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Head-to-head evidence comparison — which supplement is right for you?
B. infantis 35624 vs VSL#3 / Visbiome: VSL#3 / Visbiome has the stronger overall evidence (6.5 vs 5/10); they're alternatives for inflammation-related symptoms — the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
VSL#3 / Visbiome wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Too few graded studies
Top outcomes
Verdict
Too few graded studies
Top outcomes
1 x 10^8 CFU (100 million) daily — the dose that won the only head-to-head dose comparison; 1 x 10^10 CFU also beat placebo in a separate trial, so higher doses are not ruled out
Any time of day
Freeze-dried capsule standardized to 35624 at 1 x 10^8 CFU
Prevention and maintenance are DIFFERENT doses and are often conflated. Preventing the first onset of acute pouchitis used 900 billion CFU/day (1 sachet). Maintaining remission in established chronic or refractory pouchitis — where the effect size is largest — used 6 g/day, which at 5 x 10^11 viable bacteria per gram is about 3 trillion CFU/day, in both maintenance trials. As a ulcerative colitis add-on, 3.6 trillion CFU daily; the active-UC induction trial went highest at 3.6 trillion CFU TWICE daily (7.2 trillion/day), and the paediatric trial lowest at 450 billion/day weight-based
Any time of day
Refrigerated sachet of the De Simone Formulation
4 weeks
4 weeks
n/a
n/a
9-12 months
12 months
8-12 weeks
n/a
Efficacy of an encapsulated probiotic Bifidobacterium infantis 35624 in women with irritable bowel syndrome.
Am J Gastroenterol (2006) · Rct · n=362
1 x 10^8 CFU significantly superior to placebo AND to all other doses for the primary endpoint of abdominal pain
Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles.
Gastroenterology (2005) · Rct · n=77
Beat placebo on composite score and on abdominal pain, bloating/distention and bowel-movement difficulty for most treatment weeks
Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis.
Curr Med Res Opin (2017) · Meta analysis
Single-strain 35624 had no effect on abdominal pain, bloating/distention, or bowel-habit satisfaction
Treatment and prevention of pouchitis after ileal pouch-anal anastomosis for chronic ulcerative colitis.
Cochrane Database Syst Rev (2019) · Meta analysis
Chronic pouchitis maintenance: 85% (34/40) maintained remission at 9-12 months vs 3% (1/36) placebo — RR 20.24 (95% CI 4.28-95.81), low certainty
Oral bacteriotherapy as maintenance treatment in patients with chronic pouchitis: a double-blind, placebo-controlled trial.
Gastroenterology (2000) · Rct · n=40
Relapse in 3/20 (15%) on the probiotic vs 20/20 (100%) on placebo, P<0.001
Once daily high dose probiotic therapy (VSL#3) for maintaining remission in recurrent or refractory pouchitis.
Gut (2004) · Rct · n=36
Remission maintained at 1 year in 17/20 (85%) vs 1/16 (6%) placebo, p<0.0001
VSL#3 / Visbiome has a higher evidence score (6.5/10 vs 5/10) and wins in 2 of 3 categories.
For inflammation-related symptoms, VSL#3 / Visbiome has a higher relevance score (70 vs 35).
No documented interaction was found in the data searched. This does not establish that this exact combination is safe.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.