Vitamin supplements, for example, lack expiration studies, so manufacturer labels underestimate the amounts of active ingredients to ensure that the products contain the advertised minimum quantities at expiry Andrews et al.
As probiotics comprise live organisms, it is important to monitor handling and storing probiotics so that they do not become contaminated or degrade in a manner that makes their components harmful. While the proportion of the population willing to use probiotics after expiration has not been determined, an estimated 9.
Despite this, a study has found that A study of university students revealed they presumed that the life of medications can be extended past expiration with refrigeration Aisoonphisarnkul Furthermore, as some probiotic products are expensive Annunziata and Vecchio , consumers may be reluctant to discard them. Probiotic products are available in a variety of forms and packages that include: refrigerated food, metal blister packs, plastic—metal sachets, capsules, and tablets in plastic and glass bottles.
These formats provide varying degrees of protection from the main causes of microbial cell death under storage, namely high-water activity, oxygen and heat, yet few published scientific studies have compared packaging modalities Miller et al. While there may be a potential benefit from the consumption of dead microorganisms, these are not classified as probiotic.
Studies have proven consumption of dead, heat-treated or killed probiotics, metabolites, cell fractions, culture supernatant and probiotic microbial DNA can confer health benefit Kataria et al. This is not surprising as anti-inflammatory and immunomodulation effects can be induced by cell-free supernatants De Marco et al.
This demonstrates that there may be further use for probiotic products beyond expiry Taverniti and Guglielmetti The goal of the present study was to assess the viability of randomly acquired, expired probiotic products and look for correlations with packaging, storage conditions and the time since expiry.
We hypothesized that commercial probiotics stored in compliance with the manufacturer's guidelines will contain viable microorganisms past the date of expiration. Where possible, the microorganisms present in each probiotic product were identified by DNA sequencing to ensure that the manufacturers had labeled the products correctly. Thirty-three products listed in Table 1 were tested, of which 23 are shown in Fig. They had been acquired over a number of years and stored in sealed containers at room temperature or under refrigeration.
Probiotic viability past expiration. A Expired probiotics with more than six remaining doses. NA: not available. The following information was collected for each probiotic product evaluated: genus and species of bacteria, minimum colony forming units CFU , packaging type, storage recommendations, expiration date and storage conditions.
Products without listed expiration dates were excluded from the study. One dose capsule, lozenge, powder, etc. If the dosage format was encapsulated, the powder was added to the PBS; if there was no capsule, the whole contents were added. When sufficient quantities of the probiotic product were available, six capsules were tested, each with four replicates. Otherwise, four replicates of all available doses were prepared in this manner.
All plates were checked at 24 h and counted if there was growth; however, if no growth was observed, plates were returned to grow for an additional 24 h. Microbial contents of the probiotics were confirmed when possible with selective media based on the manufacturer's claimed microbial contents.
When this was not possible, 16S rRNA gene sequencing, and internally transcribed spacer ITS region sequencing for yeast were used to confirm microbial contents. Several selective media were used to isolate all possible species from each probiotic. SF Broth ST Streptococcus thermophilus agar For probiotic products labeled as containing only one strain, a colony was isolated when there was growth. From probiotic products containing multiple species that were differentiable by selective growth media, all differentiable colonies were collected.
For the microwave method, a small portion of a colony is spread on the inside of a PCR tube and then microwaved on high for 3 min and then PCR mix is added directly to this tube. Samples were amplified using Taq DNA polymerase. The proportion of cells that remained viable at the time of testing was used as a measure of viability. Data were log-transformed to increase validity, additivity and linearity.
Significantly higher viability in package type and packaging materials was identified using one-way analysis of variance ANOVA and Tukey's honestly significant difference HSD post hoc test with Dunnett's multiple comparison test. An unpaired t -test determined significantly higher viability based on storage conditions. Spearman correlation was used to analyze years vs viability. For all probiotics, the proportion of cells that remained viable at the time of testing was compared with the time since expiry Fig.
