Should men take a probiotic?
With so many supplements available, it can be confusing to know which kind to choose. It’s easy to find a daily probiotic supplement, but a key question is whether men should look for gender specific strains and products.
In a previous article, I looked at some ‘fledgling’ clinical research which suggested that sex hormone levels in men and women may affect the composition of the microbiome. More research is needed before any definite conclusions can be drawn. Until that time arrives, the scientific community will most likely follow the existing theory that the microbiome is the same in each gender. Using this hypothesis, probiotic supplementation guidelines are the same for men and women, therefore, men should look for a supplement designed to support their specific health requirements and symptoms in exactly the same way that women should.
Certain health conditions are different between man and women which may affect why a man takes a probiotic.
According to the Office for National Statistics, the number one cause of death for British men is Ischaemic Heart Disease (IHD), whereas for British women dementia and Alzheimer’s Disease claim the most lives1. The most common health conditions do differ according to country of residence and age, but there are a few which seem to be common around the world. We’ll look at the different strains that have been researched for these health conditions later in this article, but first, let’s look at how probiotics can support men's health, and what sort of benefits to expect.
Which are the best probiotics for men?
As previously mentioned, research hasn’t identified gender-specific microbial patterns or probiotic strains. Most clinical trials include both men and women: high quality trials randomise participants so there should be equal number of men & women per group. For more information on clinical trial design and lingo you can read Research: is it all equal?. Research for general health conditions will also apply to those who identify as non-binary and to transgender individuals. For some health conditions e.g. vaginal or prostate, a particular gender may have to be chosen for the trial, but some results, such as vaginal health studies, may also be translatable to trans men.
Let’s look at some probiotics for general gut support and common men’s health conditions:
Digestion
Men often have higher energy demands, so it’s essential for them to digest and absorb nutrients efficiently. Probiotics can encourage a healthy gut environment and provide digestive enzymes to break down foods consumed. Men commonly suffer with IBS; it’s estimated approximately 11% of men suffer with IBS in the UK2.
Bacillus coagulans Unique IS-2 was shown in a gold-standard clinical trial to reduce symptoms of IBS in adults3, from week five the probiotic group exhibited significant improvements in abdominal discomfort, bloating, urgency, incomplete evacuation, straining, passage of gas and bowel habit satisfaction.
Bacillus coagulans Unique IS-2 is part of a group of bacteria known as soil-based organisms which are commonly used in food, beverage and gummy supplement production due to the robust nature of this bacteria.
Some of the best probiotic strains for gut health include Lactobacillus acidophilus NCFM®, Bifidobacterium lactis HN019 and Bifidobacterium infantis 35624. L. acidophilus NCFM® has been shown in clinical trials to significantly reduce abdominal pain and bloating in hundreds of individuals3,4.
You can also read more on IBS here: Which probiotics are best for IBS?
Healthcare professionals can find more information on these strains in our Probiotics Database
Heart health
According to the British Heart Foundation, 7.4 million individuals in the UK suffer from heart and circulatory diseases; of these, 3.9 million of these are men5. Risk factors for heart conditions include smoking, obesity, physical inactivity, stress, raised cholesterol and high blood pressure. Currently, there’s not much research looking at the use of probiotics for heart health; however, certain probiotics may be able to help with some of the risk factors of heart disease. For example, super strain Lactobacillus acidophilus Rosell-52 has been shown to improve psychological distress and anger hostility which may contribute to high stress levels, thus increasing the risk of heart disease6. Health Professionals can read more about this probiotic strain over on the Probiotics Database: Lactobacillus acidophilus Rosell-52.
Other strains of bacteria (including: Lactobacillus plantarum CECT 7527, Lactobacillus plantarum CECT 7528 and Lactobacillus plantarum CECT 7529) have been shown in a gold standard trial to reduce cholesterol levels, which can be another contributing factor7. These probiotic strains are also safe to take with statins.
Inflammation is commonly seen in heart disease patients, usually at the site of damage. Many strains of probiotics are known to have anti-inflammatory effects. In a 2006 review of clinical trials, probiotics from both the Lactobacillus and Bifidobacterium genus were shown to have anti-inflammatory actions via their stimulation of immune system cells in the gut8. By reducing the pro-inflammatory responses and increasing the anti-inflammatory responses certain probiotics appear to be able to restore balance at an immune level.
