Do Probiotics Have Any Clinical Evidence?

A lot of health products that you’ll end up buying won’t have the evidence to back up the claims listed on the product. Probiotics are one of these supplements. Approximately 3 million adults in the U.S were estimated to take probiotics back in 2012. That number has probably increased significantly by now. Especially when research on the effects of the microbiome in various health outcomes has entered the mainstream media.

However, despite the hype around probiotics and the microbiome, it’s important to know what these products can and can’t do and to dispel any information surrounding them.

A resource of high-quality evidence on probiotics

I’ve gathered as much evidence I could on probiotics and their effectiveness as an intervention for various outcomes. You’ll find that information below. I only included systematic reviews of the literature that were either done by multiple Cochrane groups, or that were published in the last ten years, but I have not critically appraised them. This is a bit of a small project, and perhaps I’ll try to make it more comprehensive depending on how many people are interested in this resource.

Outcomes EffectivenessSource
Mood Disorders 
DepressionNohttps://www.ncbi.nlm.nih.gov/pubmed/29197739
DepressionYes, but not enough evidence and no magnitude of effecthttps://www.ncbi.nlm.nih.gov/pubmed/28239408
DepressionYes, but not enough evidence and no magnitude of effecthttps://www.ncbi.nlm.nih.gov/pubmed/27632908
DepressionYes, but not enough evidencehttps://www.ncbi.nlm.nih.gov/pubmed/27509521
Depression, anxiety, and perceived stressYeshttps://www.ncbi.nlm.nih.gov/pubmed/27841940
Irritable Bowel Syndrome
Irritable Bowel SyndromeYeshttps://www.ncbi.nlm.nih.gov/pubmed/19091823
Irritable Bowel SyndromeYeshttps://www.ncbi.nlm.nih.gov/pubmed/25780308
Irritable Bowel SyndromeYeshttps://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-9-15
Irritable Bowel Syndrome and Chronic Idiopathic ConstipationYeshttps://www.nature.com/articles/ajg2014202
Irritable Bowel SyndromeYes, but not enough evidencehttps://www.nature.com/articles/ajg200925
Pancreatitis 
Acute pancreatitisInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD010605.pub2/full
Acute pancreatitisNo, but also not enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD011384.pub2/full
Diarrhea 
Pediatric Antibiotic-Associated DiarrheaYeshttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004827.pub4/full
Acute infectious diarrhoeaYeshttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003048.pub3/full
Persistent diarrhoea in childrenYes, but not enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD007401.pub3/full
Clostridium difficile
Clostridium difficile-associated diarrheaYeshttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006095.pub4/full
Clostridium difficile-associated colitis in adultsNo/Maybe + Insufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD004611.pub2/full
Prevention of Clostridium difficile infectionYes, but not enough evidencehttps://www.ncbi.nlm.nih.gov/pubmed/20011734?dopt=Abstract
Ulcerative Colitis 
Induction of remission in ulcerative colitisNohttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005573.pub2/full
Maintenance of Remission in Ulcerative ColitisLow-quality evidence + insufficienthttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD007443.pub2/full
Crohn's Disease
Induction of remission in Crohn's diseaseVery little evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006634.pub2/full
Prevention of post-operative recurrence of Crohn's diseaseInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006873.pub2/full
Vaginal Infections 
Bacterial vaginosisMaybe, but insufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006289.pub2/full
Vulvovaginal candidiasisMaybe, low quality evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD010496.pub2/full
Bacterial vaginosis in non-pregnant womenYeshttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006055.pub2/full
Urinary Tract Infections
Urinary Tract InfectionsNo, but also not enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD008772.pub2/full
Preventing urinary tract infection in neuropathic bladder patientsMaybe, but insufficient evidence + low-qualityhttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD010723.pub2/full
Preventing recurrent urinary tract infection during pregnancyInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD009279.pub3/full
Prevention of Respiratory tract infectionsNohttps://www.ncbi.nlm.nih.gov/pubmed/19179052?dopt=Abstract
Eczema 
EczemaNohttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006135.pub2/full
EczemaInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005205.pub3/full
Prevention of Atopic Disease in InfantsYeshttps://www.ncbi.nlm.nih.gov/pubmed/26198702?dopt=Abstract
Atopic eczema in childhoodYeshttps://www.ncbi.nlm.nih.gov/pubmed/21787448?dopt=Abstract
Prevention and treatment of pediatric atopic dermatitis.Yes, for treatmenthttps://www.ncbi.nlm.nih.gov/pubmed/18206506?dopt=Abstract
Upper Respiratory Tract Infections 
Prevention of pediatric upper respiratory tract infectionsYeshttps://www.ncbi.nlm.nih.gov/pubmed/25430686?dopt=Abstract
Prevent respiratory infections in children and adolescents.Insufficient evidencehttps://www.ncbi.nlm.nih.gov/pubmed/28052594?dopt=Abstract
Acute Upper Respiratory Tract InfectionsYes, but low or very low-quality evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006895.pub3/full
Glycemic Control
Glycemic control in diabetic patientsYeshttps://www.ncbi.nlm.nih.gov/pubmed/27864537?dopt=Abstract
Glucose metabolism in type 2 diabetic patientsYeshttps://www.ncbi.nlm.nih.gov/pubmed/26987497?dopt=Abstract
Infant-related outcomes 
Prevent Infant CryingNohttps://www.ncbi.nlm.nih.gov/pubmed/24100440?dopt=Abstract
Preventing Asthma or Wheezing During PregnancyNo and not enough evidencehttps://www.ncbi.nlm.nih.gov/pubmed/24304677?dopt=Abstract
Preterm birthNo, but also not enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005941.pub2/full
Necrotizing enterocolitis in preterm infantsYeshttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005496.pub4/full
Blood PressureYes, but not enough evidencehttps://www.ncbi.nlm.nih.gov/pubmed/23823502?dopt=Abstract
Etc
Hepatic encephalopathyMaybe, low-quality evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD008716.pub3/full
Non-alcoholic fatty liver disease and steatohepatitisNot enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD005165.pub2/full
Prevention of allergic disease and food hypersensitivityMaybe, but insufficient evidence + low-qualityhttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006475.pub2/full
Recurrent abdominal pain in childhoodYes, but not enough evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD010972.pub2/full
Collagenous colitisInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003575.pub6/full
Treatment and prevention of pouchitisYes, but low or very low-quality evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD001176.pub3/full
Improving infection outcomes after liver resectionInsufficient evidencehttp://cochranelibrary-wiley.com/doi/10.1002/14651858.CD006933.pub2/full

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