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VSL#3 Probiotics Review in 2024: Is It Evidence Backed Medical Food?

In recent years, the spotlight on gut health has intensified, revealing its pivotal role in our overall well-being. Amidst this growing interest, probiotics have come up as live microorganisms that may have a health effect on people at the right dose.

VSL#3, a probiotic medical food containing eight live bacterial strains, has attracted attention for its combined effect in the treatment of chronic diseases in animals and humans, as well as children.

This article aims to provide a review of VSL#3 probiotics and give information on what it is, how it works, scientific evidence regarding some of its clinical use, and an overview of customer feedback from VSL 3 reviews available online.

How we evaluated VSL#3 probiotics

Here’s a breakdown of the factors we considered in evaluating VSL#3 probiotics:

IngredientsLactobacillus and Bifidobacterium, and Streptococcus strains
CFU count112.5 billion to 900 billion
Clinical evidenceBacked by research
Customer reviewsUser feedback and satisfaction levels
Price$65.95–$157.95
  • Ingredients. We looked for the presence of well-researched strains known to confer benefits, such as Lactobacillus and Bifidobacterium strains. We also assessed the product for any potential allergens or unnecessary additives.
  • CFU count. The Colony Forming Units (CFU) count is a measure of the number of viable bacteria in a probiotic. We compared the CFU count of VSL#3 with the recommended dosages for various health conditions, as indicated by clinical research, to determine if it offers a suitable amount.
  • Clinical evidence. We reviewed the clinical evidence supporting the use of VSL#3. Studies have shown that VSL#3 can support the management of conditions like ulcerative colitis and irritable bowel syndrome.
  • Customer reviews. Online reviews provided valuable insights into the satisfaction levels and experiences of users.
  • Price. Considering its potency and quality, we checked if the product offers a fair value for money.

What are VSL#3 probiotics?

VSL#3 is a high-dose probiotic medical food that contains eight live bacteria strains, including Streptococcus thermophilus, Bifidobacterium breve, Bifidobacterium longum (reclassified as B. lactis), Bifidobacterium infantis (reclassified as B. lactis), Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, Lactobacillus bulgaricus (reclassified as L. helveticus).

Due to this mix of beneficial bacteria, VSL#3 has a protective effect on intestinal barrier function (IBF), which is one of the important functions for addressing multiple chronic diseases such as Irritable Bowel Syndrome (IBS), Ulcerative Colitis (UC), and Pouchitis. Limited studies also suggest that VSL#3 may be beneficial in conditions like obesity, diabetes, and allergies.

The probiotic bacteria in VSL#3 are non-pathogenic, non-toxigenic, and Generally Recognized as Safe (GRAS) as food ingredients. However, VSL#3 is a medical food defined by the FDA as “a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation."

A short story about this brand is that Professor Claudio De Simone invented The De Simone Formulation in the mid-1990s and sold it under the name VSL#3 after partnering with VSL Pharmaceuticals. He severed his relations with the company in 2014 and now sells his formulation under the name “Visbiome.” The VSL company continues to sell its formulation product as VSL#3 without Professor De Simone's involvement.

Reviewing VSL#3 probiotics

VSL#3's composition is designed to deliver a high concentration of beneficial bacteria — ranging from 112.5 billion to 900 billion colony-forming units (CFUs) per serving, depending on the product form (capsules, packets, or double-strength packets).

Here, we provide a detailed look at the different forms, including their dosage, directions for use, and price.

Let’s dive in.

1. Capsules — 112.5B

VSL#3 probiotics Capsules - 112.5B

Each VSL#3 capsule contains 112.5 billion CFU of the eight bacteria strains. It is intended for use in the management of IBS and ulcerative colitis. Other ingredients in the formulation are hydroxylpropylmethylcellulose, cornstarch, magnesium stearate, silicon dioxide, stearic acid, and microcrystalline cellulose. These ingredients help to improve the texture and solubility of the capsule.

The provider recommends using it as directed by your physician and refrigerating it at 36-46ºF (2-8ºC).

One bottle contains 60 capsules, and a one-time purchase costs $65.95.

2. Packets — 450B

VSL#3 Packets - 450B

The 450 billion CFU per packet VSL#3 products are intended to support the management of IBS, ulcerative colitis, and an ileal pouch. It is unflavored and contains other ingredients, including cornstarch and silicon dioxide.

It comes as freeze-dried powder and can be mixed with cold water or yogurt before use. It should also be refrigerated at 36-46ºF (2-8ºC).

There are 30 packets per box, which costs $112.95 for a one-time purchase.

