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Probiotics lead the OTC trend attracting the natural shopper

Most consumers are now using natural OTCs, mostly because they think natural products are safer and with fewer nasty side effects.
Taffel Sturgeon

The unmistakable shift in consumer sentiment toward all things natural is percolating to OTC shelves.

Savvy drug stores should thoughtfully curate product offerings to reflect this desire among shoppers to use medicines that have at least a veneer of natural ingredients in them. 

A 2017 white paper from data analysts at IRI and Kline found one-third of consumers considered natural OTC products to be safer than their traditional counterparts. That trend has continued, with consumers increasingly choosing more natural products and ingredients, and willing to pay more for them. Most consumers are now using natural OTCs, mostly because they think natural products are safer and with fewer nasty side effects, but, perhaps surprisingly, many consumers believe natural OTCs are just as effective as synthetics. 

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“In terms of trends appealing to the ‘natural’ shopper, research conducted by IRI in November 2020 found that 20% of consumers look for products that are free of artificial ingredients and chemicals when they shop for health items,” said Barbara A. Kochanowski, senior vice president of regulatory and scientific affairs at the Consumer Healthcare Products Association, “and 13% seek out products that contain only natural ingredients.” 

Probiotics offer natural access

Probiotics are the top-selling natural ingredient in supplements. They are billion-dollar ingredients, according to Nielsen data measuring all of 2021 sales. The “friendly bacteria” populate the body’s digestive tract and larger microbiome that runs throughout the body to the tune of about 10 times as many cells as the entire rest of the human body’s cell count. 

Think about that — our bodies are made up of far more bacterial cells than human cells! That may be why the health applications for probiotics is growing far afield from the traditional digestive health and even immune function (some 70% of the body’s innate immunity is housed in the gut). Virtually every part of the human body has various bacterial cells exerting influence on the structure and function of organs and tissues. 

20% of consumers look for products that are free of artificial ingredients and chemicals when they shop for health items. (source: IRI)

Probiotics are quite the consumer-resonant term, which first came to consumer attention thanks to the live active cultures found in yogurt. Probiotics are probably the leading supplement-style ingredient to cross over to other categories, including foods, beverages, supplements and cosmetic applications. Researchers are now finding probiotics to aid in everything from cognitive function to weight management. 

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Probiotic supplements now line shelves in all retail channels, and, unlike earlier generations, do not necessarily need to be stocked in refrigerator boxes. Hundreds of reputable science and press articles have provided the public with valuable information about the role of probiotics and the microbiome in digestive health. 

Bacteria and oral health

Tom’s of Maine was the first natural toothpaste to break into the mainstream food and drug channel when the fluoride-free natural toothpaste was sold off to Colgate for a cool $100 million back in 2006. We don’t know how Tom himself thinks of the deal today, but a line extension now offers Tom’s toothpaste that actually does contain fluoride. But there are other ways to diversify oral health product sets that meet the moment with consumers. 

The oral microbiome is changing oral care away from simply brushing, flossing and rinsing. Traditional fluoride toothpaste brands, like Crest and Colgate, use sorbitol, a sweetener known to feed cariogenic bacteria in the mouth. 

Spry toothpaste

“Why are we feeding the bacteria?” said Nathan Jones, founder and owner of Xlear, which makes toothpaste using xylitol instead of sorbitol. “This is like sending a carpenter in to start rebuilding a house while the firemen are still there fighting the fire burning it down.”

Jones said use of xylitol changes the microbiome in the mouth and is a curious case where a sweetener not only does not contribute to cavities but can actually prevent cavities more so than fluoride. One study found that over a roughly  three-year period, xylitol reduced cavities 13% more than fluoride-only toothpaste. 

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Xlear also adds sodium trimetaphosphate (TMP), an enamel remineralization agent that a recent study showed led to 36% stronger enamel compared to fluoride. 


An oral probiotic formulation, ProBiora, uses three specific streptococcus bacterial strains that are found solely in the mouth. These friendly bacteria crowd out the bad, disease-causing bacteria that brushing and flossing cannot reach, between teeth and below the gum line. 

“For retailers, ProBiora provides a great opportunity to fill a missing gap on their oral-care shelves,” said Susanne Reimer-Fey, who represents the company. “Additionally, they can benefit from the increasing consumer interest in both oral care and probiotics, as well as the desire for convenient oral-care products.”

Probiotics and gut health 

Oral care represents one of those new frontiers of probiotic research and development, but the core for probiotics remains digestive health. And digestive health is a perfect category to talk about the difference between supplement shelves and drug stores. 

OTC digestive health stalwarts hone in on acute digestive complaints up and down the GI tract. These include fast-acting Tums’ calcium carbonate for heartburn or milk of magnesia for “transit” issues like constipation. While modulating the body’s beneficial bacteria can have real, positive health benefits, it can take a week, maybe three, for consumers to experience digestive relief through the use of probiotics. This actually makes the sale of a single bottle of probiotics just about a perfect pitch to consumers and stores alike. 

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OTC medicines for upset stomach or other gastrointestinal symptoms can be used to self-manage minor and acute conditions when used as directed. If symptoms don’t resolve after a short period, it’s time to consult a pharmacist or healthcare provider. 

“Once it has been established that there is no serious condition causing symptoms, it could be appropriate to take dietary supplements such as probiotics,” Kochanowski said. “Although supplements and OTCs tend to appeal to consumers committed to self-care, it’s important to note that there is a clear line between short-term use of OTC medicines to manage acute conditions and daily use of dietary supplements.” 

Dietary supplements and OTC products that contain probiotics, or otherwise modulate the body’s microbiome, are natural, on-trend — and effective. That’s a win all the way around. 

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