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Description
  • Clinically studied
  • Promote Oral Cavity Health*
  • Provide Immune Support*
  • Great for all ages 3 & up
**ProENT™ is formulated to provide 1 Billion live Cultures per chewable at time of consumption, prior to expiration, under recommended storage conditions. **Storage and handling conditions may affect the total amount of cultures delivered at consumption. Refrigeration is not necessary but recommended.

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Supplement Facts

Dissolve one tablet in mouth per day. You can take this product between 1 to 6 times daily. Consider taking this product in combination with RightWay Nutrition's® ProBalance™ 10-20-30, Fruit & Veggie VITS™, D3 Blast™ or MultiVit™ w/CLA.

Serving Size 1 chewable tablets
Servings Per Container 90
Amount Per Serving % DV
BLIS K12® 20.00 mg **
 (Streptococcus Salivarius) (Providing 1 Billion Clinically Studied Active Probiotic Cultures per Chewable) **
** Daily Value (DV) not established

Other Ingredients: Xylitol, Natural Wintergreen Flavor, Vegetable Cellulose, Vegetable Powder

Contains NO: added sugar, salt, colorings or preservatives. Free of animal products, dairy, soy, egg, fish, shellfish, tree nuts, peanuts, wheat.

Warning: Consult your physician before using this or any product if you are pregnant, nursing, trying to conceive, taking medication or have a medical condition.

MANUFACTURED FOR RightWay Nutrition14513 SOUTH CENTER POINT WAY, STE. 100BLUFFDALE, UT 84065

Health Notes

Probiotics

Probiotics
This nutrient has been used in connection with the following health goals
  • Reliable and relatively consistent scientific data showing a substantial health benefit.
  • Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
  • For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

This supplement has been used in connection with the following health conditions:

Irritable Bowel Syndrome
Dose: Refer to label instructions
A daily drink containing probiotics significantly reduced IBS symptoms in one study. (more)
Diarrhea and Antibiotic-Associated Diarrhea
Dose: 500 mg one to four times a day, or 3 billion colony-forming units of probiotic bacteria one to three times a day
(more)
Constipation
Dose: 6.5 billion colony-forming units of Lactobacillus casei Shirota
Research has shown that the probiotic strain Lactobacillus casei Shirota may help relieve chronic constipation after two weeks of supplementation. (more)
Ulcerative Colitis
Dose: 10 to 600 billion colony-forming units per day of probiotic bacteria, or 250 mg of Saccharomyces boulardii three times daily
Supplementing with probiotics has been shown to help people with ulcerative colitis.(more)
Diverticular Disease
Dose: Refer to label instructions
In a double-blind study of patients with diverticular disease in remission, supplementing with a probiotic significantly decreased the number of people who suffered a recurrence of symptoms or a flare-up of acute diverticulitis.(more)
Crohn's Disease
Dose: At least 250 mg of Saccharomyces boulardii taken three times per day
In double-blind research, diarrhea caused by Crohn's disease has partially responded to supplementation with the probiotic Saccharomyces boulardii.(more)
Tooth Decay
Dose: Add 5 to 10 x 105 CFU per ml to milk or formula
Supplementing with probiotics may inhibit cavity-causing bacteria.(more)
Canker Sores
Dose: Apply powdered culture topically several times daily and orally take 1.5 billion colony-forming units two times daily
Topical and/or oral use of Lactobacillus acidophilus and Lactobacillus bulgaricus may help people with recurrent canker sores. (more)
Halitosis
Dose: Refer to label instructions
Preparations and gums containing probiotics have shown some promise for improving halitosis.(more)
Gingivitis
Dose: Refer to label instructions
In a double-blind study, the use of probiotic lozenges resulted in a modest improvement in certain measures of periodontal disease.(more)
Immune Function
Dose: 10 billion colony-forming units a day of acidophilus or bifidobacteria-only for intestinal infections
Probiotics help stimulate the intestine's immune system and slow the growth of infectious organisms.(more)
Common Cold and Sore Throat
Dose: Refer to label instructions
A double-blind trial showed that daily supplementation with with a probiotic may decrease the incidence of upper respiratory tract infections in children. (more)
Infection
Dose: Consult a qualified healthcare practitioner
Lactobacillus acidophilus produces acids that kill invading bacteria. These and other probiotics inhibit the growth of potentially infectious organisms and have been shown to be effective against some infections.(more)
Common Cold
Dose: A total of 1,010 colony-forming units per day for the combination
In a double-blind study conducted in China, children who received probiotics for six months had a significantly lower incidence of cold symptoms compared with children who received a placebo. (more)
HIV and AIDS Support
Dose: Take under medical supervision: 1 gram three times per day of Saccharomyces boulardii for diarrhea
In one trial, Saccharomyces boulardii helped stop diarrhea in HIV-positive people.(more)
Yeast Infection
Dose: 3 capsules or 1/4 tsp powder, taken by mouth three times daily, or use powder in douche or vaginal suppositories daily
Supplementing with probiotics may prevent the overgrowth of yeast organisms.(more)
Urinary Tract Infection
Dose: 1 billion colony-forming units of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, twice a day
Double-blind research found that probiotics may help prevent UTI recurrence. (more)
Colic
Dose: Consult a qualified healthcare practitioner
Research suggests probiotics may benefit babies with colic who are breast-fed or fed milk-based formula. (more)
Chronic Candidiasis
Dose: Refer to label instructions
Lactobacillus acidophilus is a type of probiotic that appears to help re-establish proper intestinal flora and prevent yeast overgrowth.(more)
Vaginitis
Dose: Apply a daily topical preparation or a suppository containing live culture
A topical preparation or suppository containing live Lactobacillus acidophilus may help relieve symptoms and prevent recurrent infections.(more)
Vaginitis
Dose: Take a supplement providing 10 billion of each twice per day
Supplementing with probiotics may help prevent recurrences of bacterial or candidal vaginitis.(more)
Chronic Candidiasis
Dose: Refer to label instructions
Lactobacillus acidophilus is a type of probiotic that appears to help re-establish proper intestinal flora and prevent yeast overgrowth.(more)
Athletic Performance
Dose: Fermented milk containing 6.5 billion live Lactobacillus casei Shirota organisms, twice a day for 16 weeks
In a double-blind trial, supplementation with a probiotic preparation reduced the frequency of upper respiratory tract infections in training athletes during the winter. (more)
Hay Fever
Dose: Refer to label instructions
In one trial, supplementing with Bifidobacterium longum strain BB536 during the pollen season significantly decreased symptoms such as sneezing, runny nose, nasal blockage.(more)
Allergies and Sensitivities and Food Allergies
Dose: 2.6 billion organisms per day for infants
Probiotics such as Lactobacillus GG may improve digestion in people with food allergies, helping the intestinal tract control allergen absorption and changing immune system responses to foods.(more)
Eczema
Dose: 10 billion colony-forming units daily of lactobacillus-type bacteria
Pregnant women and newborns who take probiotic supplements may reduce risk of eczema in early life.(more)
Stress
Dose: Refer to label instructions
Probiotic supplements may help counteract stress's detrimental effect on the balance of intestinal bacteria.(more)
Irritable Bowel Syndrome
Dose: Refer to label instructionsIn several double-blind trials, probiotic products have been found to relieve symptoms of IBS. Preparations that have been found to be effective include 1) a combination of Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12;1 2) Lactobacillus GG;2 3) a combination of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07;3 and 4) a product known as VSL#34
References

