, Volume 47, Issue 6, pp 911–917 | Cite as

Probiotics in health and disease: fooling Mother Nature?

  • Muhammad Bilal AbidEmail author
  • Calvin J. Koh


Probiotics are ubiquitous, consumption by the general public is common, and the dogma remains that they are beneficial for general and gut health. However, evolving evidence suggests a potentially “harmful” impact of many commercially available probiotics. There is also significant variability in formulations that leads to a lack of a universally acceptable definition of probiotics. In this perspective, we review the flaws with definition, relevant observational and randomized studies that showed both positive and negative impacts on health and disease, unbiased interpretation of key trials, emerging evidence from microbiome and immuno-oncological studies, and impact on systemic immunity. We propose that caution be exercised prior to endorsements of their illness-directed consumption and rampant general usage. As a deeper understanding of the human microbiome accrues and our ability to manipulate this complex ecosystem improves, the probiotic of tomorrow might be the precision tool that deals with diseases on a broad front. Gut microbiome, akin to fingerprints, is indigenous to an individual and ‘one size fits all’ prescription strategy should be discouraged until a more universally acceptable ‘favorable taxa’ or a ‘personalized probiotic,’ to complement an individual’s native microbiota, gets fashioned.


Commercial probiotics Gut microbiome Dysbiosis 


Author contributions

MBA conceived of the idea, performed the literature search, wrote the manuscript, and drew the table. CJK co-wrote the manuscript. Both authors performed a critical revision of the manuscript.



Compliance with ethical standards

Conflict of interest

The authors declare no potential conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Divisions of Hematology/Oncology & Infectious Diseases, Department of MedicineMedical College of Wisconsin, Hub for Collaborative MedicineMilwaukeeUSA
  2. 2.Division of Gastroenterology and Hepatology, Department of MedicineNational University HospitalSingaporeSingapore

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