Probiotics seem to be all the rage these days. With many purported benefits and a relatively low risk of side effects, manufacturers are taking advantage of booming business opportunities. Rather than leave your health in the hands of big business, it is important that you be as educated as possible about the best types of probiotics so you can choose what is right for you and your family. 

Certain brands, like Attune (attunefoods.com; available at Whole Foods), have pumped up the dessert by adding probiotics. (Attune boasts 6.1 billion CFUs, or "colony forming units," a measure of live, active microorganisms per serving. As a comparison, some probiotic supplements may contain 1 to 50+ billion CFUs.) Sounds crazy, but it's backed by science. One study in the International Journal of Food Microbiology found that probiotics added to chocolate were able to reach the GI tract where they could get to work colonizing the gut with healthy bacteria.

Probiotics are “friendly” bacteria that inhabit your body. Sound strange? These microscopic roommates can be your best buds if you show them a little love. One surefire way to do that is with probiotic supplements. Probiotics support the right ratio of good to bad bacteria in your gut. For bonus points, call on digestive enzymes. These unique blends offer specific nutritional support to assist digestion and nutrient absorption. Your healthy body will quickly appreciate these lifelong friends.
That’s why adding probiotics and prebiotics to your diet provide the best possible outcome from a bacterial perspective. It isn’t always easy to eat naturally prebiotic-enriched foods, however, because they are often distasteful to eat in quantity. Would you enjoy eating several cups of raw onion or garlic every day? Probably not. Other foods that contain prebiotic fiber, such as bread and bananas, are high in calories. Consuming hundreds of calories of these foods every day is counterproductive if you’re trying to lose weight.
My husband is battling lung cancer and Sarcoma and has a lot of gut issues such as nausea and vomiting which have caused him to lose a significant amount of weight. To help with the N/V a probiotic was recommend. I’d like to try him on the BlueBiotics Ultimate Care but am concerned that by doing so it will cause him to lose even more weight which he has no extra weight to spare. What are your thoughts on this?
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.