1. Kajander K, Myllyluoma E, Rajilic-Stojanovic M, et al. Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota. Aliment Pharmacol Ther 2008;27:48-57.

2. Francavilla R, Miniello V, Magista AM, et al. A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain. Pediatrics 2010;126:e1445-52.

3. Ringel Y, Ringel-Kulka T, Maier D, et al. Probiotic bacteria: probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients With functional bowel disorders - a double-blind study. J Clin Gastroenterol 2011;45:518-25

4. Guandalini S, Magazzu G, Chiaro A, et al. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study. J Pediatr Gastroenterol Nutr 2010;51:24-30.

Diarrhea and Antibiotic-Associated Diarrhea
Dose: 500 mg one to four times a day, or 3 billion colony-forming units of probiotic bacteria one to three times a dayAn organism related to brewer's yeast, Saccharomyces boulardii (Sb), is widely used in Europe to prevent antibiotic-induced diarrhea. It is also available as a supplement in the United States. Animal research with Sb shows interference with Clostridium difficile, a common bacterial cause of diarrhea.1 In double-blind trials, Sb has prevented antibiotic-induced2 and other forms of infectious diarrhea.3 An intake of 500 mg four times per day has been used in some of this research. Sb has also helped tourists prevent traveler's diarrhea, according to double-blind research.4 In one trial, positive results were obtained at amounts as low as 150-450 mg per day.5 Even diarrhea caused by Crohn's disease has partially responded to Sb supplementation in double-blind research.6 While not every trial shows efficacy,7 the preponderance of evidence clearly supports the use of Sb in people with diarrhea caused by antibiotics or infection. Seriously ill patients should consult with their doctor before supplementing with Sb, as rare but serious cases of infection caused by Sb in such patients has been reported.8
References

1. Pothoulakis C, Kelly CP, Joshi MA, et al. Saccharomyces boulardii inhibits Clostridium difficile toxin A binding and enterotoxicity in rat ileum. Gastroenterology 1993;104:1108-15.

2. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

3. Bleichner G, Blehaut H, Mentec H, Moyse D. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A muticenter, randomized, double-blind placebo-controlled trial. Intensive Care Med 1997;23:517-23.

4. Kollaritsch H, Holst H, Grobara P, Widermann G. Prevention of traveler's diarrhea with Saccharomyces boulardii. Results of a placebo controlled double-blind study. Fortschr Med 1993;111:152-6 [in German].

5. Kirchelle A, Fruhwein N, Toburen D. Treatment of persistent diarrhea with S. boulardii in returning travelers. Results of a prospective study. Forstchr Med 1996;114:136-40 [in German].

6. Plein K, Hotz J. Therapeutic effects of Saccharomyces on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrhea-a pilot study. Z Gastroenterol 1993;31:129-34.

7. Lewis SJ, Potts LF, Barry RE. The lack of therapeutic effect of Saccharomyces boulardii in the prevention of antibiotic-related diarrhoea in elderly patients. J Infect 1998;36:171-4.

8. Piarroux R, Millon L, Bardonnet K, et al. Are live saccharomyces yeasts harmful to patients? Lancet 1999;353:1851-2 [letter].

