IBS Control Probiotic

The useful question isn't "should I take a probiotic?" but "which strain, at what dose, and why that one?" These are the questions our naturopaths ask in store to help you find the right strain.

A good fit if

• You have a specific strain in mind, from a practitioner or your own reading, and want to match it exactly
• You're comparing products and want to judge them on the strains listed and the count at expiry, not the headline billions
• You need a format that suits your life, such as shelf-stable for travel, a powder for a child or a lozenge for your mouth
• You're generally well and adding a probiotic as part of a wider approach to eating well
• You want an Australian listed product, so strain-level labelling and warning rules have been applied

Check with us first if

• You're pregnant or breastfeeding. Some ingredients must carry the statement "Not recommended for use by pregnant and lactating women". It depends on the ingredient, so read the label.
• You take immunosuppressants or immunomodulators. Several Australian probiotic ingredients must carry a warning to talk to a health professional first.
• You're taking antibiotics. One permitted ingredient must be labelled to take it 2 to 3 hours apart from them, and another to talk to a health professional first.
• You're giving a probiotic to a baby or young child. Some ingredients aren't permitted under 2 years, one warns against use under 3, and some say "Not suitable for children".
• You have a short bowel, an ileostomy or colostomy, inflammatory bowel disease, or a heart valve condition.
• You have small intestinal bacterial overgrowth, or your symptoms get worse with fermentable foods.
• You have a severe dairy allergy or a yeast allergy. Both the carrier and the organism matter.
• You're buying from an overseas website. Those products aren't TGA-regulated for quality or strain identity, so the strain may not be what the label says.

• Refrigerated multi-strain capsule. Best known for: The practitioner-style format, usually carrying the highest declared counts. Absorption: Cold storage protects viability; counts fall faster at room temperature. Typical use: Daily, kept in the fridge; ask whether it was refrigerated in transit.
• Shelf-stable multi-strain capsule. Best known for: Travel, work and anywhere a fridge is not realistic. Absorption: Formulated to hold its count at room temperature; look for a count guaranteed at expiry. Typical use: Daily; the practical choice when a fridge product would sit hours in a bag.
• Spore-forming Bacillus. Best known for: Heat and acid tolerance, because the organism travels dormant and germinates later. Absorption: Survives storage and stomach acid better than most vegetative bacteria. Typical use: Australian medicines may use only specific named Bacillus strains, declared on the label.
• Saccharomyces boulardii. Best known for: Being a yeast rather than a bacterium, and the only one in common use. Absorption: Unaffected by antibacterial antibiotics, which target bacteria rather than yeasts. Typical use: Sold as its own single-organism product rather than blended into a multi-strain formula.
• Powders and sachets. Best known for: Infants, small children and anyone who cannot swallow a capsule. Absorption: Mixed into cool food or liquid; heat kills the organisms, so hot drinks defeat the purpose. Typical use: Dosed by scoop or sachet, with the count stated per serve.
• Oral lozenges. Best known for: The mouth and throat rather than the bowel. Absorption: Made to dissolve in the mouth, so swallowing one whole misses the site it targets. Typical use: Only two Streptococcus salivarius strains are permitted here, both named on the label.
• Fermented foods, gummies and drinks. Best known for: Live cultures as ordinary eating, or a format children will accept. Absorption: Counts are usually undeclared; pasteurisation, sugar and ambient shelf life work against viability. Typical use: Good habits, but not a substitute for a named strain at a studied dose.

Reference values. There aren't any. Probiotics are live micro-organisms, not nutrients, so the NHMRC Nutrient Reference Values don't cover them. There's no RDI, EAR or Adequate Intake for any strain, and there's no such thing as a probiotic deficiency.

Typical supplemental range. Most Australian labels give 1 to 10 billion CFU per dose, and some give 50 billion or more. Published studies have used one million to ten billion CFU a day. The number to match is the dose used in research on the strain you're holding, not the biggest figure on the shelf.

Upper level. There's no NHMRC Upper Level of Intake. Instead, Australia caps some species at the strain level: 6 billion CFU a day for Bacillus coagulans MTCC 5260 and 2 billion for MTCC 5856; 5 billion for adults and 1 billion for ages 2 to 17 for the permitted Bacillus subtilis strain; and 0.5 billion for Pediococcus pentosaceus. These are conditions for listed medicines, not safety ceilings.

Worth knowing. CFU stands for colony-forming units, which means organisms that are alive and able to multiply. It tells you how many, but not which strains are there, whether they've been studied, or whether that count will still be there by the expiry date. International scientific guidance says a label should state the minimum number of live organisms for each strain at the end of shelf life, not at manufacture, and give storage instructions. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Yoghurt with live cultures: usually Streptococcus thermophilus with a Lactobacillus species; look for 'live' or 'active'
• Kefir: A fermented milk drink carrying a broader mix of bacteria and yeasts than most yoghurts
• Unpasteurised sauerkraut and kimchi: live only if refrigerated; shelf-stable jars have usually been heat-treated
• Miso and tempeh: fermented soy foods; miso is added off the heat, since boiling kills the cultures
• Aged and traditionally made cheeses: some carry live cultures, though the count is neither declared nor consistent
• Fermented foods generally: none declare a strain or a count, so none is interchangeable with a defined strain at a studied dose

This list is the part of the page we will not shorten. If any of it applies to you, talk to one of our naturopaths or your doctor before starting.

• Severely ill, critically ill or significantly immunocompromised - reported bacteraemia and fungaemia; avoid.
• Central venous catheter or intensive care - avoid.
• Preterm and hospitalised newborns - hospital decision only; an infant death and over two dozen adverse events reported to the US FDA in 2023.
• Pregnancy and breastfeeding - some ingredients carry the mandatory warning 'Not recommended for use by pregnant and lactating women'; read the label.
• Immunosuppressants and immunomodulators - mandatory Australian warning on several probiotic ingredients.
• Antibiotics - one ingredient must be labelled for dosing 2 to 3 hours apart; another to consult a health professional first.
• Children - some ingredients not permitted under 2 years, one warns against use under 3, some carry 'Not suitable for children'.
• Short bowel, ileostomy or colostomy, inflammatory bowel disease, heart valve conditions.
• Small intestinal bacterial overgrowth, or symptoms worsened by fermentable foods.
• Dairy and yeast allergies - carrier and organism both matter.
• Fever, chills or feeling systemically unwell - stop and seek medical advice promptly.
• Overseas websites - not TGA-regulated for quality or strain identity.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.