How to Choose the Best Probiotics for Celiac Disease

If you have celiac disease (CD), you understand the significance of avoiding all sources of gluten.

You may also be aware of the importance of having a healthy microbiome and wish to promote better digestive health or reduce persistent symptoms related to celiac.

Probiotics are live microorganisms that can have several beneficial effects on your health.

They're naturally present in fermented foods and yogurt and are also available in capsule form. 

While most probiotics are naturally gluten-free, this article highlights several probiotic supplements labeled as gluten-free, which means the manufacturer has gone through extra steps to ensure they meet this claim.

Also, learn other ways to support your microbiome, which may help reduce celiac symptoms.  

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How Microbiome Diversity Helps Celiac Disease Symptoms

Celiac disease (CD) is an autoimmune disorder of the small intestines that occurs when a genetically predisposed person consumes gluten. 

The immune system mistakenly identifies the gluten as dangerous which triggers an inflammatory response in the lining of the small intestines, causing chronic damage and poor absorption of nutrients.

Currently, there aren't many studies examining the gut microbiome in people with CD.

However, the studies available do show the microbiome in people with CD is different from those without CD. 

At this time, it’s unclear if the difference in microbiome plays a role in causing CD or if it’s a consequence of the condition. 

Below is a synopsis of two recent studies which both examine how probiotic supplements may affect the management of CD.

Recent Probiotic Research On Celiac Disease

A small recent study evaluated the impact probiotic supplements had on the composition of the gut microbiome and clinical symptoms (fatigue, muscle pain, bloating, and gas). 

For 12 weeks, CD patients took three probiotic capsules three times a day before meals.

The probiotic was a 10 billion CFU blend of bacteria including:

• Lactobacillus casei.
• Lactobacillus acidophilus. 
• Lactobacillus rhamnosus. 
• Lactobacillus bulgaricus.
• Bifidobacterium breve. 
• Bifidobacterium longum. 
• Streptococcus thermophilus. 

The study's findings were that CD patients in the probiotic group reported that their clinical symptoms were less severe than the placebo group.

The fecal samples and real-time PCR test also showed improvement in gut microflora. 

Another study looked to see if probiotic supplements helped manage CD symptoms.

170 children with CD participated in the study. 

All children followed a gluten-free diet, and half of the children were given a Gutcare™sachet 500mg (Clostridium butyricum and Bifidobacterium) diluted in water twice a day for 28 days.  

Researchers found that the children in the probiotic group reduced their number of daily stools by half. 

Best Probiotic Supplements For Celiac Disease

Here is a list of high-quality probiotic supplements that are claimed by their manufacturers to be gluten-free.  

Dietary supplements, including probiotics, are covered under the Food and Drug Administration’s gluten-free labeling rule.

In order for a manufacturer to claim “gluten-free” for their product, they must meet certain criteria, such as:

• It doesn’t contain wheat, rye, barley, or other gluten-containing grains.
• It doesn’t contain any ingredients that are derived from a gluten-containing grain (unless the gluten has been removed).
• Any unavoidable presence of gluten is less than 20 ppm.

The list length is limited, however, and there are many other gluten-free probiotic supplements available on the market.

We’ve listed them in alphabetical order for you. 

Align Probiotic

Align 24/7 Digestive Support*§ Probiotic Supplement contains one billion colony-forming units (CFUs) of Bifidobacterium 35624TM, which is a strain claimed to have over 20 years of research, and may help soothe occasional gas, bloating, and abdominal discomfort.

The capsules come in individual blister packs that help protect the potency and survival of the live probiotics.

Store at room temperature; refrigeration is not required. 

According to Align’s website, several ProVoice surveys (the largest sample size of any professional healthcare survey in the U.S.) claim that Align is the probiotic brand physicians recommend the most. 

While there is no information about third-party testing, they claim to have testing protocols in place, and each batch undergoes DNA testing to ensure the presence of the bacteria.

The recommended dose is one capsule per day.

Pros

• Monday-back guarantee.
• Gluten-Free.
• Soy-free.
• Effective probiotic strain.
• Recommended by many doctors.

Cons

• Contains sucrose.
• Smaller CFU potency.

Culturelle Daily Digestive Probiotic

Culturelle’s Daily Digestive Probiotic contains ten billion CFUs of Lactobacillus rhamnosus GG, one of the most studied probiotic strains. 

It’s available in capsule or chewable form, which is helpful if you have trouble swallowing pills. 

Culturelle’s probiotic may help reduce occasional bloating, gas, and diarrhea by supporting optimal digestive health and immune function. 

Culturelle takes pride in that their probiotics have been used in clinical trials since 1998 and have been proven to be safe and give desired results.

All Culturelle products are manufactured in facilities that follow current good manufacturing practices. 

They base their formulas on science and package their capsules in individually sealed packets for limited exposure to the elements to protect the live probiotics. 

The recommended dose is one capsule daily, or one dose in the morning and one at night if you’re experiencing occasional digestive discomfort.

Pros

• Non-GMO.
• Gluten-free.
• Dairy-free.
• Soy-free.
• Vegan-friendly.
• Clinically proven to be effective.
• Certified current good manufacturing practices (cGMP).

Cons

• Limited strains of probiotics.
• Some customers experience temporary digestive discomfort.

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Cymbiotica Probiotic

Cymbiotica Probiotic contains 50 billion CFUs of 19 probiotic strains as well as plant-based prebiotics (food for the probiotic bacteria).

Some of the strains of probiotics include Lactobacillus plantarum, Saccharomyces boulardii, and Bifidobacterium bifidum.

It comes in capsule form and doesn’t require refrigeration. 

