A Review of Probiotic Supplementation with Autoimmune Disease

Written by Jessica Patella, ND. This updated systematic review suggests that probiotic supplementation may help reduce inflammation in individuals with autoimmune diseases, particularly RA and MS. 

capsules on green leavesApproximately 5–10% of the global population are affected by autoimmune diseases, which are characterized by an overactive immune system that mistakenly attacks healthy tissues, resulting in chronic inflammation and tissue damage.1,2  The most common autoimmune diseases include rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), multiple sclerosis (MS), psoriasis, inflammatory bowel disease (IBD), and type 1 diabetes.1,3  In the U.S. alone, the cost of autoimmune disease is estimated to exceed $100 billion annually.1,4 Current evidence that the gut microbiota may play a role in immune system regulation prompted researchers to investigate whether probiotics improve outcomes in patients with autoimmune diseases through reviewing multiple research studies.1

An imbalance in gut bacteria, known as dysbiosis, has been associated with increased intestinal permeability, immune dysregulation, and chronic inflammation seen in many autoimmune conditions.1,5 Probiotics are beneficial bacteria that help restore a healthier balance of intestinal bacteria and may reduce inflammatory signaling throughout the body.1,6 Because of these potential benefits, researchers conducted an updated systematic review and meta-analysis to evaluate whether probiotic supplementation can improve inflammatory markers in patients with autoimmune diseases.1

This review analyzed data from 12 randomized controlled trials involving 703 participants diagnosed with RA, MS, SLE, psoriasis, type 1 diabetes, spondyloarthritis, ulcerative colitis, and chronic fatigue syndrome. Participants received either probiotic or placebo supplements for periods ranging from six weeks to twelve months and researchers compared changes in inflammatory biomarkers.1

The meta-analysis reported the following findings:

  • IL-6, one of the primary cytokines involved in chronic inflammation, was significantly reduced following probiotic supplementation, suggesting an overall decrease in inflammatory activity (pooled standardized mean difference [pSMD] = −0.83; 95% confidence interval [CI]: −1.30, −0.37).
  • TNF-α, another major inflammatory mediator involved in autoimmune diseases, also showed significant improvement in participants receiving probiotics (pSMD = −0.41; 95% CI: −0.77, −0.06).
  • High-sensitivity C-reactive protein (hs-CRP), a commonly used marker of systemic inflammation, was significantly lower in participants taking probiotics than in those receiving placebo (pSMD = −0.71; 95% CI: −1.18, −0.23).
  • RA patients appeared to benefit the most from probiotic supplementation, with significant reductions in IL-6, IL-1β, and TNF-α, suggesting probiotics may serve as a useful adjunctive therapy alongside standard medical treatment.
  • In patients with MS, probiotic supplementation significantly reduced hs-CRP levels, indicating an improvement in systemic inflammation.

Overall, this updated systematic review suggests that probiotic supplementation may help reduce inflammation in individuals with autoimmune diseases, particularly RA and MS. While these findings are encouraging, researchers caution that probiotics should currently be viewed as a complementary therapy and this review is only the first step to future investigation. Additional long-term studies are needed to determine which probiotic strains, doses, and treatment durations provide the greatest clinical benefit across different autoimmune diseases.1

Source: Chiou, Yuan-Yow, Tsu-Yun Chiu, and Mei-Ju Chen. “Effect of Probiotic and Synbiotic Oral Supplementation in Autoimmune Diseases: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Nutrients 18, no. 7 (2026): 1107.

© 2026 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons
Attribution (CC BY) license.

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Posted August 4, 2026.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health.  She earned her ND from Sonoran University (formerly Southwest College of Naturopathic Medicine in Tempe, AZ).  Dr. Patella has been involved in research since high school, when she presented her research at University of Florida on Group B Strep in pregnant women. While earning a bachelors in exercise physiology at Florida State University, her honors research was examining lifestyle effects on glucose levels in women. Dr. Patella was also a research assistant while in naturopathic medical school and has been writing for the Natural Health Research Institute since she graduated from Sonoran University in 2009. Dr. Patella currently teaches a variety of classes all related to human health.

References:

  1. Chiou YY, Chiu TY, Chen MJ. Effect of Probiotic and Synbiotic Oral Supplementation in Autoimmune Diseases: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. Mar 30 2026;18(7)doi:10.3390/nu18071107
  2. Conrad N, Misra S, Verbakel JY, et al. Incidence, prevalence, and co-occurrence of autoimmune disorders over time and by age, sex, and socioeconomic status: a population-based cohort study of 22 million individuals in the UK. Lancet. Jun 3 2023;401(10391):1878–1890. doi:10.1016/s0140-6736(23)00457-9
  3. Cooper GS, Bynum ML, Somers EC. Recent insights in the epidemiology of autoimmune diseases: improved prevalence estimates and understanding of clustering of diseases. J Autoimmun. Nov–Dec 2009;33(3-4):197–207. doi:10.1016/j.jaut.2009.09.008
  4. Miller FW. The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention. Curr Opin Immunol. Feb 2023;80:102266. doi:10.1016/j.coi.2022.102266
  5. Garrido-Mesa J, Gálvez J, Garrido-Mesa N. Editorial: The gut-immune axis: a complex training ground impacting inflammatory pathologies. Frontiers in immunology. 2023;14:1274761. doi:10.3389/fimmu.2023.1274761
  6. Kazemi A, Soltani S, Ghorabi S, et al. Effect of probiotic and synbiotic supplementation on inflammatory markers in health and disease status: A systematic review and meta-analysis of clinical trials. Clinical nutrition (Edinburgh, Scotland). Mar 2020;39(3):789–819. doi:10.1016/j.clnu.2019.04.004

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