iThei mdcdaelcinfd o c elllllrllll ethhsbmbkceThat said, most probiotics in health food stores have maintenance doses
of beneficial bacteria—doses that are too low to heal and make an impact
on intestinal flora. A super-expensive high-potency probiotic may con-
tain 10 billion CFUs per capsule, while the minimal therapeutic dose for
changing the gut flora is 60 billion CFUs.
For adults, I advise starting with a 10 billion CFU dose and increasing
every few days until die-off is seen.
I have tried a variety of different probiotics, and some were a waste of
money. To significantly change gut flora, I recommend only two probi-
otic companies.
Pure Encapsulations makes a high-quality line of multistrain probiot-
ics with 10 billion CFUs (Probiotic-5) as well as a 50-billion CFU dose
(Probiotic 50B). These are a good start but may be insufficient, depend-
ing on the degree of gut dysbiosis. In severe cases if dysbiosis, the 50
-billion dose may not be enough.
VSL#3 is a therapeutic-dose, multiple-strain, pharmaceutical-grade pro-
biotic from Sigma-Tau Pharmaceuticals, which has been studied in the
context of improving bacterial flora and disease outcomes in ulcerative
colitis and IBS. VSL#3 contains 450 billion CFUs per dose. You would
need to take forty-five capsules of the brand sold in health food stores to
equal one dose of VSL#3! (At $50 for sixty capsules, you would be spend-
ing $150 every four days!)
Sometimes we may even need to supplement in the trillions of CFUs.
This makes sense as the gut is home to 100 trillion bacteria, yeasts, and
other microbes. For a properly functioning immune system, we need a
balance of approximately 85 percent beneficial to 15 percent of poten-
tially pathogenic bacteria.
The human intestines have been found to host between 7 and 50 percent
of gram-negative bacteria. It is unclear how many CFUs of beneficial
bacteria it takes to displace one CFU of pathogenic bacteria. Providing
one trillion CFUs of beneficial bacteria seems like a lot, however, it may
pale in comparison with the 16–50 trillion pathogenic bacteria that may
be present in gut dysbiosis.
Probiotic supplements do not seem to take up residence in our intestines
permanently and are described as transitional, meaning they do not grow
in the intestines. VSL#3 strains, for example, live up to three weeks in
the intestines before reinforcements—in the form of additional probiot-
ics—need to be sent in.