Interactions on record — worth a quick check against your medications. Based on 2 of 6 ingredients. Check your meds →
Dietary supplement

Total Care Probiotic 20 Billion CFU Ingredients & Drug Interactions

by Probulin

Capsule Category: Other Combinations
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

Total Care Probiotic 20 Billion CFU is a dietary supplement by Probulin with 6 active ingredients. Its ingredients are commonly taken for replacing fluids and electrolytes, preventing dehydration during exercise or illness, treating low blood sodium (under medical care).Based on those ingredients, 513 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are Sodium, Inulin. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of Total Care Probiotic 20 Billion CFU by Probulin

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Low disclosure
Ingredient Transparency · database check
Low

Most active ingredients don't disclose an individual amount — you can't tell how much of each you're getting.

Why this rating?
  • The label discloses an exact amount for 1 of its 18 active ingredients.
  • “Total Other Probiotics” is listed as a grouped ingredient — the label doesn't break down how much of each component you get.
  • “Total Care Probiotic Blend” is a proprietary blend — the label gives one combined amount (380 mg) without saying how much of each component you get.
  • “Lactobacillus Blend + Lactobacillus Fermentation Blend” is a proprietary blend — the label doesn't break down how much of each component you get.

This product contains 18 ingredients, including 11 active probiotic strains and prebiotic fibers. The live bacterial strains are Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus helveticus, Lactobacillus brevis, Lactobacillus rhamnosus, Lactobacillus reuteri, Lactobacillus fermentum, Bifidobacteria lactis, Bifidobacteria longum, Bifidobacteria bifidum, and Pediococcus acidilactici, plus the live yeast Saccharomyces boulardii.

The formula also includes inulin (a prebiotic fiber that feeds beneficial bacteria) and Streptococcus thermophilus. The capsules contain inactive ingredients like cellulose, tricalcium phosphate, rice extract, sodium chloride, and potassium chloride.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Digestive health and gut microbiome balance.
  • We looked for evidence on: Antibiotic-associated diarrhea, Clostridioides difficile infection, Constipation, Crohn disease, Diarrhea, Irritable bowel syndrome (IBS) — and 3 related terms.
  • The strongest evidence on file: Saccharomyces Boulardii is rated "Possibly Effective" for Antibiotic-associated diarrhea (Natural Medicines).
  • Also on file: Saccharomyces Boulardii is rated "Possibly Effective" for Rotaviral diarrhea, Travelers' diarrhea, Clostridioides difficile infection.
  • Also on file: Lactobacillus Acidophilus is rated "Possibly Effective" for Antibiotic-associated diarrhea, Irritable bowel syndrome (IBS).

The evidence for probiotics varies by strain and condition. Saccharomyces boulardii is possibly effective for travelers' diarrhea, antibiotic-associated diarrhea, and Clostridioides difficile infection.

Lactobacillus acidophilus is possibly effective for irritable bowel syndrome and antibiotic-associated diarrhea. Bifidobacterium bifidum is possibly effective for irritable bowel syndrome and respiratory tract infections.

Inulin is possibly effective for constipation and diabetes. However, most other conditions listed — including cognitive function, depression, anxiety, and asthma — show insufficient evidence to rate the strains in this product.

Streptococcus thermophilus and several other strains have not been well studied for the conditions mentioned.

The evidence, ingredient by ingredient Sodium Inulin

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 8 of the 8 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 8 of 8.
  • General safety write-ups exist for 8 of 8.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

The live probiotic strains are generally well tolerated in healthy adults and children. However, rare but serious infections have been documented: live organisms can occasionally cause bacteremia, sepsis, and other infections in critically ill patients, those with weakened immune systems, or those with indwelling catheters.

Gastrointestinal side effects like bloating, flatulence, abdominal discomfort, and diarrhea are uncommon but can occur, especially when you first start taking probiotics. Sodium in this product is essential in small amounts, but too much is linked to high blood pressure and heart strain; normal dietary sodium is fine, but avoid sodium supplements or very high intake without medical advice.

