GI Health
|
May 10, 2023

Unlocking the Secrets of Lactobacillus: A Comprehensive Guide to Testing Patient Levels and Deciphering High and Low Levels

Medically Reviewed by
Updated On
September 17, 2024

Lactobacillus is a genus of beneficial bacteria found in the human gut, mouth, vagina, and certain foods. Healthy levels of these good bacteria within the human microbiome help with digestion, absorption, infection prevention, and overall well-being. This article will discuss some of the most well-researched Lactobacillus species and their health benefits. Understanding the specific indications of probiotic species and strains is required for appropriate supplementation and meeting health goals.

[signup]

What is Lactobacillus spp.?

There are over 200 species of Lactobacillus, a bacteria of the Firmicutes phylum. Many species and strains are commensal organisms of the human microbiome and are found in probiotic supplements and fermented foods. There are numerous studies on the therapeutic effects of Lactobacillus, including the formation of lactic acid, inhibition of pathogenic colonization, enhancement of the intestinal barrier integrity, production of B vitamins and short-chain fatty acids, and modulation of the immune system. (1)

What Are the Main Lactobacillus Species: What Are Their Health Benefits?

Below outlines and summarizes health benefits associated with the main Lactobacillus species.

Lactobacillus acidophilus

Lactobacillus acidophilus (L. acidophilus) is a good bacteria in the human oral, pulmonary (lungs), gastrointestinal, and genitourinary microbiomes. Supplementally, L. acidophilus is added to many probiotics in capsule, tablet, wafer, powder, and suppository form. Additionally, L. acidophilus is commercially added to many foods; it is used as a live culture in up to 80% of commercially-made yogurt in the United States. (2)

Diarrhea

L. acidophilus has been shown to effectively treat various types of diarrhea, including acute diarrhea caused by bacterial or viral infection, chronic diarrhea, and antibiotic-induced diarrhea (2).

Irritable Bowel Syndrome

Supplementation with L. acidophilus probiotics has improved abdominal pain and bloating in patients with irritable bowel syndrome (IBS) after 1-2 months.

Vaginal Infections

Lactobacilli are the most predominant type of bacteria in the vagina, producing lactic acid to prevent the growth of harmful bacteria. Reductions in Lactobacilli can predispose an individual to bacterial vaginosis (BV) and vulvovaginal candidiasis. Oral and intravaginal administration of L. acidophilus can assist in treating these infections and reduce associated vaginal inflammation. (3, 4)

Eczema

Eczema, or atopic dermatitis, is a dermatologic condition that causes dry, itchy, and inflamed skin. Eczema commonly presents itself in infancy, and dysbiosis is known to be a contributing factor to its development. One study has shown that probiotic administration containing L. acidophilus to pregnant women and their infants during the first three months of life reduced eczema prevalence in infants by 22%.

Lactobacillus brevis

Lactobacillus brevis (L. brevis) is commonly isolated from dairy products, fermented foods, and the intestinal and vaginal microbiomes. L. brevis is particularly beneficial for the stomach, inhibiting the growth of Helicobacter pylori infection and, in doing so, preventing stomach ulcers.

Lactobacillus casei

Lactobacillus casei (L. casei) is used in many probiotic formulations and has been shown to provide many health benefits, from digestive function to cancer prevention.

Digestive Health

The ability to produce antimicrobial substances, enhance the epithelial barrier, compete for pathogenic binding sites, and modulate the immune system are all likely mechanisms by which L. casei supports digestive health and function. Research has shown benefits in treating colitis, antibiotic-associated diarrhea, and H. pylori infection with L. casei probiotics. (5, 6)

Allergies

Children colonized with L. casei have a reduced risk of developing allergic diseases, like atopic dermatitis and asthma, by age five (5).

Cancer

Preliminary research has shown promising results in using L. casei probiotics in treating colorectal cancer. Additionally, probiotic therapy can improve side effects caused by cancer treatments, such as diarrhea and abdominal discomfort. (5)

Metabolic Disease

L. casei in the gut microbiome is associated with reduced rates of obesity. The ability of L. casei to modulate the immune system to reduce inflammation, along with its influence over insulin sensitivity, supports healthy weight and blood glucose control. (5, 7)

Lactobacillus delbrueckii subsp. bulgaricus and lactis

These two species of Lactobacillus are largely used in the dairy industry for cheese and yogurt production. By modulating T cells of the immune system, L. delbrueckii enhances systemic immunity and has been used in treating inflammatory bowel disease (IBD), liver disease, and periodontal disease. (8)

Lactobacillus fermentum

Because of its ability to produce antimicrobial peptides, the Lactobacillus fermentum (L. fermentum) has extended beyond human health and into food preservation. L. fermentum has been associated with improved immune function, prevention of gastrointestinal and respiratory infections, reduction of systemic cholesterol levels, and prevention of alcoholic liver disease and colorectal cancer. (9)

Lactobacillus gasseri

Lactobacillus gasseri is beneficial in treating many digestive and vaginal disorders.

