Are you a probiotic manufacturer who has become annoyed you are not allowed to market microbes that can help cultivate “intestinal flora” for consumers? Did the European Food Safety Authority tell you to stop claiming your magic potion reduces the chances of people developing diarrhea or respiratory tract infections? Did the U.S.A. force you to stop advertising that Activia yogurt and DanActive dairywhatever helps avoid colds or flu and force you to pay $21 million as part of a class-action settlement with the Federal Trade Commission and 39 states?

Do you wish you could go back to those glory days of 2008 when no one got all science-y and skeptical about the miracle cure du jour? There's no reason to give up and sell your company to or some other questionable supplement company just yet. Actually, I have good news: Asian countries don't care what you claim.

There is a reason Yakult has sales of $174 million and climbing in China - and that reason is because if you bribe the right government officials, you can claim your drink helps with immuno-regulation and improving intestinal flora and no one will mind. Hire pretty women and celebrities to repeat the message and see how it goes.

That's not to say the U.S. is nonsense-free. It is still the largest market for crazy probiotic claims. Dermot Doherty, Malavika Sharma, Adi Narayan, and Yuki Yamaguchi writing at BusinessWeek say the worldwide market for probiotic stuff could grow to $42 billion by 2016 and the U.S. will likely still be out in front unless New York City bans all food in their quest to personally nanny each and every resident there.

How did we get where we are, with probiotics so big despite any evidence they do anything outside placebo levels?  Well, we got here the same way that lots of crazy ideas take hold; a kernel of scientific truth and then some aggressive marketing.  The science is that lots of microbes in our guts are helpful. It's everything else about probiotic marketing that is made up.

The microorganisms in our guts have been co-evolving with us for as long as we can imagine so biologists have learned a few thing about them during that time. Because we have space in our guts where pathogens can take up residence, it is beneficial to have good microorganisms filling that  area instead. What is questionable is how any number of 200 modern probiotic food products can suddenly 'fill' that space and block out bad stuff.  Further, microorganisms make that Vitamin K which helps us digest our food. Also good. The problem is that no one really knows which of those live microorganisms - probiotics - are helpful. And if you can't say for sure which ones aren't helpful, you can imply that your expensive yogurts are helpful. Within reason. 

So manufacturers are just creating stuff with different strains of bacteria and selling it. Activia even trademarked its bifidus regularis, and they claim a slight benefit, but how much yogurt are you going to eat every day and how much are you willing to vomit due to eating so much of it to get that nebulous benefit?  Because in normal usage, there is no known benefit outside the sugar pill noise range. 

As Dr. Mark Crislip at Science-Based Medicine puts it
When you give probiotics to normal humans you are introducing, relative to the number and quantity of bacteria that are already there, a small amount of foreign bacteria. Continuing our metaphor, it is like trying to put a putting green in an Amazonian rain forest. For normal people, it makes no microbiologic sense to take probiotics.
Does that sound like a $42 billion industry to you?  It sounds to me like I got into the wrong business. 

Some studies even shoot for being part of the cultural lexicon and claim probiotics may be good for the brain - in mice, anyway. Probiotic bacteria is changing the vagus nerve signaling, they contend, but they don't know by what bacteria mechanism. I mean, that would be scary to consumers if the science of GMOs were that unclear but introducing unknown microbes directly into your body is apparently not an issue because it is sold in health food stores.  Good luck figuring out that intellectual schism, because if you put circles over people who are anti-GMO and over people who are pro-magic yogurt and see who is in both, you don't have a Venn diagram, you basically just have the same circle.  Scicurious at Scientific American blogs is simultaneously curious, hopeful, skeptical and shocked and rightly discourages us all from thinking yogurt will cure depression.

Kirsten Tillisch, a gastroenterologist at UCLA, did a study in a small group of human females and found that after taking probiotics the women reacted differently to angry and sad faces. "At the most basic level, we show that by changing the bacteria in the gut, we change the way the brain responds to environmental cues" Tillisch told Allison Aubrey at NPR.

Here is why you should be skeptical anyway; I am not a big regulation guy but I am a common sense one, and a regulatory definition of probiotics doesn’t even exist so who knows what these people are really selling. There are no FDA authorized health claims for probiotics in the USA.  I know, it doesn't matter to people who buy Dr. Bronner's Magic Soaps All-One but want warning labels on corn syrup, this is big business, after all.

Yogurt is one thing, juice is just as silly. But if you buy probiotic ice cream, it means you don't even know that the pasteurization killed the real microorganisms, and then a few probiotics were added back in after pasteurization and then the freezing has killed the microorganisms you just added...oh never mind, if you buy probiotic ice cream you didn't finish this article anyway.

 Probiotic ice cream. Because this is legal in India. Credit and link: Amul Prolife Probiotic Wellness