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Probiotics shown to be safe for use in almost all populations

Probiotics are generally considered harmless, however, as with all medications, there are a few considerations to keep in mind

Many studies recently have shown side effects that are mild. These side effects include bloating, constipation, heartburn, nausea, increased gas, and abdominal discomfort.1 The data from these studies provides evidence that probiotics are well tolerated in the general population.

In Canada, probiotic usage is monitored by Health Canada as part of the division that regulates natural health products. Probiotic supplements that have been licensed in Canada for use, can be found by searching the Licensed Natural Health Products Database. Products with a license have been assessed by Health Canada for safety, effectiveness, and quality under recommended conditions of use. For each product with a Natural Product Number (NPN), the database provides a list of Health Canada approved recommended uses, risk information, medicinal ingredients, and non-medicinal ingredients. When purchasing a probiotic, always ensure it is licensed for use in Canada and has an NPN on the bottle.

Unique to probiotics is the fact they are a living organism and when administered, possess the ability to cause infection to certain people that may have a weak immune system. These concerns have been identified over the years, and are extremely rare considering the widespread use of probiotics.2 The risk of infection when using probiotic products is very low and almost non-existent in healthy populations. One author estimated the risk of probiotic infection to be one case per ten million people.3 When searching probiotic products on the Licensed Natural Health Products Database, the following contra-indication is listed, “Do not use this product if you have an immune-compromised condition (e.g., AIDS, lymphoma, patients undergoing long-term corticosteroid treatment)”. Other groups of patients not listed in the warning include patients on other immunosuppressive treatments, cancer patients treated with chemotherapy, and post-organ transplantation patients.1 People with any of the aforementioned conditions should avoid probiotic supplementation. If you are unsure if a probiotic is right for you, always talk to your doctor or pharmacist.

Studies consistently demonstrate that probiotics are safe for use in the general population. Generally, probiotics should be avoided in individuals who have weakened immune systems. However, each person should discuss the risks vs benefits before using a probiotic with their doctor or pharmacist.

Bradley Linton, H.BSc., BScPhm, Pharm D., RPh

Sources:

  1. 1. Zielińska, D., Sionek, B., & Kołożyn-Krajewska, D. (2018). Safety of Probiotics. Diet, Microbiome and Health, 131–161. doi:10.1016/b978-0-12-811440-7.00006-5
  2. 2. Sanders ME, Akkermans LM, Haller D, Hammerman C, Heimbach J, Hörmannsperger G, Huys G, Levy DD, Lutgendorff F, Mack D, Phothirath P, Solano-Aguilar G, Vaughan E. Safety assessment of probiotics for human use. Gut Microbes. 2010 May-Jun;1(3):164-85. doi: 10.4161/gmic.1.3.12127. Epub 2010 Mar 4. PMID: 21327023; PMCID: PMC3023597.
  3. 3. Bernardeau, M., Guguen, M., Vernoux, J.P., 2006. Beneficial lactobacilli in food and feed: long-term use, biodiversity and proposals for specific and realistic. FEMS Microbiol. Rev. 30 (4), 487–513.