There was a negative relationship between the time since expiration and viability, suggesting that after expiration, viability decreases over time. However, there is no specific point at which viability ceases. The correlation between years expired and viability seen in this study is similar to several other studies of probiotics Mary, Moschetto and Tailliez ; Teixeira et al.
This result is expected because older probiotics have been exposed to external stresses such as oxygen, light and moisture known to cause microbial death Tripathi and Giri for more extended periods, resulting in greater microbial death. Pill type encapsulated, compressed powder or loose powder had no impact on the viability; most were encapsulated.
This study did not identify any microorganisms that were not listed on the product labels, although not all labeled microorganisms were identified. All products with more than 6 unit dosages are shown in Fig. These results indicate that labeling of genus and species in the products tested was accurate. This finding is interesting since past studies have shown inaccuracy in scientific labeling of probiotic genera and species Weese ; Coeuret, Gueguen and Vernoux One evaluation of Lactobacillus probiotics found that 3 of the 10 human probiotics products had misidentified the species present Coeuret, Gueguen and Vernoux A second study showed incorrect labeling of 9 out of 21 products, particularly in veterinary probiotic products Weese The impact on viability of the numbers of species or strains in a product was assessed, with between 1 and 12 present in a given product.
There was no difference in viability between one or more species when looking at total cell counts of the products or individual species cell counts where tested Fig. In this study, the number of species in a probiotic product had no observable impact on viability after expiration; however, only limited investigations of individual strain's viability were conducted here.
Expired probiotic packaging and material. There is no statistically significant relationship between the number of initial species and viability of probiotics after expiration. When recommended storage conditions were not followed, there was a significant decrease in strain viability past expiration [Fig. In general, manufacturers recommend that probiotics be stored in a cold, dark, dry place or a refrigerator. Most of our expired probiotics were stored in a dark, dry box or a refrigerator for the time in our possession.
Probiotics A and B had much higher viability than the other incorrectly stored probiotics. This could be because both expired relatively recently 4 and 7 years ago, respectively and were kept in metal packaging Table 1. Packaging material had a significant impact on bacterial viability, while capsule composition did not. The protective abilities of various packaging materials were evaluated Fig.
Capsule composition was categorized based on three main ingredients found in most of the tested probiotics Fig. Although there is no significant difference between plastic and glass overall, smaller scale analyses revealed that there may be a difference in some instances. Probiotics T and U Table 1 expired 13 years ago were stored correctly and presumably contained the same organism S. Probiotic T, packaged in a plastic sachet, had no viability, while probiotic U, packaged in a glass bottle, had All other comparisons between packaging material and dosage composition were found to be non-significant.
The type of seal used on the packing lids was not evaluated here and may have also been a factor. Probiotics B and D were both contained in metal, while probiotics X and Z2 were in glass bottles with light protection. There was no other correlation between the probiotics; therefore, this difference may be due to packaging materials. Overall, glass and metal were found to be better packaging material than plastic to ensure the long-term viability of probiotics, though further studies with greater numbers are required to confirm this.
The results of this study suggest that packaging type may impact the long-term viability of probiotics after expiration. This is consistent with several other studies looking at the effect of packaging on probiotic viability prior to expiration Talwalkar and Kailasapathy ; Chaikham ; Pimentel et al. The lack of a significant difference between glass and plastic might also be because glass, despite providing better protection against oxygen, allows more light to reach the probiotic.
Over time, all packages lose their integrity and allow contaminants that lead to microbial death, regardless of composition or format. These results show that none of the packaging tested consistently provided adequate protection over long periods of time.
This study has some limitations to be considered when interpreting the results. First, we used the proportion of cells remaining to quantify viability. This proportion was computed under the assumption that the number of live cells present at the time of expiry was exactly as guaranteed by the manufacturer.
Though this was acceptable for the study, it is likely not accurate across all products because manufacturers add excess bacteria or yeast to ensure their products contain the guaranteed count at end of shelf life. Since the true count at the time of expiry may have been greater or less than estimated, this could have increased or decreased the proportions used in our analysis. In future experiments, it may be better to quantify the number of dead cells and use this to calculate a proportion that more accurately represents the change in viability.
