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The probiotics industry contributes billions of dollars to the U.S. economy each year. With that being said, patients may look to purchase probiotics on their own accord or under the direction of their healthcare provider. Although they’re not usually regulated by the FDA and the guidelines for their use are relatively scarce, probiotics have been shown to have several health benefits.
Regardless of the reason a patient may want to take a probiotic, pharmacists are crucial for educating patients about potential uses, safety concerns, and choosing the best option. In some cases, patients may not be aware of how probiotics can be helpful for them.
Whether you’re a seasoned professional or just starting out, this post can help equip you with the knowledge to help patients make informed decisions about their probiotic use.
Understanding probiotics
The gut microbiome may play a role in overall health and bodily functions. Numerous microorganisms including bacteria, viruses, and fungi can be found in the gastrointestinal tract, and they often coexist in harmony. Different things can affect the balance of bacteria in the gut, including infections, diet, and the use of antibiotics.
Probiotics are live organisms that, in sufficient amounts, may help improve the overall health of the person consuming them, according to The International Scientific Association for Probiotics and Prebiotics. Probiotics generally consist of different strains of bacteria, although they can also contain yeasts. The most common types of bacteria found in probiotics include Lactobacillus, Bifidobacterium, and Streptococcus. Probiotics may also contain certain types of yeast, such as Saccharomyces boulardii.
Probiotics are typically found in fermented foods, such as yogurt and kombucha. Some foods may have added probiotics. However, the health benefits of the probiotics in these foods can vary depending on which microorganisms they contain and whether they can survive in the gastrointestinal tract.
Patients who come to the pharmacy may instead be looking for probiotics in the form of a dietary supplement. Probiotics can come in the form of capsules, powders, and liquids. They can contain a mix of various microorganisms. The label usually indicates the amount of probiotics in the product, which is measured in colony forming units (CFUs).
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Probiotic uses
Probiotics are commonly used to improve or restore gut health, but they have also been studied for various other potential health benefits. Research suggests that probiotics may have benefits for the treatment or prevention of certain health conditions, such as atopic dermatitis, infectious diarrhea, and irritable bowel syndrome.
Some evidence shows that probiotics may help reduce the risk of atopic dermatitis. Healthcare providers may recommend probiotics for patients who are taking antibiotics, as studies suggest that starting a probiotic within a couple of days of starting an antibiotic may help reduce the risk of antibiotic-associated diarrhea. Probiotics may also help relieve certain symptoms of irritable bowel syndrome.
Other benefits of probiotics may include reduced total and LDL cholesterol levels, as well as greater weight reductions in patients who are obese or overweight. More research, however, is needed to confirm the findings on these benefits of probiotics.
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Counseling patients on probiotics
Probiotics are unlikely to cause harm in most patients. Some patients may be concerned about the potential side effects and other safety concerns. However, the side effects of probiotics are generally mild and include gas, bloating, and an upset stomach.
Patients who are immunocompromised may need to avoid the use of probiotics. In general, immunocompromised patients are more prone to infections, so it’s best to use caution in these patients. There is not enough evidence to suggest that probiotics are safe in immunocompromised patients.
Different probiotic strains may have different effects on the body. Patients should choose the strain that has the most benefits for their specific needs. Pharmacists can also counsel patients on taking probiotics on an empty stomach at least 30 minutes before a meal for maximum benefits. As for storage, probiotics should be stored according to the instructions on the label, such as in the refrigerator or in a cool, dry place.
Drug interactions involving probiotics are possible. Pharmacists can educate patients to avoid taking a probiotic within at least two hours of an antibiotic, as antibiotics may reduce the efficacy of probiotics. Along the same lines, probiotics that contain yeasts may need to be avoided while taking oral antifungals.
In addition, because certain probiotics can produce vitamin K in the gut, patients should be advised about potential interaction with warfarin. Although the clinical impact has not been confirmed, probiotics may potentially decrease the effectiveness of warfarin.
Helping patients choose probiotics
Probiotics are generally sold as dietary supplements, and they’re not typically regulated by the FDA. It’s a good idea to advise patients to choose probiotics from reputable brands and manufacturers. Patients should also be cautioned about the potential for allergic reactions, especially if they have allergies to milk or yeast products that may be found in some probiotics.
Healthcare providers should take care in advising patients about the specific strain and how many CFUs to look for. Product labels might not show the CFUs for every strain the product contains, so patients should also be aware of that. Pharmacists can help counsel patients to forgo probiotics that are expired, as CFUs can decrease over time.
Some products may contain a combination of probiotics and prebiotics. It’s important to clarify the difference between probiotics and prebiotics with a patient. Prebiotics are non-digestible carbohydrates that act as food for the microorganisms found in probiotics or the gut. Probiotics and prebiotics work together to create a symbiotic relationship. Therefore, consuming both probiotics and prebiotics can help to boost the effectiveness of probiotics and improve overall gut health.
Bottom line
Probiotics can play an important role in maintaining a healthy gut microbiome and provide a variety of health benefits. As a healthcare professional, it is essential to understand the different types of probiotics available and how to use them, as well as the potential precautions and contraindications. By counseling patients on the proper use of probiotics, you can empower them to make informed decisions about incorporating probiotics into their healthcare routine.
