# probiotics, how much woo? **URL:** \ **Category:** Factual Questions\ **Created:** [December 2, 2013, 12:44am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252 "2013-12-02T00:44:46Z")\ **Posts on this page:** 20\ **Page:** 2
**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:** [December 2, 2013, 9:01pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/21 "2013-12-02T21:01:43Z")
> [@Really\_Not\_All\_That\_Bright](#): > > I was given a script for probiotics by an immunologist (I’m heavily allergic to various molds). She seemed like a sensible physician otherwise, but it even sounded like woo when she explained it. So, I have no food allergies, but you want to modify my gut flora to deal with… asthma? > [@lazybratsche](#): > > It’s not entirely crazy, but on the other hand there is not any solid clinical evidence that probiotics will treat your asthma. … Giving an adult probiotics is probably not going to do anything. Perhaps giving infants a very specific probiotic will prevent asthma. But we don’t know that yet, so we have to wait a decade or two for the basic and clinical science to give us an answer. Well said. The concept is very well established now that gut flora has tremendous impact on allergy, autoimmune disorders, metabolism, appetite, nutrient extraction, and more. Understanding the exact how and when of it, the interactions between our genetics, our microbiomes, our diets, and other aspects of our enironments … not so well understood. The broad brushstroke is that a diverse gut microbiome is likely better and that our Western microbiomes are less diverse than those of a wide variety of other cultures. Our low fiber diet is a factor. Excessive antibiotic exposure is a factor. Which germs get passed along to us from our parents is a factor. So on and on. We evolved over many many years to coexist with our microbiomes as one superorganism and we have changed them fairly dramatically. They have significant function. But the belief that throwing a relative drop of some few bacteria that someone has guessed are “healthy” into the well established huge ecosytem of your adult gut is going to do much for asthma or anything (short of a few specific circumstances, as mentioned) is currently not supported by any solid evidence. Actually[this NYT Magazine Michael Pollan article](http://www.equilibreacupuncture.co.uk/wp-content/uploads/2012/09/Say-Hello-to-the-100-Trillion-Bacteria-That-Make-Up-Your-Microbiome-NYTimes.com_.pdf) gives a pretty good review. > [@Ulfreida](#): > > The lady who prompted my OP was of the belief that the common lack of the proper intestinal flora had been decisively linked to autism and learning disorders. There are few researchers suggesting that there may _potentially_ be some link in a few cases. It is way speculative stuff right now based exclusively on the increased incidence of GI difficulties in some labeled with autism and conflicting studies that children with autism (who often have self-imposed highly restrictive diets) [do](http://www.ncbi.nlm.nih.gov/pubmed/20603222) or [do not](http://www.ncbi.nlm.nih.gov/pubmed/22997101) have microbiota differences than their neurotypical siblings. A long long long way from “decisively linked.” ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 2, 2013, 10:20pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/22 "2013-12-02T22:20:05Z")
Probiotics aren’t ‘woo” at all, but their \*direct \*benefits are primarily limited to the gut. Thus, they are not a cure-all, but very helpful in a wide variety of gut related issues, including diarrhea, constipation, irritable bowel, mouth sores, and many more. And, more or less, they are harmless. So, “why not?” may be the idea when treating conditions outside the gut. Autism? :dubious: I have real doubts- but why not? ---
**Author:** ![Ulfreida](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ulfreida/32/8014_2.png) [@Ulfreida](https://boards.straightdope.com/u/Ulfreida)\ **Post date:** [December 2, 2013, 10:25pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/23 "2013-12-02T22:25:00Z")
Well, I’m taking 'em, because my guts are always giving me trouble. I just use what I buy for the goats, though. My husband did a bit of research and said there is almost a 100% match between this brand and human-marketed brands, in terms of organisms. Much cheaper too. ---
**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:** [December 2, 2013, 10:43pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/24 "2013-12-02T22:43:44Z")
> [@Ulfreida](#): > > I just use what I buy for the goats, though. As a medical authority, I just want to say “Bah!” 😉 ---
**Author:** ![Ulfreida](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ulfreida/32/8014_2.png) [@Ulfreida](https://boards.straightdope.com/u/Ulfreida)\ **Post date:** [December 2, 2013, 10:46pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/25 "2013-12-02T22:46:46Z")
> [@Qadgop\_the\_Mercotan](#): > > As a medical authority, I just want to say “Bah!” 😉 On the jar there are dosages for pigs, calves, dogs, cats. No goats or humans. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [December 3, 2013, 1:12am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/26 "2013-12-03T01:12:58Z")
> [@DrDeth](#): > > I have real doubts- but why not? [Yeah, what’s the harm?](http://whatstheharm.net) ---
