March 2019

Are probiotics safe for everyone?

Probiotics are very popular. They are used to treat and prevent a wide-range of conditions for patients of all ages. But there is a surprising void in current probiotics research: safety data.

Recent research has brought to light just how much we DON’T know about probiotic safety. Despite the common belief that probiotics are generally safe, a recent study shows that of 384 trials conducted in healthy people, 98% of them did not adequately report safety data, including serious adverse events. While this does NOT mean that probiotics are UNSAFE, it does mean that we still have a lot to learn.

According to the American Gastroenterological Association, “probiotics should not be used indiscriminately.” Given the underreporting of safety data, we don’t know what their long-term consequences might be. For immunocompromised patients or those with a chronic disease, potential risks should be weighed against any benefits before using. Emerging research also indicates that people respond to certain strains of probiotics very differently. Responses could vary for a variety of reasons, including genetics and diet. But at this time, it’s hard to say which strain will be most beneficial for each individual and when they are most appropriate to use. In addition, probiotics might not benefit certain conditions as much as previously thought. New evidence suggests that probiotics aren’t beneficial for treating acute diarrhea and vomiting, conflicting with some current guidelines.

Probiotic products are sold as foods or dietary supplements and often contain more than one bacteria strain. At this time, there are no third-party evaluation programs that verify the quality of probiotic supplements. Although the USP has announced that they are aiming to add a USP verification for certain probiotic strains in 2019, this hasn’t been rolled out yet.

Before using probiotics, we recommend carefully weighing the possible benefits against the potential risks. While many probiotics are probably safe for most healthy people, risk of side effects might outweigh any benefit for patients with certain conditions. To see which conditions put patients at risk for serious adverse effects with probiotics, review the Interactions with Diseases sections of our Lactobacillus, Bifidobacteria, and Saccharomyces boulardii monographs.

The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2024 NatMed. Commercial distribution or reproduction prohibited. NatMed is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.