More Information Needed on Probiotic Supplement Product Labels

  • Daniel MerensteinEmail author
  • John Guzzi
  • Mary Ellen Sanders
Concise Research Reports


Probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.1 Several specific probiotic strains are the subject of numerous robust studies, which comprise level 1 evidence.2, 3 However, there have been some recent well-publicized trials in which probiotics did not fare better than placebo.4, 5 We were interested in determining the extent to which retail probiotic dietary supplements were labeled in a manner that enabled us to determine if evidence supported product claims.


The Georgetown University IRB granted exemption status for this study. Between October 2018 and March 2019, JG visited four large national probiotic retailers in the Washington, DC area. Probiotic foods were excluded. The following information was collected from the product packaging: recommended use, dosage/serving size, colony forming units (CFUs)/serving, storage information/instructions, genus/species/strain of probiotic, use...



The authors would like to gratefully acknowledge Dr. Alexandra Mannerings for designing the figures.

Compliance with Ethical Standards

Conflict of Interest

Dr. Sanders reports personal fees from California Dairy Research Foundation, personal fees from Nestle, personal fees from Danone Research, personal fees from The Dannon Company/Danone North America, personal fees from Williams Mullen, personal fees from Winclove, personal fees from Pharmavite, personal fees from Yakult, personal fees from Dutch Mill, personal fees from Clorox, personal fees from Pfizer, personal fees from Medscape, personal fees from Probi, personal fees from Mead Johnson, personal fees from GSK, personal fees from Church & Dwight, personal fees from General Mills, personal fees from Visalia Dairy Company, personal fees from International Scientific Association for Probiotics and Prebiotics, personal fees from Proctor & Gamble, personal fees from Kelly Dry & Warren LLP, non-financial support from United States Pharmacopeia, non-financial support from International Life Sciences Institute, personal fees from Kellogg, personal fees from Trouw Pet Nutrition, personal fees from JHeimbach LLC, and personal fees from Kerry, outside the submitted work.

Dr. Merenstein has received personal fees from Bayer, Pharmavite, Reckitt Benckiser, and Debevoise & Plimpton.

John Guzzi has nothing to disclose.


  1. 1.
    Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506–514.CrossRefGoogle Scholar
  2. 2.
    Goldenberg JZ, Mertz D, Johnston BC. Probiotics to Prevent Clostridium difficile Infection in Patients Receiving Antibiotics. JAMA. 2018;320(5):499–500.CrossRefGoogle Scholar
  3. 3.
    Sung V, D’Amico F, Cabana MD, et al. Lactobacillus reuteri to Treat Infant Colic: A Meta-analysis. Pediatrics. 2018;141(1).Google Scholar
  4. 4.
    Freedman SB, Williamson-Urquhart S, Farion KJ, et al. Multicenter Trial of a Combination Probiotic for Children with Gastroenteritis. N Engl J Med. 2018;379(21):2015–2026.CrossRefGoogle Scholar
  5. 5.
    Schnadower D, Tarr PI, Casper TC, et al. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. N Engl J Med. 2018;379(21):2002–2014.CrossRefGoogle Scholar
  6. 6.
    Cohen PA. Probiotic Safety-No Guarantees. JAMA Intern Med. 2018;178(12):1577–1578.CrossRefGoogle Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  1. 1.Department of Family MedicineGeorgetown UniversityWashingtonUSA
  2. 2.Research Programs Family MedicineGeorgetown University Medical CenterWashingtonUSA
  3. 3.Department of Human Science, School of Nursing and Health Studies Georgetown University Medical CenterWashingtonUSA
  4. 4.Georgetown University Medical SchoolWashingtonUSA
  5. 5.Dairy & Food Culture TechnologiesCentennialUSA

Personalised recommendations