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10 Medically Compelling Benefits for Probiotics

What Are Probiotics?

First of all, probiotics are friendly
and useful microorganism of different varieties that live in the digestive system that enhance digestion and
helps to absorb nutrients at optimal

Our gut has a favourable environment for probiotics, mainly these microorganisms
are bacteria and fungi and are collectively known as the microbiome. These probiotics are harmless and provides
plenty of health benefits for us. Probiotics and good bacteria do not only live
in your gut, but there is plenty of probiotics living on the surface of your skin.

Types of probiotics?

Probiotics are classified according
to their type and benefits they deliver. Here are the most common types of probiotics.

–Most common bacteria and you find this easily in
yoghurt and all forms of the fermented food. Lactobacillus mainly helps in cases of AID
(Antibiotic Induced Diarrhea) and in people who cannot digest lactose (sugar
part in milk) – lactose intolerant.

BifidobacteriumIt is also a commonly found bacteria in dairy products like
yoghurt and cheese. It is famous for its clinically proven effects in easing
the symptoms of irritable bowel syndrome (IBS)

Saccharomyces boulardii – it is a type of fungi, (yeast
variety) helps in diarrhoea and other
digestive problems.

10 Primary Benefits of Probiotics

1.      It restores the balance of the friendly bacteria in the gut

Bacterial imbalance in
the gut will happen due to the existence of more bad bacteria than good
bacteria. This occurs naturally as a result of
digestive diseases, poor diet or antibiotics. Prebiotics restores this
balance if taken it outside in sufficient amounts. Simply from supplementation
or adequate amounts of fermented foods and dairy products.

2.      Probiotics can treat and help
prevention of diarrhoea

Use of probiotics has
been shown to directly reduce the risk of antibiotic-associated
diarrhoea by restoring the balance among
bacteria in the gut.

Furthermore, supplementation with probiotics slow down the effects of infectious diarrhoea, with best results demonstrated in
children. However, the effects of probiotics are dependent on the type and dosage
of probiotics used.

3.      Probiotics supplements can ease the
symptoms of digestive disorders

Digestive conditions like
inflammatory bowel disease (IBS), including ulcerative colitis and Crohn’s
disease have been shown to be well controlled by probiotics supplementation.

Specifically Lactobacillus
and Bifidobacterium strains have the ability to reduce and ease the symptoms
of these conditions with considerable efficacy.

4.      Probiotics can boost the immune system
of the body

Probiotics stimulate the
production of natural antibodies inside the body and prevent the activity of
harmful bacteria.

Furthermore, they also boost the T lymphocytes
and IgA-producing cells which are important in the prevention of mild respiratory infections like common cold and urinary
tract infections, especially among middle-aged women.

5.      Most importantly it can help to
reduce extra body weight and fat.

Probiotics have the
ability to absorb dietary fat inside the small intestine of the gut and assist in excretion through faecal matter.

Additionally, probiotics
supplementation or eating plenty of probiotic foods, increases the feeling of
fullness, which reduces the intake of other foods in-between main meals. It is
a cause of indirect weight loss through dietary control. However, some dietary products containing Lactobacillus
can lead to weight gain
and you should be careful when choosing the best probiotics for your need.

6.      Can reduce the reoccurrence of
genital-urinary infections

Recurrence of urinary
conditions such as urinary infections (UTI), bacterial vaginosis, vaginal
infections, bladder cancers and bladder stones can be reduced by frequent
intake of probiotics.

Some of the best
probiotics can help prevent bad bacteria (pathogenic bacteria) from invading
the urinary tract by maintaining a population of healthy bacteria (Probiotics)
on the tract’s adherence sites.

7.      Probiotics may also have a special
role in maternal health

Pregnant women are
particularly susceptible to vaginal infections and probiotics have been
demonstrated to play a role in reducing the reoccurrence of these conditions.

And bacterial vaginosis
has been indicated as a contributing factor to pre-term labour, making probiotics a potential benefit for fetal health.

  1. Probiotics use can improve mental health conditions

There has been remarkable research and advances in use of probiotics to ameliorate
mental health conditions like depression, stress, anxiety, autism, memory loss
due to ageing and obsessive-compulsive

This is a new upcoming area of medicine, where
use of probiotics and fecal transplants have demonstrated beneficial effects in
mental health conditions.

