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Comment by zamadatix | Hacker News Reader

When I asked my doctor about which kinds of probiotics are most effective she specifically mentioned refrigerated vs non-refrigerated is not a way to identify quality or effectiveness unless you know the specific strain(s) needed cannot be made shelf-stable. This lined up with asking my endodontist after they prescribed some antibiotics for a tooth infection. They did warn that the use by dates are a bit bull, not to stock up on them as they do deteriorate in quality with time, and not to try to keep even the shelf-stable ones above room temperature.

Maybe I misunderstood what my doctor said, maybe my doctor was just wrong, maybe it's actually extremely nuanced, maybe it's something I hadn't even considered. I guess all I'm saying is it's probably better to talk to your doctor(s) about it than follow self-sourced (in both the above and this comment) medical advice from HN.

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Also frankly, doctor =/= expert on probiotics.

None of their training really addresses that and while they might be more qualified to read research than random layman I would not in general ascribe authority to what a random practitioner has to say about probiotics. Frankly, the research on probiotics is still very much in its infancy and a LOT remains to be figured out.

> doctor =/= expert on probiotics

Medical microbiologists would love to have a word with you. Medicine and medicine-adjacent disciplines each develop institutional knowledge that percolates from each specialized discipline.

> …the research on probiotics is still very much in its infancy and a LOT remains to be figured out.

I’m curious who you think does the research. It’s certainly not Bubba from down the creek.

PhDs do the research. Not your typical overworked family practitioner.

They don’t develop treatment protocols or testing modalities either. Knowledge gets disseminated as best practices and gets applied as needed to different specialties.

If probiotics is what you’re after, why not eat or drink something fermented?

Absolutely, if you have access to domain specific experts or researchers than that should trump whatever your more generalized expert will say.

Also right to highlight that just because there exist specialist in something does not mean we have the full or correct understanding yet, it's just your best place to find information regarding it unless you want to go join the field.

Great points!

>self-sourced

It's not "self-sourced" whatever that means (like that's a bad thing per se?). I saw the sausage being made and I spoke to the sausage makers. The source is the sausage makers, not me. Sorry I don't have a link. These facts may or may not be trade secrets.

"Self-sourced" as in both of our comments are hearsay: we say we heard this information from someone and our source for that is only us saying so. That's pretty bad in terms of what others can actually do with that information (from either of our comments). Not just because hearsay can be faked, but more because it's unquestionable, untestable, and the quality of the information has almost always greatly degraded compared to the source.

This doesn't mean the comments should be assumed to be false any more than they should be assumed to be true. It also doesn't imply we necessarily have some way to provide an actual source either. Just that folks will have to go elsewhere if they want any certainty about this information, since we didn't provide any as random usernames on a message board saying we heard something before.

> maybe my doctor was just wrong

Yes, doctors are similar to mechanics or any other trade, in that some simply suck.

Some got Ds.

“ and not to try to keep even the shelf-stable ones above room temperature.” - hate to ask, but night brain kicked in - could I trouble you to give me an alternative way of phrasing this? I keep parsing it as “don’t even bother trying to keep probiotics warm”

"Even the ones that can be kept outside a fridge shouldn't be kept above room temperature".

No night brain, just a good splice on my part after editing that sentence down :). stavros has a great rewrite already, but an even more succinct one for just the particular snippet could be:

"even shelf-stable probiotics should not be kept above room temperature".

"room temperature" has a whole lot of variation without even thinking about the extremes of population location. :(

They gave it as a defined term with a pdf copy of https://www.goodrx.com/drugs/medication-basics/which-is-the-... describing the ranges - I just neglected to include all of that detail in my comment :). Another example of why it's great to discuss with your doctor instead of advice from forum comments! Googling around, apparently these values are standardized for pharmacology in the US by the USP, other areas may have other standards.

Hope that helps!

Heh, yeah the "68°F to 77°F" range which that PDF quotes as room temperature (20°C to 25.6°C in proper units) is very much NOT room temperature anywhere near me either. ;)

The last step in the receipt of my first beer batch stated: "now store it at a warm place around 21ºC".

No way I could find a place this cold during Rio de Janeiro summer.

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