In a blinded four-arm study, 41 healthy volunteers received either Bifidobacterium animalis subsp. lactis Bi-07 (10 9 CFU per day), 8 g per day xylo-oligosaccharides (XOS), the combination of both or an inert maltodextrin control for 21 days 128. XOS enhanced bifidobacteria counts in faeces in both the synbiotic and prebiotic groups compared with the control and improved plasma lipid profiles and modulated markers of immune function in healthy adults. The lowest reported use of analgesics was observed during combination supplementation along with a reduced expression of CD19 on B cells (as markers of immune function). Thus, the combination exerted certain benefits that were not afforded by the probiotic or prebiotic alone. This study shows a prebiotic status for XOS used at 8 g per day. Previous evidence supports that Bifidobacterium animalis subsp. lactis Bi-07 at 10 9 CFU per day met criteria for a probiotic 112, 129. Taken together, this tested product meets our definition of a complementary synbiotic. However, because an increase of Bifidobacterium was not observed in individuals fed the combination product, it does not meet our definition of a synergistic synbiotic. Synbiotics present challenges for researchers, including deciphering mechanisms underlying the health benefit and proving that the microbiota are modulated via complementary or synergistic means. Unless appropriate experimental methods of verification are used, the product under assessment should not be referred to as ‘synbiotic’. A systematic review of 384 interventions involving prebiotics, probiotics and synbiotics found that no safety-related data were reported in 37% of the RCTs and 89 studies only used generic statements to describe AEs 76. Up to 98% of studies did not provide a definition of AEs or serious AEs, the number of participant withdrawals due to AEs, or the number of AEs and serious AEs per study group. Taken together, these results are evidence that some studies inadequately collect or report data on AEs. van den Nieuwboer and colleagues 72, 77, 78, 79 reviewed the AEs reported in studies with probiotic and synbiotic interventions and classified them according to the Common Terminology Criteria for Adverse Events system 80; they found that the incidence of AEs in each category was either no different from or often lower in the control groups than in the treatment group. Symbiotic 180-S's unique formulation contains 9 strains of beneficial bacteria, with natural prebiotic (chicory root extract) and digestive enzymes. Recommended for: Use in all animals in times of stress, illness, injury, post-antibiotic treatment or as a daily supplement to support the immune & digestive systems.
Can be used with: Any food or in-water source. Symbiotic 180-S is also compatible for use with supplements and medications such as anthelmintics, coccidiostat, minerals and vitamins.
Key Features:

Soleimani, A. et al. The effects of synbiotic supplementation on metabolic status in diabetic patients undergoing hemodialysis: a randomized, double-blinded, placebo-controlled trial. Probiotics Antimicro. Prot. 11, 1248–1256 (2019). The gastrointestinal (GI) tract of animals harbors various microorganisms along with their collective genomes. 2,3 The estimated total microbial load in the intestine is approximately 100 trillion microbial cells, representing approximately 100 times more microbial genes than the host genome. ISAPP is a non-profit collaboration of scientists dedicated to advancing scientific excellence and providing objective, science-based information on probiotics and prebiotics. The organization’s activities are funded by companies involved in the sale of probiotics and prebiotics, but ISAPP is guided by an international, all-volunteer academic board that functions independently. This ISAPP-organized panel was composed of experts in microbiology, nutrition and gastrointestinal physiology, including many who were involved in the latest updates of the probiotic 12 and prebiotic 13 definitions according to ISAPP. Panellists were charged with accomplishing the following goals: consider what a synbiotic is and provide a clear, concise and testable definition; suggest the appropriate experimental conditions necessary to establish synbiotic activity; describe the evidence required to demonstrate the health benefits and establish safety; and provide guidance for stakeholders, including researchers, industry, public health professionals and regulatory agencies. Kukkonen, K. et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: a randomized, double-blind, placebo-controlled trial. J. Allergy Clin. Immunol. 119, 192–198 (2007).

Reviews

No governing agency oversees the label claims on probiotics. Products are most likely to be of good quality if they were produced by a reputable manufacturer and underwent clinical study. I am on the second box of these capsules and feel that they have made a big difference to my beautiful boy Louie. Stokes JE, Price JM, Whittemore JC. Randomized, controlled, crossover trial of prevention of clindamycin-induced gastrointestinal signs using a synbiotic in healthy research cats. J Vet Intern Med 2017;31(5):1406-1413.

Nabhani, Z., Hezaveh, S. J. G., Razmpoosh, E., Asghari-Jafarabadi, M. & Gargari, B. P. The effects of synbiotic supplementation on insulin resistance/sensitivity, lipid profile and total antioxidant capacity in women with gestational diabetes mellitus: a randomized double blind placebo controlled clinical trial. Diabetes Res. Clin. Pract. 138, 149–157 (2018).Shakeri, H. et al. Consumption of synbiotic bread decreases triacylglycerol and VLDL levels while increasing HDL levels in serum from patients with type-2 diabetes. Lipids 49, 695–701 (2014).

As with probiotics, the desired outcome after giving prebiotics is improvement of host health. 21 However, the specific aim of giving prebiotics is to promote growth and function of the beneficial bacteria already present in the gut. Intake of prebiotics can significantly modulate the colonic microbiota by increasing the number of specific bacteria and thus changing the composition of the microbiota. 23 Prebiotics are metabolized by the resident microbiota of the colon, which, depending on fermentability, will result in the production of the short-chain fatty acids butyrate, propionate, and acetate. 23 These metabolites will diffuse through gut enterocytes and provide either local effects (e.g., enhance the intestinal epithelial barrier, decrease pro-inflammatory cytokines, regulate intestinal motility) or systemic effects (e.g., provide energy for the host). 24,25 Apart from direct prebiotic effects, dietary fibers can have additional functions in the GI tract. Psyllium, for example, has water-binding and bile acid–binding properties that improve fecal consistency, increase the intestinal mucus layer, and have beneficial effects on cell proliferation in the intestinal tract. 26 SynbioticsCoyte, K. Z., Schluter, J. & Foster, K. R. The ecology of the microbiome: networks, competition, and stability. Science 350, 663–666 (2015).