Lactobacillus is most commonly used for diarrhea, including infectious diarrhea and diarrhea in people taking antibiotics (antibiotic-associated diarrhea). Some people also used lactobacillus for general digestion problems, a long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS), excessive crying in infants (colic), long-term swelling (inflammation) in the digestive tract (inflammatory bowel disease or IBD), inflammation of the colon, and many other conditions, but there is no good scientific evidence to support many of these uses.
Coronavirus disease 2019 (COVID-19): There is no good evidence to support using lactobacillus for COVID-19. Follow healthy lifestyle choices and proven prevention methods instead.
How does it work ?
Uses & Effectiveness ?
Possibly Effective for
- Stomach pain. Taking lactobacillus short-term seems to reduce symptoms in children with stomach pain. Early research also shows that taking lactobacillus and bifidobacterium short-term can improve symptoms in women with stomach pain.
- Hay fever. Taking 2 billion colony-forming units of lactobacillus daily for 5 weeks can improve quality of life by almost 18% in people with grass pollen allergy that doesn't respond to the anti-allergy drug loratadine. In children with allergies that persist throughout the year, taking 10 billion colony-forming units of lactobacillus for 12 weeks seems to improve itchy eye symptoms. But taking lactobacillus during pregnancy doesn't seem to prevent the infant from developing allergies.
- Diarrhea in people taking antibiotics (antibiotic-associated diarrhea). Most research shows that taking probiotic products containing lactobacillus strains helps prevent diarrhea caused by antibiotics in adults and children. The most well-studied strain of lactobacillus seems to reduce the chance of diarrhea by about 60% to 70% when started within 2 days of beginning antibiotic treatment and continued for at least 3 days after finishing the antibiotics.
- Eczema (atopic dermatitis). Most research shows that taking lactobacillus products can reduce eczema symptoms in infants and children. Research also shows that lactobacillus can help PREVENT eczema from developing. When taken by a mother during the last month of pregnancy, lactobacillus probiotics can reduce the chance of the child developing eczema. But not all strains seem to work.
- Prone to allergies and allergic reactions (atopic disease). Research shows that taking certain lactobacillus strains can prevent the development of allergic reactions, such as asthma, runny nose, and eczema, in infants with a family history of this condition. However, not all strains seem to work.
- Overgrowth of bacteria in the vagina. Researchers have found that lactobacillus suppositories and vaginal tablets may be effective in treating this condition. Researchers have also found that eating yogurt or using vaginal capsules containing lactobacillus can help prevent these infections from occurring again. But taking lactobacillus capsules does not seem to prevent bacteria overgrowth in the vagina in pregnant women.
- Diarrhea caused by cancer drug treatment. A chemotherapy drug called 5-fluorouracil can cause severe diarrhea and other gastrointestinal (GI) side effects. There is some evidence that patients with cancer of the colon or rectum have less severe diarrhea, less stomach discomfort, and shorter hospital care when they take lactobacillus.
- Excessive crying in infants (colic). Some research shows that giving lactobacillus to nursing infants reduces daily crying time. Some research suggests that lactobacillus is more effective at reducing crying time than using the drug simethicone. But one large study shows that lactobacillus does not reduce crying. It's possible that infants in the large study had more severe colic than those in the earlier research.
- Constipation. Taking lactobacillus probiotics for 4-8 weeks can reduce symptoms of constipation including stomach pain and discomfort, bloating, and incomplete bowel movements. It might also increase the number of bowel movements in some people.
- Diabetes. Taking lactobacillus starting at the beginning of the second trimester of pregnancy helps to prevent diabetes during pregnancy, especially in mothers over 35 years of age and mothers that had diabetes during another pregnancy. In women who develop diabetes during pregnancy, taking lactobacillus seems to help control blood sugar. In non-pregnant adults with diabetes, some early research shows that lactobacillus reduces sugar in the blood.