**Author:** ![Ulfreida](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ulfreida/32/8014_2.png) [@Ulfreida](https://boards.straightdope.com/u/Ulfreida)\ **Post date:** [December 3, 2013, 2:27am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/27 "2013-12-03T02:27:37Z")
> [@kayaker](#): > > [Yeah, what’s the harm?](http://whatstheharm.net) My guess is that the main way probiotics could be harmful is if someone substituted probiotics for an actual medical workup and diagnosis of a serious condition. One fertile ground for woo is the undeniable fact that a lot of people have conditions that western medicine can do little for. Or even diagnose. Take for example me: from the time I got a urinary tract infection at age 23 from a poorly maintained semi-public hot tub, until my pregnancy at age 34, I suffered from chronic bladder infections which eventually could not even be cultured, for which there appeared to be zero effective treatment. I went to Stanford, where the urologist told me I had a psychological disorder. Once I got pregnant I never had another one. Why? No one the hell knows. When you are suffering like I did, and get answers like that, woo becomes more attractive, I mean, why not try ear smoke or eye of newt or whatever? Beats being told you’re crazy (I was not any crazier than I am now). ---
**Author:** ![MsBatt](https://avatars.discourse-cdn.com/v4/letter/m/c68b51/32.png) [@MsBatt](https://boards.straightdope.com/u/MsBatt)\ **Post date:** [December 3, 2013, 2:37am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/28 "2013-12-03T02:37:40Z")
I know a lot of people who’ve had weight-loss surgery who swear by probiotics. Keep in mind that the most popular form of weight-loss surgery shortens the small intestine, which seems to promote overgrowth of harmful bacteria. Those who swear by probiotics say they reduce their excessive gas and/or diarrhea, and make the smell of their gas and feces less unpleasant. ---
**Author:** ![amorali](https://avatars.discourse-cdn.com/v4/letter/a/3e96dc/32.png) [@amorali](https://boards.straightdope.com/u/amorali)\ **Post date:** [December 3, 2013, 2:45am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/29 "2013-12-03T02:45:46Z")
I have to say I’ve been extremely sick to my stomach for weeks and finally got live probiotic powder. I was cured that day. However there have been times I’ve taken them and had rapid heart beat. It’s one of the side effects. I think part of the problem with determining the efficacy is that every strain does different things. Apparently. Could be one person needs one strain, another needs something else. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 3, 2013, 3:02am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/30 "2013-12-03T03:02:05Z")
> [@kayaker](#): > > [Yeah, what’s the harm?](http://whatstheharm.net) Yeah, probiotics aren;t on that list. And, in the dozens and dozens of peer reviewed studies I have read (many of which I have linked to in earlier threads) there was exactly zero _significant_ side effects. In fact Probiotics are often used to _prevent_ side effects of certain drugs and therapies. \http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)04259-8/fulltext [ink.springer.com/chapter/10.1007/978-94-011-2364-8\_7](http://ink.springer.com/chapter/10.1007/978-94-011-2364-8_7) > **[Basic aspects and pharmacology of probiotics: an overview of...](https://www.sciencedirect.com/science/article/abs/pii/S1521691803000556)** > > Probiotics have been defined as non-pathogenic micro-organisms that, when ingested, exert a positive influence on host health or physiology. Their pha… [http://www.karger.com/Article/Abstract/51865](http://www.karger.com/Article/Abstract/51865) \*administration of probiotics may be useful for preventing or lowering the occurrence of antibiotic-associated side effects \* Please don’t talk about things of which you have no knowledge. Yes, there’s lot of “woo” out there, Probiotics, altho not fully understood as to the benefits- is not “woo”. They are proven effective medicine. ---
**Author:** ![Ulfreida](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ulfreida/32/8014_2.png) [@Ulfreida](https://boards.straightdope.com/u/Ulfreida)\ **Post date:** [December 3, 2013, 3:43am UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/31 "2013-12-03T03:43:01Z")
This has so far been a very interesting and useful discussion. Thank you to all. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [December 3, 2013, 12:23pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/32 "2013-12-03T12:23:17Z")
> [@DrDeth](#): > > Please don’t talk about things of which you have no knowledge. Yes, there’s lot of “woo” out there, Probiotics, altho not fully understood as to the benefits- is not “woo”. They are proven effective medicine. > [@DrDeth](#): > > Autism? :dubious: I have real doubts- but why not? Rightbackatcha.:rolleyes: ---
