Bacteria are often associated with diseases. Probiotics are special live, beneficial microorganisms that can be ingested and that promote our health. But when does it make sense to use probiotics? And what do you need to know when taking them? Let us throw some light on the matter.
Probiotics are living microorganisms that can have a positive effect on our health if they enter our intestines in sufficient quantities. The International Scientific Association for Probiotics and Prebiotics (ISAPP) has also defined additional criteria for probiotics:
Microorganisms most commonly used as probiotics are lactic acid bacteria, but yeasts and other species can also be used for this purpose.
In addition to probiotics, so-called prebiotics also have a beneficial effect on the composition of the intestinal flora and thus on intestinal health. Unlike probiotics, however, they are not microorganisms, but rather non-digestible components of life (usually carbohydrates, e.g. fibres such as inulin, oligofoructose), which represent a selective nutritional basis for useful intestinal bacteria and thus promote their growth and activity. Many vegetables naturally contain prebiotics, including:
A synbiotic provides a combination of probiotics and prebiotics. Both substrates work together to promote intestinal health, so that the most effective result can be achieved.
More than 100 years ago, the Russian doctor and Nobel prize winner Ilja Iljitsch Metschnikow (1845 – 1916) recognised the health-promoting effect of probiotics in the form of acidified dairy products.
However, in order for the healthy microbes to develop their positive effects, first of all they must reach their site of action, the intestine, actively and in adequate quantities. From there, they can start to work on our vitality. Health-promoting effects include, for example, restoring bowel balance by strengthening positive intestinal germs and displacing “bad” ones.
And it is not only locally that probiotics can make life difficult for pathogens. As training buddies for our defence cells, our entire immune system benefits from them. In addition, probiotics excrete specific metabolites that promote intestinal activity, digestion and nutrient absorption, in addition to strengthening our intestinal barrier. However, all of these effects – and even more (see also: therapeutic indications) – are well known: But it’s all about the right strain!
In recent decades, a lot of energy has been put into probiotic research. In this, the scientists have determined how different the effects of these special microbes actually are. Where one probiotic strain works wonders, the other is ineffective – and vice versa. Probiotics are therefore not all-rounders, working equally to cover all the scientifically documented areas of application ascribed to them. The choice of suitable probiotic strains is therefore literally a separate science.
As a rule, it takes at least 4-12 weeks for a probiotic to be beneficial. The actual duration is influenced by several factors. These include, for example:
If you would like to seek advice in your individual case, you are welcome to contact an experienced medical professional.
The two terms “intestinal rehabilitation” and “intestinal regeneration” are concepts that people who are interested in health come across time and again in the various media. This awakens the desire in many to balance their no. 1 feel-good organ, the bowel.
While doctors and therapists use different procedures, depending on their experience and training, highly concentrated probiotics with good bacteria should not be neglected when it comes to rehabilitating or strengthening the intestine.
In addition to probiotics, which contain specially cultivated strains, foods that are fermented during their production (that is, made stable by lactic acid fermentation) also supply probiotic microorganisms.
Such probiotic foods include, for example:
Probiotic supplements contain highly concentrated and clearly defined strains of bacteria that can have a special positive effect on our health. Experts should be consulted if you would like to achieve a specific benefit in the course of taking probiotics (e.g. strengthening the intestines, supporting the immune system). Because probiotics are a separate science and not every strain covers every documented benefit for probiotics, multi-stem preparations that supply several scientifically documented strains are ideal.
There are many probiotics on the market. However, in terms of quality, the wheat can be separated from the chaff. The ideal probiotic should be highly concentrated and have a variety of viable strains according to the motto: "the more, the merrier", that support each other in their effect in these so-called multi-stem preparations. Premium manufacturers also use strains that have been proven to be beneficial in scientific studies for optimum efficacy.
In order to get as many probiotics as possible into the intestine, it is best to take them in the morning on an empty stomach (approx. 30 minutes before breakfast), alternatively, during the day at least 2 hours after the last and 30 minutes before the next meal. Taking them on an empty stomach with plenty of fluid (lukewarm water is ideal) accelerates the passage through the stomach, shortens the contact time with the stomach acid and thereby increases the survival rate of the probiotic microorganisms. When taking antibiotics concomitantly, a time interval of 2-3 hours between the medicinal product and the probiotic is recommended.