- Diarrhea. Giving lactobacillus to infants and children 1-36 months old when they are admitted to the hospital seems to reduce the risk of developing diarrhea. Also, lactobacillus can reduce the risk of diarrhea from all causes in undernourished children. But most research shows that giving lactobacillus to children who already have diarrhea does not help them to get better faster. Also, lactobacillus doesn't seem to reduce the risk of diarrhea in older adults.
- A digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori). Research shows that taking lactobacillus probiotics along with "triple therapy" that consists of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor helps treat stomach ulcers caused by H. pylori. About 7-11 patients with H. pylori infections need to be treated with lactobacillus plus "triple therapy" for one additional patient to achieve remission compared to what would be achieved with "triple therapy" alone. But taking lactobacillus probiotics does not help treat the infection when taken alone, with only an antibiotic, with other "triple therapies," or with "quadruple therapy" that includes bismuth. It is unclear if lactobacillus can reduce triple therapy-related adverse effects.
- High cholesterol. Taking lactobacillus probiotics can lower total cholesterol by about 10 mg/dL and low-density lipoprotein (LDL or "bad") cholesterol by about 9 mg/dL in people with or without high cholesterol. However, lactobacillus probiotics do not seem to improve high-density lipoprotein (HDL or "good") cholesterol or fats called triglycerides.
- Swelling (inflammation) and sores inside the mouth (oral mucositis). Research shows that taking lozenges containing lactobacillus from the first day of radiation/chemotherapy treatment until one week after reduces the number of patients who develop severe mouth sores.
- A complication after surgery for ulcerative colitis (pouchitis). Taking lactobacillus by mouth seems to help treat pouchitis, a complication of surgery for ulcerative colitis. Taking a probiotic containing lactobacillus, bifidobacterium, and streptococcus for one year seems to maintain remission in 85% of people with this condition. Taking a different formulation containing two lactobacillus species and bifidobacterium for 9 months seems to reduce pouchitis severity.
- Infection of the airways. Some research shows that lactobacillus probiotics can help prevent airway infections in infants and children. Giving lactobacillus to infants and children seems to reduce the chance of upper airway infections. Also, children ages 1-6 years who attend daycare centers seem to get fewer and less severe airway infections when given milk containing lactobacillus. However, not all strains seem to work. In adults, drinking fermented milk or taking powder that contains lactobacillus might help prevent airway infections and decrease how long the symptoms last. But taking lactobacillus doesn't seem to prevent these infections in older adults.
- Rheumatoid arthritis (RA). Research shows that taking lactobacillus for 8 weeks reduces tender and swollen joints in women with RA. But early research in people with moderate-to-severe RA shows that taking lactobacillus plus bifidobacteria does not improve symptoms.
- Travelers' diarrhea. Travelers' diarrhea is caused by bacteria, viruses, or parasites that the traveler has not been exposed to before. Taking lactobacillus seems to help prevent diarrhea in travelers. The effectiveness can vary a lot depending on the travel destination because of differences in bacteria in different locations.
- A type of inflammatory bowel disease (ulcerative colitis). Lactobacillus probiotics seem to increase remission in people with ulcerative colitis. The best evidence of benefit is for a multi-species probiotic containing lactobacillus, bifidobacterium, and streptococcus. Research shows that taking this product can increase remission rates by almost 2-fold when used with standard ulcerative colitis treatment. Taking a single strain of lactobacillus also seems to improve symptoms. But lactobacillus doesn't seem to prevent ulcerative colitis relapse.
Possibly Ineffective for
- Infection of the gastrointestinal tract by a bacteria called Clostridium difficile. People who are treated for Clostridium difficile infections often experience recurrence. Although some conflicting results exist, most research shows that taking lactobacillus does not prevent recurrent episodes of Clostridium difficile diarrhea. Most research also shows that lactobacillus probiotics do not prevent first episodes of Clostridium difficile diarrhea.
- Crohn disease. Taking lactobacillus probiotics does not prevent Crohn disease from becoming active again in people who are in remission or in those who have just had surgery for Crohn disease.