**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:** [December 3, 2013, 12:23pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/33 "2013-12-03T12:23:57Z")
> [@DrDeth](#): > > … - is not “woo”. They are proven effective medicine. You do understand that the two are not mutually exclusive? Something can have some real effects and yet have claims made that are well beyond those documented benefits; be proven effective medicine for certain indications and woo for others. It is the jump from the research regarding the roles that our microbiomes play and the well documented (and usually quite modest) benefits of probiotics in certain specific circumstances, to the cure-all claims that is woo. Most of the claims made are those cure-all ones, not the modest benefits in specific circumstances. For example it is well established that certain probiotics can reduce the frequency of antibiotic associated diarrhea (AAD). Not so well appreciated that the degree of the effect is such [that](http://www.sciencedirect.com/science/article/pii/S0022347606003830) > [@](#): > > For every 7 patients that would develop diarrhea while being treated with antibiotics, one fewer will develop AAD if also receiving probiotics. Also pretty damn safe is one thing, “exactly zero” [is another](http://www.medscape.com/viewarticle/719654_12). Plus they are not usually cheap. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [December 3, 2013, 1:53pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/34 "2013-12-03T13:53:46Z")
As regards bladder infections (mentioned earlier), there’s some evidence that taking pills containing lactobacillus is [almost as good as antibiotics](http://archinte.jamanetwork.com/article.aspx?articleid=1151418) in preventing recurrent infections (a plus is not encouraging organisms to develop antibiotic resistance). I’d agree with **DSeid** that limited and promising applications of probiotics are swamped in the public view by wide-ranging and undocumented claims for products that have never undergone real clinical scrutiny. And I wonder why anyone would need probiotics to “replenish gut flora” after a bout of norovirus, which shouldn’t be treated with antibiotics (at least by docs who know what they’re doing). ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 3, 2013, 4:24pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/35 "2013-12-03T16:24:20Z")
> [@DSeid](#): > > Also pretty damn safe is one thing, “exactly zero” [is another](http://www.medscape.com/viewarticle/719654_12). Plus they are not usually cheap. Nice cite :dubious: but \*"Not a member? Sign up for a free account. Medscape is the leading destination most trusted by healthcare professionals for medical information."\* is not very helpful. ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 3, 2013, 4:26pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/36 "2013-12-03T16:26:11Z")
> [@Jackmannii](#): > > And I wonder why anyone would need probiotics to “replenish gut flora” after a bout of norovirus, which shouldn’t be treated with antibiotics (at least by docs who know what they’re doing). Yes, \*shouldn’t \*be treated with antibiotics which is not the same at all as _never be treated with antibiotics_. Many dudes self-medicate with antibiotics. ---
**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:** [December 3, 2013, 4:48pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/37 "2013-12-03T16:48:21Z")
> [@Jackmannii](#): > > … And I wonder why anyone would need probiotics to “replenish gut flora” after a bout of norovirus, which shouldn’t be treated with antibiotics (at least by docs who know what they’re doing). My WAG is that norovirus pretty much flushes out your entire plumbing via the “violent diarrhea” method. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [December 3, 2013, 5:15pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/38 "2013-12-03T17:15:37Z")
I’d like to see actual evidence that any major bout of diarrhea vanquishes your normal flora, requiring probiotic therapy, or that any such therapy is capable of doing the trick. ---
**Author:** ![Ulfreida](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ulfreida/32/8014_2.png) [@Ulfreida](https://boards.straightdope.com/u/Ulfreida)\ **Post date:** [December 3, 2013, 5:45pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/39 "2013-12-03T17:45:58Z")
> [@DSeid](#): > > … Plus they are not usually cheap. Obviously you don’t buy your probiotics at the feedstore like me. ---
**Author:** ![Deegeea](https://avatars.discourse-cdn.com/v4/letter/d/e9bcb4/32.png) [@Deegeea](https://boards.straightdope.com/u/Deegeea)\ **Post date:** [December 3, 2013, 6:49pm UTC](https://boards.straightdope.com/t/probiotics-how-much-woo/675252/40 "2013-12-03T18:49:27Z")
This link has a good summary, especially in the “What the Science Says” section: [http://nccam.nih.gov/health/probiotics/introduction.htm](http://nccam.nih.gov/health/probiotics/introduction.htm) “Based on a review of selected studies, the authors classified several applications according to the strength of evidence supporting the efficacy of probiotics in prevention and/or treatment. For example, the authors concluded that strong evidence exists for acute diarrhea and antibiotic-associated diarrhea, and substantial evidence exists for atopic eczema (a skin condition most commonly seen in infants). Promising applications include childhood respiratory infections, tooth decay, nasal pathogens (bacteria harbored in the nose), gastroenteritis relapses caused by Clostridium difficile bacteria after antibiotic therapy, and inflammatory bowel disease.” [Previous page](https://boards.straightdope.com/t/probiotics-how-much-woo/675252.md?page=1) [Next page](https://boards.straightdope.com/t/probiotics-how-much-woo/675252.md?page=3)