Probiotics

益生菌 · Probiotics

Place · Level 3

全球年销 $70B+ · 但广谱益生菌概念几乎不成立 · 真正循证的只有几个菌株 + 几个适应症

Connected to · 1

synergy · 1

IBS
Ford 2018 AGA meta: strain-specific — Lacto + Bifido blends help IBS-M/IBS-D global symptoms at B-tier evidence; 'broad-spectrum' is mostly a category error.

ISAPP definition · strain matters

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ISAPP 定义 · 菌株 ≫ 菌种

The WHO/FAO 2002 + ISAPP 2014 official definition of a probiotic: 'live microorganisms that, when administered in adequate amounts, confer a health benefit on the host'.

Four key words in that definition; each one decides whether 99% of commercial products even qualify.

① 'Adequate live amount': most supplement labels show CFU (colony-forming units); clinically effective doses are typically 10⁹-10¹⁰ CFU/day. Critically, the manufacture-date count is not the end-of-shelf-life count — most strains lose viability over time and require refrigeration, dryness, or enteric coating. Spot checks routinely find labels claiming 10 billion CFU with only 1-10% remaining at end of shelf life.

② 'Strain' ≫ 'species': the species is *Lactobacillus rhamnosus*; the strain is *Lactobacillus rhamnosus* GG (LGG). Clinical effect is strain-specific — LGG has strong evidence for preventing pediatric acute diarrhea, but another strain of the same species may be completely useless. This is the root of the 'lactic acid bacteria' confusion: vendors say 'contains probiotics' without naming the strain, which usually means an inexpensive strain with no clinical data.

③ 'Confers a health benefit on the host': requires human RCT evidence for that strain + that specific indication. Not 'theoretically beneficial', not 'improves a biomarker' — clinically meaningful improvement in a defined disease or symptom.

④ 'Live': dead organisms aren't probiotics by definition, though the *postbiotic* concept is gaining ground. This is why hot water, acidic drinks, and high-heat cooking discount the probiotic value of fermented foods.

So to judge whether the bottle on your shelf is real, check three things:

1. Does it name a specific strain (LGG / BB-12 / DSM xxxxx, etc.)?
2. Does that strain have an RCT for your indication?
3. Is the labeled CFU the minimum at end of shelf life, or just the manufacture-date number?

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Educational content, not medical advice — consult a clinician.

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