Lactobacillus acidophilus
  
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 L. acidophilus for bacterial vaginosis. Other medicinal uses of L. 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 L. acidophilus and yeast such as Saccharomyces Boulardii .
Although generally believed to be safe with few side effects, oral L. acidophilus 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, Actimel®, Bacid®, DDS-Acidophilus, Enpac®, Fermalac® (Canadian), Florajen®, Gynoflor®, Kala®, Kyo-Dophilus®, L. acidophilus milk, L. acidophilus yogurt, Lactinex®, Lactobacillaceae (family) , lactobacillus, Lacto Bacillus, lactobacilli, Lacteol Fort®, MoreDophilus®, Narine®, Probiata®, Pro-Bionate®, probiotic, 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 evidenceGrade*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
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 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 and bacterial-overgrowth related diarrhea. Further research is needed to determine what dose may be safe and effective.
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. 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
Irritable bowel syndrome
Human studies report mixed results in the improvement of bowel symptoms after taking Lactobacillus acidophilus by mouth.
C
Hepatic encephalopathy (confused thinking due to liver disorders)
There is limited study in this area, with mixed results.
C
Asthma
There is limited research in this area, with unclear 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
Lactose 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
Necrotizing enterocolitis prevention in infants
One human study using L. acidophilus in combination with another bacterium ( B. 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
* 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 (it may not work);
F: Strong scientific evidence against this use (it likely does not work).
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, allergies, cancer, canker sores, colitis, colon cancer prevention, constipation, diaper rash, Crohn's disease, diverticulitis, infection in cancer patients, fever blisters, heart disease, heartburn, hives, immune enhancer, 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.
Standardization
Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. L. acidophilus is commercially prepared as a concentrate, in a freeze-dried form, or as viable cultures. For all formulations, the dose is based on the number of living organisms. Standardization of L. acidophilus has been a challenge, because it is difficult to assess which products have live bacteria and are free from contaminants. Significant variations in effectiveness and shelf life have been observed. Storage conditions and the length of time the product is stored can alter the effectiveness, and refrigeration is recommended for L. acidophilus products. Pasteurization kills L. acidophilus.
Adults (18 years and older)
Tablets/Capsules/Liquid/Yogurt : Expert opinion suggests that a dose between 1 and 10 billion viable (live) L. acidophilus bacteria taken daily in divided doses 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 L. acidophilus in a concentration of 100 million colony-forming units (10 8 CFU) in each milliliter. Capsules containing 1.5 grams of Lactobacillus acidophilus were used in one study.
Vaginal Suppository: 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.
Children (younger than 18 years)
Tablets/Capsules/Liquid : Some natural medicine textbooks and experts suggest that one-quarter teaspoon or one-quarter capsule of commercially available L. acidophilus may be safe for use in children for the replacement of gut bacteria destroyed by antibiotics. In one study, 10-12 colony forming units (cfu) per gram twice daily for 5 days was used. It is often recommended that L. acidophilus supplements be taken two hours after antibiotic doses, because antibiotics may kill L. acidophilus if taken at the same time. Consult a qualified healthcare practitioner prior to using L. acidophilus in children, and use cautiously in those under three years of age.
Applied to the Skin: 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 L. 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.
Allergies
Lactose sensitive people may develop abdominal discomfort from dairy products containing L. acidophilus.
Side Effects and Warnings
Studies report few side effects from L. 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 to fewer than 10 billion living L. acidophilus organisms to reduce the risk of abdominal discomfort. Some women have reported burning of the vagina after using L. acidophilus vaginal tablets.
There are rare reports of infections of heart valves with L. 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 L. acidophilus . Therefore, L. acidophilus should be avoided in such individuals. People with intestinal damage or recent bowel surgery should avoid taking lactobacilli.
Pregnancy and Breastfeeding
There is not enough scientific study available to establish safety during pregnancy. Therefore, pregnant women should use L. acidophilus cautiously and under medical supervision, if at all. A small number of pregnant women have taken part in studies investigating L. acidophilus vaginal tablets and a culture of L. acidophilus with no negative effects reported. Further research is necessary.
References
1. Agerholm-Larsen L, Raben A, Haulrik N, et al. Effect of 8 week intake of probiotic milk products on risk factors for cardiovascular diseases. Eur J Clin Nutr 2000;54(4):288-297.
2. Alm L. [Acidophilus milk for therapy in gastrointestinal disorders]. Nahrung 1984;28 (6-7) :683-684.
3. Anderson JW, Gilliland SE. Effect of fermented milk (yogurt) containing Lactobacillus acidophilus L1 on serum cholesterol in hypercholesterolemic humans. J Am Coll Nutr 1999;18(1):43-50.
