Lactobacillus casei subsp. rhamnosus
Lactobacillus GG/Drug Interactions:
AlcoholAlcohol: Based on animal studies, Lactobacillus GG (Lactobacillus GG) may reduce the toxic effects of alcohol on the intestines and liver (66; 67; 2). It has been suggested that lactobacilli are negatively affected by alcohol. AntibioticsAntibiotics: Theoretically, antibiotics may kill Lactobacillus GG, thereby reducing the efficacy. It is sometimes recommended to take Lactobacillus GG three hours after antibiotics. Based on human studies, Lactobacillus GG may reduce the risk of developing antibiotic-associated diarrhea (56; 68). AntidiarrhealsAntidiarrheals: Based on human studies, Lactobacillus GG supplementation may have antidiarrheal effects (69; 49; 50). Anti-inflammatory agentsAnti-inflammatory agents: Based on human studies, Lactobacillus GG may protect the integrity of the gastric mucosa against indomethacin (70). In human research, it has also been found to exert anti-inflammatory effects (71; 72; 73). Antiulcer agentsAntiulcer agents: Theoretically, lyophilized or live probiotics might not survive gastric pH levels (1.0-2.5). Thus, gastric acid-reducing agents might theoretically increase the amount of Lactobacillus GG that survives to pass into the intestine, although this action has not yet been established in the literature.EstrogensEstrogens: Based on human studies, a combination of estradiol and Lactobacillus GG may increase the normal vaginal flora index (74). In human research, vaginal ring use was associated with larger numbers of Lactobacillus colonies positive for hydrogen peroxide production (75). ImmunoglobulinsImmunoglobulins: Based on animal research, the combined use of Lactobacillus GG and immunoglobulins may result in added benefit against infectious diarrhea (76). Based on human studies, Lactobacillus GG may stimulate an increase in intestinal IgA (71; 72; 73) and rBet v1 and rMal dl-specific IgA levels (77). When mothers were supplemented with Lactobacillus GG, the total number of IgG-secreting cells in breastfed infants increased, correlating with the concentration of sCD14 in colostrum (64). Total numbers of IgM-, IgA-, and IgG-secreting cells at 12 months were also increased in these infants. ImmunosuppressantsImmunosuppressants: Lactobacillus GG may cause infection and theoretically may interfere with immunosuppressants.LactuloseLactulose: Based on human research, Lactobacillus GG may not be an effective adjunct to lactulose for treating constipation in children (78). LaxativesLaxatives: Based on human studies, Lactobacillus GG supplementation may have antidiarrheal effects (69; 49; 50). Lactobacillus GG/Herb/Supplement Interactions:
AntibacterialsAntibacterials: Theoretically, antibiotics may kill Lactobacillus GG, thereby reducing the efficacy. It is sometimes recommended to take Lactobacillus GG three hours after antibiotics. Based on human studies, Lactobacillus GG may reduce the risk of developing antibiotic-associated diarrhea (56; 68). AntidiarrhealsAntidiarrheals: Based on human studies, Lactobacillus GG supplementation may have antidiarrheal effects (69; 49; 50). Anti-inflammatory herbsAnti-inflammatory herbs: Based on human studies, Lactobacillus GG may protect the integrity of the gastric mucosa against indomethacin (70). In human research, it has also been found to exert anti-inflammatory effects (71; 72; 73). Antiulcer herbs and supplementsAntiulcer herbs and supplements: Theoretically, lyophilized or live probiotics might not survive gastric pH levels (1.0-2.5). Thus, gastric acid-reducing agents might theoretically increase the amount of Lactobacillus GG that survives to pass into the intestine, although this action has not yet been established in the literature.ImmunostimulantsImmunostimulants: Based on human research, Lactobacillus GG may reduce the risk of infection development (52). One study suggested the effects of Lactobacillus GG may differ depending on the health status of individuals; Lactobacillus GG was found to stimulate the immune system of healthy individuals but downregulate the immunoinflammatory response in milk-hypersensitive individuals (79). ImmunosuppressantsImmunosuppressants: Lactobacillus GG may cause infection and theoretically may interfere with immunosuppressants.LaxativesLaxatives: Based on human studies, Lactobacillus GG supplementation may have antidiarrheal effects (69; 49; 50). OligosaccharidesOligosaccharides: Based on human research, a combination of galactooligosaccharides and Lactobacillus GG may increase levels of fecal bifidobacteria over Lactobacillus GG alone (80). Supplementation of infants with galactooligosaccharides has been shown to increase levels of lactobacilli in the intestine (81). Omega-3 fatty acidsOmega-3 fatty acids: Supplementation of mothers with probiotics, including Lactobacillus GG, resulted in increased levels of blood omega-3 fatty acids, linoleic acid, and dihomo-gamma linolenic acid (63). Phytic acidPhytic acid: In vitro, Lactobacillus spp. were less able to