Here’s why you’re taking probiotics wrong

What we’re discovering is that these bacteria are not just important for those who experience gut symptoms, but that they support almost all other systems and functions in the body through the gut’s clever connections. Our gut microbes can influence everything from mental health to our heart, hormones and skin.

With this growing fascination, we’ve seen a marked increase in live bacteria supplements, better known as probiotics, which are often marketed as a quick fix for digestive problems, better gut health and overall wellbeing (although the science doesn’t actually agree with this approach – more on that below). Consumer research shows that one in five of us are now regular users of probiotics, each spending on average £130 per year, with one in 10 spending over £200 annually. By 2033, the UK probiotic market alone is expected to top £2 billion.

What can probiotics do for you?

When used correctly, probiotic supplements can have a powerful impact on your health.

However, it’s important to note that our understanding of probiotics and how they work has evolved over the past decade. The idea that taking a ‘one-size-fits-all’ daily probiotic is going to improve your gut health is too simplistic.

Science tells us that each different type of probiotic strain (a strain is essentially a different type of bacteria) does different things and that’s why it’s really important that you take the right strain for your goals. You also need to be taking it at the right time, in the right way. Swallowing a tablet and hoping for the best isn’t the right approach – you need to be more targeted to get results. Much like you wouldn’t take a vitamin D supplement to treat an iron deficiency, you need the right probiotic strain for the specific issue you’re targeting. International health authorities have developed probiotic guidelines confirming the need for probiotics to be targeted to have any real benefit.

So, should we all be taking probiotics?

Science tells us that there is no evidence to support the use of a daily probiotic for your general gut health and that live bacteria supplements used in this way are a waste of money.

Instead, for general gut health and overall wellbeing, research suggests incorporating fermented foods such as kimchi and kefir into your diet and focusing on plant diversity. Aim for 30 plant points a week from what I call the 'Super Six': wholegrains, fruits, vegetables, legumes (beans and pulses), nuts and seeds, and herbs and spices. Make sure to include fermented dairy and oily fish too, if you eat animal products. These foods are rich not only in nutrients to nourish your cells, but phytochemicals (think plant chemicals associated with health benefits) that nourish anti-inflammatory gut bacteria.

The four reasons to take a probiotic supplement

As a clinician and gut health scientist, there are four areas where I would confidently recommend a specific probiotic. These are supported by strong scientific evidence and backed by international health authorities:

1. When you’re on antibiotics

Antibiotics can disrupt the gut microbiome, often causing diarrhoea, bloating and taste changes.

Randomised placebo-controlled trials show the live bacteria strain Lactobacillus rhamnosus (LGG®) has been clinically proven to reduce the incidence and duration of diarrhoea associated with antibiotic use, as well as other gastrointestinal side effects. LGG® helps maintain gut balance during and after your course of antibiotics, which is why the World Gastroenterology Organisation recommends this specific strain twice a day during antibiotics at a dose of 10 billion CFU (‘colony forming units’ is typically used as the measurement of bacteria in a dose – check the packaging to find this).

2. When you need immune support

Around 70 per cent of your immune system lives in your gut, so supporting it with the right probiotic can help when colds and flu are circulating, as well as during periods of stress or travel.

Scientific trials have clinically proven that the combination of live bacteria strains Lactobacillus rhamnosus LGG® and Bifidobacterium lactis BB-12® will reduce your likelihood of developing recurrent upper respiratory tract infections (URTIs), number of antibiotic prescriptions and duration and severity of URTIs in infants, kids and adults.

3. When your vaginal microbiome needs rebalancing

The vaginal microbiome plays a key role in women’s intimate health, protecting against imbalances and infections such thrush and bacterial vaginosis (BV).

To improve vaginal microbiome dysbiosis (otherwise known as an imbalance), research shows that combining Lactobacillus bacterial strains La-14® and HN001™ with the protein lactoferrin can significantly reduce symptoms and recurrence of both thrush and bacterial vaginosis (compared to placebo) alongside conventional therapy.

4. When you have a fussy, colicky baby

Babies with colic have been shown to have lower levels of anti-inflammatory bacteria, such as Bifidobacteria.

Randomised placebo-controlled trials show that the live bacteria strain Bifidobacterium lactis BB-12^® can significantly reduce crying and fussing in colicky infants, improve sleep, support gut and stool health and enhance parents’ overall wellbeing. This is why leading paediatric authorities recommend the BB-12^®at a dose of 1 billion in babies with colic.

There are around 20 other areas that we’re starting to investigate, including the link between probiotics and mental health, heart health and more. However, it’s essential to stress that these require further studies before recommendations can be made.

Why your probiotic isn’t working

Recent research showed that nearly 80 per cent of consumers noticed no significant improvements to their health while taking probiotics.

However, the problem isn’t that probiotics don’t work, it’s that you need to use them in the right way. Here are four reasons why your probiotic might not be working for you:

First, more doesn’t equal better. Essentially, each strain is a different type of bacteria and there are thousands of them. But, when too many are combined in one product without being tested together, they can compete, affecting the product’s overall efficacy.
Second, the dosage may be incorrect. For a probiotic to work effectively, you need the right amount of bacteria, taken at the right time. Studies have shown that we need to match the dose to what is used in clinical trials in order to reap the health benefits.
Third, the format might not be right for your needs. For example, powder forms may be more effective for colds and flu, as they interact in the nose, throat and lungs, where viruses often strike. Vaginal health, by contrast, is better supported by capsules that target the lower digestive and urogenital tract.
Finally, strains are issue-specific, meaning that taking the wrong strain won’t help you reach your goals or support your specific health needs. For instance, according to randomised placebo-controlled trials, it is the Lactobacillus rhamnosus, LGG^® strain that has been clinically proven to reduce antibiotic associated diarrhoea (AAD) and gastrointestinal side effects. Those same benefits will not be experienced by taking an alternative strain.

What to look for in a good-quality probiotic

Consumer research shows that almost three-quarters of probiotic users find it difficult to choose the right probiotic for their needs. So, what should you be looking for?

First and foremost, look for evidence: a high-quality probiotic should be backed by randomised, placebo-controlled human clinical trials (the gold standard) that show a clear health benefit for the specific strain(s) and dose used. If there’s no such evidence, it’s unlikely to be worth your time or money. Also, check that it has been lab-tested for potency to ensure the product actually contains what’s promised. Finally, don’t forget to read the label carefully. Many so-called gut health supplements contain added sugars, emulsifiers or other unnecessary additives that can work against the very health benefits you’re seeking (even those targeted at children).

Final thoughts

Probiotics can offer real benefits, but only when used correctly. The truth is, many of us are wasting time, money, and good intentions by taking the wrong strains at the wrong time and in the wrong format, or when we don’t actually need them at all.

For optimum results, your probiotic should be targeted, clinically proven and matched to your specific health needs. Generic, ‘one-size-fits-all’ probiotics don’t cut it, and in some cases may even do more harm than good.

And, if you're otherwise healthy, your best investment is a gut-nourishing diet rich in plant diversity, aiming for 30 plant points per week across fruits, vegetables, legumes, nuts, seeds, wholegrains, herbs and spices, plus fermented foods, oily fish and fermented dairy. These real foods offer far more for your long-term overall gut health than a daily probiotic ever could.