Digestive Health

Research has shown the use of L. gasseri probiotics beneficial in preventing and treating peptic ulcers, H. pylori infection, acute diarrhea, ulcerative colitis, and IBS. (10, 11)

Vaginal Health

L. gasseri is a well-documented species within the vaginal microbiome that confers a protective effect against infection, such as BV. Its antimicrobial properties appear especially effective against Gardnerella vaginalis and Prevotella bivia, both associated with BV infection. (10, 12)

Weight Loss

Several clinical trials have shown that supplementation of L. gasseri has resulted in up to 8.5% reduction in visceral fat mass in adults with obesity. (13, 14)

Lactobacillus helveticus

Lactobacillus helveticus (L. helveticus) is found naturally in the gut and certain foods like cheese, milk, and fermented vegetables. L. helveticus has been linked to improved gastrointestinal, oral, and mental health.

Gastrointestinal Health

Consumption of L. helveticus probiotics promotes butyrate production, a short-chain fatty acid that confers many benefits to the gastrointestinal tract and systemic function. L. helveticus can modulate host immune responses and enhance protection against pathogens, preventing gastrointestinal infections. Other digestive benefits provided by L. helveticus include improving food tolerance by removing allergen proteins from foods and enhancing the bioavailability of nutrients. (15)

Mental Health

L. helveticus increases serotonin, norepinephrine, and brain-derived neurotrophic factor levels in the brain, which are associated with reduced anxiety, depression, and cognitive dysfunction. Additionally, one study that gave elderly subjects fermented milk with L. helveticus improved sleep quality and quantity. Good quality sleep is known to reduce physiologic stress and improve mood. (16)

Lactobacillus paracasei

Lactobacillus paracasei (L. paracasei) is found in the mouth and intestinal tract, as well as in dairy products and fermented vegetables.

Infections and Immune Function

L. paracasei has been found to support the immune system, reducing illness rates in children attending daycare and inhibiting the growth of pathogenic bacteria, including E. coli and Salmonella. In part, the ability to prevent infection comes from L. paracasei's ability to stimulate the immune system and cytokine secretion. (17, 18)

Digestion

L. paracasei strains are resistant to heat and intestinal enzyme degradation, making it a common species in probiotic digestive formulas. Its anti-inflammatory properties, ability to promote the growth of Bifidobacterium spp., and enhancement of short-chain fatty acid production all support health, gastrointestinal health, and digestive function. (18)

Lactobacillus plantarum

Lactobacillus plantarum (L. plantarum) can bind to the intestinal mucosa, increase the population of healthy bacteria within the microbiome, and confer anti-inflammatory properties to the host. Because of this, L. plantarum has been shown to improve pain and bloating in patients with IBS and skin symptoms in children with eczema.

A healthy population of L. plantarum within the microbiome may also support metabolic health, improving physical performance, maintaining a healthy weight, and reducing blood pressure (19).

Lactobacillus reuteri

Lactobacillus reuteri (L. reuteri) can influence the immune system and has strong anti-inflammatory effects. L. reuteri upregulates the production of regulatory T (Treg) cells, suppressing inflammation and promoting self-tolerance.

L. reuteri can improve digestive function and reduce gastrointestinal symptoms, including colic and constipation (20, 21). It is also a predominant species within the vaginal microbiome and can be used orally or intravaginally to treat BV.

Lactobacillus rhamnosus

Lactobacillus rhamnosus (L. rhamnosus) is found in the intestines and vagina and is commonly added to dairy products. Many studies support its many health benefits and use in treating various conditions.

Digestive Health

L. rhamnosus has been shown to prevent the overgrowth of opportunistic and pathogenic microorganisms within the digestive tract and encourage the growth of other beneficial bacterial strains. L. rhamnosus increases the production of short-chain fatty acids and prevents intestinal barrier dysfunction, which can improve IBS symptoms. Additionally, supplementing L. rhamnosus during antibiotic therapy can reduce the risk of antibiotic-associated diarrhea from 22.4% to 12.3%. (22-24)

Cavities

Several studies have shown reductions in oral bacterial overgrowth, gum inflammation, and cavities with probiotic supplementation of L. rhamnosus (25, 26).

Genitourinary Infections

Various strains of L. rhamnosus have been shown effective in treating urinary tract infections (UTIs) and vaginal infections when given either orally or intravaginally.

What Are The Health Consequences of Unbalanced Lactobacillus in The Gut?

Given the numerous health benefits of lactobacilli, it's reasonable to expect that disruption to healthy and normal colonization could cause many downstream and unfavorable health effects.

Insufficient levels of beneficial Lactobacillus spp. can result in an elevated risk of infections, increased intestinal barrier permeability and inflammation, and decreased protective immunological factors. Dysbiosis has been linked to chronic digestive disorders, allergies, autoimmunity, and metabolic diseases.

The overgrowth of lactobacilli can also cause detrimental health effects, most often related to digestive symptoms like gas, bloating, abdominal pain and discomfort, indigestion, heartburn, reflux, constipation, and diarrhea. Nutrient malabsorption and symptoms of nutrient deficiencies can occur as well. (27)

What Causes Low Levels of Lactobacillus spp.?

Western dietary patterns, including high saturated and trans fats, high salt, and low fiber intake, have been associated with low levels of lactobacilli. A small study observing the effects of a gluten-free diet also noted reduced Lactobacillus spp. (28)

Acute and chronic stress can drastically affect the gut microbiome's composition, reducing beneficial bacteria levels and allowing pathogenic species to overgrow.

What Causes High Levels of Lactobacillus spp.?

