea, lactose intolerance, or colon cancer) Are "probiotics" useful? **URL:** \ **Category:** Factual Questions\ **Created:** [May 15, 2012, 4:21pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000 "2012-05-15T16:21:59Z")\ **Posts on this page:** 15\ **Page:** 1
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 15, 2012, 4:21pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/1 "2012-05-15T16:21:59Z")
I see certain yogurt offerings (Whole Foods seems to have a real interest in these) with “probiotic” bacteria added. Assuming you don’t have some medical malady, is there any value in this? ---
**Author:** ![purplehorseshoe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/purplehorseshoe/32/2996_2.png) [@purplehorseshoe](https://boards.straightdope.com/u/purplehorseshoe)\ **Post date:** [May 15, 2012, 4:30pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/2 "2012-05-15T16:30:10Z")
I file 'em under “can’t hurt, might help” much as I do my occasional multi-vitamins. ---
**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\ **Post date:** [May 15, 2012, 4:35pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/3 "2012-05-15T16:35:13Z")
The human microbiome is a hot and sexy research topic, currently, because technology had just gotten to the point that it’s possible to explore it. So the answer is maybe we’ll know later. ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [May 15, 2012, 4:47pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/4 "2012-05-15T16:47:48Z")
My philosophy: If there’s no clear-cut need to change your current GI flora, why do it? Now, if you know of a strain of bacteria that will happily live in the human gut and regularly excrete opioids or nicotine or benzos or alcohol as a part of their metabolism, I suggest there’ll be a market for such a product. But wise folks would avoid such. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [May 15, 2012, 5:05pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/5 "2012-05-15T17:05:25Z")
> [@purplehorseshoe](#): > > I file 'em under “can’t hurt, might help” much as I do my occasional multi-vitamins. But it could hurt, at least as far as my non-medical eye can see. ---
**Author:** ![Surreal](https://avatars.discourse-cdn.com/v4/letter/s/eada6e/32.png) [@Surreal](https://boards.straightdope.com/u/Surreal)\ **Post date:** [May 15, 2012, 5:50pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/6 "2012-05-15T17:50:01Z")
> [@Qadgop\_the\_Mercotan](#): > > My philosophy: If there’s no clear-cut need to change your current GI flora, why do it? Probiotics, even powerful ones like VSL#3, do not appear to change gut flora: > **[Gut microbiota is not modified by Randomized, Double-blind,...](https://pubmed.ncbi.nlm.nih.gov/22247743/)** > > Irritable Bowel Syndrome (IBS) is a common condition that negatively impacts the quality of life for many individuals. The exact etiology of this disorder is largely unknown; however, emerging studies suggest that the gut microbiota is a contributing... ---
**Author:** ![Happy\_Fun\_Ball](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_fun_ball/32/17664_2.png) [@Happy\_Fun\_Ball](https://boards.straightdope.com/u/Happy_Fun_Ball)\ **Post date:** [May 15, 2012, 6:45pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/7 "2012-05-15T18:45:00Z")
Not really, no, at least according to my reading though I am not a MD. What I have found is that it is a good thing to restore the gut flora after taking antibiotics; there can be some serious side effects to killing off different symbiotic bacteria in the gut. For instance, there was a woman up in Minnesota if I recall correctly that had a life threatening infection that was cured by getting a fecal transfusion (transpoosion) from her husband. There has also been research that shows that many of our immune disorders may be linked to an out of balance gut ecology. Thus the recent increase in diseases like asthma, ulcerative colitis, and chronic eczema in western countries may actually be due to our use of antibiotics. But I have also read that probiotics don’t really have much in them when compared to a healthy intestinal ecology and are not really helpful in restoring a balance. It’s an interesting field of study, and I almost wish I could go back to school to become an MD. Modern medicine is right on the edge of making huge strides in this area (understanding symbiotic/parasitic bacteria and viruses) which I predict will be even more groundbreaking that our understanding of genetics. ---