Inulin commonly causes gas, bloating, and gastrointestinal cramps, especially at higher doses. No pregnancy or breastfeeding safety data are on file for Lactobacillus bulgaricus, Lactobacillus brevis, Lactobacillus rhamnosus, Lactobacillus reuteri, Lactobacillus fermentum, Bifidobacteria lactis, Streptococcus thermophilus, Lactobacillus helveticus, Saccharomyces boulardii, Bifidobacteria bifidum, or several other ingredients in this blend; inulin is rated likely safe in pregnancy and lactation, and Bifidobacterium longum is rated possibly safe.

Side effects, ingredient by ingredient Sodium Inulin

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 7 of the 8 matched ingredients can interact with medications — Saccharomyces Boulardii, Lactobacillus Acidophilus, Inulin, Sodium, Bifidobacterium Bifidum, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: diabetes medications; lithium.
  • For scale: 513 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Before taking this product, check with your pharmacist if you use blood pressure medications, corticosteroids, lithium, didanosine (an HIV drug), sodium phosphate products, tolvaptan, antibiotic drugs, antifungals, or antidiabetes medications. Antibiotics are particularly important — they can reduce how well the live probiotics work, so timing matters.

No interactions are documented in our data for several of the probiotic strains we could not fully check.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFormula with limited ingredient disclosure with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This probiotic may help with certain types of diarrhea and gastrointestinal conditions, particularly if you're looking for a multi-strain formula. If you take blood pressure medications, lithium, antifungals, antidiabetes drugs, or antibiotics, talk with your pharmacist before starting — timing and drug interactions matter.

People who are critically ill or have weakened immune systems should avoid probiotics without medical guidance. Run your exact medications through the checker on this page first.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 8 of 18 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Nov 22, 2023.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Total Care Probiotic 20 Billion CFU, straight from the product label.

Brand Probulin
Barcode (UPC) 855757003435
Net contents 30 Capsule(s)
Market status On market
Date entered into DSLD Nov 22, 2023
DSLD ID 299946
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Halal, Gluten Free, Dairy Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Total Care Probiotic 20 Billion CFU by Probulin, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 Capsule(s)
Maximum serving Sizes:
1 Capsule(s)
Servings per container
30
UPC/BARCODE
855757003435
IngredientAmount% DV
Sodium10 mg1%
Lactobacillus acidophilus0 NP--
Lactobacillus bulgaricus0 NP--
Saccharomyces boulardii0 NP--
Inulin0 NP--
Streptococcus thermophilus0 NP--
Lactobacillus helveticus0 NP--
Lactobacillus brevis0 NP--
Lactobacillus rhamnosus0 NP--
Lactobacillus reuteri0 NP--
Lactobacillus fermentum0 NP--
Bifidobacteria lactis0 NP--
Bifidobacteria longum0 NP--
Bifidobacteria bifidum0 NP--
Total Other Probiotics0 NP--
Pediococcus acidilactici0 NP--
Total Care Probiotic Blend380 mg--
Lactobacillus Blend + Lactobacillus Fermentation Blend0 NP--
Bifidobacteria Blend + Bifidobacteria Fermentation Blend0 NP--
Pediococcus pentosaceus0 NP--
Propionibacterium freudenreichii0 NP--
Postbiotic + Prebiotic Blend40 mg--
Maktabolite Postbiotic0 NP--

Other ingredients: Complex Marine Polysaccharides, Cellulose, Tricalcium Phosphate, Rice extract, Sodium Chloride, Potassium Chloride

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
General Statements

MAKTrek 3-D "Seaweed Submarine"

Probulin is formulated by: Jason Mitchell, N.D. In collaboration with: Dr. Shekhar Challa Author of Probiotics for Dummies

Formulation

All Probulin products include the patent pending MAKTrek 3-D delivery system, to ensure that the beneficial probiotic bacteria have better survival in the body.