Overgrowth secondary to digestive dysfunction, like low stomach acid, insufficient bile acids, pancreatic insufficiency, and reduced intestinal motility, can result in overgrowth of Lactobacillus spp.  

High serum glucose levels have also been associated with increased Lactobacillus spp.

Specific dietary patterns and supplements can overstimulate the growth of lactobacilli, causing overgrowth. Plant-based diets rich in polyphenols, such as the Mediterranean diet, inulin supplementation, Lactobacillus-containing probiotics, and whey and pea proteins, are associated with increased levels of Lactobacillus spp. (28)

[signup]

How to Test Lactobacillus spp. Levels

Patient-collected fecal and vaginal samples are most commonly ordered to evaluate Lactobacillus colonies in the gastrointestinal tract and vagina.

Comprehensive Stool Test

Comprehensive stool analyses include an in-depth gut microbiome assessment through fecal specimens. Culture and PCR testing methods will analyze the health and quantity of Lactobacillus spp.

Vaginal Microbiome Analysis

A functional vaginal microbiome analysis is often recommended for patients with recurrent vaginal symptoms and infections to identify the diversity and abundance of the vaginal microbiome. Lactobacillus spp., and its most dominant species, are measured.

Foods That Help Increase Lactobacillus spp. Levels

Certain dietary intake patterns are linked to predictable shifts in Lactobacillus levels. If trying to promote the growth of lactobacilli, foods that are correlated with elevated concentrations include (28):

  • Whey and pea protein
  • Unsaturated fats: avocados, nuts (almonds, hazelnuts, pecans, walnuts), seeds (pumpkin, sesame, flax), fish, oils (olive, peanut, canola, corn, soybean)
  • Fiber: whole fruits and vegetables, nuts and seeds, whole grains, legumes
  • Resistant starch: brown rice, beans, lentils, plantains, green bananas, oats, potatoes
  • Cultured milk and dairy
  • Fermented foods: kimchi, sauerkraut, kefir, kombucha, natto, pickled vegetables
  • Polyphenol-rich foods: fruits, vegetables, seeds, tea, cocoa, wine

The Mediterranean diet has been shown to increase Lactobacillus intestinal colonies specifically. A high intake of monounsaturated and polyunsaturated fats, polyphenols and antioxidants, fiber, low glycemic carbohydrates, and vegetables associated with the diet can explain this. (28)

Supplements that Increase Lactobacillus spp. Levels

Prebiotic and probiotic supplements are often recommended to support Lactobacillus growth. Many probiotics are available, each containing a slightly different combination of Lactobacillus strains. The probiotic choice should be based on lab results and desired treatment/health outcomes.  

Prebiotics are nutrients that fuel probiotic species that are categorized into five main groups:

fructans, galactooligosaccharides, starch and glucose-derived oligosaccharides, other oligosaccharides, and non-carbohydrate oligosaccharides. Prebiotic supplements contain one or several of these to support the growth of lactobacilli and other beneficial microbiome bacteria. Probiotic formulas will often also include prebiotics to improve their efficacy.

How to Make Sure You Are Getting High-Quality Lactobacillus spp. Supplements

Good-quality probiotic supplements are essential for their efficacy. The following characteristics have been identified as important properties for lactobacilli to be effective probiotic organisms:

  • Adherence to epithelial cells
  • Reduce pathogenic adherence to epithelial cells
  • Ability to persist and multiply
  • Production of lactic acid, hydrogen peroxide, and antimicrobial chemicals
  • Resistance of vaginal microbicides
  • Safety: noninvasive, noncarcinogenic, and nonpathogenic
  • Formation of a balanced flora

Probiotic supplements' quality, purity, and strength are essential for efficacy. Choosing a cGMP-compliant, third-party-tested supplement ensures that the manufacturer has followed regulatory and quality requirements to produce a safe, effective, and shelf-stable product. Additionally, selecting a probiotic that has listed bacterial strains on the nutritional label that have been proven effective in clinical trials is important. Because the efficacy of probiotics is strain- and disease-specific, both need to be considered when making recommendations and choosing the correct probiotic supplement. (29, 30)

[signup]

Summary

Our understanding of the human microbiome is rapidly evolving as research continues to uncover the multitude of health benefits provided by the beneficial organisms that coexist within the body. Lactobacillus spp. is a group of beneficial lactic acid-producing bacteria that is comprised of over 200 distinct species. While more research is required, existing evidence supports a wide array of health benefits that healthy levels of lactobacilli provide to the body. Specialty labs can help quantify an individual's levels of lactobacilli in the body, and dietary and supplemental interventions can be implemented as needed to ensure healthy Lactobacillus spp. are growing to support a happy and healthy microbiome.

Lactobacillus is a genus of beneficial bacteria found in the human gut, mouth, vagina, and certain foods. Healthy levels of these good bacteria within the human microbiome may help with digestion, absorption, and overall well-being. This article will discuss some of the most well-researched Lactobacillus species and their potential health benefits. Understanding the specific indications of probiotic species and strains is required for appropriate supplementation and meeting health goals.

[signup]

What is Lactobacillus spp.?

There are over 200 species of Lactobacillus, a bacteria of the Firmicutes phylum. Many species and strains are commensal organisms of the human microbiome and are found in probiotic supplements and fermented foods. There are numerous studies on the potential effects of Lactobacillus, including the formation of lactic acid, support of intestinal barrier integrity, production of B vitamins and short-chain fatty acids, and modulation of the immune system. (1)

What Are the Main Lactobacillus Species: What Are Their Health Benefits?

