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Head-to-head evidence comparison — which supplement is right for you?
L. acidophilus vs VSL#3 / Visbiome: VSL#3 / Visbiome has the stronger overall evidence (6.5 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.
VSL#3 / Visbiome wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
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)
any
A product naming its strain (e.g. NCFM, DDS-1, La-14, La-5)
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
Refrigerated sachet of the De Simone Formulation
Weeks
Weeks
Course of antibiotics
9-12 months
12 months
8-12 weeks
n/a
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
Multicentre randomised controlled trial in irritable bowel syndrome (PubMed publication types: Randomized Controlled Trial, Multicenter Study)
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 (PubMed publication types: Randomized Controlled Trial)
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
Randomised, double-blind, placebo-controlled multicentre trial in inpatients aged 65 and over (PubMed publication types: Randomized Controlled Trial, Multicenter Study)
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 improve digestion, L. acidophilus has a higher relevance score (55 vs 52).
No known interactions between L. acidophilus and VSL#3 / Visbiome have been documented in our database. However, always consult a healthcare provider before combining supplements.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.