Should we trust the probiotics we take?

February 12, 2017

Labels are supposed to be windows to a product and more so, the pride of workmanship. They are supposed to be promises and assurance to consumers but in the recent years, it is discovered to be hardly so.

The world of supplements is indeed a murky one, especially when it comes to label accuracy. Label lies have blighted the history of supplements – from protein powders to caffeine, from fish oils to herbal formulas, even probiotics are not spared.

A guarantee in a product’s quality is a promise that is challenging to fulfil and also often under-delivered and here’s what we have discovered:

What are probiotics?

Probiotics are often termed “good” or “helpful” bacteria because they help keep the digestive system healthy. They are live bacteria and yeasts, with some types naturally found in the body. Probiotics can now be found in everything – from health supplements to yogurt and chocolates. As a supplement, probiotics are available as capsules, sachets, liquid and even gummies.

Probiotics are often prescribed by doctors in situations where the “good” bacteria in your body is compromised, creating an imbalance in favour of the bad bacteria. An illustration would be after a course of antibiotics, the “good” bacteria is eliminated together with the bad, and probiotics are prescribed in attempt to replace them.

“Helps to balance the “good” and “bad” bacteria, to keep your gut working like it should” is a common indication stated on probiotics supplements.

Types of Probiotics

In the realm of probiotics, there are different species. Among the different species, there are the different strains, and hence the long name ascribed to each, further confusing the consumer’s ability to choose the best among the rest. For instance, L. acidophilus and L. fermentum are strains of probiotics from the Lactobacillus Species. Strains should be specified on a product because different strains confer different health benefits and support. For e.g. L. rhamnosus is thought to be among the best Lactobacillus strains for vaginal health whereas L. reuteri has been shown to support digestive, oral, and immune health.

Check with your doctor to find out the strain/s which might best help you.

The Issues

Since probiotic strains have to be specific in order to treat or promote improvement of a health concern, supplement and food labels should explicitly state as such, but can we depend on them?

Unlike drug companies, makers of probiotic supplements don’t have to show their products to be safe or that they work – the reason why quality control of probiotics is appallingly lacking:

1. A study “Validating Bifidobacterial Species and Subspecies Identity in Commercially Available Probiotic Products” published in the journal Pediatric Research in December 2015, Lewis, et al. tested commercially available products and found “only 1 of the 16 probiotics perfectly matched its bifidobacterial label claims in all samples tested, and both pill-to-pill and lot-to-lot variation were observed.” It also concluded, “…the prevalence of misidentified bifidobacteria in these products is cause for concern for those involved in clinical trials and consumers of probiotic products.”
2.  LabDoor reported the same issues with the quality of probiotics. It was stated on their website: “Total viable bacteria ranged from -99% to +2400% vs. the products’ stated label claims.” “The tested products recorded large label claim variances, averaging viable bacteria at 206% off their stated label claims. 21 of 30 products recorded total viable bacteria at least 50% off their label claims, 7 products exceeded a 100% label claim variance, and 2 products exceeded a 1000% label claim variance.”
3. Examine.com disclosed similar issues with label accuracy: “Only one out of 17 probiotic products was a perfect match to label claims. Nine samples contained Bifidobacterium not listed on the label, 12 were missing strains claimed on the label, and four had unidentified non-Bifidobacterium species.”
4. Yet another independent supplement watchdog ConsumerLab have found “some probiotic supplements to containless than half the amount of organisms claimed on the label.”

“An average of 206% off stated label claims…”, “…unlisted… missing… unidentified species found”, “…less than half”

Reports from these studies show disquieting disparities between labels and reality, and quality control is shockingly lacking. Quality control is all the more essential for probiotics because of what it is – a delicate living organism. Its viability is challenged the moment it’s manufactured. Light, heat, oxygen and moisture are all factors that can severely shrink the number of beneficial bacteria that still has to survive shipping, processing, manufacturing, storage and final delivery.

A guarantee in a probiotic’s potency is a promise that is challenging to fulfil and also often over-promised. It has been revealed that over 50% of the brands that are tested had zero live cultures left upon purchase.

Since consumers cannot always be sure that the product actually contains the bacteria stated on the label or the product contains enough bacteria to have an effect, are there solutions?

Apart from the need to make better products, we managed to gather some tips to sieve out the good from the bad:

1. A good product will equip consumers with important and clear information on the ingredients it contains. An informational label should include:

• The genus, species, and strain of the probiotic (for example: Bifidobacterium longum, Lactobacillus plantarum)
• Oftentimes, the good bacteria are no longer viable by the time you make your purchase. A good product will provide a guarantee made by the manufacturer assuring live cultures throughout the shelf-life of the product.
• The number of organisms that will be alive by the use-by date or expiry date
• The dose
• The company name and contact information

If you cannot find important information as such on the label, it is not hard to think the maker of the supplement cares at all.

2. A responsible manufacturer will study its products rigorously to ensure it may provide any product efficacy. Review the company’s website for studies that support the product’s health claims.
3. Look for a third-party certifier to see if they have tested the product in the lab and found it to be safe and reliable.

Although taking an inferior probiotic is unlikely to cause a dangerous outcome, a lesser product will fall short of what’s expected of it, be a waste of money and add to the increasing scepticism surrounding the supplements world. The world of supplements needs better and honest products as much as the health consumer needs products of independently verified-quality.