Second, the groups considered in each analysis varied in terms of characteristics other than the ones used to define the collection e. Ideally, the groups would differ only in terms of the variable being investigated, so that any conclusion can be clearly linked to that factor.
Third, many of the products were stored according to the manufacturer's instructions that may not be representative of the general public. For diarrhea caused by Clostridium difficile: For preventing recurrence, mg of Saccharomyces boulardii twice daily for 4 weeks along with antibiotic treatment has been used. For diarrhea caused by Helicobacter pylori: mg of Saccharomyces boulardii daily for weeks is most commonly used.
Jordon Stubbemann Pundit. Why do I feel hungry after taking probiotics? When they've reached their population goal, they'll send another signal to tell your brain to stop eating. In this way, the bacteria of your gut microbiome can turn your hunger pangs on and off. Kadidiatou Choya Pundit. Which is better florastor or align?
Align has only one probiotic strain, only 1 billion live bacteria and is made in Europe, but yet one of the top selling probiotics for adults. It absolutely does not make it a quality probiotic. Florastor is a single strain probiotic made in France. Their packaging does not provide the number of live strains. Emilly Bethel Pundit. What happens if you take probiotics and antibiotics at the same time? Take Probiotics During and After Treatment. Jojo Singhofen Pundit. What is the best probiotic to take with antibiotics?
Ama Arrillaga Pundit. What to avoid while on antibiotics? Dairy products include milk as well as butter, yogurt, and cheese. After taking an antibiotic you may need to wait for up to three hours before eating or drinking any dairy products.
Grapefruit juice and dietary supplements containing minerals like calcium may also work dampen the effect of antibiotics. Tahra Schroder Teacher. Who should not take probiotics? Although probiotics are generally safe to use, findings of a review from suggest that children and adults with severe illnesses or compromised immune systems should avoid using probiotics. Some people with these conditions have experienced bacterial or fungal infections as a result of probiotic use. Vivek Wic Supporter.
Is oatmeal good for diarrhea? Bland foods that may help with diarrhea include: hot cereals, such as oatmeal , cream of wheat, or rice porridge. Yes, FlorastorBaby, FlorastorKids, and the Florastor capsule contents are appropriate for children as young as two months when added to formula, drinks, or solid foods. FlorastorBaby and Florastor are unflavored while FlorastorKids is available in a tutti-frutti-flavor.
The only difference is the tutti-frutti flavor in FlorastorKids. Florastor, FlorastorKids, FlorastorBaby, FlorastorPre, and FlorastorPlus can be found on the shelf near other digestive health products or behind the pharmacy counter in 18, 20, 30, 50, and count options. No, Florastor does not require refrigeration, making it travel-friendly.
It is manufactured with a patented lyophilization process, similar to freeze-drying. This allows for storage at room temperature without compromising cell viability. Approximately 30 minutes after ingestion, the Florastor capsule dissolves in the stomach, allowing the yeast cells to help keep your intestinal tract on track. Florastor is gluten-free and the vegetarian capsule is derived from pine bark.
Florastor does contain lactose, however, because Florastor promotes production of digestive enzymes in healthy individuals, Florastor has been successfully taken by people sensitive to lactose. Consult your physician if you have specific concerns about Florastor use.
Our manufacturing process does not include the risk of exposure or cross-contamination from corn, egg protein, fish, gluten, latex, meat, nuts or shellfish. Florastor may contain traces of soy. Do not use Florastor probiotics in the acute-care setting, especially in those individuals with open arterial and venous access required such as a Vascath, Permcath, or AV fistula. Do not use for any individual with a central line or port or in the surroundings of any patient with a central line or port.
Do not use Florastor for pre- or post- organ or bone marrow transplant patients and other patients considered severely immunocompromised or critically ill. Do not use Florastor probiotics if allergic to any components especially yeast.
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