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Head-to-head evidence comparison — which supplement is right for you?
L. casei Shirota vs L. rhamnosus GG: L. rhamnosus GG has the stronger overall evidence (6 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. rhamnosus GG 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
Mostly mechanism / observational
Top outcomes
Shared outcomes (1)
Outcomes where both L. casei Shirota and L. rhamnosus GG have evidence — compare verdict strength side-by-side.
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
10-20 billion CFU (1-2 x 10^10) daily. A meta-analysis in children with acute gastroenteritis found LGG effective at 10 billion CFU/day or more, and borderline below that.
Any time of day
Capsule standardized to ATCC 53103
4 weeks
2 weeks
2-12 weeks
8 weeks
During the antibiotic course
During hospital stay
n/a
n/a
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)
Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children.
N Engl J Med (2018) · Rct · n=971
Primary outcome (modified Vesikari score >=9 within 14 days): 11.8% with LGG vs 12.6% placebo; RR 0.96 (0.68-1.35), P=0.83
Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults.
Aliment Pharmacol Ther (2015) · Meta analysis
Antibiotic-associated diarrhea fell from 22.4% to 12.3%; RR 0.49 (0.29-0.83) pooled across 11 RCTs, n=1,308 (12 RCTs, n=1,499 included overall)
Probiotics for treating acute infectious diarrhoea.
Cochrane Database Syst Rev (2020) · Meta analysis
In studies at low risk of bias, no difference in diarrhea lasting >=48 hours (RR 1.00, 0.91-1.09; moderate certainty)
L. rhamnosus GG has a higher evidence score (6/10 vs 5/10) and wins in 2 of 3 categories.
For improve digestion, L. rhamnosus GG has a higher relevance score (72 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.