4. Arvola T, Laiho K, Torkkeli S, et al. Prophylactic Lactobacillus GG reduces antibiotic-associated diarrhea in children with respiratory infections: a randomized study. Pediatrics 1999;104(5):e64.
5. Bayer AS, Chow AW, Betts D, et al. Lactobacillemia--report of nine cases. Important clinical and therapeutic considerations. Am J Med 1978;64(5):808-813.
6. Berman S, Spicer D. Safety and reliability of lactobacillus dietary supplements in Seattle, Washington. American Public Health Association 130th Annual Meeting, November 9-13 2002;A37244.
7. Boulloche J, Mouterde O, Mallet E. Management of acute diarrhea in infants and young children: Controlled study of the antiarrheal efficacy of killed L. acidophilus (LB strain) versus a placebo and a reference drug (loperamide). Ann Pediatr 1994;41(7):457-463.
8. Chomarat M, Espinouse D. Lactobacillus rhamnosus septicemia in patients with prolonged aplasia receiving ceftazidime-vancomycin. Eur J Clin Microbiol Infect Dis 1991;10(1):44.
9. Clements ML, Levine MM, Ristaino PA, et al. Exogenous lactobacilli fed to man - their fate and ability to prevent diarrheal disease. Prog Food Nutr Sci 1983;7(3-4):29-37.
10. D'Souza AL, Rajkumar C, Cooke J, et al. Probiotics in prevention of antibiotic associated diarrhoea: meta-analysis. BMJ 2002;324(7350):1361.
11. Davies AJ, James PA, Hawkey PM. Lactobacillus endocarditis. J Infect 1986;12(2):169-174.
12. de Roos NM, Schouten G, Katan MB. Yoghurt enriched with Lactobacillus acidophilus does not lower blood lipids in healthy men and women with normal to borderline high serum cholesterol levels. Eur J Clin Nutr 1999;53(4):277-280.
13. Dehkordi N, Rao DR, Warren AP, et al. Lactose malabsorption as influenced by chocolate milk, skim milk, sucrose, whole milk, and lactic cultures. J Am Diet Assoc 1995;95(4):484-486.
14. dios Pozo-Olano J, Warram JH, Jr., Gomez RG, et al. Effect of a lactobacilli preparation on traveler's diarrhea. A randomized, double blind clinical trial. Gastroenterology 1978;74(5 Pt 1):829-830.
15. Friedlander A, Druker MM, Schachter A. Lactobacillus acidophilus and vitamin B complex in the treatment of vaginal infection. Panminerva Med 1986;28(1):51-53.
16. Gaon D, Garcia H, Winter L, et al. Effect of Lactobacillus strains and Saccharomyces boulardii on persistent diarrhea in children. Medicina (B Aires) 2003;63(4):293-298.
17. Gaon D, Garmendia C, Murrielo NO, et al. Effect of Lactobacillus strains (L. casei and L. Acidophillus Strains cerela) on bacterial overgrowth-related chronic diarrhea Medicina (B Aires). 2002;62(2):159-163.
18. Gotz V, Romankiewicz JA, Moss J, et al. Prophylaxis against ampicillin-associated diarrhea with a lactobacillus preparation. Am J Hosp Pharm 1979;36(6):754-757.
19. Griffiths JK, Daly JS, Dodge RA. Two cases of endocarditis due to Lactobacillus species: antimicrobial susceptibility, review, and discussion of therapy. Clin Infect Dis 1992;15(2):250-255.
20. Hallen A, Jarstrand C, Pahlson C. Treatment of bacterial vaginosis with lactobacilli. Sex Transm Dis 1992;19(3):146-148.
21. Halpern GM, Prindiville T, Blankenburg M, et al. Treatment of irritable bowel syndrome with Lacteol Fort: a randomized, double-blind, cross-over trial. Am J Gastroenterol 1996;91(8):1579-1585.
22. Hilton E, Isenberg HD, Alperstein P, et al. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 1992;116(5):353-357.
23. Hoyos AB. Reduced incidence of necrotizing enterocolitis associated with enteral administration of Lactobacillus acidophilus and Bifidobacterium infantis to neonates in an intensive care unit. Int J Infect Dis 1999;3(4):197-202.
24. Kim HS, Gilliland SE. Lactobacillus acidophilus as a dietary adjunct for milk to aid lactose digestion in humans. J Dairy Sci 1983;66(5):959-966.
25. Kostiuk OP, Chernyshova LI, Slukvin II. [Protective effect of Lactobacillus acidophilus on development of infection, caused by Klebsiella pneumoniae]. Fiziol Zh 1993;39(4):62-68.
26. Larvol L, Monier A, Besnier P, et al. [Liver abscess caused by Lactobacillus acidophilus]. Gastroenterol Clin Biol 1996;20(2):193-195.
