Probiotic supplements can contain billions of live microorganisms that may potentially confer several health benefits, including protection against pathogenic microorganisms, inflammation, diabetes etc.
Many probiotics are marketed with claims of health benefits for their high colony-forming units (CFUs) counts. Nevertheless, the live bacteria must be able to survive the processes of manufacturing, storage, gastrointestinal transit and the acidic conditions of the gastric environment, and still be able to reach the large intestine in adequate amounts to allow colonization and proliferation. Otherwise, the live bacteria may be dead on arrival.
Scientific studies show that the survival rates of some probiotic strains do not reach more than 10-20 %, due to the highly acidic environment in the stomach, and in some cellulose-coated capsules it is estimated that up to 96 % of probiotics die in contact with stomach acid.
There are four dosage forms readily available on the market, including powder, capsules, tablets, and stick packs, each having varying impacts in terms of probiotics efficacy.
【Tablet】
Pros:
Many shapes and sizes available. Ease of storage, portability and administration.
Cons:
Microorganisms may be harmed during drying, milling of dried cell aggregates and compression. During tableting, stresses due to compression, shear and heat occur which could have devastating effects on microbial survival.
【Liquid】
Pros:
Ease of use, suitable for survival of Lactobacillus.
Cons:
Live bacteria have difficulty surviving in the liquid form, in particular Bifidobacterium since they can survive only in dry and anoxic conditions.
【Capsule】
Pros:
Convenience and ease of use, low production cost.
Cons:
Though widely manufactured and prescribed, the survival rate of live bacteria in capsules form needs to be proven through clinical trials. It is also difficult to guarantee the release time of the capsule in the body; If the probiotics were released before passing the GI tract, the harsh gastric acid environment would likely kill the live bacteria and thwart its mission to colonize the tract. "Bifidobacterium Adolescentis" (BA) in particular are extremely fragile and can survive only in a stable environment.
【Sachet】
Pros:
Quickly absorbed by the human body, sachets do not stimulate gastric acid secretion and can be mixed with foods such as yogurt and juice.
Cons:
High production cost. In order to ensure that the sachets resists gastric acid and bile salts, increases the survival rate, and prolongs the shelf life, "microencapsulation" technology must be applied to enhance acid resistance and the ability for live bacteria to colonize .
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Reference:
Size, Shape, and Other Physical Attributes of Generic Tablets and Capsules Guidance for Industry. U.S. Department of Health and Human Services. https://www.fda.gov/files/drugs/published/Size--Shape--and-Other-Physical-Attributes-of-Generic-Tablets-and-Capsules.pdf
Fenster, Kurt et al. “The Production and Delivery of Probiotics: A Review of a Practical Approach.” Microorganisms vol. 7,3 83. 17 Mar. 2019, doi:10.3390/microorganisms7030083
Along the Process Chain to Probiotic Tablets: Evaluation of Mechanical Impacts on Microbial Viability. file:///Users/agnesliu/Downloads/pharmaceutics-12-00066-v2.pdf
