Acidophilus

L. acidophilus/Drug Interactions:

  • AlcoholAlcohol: Some natural medicine practitioners maintain that Lactobacilli are negatively affected by alcohol and that alcohol should be taken separately from Lactobacilli supplementation.
  • AmoxicillinAmoxicillin: According to human research, individuals presenting with H. pylori infection who were administered esomeprazole, amoxicillin, and furazolidone in combination with Bifid Triple Viable, which contains Lactobacillus acidophilus, Bifidobacterium bifidum, and fecal streptococci, showed improved healing rate of ulcer and erosion, as well as fewer adverse effects, compared to treatment with the antibiotics alone (114). According to human research, the use of amoxicillin, bacampicillin, or enoxacin to treat urinary tract infections in women disrupts the indigenous population of probiotic intestinal flora, including Lactobacillus acidophilus (115).
  • AntiarthriticsAntiarthritics: An isolated strain of L. acidophilus was shown to degrade sulfasalazine and phthalylsulphathiazole in vitro (116). However, according to results from clinical studies, a Lactobacillus acidophilus-containing probiotic lacked an effect on sulfasalazine metabolism in individuals presenting with rheumatoid arthritis (117).
  • AntiasthmaticsAntiasthmatics: There is unclear but negative evidence from a small, randomized, controlled trial to support the use of L. acidophilus in the treatment of allergic asthma (14).
  • AntibioticsAntibiotics: Some natural medicine practitioners believe that L. acidophilus should be taken 2-3 hours after an antibiotic dose to prevent the killing of L. acidophilus. L. acidophilus may also interfere with the metabolism of sulfasalazine, chloramphenicol, and palmitate by degrading them in the stomach, if taken concurrently in humans (53). According to a clinical trial, antibiotics may also kill resident L. acidophilus in the vaginal flora and result in vaginitis, for which probiotic therapy has been used (78). According to another clinical trial, Lactobacilli may also alter how intestinal microflora respond to antibiotic therapy (118). According to human research, individuals presenting with H. pylori infection who were administered esomeprazole, amoxicillin, and furazolidone in combination with Bifid Triple Viable, which contains Lactobacillus acidophilus, Bifidobacterium bifidum, and fecal streptococci, showed improved healing rate of ulcer and erosion, as well as less adverse effects, compared to treatment with the antibiotics alone (114). According to other clinical studies, the use of amoxicillin, bacampicillin, or enoxacin to treat urinary tract infections in women disrupts the indigenous population of probiotic intestinal flora, including Lactobacillus acidophilus (115). According to human research, combined treatment of H. pylori using L. acidophilus and Bifidobacterium lactis reduced the side effects of anti-Helicobacter pylori therapy (rabeprazole, clarithromycin, and tinidazole), but lacked an effect on compliance with antibiotic therapy and H. pylori eradication rate (119). In vitro, chlorhexidine-containing agents, such as mouth rinses and antiseptics, have shown antimicrobial activity against Lactobacillus acidophilus when applied to dentin surfaces (120). An isolated strain of L. acidophilus was shown to degrade sulfasalazine and phthalylsulphathiazole in vitro (116). However, according to results from clinical studies, Lactobacillus acidophilus-containing probiotic lacked an effect on sulfasalazine metabolism in individuals presenting with rheumatoid arthritis (117).
  • AntidiabeticsAntidiabetics: In human research, Lactobacillus acidophilus preserved insulin sensitivity, while in the control group, insulin sensitivity decreased (68).
  • AntidiarrhealsAntidiarrheals: It is unclear whether L. acidophilus, or probiotics in general, may prevent diarrhea. One study that tested L. acidophilus as monotherapy did not show benefits in preventing traveler's diarrhea (18). Other studies have used combination probiotic strains (such as LactinexT, a blend of L. acidophilus and L. bulgaricus) (121), and the results from several randomized controlled trials have been mixed (18). Probiotic treatments containing L. acidophilus were reported to prevent antibiotic-associated diarrhea in infants (122; 123) and adults (124; 125; 126); however, other studies did not show benefits in preventing either traveler's diarrhea (127) or enterotoxigenic diarrhea (128) in adults.
