By: Michael Roizen, M.D.
Since gaining popularity in the 1990s, probiotics have become a key component of many people’s diets due to their probable health benefits. Found in foods and beverages like kefir, kimchi, kombucha, or supplements, these live microorganisms are especially valued for their role in supporting digestive and immune health. Incorporating probiotics into your daily routine can provide many benefits to your microbiome.
However, amidst the surge of probiotic supplements, foods, and beverages flooding the market, consumers are often confronted with three critical considerations when selecting a supplement: colony-forming units (CFUs), survival of the CFUs past your stomach acid, and probiotic strains. Understanding these factors is vital for deciding which probiotic supplements are right for you.
What are CFUs?
Colony forming units (CFUs) represent the number of live microorganisms, or viable bacteria before the probiotic enters your body. This metric gives consumers an idea of the “potency” or concentration of the probiotic strains found in the supplement before exposure to your GI tract. However, there are three essential things to note:
- A high CFU count doesn’t always equate to the bacteria surviving where it is needed—past your stomach and duodenum into your small and large intestine
- Your stomach acid and bile will kill many live microorganisms in your probiotic in your duodenum
- Many types of bacteria have not been proven in randomized controlled studies to help the body
That said, you want a large number of CFUs that have been shown to be live after they travel from the stomach and duodenum.
Are CFUs Important?
First, it seems reasonable to ask yourself another question—”What is my general purpose for taking a probiotic? What is it effective against and does the CFU count matter if the bacteria will not survive stomach acid or duodenal bile? Is it beneficial for the condition you care about?” So while CFU count is a factor, it’s not the sole determinant of a probiotic’s effectiveness. Other elements, such as the probiotic strains present and the delivery format of the product, also play crucial roles.
I recommend probiotic products with CFU counts ranging from one to 10 billion CFUs per serving for general health maintenance and to support immune and digestive health. Children supplementing with probiotics, however, should start at the lower end of the spectrum, whereas adults can supplement with more.
Understanding Probiotic Strain Survival Past Stomach Acid and Duodenal Bile
The CFU count doesn’t matter if the bacteria do not survive the trip into your small and large intestines. Some bacteria that have been shown to have probable beneficial effects are specifically from spore form, like specific bifidobacteria. Bifidobacteria in spore form protects the probiotics on that trip through the GI tract and become activated by the stomach acid. Other probiotics used in supplements are chosen because they survived that trip, were tested for benefit, and were found to have such. Combining good bacteria found in supplements and foods is best to benefit the gut most.
Understanding Probiotic Strains Probable Health Benefits
Probiotics consist of various strains of beneficial bacteria, each potentially offering unique health benefits. Lactobacillus and Bifidobacterium, found in certain foods, are the most clinically studied combination of probiotic strains for digestive and immune health.
Also, remember that different strains have varying effects on the body. For example, Lactobacillus Acidophilus (LA-5) and Bifidobacterium Animalis (BB-12) found in TruBiotics Adult Capsules help promote healthy immune function and digestive health. In contrast, the TruBiotics Women’s Capsules contain Lactobacillus Reuteri (RC-14) and Lactobacillus Rhamnosus (GR-1), which are the most clinically researched probiotics strains shown in randomized controlled trials to keep vaginal pH and yeast in balance. Therefore, selecting probiotic products containing strains that align with your specific health goals is crucial.
So Choice of Probiotic Strains Are Important?
Yes, the probiotic strains in a product are critical, as not all are created equal. First, consumers should look for probiotics with well-researched strains supported by clinical evidence for their intended health benefits. Second, look for products that specify the strains included. Third, understand how the strains work in the capsules or gummies you decide to take. For example, TruBiotics Sugar-Free Probiotic Gummies are made with the most clinically researched Bacillus probiotic strain B Subtilis (DE-111), in spore form. TruBiotics formulated its gummies with this strain, as it can withstand the manufacturing process to create the product and still remain efficacious. What good is the probiotic if the strains used don’t work in that delivery system?
Additionally, diversity in probiotic strains can be beneficial for overall gut health. A product containing a variety of strains may have a more comprehensive impact on the gut microbiome because they survive and have immune benefits promoting balance and resilience.
Choosing the Right Probiotic
So, when selecting a probiotic product, it’s essential to consider CFUs and probiotic strains. Look for products with:
- Adequate CFU counts: Aim for products with one to ten billion CFUs per serving for general health maintenance.
- Choose a probiotic food, that is low in sugar, or supplement with a strain or strains that have been demonstrated to survive the trip through stomach acid and duodenal bile.
- Well-researched probiotic strains: Choose products containing strains with demonstrated health benefits supported by scientific evidence.
- Diversity of strains: To promote overall gut health and microbiome diversity, opt for products that offer a variety of probiotic strains.
While eating a well-balanced diet to get the various vitamins, nutrients, and, in this case, probiotics into our diets is best, our bodies might need supplements to fill the nutritional gaps without added sugars that increase inflammation and disturb the immune system, vaginal or bone health. So, it’s important to consider the factors discussed above—CFU, survival into your intestine, and effectiveness of the probiotic for your goal.
Lastly, remember to consult a healthcare professional before starting any new probiotic, food or supplement regimen, especially if you have underlying health conditions or concerns.