Constipation
Dose: 6.5 billion colony-forming units of Lactobacillus casei Shirota In one double-blind study, 70 people (average age, 44 years) with chronic constipation were randomly assigned to receive 65 ml/day of a probiotic beverage or placebo for four weeks.1 The probiotic beverage provided daily at least 6.5 billion colony-forming units of Lactobacillus casei Shirota. The treatment group began showing statistically significant improvements at the end of the second week. At the end of the treatment period, the proportion of patients having moderate or severe constipation was 34% in the active-treatment group and 83% in the placebo group.
References

1. Koebnick C, Wagner I, Leitzmann P, Stern U, Zunft HJF. Probiotic beverage containing Lactobacillus casei Shirota improves gastrointestinal symptoms in patients with chronic constipation. Can J Gastroenterol 2003;17:655-9.

Ulcerative Colitis
Dose: 10 to 600 billion colony-forming units per day of probiotic bacteria, or 250 mg of Saccharomyces boulardii three times daily

In preliminary and double-blind trials,1, 2 a probiotic supplement (in this case, a non-disease-causing strain of Escherichia coli) was effective at maintaining remission in people with UC. In a double-blind trial, a combination probiotic supplement containing Lactobacilli, Bifidobacteria, and a beneficial strain of Streptococcus has been shown to prevent pouchitis, a common complication of surgery for UC.3 People with chronic relapsing pouchitis received either 3 grams per day of the supplement or placebo for nine months. Eighty-five percent of those who took the supplement had no further episodes of pouchitis during the nine-month trial, whereas 100% of those receiving placebo had relapses within four months. Preliminary and double-blind research suggests that combination probiotic supplements may be effective at promoting recovery and preventing UC relapses as well.4, 5, 6

In a preliminary trial, people with UC significantly improved on a sugar-free, low-allergen diet with additional nutritional supplementation that included a multivitamin-mineral supplement (2-6 tablets per day); a fish oil supplement (400 mg per day); borage oil (400 mg per day); flaxseed oil (400 mg per day); and a probiotic formula containing Lactobacillus acidophilus and other species of beneficial bacteria.7 Some participants received slight variations of this regimen. Since so many different supplements were given and since the trial was not controlled, it is not possible to say which, if any, of the nutrients was responsible for the improvement observed by the researchers.

References

1. Rembacken BJ, Snelling AM, Hawkey PM, et al. Non-pathogenic Escherichia coli versus mesalazine for the treatment of ulcerative colitis: a randomised trial. Lancet 1999;354:635-9.

2. Kruis W, Schutz E, Fric P, et al. Double-blind comparison of an oral Escherichia coli preparation and mesalazine in maintaining remission of ulcerative colitis. Aliment Pharmacol Ther 1997;11:853-8.

3. Gionchetti P, Rizzello F, Venturi A, et al. Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial. Gastroenterology 2000;119:305-9.

4. Venturi A, Gionchetti P, Rizzello F, et al. Impact on the composition of the faecal flora by a new probiotic preparation: preliminary data on maintenance treatment of patients with ulcerative colitis. Aliment Pharmacol Ther 1999;13:1103-8.

5. Miele E, Pascarella F, Giannetti E, et al. Effect of a probiotic preparation (VSL#3) on induction and maintenance of remission in children with ulcerative colitis. Am J Gastroenterol 2009;104:437-43.

6. Ishikawa H, Matsumoto S, Ohashi Y, et al. Beneficial effects of probiotic Bifidobacterium and galacto-oligosaccharide in patients with ulcerative colitis: a randomized controlled study. Digestion 2011;84:128-33.

7. Edman JS, Williams WH, Atkins RC. Nutritional therapies for ulcerative colitis: literature review, chart review study, and future research. Altern Ther Health Med 2000;6:55-63.

Diverticular Disease
Dose: Refer to label instructionsIn a double-blind study of patients with diverticular disease in remission, supplementing with a probiotic significantly decreased the number of people who suffered a recurrence of symptoms or a flare-up of acute diverticulitis. The probiotic used in the study contained 24 billion Lactobacillus casei subsp. DG organisms, and was taken the first 10 days of each month for 12 months.1 It is not known whether other probiotic strains would have the same beneficial effect.
References

1. Tursi A, Brandimarte G, Elisei W, et al. Randomised clinical trial: mesalazine and/or probiotics in maintaining remission of symptomatic uncomplicated diverticular disease - a double-blind, randomised, placebo-controlled study. Aliment Pharmacol Ther 2013;38:741?51.

Crohn's Disease
Dose: At least 250 mg of Saccharomyces boulardii taken three times per day

In double-blind research, diarrhea caused by Crohn's disease has partially responded to supplementation with the beneficial bacterium Saccharomyces boulardii.1 Although the amount used in this trial, 250 mg taken three times per day, was helpful, as much as 500 mg taken four times per day has been administered in research successfully using Saccharomyces boulardii as a supplement with people suffering from other forms of diarrhea.2

References

1. Plein K, Hotz J. Therapeutic effects of Saccharomyces on mild residual symptoms in a stable phase of Crohn's disease with special respect to chronic diarrhea-a pilot study. Z Gastroenterol 1993;31:129-34.

