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In clinical trial publications, in the materials and methods section where the design of the trial is described, there is rarely, if ever, any mention of fancy techniques like enteric coating1. In a random choice of 3 highly regarded clinical trials it’s evident that no enteric coating is used: L. rhamnosus GG was given in capsule form to over 180 children with positive results2; B. lactis BI-04, L. acidophilus NCFM® and B. lactis Bi-07 were given in sachet form to over 450 adults and found to boost immunity3; and S. boulardii was given in liquid form to 200 children with acute diarrhoea, with successful results4. If enteric coating is not required for clinical trials, then it should not be a requirement for the probiotic supplements taken by consumers.
In addition, the 10 most researched strains as discussed in the Fridge myth (e.g. L. rhamnosus GG and Saccharomyces boulardii) are not enteric coated in the main markets in which they are sold across the world5,6; an indication that ‘extra protection’ simply is not necessary.
Instead of focusing on the nature of the capsule or delivery mechanism, it’s good practice to concentrate on the quality of the strains themselves. It is worthwhile choosing strains which have been shown in research to survive to reach the gut alive. This can be demonstrated by two forms of research; firstly, in a laboratory the probiotic strains are subjected to various levels of stomach acid e.g. pH 2, 3, 4, which simulates the conditions the probiotics will encounter in the stomach7. Secondly, as well as this laboratory model, it’s preferable to also have evidence that the probiotics will actually survive the human digestive tract, and this can be shown by giving the probiotics to participants in a clinical trial, and measuring any health benefits as well as analysing stool samples for presence of the probiotic strains which were administered8. This really is ultimate proof that the strains are intrinsically strong within themselves, and should survive stomach acid without any need for extra protection like enteric coating.
Quality probiotic strains that have been tested to reach the gut alive, with or without extras.
Healthcare practitioners can see: Our response to recent study on probiotics
This myth has been busted by Megan Crowch, BSc (Hons) Physiology, Herbal Medicine Diploma (IRH practicing member).