  • AntilipemicsAntilipemics: According to human research, L. acidophilus may decrease blood lipids, including cholesterol, low-density lipoproteins, and triglycerides (70; 129; 71). Theoretically, concurrent use of L. acidophilus and antilipemic agents may cause added cholesterol lowering.
  • Antiulcer and gastric acid-reducing agentsAntiulcer and gastric acid-reducing agents: Secondary sources have suggested that orally administered probiotics, either alive or lyophilized, may not survive in gastric pH (1.0-2.5) in quantities sufficient to colonize the gut. This has raised questions as to whether patients should consider taking an acid-reducing agent 30-60 minutes prior to taking Lactobacillus, although this remains theoretical, as supporting evidence in humans is lacking. However, human studies have shown that L. acidophilus may survive in an acid and bile environment (69).
  • AntiviralsAntivirals: It has been suggested that Lactobacilli have antiviral affects, as high vaginal counts of vaginal Lactobacilli are associated with decreased genital tract HIV load (130). Moreover, absence of vaginal Lactobacilli is purported to increase the risk of human immunodeficiency virus type 1 (HIV-1) infection (131). Probiotics may also exert antiviral effects by stimulating the cellular and humoral immune responses of the host (132; 133; 134).
  • BacampicillinBacampicillin: According to human research, the use of amoxicillin, bacampicillin, or enoxacin to treat urinary tract infections in women disrupted the indigenous population of probiotic intestinal flora, including Lactobacillus acidophilus (115).
  • BenzodiazepinesBenzodiazepines: Lactobacilli possess beta-glucuronidase activity (135) and theoretically may prolong the duration of action of drugs that depend on enterohepatic circulation, such as benzodiazepines. However, these are theoretical interactions with unknown clinical relevance.
  • Cardiovascular agentsCardiovascular agents: Lactobacilli are generally considered nonpathogenic; however, rare cases of endocarditis due to Lactobacilli have been documented in the literature (102; 103; 104; 98; 105). However, the incidence of Lactobacillus-related deaths has declined since 1992, possibly due to improved diagnostic procedures and treatments for endocarditis (105).
  • ClarithromycinClarithromycin: According to human research, combined treatment of H. pylori using L. acidophilus and Bifidobacterium lactis reduced the side effects of anti-Helicobacter pylori therapy (rabeprazole, clarithromycin, and tinidazole), but lacked an effect on compliance with antibiotic therapy and H. pylori eradication rate (119).
  • ContraceptivesContraceptives: According to human research, larger counts of vaginal Lactobacilli may be associated with contraceptive vaginal ring use (136). Lactobacilli possess beta-glucuronidase activity (135) and theoretically may prolong the duration of action of drugs that depend on enterohepatic circulation, such as oral contraceptives. However, these are theoretical interactions with unknown clinical relevance.
  • EnoxacinEnoxacin: According to human research, the use of amoxicillin, bacampicillin, or enoxacin to treat urinary tract infections in women disrupted the indigenous population of probiotic intestinal flora, including Lactobacillus acidophilus (115).
  • EsomeprazoleEsomeprazole: According to human research, individuals presenting with H. pylori infection who were administered esomeprazole, amoxicillin, and furazolidone in combination with Bifid Triple Viable, which contains Lactobacillus acidophilus, Bifidobacterium bifidum, and fecal streptococci, showed improved healing rate of ulcer and erosion, as well as fewer adverse effects, compared to treatment with the antibiotics alone (114).
  • FurazolidoneFurazolidone: According to human research, individuals presenting with H. pylori infection who were administered esomeprazole, amoxicillin, and furazolidone in combination with Bifid Triple Viable, which contains Lactobacillus acidophilus, Bifidobacterium bifidum, and fecal streptococci, showed improved healing rate of ulcer and erosion, as well as fewer adverse effects, compared to treatment with the antibiotics alone (114).
