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Head-to-head evidence comparison — which supplement is right for you?
L. acidophilus vs L. casei Shirota: L. casei Shirota has the stronger overall evidence (5 vs 5/10); they're alternatives for improve digestion — the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
L. casei Shirota wins 1 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
Shared outcomes (1)
Outcomes where both L. acidophilus and L. casei Shirota have evidence — compare verdict strength side-by-side.
1-100 billion CFU (10^9 to 10^11) per serving — the range FDA reviewed without objection for L. acidophilus DDS-1 in foods generally (GRAS Notice GRN 871); La-14 was noticed at 1 billion CFU per 250 g serving (GRN 502) (the one cited trial that states a dose used 10 billion CFU a day)
Any time of day
A product naming its strain (e.g. NCFM, DDS-1, La-14, La-5)
One 65-100 mL bottle of the fermented milk drink daily, delivering roughly 6.5 x 10^9 to 1 x 10^11 CFU depending on the product. Doses across trials span this whole range with no dose-comparison study to separate them.
Any time of day
Fermented milk drink containing L. casei Shirota (Yakult), 65-100 mL daily
Weeks
Weeks
Course of antibiotics
4 weeks
2 weeks
2-12 weeks
8 weeks
Lactobacillus acidophilus DDS-1 and Bifidobacterium lactis UABla-12 Improve Abdominal Pain Severity and Symptomology in Irritable Bowel Syndrome: Randomized Controlled Trial.
Nutrients (2020) · Rct · n=330
Randomised, double-blind, placebo-controlled multicentre trial in 330 adults with IBS (Rome IV), allocated 1:1:1 to placebo, L. acidophilus DDS-1 alone or B. lactis UABla-12 alone, each at 1 × 10^10 CFU/day for six weeks
The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance - a randomized, double-blind, placebo-controlled, crossover clinical trial.
Nutr J (2016) · Crossover
Randomised, double-blind, placebo-controlled crossover trial in adults with self-reported lactose intolerance confirmed by a lactose challenge: 4 weeks of DDS-1 or maltodextrin placebo once daily, with a 2-week washout
Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficile diarrhoea in older inpatients (PLACIDE): a randomised, double-blind, placebo-controlled, multicentre trial.
Lancet (2013) · Rct · n=2981
Randomised, double-blind, placebo-controlled multicentre trial in 2,981 inpatients aged 65 and over taking antibiotics, given a multistrain preparation of lactobacilli and bifidobacteria (6 × 10^10 organisms per day for 21 days) or placebo
Efficacy of daily intake of Lactobacillus casei Shirota on respiratory symptoms and influenza vaccination immune response: a randomized, double-blind, placebo-controlled trial in healthy elderly nursing home residents.
Am J Clin Nutr (2012) · Rct · n=737
PRIMARY ENDPOINTS ALL NULL: no effect on days with respiratory symptoms, probability of respiratory symptoms, or post-vaccination antibody titre
Probiotics and synbiotics in chronic constipation in adults: A systematic review and meta-analysis of randomized controlled trials.
Clin Nutr (2022) · Meta analysis
Probiotics overall increased stool frequency (SMD 0.71, 95% CI 0.37-1.04, p<0.00001) — but the effect was driven by Bifidobacterium lactis, 'not mixtures of probiotics, Bacillus coagulans Unique IS2 or Lactobacillus casei Shirota'
A study into the effect of Lactobacillus casei Shirota in preventing antibiotic associated diarrhoea including Clostridioides difficile infection in patients with spinal cord injuries: a multicentre randomised, double-blind, placebo-controlled trial.
EClinicalMedicine (2021) · Rct · n=359
PRIMARY ENDPOINT NULL: antibiotic-associated diarrhoea at 30 days 45% vs 42.1% (RR 1.071, 95% CI 0.8-1.4, p=0.639)
L. casei Shirota has a higher evidence score (5/10 vs 5/10) and wins in 1 of 3 categories.
For improve digestion, L. acidophilus has a higher relevance score (55 vs 52).
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.