How To Choose The Right Probiotic For You: A Gut Expert's Guide

If you’ve ever stood in the probiotic section of a health shop or pharmacy and wondered which probiotic is right for you, maybe while feeling a little overwhelmed, you’re not alone.

As a Gut Expert and Naturopath in Melbourne, I regularly find myself discussing probiotics and their relationship to gut health, as well as what the differences are between the hundreds of probiotic products on the market. It’s never a quick conversation as this is a complex topic, but it is one that’s worth taking the time to cover because, as a Gut Expert, I want every one of my clients to feel empowered throughout their gut healing journey.

Now I don’t know what it’s like where you live, or what your local Naturopath has access to, but if it’s anything like being a Naturopath in Melbourne (and it probably is), they’ll be able to recommend probiotics that are readily available to the public AND probiotics that are only available via a Naturopathic prescription. It’s enough to boggle the mind and I understand why clients get confused.

That’s why I compiled this gut expert's guide that reveals how to choose the right probiotic for you. Let’s look at the key elements you need to understand when it comes to probiotics.

 

What is a probiotic?

Throughout history, the definition of ‘probiotic’ has evolved along with the research. The current definition comes from the International Scientific Association for Probiotics and Prebiotics:

“Live microorganisms that, when administered in adequate amounts, confer a health benefit to the host" (1).

 While this definition tells us a lot, there’s still room for it to evolve further as even more discoveries and understandings about human health are made.
 

What does their long name mean?

That long, unpronounceable name on the back of your probiotic bottle actually means something, and it’s so important when it comes to choosing the right strain for your health.

Let's get scientific and use the example of Lactobacillus plantarum 299v.

• Genus describes the first name of a bacterium (e.g. Lactobacillus). The genus is quite general and refers to a grouping of organisms based on similarity of qualities, such as physical characteristics, metabolic end-products and metabolic requirements. 
• Species is a bacterium’s second name (e.g. plantarum). It’s a much narrower classification based on shared common features that distinguish them from other species within that genus.
• Strain is an even more specific classification that distributes members of the same species into subgroups, based on one or more properties that these bacteria have that are distinct from other members within the species (e.g. 299v) (2).

How important is the strain?

In short, SO important.
 
Each bacterial species contains a huge number of specific strains that differ in their properties. Some strains are weak, others strong, in their resilience as they journey through the upper gastrointestinal tract (GIT); some interact with your immune system; some inhibit pathogenic (bad/unwanted) bacteria.
 
When you’re choosing a probiotic that’s labelled using only genus and species, for example Lactobacillus plantarum, but hasn't mentioned the strain such as 299v, this is problematic.
 
Just because one strain of bacteria in a species has a proven action or characteristic, it doesn’t mean another strain will too, even if they’re closely related. Research tells us that strains of bacteria within the same species can have significantly different actions, properties and characteristics (1,3), and some clinical trials have found the following when studying Irritable Bowel Syndrome (IBS) and probiotics:

• Lactobacillus plantarum 299v has been shown to effectively reduce IBS symptoms (4) (Bonus tip: This strain can be found in the product IBS Support by Ethical Nutrients)
• Lactobacillus plantarum MF1298 was found to actually worsen IBS symptoms (5)

How do probiotics work?

As researchers continue to study the connection between gut health, probiotics and gut bacteria, practitioners can confidently prescribe probiotics for a wider variety of health conditions. As a Naturopath and Gut Expert, this expanding knowledge is invaluable to my treatment protocols and to my client’s success stories.

To date, research has confirmed that probiotics, depending on specific strains and species ingested, can provide the following therapeutic effects (2): 

1. Immune modulation (support a healthy immune response)
2. Anti-inflammatory activity
3. Modification of GIT transit (slow or speed up transit time)
4. Reduced visceral hypersensitivity (pain and discomfort commonly associated with IBS)
5. Antagonism against potential pathogens (help fight against 'bad' bugs)
6. Induction of GIT mucin secretion (protective secretion along gut wall)
7. Enhanced GIT IgA secretion (an important immune marker)
8. Directly attaching to rotaviruses (helps fight against viruses)
9. GIT, breastmilk and vaginal microbiota modification (help change the species found in these areas)
10. Production of beneficial compounds (e.g., short chain fatty acids)
11. Alteration of the vaginal, intestinal and colonic milieu (the environment)
12. Strengthening of the intestinal barrier/wall
13. Repair of the intestinal barrier (helpful in treating leaky gut)
14. Chemopreventive effects (supportive against cancers)
15. Metabolism of cholesterol in the GIT

 
In my professional opinion - Wow! This list excites me and is a reminder of how intelligent the human body is.
 

Are fermented foods considered probiotics?

Based on current interpretations of the probiotic definition, traditional (wild) ferments like sauerkraut, kimchi, yoghurt and kefir are technically excluded. These are considered food sources of “live and active cultures”, but not probiotics (1).

The reason for their exclusion is that fermented foods have undefined microbial content, meaning the bacterial species, strains and number can differ with each batch. Additionally, the strains within may also lack specific therapeutic qualities i.e., no health benefit for the person eating it. It is due to these variabilities that traditional fermented foods (wild ferments) cannot be relied upon for specific therapeutic effects in the same way that probiotic preparations containing well-defined strains, with well-characterised clinical effects, in precise doses can (6).  

Should you take a probiotic supplement?

If you have a condition or symptom you want to address, it’s important to choose the specific probiotic strain that has clinically proven therapeutic efficacy, to ensure you are receiving the desired therapeutic effect. It should also be noted that probiotic strains that benefit one condition will not necessarily be effective for other conditions (7), e.g. something that works for Crohn's Disease may not benefit Ulcerative Colitis, despite both being classified as Irritable Bowel Diseases.

If you want a probiotic for general gut health support and don’t have any specific symptoms or conditions in mind, there is less pressure to choose the right strain/s, and a multi-strain probiotic may be sufficient. Fermented foods that have been stored correctly are also something I recommend. By consuming fermented foods regularly, you can help increase the overall bacterial diversity in your gut, which has been linked to a lower incidence of disease (8).

IMPORTANT: If you have/suspect you’re experiencing histamine sensitivity issues, please read this article before implementing fermented foods and/or probiotics. 

 

Final Thoughts

As you can see, there’s a lot to consider when choosing the right probiotic for your health. Sifting through scientific research and clinical evidence will help you decide how to choose the right probiotic for you, but this isn’t always easy when you’re standing in the probiotic section of a health store or pharmacy. Even then, remember that you’re not selecting from the entire range, as some of the premium probiotics are ‘practitioner-only’ products.

If all of this sounds a lot to digest (pun intended), I invite you to join my course Bloated to Body Confident . It's the step-by-step strategy for finding your root cause, comprehensive functional and diagnostic testing, personalised dietary advice, holistic support, effective treatments and sustainable solutions, empowering evidence-based information and a clear action plan.

Hungry for MORE probiotic info? Check out this blog addressing the 5 biggest myths about probiotics.