Lifestyle challenges such as diet, normal aging, overuse of medications, stress, environment, alcohol consumption, and much more may all contribute to digestive imbalance of essential beneficial bacteria such as bifidobacteria. Taking a daily probiotic is an important part of your routine.

Broad-spectrum digestive support

Supports digestive health

Postbiotic Postbiotic is a term used to describe the abundant and unique compounds produced by the activity of probiotic bacteria. These unique compounds participate in supporting a healthy digestive microbiome.

No GMOs No gluten No wheat No dairy No magnesium stearate No soy NO: GMOs, wheat, gluten, milk, dairy, eggs, magnesium stearate, soy, artificial flavors, artificial colors, artificial sweeteners or shellfish.

Brand IP Statement(s)

All Probulin products include the patent pending MAKTrek 3-D delivery system, to ensure that the beneficial probiotic bacteria have better survival in the body.

Probulin The Next Generation of Probiotics

Probulin The Next Generation of Probiotics

Formula

Total Care Probiotic + Prebiotic & Postbiotic

15 Probiotic Strains 12 Billion cfu + 8 billion cfu from fermented fruits/vegetables At time of manufacturing- 2 year real-time stability in process.

Prebiotic Probulin's Total Care Probiotic features our prebiotic, which acts as food for the probiotic bacteria. Probiotic This product contains 12 billion cfu + 8 billion cfu from fermented fruits & vegetables, providing broad spectrum support to the digestive microbiome. At time of manufacturing- 2 year real-time stability in process.

Halal

FDA Statement of Identity

Dietary Supplement

FDA Disclaimer Statement

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

Suggested/Recommended/Usage/Directions

Directions: Adults take one (1) capsule daily with or without food. For best results, take at bedtime. As a reminder, discuss the supplements and medications that you take with your health care providers.

Precautions

Caution: Do not exceed recommended dose.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition or who are taking any medication should consult a physician before using this or any dietary supplement.

Pregnant or nursing mothers, children under 18, and individuals with a known medical condition or who are taking any medication should consult a physician before using this or any dietary supplement.

Do not use if seal is broken.

Keep out of the reach of children.

Seals/Symbols

Halal

See for yourself

Total Care Probiotic 20 Billion CFU by Probulin label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in Total Care Probiotic 20 Billion CFU by Probulin

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Sodium

Interacts with
205 drugs
10 mg per serving

Sodium is an essential mineral and electrolyte your body needs to balance fluids, support nerves, and help muscles work. Most people in modern diets g...

Sodium monograph & interactions

Total Care Probiotic Blend

380 mg per serving
  • › Total Other Probiotics
  • › Lactobacillus Blend + Lactobacillus Fermentation Blend
  • › Bifidobacteria Blend + Bifidobacteria Fermentation Blend

Postbiotic + Prebiotic Blend

40 mg per serving
  • Inulin
  • › Maktabolite Postbiotic

Other (inactive) ingredients: Complex Marine Polysaccharides, Cellulose, Tricalcium Phosphate, Rice extract, Sodium Chloride, Potassium Chloride. These complete the product’s ingredient list but are not active constituents.

Interaction report

Total Care Probiotic 20 Billion CFU by Probulin Drug Interactions

Want to check YOUR meds against Total Care Probiotic 20 Billion CFU?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
513Drugs
387 Moderate 126 Minor

Ingredients driving the most interactions

Sodium 205
Inulin 86

Each ingredient & the kinds of drugs it affects

For each ingredient in Total Care Probiotic 20 Billion CFU with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

Sodium7 drug types · 205 drugs

Antihypertensive Drugs

Theoretically, a high intake of dietary sodium might reduce the effectiveness of antihypertensive drugs.
High intake of dietary sodium can increase systolic and diastolic blood pressure. Also, high intake of sodium may necessitate increased use of antihypertensive medications to achieve blood pressure control in some patients, such as those with chronic kidney disease.

