Popular gut probiotic craps out in randomized controlled trial | Hacker News Reader

Popular gut probiotic craps out in randomized controlled trial

arstechnica.com

126 pointszdw181 comments

It’s interesting that both groups had their number of bowel movements double or more. Perhaps a lot of constipation is actually dehydration.

Like this magic pill to loose weight that you need to take before every meal with large glass of water, where pill is optional.

or Emegen-C or hangover cures

If they contain some salt they are better than just water.

If you take one of these little pills with a large glass of water for every alcoholic beverage you drink, then it will prevent hangovers.

Bingo. These finding probably aren't much of a surprise to many. Hydration is huge, as is having a well functioning and diverse biome that you feed regularly with raw fruits and vegetables. I have had my biome die back to the point of medical emergency and had to restore it. Keifer, various Greek yogurts, etc did nothing to help. I took half a bottle of a few pills that were loaded with different strains. Not only did it restore bowel function to its former glory, it improved my health overall and I feel like a teenager again (46). I was deficient and suffering for decades and just thought it was normal. It dawned on me that most people are likely suffering.

I'm far too overweight for my liking but now I don't feel fat. Restoring the biome made me stronger and more resilient (my muscles stay stronger between workouts). I just feel good all the time now. Before this I had psychologically written myself off as dying and was ready to accept my fate.

This sounds super interesting. The pills you are talking about are probiotics? Have some links to which ones you took and maybe some research you did about this?

Check my other replies for the brands. I don't think it matters as long as the quality is assured. I had known about probiotics for decades but never realized how fundamental they were to overall health. When I was going through this I just thought about my symptoms and took a hail Mary with this treatment. Bowel movements were extremely stressful at that stage. I was depriving myself of anything solid to alleviate the issues but overall I was not getting better. Previous to that I was doing fine, or so I thought. I never ate out, rarely ate meat or anything processed.

You will know when it's restored, you can even eat garbage (meat, processed foods) and your gut will process it and move on. You should be able to notice the subtle changes when you eat something that does not digest readily. It's not the acid and body mechanics, it's mostly the bacteria giving you life by breaking down nutrients and solids. Feed it what it needs and it will sustain itself. Raw and fermented vegetables.

Meat is nutritious and very satisfying per calorie, it is not "garbage". To think it is garbage is to have a very confused view of nutrition.

Ultra processed red meats are garbage. They contain far too much saturated fats and not nearly enough nutrients. Even their protein per calorie is not particularly good.

Humans of the past ate game meat. Very low fat, and almost all unsaturated fat. Closer to an avocado than a steak.

Wait what. I am 99% convinced my gas and bowel problem, an impairment at this point, is IBS or SIBO that started 12 years ago. I never thought a about just taking a half bottle of pills to see what would happen, I am going to have to look into this.

What the hell? Half bottle of what pills? Are you and the parent a bot?

Probiotic pills presumably.

Half a bottle over two weeks. Geesh.

I’m assuming the parent meant pills with few different strains. Seems like a massive dose of a few different strains would approach that of a fecal transplant.

You can't just slam pills. The pills contain the bacterium. You have to send it raw vegetables to feed it so it multiplies and sustains itself.

Oh no, I was confused because a lot of people say to try probiotic pills, but for many people they just don't work. So when you originally wrote half a bottle that confused me, I interpreted it as you were doing something different than those who tried probiotic pill supplements.

Could you describe your dosage? Was it a one pill per meal and you saw results after a few weeks? And you said raw vegetables to help it. I would like to try that, and any other specific things you did that worked.

> These finding probably aren't much of a surprise to many.

Conversely, you might be surprised at how many this is new information. Just because you learned something does not mean everyone hearing the information at the same time. Some people require hearing/reading something new only one time, others takes many attempts. I think the number of people that walk around with a suboptimal fluid intake is much higher than we might hope, especially in the USA

Which pills specifically did you take?

what did you take - specifically?

You should return and tell us with some specificity what you took.

I'm hesitant to mention brands. Any independently tested product with a wide variety of strains should be good. I started on Physicians Choice from Amazon and followed up with Garden of Life (not sure who sells it). During repair phase I would only eat salads made of hand shredded green and purple cabbage and kale. Equal amounts cabbage kale mixture and shredded ice berg lettuce. I used ranch dressing and added other vegetables and crushed corn chips. To each his own.

