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Probiotics: Should you be taking one for gut health?

Probiotic supplements line store shelves, but should you be taking them?

Scientists’ understanding of probiotic supplements is evolving. Once viewed as a useful daily dose of commercially manufactured mixtures meant to replicate the healthy bacteria found inside our bodies, now some experts say these products might not be as helpful as once thought.

“Each probiotic is very specific and each person is very specific in terms of what they need, especially if they’re having some GI symptoms caused by microbiome imbalance or dysfunction,” says Dr. Aditya Sreenivasan, a gastroenterologist at Lenox Hill Hospital. And since a test doesn’t yet exist to give someone an exact answer of what their gut may be lacking and what probiotic can help, it’s “really a trial and error situation,” he says.

That’s why he says he almost never tells people to stop taking them if they’re finding some benefit from it, but also rarely advises people to start.

“If they’re already taking something, and it has made some symptom get better, then great … especially if you have like significant IBS that’s not responding to (other options like) change in diet, trying probiotics is reasonable,” he says. “My caution about that is they’re really expensive, and I feel like the majority of people end up just wasting their money.”

Dr. Shilpa Ravella, transplant gastroenterologist and assistant professor of medicine at Columbia University, has also had patients who “swear that probiotics make them feel better,” but thinks supplements are best used to help with specific issues with a doctor’s guidance.

“There are specific clinical scenarios in which probiotics are prescribed,” she says, including things like inflammatory bowel disease, irritable bowel syndrome or antibiotic-associated diarrhea.

But experts say to be mindful before using them.

While probiotics are safe for almost everyone, if you have certain health conditions, such as being immunocompromised, Crohn’s disease or ulcerative colitis, “I would use them with caution,” Sreenivasan says.

The Food and Drug Administration does not classify probiotic capsules as drugs, which means they do not have to be proven “safe and effective,” CBS News chief medical correspondent Dr. Jon LaPook reported. When added to anything, probiotics only need to meet a lower standard: “generally recognized as safe.”

Ravella says the best option is to talk to your gastroenterologist about a probiotic that could help you if you have a certain condition or symptoms.

But, if you’re not having any outlying symptoms, she advises focusing instead on eating whole, plant foods to support your gut health before reaching for supplements.

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