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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
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
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
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 known interactions between L. plantarum 299v 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.