These were huge salads. I couldn't even think of eating anything else after I finished them.

I agree, and that's why they used a "randomized triple-blind placebo-controlled clinical trial".

That's plausible, but also, could be the frequent things just getting better on their own over time.

I actually thought it was misleading of the headline to say the probiotic crapped out...

A lot of people take probiotics to improve their general digestion (and not specifically for constipation). But it sounds like the study didn't even look at any of the other uses at all...

Best gut related health I ever had was living in France and eating stinky raw cheeses and different fermented foods. Like clockwork.

Gotta hit up the cheese fests now

There’s two different effects hidden in that statement

> living in France

I have had similar experience where my gut health was immediately, noticeably better in Europe. I was eating the same foods and somehow it was better.

> Eating stinky raw cheeses and different fermented foods

Raw and fermented foods in cultures across the world are linked to better gut health. However, industrial fermentation and packaging won’t help you as much because the diversity of microbes drops and packaging often kills most of them. We need to bring back the culture of home fermentation.

> my gut health was immediately, noticeably better in Europe

Its because a lot of the weird artificial junk that are allowed to be put into your food is illegal in Europe. Even things like popular sweeteners have been shown to have a negative effect on your gut health.

Most sweeteners also have been shown to cause more weight gain than sugar (they screw up your metabolism). Unless you’re diabetic, there’s literally no reason to consume them.

I'd like to see a source on that, because (excessive) sugar literally causes diabetes.

And of course high sweetener consumption is must be strongly linked with in general high calorie input and overweight people trying to reduce calorie consumption.

Your first point probably isn't actually true. The research that first connected the two showed that across a population sugar consumption up -> diabetes rates up. But it turns out that when you control for weight the effect of sugar specifically is much much smaller. To the point where if you're a healthy weight your sweet tooth isn't moving the needle.

Oh that's not true at all. First I think they taste better, they're sweet without being syrup-y. Second it allows me to drink a lot of soda, 5+ cans a day adds up when it has calories. I have no expectation that it helps me lose weight, it's just tastier water.

It's funny that folks will look down on diet soda but then be fine with tea and coffee and sports drinks like the bubbles make it meaningfully different.

5+ cans of soda a day seems unhealthy even if it's not caloric, the gas and acid will mess up your stomach.

It is not just tastier water.

Given that in France "water" means carbonated water and you have to specifically ask for "still water" I can't imagine the gas being that bad for you.

Acid I can get behind but soda is by far the least acidic thing I consume on the daily.

The carbonation creates carbonic acid in your teeth. It’s a huge driver of calories.

Of the of the issues with diet soda in particular is your tastes favor sweets. I used to drink 4-8 cans of Diet Dr Pepper daily. When I stopped, after a couple of weeks I found my taste preferences to be very different. I’d favor savory more attractive and sweet stuff would seem too sweet.

I can't fine anything talking about carbonic acid and calories. Is there something you're referring to?

Maybe they meant cavities?

Probably typed “caries” and got autocorrected

Sorry - it was supposed to be “cavities”. Too late to edit I’m afraid.

No, they have not. The evidence points the opposite way (people lose more weight on non-nutritive sweeteners than sugar).

Also non-flouridated, non-chlorinated water.

I lived most of my life in an alpine European village; water was chlorinated and flourinated, more than in my current US location. There was a huge difference in mineral content, US water being almost distilled (1 to 3 French degrees hardness) VS something like 15-20 in Europe

Water hardness varies by location worldwide, including the US.

Non-flouridated is gluten-free, right?

Artisanal

The preservatives in flour / bread / etc are illegal in Europe. My sister is allergic and can’t have any bread in the USA. But can in France and Italy.

Yeah, things like titanium dioxide are considered a carcinogen by the International Agency for Research on Cancer (IARC) yet FDA says its safe for use in food. But i guess trust the science and authorities

IARC usually says that something has carcinogenic potential, which is almost completely useless information for something that we already ingest in absurd quantities without a cancer epidemic.

Please share the names of these preservatives.

Durex and Trustex.

Europe puts plenty of E numbers in their food (the US just spells it out versus hiding it under a number). There are things illegal in the US that are used in food in Europe. A lot of the time, at least for things like pesticides, the different is country of origin of manufacturer.