  1. Probiotic supplements help to
    improve heart health

Use of probiotics can reduce the LDL (bad cholesterol) in blood and help
in decreasing blood pressure.

Additionally, probiotics have been shown to break down bile in the gut
(biochemical fluid in gut helps in fat digestion) and prevent it from
reabsorbing into the bloodstream.

  1. Probiotics can reduce the chances of some allergic conditions and

is more so especially in newborn infants
and children below 5 years. It is also beneficial for eczema in pre-pregnant
mother and locating mothers.  Furthermore, probiotics reduce the inflammatory
responses triggered by milk and dairy product allergies. 

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Probiotics – Why Settle for less? Get 1000x more!

Probiotics undoubtedly have become a primary area of wellness interest among the public and medical fraternity alike. There is overwhelming information, discoveries and innovations brought to light each and every day, both good and bad.

Whilst most of the progress is positive, I’m totally bewildered by the fact that we do not get probiotics’ benefit simply because they do not reach our guts!

Yes, less than 4% of probiotics taken orally ever reach our guts, where they are most useful! That’s crazy waste of money, time and worst of all, health benefits that accrue from probiotics use.

Ok. Let’s start from the beginning.

What are Probiotics?

According to WHO[1], Probiotics are defined as live microorganisms which, when administered in adequate amounts, confer health benefits to the host. This includes the following primary benefits:

  1. Inhibition of pathogenic growth
  2. Maintenance of health promoting gut microflora
  3. Stimulation of immune system
  4. Relieving constipation, absorption of calcium, synthesis of vitamins and antimicrobial agents, and predigestion of proteins [2]

Several health benefits have been proved for specific probiotic bacteria, and recommendations for probiotic use to promote health have been published widely.

Year after year, probiotics continue to gain popularity and increased use by clinicians based on evidence and perceived health benefits.



According to FAO/WHO recommendations, for a Probiotics to declare claims of health benefits, it must contain a concentration of 106 to 107 CFU (Colony Forming Units) of Viable probiotics bacteria.

That is how much should be contained in the formulation at the point of purchase by the customer. However, this is not always true. Probiotic viability is affected right from processing, packaging and most importantly at the retailer’s shelf. Most manufacturers try to overcome this hurdle by over-compensating with excess colonies of the probiotics. It is no surprise to find 100x excess of the label claim at manufacture, with presumption that gradual deterioration over the products’ shelf-life will result in residual amount that corresponds to the label.

The main challenges facing the probiotics currently can be largely be divided into two:

1. ) Probiotics’ Shelf-Life 

The viability of probiotics under room temperatures has been a matter of concern in the industry.

Most probiotics products take time from 2 months to 18 months on the pharmacy shelf before they can get to the final consumer.

There is gradual deterioration and loss of bacteria during this period due to storage, oxidation and other stress that impacts on the live bacteria.

2. ) Tolerance of Stomach Acid and Bile

Most probiotics do not seem to transiently survive the harsh acidity in the stomach.

At a pH below 2, most probiotics are destroyed alongside other pathogenic bacteria taken orally. This is undoubtedly body’s first line of defense against pathogens eaten alongside food or drinks and probiotics are no exception.

Lactobacilli spp. Of probiotics has been shown to only survive between 30 seconds to several minutes under these conditions.

Previously, different ways of overcoming these challenges have been attempted with varying degrees of success. Most solutions have not delivered optimal and effective ways due to a host of factors:

  1. Most techniques used have led to high stress and degradation of the live bacteria, resulting to low survival rate and reduced load upon processing.
  2. The use of various microencapsulation materials lead to unstable and sometimes non viable micro-capsules without any protection of the organism
  3. Formulations and innovations around gastric or enteric coating (enteric coated capsules) have resulted into the coating not ‘opening’ or dissolving in the GI system and thus not releasing the probiotics at all.

Velobiotics™ – What is different?

May 2018, will see the launch of Velobiotics™ range of products in the market, with the primary aim of overcoming these two primary challenges facing probiotics.

Velobiotics™ is a novel and patented technology that helps micro-protect probiotics thus increasing viability and efficacy when ingested. The technology utilizes Supercritical Carbon Dioxide (SCO2) in which two hydrophilic polymers interact to form an interpolymer complex, that ‘hides’ or ‘shields’ the probiotics at a microscopic level.

