VSL#3 (AKA "VSL3") is a high-potency probiotic medical food intended for the dietary management of ulcerative colitis (UC), IBS (irritable bowel syndrome) or an ileal pouch. Its trademark description is “The Living Shield”, which I think is very fitting for what probiotics do.
One thing to note, however, is that this is NOT the same VSL#3 that was used in studies prior to 2016. You will find out the significance of that in a moment. It is produced by Alfasigma.
VSL#3 is a medical food, which means, according to the US FDA:
Medical foods are NOT drugs and therefore do not have to go through the FDA drug-approval process.
VSL3 is composed of 8 strains of lactic acid bacteria. (Note that the strain names are not on the VSL3 website, but were published in some of the studies referenced below):
At the time of this writing, VSL3 is available in 3 different products: Please always check ingredients prior to consumption!
At the time of this writing, the product website for healthcare professionals recommends:
Please note that consumers are supposed to be working with a physician for treatment with these conditions. Follow your doctor’s recommendations as to usage.
According to the website, “Adjustment of the intestinal flora can take a few days or weeks; it may take up to 1 month for the colonization of the gut to become optimally stable.”
To my knowledge, there are limited studies with this product as of December, 2019. As noted on the Visbiome page, scientific studies performed prior to 2016 should be credited to Visbiome and NOT to VSL3, not only because of the ratios of the different probiotic organisms, but also because of the different culturing conditions. Additionally, studies performed in 2017 may or may not have been performed with this Alfasigma product. You can read more about the lawsuit involving Visbiome and VSL#3 on the Visbiome page.
Here are some studies I found:
A research summary published in March of 2019 with VSL#3 (Alfasigma) in IBD patients investigated the presence of fecal high mobility group box 1 (HMGB1) index, an important proinflammatory mediator involved in IBD development. A mouse colitis study and in vitro study were also performed comparing #3 to a Bifidobacterium longum strain. Results showed that HMGB1 were high in both active IBD and colitis mice. After treatments with the 2 investigated probiotics there were reduced serum and fecal HMGB1 levels as well as increased expression of zonula occludins-1, occludin, and claudin-1 in colon tissues of mice. In vitro, HMGB1 reduced transepithelial electrical resistance, zonula occludins-1 protein expression, and increased paracellular permeability of FITC-dextran, showing that it plays a role in IBD. Probiotic treatments had the opposite effects.
A small, pilot crossover study published June, 2019, in which the authors declared no conflict of interest, compared this probiotic and Visbiome. Results showed that feces from 10 healthy donors obtained prior to probiotic intake and feces collected after supplementation with VSL3 did not affect Candida albicans growth. On the contrary, a 3log10 inhibition of Candida growth was observed with Visbiome intake (as the European version, Vivomixx).
An in vitro wound-healing study from 2017 to test the ability of probiotics to protect gastrointestinal mucosal surfaces was undertaken with this product and Visbiome. The results showed that Visbiome did not affect monolayer morphology (cell structure) and cell density (favorable results), but VSL#3 “caused clear morphological cell damage and strongly reduced cellularity" (unfavorable results). Visbiome was declared to have protective effects, including reactive-oxygen species protection, whereas the other product did not.
A 2017 study in mice with induced colitis showed that VSL#3 and (what now is) Visbiome purchased in the UK had different effects. Visbiome, but not VSL#3, attenuated “clinical” scores of colitis.
Another study was published in 2017. In a small cohort of patients receiving combined antiretroviral therapy for HIV-1, what is now known as Visbiome was used, and then in vitro studies were performed to compare Visbiome (the previous US-made VSL#3) to VSL#3 (Alfasigma). The ultimate conclusion was, “Our data, in conjunction with previously published findings, confirm that the new Italian-made formulation of VSL#3® is different from the previous US-made VSL#3 and therefore its efficacy and safety in HIV-infected subjects is still unproven.”
Your local pharmacy may carry the non-prescription products. At this time the product is not found at Amazon.com or other distributors I work with.
Obviously, the prescription "DS" product is only available with a prescription from your doctor.
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