Likelihood Probable Evidence A
Corticosteroids

Concomitant use of mineralocorticoids and some glucocorticoids with sodium supplements might increase the risk of hypernatremia.
Mineralocorticoids and some glucocorticoids (corticosteroids) cause sodium retention. This effect is dose-related and depends on mineralocorticoid potency. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone.

Likelihood Possible Evidence D
Didanosine (Videx)

Concomitant use of didanosine with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia.
Didanosine formulations contain a significant amount of sodium.

Likelihood Probable Evidence C
Lithium

Altering dietary intake of sodium might alter the levels and clinical effects of lithium.
High sodium intake can reduce plasma concentrations of lithium by increasing lithium excretion. Reducing sodium intake can significantly increase plasma concentrations of lithium and cause lithium toxicity in patients being treated with lithium carbonate. Stabilizing sodium intake is shown to reduce the percentage of patients with lithium level fluctuations above 0.8 mEq/L. Patients taking lithium should avoid significant alterations in their dietary intake of sodium.

Likelihood Probable Evidence B
Sodium Phosphates

Theoretically, concomitant use of sodium phosphate with sodium supplements might increase the risk of hypernatremia.
Use of high doses (> 45 mL in 24 hours) of sodium phosphate, such as those used for bowel cleansing before surgery, can lead to serious electrolyte disturbances, including hypernatremia. The risk of hypernatremia is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Sodium-Containing Drugs

Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related complications.
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population. Some medications contain high quantities of sodium. When used in conjunction with sodium supplements or high-sodium diets, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.

Likelihood Possible Evidence D
Tolvaptan (Samsca)

Theoretically, concomitant use of tolvaptan with sodium might increase the risk of hypernatremia.
Tolvaptan is a vasopressin receptor 2 antagonist that is used to increase sodium levels in patients with hyponatremia. Patients taking tolvaptan should use caution with the use of sodium salts such as sodium chloride.

Likelihood Probable Evidence C

Inulin1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, inulin might increase the risk of hypoglycemia with antidiabetes drugs.
Some clinical research shows that inulin improves glycemic control in patients with diabetes; however, it is unclear if it has hypoglycemic effects.

Likelihood Unlikely Evidence D
The maker

Brand information

Manufacturer and brand details for Total Care Probiotic 20 Billion CFU, from the product label.

Probulin

See all Probulin products
Name
Probulin
Street Address
3820 NW 14th Street, Suite A & B
City
Topeka
State
KS
ZipCode
66618
Phone Number
1-888-697-8770
Web Address
www.probulin.com
Pharmacist Counseling Corner

Total Care Probiotic 20 Billion CFU by Probulin: Common Questions

Does Total Care Probiotic 20 Billion CFU by Probulin interact with any medications?
Yes. Based on its ingredients, Total Care Probiotic 20 Billion CFU has a known interaction with 513 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Total Care Probiotic 20 Billion CFU contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this with my blood pressure medication?
This product contains sodium, which can reduce how well blood pressure medications work. High sodium intake may require your doctor to increase your dose. Check with your pharmacist or doctor before starting, especially if you're on a low-sodium diet or take blood pressure medications.
What if I'm taking antibiotics?
Antibiotics can kill the live probiotic organisms in this supplement, making it less effective. Space them out — take your antibiotic at one time of day and the probiotic at another, separated by a few hours if possible. Ask your pharmacist for the best timing.
Will this help with my irritable bowel syndrome (IBS)?
Lactobacillus acidophilus and Bifidobacterium bifidum, both in this product, are possibly effective for IBS based on the evidence we hold. Results vary by person, so it's worth trying, but talk to your doctor if you don't see improvement after a few weeks.
Is this safe if I'm pregnant or breastfeeding?
Inulin in this product is rated likely safe in pregnancy and lactation. However, we don't have pregnancy or breastfeeding safety data on file for most of the probiotic strains. Talk with your doctor or pharmacist for personalized advice before taking this while pregnant or nursing.
Can this cause side effects?
Gastrointestinal side effects like bloating, gas, and abdominal discomfort are uncommon but can happen, especially when you first start. Inulin in the formula is known to cause these effects at higher doses. They usually settle down after a few days. If they don't improve, stop and talk to your doctor.
Is this safe for children?
The live probiotic strains are generally well tolerated in healthy children. However, critically ill children or those with weakened immune systems should avoid probiotics without medical guidance. Ask your pediatrician before giving this to a child with any serious health conditions.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if Total Care Probiotic 20 Billion CFU is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Total Care Probiotic 20 Billion CFU label
Sources

