Most of the prebiotics identified are oligosaccharides. They are resistant to the human digestive enzymes that work on all other carbohydrates. This means that they pass through the upper GI system without being digested. They then get fermented in the lower colon and produce short-chain fatty acids that will then nourish the beneficial microbiota that live there. Oligosaccharides can be synthesized or obtained from natural sources. These sources include asparagus, artichoke, bamboo shoots, banana, barley, chicory, leeks, garlic, honey, lentils, milk, mustards, onion, rye, soybean, sugar beet, sugarcane juice, tomato, wheat, and yacón. The health benefits from these oligosaccharides is a topic of ongoing research.

There is one Voluntary Certification Program by which a supplement manufacturer can choose to be evaluated. ConsumerLab.com (CL) is the leading provider of independent test results and information to help consumers and health-care professionals identify the best quality health and nutrition products. Products that have passed their testing for identity, strength, purity, and disintegration can print the CL Seal of Approval on their product. This is one step toward being confident that one is getting the amount and type of probiotic promised by the manufacturer.
Even if you’re not sensitive to dairy, though, probiotics that require refrigeration can be inconvenient; but there are now some that don’t need to be kept cold. For example, our probiotics are sealed in nitrogen blister packs to protect them from heat, as well as moisture and oxygen because the air can’t get in. Look for probiotics that are individually packed to protect the live cultures. If they just come in a bottle they could be losing potency from air getting in.
Taking relatively high doses of these probiotic strains before, during, and after antibiotic treatment can help your microbiome get back on its feet: B. Lactis, B. Infantis, L. Acidophilus, L. Casei, L. Bulgaricus, L. Paracasei, L. Rhamnosus GG, and S. Boulardii. Our antibiotic combatant MegaFood MegaFlora has six of these strains, as well as eight others. One serving contains 20 billion CFUs to replenish the good bacteria.
Undaunted, researchers looked into whether probiotics might be beneficial in a host of disorders, even when the connection to gut health and the microbiome was tenuous. Reviews show that there is insufficient evidence to recommend their use to treat or prevent eczema, preterm labor, gestational diabetes, bacterial vaginosis, allergic diseases or urinary tract infections.
Candida yeast species, on the other hand, can cause numerous infections in and on you. Although they are usually present in controlled amounts, Candida overcomes your usual defenses and establishes itself when conditions are favorable, such as when you take antibiotics and many beneficial bacteria, which normally would control Candida, are killed. Unlike the Saccharomyces yeasts, which are not invasive, Candida species form hyphae, finger-like projections that penetrate tissues, causing deep infections that are difficult to eliminate. Candida is also able to weaken your immune defenses.
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," says Segal. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."

After further analyzing the data, the researchers found that they could predict whether the probiotics would take hold in people's guts by examining their microbiome and gene expression in the gut taken at the start of the study. However, this prediction method needs to be confirmed in future studies. The researchers called for further research to better understand why some people resist colonization by probiotics, as that future research may enable researchers to counteract the resistance.


If you suffer from a food allergy or intolerance, make sure to check those labels! Probiotics with these dietary features often say so right on the front of the bottle, but you will also want to take a quick peek at the ingredients list as well. A word to the wise: anyone with a food allergy should also check the manufacturer’s information to ensure that cross-contamination is not likely to have occurred on-site in the packaging facility.
In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects."
They probably are. Lebwohl says probiotics may decrease the risk of getting diarrhea during the course of taking antibiotics, and may also play a role in specifically preventing the development of the dreaded antibiotic-related super diarrhea called C. difficile or C. diff. Antibiotics can wipe out the good bacteria that keep you from getting sick if you’re exposed to C. diff, or if you already have it in your system. C. diff symptoms can range from a moderate watery diarrhea several times a day to severe infections, which can be accompanied by fever, bloody stools, rapid heart rate, and can even lead to kidney failure. 500,000 Americans were infected with C. diff in 2015 and 15,000 died from it.
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," says Segal. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
The best probiotic manufacturers will list their potency (in CFUs) at the time of expiration, ensuring you get the dosage you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times bestsellers "Brain Maker" and "Grain Brain" puts it this way: “Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf life.” Each of our top picks clearly shows a specific “best by” or “expires on” date on its bottle.

The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.


To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
Fermenting a cucumber into a pickle amps up a cuke's powers, infusing the crunchy veggie with probiotics. Like sauerkraut, not all pickles offer the good bacteria, though. Look for those made with brine (salt and water) rather than vinegar. These brands will list "live cultures" on the label (like Bubbies). You can also use water, salt, and spices to naturally culture pickles and other veggies—like beets, green beans, and carrots—at home with delicious results. One warning: remember that pickles are salty—one dill can easily offer up more than 10% of your sodium needs in a day.
We love that RAW offers proprietary blends for various needs, including specialty formulas for women and men. Both support the standard systems (immune, digestive, etc.), and the women’s probiotic tacks on extras, including L. reuteri and L. rhamnosus, to support vaginal health. The men’s blend adds L .fermentum, to boost immunity during exercise and other physical exertion.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric. 

To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
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