maintain viable counts in the presence of phytic acid (82). PhytoestrogensPhytoestrogens: Based on human studies, a combination of estradiol and Lactobacillus GG may increase the normal vaginal flora index (74). In human research, vaginal ring use was associated with larger numbers of Lactobacillus colonies positive for hydrogen peroxide production (75). PrebioticsPrebiotics: Based on human research, a combination of galactooligosaccharides and Lactobacillus GG may increase levels of fecal bifidobacteria over Lactobacillus GG alone (80). ProbioticsProbiotics: Theoretically, consumption of Lactobacillus GG with other probiotics may have additive health benefits.Soy isoflavonesSoy isoflavones: Based on human research, consumption of soy isoflavones and Lactobacillus GG may reduce excretion of individual isoflavones (83). Vitamin KVitamin K: Theoretically, Lactobacillus GG supplementation could increase vitamin K production.Lactobacillus GG/Food Interactions:
Phytic acid-containing foodsPhytic acid-containing foods: In vitro, Lactobacillus spp. were less able to maintain viable counts in the presence of phytic acid (82). Prebiotic-containing foodsPrebiotic-containing foods: Based on human research, a combination of galactooligosaccharides and Lactobacillus GG may increase levels of fecal bifidobacteria over Lactobacillus GG alone (80). Probiotic-containing foodsProbiotic-containing foods: Theoretically, consumption of Lactobacillus GG with other probiotics may have additive health benefits.Rye breadRye bread: Based on human research, Lactobacillus GG plus rye bread consumption may reduce gastrointestinal side effects associated with rye bread consumption (84). SoySoy: Based on human research, consumption of soy isoflavones and Lactobacillus GG may reduce excretion of individual isoflavones (83). In human subjects, fermented soy milk consumption increased the populations of Lactobacillus spp. in the intestines (85). Lactobacillus GG/Lab Interactions:
Fecal calprotectinFecal calprotectin: In children with cystic fibrosis, Lactobacillus GG resulted in a reduction in the elevated concentrations of fecal calprotectin (86). Immune panelImmune panel: Based on in vitro studies, stimulation with Lactobacillus GG may result in significantly enhanced release of IL-10 and IFN-gamma from mononuclear cells (87). Based on human research, Lactobacillus GG may increase IL-10 in children with atopic dermatitis (88), and increased interferon-gamma in children with cow's milk allergy (89). Serum concentrations of sCD14 were higher in infants receiving probiotics, including Lactobacillus GG (72). In infants with IgE-associated atopic eczema/dermatitis symptoms, Lactobacillus GG induced an increase in C-reactive protein and IL-6 levels (90). Based on human research, Lactobacillus GG may result in decreased hsCRP (91). In marathon runners, Lactobacillus GG had no effect on inflammatory allergy markers (92). ImmunoglobulinsImmunoglobulins: Based on human studies, Lactobacillus GG may stimulate an increase in intestinal IgA (71; 72; 73) and rBet v1 and rMal dl-specific IgA levels (77). When mothers were supplemented with Lactobacillus GG, the total number of IgG-secreting cells in breastfed infants increased, correlating with the concentration of sCD14 in colostrum (64). Total numbers of IgM-, IgA-, and IgG-secreting cells at 12 months were also increased in these infants. Intestinal enzymesIntestinal enzymes: Based on human research, Lactobacillus GG may modify levels of enzymes in the intestinal environment, including a decrease in fecal beta-glucuronidase, nitroreductase, and glycocholic acid hydrolase activities (93). Intestinal inflammatory markersIntestinal inflammatory markers: Based on human research, Lactobacillus GG may decrease levels of the inflammatory marker alpha1-antitrypsin (73). Intestinal levels of Lactobacillus GGIntestinal levels of Lactobacillus GG: In preterm infants and toddlers, Lactobacillus GG supplementation resulted in Lactobacillus GG colonization of the bowel (94; 95; 96). LactaseLactase: Theoretically, Lactobacillus GG supplementation could increase lactase production.Nitric oxideNitric oxide: In children with cystic fibrosis, Lactobacillus GG resulted in a reduction in the elevated concentrations of rectal nitric oxide (86). In vitro, Lactobacillus GG stimulated nitric oxide synthesis (97). Omega-3 fatty acidsOmega-3 fatty acids: Supplementation of mothers with probiotics, including Lactobacillus GG, resulted in increased levels of blood omega-3 fatty acids, linoleic acid, and dihomo-gamma linolenic acid (63). Urinary p-cresolUrinary p-cresol: Based on human research, Lactobacillus GG may modify levels of enzymes in the intestinal environment, including a decrease in urinary excretion of p-cresol (93). Vancomycin-resistant EnterococciVancomycin-resistant Enterococci: In renal patients, Lactobacillus GG cleared vancomycin-resistant Enterococci (98). Vitamin KVitamin K: Theoretically, Lactobacillus GG supplementation may increase vitamin K production.