Probiotics + Fermented Medicine Food Homology is Go Viral?

In recent years, with the explosive growth of health consumption demand, the combination of "medicine food homology + fermentation technology" has become an innovative focus in the dietary supplement and beverage sector. This is a field full of both allure and hidden risks. The wave of fermented medicine food homology, which blends ancient wisdom with modern technology, is sweeping the market. However, the risks behind it may far exceed our imagination.

Food medicine homology carries millennia of health preservation wisdom, fermentation is hailed as a modern biotechnology that enhances nutrient absorption, and probiotics are the "celebrity endorsers" of gut health. The combination of the three sounds like a match made in heaven, painting a perfect blueprint for the modernization of traditional Chinese medicine (TCM). Ancient herbs are revitalized through fermentation, with enhanced efficacy and improved taste. Isn’t this exactly what we’ve been pursuing? Making traditional Chinese medicine keep pace with the times and better serve public health.

Indeed, many studies suggest that probiotic fermentation can break down macromolecules in Chinese herbal medicines into smaller molecules, improving bioavailability and even reducing toxic side effects. This has undoubtedly injected a shot of confidence into the market. For instance, microorganisms can decompose hard-to-absorb macromolecular active ingredients into smaller molecules, thereby increasing their absorption and utilization rates in the body. There are even reports that fermented Chinese medicines may not only have enhanced potency but also see toxic components broken down or modified by microorganisms, reducing side effects.

This sounds wonderful, doesn’t it? Coupled with consumers’ inherent trust in food & medicine homology, businesses naturally see an opportunity. They hope to shed the low-end image of traditional processing and open up new growth points through this innovative approach. The logic chain seems very smooth.

However, when we cut through the marketing fog of "high-tech" and "all-natural," a startling fact may emerge: current practices in fermented medicine food homology are largely irregular, unscientific, and uncontrolled. It’s like a meticulously planned market carnival, behind which lurks an invisible crisis concerning the inheritance of TCM and consumer health. We cannot just see the surface prosperity; we must also be vigilant about the risks quietly brewing.

Why is fermentation like a Pandora's box? 

Because its essence is an extremely complex process of microbial metabolism. Do you think it's as simple as putting bacteria and herbs together? Too naive. In many current practices in the functional food sector, this process is more like an unpredictable Pandora's box. Once opened, it may release not only the expected beneficial components but also various safety risks. It's like opening an unknown box—you don't know what will come out, a pleasant surprise or a nasty shock? We must face this uncertainty.

The key to successful fermentation lies in the absolute dominance of advantageous microbial communities. That is, the beneficial bacteria we want must occupy an absolute advantage throughout the fermentation process to ensure the quality and efficacy of the product. But in real-world production, microbial contamination is an almost inescapable nightmare. Many manufacturers have loopholes in production environment and raw material processing, allowing hybrid bacterium to mix in. These uninvited hybrid bacterium not only compete with our target strains for nutrients but, more frighteningly, may produce toxins during fermentation.

You may have heard of cases where homemade fruit enzymes caused diarrhea—this is the simplest form of hybrid bacteria pollution. At the industrial production level, the consequences could be more severe. For example:

• Contamination by Clostridium botulinum can produce fatal botulinum toxin.

• Contamination by certain molds may produce aflatoxins and other potent carcinogens.

Chinese medicine fermentation is often promoted as modern alchemy, but the production process of many products may be more like a "hotchpotch." Think about it: temperature, humidity, time, strain ratio, herb batch—any slight fluctuation in these variables can lead to huge differences in the final product. This directly results in extremely unstable product quality, where efficacy can vary dramatically between batches.

Even more dangerously, the chemical reactions during fermentation are extremely complex. Besides the expected active ingredients, a large number of unknown, even harmful metabolites may be produced. For example:

• Improper fermentation may produce excessive nitrites, methanol, higher alcohols, and other harmful substances. 

• These harmful substances are often not detected in factory inspections or routine tests, leaving huge safety hazards for consumers.

In recent years, the most notable negative incident in the fermentation sector is the Japanese Kobayashi Pharmaceutical's "red yeast rice" incident. Red yeast rice itself is a typical product of rice fermented with Monascus purpureus. However, the products involved were found to be contaminated with Penicillium, producing the toxic compound "puberulic acid," which caused severe kidney damage in many consumers and even deaths. This incident serves as a wake-up call: fermentation can bring not only essence  but also toxins. This bloody lesson tells us that the control and safety assessment of the fermentation process must not be taken lightly.