Probiotics should ideally be taken in the morning on an empty stomach. High-dose premium preparations can also be consumed during the day approx. 2 hours after the last meal and 30 minutes before the next meal.
Just as every person is individual, the ideal probiotic quantity varies from person to person. Those who do not want individual advice should best follow the manufacturer's recommendations – for quality manufacturers such as BIOGENA, these are based on the latest scientific findings.
Yes, probiotics can be taken on a permanent basis as a food supplement. Curative administration is also possible, for example with the aim of strengthening the intestinal flora after taking antibiotics.
More is not automatically always better. It is much more important to take the product regularly and to select a high-quality probiotic. It is best to follow the manufacturer’s or healthcare professional’s recommended use.
In rare cases, probiotics and/or prebiotics can lead to an “initial deterioration” (e.g. digestive problems or a deterioration of the skin), which is usually the case if the gut and the intestinal flora were in a particularly poor state before the start of use. However, this usually only lasts a few days. Users who have this experience can try taking the probiotic more gradually (e.g. initially only one capsule instead of the target dose of two capsules).
Antibiotics undoubtedly play a decisive role in the treatment of infections. However, their use can lead to serious changes in the human intestinal flora and subsequent symptoms based on this, which is logical, since the antibiotic cannot distinguish between good and bad bacteria. In order to nip this problem in the bud right from the start, the concomitant use of probiotics with antibiotics should be a mandatory programme in order to provide the bowel with beneficial intestinal bacteria. Correctly dosed probiotics stabilise the intestinal flora and make it more resistant to unwanted bacteria. The efficacy of probiotics in the prevention and treatment of antibiotic-associated diarrhoea has been proven in studies.
To prevent the weakening of the intestinal flora, probiotics can be taken during antibiotic therapy and this is actually to be recommended. There must be a time interval of 2-3 hours between taking the medication and the probiotics, otherwise the antibiotic will also eliminate the newly administered probiotics.
While occasional alcohol consumption is not usually a problem, excessive consumption can damage the bowel and its flora and make the bowel barrier permeable. By contrast, the targeted intake of probiotics can help to redress the situation with the intestine and its flora.
A healthy digestion is essential for our well-being. The targeted use of probiotics can not only strengthen the natural balance of the intestinal flora, it can also positively influence our gut activity. For example, certain strains can shorten the duration of diarrhoeal infections, others are useful for the prevention of antibiotic-related diarrhoea. However, they also offer support for the opposite problem, constipation. There are also special cultures for this (e.g. Lactobacillus acidophilus, L. plantarum, L. rhamosus) that have a stimulating effect on the intestinal activity.
A feeling of fullness, diarrhoea, constipation – irritable bowel has many faces. In addition to unpleasant digestive problems, abdominal pain, impaired intestinal flora, increased susceptibility to intestinal infections and greater permeability of the intestinal wall (leaky gut) can also occur. Studies now show that special strains of bacteria (e.g. Bifidobacterium breve, B. longum, B. lactis, L. rhamosus, L. paracasei, Streptococcus thermophilus) can alleviate the symptoms of irritable bowel syndrome. The German Society for Gastroenterology, Digestive and Metabolic Diseases (Deutsche Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselerkrankungen – DGVS) has now included the use of probiotics in their therapy guidelines.
If the natural intestinal barrier is impaired (= leaky gut), not only can local problems occur, but this can also have a far-reaching effect (e.g. inflammation) on the entire organism. It is therefore all the more important to bring the bowel and its barrier back into balance. Probiotics, such as Bifidobacterium longum, Lactobacillus acidophilus or L. helveticus, not only strengthen the "bulwark" of healthy bacteria in the intestine, they also produce substances that help our intestinal mucosa to regenerate.
Our entire gastrointestinal tract can benefit from special probiotic strains. If the stomach is suffering with the bacterium Helicobacter pylori, which can lead to inflammation of the gastric mucosa and increase the risk of gastric or small intestine ulcers, this is a particular case. PylopassTM is a special inactivated strain of Lactobacillus reuteri that has the ability to bind Helicobacter pylori to itself and excrete it via the digestive tract.
Like the intestine, the mouth is also colonised by a colourful community of microorganisms. But not all of us are blessed with favourable oral flora. In particular, bacteria that inhabit the indentations of the tongue can produce foul-smelling sulphur compounds when organic substances are broken down, which manifest as bad breath.