E numbers have very little to do with this. They are just a way to categorize food additives.

What else would you characterize “ weird artificial junk” as?

E numbers cover everything that can be added to food. Some examples would be E164 Saffron, E290 carbon dioxide, E428 gelatin.

None of these are anywhere near the "weird chemicals category". You'll find that all euro foods have Es in them, but it doesn't mean they have half-tested industrial food additives in them.

Those are very selective things you picked.

E100–E199: Food coloring, such as turmeric (E100) and paprika (E160c)

E200–E299: Preservatives, such as sulfur dioxide (E220)

E300–E399: Antioxidants and acidity regulators, such as ascorbic acid (E300)

E400–E499: Thickeners, stabilizers, emulsifiers, and gelling agents

E500–E599: Acidity regulators and anti-caking agents

This is pretty much the spectrum. Red 40, aka Allura Red AC aka E129 is illegal in the US, legal in the EU, and carries a warning in the EU. Let’s not pretend that the wonderful world of chemicals and industrialization doesn’t exist in Europe.

No one is pretending anything. I said all foods in the EU have E numbers in them, but it doesn't mean they have industrial chemicals.

Allura red isn't illegal in the US.

Also, just wondering, what do you think is the problem with turmeric and paprika?

Growing up in the EU in the 00s there was always the public health concerns of E numbers causing this or that.

Ironic in a way, because E numbers mean that the specific chemical has been cleared as a foodstuff in the EU, IIRC.

Though I suppose it’s more concerning if an approved substance has some unforeseen effect versus an unapproved one and you’d want to investigate further.

I guess it shows how government regulation of naturally occurring substances (though perhaps synthesized, or refined) carries with it a new set of incentives, and reasons to be political. Not that I’m against regulation, but it’s hard if not impossible to have a truly politically neutral approach.

> a lot of the weird artificial junk that are allowed to be put into your food is illegal in Europe

What are some examples? A list would be helpful.

I don’t follow this too closely, but having been in Europe for a few weeks, the food tastes noticeably better and is often cheaper than the US.

One of the things you notice is shorter ingredient lists on prepared food. The ingredients in Italy for McDonald’s French fries are: potato, salt, oil. In the US there’s 7-8 including hydrogenated soybean oil and flavor/color agents. Oreos were similarly different, and arguably better tasting.

I believe they regulate flavors and coloring additives differently, and many people feel both of these type of items can be problematic.

But of course can never happen because it only takes a minority to cry about a few factual bad stories and present the fallacious "is it worth it" argument. "Is your epicurian enjoyment worth even one dead baby?" And a majority who have no reason to think much about it go along with it because no one will say "yes it's worth it" and few are able to articulate how the question was invalid in the first place.

The opposite minority argument, that variety, depth, richness, are important, not luxuries, don't have their own dead babies to present. They do exist, but they aren't visible except in aggregate. You can measure a change in average health over the course of entire generations, and from that you can extrapolate the change in number or frequency of deaths, and then you could compare numbers of dead babies. But you can't obviously show any particular cause & effect because there are so many other variables, and even if you could, it took entire generations whole lives lived and died before they could benefit anyway.

okay wow deep breath, you can just ferment things at home, it’s fine, I did it twice last week

That doesn't actually solve anything.

How do you know until you've fermented something at home and risked life, limb, dead babies etc. by consuming it? I think more people die from food poisoning in restaurants each year than people do from doing something stupid while making sourdough bread, natto, tempeh, kombucha, beer, wine etc. at home.

Also, it’s usually pretty obvious when fermenting goes bad. My take is fermentation takes a while which really allows the biological process to become really positive or really rancid.

It doesn't solve anything because it's an individual action to a societal problem.

There's no societal problem of hidden deaths because of fermented foods. But assuredly there is because of "safe" ultra-processed convenience foods.

The societal problem is that we have low quality food. Across the board. Every where you go, all that's available is mostly low quality.

The option to spend more money, or have your own garden, or do some kind of home production is a vanishingly insignificant individual action that solves nothing except for like 11 people.

But of course can never happen

Home fermentation of foodstuffs is allowed, and always has been.