Mood and wellbeing
Approximately one in every eight men suffers with a mental health issue9. This is thought to be due to many factors including rising societal pressures or reluctance to seek support10, but there is also a strong connection to gut health. This is known as the gut brain axis. Scientists still don’t fully understand this connection, but we know that 90% of serotonin (happy hormone) is produced in the intestines, and gut bacteria are involved with its metabolism. Gamma-aminobutyric acid (GABA), a neurotransmitter associated with good mood and sleep, is produced by microbes in the gut including genera like Bifidobacteria and Lactobacilli which are commonly used in probiotic supplements11.
As previously mentioned, the L. acidophilus Rosell-52 and Bifidobacterium longum Rosell-175 strains have been shown to improve our mental wellbeing. A 2019 pilot study evaluated the effects of these strains on symptoms of low mood, anhedonia (inability to feel pleasure) and sleep disturbance, with significant positive results12 .These results were supported by another gold standard clinical trial in which the strains were shown to improve depression scores in those with major depressive disorders13. Read more about these strains, and others in Dr. Aislings informative article: Probiotics for stress.
Healthcare professionals can also read more information on these two strains here; Two probiotic strains show promise for mental health.
Probiotics for prostate health
According to ‘The Men’s Health Resource Center’, over 30 million men globally suffer from prostate conditions14. These include Benign Prostatic Hyperplasia (BPH), prostate cancer, and prostatitis. Very little research has been done specifically looking at the effects of probiotics on prostate health. Probiotic products specifically marketed for prostate health tend to include other vitamins, minerals or botanicals (such as cranberry) which are more commonly used for uro-genital health.
However, there’s a small amount of probiotic research which has so far yielded encouraging results. In one clinical trial scientists analysed microbial communities within the semen samples of 46 healthy males, and a further 21 who suffered from chronic prostatitis (inflammation of the prostate). It was found that the healthy samples contained greater quantities of the friendly bacteria Lactobacilli, whereas the samples taken from those with prostatitis showed higher levels of inflammatory Proteobacteria15. The relevance of this finding is not yet fully understood, and more research is required to ascertain whether the seminal microbiome can be effectively altered through probiotic supplementation.
Male reproductive health may also be impacted by the seminal microbiota. It has been successfully demonstrated in trials that the semen of infertile men has a different microbial composition to that of fertile males16. One human trial showed that supplementing with Lactobacillus rhamnosus CECT 8361 and Bifidobacterium longum CECT 7347 elicited improvements in sperm quality parameters and sperm motility over 6 weeks17. In the longer term, this could have excellent potential for the therapeutic use of probiotics for male infertility, or sub-fertility.
Probiotics for respiratory health
Whether you believe in ‘man flu’, it’s true that many men suffer with respiratory conditions and need to support their immune function. Many factors can impact our immune system including smoking, poor diet, high activity levels and stress. There’s a growing body of research which indicates that probiotics can positively affect immune function and resistance to infection.
A Japanese trial showed that when smokers took Lactobacillus casei Shirota®, NK cell activity improved18,19. NK cells are white blood cells, important for fighting off viral infections, these cells are usually lower in smokers.
In another gold standard study, 465 healthy adults were given the probiotic strain Bifidobacterium lactis Bl-04 over a 5 month period. The probiotic reduced incidences of upper respiratory tract infections by 27%20. A further group of participants in this study were given a different probiotic containing L. acidophilus NCFM® & B. lactis Bi-07. This group also saw a reduction in infection incidence rate.
(Health Professionals can read about these probiotic strains over at the Probiotics Database: L. acidophilus NCFM®, B. lactis Bi-07, B. lactis Bl-04)
In a large-scale study involving 1104 healthy participants, a milk preparation containing the probiotic strain Lactobacillus paracasei CASEI 431® reduced the duration of flu-like symptoms by 3 days after taking the influenza vaccine.21
Health Professionals can view research using this strain on the Probiotics Database Lactobacillus paracasei CASEI 431®.
You can read more on: Probiotics for winter immunity.
Healthcare professionals can also explore the complex relationship between the microbiome and immunity in Probiotics for immunity.
Best probiotic for men over 60
Once we hit adulthood, there are no specific age-related probiotics, though we do know that, as we age, a certain group of friendly bacteria, Bifidobacteria, can decline. These are particularly important for digestion & immunity. Bifidobacteria are abundant in healthy babies and children’s guts, and their decline could explain why older people experience more colds and flu, digestive upsets, and regularity issues.