Sources & How We Checked

Total Care Probiotic 20 Billion CFU's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 147 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Sodium 38 references
  1. Garabedian-Ruffalo SM, Ruffalo RL. Drug and nutrient interactions. Am Fam Physician 1986;33:165-74.
  2. Food and Drug Administration Science Background: Safety of Sodium Phosphates Oral Solution. September 17, 2001. Available at: http://www.fda.gov/cder/drug/safety/sodiumphospate.htm
  3. Coton T, Mallaret C, Coilliot C, Carre D, Guisset M. Severe acute ulcerated gastritis induced by salt. Presse Med 2009;38(3):499-500. PubMed
  4. Frings-Meuthen P, Buehlmeier J, Baecker N, et al. High sodium chloride intake exacerbates immobilization-induced bone resorption and protein losses. J Appl Physiol 2011;111(2):537-542. PubMed
  5. Frings-Meuthen P, Baecker N, Heer M. Low-grade metabolic acidosis may be the cause of sodium chloride-induced exaggerated bone resorption. J Bone Miner Res 2008;23(4):517-524. PubMed
  6. Alam S, Johnson AG. A meta-analysis of randomised controlled trials (RCT) among healthy normotensive and essential hypertensive elderly patients to determine the effect of high salt (NaCl) diet of blood pressure. J Hum Hypertens 1999;13(6):367-74.
  7. Boudville N, Ward S, Benaroia M, House AA. Increased sodium intake correlates with greater use of antihypertensive agents by subjects with chronic kidney disease. Am J Hypertens 2005;18(10):1300-5. PubMed
  8. Bennett WM. Drug interactions and consequences of sodium restriction. Am J Clin Nutr 1997;65(2 Suppl):678S-681S. PubMed
  9. Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med 1994;97(4):383-9. PubMed
  10. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academy Press, 2005. Available at: http://www.nap.edu/openbook.php?record_id=10925. DOI
  11. D'Elia L, Rossi G, Ippolito R, Cappuccio FP, Strazzullo P. Habitual salt intake and risk of gastric cancer: a meta-analysis of prospective studies. Clin Nutr 2012;31(4):489-98. PubMed
  12. Goldsmith SR. Hyponatremia in heart failure: time for a trial. J Card Fail 2013;19(6):398-400. PubMed
  13. Willocks L, Brettle R, Keen J, Valentine C, Pinching AJ. Formulations of didanosine (ddI) and salt overload. Lancet 1992;339(8786):190.
  14. Chen L, Zhang Z, Chen W, Whelton PK, Appel LJ. Lower Sodium Intake and Risk of Headaches: Results From the Trial of Nonpharmacologic Interventions in the Elderly. Am J Public Health. 2016;106(7):1270-5. PubMed
  15. Cook NR, Appel LJ, Whelton PK. Lower levels of sodium intake and reduced cardiovascular risk. Circulation. 2014;129(9):981-9. PubMed
  16. Cook NR, Appel LJ, Whelton PK. Sodium Intake and All-Cause Mortality Over 20 Years in the Trials of Hypertension Prevention. J Am Coll Cardiol. 2016;68(15):1609-1617. PubMed
  17. Mente A, O'Donnell M, Rangarajan S, et al. Associations of urinary sodium excretion with cardiovascular events in individuals with and without hypertension: a pooled analysis of data from four studies. Lancet. 2016;388(10043):465-75. PubMed
  18. Moosavian SP, Haghighatdoost F, Surkan PJ, Azadbakht L. Salt and obesity: a systematic review and meta-analysis of observational studies. Int J Food Sci Nutr. 2017;68(3):265-277. PubMed
  19. O'Donnell M, Mente A, Rangarajan S, et al. Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014;371(7):612-23. DOI
  20. Poggio R, Gutierrez L, Matta MG, Elorriaga N, Irazola V, Rubinstein A. Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies. Public Health Nutr. 2015;18(4):695-704. PubMed