Below outlines and summarizes potential health benefits associated with the main Lactobacillus species.

Lactobacillus acidophilus

Lactobacillus acidophilus (L. acidophilus) is a good bacteria in the human oral, pulmonary (lungs), gastrointestinal, and genitourinary microbiomes. Supplementally, L. acidophilus is added to many probiotics in capsule, tablet, wafer, powder, and suppository form. Additionally, L. acidophilus is commercially added to many foods; it is used as a live culture in up to 80% of commercially-made yogurt in the United States. (2)

Diarrhea

L. acidophilus has been studied for its potential to help manage various types of diarrhea, including acute diarrhea caused by bacterial or viral infection, chronic diarrhea, and antibiotic-associated diarrhea (2).

Irritable Bowel Syndrome

Supplementation with L. acidophilus probiotics has been associated with improvements in abdominal pain and bloating in patients with irritable bowel syndrome (IBS) after 1-2 months.

Vaginal Health

Lactobacilli are the most predominant type of bacteria in the vagina, producing lactic acid that may help maintain a healthy balance of bacteria. Reductions in Lactobacilli can predispose an individual to bacterial vaginosis (BV) and vulvovaginal candidiasis. Oral and intravaginal administration of L. acidophilus may assist in maintaining vaginal health. (3, 4)

Skin Health

Eczema, or atopic dermatitis, is a dermatologic condition that causes dry, itchy, and inflamed skin. Eczema commonly presents itself in infancy, and dysbiosis is known to be a contributing factor to its development. One study has shown that probiotic administration containing L. acidophilus to pregnant women and their infants during the first three months of life was associated with a reduced prevalence of eczema in infants by 22%.

Lactobacillus brevis

Lactobacillus brevis (L. brevis) is commonly isolated from dairy products, fermented foods, and the intestinal and vaginal microbiomes. L. brevis is particularly beneficial for the stomach, and studies suggest it may help manage Helicobacter pylori infection, which is associated with stomach ulcers.

Lactobacillus casei

Lactobacillus casei (L. casei) is used in many probiotic formulations and has been studied for its potential health benefits, from supporting digestive function to promoting overall well-being.

Digestive Health

The ability to produce antimicrobial substances, enhance the epithelial barrier, compete for pathogenic binding sites, and modulate the immune system are all likely mechanisms by which L. casei supports digestive health and function. Research has shown benefits in managing colitis, antibiotic-associated diarrhea, and H. pylori infection with L. casei probiotics. (5, 6)

Allergies

Children colonized with L. casei have been observed to have a reduced risk of developing allergic diseases, like atopic dermatitis and asthma, by age five (5).

Metabolic Health

L. casei in the gut microbiome is associated with supporting healthy weight and blood glucose control. The ability of L. casei to modulate the immune system to reduce inflammation, along with its influence over insulin sensitivity, may contribute to these benefits. (5, 7)

Lactobacillus delbrueckii subsp. bulgaricus and lactis

These two species of Lactobacillus are largely used in the dairy industry for cheese and yogurt production. By modulating T cells of the immune system, L. delbrueckii may support systemic immunity and has been studied for its potential role in managing inflammatory bowel disease (IBD), liver health, and oral health. (8)

Lactobacillus fermentum

Because of its ability to produce antimicrobial peptides, the Lactobacillus fermentum (L. fermentum) has extended beyond human health and into food preservation. L. fermentum has been associated with supporting immune function, maintaining gastrointestinal and respiratory health, and promoting healthy cholesterol levels. (9)

Lactobacillus gasseri

Lactobacillus gasseri is beneficial in supporting many digestive and vaginal health functions.

Digestive Health

Research has shown the use of L. gasseri probiotics may be beneficial in supporting digestive health, including managing peptic ulcers, H. pylori infection, acute diarrhea, ulcerative colitis, and IBS. (10, 11)

Vaginal Health

L. gasseri is a well-documented species within the vaginal microbiome that may confer a protective effect against infection, such as BV. Its antimicrobial properties appear especially effective against Gardnerella vaginalis and Prevotella bivia, both associated with BV infection. (10, 12)

Weight Management

Several clinical trials have shown that supplementation of L. gasseri has been associated with a reduction in visceral fat mass in adults with obesity. (13, 14)

Lactobacillus helveticus

Lactobacillus helveticus (L. helveticus) is found naturally in the gut and certain foods like cheese, milk, and fermented vegetables. L. helveticus has been linked to supporting gastrointestinal, oral, and mental health.

Gastrointestinal Health

Consumption of L. helveticus probiotics may promote butyrate production, a short-chain fatty acid that supports gastrointestinal tract and systemic function. L. helveticus can modulate host immune responses and enhance protection against pathogens, potentially supporting gastrointestinal health. Other digestive benefits provided by L. helveticus include improving food tolerance by removing allergen proteins from foods and enhancing the bioavailability of nutrients. (15)

Mental Health

L. helveticus has been associated with increased serotonin, norepinephrine, and brain-derived neurotrophic factor levels in the brain, which are linked to reduced anxiety, depression, and cognitive dysfunction. Additionally, one study that gave elderly subjects fermented milk with L. helveticus reported improved sleep quality and quantity. Good quality sleep is known to reduce physiologic stress and improve mood. (16)

Lactobacillus paracasei

Lactobacillus paracasei (L. paracasei) is found in the mouth and intestinal tract, as well as in dairy products and fermented vegetables.