  • Gastrointestinal agentsGastrointestinal agents: Lactobacilli efficiently attach to and colonize the human gut, beginning in infancy (137), and this may occur by attaching to antigens expressed on the intestinal mucosa (138). Lactobacillus acidophilus is purported to modulate intestinal function by inducing differential gene-regulatory networks in the small intestines; these networks regulate basal mucosal processes (139). Lactobacilli and other probiotics are thought to reduce the incidence of gastrointestinal disorders, and several mechanisms of action have been proposed (133; 138; 134). In clinical research, ingestion of Lactobacillus acidophilus-containing yogurt (Yoptimal? or Yoptimal-10?) resulted in an increase in the level of beneficial bacteria in the gut, while the presence of potentially pathogenic bacteria decreased (140). However, Lactobacillus peritonitis has been reported for patients who recently experienced abdominal surgery, abdominal trauma, or surgery for liver cirrhosis (107), and rare endoscopic findings of black esophagus have revealed infection with L. acidophilus (60).
  • ImmunostimulantsImmunostimulants: Probiotics may stimulate the cellular and humoral immune responses of the host (132; 133; 134). L. acidophilus has been proposed to enhance the activity of macrophages, antigen-presenting cells, and other aspects of the immune system. Lactobacilli have been shown to modulate the function of dendritic cells, which in turn regulate T cell responses (141; 142). Cellular components of Lactobacilli have also been shown to modulate cytokine response (143). Combination probiotic supplements have been demonstrated to modulate cellular and humoral immunity in adults (1).
  • ImmunosuppressantsImmunosuppressants: Probiotics may stimulate the cellular and humoral immune responses of the host (132; 133; 134). L. acidophilus has been proposed to enhance the activity of macrophages, antigen-presenting cells, and other aspects of the immune system. Lactobacilli have been shown to modulate the function of dendritic cells, which in turn regulate T cell responses (141; 142). Cellular components of Lactobacilli have also been shown to modulate cytokine response (143). Combination probiotic supplements have been demonstrated to modulate cellular and humoral immunity in adults (1).
  • Iron saltsIron salts: According to human research, ingestion of iron-fortified fermented milk inoculated with Lactobacillus acidophilus improved red blood cell status, energy, and nutrient intake, and had a positive correlation between iron intake and hemoglobin, in children aged 2-5 years, compared to baseline (144).
  • RabeprazoleRabeprazole: According to human research, combined treatment of H. pylori using L. acidophilus and Bifidobacterium lactis reduced the side effects of anti-Helicobacter pylori therapy (rabeprazole, clarithromycin, and tinidazole), but lacked an effect on compliance with antibiotic therapy and H. pylori eradication rate (119).
  • TinidazoleTinidazole: According to human research, combined treatment of H. pylori using L. acidophilus and Bifidobacterium lactis reduced the side effects of anti-Helicobacter pylori therapy (rabeprazole, clarithromycin, and tinidazole), but lacked an effect on compliance with antibiotic therapy and H. pylori eradication rate (119).
  • VaccinationsVaccinations: Human research has shown L. acidophilus consumption to enhance immune response to vaccinations, including oral polio vaccine (OPV) (72), tetanus toxoid (TT), and Staphylococcus enterotoxin B (SEB) (88).

    • L. acidophilus/Herb/Supplement Interactions:

  • AntiarthriticsAntiarthritics: An isolated strain of L. acidophilus was shown to degrade sulfasalazine and phthalylsulphathiazole in vitro (116). However, according to results from clinical studies, Lactobacillus acidophilus-containing probiotic lacked an effect on sulfasalazine metabolism in individuals presenting with rheumatoid arthritis (117).
  • AntiasthmaticsAntiasthmatics: There is unclear but negative evidence from a small, randomized, controlled trial to support the use of L. acidophilus in the treatment of allergic asthma (14).