2. Bleichner G, Blehaut H, Mentec H, Moyse D. Saccharomyces boulardii prevents diarrhea in critically ill tube-fed patients. A muticenter, randomized, double-blind placebo-controlled trial. Intensive Care Med 1997;23:517-23.

Tooth Decay
Dose: Add 5 to 10 x 105 CFU per ml to milk or formula

In a double-blind study of children aged 1 to 6 years, supplementation with Lactobacillus GG five days a week in milk for seven months reduced the incidence of cavities by 49%, compared with unsupplemented milk.1 The amount of Lactobacillus added to the milk was 5 to 10 x 105 CFU per ml.

In another study, supplementing with Lactobacillus reuteri strain ATCC 55730 (derived from breast milk) significantly decreased the number of children who had dental cavities at 9 years of age. The probiotic was given in the amount of 108 colony-forming units per day to the mother during the last 4 weeks of pregnancy, and then to the infant in the same daily amount during the first year of life.2
References

1. Nase L, Hatakka K, Savilahti E, et al. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 2001;35:412-420.

2. Stensson M, Koch G, Coric S, et al. Oral administration of Lactobacillus reuteri during the first year of life reduces caries prevalence in the primary dentition at 9 years of age. Caries Res 2014;48:111?7.

Canker Sores
Dose: Apply powdered culture topically several times daily and orally take 1.5 billion colony-forming units two times daily

According to preliminary reports, some people with recurrent canker sores may respond to topical and/or oral use of Lactobacillus acidophilus1 and Lactobacillus bulgaricus.2 However, a double-blind study found no effect of acidophilus bacteria on the healing time of canker sores.3

References

1. James APR. Common dermatologic disorders. CIBA Clin Symposia 1967;19:38-64.

2. Werbach MR. Nutritional Influences on Illness, 2d ed. Tarzana, CA: Third Line Press, 1993, 56 [review].

3. Gerenrich RL, Hart RW. Treatment of oral ulcerations with Bacid (Lactobacillus acidophilus). Oral Surg 1970;30:196-200.

Halitosis
Dose: Refer to label instructionsIn a preliminary trial, treatment with a probiotic preparation significantly improved halitosis by about 33%. The preparation used in the study was a tablet containing Lactobacillus salivarius strain WB21 and 280 mg of xylitol. One tablet was taken 3 times per day for 2 to 4 weeks.1 In a double-blind trial, use of a probiotic-containing chewing gum twice a day for 2 weeks significantly improved halitosis in people with self-reported bad morning breath. The gum used in this study contained 100 million colony-forming units each of Lactobacillus reuteri DSM 17938 and L. reuteri ATCC PTA 5289 per piece.2
References

1. Iwamoto T, Suzuki N, Tanabe K, et al. Effects of probiotic Lactobacillus salivarius WB21 on halitosis and oral health: an open-label pilot trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:201-8.

2. Keller MK, Bardow A, Jensdottir T, Lykkeaa J, Twetman S. Effect of chewing gums containing the probiotic bacterium Lactobacillus reuteri on oral malodour. Acta Odontol Scand 2012;70:246-50.

Gingivitis
Dose: Refer to label instructionsIn a double-blind study of patients with chronic periodontal disease (periodontitis), use of probiotic lozenges resulted in modest improvement in certain measures of periodontal disease (a decrease in pocket depth and an improvement in attachment), when compared with a placebo. The product used in the study contained 2 different strains of Lactobacillus reuteri (Prodentis; BioGaia, Lund, Sweden); one lozenge was dissolved in the mouth twice a day (after tooth brushing) for 12 weeks.1
References

1. Teughels W, Durukan A, Ozcelik O, et al. Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study. J Clin Periodontol 2013;40:1025?35.

Immune Function
Dose: 10 billion colony-forming units a day of acidophilus or bifidobacteria-only for intestinal infectionsSupplements of probiotics (friendly bacteria) such as Lactobacillus acidophilus, or the growth factors that encourage their development in the gastrointestinal tract may help protect the body from harmful organisms in the intestine that cause local or systemic infection according to published research,1, 2 including controlled3 trials. The effective amount of probiotics depends on the strain used, as well as the number of viable organisms. Infectious diarrhea in children has been successfully reduced with supplements of friendly bacteria in several trials, some of which were double-blind.4, 5
References

1. Fernandes CF, Shahani KM, Amer MA. Therapeutic role of dietary lactobacilli and lactobacillic fermented dairy products. FEMS Micro Rev 1987;46:343-56.

2. Bengmark S. Immunonutrition: role of biosurfactants, fiber, and probiotic bacteria. Nutrition 1998;14:585-94 [review].

3. Phuapradit P, Varavithya W, Vathanophas K, et al. Reduction of rotavirus infection in children receiving bifidobacteria-supplemented formula. J Med Assoc Thai 1999;82:S43-8.

4. Pedone CA, Arnaud CC, Postaire ER, et al. Multicentric study of the effect of milk fermented by Lactobacilus casei on the incidence of diarrhea. Int J Clin Pract 2000;54:568-71.