Through research carried out on various probiotics, the SCO2 technology was shown deliver up to 1000x more probiotics to your gut than non-encapsulated probiotics. This was achieved by increasing the shelf-life of the probiotics as well as safe transit through the stomach acid into the gut.

For the VERY FIRST TIME, this has led to probiotics being included in ready-to-eat powder preparations, sports supplements and meal replacements!

Why Settle for Less?

With Velobiotics™, that’s the question that we’re aiming to answer and provide solutions that makes everyone access the full benefits of probiotics.


From meal replacements providing nutritional support for recovery, to sports supplements, Velobiotics™ delivers 1000x more probiotics than non-encapsulated probiotics. From as much as 10 Billion CFU per meal serving (Femina™ with Cranberry) to 16Billion CFU per capsule (Ultima16™) there is absolutely no reason, why you should settle for less.


[1] FAO/WHO. Probiotics in Food.Health and Nutritional Properties and Guidelines for Evaluation, FAO Food and Nutrition Paper 85World Health Organization and Food and Agriculture Organization of the United Nations, Rome; 2006
[2] J. Rafter, 2003Probiotics and colon cancer. Best Pract. Res. Clin. Gastroenterol. 17849859

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Video-Observed Treatment Instead of Directly Observed Treatment for TB

Smartphone-enabled video observation of tuberculosis treatment (VOT) was effective and has multiple advantages over traditional directly observed therapy (DOT).  In the full follow-up period, completed observations were significantly higher in the VOT than DOT group (77% vs. 39%, respectively). 

Directly observed treatment (DOT) for tuberculosis (TB) has been recommended to improve treatment completion particularly among groups with poor adherence. Smartphone technology makes video-observed treatment (VOT) feasible. U.K. investigators compared TB treatment completion using traditional DOT versus asynchronous VOT (recorded video clips forwarded and reviewed later).

Investigators randomized patients aged ≥16 years with active TB (MDR-TB excluded to DOT [direct observation 3–5 times per week]) or VOT. VOT participants received smartphones and training to record and send videos of themselves taking medication. Trained observers assessed whether participants had taken doses. Smartphone participants could report adverse events and could call and text. More than half of both groups gave histories of homelessness, imprisonment, drug or alcohol problems, or mental health problems.

In intention-to-treat analysis, 70% of 112 VOT participants completed at least 80% of observations during first 2 months (including among those at increased risk for nonadherence) versus 31% of 114 on DOT. In the full follow-up period, completed observations were significantly higher in the VOT than DOT group (77% vs. 39%, respectively). Positive sputum cultures did not differ significantly between VOT and DOT at 2 months. Adverse events were reported by more VOT-group than DOT-group participants. VOT required less staff time and was cheaper than DOT.


Video-enabled TB treatment observation resulted in greater confirmed treatment compliance than DOT and achieved good results even in patients at high risk for poor adherence. VOT took less time for health workers and patients, was cheaper, and did not reduce identification of adverse events. The study was too small to detect differences in culture conversion or resistance development. It did not include patients with multidrug-resistant TB. This approach could have broad applicability as smartphone technology is widely available in most countries; good internet and cellular connections are needed. These results led U.K. National Health Service in London to adopt VOT.

Mary E. Wilson, MD reviewing Story A et al. Lancet 2019 Feb 21

EDITOR DISCLOSURES AT TIME OF PUBLICATION:  Disclosures for Mary E. Wilson, MD at time of publication: Consultant/Advisory Board : FXB Center for Health and Human Rights, Harvard T.H. Chan School of Public Health; Fogarty International Center

Royalties : UpToDate

Editorial Boards : Travel Medicine and Infectious Diseases; Journal of Travel Medicine

CITATION(S):Story A et al. Smartphone-enabled video-observed versus directly observed treatment for tuberculosis: A multicentre, analyst-blinded, randomised, controlled superiority trial. Lancet 2019 Feb 21;


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Transmitted Resistance to All Integrase Inhibitors: A Rare Event, or the Tip of the Iceberg?

The first documented case of primary resistance to all integrase strand transfer inhibitors (INSTIs) in an ART-naive woman raises questions about universal screening for INSTI resistance.