Do you strain with infrequent bowel movements? Do the feces look like separate hard lumps or like bunches of hard lumps stuck together, or are they pencil-thin? You may have constipation. The Bristol stool chart (BSC) was developed by two doctors as a way to differentiate between states of constipation, normal elimination, a state of lacking fiber, and states of inflammation. Stools are supposed to be long and sausage-like, with few or no cracks in the surface.
I’ve been taking a Jamieson Probiotic for weeks now for my IBS. I’m not really getting results. It has 10 billion cells and about 14 strains. I tried taking it every day but then I was crampy, bloated and almost constipated. A friend suggested taking every other day so I did that and it was just the opposite. I’ve been trying to eat a low fodmaps diet as well. Can you tell me how long its supposed to take to work and also if I should possibly try something else? This probiotic was inexpensive so I’m wondering if you get what you pay for.
Whether a brand of probiotics works really depends on its quality and your body's own gut. Everyone has a different set of gut flora so try several to see what works for you. Using a brand of at least 40 billion CFU is best. There seems to be some debate as to whether one should use refrigerated or unrefrigerated probiotics. I went with the side that claims unrefrigerated are sturdier and less prone to die off.
This Korean staple relies on lactic acid fermentation (also called lacto-fermentation) to turn cabbage or other vegetables into a spicy, pungent side dish that's packed with vitamin C. Order it at Korean restaurants or buy it in the refrigerated section of your grocery store (King's Kimchi is widely available at Walmart). For some guidance on making your own, turn to The Art of Fermentation ($23; amazon.com). Then, use it to spike veggie-laden rice bowls, top on soup, or serve alongside meat.
Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.
Animals, including humans, have microbes inside them that benefit them in multiple ways. These microbes are in a loose sense like probiotics, but the definition of probiotics was established to designate those microbes that have been isolated, studied, tested in a laboratory dish and/or clinically in animals and/ or humans, and proven to have beneficial properties. In many cases their genetic fingerprints were sequenced for identification purposes and also to check for potentially harmful genetic components. The official term “probiotics” established specific criteria for scientific studies and probiotic supplements, foods, and drinks.
Yet that’s how probiotics are often offered. They can be distributed in the United States as food, supplements or drugs. The regulations for each are very different. Most people looking for probiotics don’t see the distinctions. Ideally, the ways in which we use and consume probiotics would conform to the data and evidence that back them up. That rarely happens.
After suffering from liquid nighttime but painless diarrhea for over a year (which I semi-controlled with one Imodium/day), I had a colonoscopy that gave a diagnosis of microcolitis. After the colonoscopy, I developed for the first time excrutiatingly painful gas pain in the LLQ. Usually this pain started during aerobic activity such as walking, but not always. Sometimes I woke up with it. CT scan revealed nothing. Will a probiotic help and if so, which would be best? There are so many it is hard to choose.
Make sure to keep them away from moisture and heat which can kill off some of the microbes. I recommend taking on an empty stomach, ideally right when you wake up. You should always store supplements in a cool, dark place but refrigeration is best. Most of the strains of probiotics are fragile and should be protected from heat- so refrigeration is ideal. I recommend the probiotic Gut Instinct from HUM Nutrition for transparency and high quality.
Selecting a multi-strain probiotic is also consistent with the theory that filling your gut with enough good bacteria outcompetes any bad bacteria for the same space and resources. In your gut, the more diversified the good bacteria, the harder it is for the baddies to gain a foothold. With all this in mind, we only looked at supplements containing multiple strains of bacteria.
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Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "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," Eran Segal said in a statement. "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."
There are a lot of factors that play a role in how well probiotics survive before it actually hits your system. How long a store keeps the product in storage before selling it, the temperature at which you store the probiotic, the foods you eat the probiotic with, or the medications you take can affect the effectiveness of the probiotic. If you’re buying a product closer to its “Sell By” date, you might not reap the full benefits because that probiotic may not be as strong.
Do you strain with infrequent bowel movements? Do the feces look like separate hard lumps or like bunches of hard lumps stuck together, or are they pencil-thin? You may have constipation. The Bristol stool chart (BSC) was developed by two doctors as a way to differentiate between states of constipation, normal elimination, a state of lacking fiber, and states of inflammation. Stools are supposed to be long and sausage-like, with few or no cracks in the surface.
The side effects of antibiotic use are often not trivial. Many people experience discomfort and a change in bowel habits, but some experience more severe infections, such as opportunistic colonization of the gut with bacteria such as Clostridium difficile (C.diff), which affected half a million Americans in 2015 and was directly responsible for at least 15,000 deaths.
It seems like one minute you have diarrhea (D) and the next minute you are constipated (C). Abdominal pain, cramping, and bloating come and go. You are tired of running to the bathroom frequently, or spending a long time in the bathroom waiting for something to happen. Irritable bowel syndrome (IBS) is a diagnosis of exclusion. Infections and other causes of your IBS-C dominant or IBS-D dominant symptoms have to be ruled out, but in many cases the diagnosis of IBS doesn’t really provide answers. You may be on a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, which helps, but is restrictive.
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.
I currently have stage 1 breast cancer; history of pseudo inflammatory eye tumor, stroke, digestion issues, constipation, candida and toenail fungus. No one can tell me cause of inflammation throughout my body. Would BlueBiotics be my best choice? Does it have lactose? Tried about everything on market but need something that targets the above. Thank you.
I did the “milk test” on these New Rythm probiotics, along with Culturelle I had purchased in 2 different states (TX & MA, as I was traveling); my mother’s CVS brand acidophilus; and one “control” cup with milk only (so, 5 cups total in my experiment). The New Rythm became a solid yogurt consistency, while the other 4 remained liquids. I did the experiment twice, just to be sure of the results. I could not believe it!!! New Rhythm is my brand, hands down!!! I also would like to mention that my product usually arrives the day after it ships. So it will take a few days to ship when I select standard shipping, which is to be expected, but it doesn’t stay in transit long which is ideal for preserving the living cultures.
Unlike other probiotics on the market that are shelf stable, Garden of Life’s Raw Probiotics for Women are completely raw and alive at the time of delivery. In fact, these probiotics are so fresh that they are shipped in cold storage and delivery to keep all of those helpful cultures alive during transport and will need to be popped in your fridge immediately upon arrival.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.

When I polled friends and family about their personal experiences with probiotics, I got a real mixed bag of responses. Some called them a lifesaver and others felt no effects whatsoever. I put the anecdotes aside and talked to Ben Lebwohl, gastroenterologist and director of clinical research at Columbia University’s Celiac Disease Center, to get the straight poop on whether probiotics are miracle or myth.