  • AntibacterialsAntibacterials: Some natural medicine practitioners believe that L. acidophilus should be taken 2-3 hours after an antibiotic dose to prevent the killing of L. acidophilus. Antibiotics may also kill resident L. acidophilus in the vaginal flora and result in vaginitis, for which probiotic therapy has been used (78). Lactobacilli may also alter how intestinal microflora respond to antibiotic therapy (118). According to human research, individuals presenting with H. pylori infection who were administered esomeprazole, amoxicillin, and furazolidone in combination with Bifid Triple Viable, which contains Lactobacillus acidophilus, Bifidobacterium bifidum, and fecal streptococci, showed improved healing rate of ulcer and erosion, as well as fewer adverse effects, compared to treatment with the antibiotics alone (114). According to clinical studies, the use of amoxicillin, bacampicillin, or enoxacin to treat urinary tract infections in women disrupted the indigenous population of probiotic intestinal flora, including Lactobacillus acidophilus (115). According to human research, combined treatment of H. pylori using L. acidophilus and Bifidobacterium lactis reduced the side effects of anti-Helicobacter pylori therapy (rabeprazole, clarithromycin, and tinidazole), but lacked an effect on compliance with antibiotic therapy and H. pylori eradication rate (119). In vitro, chlorhexidine-containing agents, such as mouth rinses and antiseptics, have shown antimicrobial activity against Lactobacillus acidophilus when applied to dentin surfaces (120). An isolated strain of L. acidophilus was shown to degrade sulfasalazine and phthalylsulphathiazole in vitro (116). However, according to results from clinical studies, a Lactobacillus acidophilus-containing probiotic lacked an effect on sulfasalazine metabolism in individuals presenting with rheumatoid arthritis (117).
  • AntidiarrhealsAntidiarrheals: It is unclear whether L. acidophilus, or probiotics in general, may prevent diarrhea. One study that tested L. acidophilus as monotherapy showed no benefits in preventing traveler's diarrhea (18). Other studies have used combination probiotic strains (such as LactinexT, a blend of L. acidophilus and L. bulgaricus) (121), and the results from several randomized controlled trials have been mixed (18). Probiotic treatments containing L. acidophilus were reported to prevent antibiotic-associated diarrhea in infants (122; 123) and adults (124; 125; 126); however, other studies showed no benefits in preventing either traveler's diarrhea (127) or enterotoxigenic diarrhea (128) in adults.
  • AntilipemicsAntilipemics: According to human research, L. acidophilus may decrease blood lipids, including cholesterol, low-density lipoproteins, and triglycerides (70; 129; 71).
  • Antiulcer and gastric acid-reducing agentsAntiulcer and gastric acid-reducing agents: Secondary sources have suggested that orally administered probiotics, either alive or lyophilized, may not survive in gastric pH (1.0-2.5) in quantities sufficient to colonize the gut. This has raised questions as to whether patients should consider taking an acid-reducing agent 30-60 minutes prior to taking Lactobacillus, although this remains theoretical, as supporting evidence in humans is lacking. However, human studies have shown that L. acidophilus may survive in an acid and bile environment (69).
  • AntiviralsAntivirals: It has been suggested that Lactobacilli have antiviral affects, as high vaginal counts of vaginal Lactobacilli are associated with decreased genital tract HIV load (130). Moreover, absence of vaginal Lactobacilli is purported to increase the risk of human immunodeficiency virus type 1 (HIV-1) infection (131). Probiotics may also exert antiviral effects by stimulating the cellular and humoral immune responses of the host (132; 133; 134).
  • CalciumCalcium: According to human research, fermented soya milk inoculated with Lactobacillus acidophilus lacked an effect on calcium absorption in osteopenic postmenopausal women (145).