Infections and Immune Function

L. paracasei has been found to support the immune system, potentially reducing illness rates in children attending daycare and inhibiting the growth of pathogenic bacteria, including E. coli and Salmonella. In part, the ability to support immune function comes from L. paracasei's ability to stimulate the immune system and cytokine secretion. (17, 18)

Digestion

L. paracasei strains are resistant to heat and intestinal enzyme degradation, making it a common species in probiotic digestive formulas. Its anti-inflammatory properties, ability to promote the growth of Bifidobacterium spp., and enhancement of short-chain fatty acid production all support gastrointestinal health and digestive function. (18)

Lactobacillus plantarum

Lactobacillus plantarum (L. plantarum) can bind to the intestinal mucosa, increase the population of healthy bacteria within the microbiome, and confer anti-inflammatory properties to the host. Because of this, L. plantarum has been shown to support digestive health and may help manage pain and bloating in patients with IBS and skin symptoms in children with eczema.

A healthy population of L. plantarum within the microbiome may also support metabolic health, improving physical performance, maintaining a healthy weight, and supporting blood pressure (19).

Lactobacillus reuteri

Lactobacillus reuteri (L. reuteri) can influence the immune system and has been studied for its anti-inflammatory effects. L. reuteri may support the production of regulatory T (Treg) cells, which are involved in managing inflammation and promoting self-tolerance.

L. reuteri can support digestive function and may help manage gastrointestinal symptoms, including colic and constipation (20, 21). It is also a predominant species within the vaginal microbiome and can be used orally or intravaginally to support vaginal health.

Lactobacillus rhamnosus

Lactobacillus rhamnosus (L. rhamnosus) is found in the intestines and vagina and is commonly added to dairy products. Many studies support its potential health benefits and use in supporting various functions.

Digestive Health

L. rhamnosus has been shown to support the balance of microorganisms within the digestive tract and encourage the growth of other beneficial bacterial strains. L. rhamnosus increases the production of short-chain fatty acids and supports intestinal barrier function, which may help manage IBS symptoms. Additionally, supplementing L. rhamnosus during antibiotic therapy may reduce the risk of antibiotic-associated diarrhea. (22-24)

Oral Health

Several studies have shown reductions in oral bacterial overgrowth, gum inflammation, and cavities with probiotic supplementation of L. rhamnosus (25, 26).

Genitourinary Health

Various strains of L. rhamnosus have been studied for their potential role in supporting urinary tract health and vaginal health when given either orally or intravaginally.

What Are The Health Consequences of Unbalanced Lactobacillus in The Gut?

Given the numerous potential health benefits of lactobacilli, it's reasonable to expect that disruption to healthy and normal colonization could cause many downstream and unfavorable health effects.

Insufficient levels of beneficial Lactobacillus spp. can result in an elevated risk of infections, increased intestinal barrier permeability and inflammation, and decreased protective immunological factors. Dysbiosis has been linked to chronic digestive disorders, allergies, autoimmunity, and metabolic diseases.

The overgrowth of lactobacilli can also cause detrimental health effects, most often related to digestive symptoms like gas, bloating, abdominal pain and discomfort, indigestion, heartburn, reflux, constipation, and diarrhea. Nutrient malabsorption and symptoms of nutrient deficiencies can occur as well. (27)

What Causes Low Levels of Lactobacillus spp.?

Western dietary patterns, including high saturated and trans fats, high salt, and low fiber intake, have been associated with low levels of lactobacilli. A small study observing the effects of a gluten-free diet also noted reduced Lactobacillus spp. (28)

Acute and chronic stress can drastically affect the gut microbiome's composition, reducing beneficial bacteria levels and allowing pathogenic species to overgrow.

What Causes High Levels of Lactobacillus spp.?

Overgrowth secondary to digestive dysfunction, like low stomach acid, insufficient bile acids, pancreatic insufficiency, and reduced intestinal motility, can result in overgrowth of Lactobacillus spp.  

High serum glucose levels have also been associated with increased Lactobacillus spp.

Specific dietary patterns and supplements can overstimulate the growth of lactobacilli, causing overgrowth. Plant-based diets rich in polyphenols, such as the Mediterranean diet, inulin supplementation, Lactobacillus-containing probiotics, and whey and pea proteins, are associated with increased levels of Lactobacillus spp. (28)

[signup]

How to Test Lactobacillus spp. Levels

Patient-collected fecal and vaginal samples are most commonly ordered to evaluate Lactobacillus colonies in the gastrointestinal tract and vagina.

Comprehensive Stool Test

Comprehensive stool analyses include an in-depth gut microbiome assessment through fecal specimens. Culture and PCR testing methods will analyze the health and quantity of Lactobacillus spp.

Vaginal Microbiome Analysis

A functional vaginal microbiome analysis is often recommended for patients with recurrent vaginal symptoms and infections to identify the diversity and abundance of the vaginal microbiome. Lactobacillus spp., and its most dominant species, are measured.