Interestingly, slow stool transit is common in Parkinson’s disease, a disease which typically develops in older people, and is 1.5 times more common in men than women24. Read this article to find out more about how Parkinson’s is linked to gut bacteria.
The premium probiotic strain Bifidobacterium lactis BB-12® has been researched in all age groups including the elderly and found to increase bowel movements and improve immune function22,23.
Healthcare professionals can find more information on B. lactis BB-12® on the Probiotics Database.
For more information read Can Older People take Probiotics?
Probiotics for weight loss
Obesity and metabolic conditions are common in men. Probiotics and weight loss research is in its infancy with inconsistent findings; however, probiotics are becoming more associated with metabolic health and there are promising results using probiotics in those with type 2 diabetes and metabolic syndrome.
There is some preliminary evidence that Bifodobacterium lactis HN019 is able to reduce BMI, cholesterol and inflammatory markers in those with metabolic syndrome25. L. acidophilus NCFM® was shown in a pilot study to preserve insulin sensitivity in those with normal and impaired insulin sensitivity26. Both these results are promising, but it must be noted these trials were small and more trials are needed to confirm their efficacy.
Healthcare professionals can read more on this topic: Can probiotics help with weight loss? and visit the Probiotics Database for further research on B. lactis HN019.
The microbiome in men
Interestingly, two 2013 studies by Markle et al.29 and Flak et al.28 applied a different slant to the growing body of research by looking at the differences in microflora caused solely by host sex. This new area of study has been dubbed the ‘microgenderome’, and highlights the differences in microbiome according to sex, and therefore exposure to the different male or female sex hormones.
The study of the ‘microgenderome’ is still in its infancy, but its applications for the future look promising. To get closer to understanding why males are more likely to suffer with conditions such as Coronary Artery Disease and stroke, whereas women are 20-40%30 more likely to suffer a mental disorder and three times as likely31 to develop an autoimmune condition than men, would be a huge breakthrough in medical science.
Benefits of probiotics for men
Probiotics can benefit most individuals, providing they are not seriously unwell or have immune supressing health conditions. Read our article 'When should I not take probiotics?' to find out more about known contraindications. If in doubt whether a probiotic is safe for you always check with your GP.
Probiotics support the microbiome by topping it up with beneficial bacteria. These ‘good guys’ are vital in supporting digestive, immune, mental, skin, metabolic and intimate health and more! Unfortunately, modern lifestyles are not very microbiome friendly- we’re all busy balancing work, family, and social lives, and maybe opting for quick and easy fast or convenience foods which are typically higher in fats, sugar, and salt. All these factors can cause dysbiosis, a microbial imbalance with depleted levels of beneficial microbes. Dysbiosis is associated with numerous health conditions, so it’s always worth considering gut health as part of any health regime. Probiotics may be able to rebalance dysbiosis, but it’s important to choose the best strain.
Probiotic supplements for men
There are many different types of probiotic supplements available, from liquids to powders, but most adults tend to prefer a capsule as this is easier to fit in their morning breakfast routine. Some gym goers like to open their capsule or add a powder sachet to their morning protein shake just before consumption. For those who really don’t like capsules or powders, then gummy products for adults are available. However, it is important to choose ones that contain strains of very robust bacteria (known as soil-based organisms) which allows them to survive the manufacturing process, for example Bacillus coagulans Unique IS-2.
Don’t forget your diet - you can even find friendly bacteria in food! Some of the best probiotic food for men (and women!) include fermented foods such as Kefir, Kimchi and Sauerkraut. All of these are good sources of bacteria which can support gut health.
Take a look at some of Our favourite fermented foods and recipes!
Summary
There is little data to show that the gut microbiome differs in men and women, therefore when looking for the best probiotics for men, keep an eye on strains researched for the health condition you’re trying to support, and/or general gut support.
Don’t forget to think about diet and lifestyle too - men can also support their gut health by:
Boosting activity levels- running, football, badminton or even bootcamp if you're feeling super energetic!
Reduce alcohol intake - the odd beer is fine, but it’s all about moderation!
Sleep! Try and get into regular sleep cycles as disrupted sleeping cycles may negatively impact our microbiome.
Diet - increase fibre and reduce sugar & salt. Sugar can feed harmful bacteria in the gut encouraging dysbiosis.
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