In addition, the care of the oral flora has a beneficial effect on the intestinal flora and vice versa – because the intestines and the mouth area are in constant dialogue with each other, exchanging both bacteria and microbes.
Increasing numbers of studies now indicate that taking certain strains of bacteria regularly can alleviate bad breath. In fact, a review showed that certain probiotic cultures such as Lactobacillus salivarius, L. reuteri, Streptococcus salivarius and Weissella cibaria can actually reduce the formation of bad breath by reducing the concentration of the "smelly" sulphur compounds – at least for a short time.
The fact that lifestyle, nutrition and genetic predisposition affect weight is nothing new. However, it is now known that the composition of the intestinal flora also has an influence on this. For example, an excess of so-called Firmicutes (“fattening bacteria”) in comparison to Bacteroides (“slimming bacteria”) ensures that we are better food converters. The former provide a more effective breakdown of complex carbohydrates, whereby more calories are ingested via the intestinal mucosa.
In addition to composition, however, there are also other characteristics in which "thick" and "thin" intestinal flora differ from each other. For example, people with weight problems often have less biodiversity than their leaner peers. Scientists sometimes blame our modern low fibre, high fat diet for the death of this species in the intestinal tract.
It is therefore all the more important to promote the growth of favourable bacteria. A plant-based diet with indigestible fibre (= prebiotics) and the probiotic support with several suitable strains (e.g. Lactobacillus gasseri, L. curvatum, L. casei, L. plantarum, L. rhamnosus, Bifidobacterium longum, B. adolescentis) is a step in the right direction.
If our bowels are out of sorts, our skin will also suffer. This is underpinned by studies that show that people with problem skin often have problems with their intestinal flora (e.g. too few lactobacilli and bifidobacteria) and intestinal barrier – problems that can be further exacerbated under stressful situations.
In addition to stress, drugs such as antibiotics or laxatives, and a nutrient-poor, unhealthy diet can endanger the biodiversity of the intestinal flora – something that ultimately also affects the microbially generated substance cocktail and the performance of the intestinal flora in the metabolisation of food and the detoxification process, and which is reflected in our skin through the networking described above.
If you are struggling with problem skin, you should not simply take care of your skin but also support your insides with a multi-strain preparation and a prebiotic diet.
Probiotics can not only help to alleviate allergic symptoms through their immune-regulating effect, their intake can also alleviate food intolerances by helping the intestinal tract irritated by intolerance and its intestinal flora to get back to normal.
In the case of histamine intolerance, some strains even have a histamine-lowering effect. These include strains such as Bifidobacterium longum, B. lactis, B. bifidum and B. infantis. Other bacterial cultures remain controversial as they may inhibit the breakdown of histamine. Histamine intolerance must always be considered individually. Accordingly, multi-strain preparations are tolerated differently by those with a histamine intolerance. Tolerability should therefore ideally be tested individually.
The regulating effect on the microbiome is an essential step in suppressing the bacteria that produce histamine in the long term and thus contributes to the reduction in the symptoms of histamine intolerance.
Many researchers now agree that our lives – our world of feelings and thoughts, our decisions and our health – are influenced even more strongly by the gut than we previously thought.
If our guts are in order, positive information enters the brain via the intestinal-brain axis and creates a good mood there. According to studies, it is thought that influencing the intestinal flora could also be beneficial for psychological symptoms. For example, a human study in 2022 showed that probiotics support the effect of antidepressants via the intestinal-brain axis and can thus contribute to the reducing the effects of depression. According to researchers, the microbial metabolic products that act on the nervous system are likely to be of influence here.
The gut is the root of our health. Not only does it provide us with energy and vital micronutrients through its digestive capacity, it also influences many processes throughout our body.
It is therefore all the more important for our vitality and well-being to support this central key organ with a gut-friendly plant-based diet, sufficient prebiotic foods and active intestinal bacteria. This way, any negative influences due to poor nutrition and stress can be compensated.
The intestinal flora interacts with our immune system. Useful intestinal bacteria not only fight off pathogens and pollutants, but also act as a "training camp" for our entire immune system. Here, our immune cells collect valuable "fighting" experience and also learn – especially in the first year of life – to distinguish between friend (the body's own or harmless antigens) and foe.
Good bacteria not only keep our gut fit, they can also arm our immune system. For example, studies show that the targeted intake of certain probiotics (e.g. Lactobacillus plantarum, L. paracasei ) can reduce the frequency of colds and the number of sick days. In addition, certain probiotics can also reduce the risk of fungal and bacterial infections of the vagina and urinary tract infections (e.g. L. rhamnosus and L. fermentum).
