What is Prescript Assist?
Prescript Assist is a popular probiotic supplement in the paleo community because it’s marketed as following ancestral principles. The claim is that this product contains microorganisms found in soil, which are “natural” and what our ancestors consumed with their unwashed produce. Some of the claims of this product are the following:
- It can survive the harsh conditions of the gastrointestinal tract
- It can colonize the gut
- It has beneficial organisms in it
- It has clinical evidence behind it
- The product has prebiotics that will feed the bacteria in the product
Wow! The product seems like a miracle that addresses so many difficulties encountered by lactic-acid bacteria probiotics. The old Prescript Assist formula had 29 species of “soil-based organisms," the new formula has 28, with several new species replacing old ones. Here are some of the microbes that are included in it:
- Red text = Not known to be found in humans
- Gray text = mixed evidence (some opportunistic pathogens)
|Old Formula||New Formula|
|Arthrobacter agilis||Arthobacter globiformis|
|Arthrobacter citreus||Azospirillum brasilense|
|Arthrobacter globiformis||Azosprillum lipoferum|
|Arthrobacter luteus||Azotobacter chroococcum|
|Arthrobacter simplex||Azotobacter paspali|
|Acinetobacter calcoaceticus||Azotobacter vinelandii|
|Azotobacter chroococcum||Bacillus amyloliquefaciens|
|Azotobacter paspali||Bacillus atrophaeus|
|Azospirillum brasiliense||Bacillus licheniformis|
|Azospirillum lipoferum||Bacillus megaterium|
|Bacillus brevis||Bacillus pumilus|
|Bacillus macerans||Bacillus subtilis|
|Bacillus pumilus||Bacillus thuringiensis|
|Bacillus polymyxa||Bacillus firmus|
|Bacillus subtilis||Brevibacillus brevis|
|Bacteroides lipolyticum||Cellulomonas fimi|
|Bacteriodes succinogene||Kurthia zopfii|
|Brevibacterium lipolyticum||Micrococcus luteus|
|Brevibacterium stationis||Nocardioides simplex|
|Kurthia zopfii||Pseudomonas fluorescens|
|Myrothecium verrucaria||Pseudomonas putida|
|Pseudomonas calcis||Rhodobacter sphaeroides|
|Pseudomonas dentrificans||Rhodococcus rhodochrous|
|Pseudomonas fluorescens||Rhodopseudomonas palustris|
|Pseudomonas glathei||Rhodospirillum rubrum|
|Phanerochaete chrysosporium||Streptomyces griseus|
|Streptomyces fradiae||Streptomyces griseoflavus|
|Streptomyces cellulosae||Streptomyces venezuelae|
Let’s first explore whether it makes any sense to include these strains in a probiotic supplement. Some questions to consider:
- Are these microorganisms found in the human GI tract?
- Are these microbes found in foods that humans regularly eat?
- How do these microbes interact with each other?
- How do these microbes interact with human microbes? Will they produce antibiotics that could kill human bacteria?
- What effects will they have on the immune system? Are they safe?
- Have been they tested in large human studies, what about animal models?
- Have they been tested over long periods of time?
Let’s do some investigative research. Searches of MEDLINE, the database of studies that are searchable using the search engine PubMed yield almost no human or animal results for several of these microorganisms. Species colored red lack evidence in humans as being probiotics while those shaded gray are mixed (some of them have been found to be opportunistic pathogens in different areas of the body, and there’s *rare* evidence that some of them may be beneficial*).
In fact, a lot of these organisms are used for agricultural and industrial purposes, and several of the listed species above are known to produce antibiotics. One thing to consider is that if these organisms are spore-forming, antibiotic-producing bacteria, then it’s very possible that several of them (the clear majority in this product, which has not been studied) are competing with microorganisms in the gut for resources.
The Clinical Evidence
However, the old formulation claims to be tested in a clinical trial and claims to be beneficial for symptoms of IBS. In fact, most of the paleo community and several folks such as Chris Kresser and Sarah Ballantyne have promoted the product because of this clinical evidence. Let’s look at this study.
Here are the positives of this study
- A randomized trial with a placebo as a control
- Used a repeated-measures ANCOVA for data analysis (this increases the precision of the data)
- Only two weeks long
- Had 26 participants
- Used an IBS questionnaire that is not validated
- Atrocious reporting of the study (then again, it's an old study, so it's somewhat understandable)
A randomized trial with 26 participants, that’s only two weeks long should not be used to market a product. There is a reason drugs and interventions must go through *extensive* testing before they’re allowed to be marketed as being effective for a condition/disease. Small sample sizes have lots of variability in the data and give imprecise results. If you want to understand why sample sizes are so important, see my article here. And with something like the microbiome, a two-week study does not justify the safety of this product.
Yet, several leaders in the paleo sphere have been affiliates for this product and were hesitant to recommend the new formulation because it didn’t have the clinical evidence to back it, however, the clinical evidence to back the product in the first place was never strong!
Are Probiotics a Waste of Money?
Probiotic supplementation does have research behind it as an intervention for several outcomes. If you want to see this research, look at my comprehensive table here, where I gather some research surrounding probiotic supplementation.
If you’re going to ingest microorganisms to improve your health, you want to make *sure* that they’re safe and that they’ve been tested rigorously in human trials. If you're going to be a bit more cutting edge because you’re desperate, you may at least want to be sure that the theory behind what you’re ingesting is sound.
For example, probiotics with lactic acid bacteria are found in fermented foods, like yogurt, which seems to be linked with improved health outcomes. They’ve been tested in in-vitro studies (Petri dishes), in animal models, and in humans. Fecal transplants make sense hypothetically, take bacteria from someone healthy and insert it into someone who’s not so healthy. It’s been tested in animal models, and it’s been successful in human trials for Clostridium difficile infections and is being investigated for several other outcomes.
Putting random organisms from the soil (a vast ecosystem, with who knows how many bacteria, doesn’t seem like a good idea). Especially when there’s no evidence to suggest these will have any help.