Probiotics: Boon Or A Bane

Shailja Pandey, Shweta Singh and Saif Hameed, Amity Institute of Biotechnology, Amity University Haryana, Gurgaon (Manesar)-122413, India

2016-07-17 11:05:16

Credit: lifezen.in

Credit: lifezen.in

Microorganisms especially bacteria are considered to be causative agent of many infectious diseases. But with the drastic development in the field of science and technology this notion has been proved wrong since the advent of probiotics. These probiotics are generally in the form of bacteria or sometimes are a type of yeast. Grocery stores these days contain a number of probiotics due to their increased demand. Probiotics are an increasing trend nowadays but they have been consumed in different forms over years. Probiotics are also called “good bugs”. It is because they not only keep our digestive system healthy but also helps in building strong immunity 

Probiotics are primarily beneficial in reducing chances of cancer, reducing blood pressure and cholesterol. Natural probiotics such as yogurt helps in keeping our digestive system in a healthy state. Other than this, probiotics are also helpful in treating urinary tract infections and ulcer. They can be taken in the form of food and supplements. From yogurt to chocolate, probiotics have a variety of forms. Whether taken naturally or through supplements probiotics have an overall benefit to the users. Nowadays, even there are many probiotic fermented drinks which ensures boost in immunity due to the presence of bacteria.  Although, probiotics can be taken in many ways but they are naturally present in our body as well. Since the mid 90’s, probiotics have become an interesting area of research. There are a number of bacteria that are classified under the category of probiotics. But most of the probiotics come from the two main groups of bacteria namely: lactobacillus and bifidobacterium. However, like every coin has two faces these “good bugs” have some significant disadvantages as well. These disadvantages might not be prominent enough in every individual consuming it but it is important to be aware of the dark side as well.

  Infection or sepsis: 

There have been several reports regarding infection caused by probiotics in heart (inner lining) of patients leading to endocarditis. Probiotics in form of consumables also causes fungemia and bacteremia in individuals. Even though the chance of these occurring is rare but such possibility cannot be ignored. Therefore many antibiotics are taken for relief in such cases.

Bloating                                                                                                                   

Probiotics could lead to bacterial overgrowth. These overgrown microorganisms trigger fermentation in the gut which leads to gas and bloating. It has been reported that too much probiotics can also lead to flatulence and diarrhea which cause discomfort in the gastrointestinal tract. Certain level of discomfort in taking probiotics may also result in obstruction during breathing.

 Allergy

Just like the case with most medicines and food products, probiotics can also cause allergic reactions in many users. Anaphylaxis is an example of one of the allergic reaction experienced so far. It might look like a simple allergy but there have been reports of death due to these reactions. Some of the symptoms that can be observed in patients are low blood pressure, throat swelling, itchy rashes and others.

 Interference of probiotics with medications

According to recent studies, probiotics can react with certain drugs like sulfasalazine that can lead to probiotic-drug interaction. In fact, these probiotics can cause interactions with drugs and get metabolized much quickly than their usual rates. Thereby, results in higher quantities of them in the body.

Extent or severity of immune modulation is hard to predict.                                       

Factors such as age and pre-existing conditions may affect immune activity which can vary from individual to individual. This is particularly concerned with neonates and pregnant women. Individuals with immune disorders also belong to this group. In some cases, patients suffering from Crohn’s Disease (which is an autoimmune disease) have previously shown unpleasant outcomes after probiotic administration.

 Effects on metabolism                                                                                            

Theoretically, probiotics can affect metabolic activity, as intestinal microbiota plays a central role in carbohydrate and lipid metabolism and glucose homeostasis. Although, there are no documented studies which show any effects on growth or nutrition, it is an unexplored area which needs further investigation.

Microbial resistance                                                                                                    

 According to available data in most circumstances the human intestine contains probiotics aligned in transient manner. Nevertheless, concern regarding the possible transfer of antimicrobial resistance from the developed probiotic strains to more pathogenic bacteria still exists. This bacterium is present in the intestinal microbiota. For example, many Lactobacillus strains are naturally resistant to vancomycin. This increases concerns regarding the possible transfer of such microbial resistance to more pathogenic microorganisms (particularly Enterococci and Staphylococcus aureus. However, in Lactobacillus the genes which are vancomycin-resistant are chromosomal. Therefore, these are not readily transferable to other species.

AREAS OF UNCERTAINTY IN THE USE OF PROBIOTICS

Specificity of probiotic effects:                                                        

In some cases, analyzed data shows significant treatment effects the probiotics as a whole. Variety of probiotics can have different effects whether in vivo or in vitro analysis. Therefore, there is no specific way in which probiotics affect the human body. 

 Probiotic treatment schedules:

Less information is available about appropriateness of probiotic dose given to different individuals. Although probiotic supplements don’t have any particular dose, consulting a physician is wise especially in case of pregnant women, infants and people suffering from various immune disorders.

Probiotic mechanisms of action:

One of the problems in assessing the probiotics in clinical practice is the limited understanding of their mechanisms of action which includes microbiological and immunologic mechanism.

Probiotics are safe for healthy people. But it should be kept in mind that the physiological effects that they show may not always be good. Some effects may over stimulate the immune system or adversely affect the metabolism of the body. If a person is immune-compromised, has certain bowel problems or is seriously ill in other ways, then the doctor’s consultation is necessary. Use of probiotic supplements should be avoided unless it is the recommended by the physician. Probiotics should be cautiously taken by pregnant women, infants and young children. It should never be given to premature infants. In patients with weakened immunity sensitivity to probiotics and its side effects may be more severe. Therefore, the developing probiotic strains should be thoroughly evaluated before being marketed for safety. The mechanisms of action and the appropriateness regarding administration of probiotic strains are not specific. It is clear that different strains can have very different and specific effects. In view of the increasing use of probiotics, clinicians need to be aware of the risks as well as the benefits of these treatments.