From childhood onwards, the gut plays a key role in health and wellbeing. Exaggerated hygiene, stress, antibiotics – and more – can, however, result in the feel-good organ getting upset in even the smallest of us.
It is therefore all the more important to keep the intestines and its inhabitants healthy during childhood in particular. While prebiotic foods (e.g. from flaxseed, psyllium, chicory, apples, citrus fruits) help to build up a healthy intestinal flora, the targeted use of special children's probiotics can further strengthen the intestinal flora if necessary (e.g. antibiotic therapy, digestive problems).
Many expectant mothers revel in their pregnancy. However, the associated physical and hormonal changes can unfortunately lead to unpleasant side effects such as flatulence or constipation. While a plant-based diet, regular exercise, plenty of fluids and sleep have a beneficial effect on digestion, multi-strain preparations can also make a difference to the mother’s gut feeling. Thus, their use promotes the maternal intestinal balance and colonisation with beneficial microorganisms – a measure that ultimately also benefits the baby (especially during vaginal delivery).
The maternal microbiome is also closely linked to that of the child during breastfeeding. For example, breast milk not only contains a large number of specific nutrients that allow desired microorganisms (especially bifidobacteria) to grow, in itself it also contains several hundreds of bacterial species (especially lactobacteria), which are transferred from the digestive tract into the mammary glands. This makes breast milk a true vital drink for the nursing child by promoting its intestinal flora, the maturation of its immune system and the overall health of the baby.
Women who use the contraceptive pill can also use probiotics.
The targeted use of probiotics can alleviate digestive problems such as flatulence, abdominal pain and irregular bowel movements, which occur more frequently during menopause.
In addition, the science of recent years has shown that there is a mutual interaction between the female hormone oestrogen and our intestinal flora (= the oestrogen-intestinal microbiome axis). If the intestinal flora is impaired, this can affect the level of circulating oestrogen and affect your libido, weight and mood, as well as encourage endometriosis or polycystic ovarian syndrome.
Travelling to faraway lands, discovering foreign cultures and unwinding – the dream holiday in the sun can quickly be spoiled by unpleasant digestive problems. 35 to 50% of all long-haul travellers are struck down by Montezuma’s revenge. What initially sounded like an adventure becomes anything but for those affected. The digestion reacts to unusual food, travel stress and pathogens in the food and drinking water with traveller’s diarrhoea. As a preventative measure, the rule of thumb "Cook it, peel it or forget it" therefore applies to long-distance travel in foreign climes. In addition, the intestinal flora should be strengthened with valuable intestinal bacteria even before travelling and also benefits from continuous support during the journey.
Conclusion: Probiotics are living microorganisms that enter our intestines in sufficient quantities and thus not only nourish our intestines and our gut flora, but can also have a positive effect on our entire organism. More and more studies now prove the power of these microbes – so why not use them specifically for our benefit? However, at the latest in the event of digestive problems or in the course of antibiotic therapy, probiotics should figure on the self-care plan.
Further reading:
Francavilla R et al: Lactobacillus reuteri Strain Combination In Helicobacter pylori Infection: A Randomized, Double-Blind, Placebo-Controlled Study. J Clin Gastroenterol. 2013 Nov 27. https://pubmed.ncbi.nlm.nih.gov/24296423/
Huang, N., et al. 2022. Efficacy of probiotics in the management of halitosis: a systematic review and meta-analysis. BMJ Open, 12(12), e060753. https://pubmed.ncbi.nlm.nih.gov/36600415/
Yoo, H. J., et al. 2020. Inhibitory effect of Streptococcus salivarius K12 and M18 on halitosis in vitro. Clin Exp Dent Res, 6(2), 207-214. https://pubmed.ncbi.nlm.nih.gov/32250565/
Sticherling M. 2020. Mit Probiotika lässt die Darm-Haut-Achse positiv beeinflussen. Kompass Autoimmun 2020;2:106-107. DOI: 10.1159/000509637.
