Probiotics
What are Probiotics?
Probiotics are live bacteria or yeast that are beneficial to our digestion, immune system, and gut health. Many people think of probiotics as just a supplement, but they also naturally live in and on your body (think: gut, mouth, skin, etc). Probiotics benefit our gut by supporting the growth of other good bacteria in the gut and crowding out the bad bacteria. The goal is a good balance with a majority being beneficial! Probiotics can be found in supplements or food. Food sources of probiotics include fermented foods like yogurt, kefir, kombucha, sauerkraut, and other fermented products.
Different strains of probiotics may benefit certain conditions more than others. For example, the probiotic Saccharmyces boulardii is especially beneficial for diarrhea and leaky gut syndrome, while other strains are more helpful for constipation.
What is the Difference Between Probiotics and Prebiotics?
While the names are similar, they couldn’t be more different. Probiotics are live bacteria while prebiotics are fibers that help grow probiotics (bacteria) in your gut. This means that eating a diet rich in fiber can help support healthy bacterial growth in the gut! If your child doesn’t eat many fruits, vegetables, or whole grains, you can consider supplementing with prebiotics to fill in while you’re working on expanding their diet. And yes, many people take both of these supplements at the same time! Some probiotics may even contain prebiotics, which may or may not be helpful or necessary given your child’s needs and diet.
Are Probiotics Beneficial for Autism?
Generally, yes! But it depends on a few factors, and there is some conflicting research. First - it’s important to realize the importance of a healthy gut microbiome (i.e. the balance of bacteria in the gut). What’s amazing is that healthy gut bacteria are able to produce neurotransmitters, impact our mood & behavior, and even influence anxiety & stress. Our gut is directly linked to our brain via the vagus nerve in what scientists call the “Gut-Brain Axis”. This means that the gut directly impacts the brain and vice versa. This is especially true for many neurological disorders - autism included! [1]
In children with ASD, the GI dysfunction may be associated with a higher rate of irritability, anger, aggressive behaviors and sleep disturbances. Children with autism have higher rates of gut issues and imbalance of gut bacteria. Research studies suggest that probiotics can be a relatively low-risk and cost-efficient way to manage GI symptoms in children with ASD. [2, 3]. One research study showed that kids on the spectrum have lower levels of Bifidobacterium and higher levels of Lactobacillus [4]. When stool of kids on the spectrum was compared to their non-autistic siblings, those on the spectrum showed higher levels of “unhealthy” & toxin-producing bacteria. [5]
It’s important to note that there is conflicting research (as well as a lack of randomized controlled trials) on whether or not probiotics can mitigate behavioral symptoms. There are research studies on either side of the argument, showing that they either improve behavioral issues with ASD or they have no effect. In studies across the board, there is no standardized probiotics regimen, with most studies using multiple different strains and concentrations of probiotics, and variable duration of treatments. We need more studies that are consistent in their regimen including concentrations, combination of strains, and duration of use. [6]
BOTTOM LINE:
Probiotics can be a helpful tool to balance the gut microbiome and improve bowel health. However, there is no one-size-fits all formulation, so sometimes it may take some trial and error to find the perfect probiotic for your child. Working with a functional medicine practitioner is a great way to support you in this journey!
Which Probiotics Are Best for Autism?
It’s important to know that everybody’s guts are uniquely different. Some scientists believe they are equivalent to a fingerprint - meaning no two are alike. That being said, no probiotic is going to be right for every single person! Sometimes it takes some trial and error to find the probiotic that is the most successful for your child’s gut. Overall, we suggest a probiotic containing the following strains (if not all!)
Lactobacillus acidophilus, rhamnosus GG, reuteri
Saccharomyces boulardii (a yeast probiotic)
Bifidobacterium
It’s also ideal to have a probiotic free from allergens including gluten, dairy, soy, and corn ingredients.
Supplementation*
Dosing
For kids on the autism spectrum, we generally aim for a probiotic offering 10 billion CFU. Since our gut has trillions of living bacteria at any given time, it is important to supplement with dosages high enough to make an impact, especially if your child is experiencing GI symptoms.
Choose a probiotic with at least 5 strains of bacteria. Generally we are looking for lactobacillus (especially acidophilus, rhamnosus GG, reuteri), bifidobacterium, and Saccharomyces boulardii (a yeast probiotic)
Our Favorite Probiotic Supplements:
Powder
Great for if you’re looking to give a variety of bacteria (12 strains) in a concentrated & flavorless probiotic. Just 1/4 tsp gives 100 billion CFU. Since most kids don’t need that kind of support, 1/16 tsp is a typical dose that still provides 25 billion CFU.
Great for if you’re looking to give a variety of bacteria (12 strains) in a less concentrated probiotic (still flavorless). 1/4 tsp gives 10 billion CFU. This probiotic contains a strain of Streptococcus, which is generally not recommended for kids with PANS/PANDAS.
Great for if you’re looking for digestive support in addition to a probiotic Includes digestive enzymes and Saccharomyces Boulardii. Keep in mind it also contains vitamin A and zinc, so double check you’re not going over the Upper Limit of those nutrients by using this. Click on each nutrient note under “toxicity” to see the UL for your child’s age. This supplement is flavorless.
Use code ASN98-FS for free shipping
Capsule
Great for if you’re looking to give a variety of bacteria (12 strains) in a concentrated capsule probiotic. Just 1 capsule provides 25 billion CFU.
Great for if you’re looking for digestive support in addition to a probiotic Includes digestive enzymes and Saccharomyces Boulardii. Keep in mind it also contains vitamin A and zinc, so double check you’re not going over the Upper Limit of those nutrients by using this. Click on each nutrient note under “toxicity” to see the UL for your child’s age. This supplement is flavorless.
Use code ASN98-FS for free shipping
Gummy**
Great for if you’re looking to give a variety of bacteria (12 strains) in a concentrated capsule probiotic. Just 1 tablet provides 25 billion CFU.
Not my preferred option, but your child needs a gummy for sensory reasons, this is an option that is easy to find in most stores. I prefer the adult version as it is the same formulation as the kids but provides 7 billion CFU for 2 gummies.
DISCLAIMER: Before starting any supplement or medication, always consult with your healthcare provider to ensure it is a good fit for your child. Dosage can vary based on age, weight, gender, and current diet.
*All supplements are linked to Amazon for convenience, however, buying supplements on Amazon does not guarantee quality, as there are many “unverified resellers” selling nutrition supplements. To buy supplements that are verified to be sent directly to the consumer, you can create an account on the Autism Dietitian FullScript and search for the supplement under “Catalog”.
**Gummy form often has the lowest levels of bacteria, so if your child is able to take another form, liquid or capsule is often the most efficient at improving gut function or reducing symptoms.
