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Jan. 25, 2020, 2:08 p.m. EST

Are probiotics a waste of money?

Does the science support the marketing?

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By Carli Pierson

iStock/Getty Images
In 2018, the global probiotics market was estimated at $48.38 billion.

This article is reprinted by permission from NextAvenue.org .

Humans are made up of over 100 trillion microbes, with the majority of them living in our large intestine. These microbes — fungi, yeast, bacteria and protozoa — are collectively called the microbiome. Our microbiome (unique to each individual) interacts with our immune system and has multiple functions, including digestion and producing vitamin K, vitamin B12, thiamine and riboflavin.

For many years, people have been using “probiotics” to improve or enhance the health of their microbiomes or to address gastrointestinal problems. According to the National Center for Complementary and Integrative Health, a government agency, probiotics are “live microorganisms that are intended to have health benefits when consumed or applied to the body. They can be found in yogurt and other fermented foods, dietary supplements and beauty products.”

Most probiotics are either strains of bacteria or yeast, and we’ve been consuming some of them, like yogurt, for millennia. But despite our long history of consuming these microorganisms, our knowledge of how the microbiome relates to our overall health is limited. Despite the lack of information on how much probiotics improve our health, that hasn’t stopped companies from marketing their supposed benefits to consumers.

Does the probiotic science support the marketing?

The microbiome craze has been at the forefront of the complementary and alternative medicine industry for years. In 2018, the global probiotics market was estimated at  $48.38 billion  and some estimates put it at  $76 billion by 2024.

As patients continue to seek alternative therapies and treatments, probiotics have been sold to the American public as the panacea for an assortment of ailments. These products vary widely in price and can be quite expensive. A 2014 story in HuffPost reported that some products cost more than $1 per dose, according to a 2013 study by ConsumerLab.com.

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For the most part, the science behind probiotics seems pretty anti-climactic. According to Dr. Pieter Cohen, an associate professor at Harvard Medical School who is considered the most widely recognized critic of the supplements industry, that’s because probiotics are largely unhelpful. Some studies have shown limited relief for certain antibiotic-related diarrheal conditions and other inflammatory bowel diseases, but the evidence doesn’t appear to go much further than that, notes Cohen.

In addition to his work as a professor and physician, Cohen is a leading expert in the field of nutritional supplement and probiotic safety. He was even sued for defamation by a supplement provider and won against the provider.

“If someone’s healthy and has no medical condition and their doctor hasn’t told them they need to take a probiotic or multivitamin, then there is no need to take one,” Cohen says. “There’s no strain [of probiotic] that I would recommend to a healthy person to stay healthy.”

Researchers have conducted hundreds of studies on probiotics related to a variety of different medical conditions.

“The problem is when we talk about probiotics, we’re talking about live organisms: yeast and bacteria. There are variations that are called strains. The medical understanding is that we’re at a very preliminary stage and there’s very little we can recommend specific strains for,” says Cohen.

Could probiotics be harmful?

What’s more, probiotics also have the potential to be problematic, or even dangerous. “We have these theoretical concerns about whether probiotics can interfere with a return to your normal digestive health, your normal intestinal bacteria. Could they be introducing new genes to your intestinal bacteria? So, that’s where we are now and that is different from where the marketing leads us to think,” Cohen says.

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