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Head-to-head evidence comparison — which supplement is right for you?
L. plantarum 299v 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.
Verdict
Too few graded studies
Top outcomes
Verdict
Too few graded studies
Top outcomes
1 x 10^9 CFU (1 billion) daily taken WITH the iron-containing meal is sufficient for the iron effect — in the dual-isotope crossover trial 10^9 was significant (28.6% vs 18.5%, p<0.028) while 10^10 was NOT (29.1% vs 20.1%, p=0.080). The freeze-dried capsule and IBS trials used 1 x 10^10 CFU daily, and the pregnancy trial used 1 x 10^10 CFU twice daily (2 x 10^10 CFU/day)
With meals
Freeze-dried capsule standardized to 299v (DSM 9843)
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
Immediate, per meal
12-25 weeks
4 weeks
n/a
9-12 months
12 months
8-12 weeks
n/a
A Systematic Review and Meta-Analysis on the Effects of Probiotic Species on Iron Absorption and Iron Status.
Nutrients (2019) · Meta analysis
Pooled SMD 0.55 (95% CI 0.22-0.88, p=0.001) for increased iron absorption across 8 studies
The effect of Lactiplantibacillus plantarum 299v together with a low dose of iron on iron status in healthy pregnant women: A randomized clinical trial.
Acta Obstet Gynecol Scand (2021) · Rct · n=326
Iron deficiency at week 35: 59% vs 78% (p=0.017); iron-deficiency anaemia 7.4% vs 21% (p=0.023)
Efficacy of Probiotics in Irritable Bowel Syndrome: Systematic Review and Meta-analysis.
Gastroenterology (2023) · Meta analysis
For global IBS symptoms, certainty of evidence was LOW for this strain (moderate only for Escherichia strains)
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, VSL#3 / Visbiome has a higher relevance score (52 vs 50).
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.