  21. Stallings VA, Harrison M, Oria M; Committee to Review the Dietary Reference Intakes for Sodium and Potassium, Food and Nutrition Board, Health and Medicine Division, National Academies of Sciences, Engineering, and Medicine. Washington (DC): National Acad
  22. Mahtani KR, Heneghan C, Onakpoya I, et al. Reduced Salt Intake for Heart Failure: A Systematic Review. JAMA Intern Med. 2018 Dec 1;178(12):1693-1700. PubMed
  23. Yancy CW. Sodium Restriction in Heart Failure: Too Much Uncertainty-Do the Trials. JAMA Intern Med. 2018 Dec 1;178(12):1700-1701. PubMed
  24. He FJ, Campbell NRC, Ma Y, MacGregor GA, Cogswell ME, Cook NR. Errors in estimating usual sodium intake by the Kawasaki formula alter its relationship with mortality: implications for public health. Int J Epidemiol. 2018;47(6):1784-1795. PubMed
  25. Murthy K, Ondrey GJ, Malkani N, et al. THE EFFECTS OF HYPONATREMIA ON BONE DENSITY AND FRACTURES: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endocr Pract. 2019;25(4):366-378. PubMed
  26. Messerli FH, Hofstetter L, Syrogiannouli L, et al. Sodium intake, life expectancy, and all-cause mortality. Eur Heart J 2021;42(21):2103-2112. PubMed
  27. Graudal NA, Hubeck-Graudal T, Jurgens G. Effects of low sodium diet versus high sodium diet on blood pressure, renin, aldosterone, catecholamines, cholesterol, and triglyceride. Cochrane Database Syst Rev 2020;12(12):CD004022. PubMed
  28. Giatti S, Santos RB, Aielo AN, et al. Association of sodium with obstructive sleep apnea. The ELSA-Brasil study. Ann Am Thorac Soc 2021;18(3):502-510. PubMed
  29. Nan X, Lu H, Wu J, et al. The interactive association between sodium intake, alcohol consumption and hypertension among elderly in northern China: a cross-sectional study. BMC Geriatr 2021;21(1):135. PubMed
  30. Kyozuka H, Fukusda T, Murata T, et al. Impact of preconception sodium intake on hypertensive disorders of pregnancy: The Japan Environment and Children's study. Pregnancy Hypertens 2021;23:66-72. PubMed
  31. Zhao L, Ogden CL, Yang Q, et al. Association of usual sodium intake with obesity among US children and adolescents, NHANES 2009-2016. Obesity (Silver Spring) 2021;29(3):587-594. PubMed
  32. Ma Y, He FJ, Sun Q, et al. 24-Hour urinary sodium and potassium excretion and cardiovascular risk. N Engl J Med 2022;386(3):252-263. PubMed
  33. Liu J, Yang X, Zhang P, et al. Association of urinary sodium excretion and left ventricular hypertrophy in people with type 2 diabetes mellitus: A cross-sectional study. Front Endocrinol (Lausanne) 2021;12:728493. PubMed
  34. Filippini T, Malavolti M, Whelton PK, Vinceti M. Sodium intake and risk of hypertension: A systematic review and dose-response meta-analysis of observational cohort studies. Curr Hypertens Rep 2022;24(5):133-144. PubMed
  35. Wang DD, Li Y, Nguyen XT, et al. Dietary sodium and potassium intake and risk of non-fatal cardiovascular diseases: The million veteran program. Nutrients 2022;14(5):1121. PubMed
  36. Kwak JH, Park CH, Eun CS, et al. The associations of dietary intake of high sodium and low zinc with gastric cancer mortality: A prospective cohort study in Korea. Nutr Cancer 2022;74(10):3501-3508. PubMed
  37. George S, Maiti R, Mishra BR, Jena M, Mohapatra D. Effect of regulated add-on sodium chloride intake on stabilization of serum lithium concentration in bipolar disorder: A randomized controlled trial. Bipolar Disord 2023;25(1):66-75. PubMed
  38. Zhou TL, Schütten MTJ, Kroon AA, et al. Urinary Sodium Excretion and Salt Intake Are Not Associated With Blood Pressure Variability in a White General Population. J Am Heart Assoc 2023;12(1):e026578. PubMed