27. Lidbeck A, Nord CE, Gustafsson JA, et al. Lactobacilli, anticarcinogenic activities and human intestinal microflora. Eur J Cancer Prev 1992;1(5):341-353.
28. Lin SY, Ayres JW, Winkler W, Jr., et al. Lactobacillus effects on cholesterol: in vitro and in vivo results. J Dairy Sci 1989;72(11):2885-2899.
29. Macbeth WA, Kass EH, McDermott WV. Treatment of hepatic encephalopathy by alteration of intestinal flora with lactobacillus acidophilus. Lancet 1965;399-403.
30. Michielutti F, Bertini M, Presciuttini B, et al. [Clinical assessment of a new oral bacterial treatment for children with acute diarrhea]. Minerva Med 1996;87(11):545-550.
31. Neri A, Sabah G, Samra Z. Bacterial vaginosis in pregnancy treated with yoghurt. Acta Obstet Gynecol Scand 1993;72(1):17-19.
32. Newcomer AD, Park HS, O'Brien PC, et al. Response of patients with irritable bowel syndrome and lactase deficiency using unfermented acidophilus milk. Am J Clin Nutr 1983;38(2):257-263.
33. Ozmen S, Turhan NO, Seckin NC. Gardnerella-associated vaginitis: comparison of three treatment modalities. Turkish J Med Sciences 1998;28(2):171-173.
34. Parent D, Bossens M, Bayot D, et al. Therapy of bacterial vaginosis using exogenously-applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneimittelforschung 1996;46(1):68-73.
35. Patel R, Cockerill FR, Porayko MK, et al. Lactobacillemia in liver transplant patients. Clin Infect Dis 1994;18(2):207-212.
36. Read AE, McCarthy CF, Heaton KW, et al. Lactobacillus acidophilus (enpac) in treatment of hepatic encephalopathy. Br Med J 1966;5498:1267-1269.
37. Reuman PD, Duckworth DH, Smith KL, et al. Lack of effect of Lactobacillus on gastrointestinal bacterial colonization in premature infants. Pediatr Infect Dis 1986;5(6):663-668.
38. Saltzman JR, Russell RM, Golner B, et al. A randomized trial of Lactobacillus acidophilus BG2FO4 to treat lactose intolerance. Am J Clin Nutr 1999;69(1):140-146.
39. Satta A, Delplano A, Cossu P, et al. [Treatment of enterocolitis and other intestinal disorders with a Bifidobacterium bifidum and Lactobacillus acidophilus combination]. Clin Ter 1980;94(2):173-184.
40. Schaafsma G, Meuling WJ, van Dokkum W, et al. Effects of a milk product, fermented by Lactobacillus acidophilus and with fructo-oligosaccharides added, on blood lipids in male volunteers. Eur J Clin Nutr 1998;52(6):436-440.
41. Shalev E, Battino S, Weiner E, et al. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med 1996;5(10):593-596.
42. Siboulet A. [Vaccination against nonspecific bacterial vaginosis. Double-blind study of Gynatren]. Gynakol Rundsch 1991;31(3):153-160.
43. Simakachorn N, Pichaipat V, Rithipornpaisarn P, et al. Clinical evaluation of the addition of lyophilized, heat-killed Lactobacillus acidophilus LB to oral rehydration therapy in the treatment of acute diarrhea in children. J Pediatr Gastroenterol Nutr 2000;30(1):68-72.
44. Sussman JI, Baron EJ, Goldberg SM, et al. Clinical manifestations and therapy of Lactobacillus endocarditis: report of a case and review of the literature. Rev Infect Dis 1986;8(5):771-776.
45. Tankanow RM, Ross MB, Ertel IJ, et al. A double-blind, placebo-controlled study of the efficacy of Lactinex in the prophylaxis of amoxicillin-induced diarrhea. DICP 1990;24(4):382-384.
46. Unoki T, Nakamura I, Fujisawa T, et al. [Infective endocarditis due to Lactobacillus acidophilus group. Report of a case and review of the literature]. Kansenshogaku Zasshi 1988;62(9):835-840.
47. Van Niel CW, Feudtner C, Garrison MM, et al. Lactobacillus therapy for acute infectious diarrhea in children: a meta-analysis. Pediatrics 2002;109(4):678-684.
48. Wheeler JG, Shema SJ, Bogle ML, et al. Immune and clinical impact of Lactobacillus acidophilus on asthma. Ann Allergy Asthma Immunol 1997;79(3):229-233.
49. Witsell DL, Garrett CG, Yarbrough WG, et al. Effect of Lactobacillus acidophilus on antibiotic-associated gastrointestinal morbidity: a prospective randomized trial. J Otolaryngol 1995;24(4):230-233.
January 01, 2004 
|