Lots of people do it. Kits are available on Amazon, and many grocery stores will even sell them in-store. As other people on this thread of have pointed out, they ferment a lot of their own foods and drinks.

What isn't allowed is selling home-fermented stuff to others. When someone goes commercial, rules kick in to protect their customers

What can never happen is the majority agreeing that it's good, and actually doing it, and having this become so accepted that it is no longer disallowed for selling. Without selling, most people will not get it.

It's possible. A wave could go through where it becomes popular and the majority adopt some new attitude on that topic. But it "can never" because of the dynamic I expressed. That works against it. The new thought is not developing in a vacuum.

having this become so accepted that it is no longer disallowed for selling.

This is a nonsensical train of thought that conflates multiple distinct issues.

Fermented products are already widely sold in stores and restaurants. And homemade foodstuffs can already be sold but are subject to the same rules and regulations that govern foods made in commercial facility. These rules generally preclude the sale of homemade fermented foodstuffs, because the risk of contamination if the foods are improperly fermented is extremely high and most home kitchens lack the necessary equipment or facilities needed because this is all very expensive compared to consumer equipment. This is why there are so few fermented foodstuffs available at farmer's markets in the U.S.; the initial capital outlay puts it out of reach.

I agree about diversity. We use a very limited range of cultures in mass manufactured foods.

>I have had similar experience where my gut health was immediately, noticeably better in Europe. I was eating the same foods and somehow it was better.

Could be due to you being in a better mental state. Gut-brain axis is very evident for me personally. If I am tense gut is the first to get affected.

The refusal to over-industrialise food in Europe (compare to the US) leads to higher quality, more "natural" food.

Another possibility: dishwashers are more rare in Europe - the soap residue some of them leaves on irritates some stomachs.

That sounds counter-intuitive? I doubt most people take the time to rinse everything off with clear water. Dishwashers on the other hand always have a rinsing step

Maybe the problem is rinse aids in dishwashers? These prevent spotting on glass by adding detergent.

I just put water in the rinse aid dispenser of my dishwasher.

redacted, see correct info in replies

I don't believe that's true. To quote wikipedia: "Rinse aid (sometimes called rinse agent) contains surfactants and uses Marangoni stress to prevent droplet formation, so that water drains from the surfaces in thin sheets, rather than forming droplets."

Looking at the back of a bottle of Finish Jet Dry (which I have refilled with water), the original stuff's first ingredient (after water) is "C 12-15 Alcohols Ethoxylated Propoxylated". These are nonionic surfactants, and are not what one normally means by "alcohol" (ethanol).

I can understand where the idea came from. Drinks like wine will exhibit sheeting on the sides of glasses too. The concentration of alcohol needed for that to happen is probably too high in a dishwasher, I'd imagine.

> I just put water in the rinse aid dispenser of my dishwasher.

Curious... Rinse cycle already uses plain water, so you are adding water to... water?

It's to keep the annoying "fill the rinse aid dispenser" light from always being on.

Yeah but dishwasher soap is a different kind of soap, it's way stronger. Plus dishwashers also use rinse aid which has its own set of problems.

There is enough residue left over that even diluted 1:10 its still cytotoxic. [1]

I seem to recall a post here a while ago showing that dishwasher residue was genotoxic as well but can't find it atm.

[1] https://www.sciencedirect.com/science/article/pii/S009167492...

It was about the rinse aids in commercial dishwashers at commercial dose levels. Residential levels were not shown to be harmful.

I've healed several friends' tummies by telling them to stop using rinse aid.

It's very, very definitely a thing.

Here is the full text of that article:

https://www.sciencedirect.com/science/article/pii/S009167492...

https://www.statista.com/forecasts/1174175/dishwasher-owners...

I'd love to see this stat but I don't have access - mind posting the gist of it?

the travel makes people on average bodily better. usually a lot of walking involved, which has a lot of health benefits, especially for folks who come from the US

My wife recently got Kombucha mushroom from a friend, and got into fermenting it herself. Its trivial to do, you need to really screw up something for it to go wrong, tons of good bacteria inside. She takes some basic precautions like avoiding metal parts (since the drink becomes acidic), otherwise its on autopilot, good bacteria outcompete everything else for resources.