See these in context on the Sodium monograph →

Lactobacillus Acidophilus 15 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Begtrup LM, de Muckadell OB, Kjeldsen J, Christensen RD, Jarbøl DE. Long-term treatment with probiotics in primary care patients with irritable bowel syndrome--a randomised, double-blind, placebo controlled trial. Scand J Gastroenterol 2013;48(10):1127-35 PubMed
  3. Chatterjee S, Kar P, Das T, Ray S, Gangulyt S, Rajendiran C, Mitra M. Randomised placebo-controlled double blind multicentric trial on efficacy and safety of Lactobacillus acidophilus LA-5 and Bifidobacterium BB-12 for prevention of antibiotic-associated
  4. Shavakhi A, Tabesh E, Yaghoutkar A, Hashemi H, Tabesh F, Khodadoostan M,Minakari M, Shavakhi S, Gholamrezaei A. The effects of multistrain probiotic compound on bismuth-containing quadruple therapy for Helicobacter pylori infection: a randomized placebo-c
  5. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  6. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
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  9. Xiao SD, Zhang DZ, Lu H, et al. Multicenter, randomized, controlled trial of heat-killed Lactobacillus acidophilus LB in patients with chronic diarrhea. Adv Ther. 2003;20(5):253-60.
  10. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed
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See these in context on the Lactobacillus Acidophilus monograph →

Saccharomyces Boulardii 26 references
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See these in context on the Saccharomyces Boulardii monograph →

Inulin 17 references
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See these in context on the Inulin monograph →

Streptococcus Thermophilus 21 references
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  12. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
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See these in context on the Streptococcus Thermophilus monograph →

Lactobacillus Helveticus 2 references
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  2. Rossi F, Amadoro C, Gasperi M, Colavita G. Lactobacilli infection case reports in the last three years and safety implications. Nutrients. 2022;14(6):1178. PubMed