- Tooth plaque. Giving lactobacillus to pregnant women starting 4 weeks before delivery until birth, and then continuing in the infants until 12 months of age, does not seem to reduce tooth plaque in the baby teeth of the child by the age of 9 years.
- Airway infections caused by exercise. Research in trained athletes shows that taking lactobacillus probiotics does not reduce the risk of developing a airway infection. It also does not seem reduce the symptoms of airway infections in athletes.
- Vaginal yeast infections. Taking lactobacillus by mouth or eating yogurt enriched with lactobacillus doesn't prevent vaginal yeast infections in women that have used antibiotics. However, symptoms seem to improve if vaginal suppositories containing lactobacillus are used along with conventional treatment.
Insufficient Evidence for
- Aging skin. Early research shows that taking lactobacillus improves skin moisture and reduces wrinkles.
- Eye strain (asthenopia). Early research shows that taking lactobacillus does not reduce the strain on the eyes caused by monitors and screens. However, in some people who already have a lot of strain on the eyes, taking lactobacillus might help to reduce additional strain and redness.
- Asthma. A small clinical study in children with asthma shows that taking lactobacillus slightly reduces asthma severity and increases asthma control.
- Bipolar disorder. Taking a probiotic containing lactobacillus and bifidobacterium after being discharged from the hospital might reduce the chance that people with bipolar disorder will need to be readmitted due to worsening of symptoms.
- Common cold. Early research shows that taking lactobacillus daily for 12 weeks reduces the risk of common cold by about 12% and reduces the number of days with symptoms from 8.6 to 6.2 in adults. Also, taking lactobacillus plus bifidobacterium for 3 months seems to reduce school absences due to cold symptoms. However, research is inconsistent. Taking some lactobacillus strains does not seem to reduce the risk of catching a cold or the number of cold/flu days.
- Cystic fibrosis. Research suggests that taking lactobacillus daily for 6 months reduces the percentage of cystic fibrosis patients with lung complications from 37% to 3% and the percentage with upper respiratory tract infections from 20% to 3%.
- Cavities. Giving lactobacillus to pregnant women starting 4 weeks before delivery until birth, and then continuing in the infants until 12 months of age, helps to prevent cavities in the child's baby teeth. But giving lactobacillus to infants does not prevent cavities in teeth.
- Depression. Early research in patients with major depression shows that taking lactobacillus plus bifidobacteria for 8 weeks seems to improve symptoms of depression.
- Inflammation of small pouches on the intestine wall (diverticulitis). Early research in people with this diverticulitis shows that taking lactobacillus along with antibiotics reduces pain and time spent in the hospital.
- Fractures. Early research shows that taking lactobacillus improves hand function and pain after fracture in elderly people.
- Genital herpes. Early research in patients with genital herpes shows that applying lactobacillus in the vagina may reduce symptoms of genital herpes. Higher quality research is needed to confirm these results.
- High levels of fats called triglycerides in the blood (hypertriglyceridemia). Some research in people with this condition shows that taking lactobacillus modestly reduces triglycerides in the blood.
- Flu (influenza). Taking a drink containing one strain of lactobacillus 5 days weekly for 8 weeks reduces the incidence of the flu in schoolchildren during flu season. Taking a different lactobacillus strain daily for 6 weeks does not reduce the number of cold/flu days in otherwise healthy adults.
- A long-term disorder of the large intestines that causes stomach pain (irritable bowel syndrome or IBS). Many studies have evaluated lactobacillus species for treating IBS. Some strains might reduce IBS symptoms including abdominal pain, bloating, and gas in some people. But other lactobacillus strains don't seem to work in most people with IBS. Lactobacillus strains also might work better for specific types of IBS.
- Inability to properly digest the sugar lactose (lactose intolerance). Some research shows that drinking milk with lactobacillus still causes symptoms, like gas, in people with lactose intolerance. But other research shows that drinking a milk product containing lactobacillus reduces symptoms of lactose intolerance.
- Infants born weighing less than 2500 grams (5 pounds, 8 ounces). Supplementing feed with lactobacillus in very low birth weight infants is not linked to improved movement or mental abilities at two years of age.
