In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
In a food sensitivity, the immune reaction is delayed, usually several hours to days after the exposure. Food sensitivities are the most difficult to determine since there is not an immediate reaction. These kinds of issues with foods can cause a wide range of physical and mental problems. An elimination diet followed by reintroduction is one of the best ways to determine a food sensitivity.
Jo A. Panyko is a Master Nutrition Therapist and author of two books about probiotics. She is a professional member of the National Association of Nutrition Professionals (NANP) and works as a functional medicine nutrition therapist (nutritionist) at her company, Chrysalis Nutrition and Health. She writes about how to be healthy with probiotics on her website, powerofprobiotics.com.
More than 80 years later, probiotics have become wildly popular and incredibly profitable. A 2012 survey by the National Institutes of Health showed that 3.9 million Americans stated they had used some form of probiotics or prebiotics (a type of dietary fiber thought to feed the friendly bacteria in your gut) in the last 30 days—3 million more people than in the previous study in 2007. Probiotics are now available for consumption in almost every imaginable form—pills, tablets, yogurts, juices, cereals, and energy bars. They have been touted as having benefits not only for digestive health, but also mood disorders, cancer, cold and flu prevention, and reproductive health issues.
D-Mannose can be naturally found in citric fruits like cranberries and has been found to be extremely beneficial in the prevention and relief of urinary tract infections. However, unless you are growing your own cranberries or spending hours in the kitchen measuring out portions, it can be extremely difficult (if not impossible!) to know how much D-Mannose you are ingesting by eating alone. That’s why HyperBiotics cut out the middle man and includes the D-Mannose compound directly in its probiotic blend. 

The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
Because there's a huge variety of probiotic products available on the market, many people struggle to find the right one for them. "There are many different strains of bacteria in different combinations within different probiotic supplements," explains Brooke Scheller, a clinical and functional nutritionist. "For example, a probiotic may contain a single strain of bacteria or many. It may also contain other vitamins, minerals, or other ingredients that may tout health benefits," she says. There are many different dosages, delivery systems (powder, tablets, capsules), and formulations (refrigerated vs. shelf-stable), and some probiotics also contain prebiotics, which basically act as fertilizer for the probiotics. (Related: Why Your Probiotic Needs a Prebiotic Partner)
There are two main types of probiotics; the first is the live cultures I describe above, like the strains of Lactobacillus and Bifidobacterium. You might have heard some naysaying about this kind of probiotic—the typical argument against them is that the classic form of live cultures is destroyed by the acidic environment in the stomach. To get around this, quality probiotics are made with an acid-resistant capsule so that they don’t get immediately broken down. (Which means you don’t have to take the probiotics with food, although I normally do. I’ll sometimes break the capsule and mix it into a smoothie, or use the powder form. You might lose a bit of potency but it’s not significant.)
Additionally, it's a good idea to take note of the number of colony-forming units (CFUs) that are in the supplement you're considering, Angelone says. CFU count tells you the number of viable, active bacteria present in a tablet, she explains, and one billion (yes, seriously) is a typical dose. However, if you're struggling with a specific health condition, you may need more than that, Warren says. Your doctor can help you decide whether that's the case and may be able to steer you toward a good supplement to get you started. Here are a few to consider if you decide that probiotics are right for you.
If you've ever been to an Indian restaurant, then you've probably seen a lassi—a smoothie made of milk, yogurt, fruit, honey, and cardamom. The drink goes well with spicy Indian food because it helps extinguish the fiery feeling in your mouth. If you want to try it at home, you can pick up bottles from brands like Dahlicious, which contain 15 billion live probiotics per serving and are available in flavors like mango and turmeric. Or, try this mango lassi recipe. 