5. Saavedra J. Probiotics and infectious diarrhea. Am J Gastroenterol 2000;95:S16-8 [review].

Common Cold and Sore Throat
Dose: Refer to label instructionsIn a double-blind trial, daily supplementation with Lactobacillus GG (a probiotic organism) for 3 months decreased the incidence of upper respiratory tract infections by 34% in children attending daycare centers.1 Another double-blind trial found that a probiotic preparation taken for 3 months during the winter decreased the incidence of common infectious diseases in children aged 3-7 years.2 The product used in that study contained Lactobacillus helveticus R0052, Bifidobacterium infantis R0033, Bifidobacterium bifidum R0071, and fructo-oligosaccharides.
References

1. Hojsak I, Snovak N, Abdovic S, et al. Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centers: a randomized, double-blind, placebo-controlled trial. Clin Nutr 2010;29:312-6.

2. Cazzola M, Pham-Thi N, Kerihuel JC, et al. Efficacy of a synbiotic supplementation in the prevention of common winter diseases in children: a randomized, double-blind, placebo-controlled pilot study. Ther Adv Respir Dis 2010;4:271-8.

Infection
Dose: Consult a qualified healthcare practitioner

Lactobacillus acidophilus (the friendly bacteria found in yogurt) produces acids that kill invading bacteria.1 The effective amount of acidophilus depends on the strain used, as well as the concentration of viable organisms. These and other friendly bacteria known as probiotics inhibit the growth of potentially infectious organisms (pathogens) by producing acids, hydrogen peroxide, and natural antibiotics called bacteriocins and microcins, by utilizing nutrients needed by pathogens, by occupying attachment sites on the gut wall that would otherwise be available to pathogens, and by stimulating immune attacks on pathogens. Infections that have been successfully prevented or treated with friendly bacteria include infectious diarrhea, vaginitis, and urinary tract infections.2, 3

References

1. Fernandes CF, Shahani KM, Amer MA. Therapeutic role of dietary lactobacilli and lactobacillic fermented dairy products. FEMS Micro Rev 1987;46:343-56.

2. Mombelli B, Gismondo MR. The use of probiotics in medical practice. Int J Animicrob Agents 2000;16:531-6 [review].

3. Merenstein D, Murphy M, Fokar A, Hernandez et al. Use of a fermented dairy probiotic drink containing Lactobacillus casei (DN-114 001) to decrease the rate of illness in kids: the DRINK study. A patient-oriented, double-blind, cluster-randomized, placebo-controlled, clinical trial. Eur J Clin Nutr 2010;64:669-77.

Common Cold
Dose: A total of 1,010 colony-forming units per day for the combination In a double-blind study conducted in China, children who received probiotics for six months had a significantly lower incidence of cold symptoms compared with children who received a placebo. The product used in this study was Lactobacillus acidophilus NCFM (1,010 colony-forming units per day), alone or in combination with Bifidobacterium animalis subsp lactis Bi-07 (a total of 1,010 colony-forming units per day for the combination).1
References

1. Leyer GJ, Li S, Mubasher ME, et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009;124:e172-9.

HIV and AIDS Support
Dose: Take under medical supervision: 1 gram three times per day of Saccharomyces boulardii for diarrhea

In a double-blind trial, the non-disease-causing yeast Saccharomyces boulardii (1 gram three times per day) helped stop diarrhea in HIV-positive people.1 However, people with severely compromised immune function have been reported to develop yeast infections in the bloodstream after consuming some yeast organisms that are benign for healthy people.2, 3 For that reason, people with HIV infection who wish to take Saccharomyces boulardii, brewer's yeast(Saccharomyces cerevisiae), or other live organisms should first consult a doctor.

References

1. Blehaut H, Saint-Marc T, Touraine J. Double blind trial of Saccharomyces boulardii in AIDS-related diarrhea. International Conference on AIDS/Third STD World Congress, 1992, Abstract #2120, July 19-24.

2. Eng RHK, Drehmel R, Smith SM, Goldstein EJC. Saccharomyces cerevisiae infection in man. Sabouraudia: J Med Vet Mycol 1984;22:403-7.

3. Bassetti S, Frei R, Zimmerli W. Fungemia with Saccharomyces cerevisiae after treatment with Saccharomyces boulardii. Am J Med 1998;105:71-2.

Yeast Infection
Dose: 3 capsules or 1/4 tsp powder, taken by mouth three times daily, or use powder in douche or vaginal suppositories daily

Lactobacillus acidophilus is a species of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help to maintain the vaginal ecosystem by preventing the overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic.

Lactobacillus acidophilus can be taken orally in the form of acidophilus yogurt, or in capsules or powder. It can also be administered vaginally. In a controlled trial, women who consumed 8 ounces of Lactobacillus acidophilus-containing yogurt per day had a threefold decrease in the incidence of vaginal yeast infections and a reduction in the frequency of Candida colonization in the vagina.1 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (e.g., Gyne-Lotrimin(R)), or placebo weekly for 21 months.2 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis-a result almost as good as that achieved with clotrimazole.

Many women find relief using an acidophilus-containing yogurt douche daily for a few days or weeks, depending on the severity of the infection.3 Three capsules of acidophilus or one-quarter teaspoon of powder can be taken orally one to three times daily. Acidophilus can also be taken preventively during antibiotic use to reduce the risk of Candida vaginitis.4, 5

References

1. Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 1992;116:353-7.

2. Williams A, Yu C, Tashima K, et al. Weekly treatment for prophylaxis of Candida vaginitis. Presentation. 7th Conference on Retroviruses and Opportunistic infections. Foundation for Retrovirology and Human Health in collaboration with the (US) National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention. January 30-February 2, 2000.

