- Lactobacillus acidophilus
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Lactobacillus acidophilus
Background
Lactobacilli are bacteria that normally live in the human small intestine and vagina. Lactobacillus acidophilus is generally considered to be beneficial because it produces vitamin K, lactase, and anti-microbial substances such as acidolin, acidolphilin, lactocidin, and bacteriocin. Multiple human trials report benefits of Lactobacillus acidophilus for bacterial vaginosis. Other medicinal uses of Lactobacillus acidophilus are not sufficiently studied to form clear conclusions.The term "probiotic" is used to describe organisms that are used medicinally, including bacteria such as Lactobacillus acidophilus and yeast such as Saccharomyces boulardii .Although generally believed to be safe with few side effects, Lactobacillus acidophilus taken by mouth should be avoided in people with intestinal damage, a weakened immune system, or with overgrowth of intestinal bacteria.Synonyms
Acidophilus, Acidophilus Extra Strength®, acidophilus milk, Actilact, Actimel®, Bacid®, Cultura®, DDS-Acidophilus, Endolac®, Enpac®, Fermalac® (Canadian), Florajen®, fresh poi, Gynoflor®, Infloran®, Kala®, Kyo-Dophilus®, L-92, Lacteol Fort®, lactic acid bacteria mixture (Oxadrop), lactic acid-producing bacteria (LAB), Lactinex®, Lactobacillaceae (family), lactobacilli, lactobacillus, Lactobacillus acidophilus 145, Lactobacillus acidophilus DDS-1, Lactobacillus acidophilus LA 02, Lactobacillus acidophilus La5, Lactobacillus acidophilus L-92, Lactobacillus acidophilus milk, Lactobacillus acidophilus NCFM, Lactobacillus acidophilus OLL2769, Lactobacillus acidophilus NCK56, Lactobacillus acidophilus strain 27L, Lactobacillus acidophilus strain LB (LaLB), Lactobacillus acidophilus yogurt, Lactobacillus LB, Lacto Bacillus, MoreDophilus®, Narine®, poi, Probiata®, Pro-Bionate®, probiotic, sour poi, Superdophilus®, yogurt.Evidence
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Uses based on scientific evidence Grade* Bacterial vaginosis Multiple human studies report that Lactobacillus acidophilus vaginal suppositories are effective in the treatment of bacterial vaginosis. A small number of studies suggest that eating yogurt enriched with Lactobacillus acidophilus may be similarly beneficial. Additional research is necessary before a firm conclusion can be reached. Patients with persistent vaginal discomfort are advised to seek medical attention. B Allergic disorders (Japanese cedar pollen) A small study was conducted to evaluate the effects of Lactobacillus acidophilus strain L-92 (L-92) on the symptoms of Japanese cedar pollen allergy. Further research is needed before a decision can be made. C Asthma There is limited research in this area with unclear results. C Atopic dermatitis There is currently not enough evidence to suggest a benefit of Lactobacillus acidophilus for this condition. C Breast cancer Early studies in humans have failed to show a consistent benefit of Lactobacillus acidophilus in breast cancer. Further studies are needed. C Colitis (collagenous colitis) Early studies fail to show a benefit of Lactobacillus acidophilus in this condition. More high-quality studies are needed. C Diarrhea prevention A small amount of human research suggests that Lactobacillus acidophilus may not be effective when used to prevent diarrhea in travelers or in people taking antibiotics, but results are mixed. Several studies report that the related species, Lactobacillus GG, may be helpful for the prevention of diarrhea in children and travelers. Additional study is needed in these areas before a firm conclusion can be drawn. C Diarrhea treatment (children) A small amount of research in children, using different forms of acidophilus, reports no improvement in diarrhea. Future studies should use a viable Lactobacillus acidophilus culture to assess effects on diarrhea. Lactobacillus GG, a different species, is suggested by multiple human studies to be a safe and effective treatment for diarrhea in otherwise healthy infants and children. Lactobacillus acidophilus may aid in the management of chronic or persistent diarrhea, bacterial-overgrowth related diarrhea, and acute watery diarrhea in infants. Further research is needed to determine what dose may be safe and effective. C H. pylori infection Early studies in humans suggest a potential benefit of Lactobacillus acidophilus in this condition. More large, high-quality studies are needed to understand this relationship. C Hepatic encephalopathy (confused thinking due to liver disorders) There is limited study in this area with mixed results. C High cholesterol There is conflicting information from several human studies regarding the effects of Lactobacillus acidophilus- enriched dairy products on lowering blood levels of total cholesterol or low-density lipoprotein ("bad cholesterol"). C Immunomodulation Early studies fail to show consistent evidence of benefit of Lactobacillus acidophilus in immunomodulation. Additional studies are needed. C Intestinal blockage (partial adhesive small-bowel obstruction) Early studies suggest potential benefit of adjunct therapy with Lactobacillus acidophilus in this condition. Additional high-quality studies are needed. C Intestinal inflammation (pouchitis) Early studies in humans have failed to show a benefit of Lactobacillus acidophilus in this condition. More studies are needed. C Irritable bowel syndrome Human studies report mixed results in the improvement of bowel symptoms after taking Lactobacillus acidophilus by mouth. C intolerance There is conflicting information from several human studies as to whether using Lactobacillus acidophilus by mouth improves digestion of lactose. More research is needed in this area a before a conclusion can be drawn. C Leaky gut syndrome (gut barrier function) Early human studies suggest potential benefit of Lactobacillus acidophilus in the improvement of gut barrier function. More high-quality studies are needed to understand this relationship. C Necrotizing enterocolitis prevention in infants One human study using Lactobacillus acidophilus in combination with another bacterium ( Bifidobacterium infantis ) in infants reported fewer cases of necrotizing enterocolitis (severe inflammation of the gut), and no complications related to treatment. Additional research is necessary in this area before a conclusion can be drawn. C Premature birth prevention Early studies suggest a potential benefit of Lactobacillus acidophilus for prevention of premature birth. More studies are needed to clarify this relationship. C Vaginal candidiasis (yeast infection) Lactobacillus acidophilus taken by mouth or as a vaginal suppository has not been adequately assessed for the prevention or treatment of vaginal yeast infections. More research is needed in this area a before a strong conclusion can be drawn. C *Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.Grading rationale
Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.Acne, AIDS, antimutagenic (antigenotoxic), cancer, canker sores, colon cancer (prevention), constipation, Crohn''s disease, diaper rash, diverticulitis, E. coli infection in cancer patients, fever blisters, gastric ulcer (ASA-induced alteration prevention), heart disease, heartburn, hives, indigestion, infection, overgrowth of bacteria in the small bowel, preoperative prevention of infections or gut bacteria loss, stomach ulcer, thrush, ulcerative colitis, urinary tract infection.