- Swelling of breast tissue (mastitis). Early research in pregnant women shows that taking lactobacillus reduces breast tissue swelling involving an infection.
- A grouping of symptoms that increase the risk of diabetes, heart disease, and stroke (metabolic syndrome). Early research shows that taking lactobacillus doesn't improve weight, blood pressure, blood sugar, or lipid levels in people with this condition.
- A serious intestinal disease in premature infants (necrotizing enterocolitis or NEC). When results from multiple clinical studies are evaluated, giving lactobacillus to preterm infants seems to reduce the risk of severe NEC. But some individual studies disagree. It's possible that some individual clinical studies are too small to show benefit. It's also possible that lactobacillus may be more beneficial when used along with other probiotics than when used as a single probiotic.
- Obesity. Some research shows that taking lactobacillus does not reduce fat or weight in most obese adults. But it might reduce body weight by a small amount in some people.
- A serious gum infection (periodontitis). Early research shows that taking a lactobacillus lozenge doesn't improve gum health in people with this condition.
- Skin rash caused by sun exposure (polymorphous light eruption or PMLE). Early research shows that taking a supplement containing lactobacillus and other ingredients reduces how severe skin reactions are after sun exposure in people with a disorder called polymorphous light eruption.
- Diarrhea caused by rotavirus. Some small studies show that certain lactobacillus strains can help some children with rotaviral diarrhea get over their diarrhea up to 3 days sooner. But other research shows that giving lactobacillus to children with rotaviral diarrhea does not help them to get better faster. More research is needed to understand which strains, if any, can help with this condition. Also, more research is needed to determine if lactobacillus has different effects in children who have been given rotavirus vaccine compared with those who have not.
- Excessive growth of bacteria in the small intestines. Some clinical research has evaluated lactobacillus for treating and preventing the growth of potentially harmful bacteria in the intestines. Some of this research shows slight improvements in symptoms such as stomach pain, bloating, and diarrhea. But other research has found no benefit in people with this condition. Lactobacillus does not seem to be helpful for preventing growth of harmful bacteria in the intestines.
- Stress. Early research shows that taking lactobacillus reduces stress and sleep problems in students preparing for exams.
- Infections of the kidney, bladder, or urethra (urinary tract infections or UTIs). There is some early evidence that taking lactobacillus by mouth or putting it on the vagina might be helpful for preventing UTIs. However, not all strains seem to work, and not all studies agree.
- Pneumonia in people on breathing machines in the hospital. Early research shows that taking lactobacillus might reduce the incidence of pneumonia in people in the intensive care unit.
- Boosting the immune system.
- Canker sores.
- Child development.
- Growth and development in premature infants.
- Reduced or blocked flow of bile from the liver (cholestasis).
- Fever blisters.
- Lyme disease.
- Diarrhea caused by radiation therapy.
- Other conditions.
When applied to the vagina: Lactobacillus is LIKELY SAFE for women to use inside the vagina.
Special Precautions and Warnings
Pregnancy and breast-feeding: Lactobacillus is POSSIBLY SAFE when taken by mouth appropriately while pregnant and breast-feeding.
Weakened immune system: There is some concern that lactobacillus from supplements that contain live bacteria might grow too well in people whose immune systems are weakened. This includes people with HIV/AIDS or people who have taken medicines to prevent rejection of a transplanted organ. Lactobacillus has caused disease (rarely) in people with weakened immune systems. To be on the safe side, if you have a weakened immune system, talk with your healthcare provider before taking lactobacillus.
Short bowel syndrome: People with short bowel syndrome might be more likely than other people to develop lactobacillus infections. If you have this condition, talk with your healthcare provider before taking lactobacillus.
Ulcerative colitis: People with ulcerative colitis that is severe enough to require hospitalization might be more likely than other people to develop lactobacillus infections. If you have this condition, talk with your healthcare provider before taking lactobacillus.