3. Neri A, Sabah G, Samra Z. Bacterial vaginosis in pregnancy treated with yogurt. Acta Obstet Gynecol Scand 1993;72:17-9.

4. Eschenback H. Vaginal infection. Clin Obstet Gynecol 1983;26:186-202.

5. Vincent J, Voomett R, and Riley R. Antibacterial activity associated with Lactobaccillus acidophilus. J Bacteriol 1959;A78:477-84.

Urinary Tract Infection
Dose: 1 billion colony-forming units of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, twice a day In a double-blind study of postmenopausal women who had a history of recurrent UTIs, treatment with a probiotic preparation reduced the number of recurrences over a one-year period by 51%. The preventive effect of the probiotic was almost as great as that of an antibiotic (trimethoprim-sulfamethoxazole) and, unlike antibiotic treatment, probiotic therapy did not lead to the appearance of antibiotic- resistant bacteria. The preparation used in this study provided 1 billion colony-forming units of Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14, and was taken twice a day for one year.1 Previous research has shown that this probiotic product is particularly effective for preventing genitourinary infections. Additional research is therefore needed to determine whether other probiotic strains would also help prevent UTIs.
References

1. Beerepoot MAJ, ter Riet G, Nys S, et al. Lactobacilli vs. antibiotics to prevent urinary tract infection. A randomized, double-blind, noninferiority trial in postmenopausal women. Arch Intern Med 2012;172:704-12.

Colic
Dose: Consult a qualified healthcare practitioner

In a double-blind study of infants, supplementation of a standard milk-based formula with probiotic organisms (Bifidobacterium lactis and Streptococcus thermophilus) significantly reduced the frequency of colic, compared with the same formula without the probiotics.1 Another double-blind study found that the probiotic preparation, Lactobacillus reuteri, was an effective treatment for colic in exclusively breast-fed infants.2 In another study, L.reuteri taken once a day was significantly more effective than simethicone, a drug frequently used to treat colic.3 Other double-blind research has confirmed the benefit of probiotics in infants with colic.4

References

1. Saavedra JM, Abi-Hanna A, Moore N, Yolken RH. Long-term consumption of infant formulas containing live probiotic bacteria: tolerance and safety. Am J Clin Nutr 2004;79:261-7.

2. Savino F, Cordisco L, Tarasco V, et al. Lactobacillus reuteri DSM 17938 in infantile colic: a randomized, double-blind, placebo-controlled trial. Pediatrics 2010;126:e526-33.

3. Savino F, Pelle E, Palumeri E, et al R. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 2007;119(1):e124-30.

4. Kianifar H, Ahanchian H, Grover Z, et al. Synbiotic in the management of infantile colic: a randomised controlled trial. J Paediatr Child Health 2014;50:801-5.

Chronic Candidiasis
Dose: Refer to label instructions

Lactobacillus acidophilus products are often used by people with candidiasis in an attempt to re-establish proper intestinal flora. Acidophilus produces natural factors that prevent the overgrowth of the yeast.1, 2 Although there are no human trials, supplementation of acidophilus to immune-deficient mice infected with C. albicans produced positive effects on immune function and reduced the number of Candida colonies.3 The typical amount of acidophilus taken as a supplement is 1-10 billion live bacteria daily. Amounts exceeding this may induce mild gastrointestinal disturbances, while smaller amounts may not be able to sufficiently colonize the gastrointestinal tract.

References

1. Collins EB, Hardt P. Inhibition of Candida albicans by Lactobacillus acidophilus. J Dairy Sci 1980;63:830-2.

2. Fitzsimmons N, Berry DR. Inhibition of Candida albicans by Lactobacillus acidophilus: evidence for the involvement of a peroxidase system. Microbios 1994;80:125-33.

3. Wagner RD, Pierson C, Warner T, et al. Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice. Infect Immun 1997;65(10):4165-72.

Vaginitis
Dose: Apply a daily topical preparation or a suppository containing live culture

Lactobacillus acidophilusis a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.1 In another trial, application of a vaginal capsule containing Lactobacillus rhamnosus, Lactobacillus acidophilus, and Streptococcus thermophilus reduced the recurrence rate of bacterial vaginosis. The treatment was given for 7 consecutive days, and then after 7 days off was given for another 7 days.2 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.3 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis-a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.4 Over 90% of them were reported to be cured of their clinical symptoms in that time.

Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 10 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.5

References

1. Karkut G. Effect of lactobacillus immunotherapy on genital infections in women. Geburtshilfe Frauenheilkd 1984;44:311-4 [in German].

2. Ya W, Reifer C, Miller LE. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. Am J Obstet Gynecol 2010;203:120.e1-e6.

3. Williams A, Yu C, Tashima K, et al. Weekly treatment for prophylaxis of Candida vaginitis. Presentation. 7th Conference on Retroviruses and Opportunistic infections. Foundation for Retrovirology and Human Health in collaboration with the (US) National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention. January 30-February 2, 2000.

4. Litschgi MS, Da Rugna D, Mladenovic D, Grcic R. Effectiveness of a lactobacillus vaccine on Trichomonas infections in women. Preliminary results. Fortschr Med 1980;98:1624-7 [in German.]

5. Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect 2006;8:1450-4.