Dosing
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older)Expert opinion suggests that a dose between 1 and 10 billion viable (live) Lactobacillus acidophilus bacteria taken daily in divided doses by mouth is sufficient for most people. Higher doses may cause mild abdominal discomfort, and smaller doses may not be able to establish a stable population in the gut. For vaginal bacterial infections, a dose that has been used is 8 ounces of yogurt containing Lactobacillus acidophilus in a concentration of 100 million colony-forming units (108 CFU) in each milliliter. Capsules containing 1.5 grams of Lactobacillus acidophilus were used in one study.Doses that have been used for vaginal infections include 1 to 2 tablets (containing 10 million to 1 billion CFU in each tablet), inserted into the vagina once or twice daily. Capsules containing 1.5 grams of Lactobacillus acidophilus have been used to treat diarrhea as anal suppositories.Children (younger than 18 years)Some natural medicine textbooks and experts suggest that one-quarter teaspoon or one-quarter capsule of commercially available Lactobacillus acidophilus may be safe for use in children for the replacement of gut bacteria destroyed by antibiotics. Up to 12 billion lyophilized heat-killed Lactobacillus acidophilus has been given every 12 hours by mouth for up to five days. It is often recommended that Lactobacillus acidophilus supplements be taken two hours after antibiotic doses because antibiotics may kill Lactobacillus acidophilus if taken at the same time. Consult a qualified healthcare practitioner prior to using Lactobacillus acidophilus in children, and use cautiously in those under three years of age.Liquid preparations have been used on the diaper area to treat yeast infections, although safety and effectiveness are not well studied. Consult a qualified healthcare practitioner prior to using Lactobacillus acidophilus in children, and use cautiously in those under three years of age.Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
AllergiesLactose sensitive people may develop abdominal discomfort from dairy products containing Lactobacillus acidophilus .Side Effects and WarningsStudies report few side effects from Lactobacillus acidophilus when used at recommended doses. The most common complaint is abdominal discomfort or gas, which usually resolves with continued use. Some experts recommend limiting the daily dose of living Lactobacillus acidophilus organisms to reduce the risk of abdominal discomfort. Some women have reported burning of the vagina after using Lactobacillus acidophilus vaginal tablets.There are rare reports of infections of heart valves with Lactobacillus acidophilus , and the risk may be greater in people with artificial heart valves. People with severely weakened immune systems (due to disease or drugs like cancer chemotherapy and organ transplant immunosuppressants) may develop serious infections or bacteria in the blood from taking Lactobacillus acidophilus . Therefore, Lactobacillus acidophilus should be avoided in such individuals. People with intestinal damage or recent bowel surgery should avoid taking lactobacilli.Pregnancy and BreastfeedingThere is not enough scientific study available to establish safety during pregnancy. Therefore, pregnant women should use Lactobacillus acidophilus cautiously and under medical supervision, if at all. A small number of pregnant women have taken part in studies investigating Lactobacillus acidophilus vaginal tablets and a culture of Lactobacillus acidophilus with no negative effects reported. Further research is necessary.Interactions
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with DrugsSome experts believe that Lactobacillus acidophilus taken by mouth should be used two to three hours after antibiotic doses, to prevent killing the Lactobacillus acidophilus . It has also been suggested that lactobacilli are damaged by alcohol and should not be taken at the same time. Scientific research is limited in these areas.In theory, Lactobacillus acidophilus taken by mouth might not survive the acidic environment of the stomach. Some experts have suggested that antacids should be taken 30 to 60 minutes before taking lactobacilli. However, this has not been well studied in humans.In theory, Lactobacillus acidophilus may prolong the effects of some drugs, including birth control pills, the contraceptive vaginal ring, or benzodiazepines such as diazepam (Valium®). Based on laboratory experiments, Lactobacillus acidophilus may reduce the effectiveness of sulfasalazine (Azulfidine®), a drug used for inflammatory bowel disease.Interactions with Herbs and Dietary SupplementsFructo-oligosaccharides (FOS, also called "prebiotics") are non-digestible sugar chains that are nutrients for lactobacilli. Some experts believe that FOS, taken by mouth, may help the growth of lactobacilli. Natural food sources of FOS include banana, Jerusalem artichoke, onion, asparagus, and garlic.Lactobacillus casei , Saccharomyces boulardi , or other probiotics may add to the effects of Lactobacillus acidophilus .Methodology
This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD, MPhil, MSc (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Ron Dixon, MD (Massachusetts General Hospital); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Carolyn Williams Orlando, MA (American Botanical Council); David Sollars, MAc, HMC (Merrimack College); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Lisa Wendt, PharmD (Albany College of Pharmacy); Wendy Weissner, BA (Natural Standard Research Collaboration).
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