The probiotic is claimed to help balance the gut microbiome, lower stress, reduce digestive issues, and boost energy. 

Cymbiotica is proud to maintain high product standards and has all its ingredients go through third-party testing.

The supplement contains no sugar, soy, or gluten and is vegan-friendly.

The recommended serving is three capsules taken daily on an empty stomach.

Pros

• Gluten-free.
• Vegan.
• Made in the U.S.
• Soy free.
• cGMP certified.
• Non-GMO.

Cons

• Higher price point.

Stonehenge Health® Dynamic Biotics™

Stonehenge Health® Dynamic Biotics™ contains 55 billion CFUs of 16 diverse probiotic strains, including six of the most studied strains found to be beneficial: L. Gasseri, L. Rhamnosus, L. Reuteri, L. Acidophilus, B. Bifidum, and B. Longum.

It also contains a prebiotic to help nourish all the probiotics. 

The probiotic comes in capsule form in a dark amber glass bottle that helps protect the probiotic and improve its survivability. 

The capsule is delayed release making sure the probiotics get into the intestines where they survive and are most beneficial. 

The suggested use is one capsule taken daily, each bottle contains 30 capsules.

Pros

• Made in the U.S.
• Third-party tested.
• Non-GMO.
• Gluten-free.
• cGMP certified.
• 90-day money-back guarantee.

Cons

• Often out of stock.

Thorne Probiotic

Thorne’s FloraMend Prime Probiotic contains a five billion CFU blend of Lactobacillus gasseri KS-13, Bifidobacterium longum MM-2, and Bifidobacterium bifidum G9-1.

The product is claimed to support digestive health and metabolism.

According to the manufacturer, the probiotics in the blend have been proven in studies to help support healthy weight management.

Thorne has established its credibility with many sports teams and leagues.

All the ingredients go through several tests, and the manufacturing facility is third-party certified and compliant with all good manufacturing practices. 

The capsules are designed to resist acid and moisture to ensure the probiotics get past the stomach and into the intestines where it’s most needed.   

The suggested dose is one capsule taken daily with a meal.

Pros

• Made in the U.S.
• Gluten-free.
• Dairy-free.
• Soy-free.
• cGMP certified.
• Third-party tested.

Cons

• Plastic bottle (probiotics have a better shelf life when stored in glass bottles or individual packets).
• Smaller CFU potency.

Choosing Gluten-Free Probiotic Supplements  

Probiotics are typically gluten-free in nature.

The capsules are made from gelatin or vegetable cellulose, and the probiotic powder inside is made from bacterial or fungal strains. 

It’s important to note that some manufacturing plants may produce other products that contain gluten and the probiotic supplement may come in contact with a trace amount of it. 

However, experts define gluten-free as containing less than 20 parts per million of gluten, and trace amounts are considered safe. 

Look For Gluten-Free Products

When looking for a probiotic supplement, check the label for any possible gluten-containing ingredients, such as starch or dextri-maltose.

Most companies highlight these dietary considerations on the front of the package so they’re easy to identify.

For example, the supplement packaging may list common allergens such as:

• Gluten-free.
• Dairy-free.
• Soy-free.
• Nut-free.

If you have celiac disease, you should select a probiotic supplement that claims to be gluten-free.

If you also have a hard time digesting dairy (as some people with CD do) also check for the dairy-free claim.

Choose High-Quality Supplements From Reputable Brands 

When deciding on a probiotic supplement, it’s important to choose from a company with a reputation for high-quality products.

Here are several key traits to look for:

• Made in the U.S.: Products made here in the U.S. have to go through federal regulations, ensuring that their supplements are safe and that the labels are truthful. 
• Third-party testing: Companies that opt for third-party testing of their products are ensuring the public that their products are safe and contain what they claim to be.
• Current Good Manufacturing Practices (cGMP): The cGMP regulations, enforced by the FDA, ensure proper design, monitoring, and control of manufacturing processes. This guarantees the quality and purity of the products.

Consider Different Strains Of Probiotics 

You can find probiotic supplements with several strains of bacteria, while others have limited or single strains. 

There’s currently no research on which type is best for celiac disease.

Talk with your dietitian or healthcare provider for their recommendation on which type of probiotic may be best for you. 

The strains of bacteria used in the recent probiotic research discussed above included:

• Lactobacillus casei.
• Lactobacillus acidophilus. 
• Lactobacillus rhamnosus. 
• Lactobacillus bulgaricus.
• Bifidobacterium breve. 
• Bifidobacterium longum. 
• Streptococcus thermophilus. 
• Clostridium butyricum.

When considering a probiotic supplement, you’ll want to review the listed CFUs.

The CFU indicates the number of live bacterial cells.

Amounts available in probiotics have a wide range.

Some offer 1 billion CFU (or 1 x 109) or 10 billion CFU (pr 1 x 1010). Some even go up to or higher than 50 billion CFU.

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Takeaway

Newer research shows promise that probiotic supplements may be helpful in managing CD symptoms and enhancing the gut microbiome of people with CD.

However, more research is needed to better understand how probiotic supplements could benefit CD, which strains may be the most impactful, and which CFU level delivers the best results. 

When looking for a probiotic supplement, check that the label claims to be gluten-free.

You may also want to check for dairy-free if you have trouble digesting dairy. 

How A Dietitian Can Help

Nourish dietitians follow a food-first approach meaning they will guide you through which foods help strengthen your gut microbiome.

However, if after trying this approach, symptoms persist and they feel it necessary, they can help you select an appropriate probiotic supplement. 

Talk with a celiac dietitian today to learn more about how probiotics can affect CD and determine if a probiotic is right for you.