Damaged heart valves: Lactobacillus can cause an infection in the inner lining of the heart chambers and heart valve, but this is extremely rare. However, people with damaged heart valves might be more likely than other people to develop this type of infection, especially if they take lactobacillus before dental or invasive stomach and intestinal procedures. People with damaged heart valves should stop taking probiotics before dental procedures or invasive stomach and intestinal procedures such as an endoscopy.
Antibiotic drugs interacts with LACTOBACILLUS
Antibiotics are used to reduce harmful bacteria in the body. Antibiotics can also reduce friendly bacteria in the body. Lactobacillus is a type of friendly bacteria. Taking antibiotics along with lactobacillus can reduce the effectiveness of lactobacillus. To avoid this interaction take lactobacillus products at least 2 hours before or after antibiotics.
Medications that decrease the immune system (Immunosuppressants) interacts with LACTOBACILLUS
Lactobacillus contains live bacteria and yeast. The immune system usually controls bacteria and yeast in the body to prevent infections. Medications that decrease the immune system can increase your chances of getting sick from bacteria and yeast. Taking lactobacillus along with medications that decrease the immune system might increase the chances of getting sick.
Some medications that decrease the immune system include azathioprine (Imuran), basiliximab (Simulect), cyclosporine (Neoral, Sandimmune), daclizumab (Zenapax), muromonab-CD3 (OKT3, Orthoclone OKT3), mycophenolate (CellCept), tacrolimus (FK506, Prograf), sirolimus (Rapamune), prednisone (Deltasone, Orasone), corticosteroids (glucocorticoids), and others.
Be cautious with this combination
The following doses have been studied in scientific research:
- For hay fever: At least 2 billion colony-forming units of lactobacillus daily for 7 weeks has been used along with 10 mg of loratadine once daily for 5 weeks.
- For diarrhea in people taking antibiotics (antibiotic-associated diarrhea): Many different lactobacillus species have been studied. In most cases, lactobacillus is given in daily doses that provide 10-100 billion colony-forming units daily. Lower doses of 100 million colony-forming units have also been used. Usually treatment is started within 2 days of beginning antibiotic treatment and continued for at least 3 days after antibiotic treatment is complete.
- For eczema (atopic dermatitis): For preventing eczema in children, lactobacillus has been given to pregnant women during the last month of pregnancy. Typically, lactobacillus is given alone or along with other probiotic species in doses of 100 million to 10 billion colony-forming units. Doses vary depending on the lactobacillus strain and if the product is a multi-species probiotic.
- For a condition associated with being prone to allergies and allergic reactions (atopic disease): 10-20 billion colony-forming units of lactobacillus have been used daily for 2-4 weeks before delivery.
- For overgrowth of bacteria in the vagina: 150 mL of yogurt containing lactobacillus has been used daily for 2 months.
- For preventing diarrhea caused by cancer drug treatment: 5-10 billion colony-forming units of lactobacillus has been used twice daily during 24 weeks of chemotherapy.
- For constipation: 200-400 million colony-forming units of lactobacillus has been taken daily for 4-8 weeks. Also, a multi-species probiotic product containing 5 billion colony-forming units of lactobacillus and other probiotic species has been used twice daily for 7 days.
- For diabetes: For diabetes during pregnancy, probiotic products containing 2-6 billion colony-forming units of lactobacillus daily have been used for at least 6 weeks. For type 2 diabetes, 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For stomach pain: 20 billion colony-forming units of lactobacillus has been taken daily for 30 days.
- For a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori): Probiotic products containing 200 million to 15 billion colony-forming units of lactobacillus daily have been used along with triple therapy. Also, a multi-strain probiotic containing 30 million colony-forming units of lactobacillus and other probiotic species has been used for 2 weeks before until 2 weeks after triple therapy. In all cases, triple therapy consisted of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor.
- For high cholesterol: Probiotic products containing 39 million to 50 billion colony-forming units of lactobacillus have been used for 6-12 weeks.
- For swelling (inflammation) and sores inside the mouth (oral mucositis): Lozenges containing 2 billion colony-forming units of lactobacillus have been dissolved in the mouth every 2-3 hours up to 6 times daily during chemotherapy and continuing until one week after.