Foods That May Help Increase Lactobacillus spp. Levels

Certain dietary intake patterns are linked to predictable shifts in Lactobacillus levels. If trying to promote the growth of lactobacilli, foods that are correlated with elevated concentrations include (28):

  • Whey and pea protein
  • Unsaturated fats: avocados, nuts (almonds, hazelnuts, pecans, walnuts), seeds (pumpkin, sesame, flax), fish, oils (olive, peanut, canola, corn, soybean)
  • Fiber: whole fruits and vegetables, nuts and seeds, whole grains, legumes
  • Resistant starch: brown rice, beans, lentils, plantains, green bananas, oats, potatoes
  • Cultured milk and dairy
  • Fermented foods: kimchi, sauerkraut, kefir, kombucha, natto, pickled vegetables
  • Polyphenol-rich foods: fruits, vegetables, seeds, tea, cocoa, wine

The Mediterranean diet has been shown to be associated with increased Lactobacillus intestinal colonies specifically. A high intake of monounsaturated and polyunsaturated fats, polyphenols and antioxidants, fiber, low glycemic carbohydrates, and vegetables associated with the diet can explain this. (28)

Supplements that May Help Increase Lactobacillus spp. Levels

Prebiotic and probiotic supplements are often recommended to support Lactobacillus growth. Many probiotics are available, each containing a slightly different combination of Lactobacillus strains. The probiotic choice should be based on lab results and desired health outcomes.  

Prebiotics are nutrients that fuel probiotic species that are categorized into five main groups:

fructans, galactooligosaccharides, starch and glucose-derived oligosaccharides, other oligosaccharides, and non-carbohydrate oligosaccharides. Prebiotic supplements contain one or several of these to support the growth of lactobacilli and other beneficial microbiome bacteria. Probiotic formulas will often also include prebiotics to improve their efficacy.

How to Make Sure You Are Getting High-Quality Lactobacillus spp. Supplements

Good-quality probiotic supplements are essential for their efficacy. The following characteristics have been identified as important properties for lactobacilli to be effective probiotic organisms:

  • Adherence to epithelial cells
  • Reduce pathogenic adherence to epithelial cells
  • Ability to persist and multiply
  • Production of lactic acid, hydrogen peroxide, and antimicrobial chemicals
  • Resistance of vaginal microbicides
  • Safety: noninvasive, noncarcinogenic, and nonpathogenic
  • Formation of a balanced flora

Probiotic supplements' quality, purity, and strength are essential for efficacy. Choosing a cGMP-compliant, third-party-tested supplement ensures that the manufacturer has followed regulatory and quality requirements to produce a safe, effective, and shelf-stable product. Additionally, selecting a probiotic that has listed bacterial strains on the nutritional label that have been studied in clinical trials is important. Because the efficacy of probiotics is strain- and condition-specific, both need to be considered when making recommendations and choosing the correct probiotic supplement. (29, 30)

[signup]

Summary

Our understanding of the human microbiome is rapidly evolving as research continues to uncover the multitude of potential health benefits provided by the beneficial organisms that coexist within the body. Lactobacillus spp. is a group of beneficial lactic acid-producing bacteria that is comprised of over 200 distinct species. While more research is required, existing evidence supports a wide array of potential health benefits that healthy levels of lactobacilli may provide to the body. Specialty labs can help quantify an individual's levels of lactobacilli in the body, and dietary and supplemental interventions can be implemented as needed to support healthy Lactobacillus spp. growth and a happy and healthy microbiome.

The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

Learn more

No items found.

Lab Tests in This Article

1. Dempsey, E., & Corr, S.C. (2022). Lactobacillus spp. for Gastrointestinal Health: Current and Future Perspectives. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.840245

2. Remes-Troche, J.M., Adame, E.C., Diaz, M.A., et al. (2020). Lactobacillus acidophilus LB: a useful pharmabiotic for the treatment of digestive disorders. Therapeutic Advances in Gastroenterology, 13, 175628482097120. https://doi.org/10.1177/1756284820971201

3. Ravel, J., Gajer, P., Abdo, Z., et al. (2011). Vaginal microbiome of reproductive-age women. Proceedings of the National Academy of Sciences of the United States of America, 108(supplement_1), 4680–4687. https://doi.org/10.1073/pnas.1002611107

4. Falagas, M.E., Betsi, G.I., & Athanasiou, S. (2007). Probiotics for the treatment of women with bacterial vaginosis. Clinical Microbiology and Infection, 13(7), 657–664. https://doi.org/10.1111/j.1469-0691.2007.01688.x

5. Hill, D., Sugrue, I., Tobin, C., et al. (2018). The Lactobacillus casei Group: History and Health Related Applications. Frontiers in Microbiology, 9. https://doi.org/10.3389/fmicb.2018.02107

6. Dempsey, E., & Corr, S.C. (2022). Lactobacillus spp. for Gastrointestinal Health: Current and Future Perspectives. Frontiers in Immunology, 13. https://doi.org/10.3389/fimmu.2022.840245

7. Nakamura, Y., & Omaye, S.T. (2012). Metabolic diseases and pro- and prebiotics: Mechanistic insights. Nutrition & Metabolism, 9(1), 60. https://doi.org/10.1186/1743-7075-9-60