Vaginitis
Dose: Take a supplement providing 10 billion of each twice per day

Lactobacillus acidophilus is a strain of friendly bacteria that is an integral part of normal vaginal flora. Lactobacilli help maintain the vaginal microflora by preventing overgrowth of unfriendly bacteria and Candida. Lactobacilli produce lactic acid, which acts like a natural antibiotic. These friendly bacteria also compete with other organisms for the utilization of glucose. The production of lactic acid and hydrogen peroxide by lactobacilli also helps to maintain the acidic pH needed for healthy vaginal flora to thrive. Most of the research has used yogurt containing live cultures of Lactobacillus acidophilus or the topical application of such yogurt or Lactobacillus acidophilus into the vagina. The effective amount of acidophilus depends on the strain used, as well as on the concentration of viable organisms.

Vaginal application of a proprietary Lactobacillus acidophilus preparation may help bacterial vaginitis. In one trial, 80% of women with bacterial vaginitis who used the preparation were either cured or experienced marked improvement in symptoms.1 In another trial, women who were predisposed to vaginal Candida infection because they were HIV-positive received either Lactobacillus acidophilus vaginal suppositories, the antifungal drug, clotrimazole (for example, Gyne-Lotrimin), or placebo weekly for 21 months.2 Compared to those receiving placebo, women receiving Lactobacillus acidophilus suppositories had only half the risk of experiencing an episode of Candida vaginitis-a result almost as good as that achieved with clotrimazole. In a preliminary trial, women with vaginal Trichomonas infection received vaginal Lactobacillus acidophilus suppositories for one year.3 Over 90% of them were reported to be cured of their clinical symptoms in that time.

Two specific strains of lactobacillus (Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14) have been found to be effective against bacterial vaginosis when taken orally. In a double-blind study, supplementation with a capsule containing 1 billion of each of these organisms twice a day for 30 days increased the cure rate from antibiotic therapy to 88%, compared with a 40% cure rate in the group receiving antibiotics alone.4 In another double-blind trial, women with bacterial vaginosis received one capsule of L. rhamnosus GR-1 and L. reuteri RC-14 (1 billion of each strain per capsule) twice a day or placebo for 6 weeks. After 6 weeks, the percentage women who no longer had bacterial vaginosis was significantly higher in the probiotics group than in the placebo group (62% vs. 21%).5 Women with bacterial vaginosis should consult their doctor to determine whether these probiotic strains might be an effective alternative to antibiotics.

References

1. Karkut G. Effect of lactobacillus immunotherapy on genital infections in women. Geburtshilfe Frauenheilkd 1984;44:311-4 [in German].

2. Williams A, Yu C, Tashima K, et al. Weekly treatment for prophylaxis of Candida vaginitis. Presentation. 7th Conference on Retroviruses and Opportunistic infections. Foundation for Retrovirology and Human Health in collaboration with the (US) National Institute of Allergy and Infectious Diseases and the Centers for Disease Control and Prevention. January 30-February 2, 2000.

3. Litschgi MS, Da Rugna D, Mladenovic D, Grcic R. Effectiveness of a lactobacillus vaccine on Trichomonas infections in women. Preliminary results. Fortschr Med 1980;98:1624-7 [in German.]

4. Anukam K, Osazuwa E, Ahonkhai I, et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect 2006;8:1450-4.

5. Vujic G, Jajac Knez A, Despot Stefanovic V, Kuzmic Vrbanovic V. Efficacy of orally applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double-blind, randomized, placebo-controlled study. Eur J Obstet Gynecol Reprod Biol 2013 Feb 7 [Epub ahead of print].

Chronic Candidiasis
Dose: Refer to label instructions

Lactobacillus acidophilus products are often used by people with candidiasis in an attempt to re-establish proper intestinal flora. Acidophilus produces natural factors that prevent the overgrowth of the yeast.1, 2 Although there are no human trials, supplementation of acidophilus to immune-deficient mice infected with C. albicans produced positive effects on immune function and reduced the number of Candida colonies.3 The typical amount of acidophilus taken as a supplement is 1-10 billion live bacteria daily. Amounts exceeding this may induce mild gastrointestinal disturbances, while smaller amounts may not be able to sufficiently colonize the gastrointestinal tract.

References

1. Collins EB, Hardt P. Inhibition of Candida albicans by Lactobacillus acidophilus. J Dairy Sci 1980;63:830-2.

2. Fitzsimmons N, Berry DR. Inhibition of Candida albicans by Lactobacillus acidophilus: evidence for the involvement of a peroxidase system. Microbios 1994;80:125-33.

3. Wagner RD, Pierson C, Warner T, et al. Biotherapeutic effects of probiotic bacteria on candidiasis in immunodeficient mice. Infect Immun 1997;65(10):4165-72.

Athletic Performance
Dose: Fermented milk containing 6.5 billion live Lactobacillus casei Shirota organisms, twice a day for 16 weeks In a double-blind trial, supplementation with a probiotic preparation reduced the frequency of upper respiratory tract infections in training athletes during the winter.1 The product used in the study was fermented milk that contained 6.5 billion live Lactobacillus casei Shirota organisms, given twice a day for 16 weeks. Further research is needed to determine whether other probiotic strains would have the same effect.
References

1. Gleeson M, Bishop NC, Oliveira M, Tauler P. Daily probiotic's (Lactobacillus casei Shirota)reduction of infection incidence in athletes. Int J Sport Nutr Exerc Metab 2011;21:55-64.