Researchers present the case of a 42-year-old woman who had a negativeHIV test in August 2016 and was diagnosed with HIV infection in May 2018. She denied any history of antiretroviral therapy (ART), including pre- or postexposure prophylaxis.

A pretreatment genotype, including integrase sequencing, was obtained and showed three major INSTI mutations: E138A, G140S, and Q148H. These were also demonstrated on a repeat genotype. Subsequent genotypic sequencing of the presumed source patient, an HIV-infected sexual partner, revealed the same integrase mutations, confirming that this almost certainly represented transmitted integrase resistance. The source patient’s treatment history included raltegravir and dolutegravir.

INSTIs are now a component of every recommended initial regimen for ART-naive patients, per U.S. Department of Health and Human Services and International Antiviral Society -USA Panel guidelines.

This report leads us to ask once again if integrase resistance testing should be performed universally at HIV diagnosis. Despite this concerning case, the jury is still out, and the answer may depend on whether the initial regimen contains first- or second-generation INSTIs.

The first-generation agents, raltegravir and elvitegravir, have a lower barrier to resistance; multiple mutations to these agents can lead to cross-resistance to the second-generation agents, dolutegravir and bictegravir, as likely happened in the source patient.

Whether this mutational pattern would have led to virologic failure on a bictegravir- or dolutegravir-containing regimen is unknown, but a first-generation INSTI regimen would have been significantly compromised.

Modeling data (Clin Infect Dis 2017; 65:1274) suggest that baseline integrase resistance testing is not cost-effective and leads to worse clinical outcomes when the initial regimen contains a second-generation INSTI, but slightly better outcomes when a first-generation agent is selected. Continued monitoring of transmitted INSTI resistance is necessary and will help inform future recommendations.
EDITOR DISCLOSURES AT TIME OF PUBLICATIONDisclosures for Wendy S. Armstrong, MD at time of publicationNothing to disclose
CITATION(S):McGee KS et al. Canary in the coal mine? Transmitted mutations conferring resistance to all integrase strand transfer inhibitors in a treatment-naive patient. Open Forum Infect Dis 2018 Nov 8; 5:ofy294. (
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Improving HIV Self-Testing Among Male Partners of Pregnant Women in Malawi

A trial in Malawi showed that self-test kits given to pregnant women for their male partners along with a monetary incentive improved male HIV testing.

Salim S. Abdool Karim, MD, PhD reviewing Choko AT et al. PLoS Med 2019 Jan 2

A total of 2349 Malawian women attending a prenatal clinic for the first time during their current pregnancy were randomized to either a control standard-of-care arm (including a letter inviting the partner to test) or one of five intervention arms, all with two HIV self-test kits: either (1) the kits alone, (2) the kits with one of three levels of monetary incentive ($3, $10, or a 10% chance of receiving $30 in a lottery), or (3) the kits with a phone call reminder.

Interviewed at 28 days, women in the standard-of-care arm reported that 17.4% of their partners tested, while among the intervention arms, reported testing ranged from 87.0% to 95.4%. However, only 28.8% of male partners in the intervention arms had tested and were linked to treatment or prevention services within 28 days (the primary endpoint).

Testing rates among male partners of those receiving the HIV self-test alone or the test with a lottery entry were similar to those receiving the standard of care. However, partners of women receiving the HIV self-test kits in combination with the $3 or $10 monetary incentive or with a phone reminder were, respectively, 3.0, 3.7, and 1.6 times more likely than those in the standard-of-care arm to meet the primary endpoint.

The estimated program cost per man who tested and came to the health service was about $24 for those in the $3 incentive arm, while it cost about $28 per man in the $10 incentive arm.


In Malawi, HIV self-test kits, together with a $3 or $10 incentive or a phone call reminder, were effective in improving HIV testing rates with linkage to care or prevention for male partners of pregnant women. The strategy could be important in settings where men are hard to reach and have low testing coverage. Cost estimates indicate that this is an affordable strategy for Malawi.

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As A Strategy for HIV Prevention, Disabling the CCR5 Gene in Embryos Implanted in HIV-Negative Mothers Makes Zero Sense

Dr. Paul Sax weighs in on scientist He Jiankui’s “disturbing” gene-editing experiment, in HIV and ID Observations.