  • Cardiovascular agentsCardiovascular agents: Lactobacilli are generally considered nonpathogenic; however, rare cases of endocarditis due to Lactobacilli have been documented in the literature (102; 103; 104; 98; 105). However, the incidence of Lactobacillus-related deaths has declined since 1992, possibly due to improved diagnostic procedures and treatments for endocarditis (105).
  • ContraceptivesContraceptives: According to human research, larger counts of vaginal Lactobacilli may be associated with contraceptive vaginal ring use (136).
  • Gastrointestinal agentsGastrointestinal agents: Lactobacilli efficiently attach to and colonize the human gut, beginning in infancy (137), and this may occur by attaching to antigens expressed on the intestinal mucosa (138). Lactobacillus acidophilus is purported to modulate intestinal function by inducing differential gene-regulatory networks in the small intestines; these networks regulate basal mucosal processes (139). Lactobacilli and other probiotics are thought to reduce the incidence of gastrointestinal disorders, and several mechanisms of action have been proposed (133; 138; 134). In clinical research, ingestion of Lactobacillus acidophilus-containing yogurt (Yoptimal? or Yoptimal-10?) resulted in an increase in the level of beneficial bacteria in the gut, while the presence of potentially pathogenic bacteria decreased (140). However, Lactobacillus peritonitis has been reported in patients who recently experienced abdominal surgery, abdominal trauma, or surgery for liver cirrhosis (107), and rare endoscopic findings of black esophagus have revealed infection with L. acidophilus (60).
  • Hyperglycemics and hypoglycemicsHyperglycemics and hypoglycemics: In human research, Lactobacillus acidophilus preserved insulin sensitivity, while in the control group, insulin sensitivity decreased (68).
  • ImmunomodulatorsImmunomodulators: Probiotics may stimulate the cellular and humoral immune responses of the host (132; 133; 134). L. acidophilus has been proposed to enhance the activity of macrophages, antigen-presenting cells, and other aspects of the immune system. Lactobacilli have been shown to modulate the function of dendritic cells, which in turn regulate T cell responses (141; 142). Cellular components of Lactobacilli have also been shown to modulate cytokine response (143). Combination probiotic supplements have been demonstrated to modulate cellular and humoral immunity in adults (1).
  • IronIron: According to human research, ingestion of iron-fortified fermented milk inoculated with Lactobacillus acidophilus improved red blood cell status, energy, and nutrient intake, and had a positive correlation between iron intake and hemoglobin, in children aged 2-5 years, compared to baseline (144).
  • Phytic acidPhytic acid: Species of Lactobacillus may be inhibited by phytic acid, which is found in many plant products (particularly bran) (146).
  • PrebioticsPrebiotics: Short-chain carbohydrates, galactooligosaccharides (GOS), and fructooligosaccharides (FOS) have been shown to promote the growth of gut microflora (including Lactobacilli) (147).
  • ProbioticsProbiotics: In theory, other probiotics (such as L. casei and Saccharomyces boulardii) may have additive effects when used with L. acidophilus. Strains of Lactobacilli vary in their ability to adhere to the intestinal tissue. L. rhamnosus GG has demonstrated a 10-100 times greater adherence to human intestinal tissue compared to L. acidophilus (148).

    • L. acidophilus/Food Interactions:

  • AlcoholAlcohol: Natural medicine practitioners believe that Lactobacilli are negatively affected by alcohol, and that alcohol should be taken separately from Lactobacilli supplementation.
  • Low-oxalate dietLow-oxalate diet: Probiotic preparations containing L. acidophilus have been shown to moderate urinary oxalate excretion (149).
  • Phytic acidPhytic acid: Species of Lactobacillus may be inhibited by phytic acid, a form of phosphorus stored in many plant tissues (particularly bran) (146).
  • PolysaccharidesPolysaccharides: According to clinical research, ingestion of polydextrose supplements lacked an effect on fecal contents of Lactobacillus acidophilus (150).
  • PrebioticsPrebiotics: Natural medicine practitioners believe that natural food sources of prebiotic oligosaccharides, such as fructooligosaccharides (FOS), found in bananas, Jerusalem artichokes, onions, asparagus, and garlic, may have a positive interaction on the effectiveness of Lactobacilli.
