Straight Answers for Healthcare Professionals

Who should take probiotics?

Nearly everyone can benefit from probiotics. These healthy bacteria assist us in digestion. They provide our intestinal cells with much needed short-chain fatty acids that are used for energy. These microorganisms maintain our immune response and produce vitamins B and K for us.

Although diet, alcohol consumption, foreign travel, aging, and numerous medications can cause disruptions in our gastrointestinal flora, antibiotics are the number one cause of bacterial imbalances in the intestinal tract. This means that patients taking systematically-acting antibiotics may benefit from probiotics.

In addition, anyone suffering with chronic gastrointestinal distress may find relief by restoring normal gut flora.

Numerous clinical studies have found that probiotics may be helpful with various medical conditions—for example, a variety of urogenital infections and allergic disorders such as eczema.

I already recommend yogurt to my patients. How do probiotic supplements differ from yogurt?

Florajen probiotic supplements contain some of the very same strains of healthy bacteria used by the yogurt and dairy industries. However, the cell counts in Florajen supplements are considerably higher than that found in all yogurt products. When yogurts are manufactured, roughly 2 billion bacteria are added to every 8 ounces of yogurt. Due to the moisture content and pH of yogurt, approximately half of the added probiotic culture will die within two weeks. In contrast, each Florajen Acidophilus capsule is guaranteed to contain more than 20 billion cultures per capsule throughout the product’s refrigerated shelf life and each Florajen3 capsule will retain more than 15 billion viable cells through its expiration date.

Have any probiotics received FDA approval?

At the present time, probiotics in the United States are largely considered to be alternative and complementary medicines. As such, no probiotics have received FDA-approval. Furthermore, due to lack of regulatory oversight, studies have repeatedly demonstrated that many less well-characterized probiotic supplements contain neither the strain of bacteria nor the viable cell counts that are stated on the label.

How are Florajen probiotics different from other brands of probiotics?

Florajen probiotics undergo quality control checks by independent laboratories in order to guarantee both the purity and potency of their products. Only the specific bacterial strains stated on Florajen’s labels will be found in Florajen products. When stored under refrigerated conditions the viable cell counts remaining in each Florajen capsule will not only meet, but will actually exceed the number of viable bacteria guaranteed on the label.

How should Florajen probiotics be stored?

Florajen probiotics should be kept refrigerated to maintain highest possible viable bacteria. Encourage your patients to keep Florajen products refrigerated at home, too. You can reassure patients that Florajen probiotics will not experience a significant reduction in cell count when stored at room temperature for up to three weeks, so packing probiotics during periods of vacation and travel is encouraged. However, twelve weeks at room temperature may reduce the cell counts by up to 25%.

Florajen probiotics contain more than 15 billion bacteria per capsule. Is it safe to take that many bacteria?

Our gastrointestinal tract is home to more than 1 trillion bacteria in each gram of fecal matter. With such large numbers of bacteria already residing in our intestines, it is not possible to “overdose” on bacterial supplements. In fact, some clinical studies have utilized 2 trillion probiotic bacteria daily in patients.

At what time of day should Florajen probiotics be taken?

Florajen probiotics are best taken on an empty stomach one hour before meals or two-three hours after meals. That is because stomach acid and bile acid can be detrimental to probiotic viability. For best results, Florajen probiotics should be swallowed with a glass of non-chlorinated water, juice, or milk. If patients are taking antibiotics simultaneously, probiotics should be taken as far apart from each antibiotic dose as possible.

Are there any side effects from taking probiotics?

Probiotics are remarkably safe. An analysis of probiotic clinical studies conducted over a 38 year time period revealed no adverse effects in more than 7,000 participants.

Some patients may tell you that when they initiate probiotic therapy, they feel bloated and ‘gassy’. These effects are believed to occur when the normal flora are being re-balanced. During initial therapy, the addition of large numbers of healthy bacteria may compete with some unwanted (and even harmful) microbial species for space and nutrients. As a result of this competition, some bacterial species will die—
a process known as the Herxheimer reaction. This temporary gastrointestinal discomfort always subsides within 7 days or less and it seems to be more severe in those whose gastrointestinal flora is significantly disrupted.

Is there anyone who should not take a probiotic supplement?