8. Kafsi, H.E., Binesse, J., Loux, V., et al. (2014). Lactobacillus delbrueckii ssp. lactis and ssp. bulgaricus: a chronicle of evolution in action. BMC Genomics, 15(1). https://doi.org/10.1186/1471-2164-15-407

9. Naghmouchi, K., Belguesmia, Y., Bendali, F., et al. (2020). Lactobacillus fermentum: a bacterial species with potential for food preservation and biomedical applications. Critical Reviews in Food Science and Nutrition, 60(20), 3387–3399. https://doi.org/10.1080/10408398.2019.1688250

10. Selle, K., & Klaenhammer, T.R. (2013). Genomic and phenotypic evidence for probiotic influences of Lactobacillus gasseri on human health. Fems Microbiology Reviews, 37(6), 915–935. https://doi.org/10.1111/1574-6976.12021

11. Nobutani, K., Sawada, D., Fujiwara, S., et al. (2017). The effects of administration of the Lactobacillus gasseri strain CP2305 on quality of life, clinical symptoms and changes in gene expression in patients with irritable bowel syndrome. Journal of Applied Microbiology, 122(1), 212–224. https://doi.org/10.1111/jam.13329

12. Khodaverdi, S., Mohammadbeigi, R., Khaledi, M., et al. (2019). Beneficial Effects of Oral Lactobacillus on Pain Severity in Women Suffering from Endometriosis: A Pilot Placebo-Controlled Randomized Clinical Trial. International Journal of Fertility & Sterility, 13(3), 178–183. https://doi.org/10.22074/ijfs.2019.5584

13. Kadooka, Y., Sato, M., Ogawa, A., et al. (2013). Effect of Lactobacillus gasseri SBT2055 in fermented milk on abdominal adiposity in adults in a randomised controlled trial. British Journal of Nutrition, 110(9), 1696–1703. https://doi.org/10.1017/s0007114513001037

14. Kim, J.H., Yun, J.H., Kim, M., et al. (2018). Lactobacillus gasseri BNR17 Supplementation Reduces the Visceral Fat Accumulation and Waist Circumference in Obese Adults: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of Medicinal Food, 21(5), 454–461. https://doi.org/10.1089/jmf.2017.3937

15. Taverniti, V., & Guglielmetti, S. (2012). Health-Promoting Properties of Lactobacillus helveticus. Frontiers in Microbiology, 3. https://doi.org/10.3389/fmicb.2012.00392

16. Messaoudi, M., Violle, N., Bisson, J., et al. (2011). Beneficial psychological effects of a probiotic formulation (Lactobacillus helveticusR0052 and Bifidobacterium longum R0175) in healthy human volunteers. Gut Microbes, 2(4), 256–261. https://doi.org/10.4161/gmic.2.4.16108

17. Nocerino, R., Paparo, L., Terrin, G., et al. (2017). Cow's milk and rice fermented with Lactobacillus paracasei CBA L74 prevent infectious diseases in children: A randomized controlled trial. Clinical Nutrition, 36(1), 118–125. https://doi.org/10.1016/j.clnu.2015.12.004

18. Bengoa, A.A., Dardis, C., Garrote, G.L., et al. (2021). Health-Promoting Properties of Lacticaseibacillus paracasei: A Focus on Kefir Isolates and Exopolysaccharide-Producing Strains. Foods, 10(10), 2239. https://doi.org/10.3390/foods10102239

19. Huang, W.C., Lee, M., Lee, C., et al. (2019). Effect of Lactobacillus plantarum TWK10 on Exercise Physiological Adaptation, Performance, and Body Composition in Healthy Humans. Nutrients, 11(11), 2836. https://doi.org/10.3390/nu11112836

20. Riezzo, G., Di Mauro, A., Riezzo, G., et al. (2014). Prophylactic Use of a Probiotic in the Prevention of Colic, Regurgitation, and Functional Constipation. JAMA Pediatrics, 168(3), 228. https://doi.org/10.1001/jamapediatrics.2013.4367

21. Del Campo, R., Garriga, M.C., Pérez-Aragón, A., et al. (2014). Improvement of digestive health and reduction in proteobacterial populations in the gut microbiota of cystic fibrosis patients using a Lactobacillus reuteri probiotic preparation: A double blind prospective study. Journal of Cystic Fibrosis, 13(6), 716–722. https://doi.org/10.1016/j.jcf.2014.02.007

22. Verdenelli, M.C., Ghelfi, F., Silvi, S., et al. (2009). Probiotic properties of Lactobacillus rhamnosus and Lactobacillus paracasei isolated from human faeces. European Journal of Nutrition, 48(6), 355–363. https://doi.org/10.1007/s00394-009-0021-2

23. Flach, J., Van Der Waal, M., Kardinaal, A., et al. (2018). Probiotic research priorities for the healthy adult population: A review on the health benefits of Lactobacillus rhamnosus GG and Bifidobacterium animalis subspecies lactis BB-12. Cogent Food & Agriculture, 4(1), 1452839. https://doi.org/10.1080/23311932.2018.1452839

24. Szajewska, H., & Kolodziej, M. (2015). Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Alimentary Pharmacology & Therapeutics, 42(10), 1149–1157. https://doi.org/10.1111/apt.13404

