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

  • immune modulation

  • reducing inflammation

  • treating anxiety and depression

 

References:

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]