**Author:** ![dropzone](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dropzone/32/7515_2.png) [@dropzone](https://boards.straightdope.com/u/dropzone)\ **Post date:** [May 15, 2012, 9:35pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/8 "2012-05-15T21:35:04Z")
> [@Qadgop\_the\_Mercotan](#): > > Now, if you know of a strain of bacteria that will happily live in the human gut and regularly excrete opioids or nicotine or benzos or alcohol as a part of their metabolism, I suggest there’ll be a market for such a product. But wise folks would avoid such. Wise, schmise! It would be a food supplement so it would be legal long enough to buy me a place in Antigua. How do you do that gene splicing again? ---
**Author:** ![Greg\_Charles](https://avatars.discourse-cdn.com/v4/letter/g/839c29/32.png) [@Greg\_Charles](https://boards.straightdope.com/u/Greg_Charles)\ **Post date:** [May 15, 2012, 10:35pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/9 "2012-05-15T22:35:52Z")
I was listening to _The Naked Scientist_ podcast, and they were asking a Scottish biologist this very question. Her fascinatingly accented response ran along the lines that any probiotics you’d get from food would be so small compared to the normal level you have already in your “goot” that they really wouldn’t make any difference. However, she thought they could be useful after medical procedures that greatly reduced your natural bacteria … ones that required big doses of antibiotics I guess. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [May 16, 2012, 12:10am UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/10 "2012-05-16T00:10:44Z")
> [@Surreal](#): > > Probiotics, even powerful ones like VSL#3, do not appear to change gut flora: > > [Gut microbiota is not modified by Randomized, Double-blind, Placebo-controlled Trial of VSL#3 in Diarrhea-predominant Irritable Bowel Syndrome - PubMed](http://www.ncbi.nlm.nih.gov/pubmed/22247743) Not all the studies say that. [http://www.isapp.net/docs/asiaprasadabst.pdf](http://www.isapp.net/docs/asiaprasadabst.pdf) > **[Bacterial and fungal microbiota in relation to probiotic therapy (VSL#3) in...](https://pubmed.ncbi.nlm.nih.gov/16401690/)** > > Probiotic therapy with VSL#3 increases the total number of intestinal bacterial cells as well as the richness and diversity of the bacterial microbiota, especially the anaerobic flora. The diversity of the fungal flora is repressed. Restoration of... > **[Impact on the composition of the faecal flora by a new probiotic preparation:...](https://pubmed.ncbi.nlm.nih.gov/10468688/)** > > These results show that this probiotic preparation is able to colonize the intestine, and suggest that it may be useful in maintaining the remission in ulcerative colitis patients intolerant or allergic to 5-ASA. Controlled trials are warranted to... ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [May 16, 2012, 12:04pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/11 "2012-05-16T12:04:53Z")
At least eating active culture fermented dairy does appear to have [some benefits](http://www.springerlink.com/content/g141j6476328t264/), although I don’t see how that translates into added “probiotic” cultures should make a difference. The impression I am getting from what I’ve read is that our gut microbiomes tend to fall into patterns (enterotypes) based less on what _bacteria_ we ingest than on what _foods_ we ingest over a long term. See [here](http://www.sciencemag.org/content/334/6052/105.abstract?sid=dca4e65b-178a-432b-bd8d-d43d6ce699ae) and [this perspective on the study](http://www.sciencemag.org/content/334/6052/45.summary) (preview linked, quote from beyond wall). > [@](#): > > There is a multimillion-dollar industry based on the concept that introducing beneficial bacteria into the human intestines will improve our health. The trillions of symbionts in the large intestine profoundly affect our metabolism and immunity. Accordingly, abnormal bacterial communities have been identified in several human diseases such as inflammatory bowel diseases (1–3), colon cancer (4, 5), irritable bowel syndrome (6), and nonalcoholic fatty liver disease (7). The composition of microbial communities is generally stable within each individual. Past studies of the gut microbiota emphasized the huge impact of nutrition (8), which is likely to outweigh that of the host genotype (9). On page 105 of this issue. Wu et al. (10) further explore how dietary factors can influence the profile and stability of intestinal microbes. … They found that higher fat intake and lower fiber intake are associated with particular bacterial groups. Intriguingly, enterotypes appeared to be determined by long-term diet: The Bacteroides enterotype was positively associated with animal protein and saturated fats, whereas the Prevotella enterotype was associated with a predominantly plant-based nutrition with high carbohydrates and low meat and dairy consumption … enterotypes appear