Evidence-Based Probiotic Prescription
Medicinal probiotics are microbes, usually bacteria, clinically proven to provide a particular health benefit. It’s a fallacy that multiple strain or higher potency probiotics are always better- benefits are strain specific, and evidence-based probiotics are mostly single strain.
Probiotics have proven helpful for a range of conditions, including IBS, inflammatory bowel disease, allergy prevention, autoimmune disease and bacterial vaginosis. Preliminary evidence also suggests their value in weight maintenance and anxiety and depression. Medicinal probiotics frequently prescribed include:
Lactobacillus rhamnosus GG
-the world’s most researched probiotic
Saccharomyces boulardii (Yomogi)
Lactobacillus plantarum 299V
Lactobacillus rhamnosus GR-1 & Lactobacillus reuteri RC-14
Escherichia coli Nissle 1917
Vivomixx (multi-strain, high potency probiotic)
Lactobacillus reuteri DSM 17938
Lactobacillus acidophilus LA-5 & Bifidobacterium lactis BB12
Prebiotics- Restoring Keystone Species
Prebiotics are a type of fibre that selectively feed beneficial bacteria like Bifidobacteria, Lactobacillus, Roseburia and Akkermansia. Their use through diet and supplementation is a key component of microbiome restoration. Increasing Bifidobacteria increases immune tolerance and reduces systemic inflammation, while boosting Akkermansia muciniphila helps restore the mucus layer- an important functional component of the intestinal barrier.
Vitamins, Minerals, Enzymes and More
Specific nutrition may be prescribed depending on clinical need. Vitamin or mineral deficiencies can restrict adequate mucous membrane function, contributing to dysbiosis and an inadequate intestinal barrier.
Herbal Microbiome Modulators
Emerging evidence is revealing that particular herbs inhibit pathogens while simultaneously stimulating the growth of beneficial bacteria. This capability for selective microbiota modulation makes them ideal candidates for microbiome restoration. Herbal medicines can also be very effective for:
priming the digestive system
reducing IBS symptoms
treating anxiety and depression
Malfertheiner P et.al. 2017. STW 5 (Iberogast) Therapy in Gastrointestinal Functional Disorders. Dig. Dis. 35 Suppl 1:25-29
Ng QX. et.al. 2016. Clinical use of Hypericum perforatum (St John’s Wort) in depression: A meta-analysis. J Affect Discord. Mar 1:210:211-221
Peterson CT et.al. 2018. Prebiotic Potential of Herbal Medicines Used in Digestive Health and Disease. J Altern. Complement. Med. [Epub]