  • ProbioticsProbiotics: Sources of other probiotics, including fermented soy milk, may have additive effects on L. acidophilus (151).
  • ProteinProtein: According to human research, ingestion of Lactobacillus acidophilus (LC1) yogurt lacked an effect on ammonia levels excreted by the colon (152).

    • L.acidophilus/Lab Interactions:

  • Ammonium ion testAmmonium ion test: L. acidophilus and other probiotic species have been shown to decrease fecal pH and ammonia levels in blood and feces (11). According to human research, ingestion of Lactobacillus acidophilus (LC1) yogurt lacked an effect on ammonia levels excreted by the colon (152).
  • Bacteria flora in the gutBacteria flora in the gut: According to clinical research, identifying the presence of particular strains of Lactobacillus in the gut, including Lactobacillus salivarius NCIMB 30211 and Lactobacillus acidophilus NCIMB 30156, may be achieved using random amplified polymorphic DNA (RAPD) assays (153). In clinical research, ingestion of Lactobacillus acidophilus-containing yogurt (Yoptimal? or Yoptimal-10?) resulted in an increase in the level of beneficial bacteria in the gut, while the presence of potentially pathogenic bacteria decreased (140). Similarly, ingestion of a probiotic yogurt containing Bacillus bifidus, Lactobacillus acidophilus, Lactobacillus bulgaricus, and Streptococcus thermophilus by patients with chronic liver disease improved intestinal flora balance and reduced symptoms associated with liver disease (154). Also, ingestion of the probiotic VSL#3, which contains four strains of lactobacilli, including Lactobacillus acidophilus, three strains of bifidobacteria, and one strain of streptococcus, increased the number, diversity, and richness of intestinal bacteria while decreasing the diversity of fungal flora in patients with ulcerative colitis who recently underwent ileal pouch anal anastomosis (155).
  • However, according to other clinical research, ingestion of Lactobacillus acidophilus NCFM supplementation lacked an effect on bacterial populations in fecal matter of children presenting with atopic dermatitis (156).
  • According to cell culture research, the enzymatic activity of species of Lactobacillus found in the gut may be performed using API-50 system, while the genomic structure may be assessed using 16S rNA gene sequence analysis (157).
  • Blood glucoseBlood glucose: In human research, Lactobacillus acidophilus preserved insulin sensitivity, while in the control group, insulin sensitivity decreased (68).
  • Dental plaqueDental plaque: Compared to individuals with cleft palates, individuals with occlusal disturbance and malocclusion but lacking a cleft palate showed higher levels of L. acidophilus in their saliva; this increased bacteria colonization correlated with a higher plaque index value and increased caries danger (55).
  • Lactose intoleranceLactose intolerance: According to human research, ingestion of milk inoculated with high cell counts of Lactobacillus acidophilus reduced lactose maldigestion, although the effect milk inoculated with Lactobacillus bulgaricus was more significant (158).
  • Lipid profileLipid profile: According to human research, L. acidophilus may decrease blood lipids, including cholesterol, low-density lipoproteins, and triglycerides (70; 129; 71).
  • Small bowel permeabilitySmall bowel permeability: According to clinical research, the ingestion of fermented milk inoculated with Streptococcus thermophilus, Lactobacillus bulgaricus, Lactobacillus acidophilus, and Bifidobacterium longum improved mucosal barrier function and decreased mean global irritable bowel syndrome scores in patients with irritable bowel syndrome (159).
  • VaccinationsVaccinations: Clinical studies have shown L. acidophilus consumption to enhance immune response to vaccinations, including oral polio vaccine (OPV) (72), tetanus toxoid (TT), and Staphylococcus enterotoxin B (SEB) (88).
  • Viral loadViral load: High vaginal counts of vaginal Lactobacilli are associated with decreased genital tract HIV load (130).