Thanks for the question, Sherry. It is always nice to hear from a Savannah reader via the “AskDrKarp” Facebook page. I would say this; most of the time, taking oral probiotics is “ahead of the science.” Now, that phrase is a “buzz phrase,” used quite a bit in dietary supplement advertising. On the surface, it does seem like a good thing. However, there is quite a difference between being at the “cutting edge” of science and being “ahead of the science.”

    First of all, exactly what is a probiotic? A probiotic is a substance, most commonly a dietary supplement, which contains “good” bacteria identical or similar to bacteria which are normally found in the body. Eating these oral probiotics is advertised as having beneficial effects on digestion and absorption, on a person’s immunity, as well as having other health benefits. Reviewing all the science, right now, the only three conditions for which probiotics have been shown to have some limited beneficial effects are acute diarrhea, diarrhea caused by extended use of oral antibiotics, and a skin condition, usually seen in infants, called ectopic dermatitis. That’s about it.

    Now, that’s not to say that there aren’t a lot of good studies published carefully examining other uses of probiotics. However, you cannot “pick and choose” this study or that, to support a pre-determined bias or “hope.” Individual studies are the "trees" of knowledge; to understand what is really going on, you need to climb to the top of the trees and look at the "forest" of data. The probiotic “data forest” right now does support recommending probiotics for any other conditions, except those three already mentioned. Any other recommendation, at this point, is “wishful thinking.”

    You are probably surprised by this because of wide variety of foods that are presently being enriched with probiotics and marketed and advertised as being beneficial. Yogurts with added probiotics and oral probiotic pills are good examples of products claiming all sorts of health benefits. How can this be, you wonder, if the data are not there to support the claims? It is because probiotics are sold as dietary supplements. Dietary supplements are a group of substances, governed by the “Dietary Supplement Health and Education Act of 1994 (DSHEA). Dietary supplements are classified neither as a food nor as a drug. This means that they do not fall under the jurisdiction of either the USDA or the FDA.

    This also means that the safety and proof of health benefits lies on the shoulder of the manufacturer of the product. The only time the FDA can step in is if the product has been shown to be unsafe AFTER it is sold. Does this bring to mind the expression, “putting the fox in charge of the hen house?” It should. So, you need to understand that dietary supplements are governed by political and economic concerns, rather than science. These products are not scientifically-validated and proven products. My experience has been that most people are not aware this because they find it unbelievable that a “health” product would be marketed without conclusive proof that it is effective. It may answer the question about why a dietary supplement must carry the labeling message, "This product has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease." In other words, there is no good evidence that it can do what it claims.

    I always keep up-to-date on dietary supplements to see which of them evolve from being untested remedies to true, scientifically studied and verified approaches to disease prevention and management. At this point, looking at ALL the data, the unavoidable conclusion is that the use of probiotics in otherwise normal healthy adults does not lead to any type of increased health benefits. The phrase most used in the conclusions of scientific studies is "promising but unproven." So, I hope this information is useful to you. What is the “no-nonsense” nutrition advice for today? Simply this; don’t put anything in your body that is “ahead of the science.” 

by Dr. Warren Karp  - "No-Nonsense Nutrition Advice"