Szántó M, Dózsa A, Antal D, et al.: Targeting the gut-skin axis – probiotics as new tools for skin disorder management? Experimental Dermatology. 2019; 28: 1210 – 1218. https://pubmed.ncbi.nlm.nih.gov/31386766/
Polkowska-Pruszyńska B, Gerkowicz A, Krasowska D, 2020. The gut microbiome alterations in allergic and inflammatory skin diseases - an update. J Eur Acad Dermatol Venereol. 2020 Mar;34(3):455-464 doi: 10.1111/jdv.15951. Epub 2019 Nov 19. https://pubmed.ncbi.nlm.nih.gov/31520544/
Schaub, A.-C. et al.2022. Clinical, gut microbial and neural effects of a probiotic add-on therapy in depressed patients: A randomized controlled trial Translational Psychiatry (2022), doi: 10.1038/s41398-022-01977-z. https://pubmed.ncbi.nlm.nih.gov/35654766/
Kim, J. Y. et al. 2010. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol Off Publ Eur Soc Pediatr Allergy Immunol. 21(2 Pt 2): e386-393. https://pubmed.ncbi.nlm.nih.gov/19840300/
Zhu, T. H. et al. 2018. Epithelial barrier dysfunctions in atopic dermatitis: a skin–gut–lung model linking microbiome alteration and immune dysregulation. Br J Dermatol. 179(3):570–581 https://pubmed.ncbi.nlm.nih.gov/29761483/
Nance, C. L. et al. 2020. The Role of the Microbiome in Food Allergy: A Review. Children. 7(6) https://pubmed.ncbi.nlm.nih.gov/32466620/
Cazzola, M. et al. 2010. Efficacy of a synbiotic supplementation in the prevention of common winter diseases in children: a randomized, doubleblind, placebo-controlled pilot study. Ther Adv Respir Dis. 4(5):271–278. https://pubmed.ncbi.nlm.nih.gov/20729255/
Hojsak, I. et al. 2010. Lactobacillus GG in the Prevention of Nosocomial Gastrointestinal and Respiratory Tract Infections. Pediatrics. 125(5):e1171–e1177. https://pubmed.ncbi.nlm.nih.gov/20403940/
Berggren, A. et al. 2011. Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr. 50(3):203–210. https://pubmed.ncbi.nlm.nih.gov/20803023/
Hoesl, C. E., Altwein, J. E. 2005. The Probiotic Approach: An Alternative Treatment Option in Urology. Eur Urol. 47(3):288–296. https://pubmed.ncbi.nlm.nih.gov/15716188/
Verstraelen, H., Senok, A. C. 2005. Vaginal lactobacilli, probiotics, and IVF. Reprod Biomed Online. 11(6):674–675. https://pubmed.ncbi.nlm.nih.gov/16417727/
Skrzydło-Radomańska, B. et al. 2021. The Effectiveness and Safety of MultiStrain Probiotic Preparation in Patients with Diarrhea-Predominant Irritable https://pubmed.ncbi.nlm.nih.gov/33652763/
Bowel Syndrome: A Randomized Controlled Study. Nutrients. 13(3):756 https://pubmed.ncbi.nlm.nih.gov/33652763/
Lesbros-Pantoflickova, D. et al. 2004. Meta-analysis: the treatment of irritable bowel syndrome. Aliment Pharmacol Ther. 20(11–12):1253–1269 https://pubmed.ncbi.nlm.nih.gov/15606387/
Kajander, K. et al. 2008. Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota. Aliment Pharmacol Ther. 27(1):48–57. https://pubmed.ncbi.nlm.nih.gov/17919270/
Mezzasalma, V. et al. 2016. A Randomized, Double-Blind, Placebo-Controlled Trial: The Efficacy of Multispecies Probiotic Supplementation in Alleviating Symptoms of Irritable Bowel Syndrome Associated with Constipation. Bio Med Res Int. 2016. https://pubmed.ncbi.nlm.nih.gov/27595104/
Pascal, M. et al. 2018. Microbiome and Allergic Diseases. Front Immunol. 9. https://pubmed.ncbi.nlm.nih.gov/30065721/
Markowiak , P., Śliżewska, K. 2017. Effects of Probiotics, Prebiotics, and Synbiotics on Human Health. Nutrients. 9(9). https://pubmed.ncbi.nlm.nih.gov/28914794/
Rao, R.K. et al. 2013. Protection and Restitution of Gut Barrier by Probiotics: Nutritional and Clincal Implications. Curr Nutr Food Sci. 9(2):99-107. https://pubmed.ncbi.nlm.nih.gov/24353483/
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