Chinese scientist He Jiankui recently announced he used an editing technique to alter the embryos of two babies. The research was initially described as an “AIDS vaccine development project.” But, points out Dr. Paul Sax in the latest HIV and ID Observations blog post, babies are not at risk for HIV, even if the mother’s male sexual partner has the virus.

Here are a bunch of things we know about HIV prevention, listed roughly in order of when we learned them — and forgive me if this is an oversimplification for this sophisticated readership:

  • Condoms work very well in preventing HIV transmission.
  • Taking a brief course of HIV therapy soon after exposure reduces the risk of HIV acquisition.
  • Babies born to HIV-positive mothers do not contract HIV if the moms take suppressive HIV therapy.
  • Male circumcision reduces the risk of these men acquiring HIV.
  • People do not contract HIV from their HIV-positive partners if the person with HIV takes suppressive HIV therapy.
  • People taking pre-exposure prophylaxis markedly reduce their risk for HIV acquisition.

You’ll note that nowhere on this list is anything about preventing HIV in babies born to women who don’t have the virus to begin with — because the babies are not at risk, even if the mother’s male sexual partner has HIV.

Just typing that sentence felt a little strange, it’s so obvious. However, it seems that He Jiankui may not understand this basic fact.

He’s the scientist who startled the world by releasing news that he and his research team had used CRISPR–Cas9 genome-editing to alter the embryos of two babies. The editing disabled the CCR5 gene, which means the babies lack a key co-receptor that HIV uses to infect cells.

However, as noted at 1:53 in the above-linked video, it’s the father who has HIV. Indeed, reports indicate that eight serodiscordant couples have participated in his studies — all with the fathers having HIV.

I’ll let others with far greater knowledge of genetics, embryology, and medical ethics comment on just how reckless this experiment was — here’s a good take (there have been many).

But from an HIV prevention perspective, it’s easy to judge — it makes zero sense to do this since the babies aren’t at risk of getting HIV to begin with. For them and their families, the genome-editing was all risk and no reward.

Let’s hope the mothers understood this before they agreed to participate in this disturbing experiment.

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More Evidence for Dolutegravir/Lamivudine as Initial HIV Therapy

In antiretroviral-naive adults with HIV infection, the two-drug regimen was noninferior to a standard three-drug regimen.

Two-drug antiretroviral therapy (ART)regimens for ART-naive adults with HIV infection are of considerable interest.Now, investigators have conducted two identical randomized, controlled trials(GEMINI 1 and 2) to evaluate what is currently the most promising two-drugcombination — dolutegravir/lamivudine — for ART-naive HIV-positive adults.


November 29, 2018

Wendy S. Armstrong, MD reviewing Cahn P et al. Lancet 2018 Nov 9

A total of 1441 participants wereassigned 1:1 to dolutegravir/lamivudine or a standard three-drug regimen:dolutegravir/tenofovir/emtricitabine. At enrollment, participants had viralloads of 1000 to 100,000 copies/mL (increased during the trial to an upperlimit of 500,000 copies/mL).

At 48 weeks, pooleddata from the intention-to-treat analysis demonstrated virologic suppression of<50 copies/mL in 91% in the two-drug group and 93% in the three-drug group,demonstrating non inferiority for the two-drug regimen. In subgroup analysis, no differences in rates of viral suppression were observed in those with viralloads >100,000 copies/mL, but rates of suppression were significantly lower in those with a baseline CD4 count <200 cell/mm3.

The latter group represented only 8%–9% of the total study population, and most endpoints did not represent virologic failure, limiting the interpretation of this finding.Among 10 patients who met criteria for virologic withdrawal (all with rebound),none developed mutations to agents in their treatment regimen.

COMMENTThe GEMINI studies add support to the use of dolutegravir/lamivudine as a two-drug regimen for initial treatment of adults with HIV infection, with important caveats: The studies excluded patients with viral loads >500,000 copies/mL, and the performance in those with CD4 counts <200 remains uncertain. Additional 96- and 144-week data analyses are planned to assess durability and experience in “real-world” patients to further clarify the risks for resistance. If these promising results are maintained, the most important advantage of this regimen is the potential for dramatic cost savings with the use of branded dolutegravir and generic lamivudine, which could introduce much needed price competition to the ART market.