Now, let's back to fermented medicine food homology

Introducing probiotics into fermented medicine food homology is often seen as an innovative powerful collaboration . After all, probiotics have undergone safety and metabolic assessments during approval, which sounds more reliable. However, this seemingly perfect combination faces profound scientific and safety challenges in reality. We must clearly recognize that probiotics are not a panacea. Blindly applying them to all fermented medicine food homology is not without risks. We need to deeply consider whether the mechanism of probiotics in fermentation is fully understood and whether they can truly deliver the expected effects as desired.

This hides a huge technical bottleneck and scientific misunderstanding. Not all probiotics are suitable for fermenting all herbs. The components of Chinese herbal medicines vary widely, and their interaction mechanisms with specific strains—what TCM calls compatibility relationships — are extremely complex. Current industry research on this is still very lacking. Using one strain to handle all herbs is like using one key to open all locks—the effect is predictable. This essentially reflects a lack of targeted directional fermentation thinking.

A deeper issue lies in the core of TCM theory: the "four natures and five flavors" and "monarch, minister, assistant, envoy" compatibility principles. The "cold, hot, warm, cool" nature, “sour, bitter, sweet, pungent, salty” flavor, and “meridian tropism” of an herb collectively determine its efficacy. Fermentation is a process that thoroughly alters chemical structures, inevitably changing the original nature and flavor of the herb. So the question arises: After fermentation, does a originally warm herb remain warm? Does a herb that originally entered the liver meridian still do so? How do the countless new components produced by fermentation align with the theory of TCM compatibility? These are fundamental questions that modern fermentation technology must answer but currently rarely does.

If we simply equate fermentation with efficacy enhancement while ignoring the fundamental changes to the herb’s nature, this is theoretical cutting the feet to fit the shoes. Ultimately, it may distort TCM beyond recognition, losing its soul for guiding clinical application.

• On one hand, the market flocking to this concept, with various products emerging endlessly.

• On the other hand, the theoretical foundation supporting TCM development is somewhat neglected or even challenged.

This disconnect between market demand and theoretical basis deserves deep thought. Are we pursuing speed and scale while ignoring quality and connotation? Could this be hollowing out the treasure trove of TCM from within? 

Specifically, there are indeed regulatory gray areas. For instance, while there is a clear list of approved food & medicine homology items, some manufacturers completely disregard approval requirements when developing products or lack sufficient safety assessment for fermented outcomes. At the national level, there is currently no unified and clear standard or quality testing system specifically for finished food & medicine homology fermented products. Most products on the market either adhere to beverage standards or simply establish their own enterprise standards. Beverage standards have relatively fewer restrictions, which provides opportunities for unscrupulous businesses to exploit. Additionally, the prevalence of contract manufacturing models has made quality control in the production chain incredibly fragile. Once issues arise, accountability becomes extremely difficult.

Many food companies pursue a "short, flat, fast" approach in product development. However, the complexity of fermented medicine food homology requires extended cycles for both process research and functional studies, which contradicts manufacturers' goals of rapid product launches. As a result, very few companies conduct these two types of research thoroughly. Yet, consumers are generally unaware of this. When they see terms like "food & medicine homology" and "probiotic fermentation," they assume the products are inherently functional and safe.

Businesses capitalize on this information asymmetry by using exquisite packaging and sensationalized marketing to position these products as tools for exploiting consumers' lack of knowledge. Over time, this trend risks eroding consumer trust in traditional Chinese medicine (TCM).

The purpose of discussing this topic is by no means to completely deny the value of fermented medicine food homology technology. On the contrary, I highly recognize its significant role and enormous potential in the modernization of TCM at this stage. However, the application of any technology must be grounded in rigorous scientific research and strict quality control. The current market chaos is largely driven by short-term interests. We must not sacrifice the 5,000-year foundation of TCM for immediate gains. TCM is already vulnerable enough—let us not allow the "fire" of fermentation to burn in the wrong direction and ultimately destroy the heritage of TCM. Instead, we must return to prudence and science, ensuring that the modernization of TCM proceeds steadily and sustainably.