From the Guidelines
For celiac disease, the most effective probiotics are those that contain multiple strains, including Lactobacillus and Bifidobacterium species, which have been shown to improve digestion, boost immunological function, and maintain a healthy balance of gut bacteria, as supported by the most recent study in 2024 1. When selecting a probiotic for celiac disease, consider the following key points:
- Look for products that contain a combination of strains, such as Lactobacillus acidophilus, Bifidobacterium infantis, and Saccharomyces boulardii, which have been suggested to be beneficial in managing celiac symptoms and supporting gut health 1.
- Ensure the product contains at least 1-10 billion CFUs per serving, as this concentration has been shown to be effective in promoting gut health.
- Choose a probiotic that is certified gluten-free to avoid triggering symptoms.
- Take the probiotic daily, preferably with meals, for at least 8-12 weeks to evaluate its effectiveness.
- If adverse reactions occur, start with a lower dose and gradually increase to the recommended amount. It is essential to note that while probiotics can complement treatment, they do not replace a strict gluten-free diet, which remains the primary treatment for celiac disease. The use of probiotics in celiac disease is supported by the idea that they can help restore beneficial gut bacteria, strengthen the intestinal barrier, reduce inflammation, and improve digestion of nutrients that may be poorly absorbed due to intestinal damage from gluten exposure 1.
From the Research
Probiotics for Celiac Disease
- The use of probiotics as an adjuvant treatment for celiac disease has been studied in several clinical trials, with some showing improvement in gastrointestinal symptoms and quality of life 2, 3, 4.
- Certain probiotic strains, such as Bifidobacterium and Lactobacillus, have been found to be beneficial in reducing gastrointestinal symptoms and improving immune response in celiac disease patients 2, 5, 4.
- A systematic review and meta-analysis of randomized controlled trials found that probiotics improved gastrointestinal symptoms in patients with celiac disease, with a significant increase in the levels of Bifidobacteria 4.
- Another study found that Bifidobacterium species were able to digest intact gluten proteins, reducing cytotoxicity and proinflammatory responses 5.
- The current evidence suggests that probiotics may be a useful adjunctive treatment for celiac disease, but high-quality clinical trials are needed to increase the level of evidence and determine the most suitable combination of probiotics 2, 3, 4.
Beneficial Probiotic Strains
- Bifidobacterium: has been found to be beneficial in reducing gastrointestinal symptoms and improving immune response in celiac disease patients 2, 5, 4.
- Lactobacillus: has been found to be beneficial in reducing gastrointestinal symptoms and improving immune response in celiac disease patients 2, 3.
- Bifidobacterium bifidum, Bifidobacterium longum, Bembidion breve, Bifidobacterium animalis: have been found to be able to digest intact gluten proteins, reducing cytotoxicity and proinflammatory responses 5.
Limitations and Future Directions
- The current evidence is limited by the small number of studies and the variability in the probiotic strains and dosages used 2, 3, 4.
- Further studies are needed to determine the most suitable combination of probiotics and to establish the long-term safety and efficacy of probiotic treatment in celiac disease patients 2, 3, 4.