Keep in mind that when supplements contain a specific number of organisms, this number may not be what is actually within each capsule at the time of purchase. Probiotics are living organisms and can die out easily. Especially if that supplement sits on your drugstore or warehouse shelf for months or longer, the number of organisms you get may be far less than what the bottle claims. Hardier strains have a longer shelf life. Capsule strength decays faster if the probiotic has been sitting around at elevated temperatures during transport to the store. Companies actually have to produce probiotics with a much higher CFU (colony-forming units; see below) count in each capsule in order to guarantee the label potency by the expiration date.
If you’re giving probiotics to a baby under two years old, you want to look for specific strains, though, that are better suited to such young microbiomes. For babies, these are the strains of Lactobacillus to look for: rhamnosus, casei, paralisei, gasseri, salvarius. And for Bifidobacterium: infantis, bifidum, longum, breve, lactis. If you’re breastfeeding, you can put probiotics on your breast, or you can heat up formula and put probiotics in it, or wet your finger and dip it in the probiotics powder and let your baby suck on your finger.
Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
Some of their benefits are universal, no matter your age or gender: supporting gut health, healthy skin, weight management, and strong teeth. But gender-specific probiotic benefits also exist. For instance, women who take probiotic supplements may be more likely to maintain vaginal and breast health, and expecting mothers who take probiotics can get support with some of the less pleasant side effects of pregnancy.
D-Mannose can be naturally found in citric fruits like cranberries and has been found to be extremely beneficial in the prevention and relief of urinary tract infections. However, unless you are growing your own cranberries or spending hours in the kitchen measuring out portions, it can be extremely difficult (if not impossible!) to know how much D-Mannose you are ingesting by eating alone. That’s why HyperBiotics cut out the middle man and includes the D-Mannose compound directly in its probiotic blend.
About 60 to 80 percent of our immune system lives in our gut. Imbalances in the gut’s microbiome (which is primarily made up of bacteria) lead to digestive issues, while many many other potential effects can be felt throughout the body—from feelings of fatigue to depression, thyroid dysfunction, autoimmunity, and a host of skin issues. Conditions like rosacea, psoriasis, eczema, and acne are really inflammatory conditions, and often a manifestation of something that is happening deeper within the body. When you fix the gut (which, depending on your health, might include getting rid of an infection like Candida, eating a clean diet, and taking a probiotic), skin issues often resolve as well.
Directions Take 2 Vegetarian Capsules with or without food. As a dietary supplement, take two (2) capsules once daily. For best results, take one (1) capsule during the day and one (1) capsules in the evening. Repeat the process daily. Do not exceed two capsules per day. As a dietary supplement, take one (1) veggie probiotic capsule once daily. Because our probiotic uses delayed release capsules, do not chew or crush. Our capsules help ensure the active probiotic strains reach your intestinal tract. Adults take 1 capsule daily. May be taken with or without food. Capsules can be opened. Contents can be taken directly with water or juice. Not intended for children.
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.
Supplements: dietary probiotic supplements -- which are available in capsules, tablets, powders and liquid extracts -- each contain a specific type of probiotic. These products are available at health food and natural food stores, vitamin shops, and other stores. As an example, one commonly used supplement is acidophilus, which is available from several supplement manufacturers.
“Microbiome” refers to the trillions of bacteria and microorganisms that live on and in our individual bodies. “There’s increased recognition of the various ways that the microbiome affects our health,” Lebwohl tells me. “And with that recognition comes the true observation that many bacteria are good for us. This goes against the old idea that bacteria equal germs, which equal harm. It turns out that many bacteria keep us healthy and probiotics could potentially support that notion.”
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
The second type of probiotics are soil-based organisms (SBO), which tend to be more resistant to acid in the gut. Here’s the thinking behind soil-based probiotics: Many people (particularly in the paleo community) believe that widespread gut and health issues today are the result of life in a too-clean society. In the past, when more people worked in the dirt, played in the dirt, there was less obsessing over cleanliness and antibacterial products, we got more natural exposure to probiotics. The benefit of soil-based probiotics is that they come from the earth, and the bacteria (which are still living) have their own natural, protective capsule surrounding them. I recommend soil-based probiotics to patients with autoimmunity, in addition to the classic form. They are particularly helpful for people with SIBO (small intestinal bacterial overgrowth)—with SIBO, you also have an overgrowth of good bacteria; and in this case, the classic form of probiotic is not what you need to fight the infection.

A 2017 survey of cancer patients showed that more than 80 percent were taking some sort of dietary supplement, vitamin, mineral, or herb to treat digestive issues they were experiencing due to chemotherapy. Researchers noted that while supplements can be beneficial in some cases, they can also change the metabolism of anti-cancer drugs, or lead to life-threatening conditions like sepsis because of the patient’s compromised immune system.
Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
Probiotics are officially defined by the Joint Food and Agricultural Organization of the United Nations/World Health Organization Working Group as “Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Basically, probiotics at this point in time are live bacteria and yeasts that provide health benefits to you if you take them in adequate quantities.

Prebiotic fibers are the non-digestible parts of food that are typically found in fruits, vegetables, and legumes. These fibers act as food for the healthy bacteria in your gut, and are an essential part of the digestive process. That’s why the Vitamin Bounty Women’s Pro-Daily Probiotic contains prebiotics and probiotics for a truly complete formula that helps ease digestive issues while also maintaining proper feminine health.
The U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.

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Hi Joan, it’s possible, but not ideal because most pill form probiotic supplements are designed to be protected from stomach acid until the capsule reaches the intestines. It’s impossible to say how many probiotic microorganisms would survive by taking them this way, but certainly less than if you swallow the pills. I would recommend trying a probiotic gummy product or some other probiotic that comes in something other than pill form rather than opening up the capsules.
Though rates of serious lung issues have been dropping among men in the Western world, they're still a major concern, with over three million men affected by ongoing respiratory conditions.1 While steroids and antibiotics are the go-to treatments for these conditions, they often fail to address the underlying issue, and they destroy bacteria indiscriminately, creating conditions in which undesirable bacteria can thrive.

Nevertheless, the presence of certain bacteria in the lower gut benefits overall health, not only digestion. The science on the role of the lower gut is changing every day and has advanced significantly — even over the past 10 years. Research strongly suggests that a favorable bacterial balance in the lower gut positively affects the factors influencing heart disease, immunity, bone strength, depression, and obesity and weight loss. Science has only just begun to determine the roles that bacteria play in human health, but it seems clear that healthier people have healthier bacterial balances. People with poorly balanced bacteria levels are more likely to suffer serious health problems.
If your child has a history of stomach problems that medicine doesn’t seem to help, adding a probiotic to his or her diet can help. We love the OLLY Kids Happy Tummy Gummy Supplements because they offer complete probiotic support in a kid-friendly gummy form. Each gummy has a blend of prebiotic, probiotic, and peppermint to help soothe upset stomachs. They contain 500 million CFU of Bacillus coagulans. This container comes with 30 gummies (to be taken once a day) and is recommended for children 2 years and older.
Niv Zmora, Gili Zilberman-Schapira, Jotham Suez, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Eran Kotler, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Yotam Cohen, Raquel Linevsky, Daphna Rothschild, Andreas E. Moor, Shani Ben-Moshe, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Hagit Shapiro, Meirav Pevsner-Fischer, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features. Cell, 2018; 174 (6): 1388 DOI: 10.1016/j.cell.2018.08.041
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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