She mixes it with some cut fruits to get some sugars for fermentation, the result is very mild alcohol content (maybe 0.5%) and it tastes like cider. I mix it maybe 1:3 with water and its semi-eternal homemade drink. Can't really complain.

That and of course french cheese, we live maybe 5km from French border and for cheese its much better place than even Switzerland (sorry guys gruyere is great but french variety is huuuuge in comparison and they even usually have specialties like old dutch gouda which is taste heaven for me and various truffle-infused ones).

Fyi kombucha isn't made from a "mushroom". It's a combination of bacteria and yeast and can be found in the liquid itself or the pellicle (blob of organic tissue) that forms during fermentation.

https://en.m.wikipedia.org/wiki/SCOBY

Wow, hearing about “tea mushroom” (that’s how it’s called in Ukraine) for my whole life, and it’s not a mushroom!

Fascinating.

Well, it is a partly a yeast, which is a fungus, as are mushrooms. The main thing is that it is a symbiotic combination of particular yeast and bacteria strains, unlike what is used for brewing alcoholic drinks (just yeast) or fermenting dairy into yogurt (just bacteria).

Kefir is another combination of yeast and bacteria, though different strains.

It’s called a scoby

There are some choices you can make that seem innocuous but dramatically increase the chances of lethal outcomes, like using corn or coconut.

https://www.youtube.com/watch?v=yXnSYfv6bCA https://en.wikipedia.org/wiki/Bongkrek_acid

Thank you, I would never thought about using corn for such stuff, but that coconut surprised me

Are you lactose intolerant?

A small amount of lactose can have a sort of laxative effect without causing discomfort.

This is about Bifidobacterium animalis subsp. lactis.

Personally I take L. Reuteri supplements, which for me have made an unbelievable difference in suffering from IBS symptoms (and have some clinical evidence to support having an effect). This was a result a recommendation somewhere else on HN about 2 years ago now, so I'll pass it forward whenever the topic comes up.

In my experience it took about 3 months to see effects (during which time I did feel somewhat worse), and currently if something happens - i.e. I get sick - then there's a bit of reversion towards feeling bad. But: I was also able to stop taking them for about 6-9 months before it seemed like the effect was diminishing.

Which version of L. Reuteri did you take?

I use Biogaia Protectis by brand.

This has helped some folks' IBS symptoms: https://www.vsl3.com/

Contains:

  Streptococcus thermophilus 
  Bifidobacterium breve 
  Bifidobacterium lactis (previously classified as B. longum)
  Bifidobacterium lactis (previously classified as B. infantis)
  Lactobacillus acidophilus
  Lactobacillus plantarum
  Lactobacillus paracasei
  Lactobacillus helveticus (previously classified as L. delbrueckii subsp. bulgaricus)

I'll have to research L Reuteri, thank you for mentioning it.

Might include b. subtilis on your list.

Same. Immensely helped my gut, and uh, other things too.

There is a lot of confusion on how to interpret studies.

The reasoning of this article seems to be "The study did not produce a significant result, therefore the treatment is ineffective".

But that is not how to think about significance.

Otherwise, you could show for any treatment that it is ineffective. By simply doing a study small enough to produce an insignificant result.

True, but in this case the study sponsor is financially motivated to find a non-null result, not a null result.

This mistake is so unbelievably frequent. Need a concise quip like “correlation isn’t causation”.

Yes, that might be helpful.

First attempt:

    Insignificant does not mean ineffective

Not as good as "correlation isn't causation" though. I wonder if there is a better quip. Or if the concept is too complex to wrap in a catchy statement.

“Insignificance isn’t ineffectiveness”

Don't buy probiotics - eat quality grass-fed organic yogurt (such as Trimona [0]) and home-made sauerkraut - these have centuries of evidence. As a Bulgaria, we traditional make sauerkraut every year. It's pretty easy to have it, you just need a little more attention to it in the first weeks. The juice is amazing, too. You can buy it from Amazon [1].

[0]: https://trimonafoods.com/

[1]: https://amzn.to/3ZO0Sxl

and by "evidence" you mean?

Longevity in general (don't judge by today's fully Lidl-ized & Kaufland-ized diet of modern Bulgarians). The research dates back to the 19th century and Ilya Ilyich Mechnikov [0].