Hay Fever
Dose: Refer to label instructions

In a double-blind trial, supplementation with a specific probiotic strain (Bifidobacterium longum strain BB536) during the pollen season significantly decreased symptoms such as sneezing, runny nose, nasal blockage, compared with a placebo.1

References

1. Xiao JZ, Kondo S, Yanagisawa N, et al. Probiotics in the treatment of Japanese cedar pollinosis: a double-blind placebo-controlled trial. Clin Exp Allergy 2006;36:1425-35.

Allergies and Sensitivities and Food Allergies
Dose: 2.6 billion organisms per day for infants

Probiotics may be important in the control of food allergies because of their ability to improve digestion, by helping the intestinal tract control the absorption of food allergens and/or by changing immune system responses to foods.1, 2, 3 One group of researchers has reported using probiotics to successfully treat infants with food allergies in two trials: a double-blind trial using Lactobacillus GG bacteria in infant formula, and a preliminary trial giving the same bacteria to nursing mothers.4 Probiotics may also be important in non-allergy types of food intolerance caused by imbalances in the normal intestinal flora.5

References

1. Kirjavainen PV, Gibson GR. Healthy gut microflora and allergy: factors influencing development of the microbiota. Ann Med 1999;31:288-92 [review].

2. Pelto L, Isolauri E, Lilius EM, et al. Probiotic bacteria down-regulate the milk-induced inflammatory response in milk-hypersensitive subjects but have an immunostimulatory effect in healthy subjects. Clin Exp Allergy 1998;28:1474-9.

3. Salminen S, Isolauri E, Salminen E. Clinical uses of probiotics for stabilizing the gut mucosal barrier: successful strains and future challenges. Antonie Van Leeuwenhoek 1996;70:347-58 [review].

4. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99:179-85.

5. Hunter JO. Food allergy-or enterometabolic disorder? Lancet 1991;24:495-6 [review].

Eczema
Dose: 10 billion colony-forming units daily of lactobacillus-type bacteria

A double-blind trial reported that use of a hypoallergenic infant formula plus probiotics (500 million organisms of Lactobacillus GG bacteria per gram of formula, taken for one month) initially led to improvement in eczema symptoms in infants with suspected allergy to cow's milk.1 However, by the end of two months, both the group receiving Lactobacillus GG and the placebo group had improved approximately the same amount. In the same report, a preliminary trial giving 20 billion lactobacilli twice per day to breast-feeding mothers led to significant improvement of their allergic infants' eczema after one month. However, another double-blind trial found that Lactobacillus GG was no more effective than a placebo in infants with mild to moderate eczema.2 In another double-blind trial, a different probiotic preparation (1 billion organisms of Lactobacillus fermentum VRI-033 PCC taken twice a day) reduced the severity of eczema in a group of young children with moderate or severe eczema.3Probiotics may reduce allergic reactions by improving digestion, by helping the intestinal tract control the absorption of food allergens, and/or by changing immune system responses.

References

1. Majamaa H, Isolauri E. Probiotics: a novel approach in the management of food allergy. J Allergy Clin Immunol 1997;99:179-85.

2. Gruber C, Wendt M, Sulser C, et al. Randomized, placebo-controlled trial of Lactobacillus rhamnosus GG as treatment of atopic dermatitis in infancy. Allergy 2007;62:1270-6.

3. Weston S, Halbert A, Richmond P, Prescott SL. Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child 2005;90:892-7.

Stress
Dose: Refer to label instructions

Stress is understood to have a detrimental effect on the balance of intestinal bacteria,1, 2 but whether probiotic supplements improve the ability to handle stress is unknown. In a six-month preliminary trial, a multivitamin-mineral (MVM) supplement that also contained a blend of Lactobacillus acidophilus, Bifidobacterium bifidum, and Bifidobacterium longum was effective for improving scores on a stress questionnaire.3 However, this improvement could have been a placebo effect or could have been due to the MVM component. Controlled research comparing MVM supplements with and without added probiotics is necessary to determine whether probiotics are helpful for treating stress.

References

1. Huis in 't Veld, JH. Gastrointestinal flora and health in man and animal. Tijdschr Diergeneeskd 1991;116:232-9 [review, in Dutch].

2. Moore WE, Cato EP, Holdeman LV. Some current concepts in intestinal bacteriology. Am J Clin Nutr1978;31(10 Suppl):33S-42S.

3. Gruenwald J, Graubaum HJ, Harde A. Effect of a probiotic multivitamin compound on stress and exhaustion. Adv Ther 2002;19:141-50.

Probiotic bacteria favorably alter the intestinal microflora balance, inhibit the growth of harmful bacteria, promote good digestion, boost immune function, and increase resistance to infection.1, 2 People with flourishing intestinal colonies of beneficial bacteria are better equipped to fight the growth of disease-causing bacteria.3, 4Lactobacilli and bifidobacteria maintain a healthy balance of intestinal flora by producing organic compounds-such as lactic acid, hydrogen peroxide, and acetic acid-that increase the acidity of the intestine and inhibit the reproduction of many harmful bacteria.5, 6 Probiotic bacteria also produce substances called bacteriocins, which act as natural antibiotics to kill undesirable microorganisms.7

Copyright 2014 Aisle7. All rights reserved. Aisle7.com

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2015.

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