to reflect long-term nutritional habits, and altering them may require a more prolonged dietary intervention, unless it is preceded by antibiotic treatment, which is usually undesirable. Is the goal of switching enterotypes really desirable, even if one enterotype should be shown to correlate with increased disease risk? Establishing causation from microbiota-disease associations is difficult. Moreover, bacteria to which health benefits have been attributed, such as Faecalibacterium prausnitzii (14), have not been associated with a particular enterotype. Thus, although the enterotypes represent a useful framework for the study of the gut microbiota, the clinical value of knowing one’s enterotype remains to be determined. … ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [May 16, 2012, 12:16pm UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/12 "2012-05-16T12:16:45Z")
> [@Surreal](#): > > Probiotics, even powerful ones like VSL#3, do not appear to change gut flora …in Diarrhea-predominant Irritable Bowel Syndrome. Which is not most of us. I haven’t found them to be much use unless, as it states in **DSeid** ’s quote, “it is preceded by antibiotic treatment.” IOW, need to take antibiotics? It’s probably worth eating some extra yogurt. Even if it doesn’t “restore gut flora”, it’s cheap, it’s fairly healthy, and it gives that patient something to do to feel like she’s able to have a positive impact on her health. (But this is nurse thinking, not doctor thinking.) Not on antibiotics and everything’s hunky-dory south of the border? Eat yogurt if you like it, but don’t stress it if you don’t. I think the jury is still out and studies too conflicting to take a stronger stand on either side of the issue, or to routinely recommend the more expensive probiotic formulations. Time will tell. ---
**Author:** ![urban1a](https://avatars.discourse-cdn.com/v4/letter/u/e47c2d/32.png) [@urban1a](https://boards.straightdope.com/u/urban1a)\ **Post date:** [May 17, 2012, 2:27am UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/13 "2012-05-17T02:27:12Z")
A timely post for me. I had been going to ask my doctor whether the hype was of any consequence but this post answered the question for me. I’ve always been suspicious of health claims anyway and I have never even eaten yoghurt (despite the 'good for you ’ claims), but then I don’t drink sour milk either, which is all yoghurt is. Adding a few more bacteria, and claiming benefit to your GI system, only increases sales. Other things to be suspicious of - colon cleansing, body detoxification (through the soles of your feet). Bob ---
**Author:** ![ZenBeam](https://avatars.discourse-cdn.com/v4/letter/z/3ab097/32.png) [@ZenBeam](https://boards.straightdope.com/u/ZenBeam)\ **Post date:** [May 17, 2012, 3:00am UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/14 "2012-05-17T03:00:38Z")
My wife has our kids use them (Danactive) so that they’ll be, shall we say, less gassy. Seems to help. That’s probably an “off label” use, though. 😉 ---
**Author:** ![Rampant\_Coypu](https://avatars.discourse-cdn.com/v4/letter/r/439d5e/32.png) [@Rampant\_Coypu](https://boards.straightdope.com/u/Rampant_Coypu)\ **Post date:** [May 17, 2012, 5:31am UTC](https://boards.straightdope.com/t/if-you-dont-have-diarrhea-lactose-intolerance-or-colon-cancer-are-probiotics-useful/622000/15 "2012-05-17T05:31:06Z")
Seems to me that if your intestinal flora are in pretty good balance, introduced probiotics are just going to get out competed by your personally evolved intestinal bacteria. How can something from the outside compete with bacteria that have evolved in your intestines for millions of generations? One thing the OP didn’t mention is disruption of intestinal fauna by antibiotics. I was a professional rodent breeder for a few years and found that probiotics really helped when I had to use antibiotics. But I now think using antibiotics to treat wet tail in hamsters is mostly useless. I did some work with a vet that convinced me most wet tail is caused by parasites. Quinine and metronidazole are better than Clavamox and tetracycline. I would not recommend giving an antibiotic to a hamster, but if you do, give probiotics also. And yes, you can still get fairly pure quinine if you know where to look. I think the only time most humans could benefit from probiotics is when intestinal fauna are disrupted by antibiotics. But don’t mess around with probiotics marketed toward humans, go for the hardcore stuff in pet supply stores. Not the stuff in the dog department, go for the small animals dept. The two major chains can special order you a jar of this stuff. Your vet can probably get it too if they treat rodents. If a rodent needs a sprinkle, you need a spoonful.