"Many chronic health problems and inflammatory diseases are caused by a damaged microbiome where the good bacteria is overrun by the harmful bacteria and can't reinforce the gut walls, which results in increased intestinal permeability where bacteria and toxins leak through the intestines into the bloodstream triggering a system-wide immune response of inflammation that is a part of our body's natural healing cycle."
Afif Ghannoum said the key insight, one that he called groundbreaking, is that his father’s team found that fungi and microbes were cooperating in the construction of the plaques.  He said election microscope images show the filaments of the fungi being incorporated into the carbohydrate ‘armor’ that the bacteria start to secrete once enough individual cells have gathered at a certain location. Without the addition of the digestive enzyme to their product, he said that the plaques, once adhered to the intestinal wall, would be difficult to attack.
You also want to look at the guarantee fine print: If the CFU number is guaranteed at time of manufacturing, but not at the time of expiration, you could be taking a less potent dose of probiotics than you think because potency fades over time. I made this mistake when I was traveling once and went to the grocery store to pick up probiotics. On the bottle label it said guaranteed at 20 billion CFU at the time of manufacturing. This doesn’t tell you the CFU for when I was actually taking the probiotics. For instance, our probiotics are manufactured at 60 billion and 200 billion CFU, and guaranteed at 30 billion and 100 billion CFU, respectively, at time of expiration.
The second piece of research investigated whether patients should take probiotics to help the recovery of the natural gut bacteria after treatment with antibiotics. The evidence supporting this is not entirely clear and the FDA does not officially recommend it, but there are some reputable sources which discuss their use, such as this blog from Harvard Medical School. Research has suggested that up to 60% of healthcare professionals in the U.S. recommend taking probiotics, but is this justified and could it even be harmful?
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.

Inside your body bacterial and other microbial cells live in close contact with your own cells, and in healthy conditions the thing that separates them from you is a layer of mucus. Between that layer of mucus and the inside of you is a layer of skin-like cells one-cell thick. One thing you have to understand about your gastrointestinal (GI) tract is that although it resides within you, it is really connected to the outside world, from your lips to your anus, and the things that protect you from the outside world are the mucus; the skin-like layer of cells with immune, nervous, and endocrine cells below it; and the beneficial microbes. At least 70 percent of your immune system is in your GI tract! This is why taking probiotics benefits the immune system greatly.


If you've tried a probiotic after following these steps and it doesn't seem to be working for you (or you just want some extra guidance in choosing one), head to your doctor (or a dietitian) to get a recommendation. "Have a thorough discussion with your doctor to make sure you are taking the appropriate bacterial strain for the appropriate reason," advises Dr. Ivanina. "Then, follow up after taking the probiotic to make sure it is having the intended effect."
However, a 2003 pilot study and 2011 randomized, controlled trial both reported that RA activities remained unchanged, but the subjects treated with probiotics reported statistically significantly higher levels of “subjective well-being.” One suggested reason for this was that the trials were too short to establish changes in the observable changes in the internal earmarks of RA.
What are the gut microbiota and human microbiome? Microbes are commonly associated with disease, but there are millions inside the human body, and some provide distinct benefits. The microbiota and microbiome of the human body have been researched intensively in recent years. Find out about what we now know about them and what they mean for health. Read now
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Many everyday things can throw off your balance (stress, sex, pregnancy, aging, even medications! This product supports your feminine health and maintain a healthy pH so that you can own your day! It contains INTELLIFLORATM: a probiotic blend of four lactobacilli that are associated with vaginal health* (Lactobacillus crispatus LBV 88, Lactobacillus rhamnosus LBV 96, Lactobacillus jensenii LBV 116, and Lactobacillus gasseri LBV 150.)  The INTELLIFLORATM blend has been shown in clinical studies to help restore and maintain the healthy balance of the vaginal microbiota.*
That’s why adding probiotics and prebiotics to your diet provide the best possible outcome from a bacterial perspective. It isn’t always easy to eat naturally prebiotic-enriched foods, however, because they are often distasteful to eat in quantity. Would you enjoy eating several cups of raw onion or garlic every day? Probably not. Other foods that contain prebiotic fiber, such as bread and bananas, are high in calories. Consuming hundreds of calories of these foods every day is counterproductive if you’re trying to lose weight.
If you don’t have a specific health goal in mind and want to bolster the number of good bacteria floating around your system, Perlmutter recommends starting with a minimum of eight to 10 different bacterial species. He included a core five (L. Plantarum, L. Acidophilus, L. Brevis, B. Lactis, and B. Longum) and we added five more highly researched and universally beneficial strains for a general health pick. Vita Miracle, formerly Islands Miracle, has nine of those 10, plus 30 billion CFUs per serving.