- For a complication after surgery for ulcerative colitis (pouchitis): A combination probiotic containing 900-1500 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been taken twice daily for up to one year. Another probiotic containing about 10 billion colony-forming units of lactobacillus and bifidobacterium has been taken daily for 9 months.
- For infection of the airways: Drinking fermented milk containing lactobacillus (LCS, Yakolt) 100 billion colony-forming units daily for 12 weeks. A lactobacillus powder containing 1 billion colony-forming units has been used daily for 12 weeks.
- For rheumatoid arthritis (RA): 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For travelers' diarrhea: 2 billion colony-forming units of lactobacillus has been used daily, starting 2 days before traveling and continuing until the end of the trip.
- For a type of inflammatory bowel disease (ulcerative colitis): A product containing 25 billion colony-forming units of lactobacillus has been taken twice daily for 8 weeks. Also, a probiotic containing 900-1500 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been taken once or twice daily.
- For overgrowth of bacteria in the vagina: One to two vaginal tablets containing 10 million colon-forming units of lactobacillus per tablet have been taken daily along with 0.3 mg estriol for 6 days. Intravaginal suppositories containing 100 million to 1 billion colony-forming units of lactobacillus, given twice daily for 6 days, has also been used.
- For hay fever: 10 billion colony-forming units of lactobacillus has been taken once daily for 12 weeks along with 5 mg of levocetirizine in children 7-12 years-old.
- For diarrhea in people taking antibiotics (antibiotic-associated diarrhea): 10-20 billion colony-forming units of lactobacillus has been taken once daily; 20 billion colony-forming units twice daily has also been used.
- For eczema (atopic dermatitis): For treating eczema in children, 10-100 billion colony-forming units of lactobacillus has been taken daily for 6-12 weeks. For preventing eczema, 100 million to 6 billion colony-forming units of lactobacillus daily from birth until 1-2 years has been used. Also, a probiotic containing 10 billion colony-forming units of lactobacillus and Bifidobacterium has been used daily from birth until 6 months.
- For a condition associated with being prone to allergies and allergic reactions (atopic disease): 10-20 billion colony-forming units of lactobacillus have been used daily for the first 3-6 months of life.
- For constipation: 100 million colony-forming units of lactobacillus have been used daily for 8 weeks.
- For diarrhea: Six billion colony-forming units of lactobacillus has been used twice daily in infants while hospitalized. Also, 37 billion colony-forming units of lactobacillus has been used daily, 6 days weekly, for 15 months in children 6-24 months-old.
- For stomach pain: One hundred million colony-forming units of lactobacillus have been used twice daily for 4 weeks in children aged 6-16 years.
- For a digestive tract infection that can lead to ulcers (Helicobacter pylori or H. pylori): A probiotic containing about 100 billion colony-forming units of lactobacillus and bifidobacterium has been used for 2 weeks along with triple therapy and for 4 weeks after triple therapy was complete. Triple therapy consisted of the prescription drugs clarithromycin, amoxicillin, and a proton-pump inhibitor.
- For excessive crying in infants (colic): 100 million colony-forming units of lactobacillus have been used daily for up to 90 days in breast-fed and formula-fed infants. Also, a specific multi-ingredient product containing 65 mg of lemon balm, 9 mg of German chamomile, and 1 billion colony-forming units of lactobacillus (ColiMil Plus by Milte Italia SPA ) has been used twice daily for 4 weeks.
- For infection of the airways: Milk products containing 130 million to 10 billion colony-forming units of lactobacillus have been used daily.
- For travelers' diarrhea: 2 billion colony-forming units of lactobacillus has been used daily, starting 2 days before traveling and continuing until the end of the trip.
- For a type of inflammatory bowel disease (ulcerative colitis): A combination probiotic containing 450-1800 billion colony-forming units of lactobacillus, bifidobacterium, and streptococcus has been used daily in children with moderate-to-severe ulcerative colitis.
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