25. Näse, L., Hatakka, K., Savilahti, E.M., et al. (2001). Effect of Long–Term Consumption of a Probiotic Bacterium, Lactobacillus rhamnosus GG, in Milk on Dental Caries and Caries Risk in Children. Caries Research, 35(6), 412–420. https://doi.org/10.1159/000047484

26. Alanzi, A., Honkala, S., Honkala, E., et al. (2018). Effect of Lactobacillus rhamnosus and Bifidobacterium lactis on gingival health, dental plaque, and periodontopathogens in adolescents: a randomised placebo-controlled clinical trial. Beneficial Microbes, 9(4), 593–602. https://doi.org/10.3920/bm2017.0139

27. Animalu, C.N. a. M. M. Bacterial Overgrowth Syndrome Clinical Presentation: History, Causes, Physical Examination. https://emedicine.medscape.com/article/212861-clinical

28. Singh, R., Chang, H., Yan, D., et al. (2017). Influence of diet on the gut microbiome and implications for human health. Journal of Translational Medicine, 15(1). https://doi.org/10.1186/s12967-017-1175-y

29. McFarland, L.V., Evans, C.T., & Goldstein, E.J.C. (2018). Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. Frontiers in Medicine, 5. https://doi.org/10.3389/fmed.2018.00124

30. Grumet, L., Tromp, Y., & Stiegelbauer, V. (2020). The Development of High-Quality Multispecies Probiotic Formulations: From Bench to Market. Nutrients, 12(8), 2453. https://doi.org/10.3390/nu12082453

Order from 30+ labs in 20 seconds (DUTCH, Mosaic, Genova & More!)
We make ordering quick and painless — and best of all, it's free for practitioners.

Latest Articles

View more on GI Health
Subscribe to the magazine for expert-written articles straight to your inbox
Join the thousands of savvy readers who get root cause medicine articles written by doctors in their inbox every week!
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Subscribe to the Magazine for free to keep reading!
Subscribe for free to keep reading, If you are already subscribed, enter your email address to log back in.
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Are you a healthcare practitioner?
Thanks for subscribing!
Oops! Something went wrong while submitting the form.
Trusted Source
Rupa Health
Medical Education Platform
Visit Source
Visit Source
American Cancer Society
Foundation for Cancer Research
Visit Source
Visit Source
National Library of Medicine
Government Authority
Visit Source
Visit Source
Journal of The American College of Radiology
Peer Reviewed Journal
Visit Source
Visit Source
National Cancer Institute
Government Authority
Visit Source
Visit Source
World Health Organization (WHO)
Government Authority
Visit Source
Visit Source
The Journal of Pediatrics
Peer Reviewed Journal
Visit Source
Visit Source
CDC
Government Authority
Visit Source
Visit Source
Office of Dietary Supplements
Government Authority
Visit Source
Visit Source
National Heart Lung and Blood Institute
Government Authority
Visit Source
Visit Source
National Institutes of Health
Government Authority
Visit Source
Visit Source
Clinical Infectious Diseases
Peer Reviewed Journal
Visit Source
Visit Source
Brain
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Rheumatology
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the National Cancer Institute (JNCI)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Cardiovascular Magnetic Resonance
Peer Reviewed Journal
Visit Source
Visit Source
Hepatology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Clinical Nutrition
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Bone and Joint Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Kidney International
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Allergy and Clinical Immunology
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Surgery
Peer Reviewed Journal
Visit Source
Visit Source
Chest
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Neurology, Neurosurgery & Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Blood
Peer Reviewed Journal
Visit Source
Visit Source
Gastroenterology
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Respiratory and Critical Care Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The American Journal of Psychiatry
Peer Reviewed Journal
Visit Source
Visit Source
Diabetes Care
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of the American College of Cardiology (JACC)
Peer Reviewed Journal
Visit Source
Visit Source
The Journal of Clinical Oncology (JCO)
Peer Reviewed Journal
Visit Source
Visit Source
Journal of Clinical Investigation (JCI)
Peer Reviewed Journal
Visit Source
Visit Source
Circulation
Peer Reviewed Journal
Visit Source
Visit Source
JAMA Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
PLOS Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Annals of Internal Medicine
Peer Reviewed Journal
Visit Source
Visit Source
Nature Medicine
Peer Reviewed Journal
Visit Source
Visit Source
The BMJ (British Medical Journal)
Peer Reviewed Journal
Visit Source
Visit Source
The Lancet
Peer Reviewed Journal
Visit Source
Visit Source
Journal of the American Medical Association (JAMA)
Peer Reviewed Journal
Visit Source
Visit Source
Pubmed
Comprehensive biomedical database
Visit Source
Visit Source
Harvard
Educational/Medical Institution
Visit Source
Visit Source
Cleveland Clinic
Educational/Medical Institution
Visit Source
Visit Source
Mayo Clinic
Educational/Medical Institution
Visit Source
Visit Source
The New England Journal of Medicine (NEJM)
Peer Reviewed Journal
Visit Source
Visit Source
Johns Hopkins
Educational/Medical Institution
Visit Source
Visit Source

Hey practitioners! 👋 Join Dr. Chris Magryta and Dr. Erik Lundquist for a comprehensive 6-week course on evaluating functional medicine labs from two perspectives: adult and pediatric. In this course, you’ll explore the convergence of lab results across different diseases and age groups, understanding how human lab values vary on a continuum influenced by age, genetics, and time. Register Here! Register Here.