[0]: https://en.wikipedia.org/wiki/%C3%89lie_Metchnikoff

https://nutritionsource.hsph.harvard.edu/food-features/yogur...

That article says

> Epidemiological research on specific health effects of yogurt is still limited but a few studies suggest a benefit.

It then describes three non-randomized observational studies.

That's the issue with nutrition - you can't really randomize as every person is on a different diet that's hard to control. Plus, how are you going to radomize when people know what they're eating - you can't create non-yogurt that's identical to yogurt for the controls!

Well, you can’t blind it but you can still randomize. If your outcome variables are sufficiently objective and important (e.g., mortality or cancer risk, not just perceived health), the possibility that the causality flows through a placebo effect is much less worrying. If [people correctly believing that they ate yogurt] reduces [the incidence of cancer], great!

I meant to say blind, not randomize, sorry.

So you admit that those links you posted don't constitute evidence towards the products you suggested. Interestingly enough, you were so happy to dismiss the studies about probiotics yet you are so keen not to do the same for yours even when none of them have any evidence towards its benefits

> these have centuries of evidence

This sounds like the good old 'we have always done it therefore it must be good'. That is not evidence.

Read the work of Ilya Ilyich Mechnikov [0].

[0]: https://en.wikipedia.org/wiki/%C3%89lie_Metchnikoff

Huberman [1] lists several studies emphasising mucrobiota diversity and health as the major factor. These studies seen to find that the way to get it is fermented foods, like sauerkraut, kimchi, kefir etc. and that commercial probiotics don't seem to do much.

[1] https://www.hubermanlab.com/newsletter/6-key-tools-to-improv...

Should be noted that constipation relief is far from the only benefit that probiotics provide to your gut biome. Healthy gut biome has been linked to lower levels of depression and lots of other things seemingly unrelated.

> Should be noted that constipation relief is far from the only benefit that probiotics provide to your gut biome.

You mean claimed to provide.

Anecdotal but I'm on a very strict diet, to the point where I have the same thing every meal, every day. There's certain probiotics I take that help bowel movements and some that slow things down. It's very repeatable and given I eat the same thing every meal every day and I'm on a regular eating and activity schedule that leaves very little other variables.

My guess is that for regular people the benefit is insignificant but it's greater for people with issues (dysbiosis).

And the type of dysbiosis you have will determine the effect of the probiotics. For some it can slow motility or cause constipation and others increase motility or cause diarrhea.

There's so many internal variables with your gut microbiome and there's a general lack of reliable methods to test your microbiome. This makes tests like these really difficult and also makes it difficult to treat digestion issues. Because of this, all gastro doctors can really do is slap on IBS/IBS label but not really have a course of action with any decent success rate.

Read the article, placebo was just as effective as these "probiotics".

Wasn't this only about supplementation?

Why is it interesting to just test one brand of probiotic with a single strain of bacteria?

Surprised to see it on arstechnica and HN.

The companies selling products containing that bacteria would like to sell more units. Agree that the null result is not super interesting.

Yeah, both the title and content of the arstechnica are spreading misinformation. The mainstream media has always been terrible at accurately representing the findings of a given academic study, but this is disappointing.

The study was conducted with people who had chronic constipation as measured by complete spontaneous bowel movements (CSBMs). A bowel movement qualifies as a CSBM if the individual had not used a laxative within the last 24 hours. Prior to intervention, participants had a mean of 0.77 CSBMs/week with an SD of 1.0. That is quite extreme so the results of the study cannot be generalized to the general public.

Additionally, both the probiotic group and control group experienced positive effects, even if the probiotic group didn't outperform the control group. That's extremely meaningful and requires further investigation. Perhaps the belief of taking a digestive supplement caused individuals lower stress and/or motivated other healthy lifestyle changes? Science shouldn't be viewing the placebo effect as evidence that something else is BS; we need to view the placebo effect as a psychological tool to effect positive change.

Finally, the study tested only one bacteria strain. I have not seen any recommended probiotic supplement that includes only one strain of bacteria.

More research is needed; the title is clickbait and the article doesn't sufficiently emphasize the major limitations of the study. Really a shame to see that type of reporting.

For what it's worth, I always thought that yogurts, etc. are better at slowing down digestion/dealing with diarrhea than constipation.

