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Acidophilus Herb - Dosage and Useful Properties

Common Trade Names

Bacid, DDS-Acidophilus, Florajen Acidophilus Extra Strength, KyoDophilus, Lactinex (mixed culture of Lactobacillus acidophilus and Lactobacillus bulgaricus), MoreDophilus, Probiata, Pro-Bionate, Superdophilus

Common Forms

Available in various dosages, in cultures ranging from 500 million to 4 billion viable organisms of L. acidophilus, in capsules, granules, powders, softgels, suppositories, and tablets as well as in milk and yogurt.

Source

L. acidophilus is usually commercially prepared as concentrated, dried, viable cultures. The cultures can be found in varying quantities in many dairy products, especially milk and yogurt.

Chemical components

L. acidophilus and other Lactobacillus species (Lobular, Locate, Lifer, L. jensen ii, and Laminates) are anaerobic, gram positive, menstruating bacilli that typically inhabit the vagina and GI tract of mammals. There is some evidence that L. acidophilus may produce a compound that improves its ability to survive in environments that contain competing bacteria. Although usually nonpathogenic, lactobacilli have been implicated as possible causes of some infections.

Actions

L. acidophilus may aid digestion and absorption of food nutrients and produce B complex vitamins and vitamin K. The bacterium normally resides in the GI tract with about 400 other species of bacteria and yeasts. It helps to maintain a balance of bacterial diversity and prevent the overgrowth of any single species. As part of the normal GI flora, L. acidophilus inhibits the growth of other organisms by competing for nutrients, altering the pH of the environment, or producing bactericides, such as hydrogen peroxide, lactic acid, and acetic acid.

Some exogenous antibacterial compounds produced by L. acidophilus affect interferon production. Others may exert antibacterial activity against Helicobacter pylori and other intestinal bacteria.

Human studies have shown that the ingestion of L. acidophilus reduces the concentration of certain fecal enzymes that promote the formation of carcinogens in the colon. It is not known whether or not this reduction influences the prevalence of colon cancer.

Reported uses

Acidophilus cultures are commonly used to prevent or treat uncomplicated diarrhea caused by antimicrobials that disrupt normal intestinal flora. These cultures are also claimed to be useful in patients with disarticulates, H. pylori-induced gastric ulcers, infectious diarrhea, irritable bowel syndrome, or ulcerative colitis, but evidence to support these claims is lacking.

Acidophilus may be useful in the prevention and treatment of bacterial vaginosis and vaginal yeast infections caused by Candida albicans. Clinical trials have been inconclusive.

Limited evidence suggests that acidophilus may offer relief patients with fever blisters, hives, canker sores, and acne, but these skin conditions are largely self-limiting and study results are inconclusive.

Attempts to document a cholesterol-lowering effect for acidophilus products in humans have proved unsuccessful.

Dosage

Dosage is based on the number of live organisms in a commercial acidophilus culture.

For most reported uses, 1 to 10 billion viable organisms/day in divided doses t.i.d. or q.i.d. is cited as a reasonable regimen.

Adverse reactions

GI: flatulence.

Interactions

Warfarin : May enhance intestinal production and absorption of vitamin K, decreasing warfarin's efficacy. Monitor appropriately.

Contraindications and precautions

Lactose-sensitive patients may find it difficult to tolerate dairy products that contain acidophilus cultures.

Special considerations

To be effective, acidophilus products must provide viable L. acidophilus organisms that can survive the hostile environment of the GI tract. Proper manufacturing techniques, packaging, and storage are needed to ensure viability. Some manufacturers require refrigeration of their products, depending on which subspecies is used for the parent cultures.

Inform the patient that some dairy sources of acidophilus, particularly yogurt and milk, may not contain viable cultures because of dramatic temperature fluctuations during transport.

Advise the patient that the FDA does not consider acidophilus products safe and effective for use as antidiarrheals.

Tell the patient to expect some flatus, at least initially. This reaction subsides with continued use.

Points of interest

Many acidophilus products contain questionable levels of L. acidophilus as well as other bacterial species of uncertain benefit.

Significant variations in potency and stability have been observed.

Products made by the same company but having different lot numbers have produced conflicting results in clinical trials.

Commentary

Data supporting the use of L. acidophilus-containing products for their antidiarrheal benefits and for maintaining normal levels of intestinal and vaginal bacteria and yeasts stem mainly from in vitro studies and theoretical evidence. Clinical trials in humans have not yielded many positive 'results. To further complicate the issue, variability of the quality of acidophilus cultures ingested might have influenced these results. Standardization of these products must be accomplished before conducting studies that evaluate their efficacy for therapeutic use.

   

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