A column on probiotics brought this response from Don S. in Arizona: "One of my docs thinks supplements are important, the other thinks they are worthless. A continuing mystery until I read your quiz. My question: How do I know my (probiotic) supplements are alive? The capsules are kept at room temp for up to four weeks and the predelivery environment is an unknown."
Not an easy answer to this one, Don. As you stated, it is very important that the probiotics you consume are "live and active." In fact, the International Scientific Association for Probiotics and Prebiotics defines probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host."
How to determine if the good bugs in your particular supplement are alive is tricky.
According to the Office of Dietary Supplements (ODS), which is part of National Institutes of Health, manufacturers of these products are only required to list the total weight of the beneficial bacteria on the product's label. This doesn't tell you whether these organisms are dead or alive.
But there's another way to determine if your capsules contain live microorganisms, says the ODS. Look for the amount of colony forming units (CFUs), which some probiotic manufacturers voluntarily list on their labels. This will tell you the number of good bugs that are actually living.
But here's the kicker, as you mentioned in your question. These live probiotics can die over time, which renders them useless healthwise. That's why a good manufacturer will list the amount of CFUs in a product at the end of its shelf life or expiration date, not at the time it was manufactured.
Remember also to follow the label instructions for how to store your probiotics. Some need to be refrigerated and others can be stored at room temperature.
Here's another thing. When you're looking at the amount of probiotics in a product, one with 50 billion CFUs is not always better than one with 10 billion. That's because the healthfulness of a probiotic supplement depends on what particular strains (types) of helpful bacteria it contains and what specific health benefits have been attributed to those strains, according the World Gastroenterology Organization.
Perhaps that is why your docs have differing opinions on probiotics. Because they are not regulated by the same strict standards as drugs, it's not easy to determine which products have scientific evidence to back them up. Hence, many professional health organizations have yet to make specific recommendations for or against probiotic use by healthy people.
Lastly, don't forget that probiotics also live in fermented foods such as yogurt. Experts say these good bugs typically survive through a product's shelf life.
Barbara Intermill is a registered dietitian nutritionist and syndicated columnist. She is the author of "Quinn-Essential Nutrition: The Uncomplicated Science of Eating." Email her at [email protected].