That is my experience too. Although *google says this probiotic is associated with both diarrhea and constipation, by improving gastrointestinal health

And would probably depend on what caused their constipation

Gastroenterologist here: Almost all probiotics are just a placebo with good marketing. There are a few that actually help like Florastor for C difficile colitis (https://florastor.com/) and VSL#3 for Ulcerative Colitis (https://www.vsl3.com/). Stop wasting your money.

I'd never heard a single strain could affect constipation, so these results unsurprising.

Where attention to the gut biome has really saved lives is when a person has massive Clostridium difficile overgrowth – which is more associated with uncontrollable diarrhea than constipation. This state of extreme illness is typically only possible because prior antibiotic use cleared out the natural variety of commensal bacteria that normally keeps this particular strain at bay (or totally absent).

In such cases, people near death can bounce back after a full-spectrum "fecal microbiome transplant" (FMT) where all of the hundreds-or-more of distinct bacterial species are transferred from a healthy donor to the patient.

It's quite hard to package all those sensitive, beneficial, adapted-just-to-the-human-gut strains for reproducible evaluation & administration – so FMT is hard to fit into standard medical studies & FDA approval processes.

But sometimes a mere dot's worth of a healthy person's feces can be a miracle cure for someone else! So, a company has driven an approval of their particular $10k-per-treatment shit-pill through FDA processes, and partially as a consequence, the FDA has been cracking down on people arranging FMTs in less-formal & far-cheaper ways – despite a great record of safety and effectiveness.

A well-informed & highly-opinionated rant on this topic: "A Monopoly on Poop" https://stephenskolnick.substack.com/p/a-monopoly-on-poop

Apparently almost any strain of lactobacillus should be able to make some type of yogurt (each one with a distinct flavor). I have taken relatively expensive probiotic supplements sold in a very famous supermarket in the US known for this type of thing (yes, that one), which claim to have close to a dozen strains of lactobacillus. It was utterly incapable of even beginning to make yogurt. It was just plain milk at the end of the process, not even a discernible yogurty taste to it. On the other hand, we had great success using a cheap yogurt starter we found sitting around that had expired 5 years ago. I would love to have a full spectrum of probiotics, but can't spend the money to actually find one that works, so I have to stick to homemade yogurt.

After getting really annoyed with the pseudoscientific naming around this I built a whole site about it a couple of decades ago to get to the top of search results and got threatened with a lawsuit by Danone...

https://whatisbifidusregularis.org/

More specifically "probiotic X didn't work for Chinese people with constipation"

But that's a typical arstechnica title

The thing that has treated acute IBS episodes for me is ib guard. The green box. Though I'm pretty sure the primary ingredient is just peppermint oil.

Maybe they need to move upstream.

My wife is all-enthusiastic about oral probiotics (as a cure-all). She's been watching some Chinese medical experts yak about that.

“Popular gut probiotic craps out…”

My hat’s off to the copy editor who wrote that headline.

How does one actually go about procuring good probiotics? Short of doctor I mean

The headline is some of the best output I've recently seen.

It's a solid and well-formed contribution.

Both of you sound like bots

That was the wrong criticism and your model will need to be retrained. The correct response is "this isn't Reddit".

good bot

Ah, I'm not definitely not todsacerdoti , who automated reposting all of lobste.rs to HN.

My pithy comment was actually inspired by Sir Patrick Stewart's interview about his role in the Emoji movie: https://youtu.be/CgAIqP6hNlQ?t=215

I prefer these bots to those that prose profusely generating larger than human piles of crap...

Yeah, but the register is more regular. This one’s been ripening for a decade and is as fresh as the day it was produced:

https://www.theregister.com/2014/01/20/haribo_gummy_bears_im...

Beth Mole is as consistent as ever

Every so often you get the chance to make something perfect. Must have been a good day.

Whenever some theme gets broad advertising, I get suspicious. "Helps boost the immune system!" -- WTF does that mean?

"Probiotics for gut health!" -- yeah, right. Get back to me in 10 years when you have some actual evidence.

im over ars

It also became a site I rarely visit compared to some years back when I did several times a day and even subscribed. They have some good writers in house but otherwise it has descended into politics and pop culture movies and gadgets, with the odd ode to violence like monkey torture stories or Viking eviscerations. The space news are maybe the best online.

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