Almost everyone can benefit from probiotic supplements. Nonetheless, remember, that probiotics contain viable bacteria. Individuals that are extremely immunocompromised could be at an increased risk of infection. Specifically, HIV patients with low CD4+ cell counts, cancer patients with neutropenia, acute pancreatitis patients, or patients taking potent immunosuppressant drugs should discuss the use of probiotics with their healthcare provider and be alert for any signs of infection. With that said, the likelihood of infection appears to be extremely low, and is estimated to be considerably less than 1 case per million for patients taking probiotics.*

Can patients with milk-sensitivity take Florajen probiotics?

Yes, patients with milk-sensitivities can take Florajen probiotics without any problems. Florajen probiotics are also free of yeast, sugar, soy, eggs, wheat, gluten, artificial colorings, and preservatives.

Additionally, patients that are lactose intolerant typically do very well with probiotics. All three of the bacterial strains used to make Florajen probiotics actually produce lactase—the enzyme that is deficient in those suffering from lactose intolerance.

Florajen Acidophilus

Women frequently ask about ‘acidophilus’ supplements. Can I recommend any of the Florajen products to these women?

Florajen High Potency Acidophilus is a great choice for these women. More and more physicians are encouraging women to use acidophilus to prevent recurrent vaginal infections, including infections caused by candida.

Why is acidophilus good for vaginal infections?

During the reproductive years, a healthy woman’s vaginal flora is comprised almost entirely of lactobacilli, but antibiotics, spermicides, hormones, and sexual activity can alter that flora. When vaginal flora is altered, women may experience vaginal discomfort and itching, unusual vaginal discharges, and may be at an increased risk of sexually transmitted diseases.

Florajen’s Lactobacillus acidophilus can be used to restore the normal lactobacilli-dominant flora. Florajen Acidophilus secretes trace amounts of hydrogen peroxide and great amounts of lactic acid. In the vagina, lactic acid lowers the pH of vaginal secretions, making the vaginal environment less hospitable for overgrowth of other microbial species. Additionally, Lactobacillus acidophilus secretes surfactants that make it more difficult for other bacterial species to attach and proliferate in urogenital areas.

Studies have also shown that probiotics may help treat and prevent bacterial infections of the vagina, a condition known as bacterial vaginosis. Bacterial vaginosis can predispose women to acquiring sexually transmitted diseases and it is a known risk factor for premature labor and delivery. Additionally, it is widely believed that probiotics prevent recurrent vaginal yeast infections.

Florajen3

Is Florajen3 the same as acidophilus?

Yes, but Florajen3 contains two additional beneficial bifidobacteria, Bifidobacterium lactis (bifidum) and Bifidobacterium longum. Experts agree, for effective lower GI restoration of flora, using Bifidobacterium species simultaneously with Lactobacillus acidophilus is probably more efficacious than simply replacing one species.
That is because our gastrointestinal tract is home to approximately 500 different species of bacteria. Since the individual functions of each of those bacteria are presently unknown, it makes sense to supplement simultaneously with several species that are known to have beneficial functions. But beware of probiotics products with “many” species, as many of these species are bile-sensitive.  Probiotics need to be bile tolerant.

What benefits do bifidobacteria provide?

Bifidobacteria are the predominant bacteria in a healthy vaginally delivered, breast-fed, infant’s digestive tracts within days of birth. These bacteria are known to have important immune-stimulating properties, helping infants’ immature immune systems to mature appropriately. Replacement of bifidobacteria has been shown to decrease the incidence of developing food allergies and eczema in high risk children, to reduce the incidence of colic in infants and toddlers, and to reduce the severity and shorten the duration of diarrhea. Furthermore, bifidobacteria continue to remain an important part of gastrointestinal flora throughout all stages of life.

If Florajen3 is taken with antibiotics, won’t the antibiotics kill the probiotic bacteria?

Taking probiotics with antibiotics is a great strategy to reduce the incidence of antibiotic-associated diarrhea. To prevent disruption of gastrointestinal flora associated with antibiotics, it is recommended that probiotics be dosed as far apart as possible from all antibiotic doses. When dosing probiotics, recommend they be given a minimum of 1 to 2 hours, but preferably 3 to 4 hours, after each dose of antibiotic.

Remember, the beneficial actions of probiotic bacteria occur primarily in the colon. Most antibiotics are absorbed in more distal portions of the intestinal tract, so while there will be some antagonistic actions, if beneficial bacteria are not dosed simultaneously with antibiotics, it is anticipated a significant fraction of probiotic bacteria will remain viable and active in the colon.

*For a citation review on probiotic safety, please call American Lifeline at 800-257-5433.