3. Double Strength Packets — 900B

VSL#3 Double Strength Packets - 900B

The VSL#3 Double Strength Packets contain 900 billion CFU per packet, which is the highest potency of the three forms. It is formulated for use in patients with ulcerative colitis and an ileal pouch.

Other ingredients in the blend include maltose, cornstarch, and silicon dioxide.

Each box contains 20 packets, priced at $157.95 for a one-time purchase.

Below is a quick comparison of the VSL#3 probiotics.

Comparing VSL#3 products

TypeOne-time purchase pricePrice per one capsule/packetCapsules/packets per containerCFU count Indications
Capsules$65.95$1.1060112.5 billionIBS, UC
Packets$112.95$3.7730450 billionIBS, UC, an ileal pouch
Double strength packets$157.95$7.9020900 billionUC, an ileal pouch

How do VSL#3 probiotics work?

VSL#3 works through the effect of the eight strains of bacteria, each with its role in supporting gut health. S. thermophilus bacteria is said to be responsible for its defensive effects. Bifidobacterium strains are thought to promote intestinal barrier integrity, and Lactobacillus strains are predicted to encode signaling proteins, thereby sending signals that help maintain balance in the gut.

In general, VSL#3 is said to positively regulate intestinal microbial composition, which is a crucial factor in various gut conditions such as irritable bowel syndrome and ulcerative colitis.

Results from a 2021 study that included 15 subjects showed that VSL#3 helped to reduce colonic permeability and abdominal pain symptoms in adult patients with IBS. The exact mechanism responsible for this effect is not clear.

A systematic review conducted in 2020 found that VSL#3 achieved good results in clinical remission and clinical response in active ulcerative colitis. The mechanism by which VSL#3 benefits UC patients is unknown. Still, researchers from the study mentioned that it could derive from the protective effects of the eight probiotic strains on the intestinal barrier.

Are there any risks when consuming VSL#3 probiotics?

The ingredients in VSL#3 are Generally Recognized as Safe (GRAS) food ingredients by the FDA. Some mild side effects that have been reported include bloating, gas, abdominal cramps, vomiting, and diarrhea.

It is gluten, soy, GMO, and dairy-free.

VSL#3 may interact with some medications, such as doxycycline and prednisone. It should also be used with caution in immunosuppressed patients.

Lastly, it is essential to note that as a probiotic medical food, VSL#3® is specifically formulated and processed to be consumed by oral intake under the supervision of a physician and is intended for the dietary management of individuals with IBS, UC, and an ileal pouch, which present distinctive nutritional requirements that cannot be adequately managed through the normal diet.

How to take VSL#3 probiotics

Use VSL#3 as prescribed by your doctor. The provider states that it can be mixed with cold yogurt, ice cream, or non-carbonated beverages. Avoid using it with warm beverages because exposure to heat and moisture may reduce bacterial viability and activity.

If VSL#3 is left at room temperature for longer periods (beyond two weeks) or exposed to excessive heat, the number of beneficial bacteria in it can be reduced, so it is best to keep it refrigerated at 36-46°F ( 2-8°C).

VSL#3 reviews: customer feedback

VSL#3 has received user feedback across various platforms. On Amazon, the capsule product has an overall rating of 4.6/5 from 2307 customers with 1000+ five-star reviews.

VSL#3 reviews on Trustpilot are generally positive, with a 4.4/5 overall rating from 142 customers. Some users have reported that the product is too strong for them.

The product has received positive feedback on the official VSL#3 website, with users reporting improved gut health.

While most users find VSL#3 beneficial, some have reported negative experiences like excessive gas and bloating. Also, a common concern among customers is the high cost of the product.

VSL#3 review conclusion

In our opinion, VSL#3 is a medical food that may be beneficial for gut conditions like irritable bowel syndrome, ulcerative colitis, and an ileal pouch. It is generally considered safe for use in animals and humans (children included) by the FDA and can be mixed with cold food like yogurt and ice cream before taking it.

Individual responses to probiotics, including VSL#3, can differ. We advise consulting a physician before incorporating this product into your routine.

What we like

We like that VSL#3 has a robust scientific foundation in managing conditions like IBS and UC. Its dairy-free composition is commendable, making it a suitable choice for those with dairy allergies. In addition, we appreciate that it is available in various forms to cater to diverse needs.

What we don't like

While the benefits of VSL#3 could be significant, the cost may be a barrier for some individuals considering long-term use. Also, as with many probiotics, some users may experience mild digestive discomfort, such as bloating or gas, when they first begin taking VSL#3. These symptoms are generally temporary and subside as the body adjusts to the supplement.


Other supplements for better gut health

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