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Does dose has an influence on probiotic effectivity?


There is a tendency among probiotic manufacturers to add high number of probiotic cell counts to probiotic formulations, but added bacteria do not automatically equal added health benefits.

How much of a probiotic supplement should you be taking every day in order to see positive results?

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No definition exists about the minimum amount of probiotic bacteria you should be taking every day in order to see a health benefit. The definition of probiotics requires the administration of an “adequate amount” in order to obtain a health benefit. But what defines an adequate amount? The most common dose of probiotics are around 1x109 cfu/g.  It is not clear if higher doses show better health effect.

The health effect of probiotics not only depends on the dose, other variables such as; health endpoint, the specific probiotic used and mode of delivery also play a role. For these reseasons it’s impossible to determine a fixed dose that guarantees effectivity. However, meta-analyses could point in a direction towards an optimal dose. Meta-analyses enable the comparison of a large number of studies for a given health benefit. 



CFU stands for “colony forming units” and is used to quantify how many bacteria in probiotics are capable of dividing and forming colonies.

A recently published study by Ouwehand (A review of dose-responses of probiotics in human studies) investigated whether any suggestions on probiotic dose could be gleaned from the large number of human intervention studies on probiotic efficacy. The study excluded in vitro and animal studies since these are not very useful in establishing an efficacious dose in humans. The researchers divided studies in meta-analyses, meta-analyses on specific probiotic strains and studies testing two or more doses of a probiotic in the same study.


From the results the authors concluded that there is no homogeneous picture on the influence dose has on probiotic efficacy.  There are indications that dose-response effects apply for antibiotic associated diarrhoea (AAD). However, for Clostridium difficile associated diarrhoea no  dose response effect was observed.  For blood pressure, a meta-analyisis observed that higher doses (greater than 1x1011 CFU/gram) were more effective than lower doses. For other end points such as necrotising enterocolitis, prevention of atopic dermatitis, slow intestinal transit, prophylaxis in colorectal cancer, relief of irritable bowel syndrome, immune markers, general health, and bowel function no dose rose response effects were observed or the data did not allow determination of the optimal dose. 

Reasons why this study did not find a lower limit below which no effect can be observed might be due to a variety of reasons. First of all, the range of doses was very limited. In particular lower doses (less than 1x108) are lacking. Break points below which no effect is observed may therefore not be reached. Second, meta-analyses also include studies with no effect. These null studies are potentially confusing for the current research question on dose-response. It can be that the effect was not dependant on the dose but for other reasons e.g. healthy subjects, short intervention, etc. At last, the doses stated on the package might not be the actual dose in the formulation. It is common practice in the probiotic industry to overdose to ensure that the target dose is met at the end of the shelf-life. 



It is common practice in the probiotic industry to overdose to ensure that the target dose is met at the end of the shelf-life. 







 Added bacteria do not equal added benefits.

It can be concluded that the present data does not allow drawing conclusions about an optimal dose. Though, there is a tendency among probiotic manufacturers to add high number of probiotic cell counts suggesting a more effective probiotic. This however, is not backed up by the current scientific evidence. It is also important to bear in mind that the effectiveness of a probiotic not only depends on the amount of bacteria.  In the end of the day, even if a probiotics' CFU count is in double-digit billions, it’s all useless if the product fails in delivering the bacteria in reaching their intended destination. 

To be effective probiotic cultures must be able to retain their probiotic properties after processing , survive in the product during shelf-life,  stay alive during their travel through the gastrointestinal tract and become active in the intestine. Viability and metabolic activity are crucial for a probiotic to exert their health benefits. For this reason, Winclove adds PROBIOACT® Technology to their formulations. PROBIOACT® Technology includes ingredients that give food and protection to the probiotic bacteria. Every Winclove formulation contains a different mixture of bacteria and thus different PROBIOACT® ingredients. PROBIOACT® Technology boosts the effect of probiotics to optimize the result for the consumer.




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Does dose influence efficacy

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