See these in context on the Lactobacillus Helveticus monograph →

Bifidobacterium Longum 21 references
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  2. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  3. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  4. Rautava S, Kainonen E, Salminen S, Isolauri E. Maternal probiotic supplementation during pregnancy and breast-feeding reduces the risk of eczema in the infant. J Allergy Clin Immunol. 2012;130(6):1355-60. PubMed
  5. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  6. Pellonperä O, Vahlberg T, Mokkala K, et al. Weight gain and body composition during pregnancy: a randomised pilot trial with probiotics and/or fish oil. Br J Nutr. 2020 Nov 4:1-11. PubMed
  7. Pellonperä O, Mokkala K, Houttu N, et al. Efficacy of fish oil and/or probiotic intervention on the incidence of gestational diabetes mellitus in an at-risk group of overweight and obese women: A randomized, placebo-controlled, double-blind clinical trial PubMed
  8. Shahriari A, Karimi E, Shahriari M, Aslani N, Khooshideh M, Arab A. The effect of probiotic supplementation on the risk of gestational diabetes mellitus among high-risk pregnant women: A parallel double-blind, randomized, placebo-controlled clinical trial PubMed
  9. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed
  10. Enomoto T, Sowa M, Nishimori K, et al. Effects of bifidobacterial supplementation to pregnant women and infants in the prevention of allergy development in infants and on fecal microbiota. Allergol Int 2014;63(4):575-85. PubMed
  11. US Food and Drug Administration (FDA). Dear Healthcare Provider Letter: Warning Regarding Use of Probiotics in Preterm Infants. September 2023. Available at: https://www.fda.gov/media/172606/download?attachment. Accessed November 1, 2023.
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  13. Sabaté JM, Iglicki F. Effect of Bifidobacterium longum 35624 on disease severity and quality of life in patients with irritable bowel syndrome. World J Gastroenterol 2022;28(7):732-744.
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  16. Tamaki H, Nakase H, Inoue S, et al. Efficacy of probiotic treatment with Bifidobacterium longum 536 for induction of remission in active ulcerative colitis: A randomized, double-blinded, placebo-controlled multicenter trial. Dig Endosc 2016;28(1):67-74.
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  18. Esaiassen E, Cavanagh P, Hjerde E, Simonsen GS, Støen R, Klingenberg C. Bifidobacterium longum subspecies infantis bacteremia in 3 extremely preterm infants receiving probiotics. Emerg Infect Dis 2016;22(9):1664-6.
  19. Tena D, Losa C, Medina MJ, Sáez-Nieto JA. Peritonitis caused by Bifidobacterium longum: case report and literature review. Anaerobe 2014;27:27-30. PubMed
  20. Sangkanjanavanich S, Pradubpongsa P, Mitthamsiri W, Sangasapaviliya A, Boonpiyathad T. Bifidobacterium infantis 35624 efficacy in patients with uncontrolled asthma: A randomized placebo-controlled trial. Ann Allergy Asthma Immunol 2022;129(6):790-792. PubMed
  21. Wilson HL, Ong CW. Bifidobacterium longum vertebrodiscitis in a patient with cirrhosis and prostate cancer. Anaerobe 2017;47:47-50. PubMed

See these in context on the Bifidobacterium Longum monograph →

Bifidobacterium Bifidum 7 references
  1. Pierce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press, 1999:19.
  2. Xiao JZ, Takahashi S, Odamaki T, et al. Antibiotic susceptibility of bifidobacterial strains distributed in the Japanese market. Biosci Biotechnol Biochem. 2010;74(2):336-42. PubMed
  3. Rerksuppaphol S, Rerksuppaphol L. Randomized controlled trial of probiotics to reduce common cold in schoolchildren. Pediatr Int. 2012;54(5):682-7. PubMed
  4. Karamali M, Dadkhah F, Sadrkhanlou M, et al. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab 2016;42(4):234-41. PubMed
  5. Badehnoosh B, Karamali M, Zarrati M, et al. The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes. J Matern Fetal Neonatal Med. 2018 May;31(9):1128-1136.
  6. Pruccoli G, Silvestro E, Pace Napoleone C, Aidala E, Garazzino S, Scolfaro C. Are probiotics safe? Bifidobacterium bacteremia in a child with severe heart failure. Infez Med. 2019;27(2):175-178.
  7. Esaiassen E, Hjerde E, Cavanagh JP, Simonsen GS, Klingenberg C; Norwegian Study Group on Invasive Bifidobacterial Infections. Bifidobacterium bacteremia: Clinical characteristics and a genomic approach to assess pathogenicity. J Clin Microbiol. 2017;55(7) PubMed

See these in context on the Bifidobacterium Bifidum monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

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