Can You Take Too Many Probiotics?

Probiotic supplements are beneficial bacteria that promote wellness. As there are various strains of probiotics available on the market, you may wonder — which probiotic strains will benefit me? Am I taking too many probiotics? Are there any adverse effects of probiotics? Although probiotics are considered safe, scientific evidence suggests some caution. Let us find out more about safety and various probiotic strains.

A report by the Food & Agricultural Organization/World Health Organization in 2002 outlined expectations to label a supplement "probiotic." The term probiotic was defined as “live microorganisms which, when administered in adequate amounts, confer a health benefit on the host.” Over the years, regulatory authorities from various nations across the globe have accepted this definition of probiotics.

Yogurt and fermented milk are some of the earliest known probiotics. However, probiotics are available in various forms such as capsules, drinks, and food. As more and more people follow self-care routines to promote their health, the interest in probiotic supplements continues to grow. Unfortunately, there are not enough rigorous scientific studies that investigate the safety and toxicity of probiotics.

Probiotics for general well-being

Due to the rising popularity of integrative medicine and social media influence, people are consuming probiotic supplements to promote general well-being. Probiotics are effective in relieving day-to-day stress and anxiety. Probiotics help reduce fatigue, weakness, and pain. Probiotics are also known to improve reproductive functions and increase longevity.

Some common strains of probiotics consumed for general well-being are:

• Lactobacilli
• Bifidobacterium
• Lactococcus
• Streptococcus

Probiotics for various diseases

Probiotics can help with various diseases, including:

• Autoimmune disorders. In autoimmune disorders, the composition of gut bacteria changes and lacks the necessary diversity of bacterial strains. Research has proven probiotics improve immune function by restoring the gut microbiome. Research has shown that probiotics have therapeutic use in treating autoimmune diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis, Celiac disease, Crohn’s disease, ulcerative colitis, myasthenia gravis, and multiple sclerosis.
• Gastrointestinal disorders. Gastrointestinal disorders like irritable bowel syndrome and inflammatory bowel disease are associated with gut flora dysfunction. In these conditions, physicians may prescribe probiotic therapy along with other medications. Probiotic therapy can help restore the presence of Lactobacillus and Bifidobacterium bacteria in the GI tract.
• Metabolic diseases. Research has shown that probiotics are useful in carbohydrate and lipid metabolism. Probiotics are known to reduce blood cholesterol levels when people consume foods such as fermented milk. Probiotic therapy is beneficial in diseases such as hyperlipidemia and diabetes.

Can you take too many probiotics?

Probiotics are classified as supplements and are considered safe enough to be taken over the counter. Although no extreme adverse events, such as death, have been reported after taking probiotics, recent research has shown that probiotics can cause undesirable effects. These side effects are not always associated with dose, and research has shown a lack of dose-response relationship in probiotics.

The Food and Drug Administration has classified strains such as Lactobacillus as “generally recognized as safe" (GRAS). These GRAS strains can be used as starter cultures in fermenting various dairy products. Additionally, these cultures can be used to improve the taste and aroma of foods while improving their nutritional value. However, not all probiotic strains have GRAS classification. Such non-GRAS probiotics need to be consumed cautiously, as they may lead to an imbalance in the composition of the gut bacteria.

The toxic effects of probiotics can be local (impacting the digestive system) or systemic (impacting the entire body). The adverse effects of probiotics can be broadly summarized into four categories:

• Infectious. Endocarditis, meningitis, endometritis, peritonitis, pneumonia.
• Gastrointestinal. Nausea, vomiting, flatulence, taste disturbance, low appetite, liver abscess.
• Allergic. Rhinitis, wheezing bronchitis, rash.
• Genetic. Antibiotic resistance.

Doctors do not recommend probiotics for persons with heart anomalies, critically ill people, and persons with HIV. Additionally, doctors do not recommend probiotic supplements in certain conditions such as pregnancy, low white blood cell count, abdominal surgery, radiotherapy or chemotherapy, and during post-operative care.

One of the undesirable effects of probiotics is that it can cause gene transfer. Pathogenic bacteria in the intestine can transfer their antibiotic-resistant gene to probiotic bacteria. Such probiotic bacteria cannot conduct their function of restoring healthy gut flora and thereby are not beneficial in resolving the disease condition. The European Food Safety Authority (EFSA) has provided guidelines to test probiotics for their antibiotic sensitivity.

As the scientific community continues to research probiotics, the outcomes of the studies highlight the need to regulate probiotic consumption. The myth that probiotics do not cause any harm needs to be busted. Probiotic treatments can be effective when tailored to bacterial strains, disease, and the gut environment.

Probiotic supplements help restore wellness. Although most strains of probiotics are safe, some probiotics can cause adverse effects such as brain fog, bloating, and infections. These side effects may not be related to probiotic dose but to the type of probiotic and duration of intake. Discuss probiotics with your healthcare provider. If you are already taking probiotics, contact your doctor if you notice any side effects.