Our body normally has what we would call good or helpful bacteria and bad or harmful bacteria. Maintaining the correct balance between these bacteria is necessary for optimal health. Age, genetics, and diet may influence the composition of the bacteria in the body (microbiota). An imbalance is called dysbiosis, and this has possible links to diseases of the intestinal tract, including ulcerative colitis, irritable bowel syndrome, celiac disease, and Crohn's disease, as well as more systemic diseases such as obesity and type 1 and type 2 diabetes. How do you know if you need probiotics? This article will help you decide.
The research also showed that while probiotics colonised the gastrointestinal tract of some people, the gut microbiome of others just expelled them. There was no way of telling from their stool sample which category people fell into. “Some people accept probiotics in their gut, while others just pass them from one end to the other,” says Elinav. They found that the probiotic colonisation patterns were highly dependent on the individual. That tells us that the concept that everyone can benefit from a universal probiotic bought from the supermarket is empirically wrong, he says.
The second piece of research investigated whether patients should take probiotics to help the recovery of the natural gut bacteria after treatment with antibiotics. The evidence supporting this is not entirely clear and the FDA does not officially recommend it, but there are some reputable sources which discuss their use, such as this blog from Harvard Medical School. Research has suggested that up to 60% of healthcare professionals in the U.S. recommend taking probiotics, but is this justified and could it even be harmful?
 Do you ever feel like your thinking is clouded, where it is hard to think, hard to focus, and hard to recall events that happened recently? You may have a case of brain fog. Brain fog is a group of neurocognitive symptoms that make a person feel groggy and not quite “with it.” There are many causes, such as lack of sleep, a hangover, fever and illness, neurotoxins such as MSG, chronic inflammation, infections, autoimmune disease, heavy metals toxicity, consumption of reactive foods, vitamin deficiencies, blood sugar fluctuations, hormonal fluctuations, and bacterial by-products. The end result is neuroinflammation, which causes the clouded thinking.
Large bodies of evidence suggest that probiotics are effective against several forms of diarrhea, including antibiotic-associated diarrhea, acute diarrhea, traveler’s diarrhea, infectious diarrhea and other associated diarrhea symptoms. They also help with constipation relief. Probiotics have also been found in meta-analyses to reduce the pain and severity of irritable bowel syndrome (IBS) symptoms, aid in the eradication of H. pylori and treat pouchitis, a condition that occurs after the surgical removal of the large intestine and rectum.
Yeast Infections and Bacterial Vaginosis (BV) – If you’ve ever experienced the discomfort of a yeast infection or BV, then you are probably aware that an overgrowth of bacteria causes these unfortunate episodes. While your reproductive system is supposed to foster a healthy environment for yeast, sometimes these levels can increase causing the pain and discomfort of a yeast infection or bacterial infection. By taking a probiotic that contains prebiotics and feminine health probiotics, you can treat and prevent recurrent symptoms!
There are both probiotics and prebiotics in fermented foods. I differ from a lot of doctors in that I recommend that patients with infections like Candida and SIBO don’t eat prebiotics until they’ve cleared up the infection—because the prebiotics can feed those infections, too. I find that it’s better to get rid of those infections first, and then add in prebiotics to your diet after. [See here for more from Dr. Myers on treating yeast infections.]
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.
They can break down substances in foods that keep you from absorbing the micronutrients inside. They not only protect against the consequences of rogue molecules passing through a leaky gut, but they assist your intestinal cells in staying healthy to optimize nutrient absorption. In addition, some of the metabolic by-products of probiotics, such as short-chain fatty acids and vitamin production, are very nourishing to your GI tract.
Probiotics are found in everything from chocolate and pickles to hand lotion and baby formula, and millions of people buy probiotic supplements to boost digestive health. But new research suggests they might not be as effective as we think. Through a series of experiments looking inside the human gut, researchers show that many people's digestive tracts prevent standard probiotics from successfully colonizing them. Furthermore, taking probiotics to counterbalance antibiotics could delay the return of normal gut bacteria and gut gene expression to their naïve state. The research publishes as two back-to-back papers on September 6 in the journal Cell.

What's more, there's still a lot more to learn about the microbiome and probiotics, in general. "Truth be told, the research area of probiotics and health is still pretty much in its infancy," says registered dietitian Kate Scarlata. Research is growing in the area of gut microbiome daily—but it is much more complicated than first thought." With all these options and major gaps in the available information, where are you supposed to start? Here, gut experts narrow it down to three simple tips for picking the right probiotic for you.


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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