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.
More and more evidence shows that the gut microbiota may play an important role in the development of obesity, obesity-associated inflammation and insulin resistance. Obesity and Type 2 diabetes are associated with changes in gut microbiota. Several studies describe differences between the microbiota of lean individuals and those who are obese. The potential for using probiotics in weight management and obesity and diabetes prevention is exciting.

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.


An imbalance between good bacteria and pathogenic bacteria, yeasts or fungi, or a change in the bacteria species that colonize the digestive tract is called dysbiosis. It can have short and long-term effects on our body functions. These disruptions can reduce the immune system’s effectiveness, create unpleasant digestive symptoms (diarrhea, constipation, gas, etc.), be a contributor to certain chronic illnesses like obesity, and participate in producing pro-inflammatory metabolites.
Like some of the other probiotics we’ve reviewed, the HyperBiotics PRO-Women Probiotics with Cranberry Extract and D-Mannose do not need to be refrigerated in between uses. What sets this particular formula apart though is its longer shelf life made possible by the patented HyperBiotics ‘LiveBac’ manufacturing process. In fact, the HyperBiotics PRO-Women Probiotics formula can usually last for more than a year when stored in normal indoor conditions!
Since feminine health is all about balance, it only makes sense that vH’s formula would also contain a healthy dose of probiotic cultures. These live bacteria work with the prebiotic formula and pre-existing bacteria in your system to create a thriving environment for your feminine health. These probiotics are particularly helpful at promoting vaginal and urinary tract health.
The Number of CFUs The quality of a probiotic supplement has more to do with strains and how many CFUs it provides. (CFU stands for colony forming units, and it refers to the amount of live microorganisms in your supplement.) Although recommendations may vary, Gans says to look for probiotics with at least 1 billion CFUs: “Doses will typically range from 1 billion to 10 billion CFUs for adults; although doses for children are often under 1 billion.”

This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.

Russian microbiologist Elie Metchnikoff (1845-1916) was the first to associate the large amounts of fermented dairy products with the good health and longevity of Bulgarians back in 1907. He proposed that the acid-producing organisms in fermented dairy products could prevent what he called "fouling" in the large intestine. He believed if eaten regularly, these foods could lead to a longer, healthier life. One version of the Old Testament even attributes Abraham's long life — 175 years — to the "consumption of sour milk." Fermented milk products may have also been used to treat illnesses of the digestive tract during Roman times.


In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.
4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.

Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a "folk" remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn't enough evidence yet to recommend it over conventional approaches. (Vaginosis must be treated because it creates a risk for pregnancy-related complications and pelvic inflammatory disease.) Probiotic treatment of urinary tract infections is under study.
In these cases, IBS is essentially just TMI. “For the colon to be functioning properly, it needs to be contracting and relaxing in a way that is conducive to regular bowel movements that occur at predictable times and don’t occur too frequently or too rarely," Lebwohl says. "And the bowel needs to be giving infrequent feedback to the brain. People should not be getting updates from their bowel in terms of cramps or the feeling of having to have a bowel movement too often. Yet, people with IBS get very frequent unsolicited ‘progress reports’ from the bowel.”

The authors discuss the need for “pscyhobiotics” (probiotics that impact brain function) in handling the development of these conditions. This anti-inflammatory quality is what seems to interest researchers most. While no studies have been conducted in humans, early research suggests that, in animals, probiotic supplements may help alleviate symptoms of anxiety by reducing inflammation along this gut-brain connection.

"This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement," study co-senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel, said in a statement. However, it may be possible to tailor probiotic treatments to the individual, based on the types of microbes already in his or her gut, as well as other factors, so that he or she gets the most benefit from probiotics, the researchers said.


“​You have all sorts of microbiomes in your body, in the lungs, the oral cavity, the vagina and of course the gut. Everybody was looking at the microbiome as just being about just good bacteria,​”​Afif Ghannoum said.  The elder Ghannoum, who is associated with Case Western Reserve University in Cleveland, OH, showed the importance of the fungal components of those microbiomes, he said.
Although most studies have shown few, if any, negative side effects, it is important to keep in mind that research on probiotics is still in a preliminary phase. There may be some risk for people who have certain health conditions. As with any supplement, it is essential that before you begin to take a probiotic supplement, that you speak with your physician first to help to ensure that you will not be putting your health at risk.

Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way. However, the researchers were surprised to find that this prevented the return of the person’s normal microbiome for up to six months. “The probiotics very potently and persistently prevented the original microbiome returning to its original situation,” says Elinav. “This was very surprising and alarming to us. This adverse effect has not been described to date.”


B. Bifidum has also been shown to prevent intestinal pathogens or digestive disrupters from flourishing in the gut, essential in restoring the bacterial balance and optimizing digestion. Clinical research found it supports a significant reduction in IBS symptoms, an improvement in quality of life and even helps relieve occurrences of ulcerative colitis – a chronic inflammatory bowel disease. [1].
Overall, Enzymatic Therapy Acidophilus Pearls are a great daily probiotic supplement. They give you a ton of flexibility and is convenient since it doesn’t need to be refrigerated and can be taken with or without food! This probiotic makes on-the-go belly support a breeze. All in all, Enzymatic Therapy Acidophilus Pearls finally make it easy to travel with probiotics, are simple to take, and can give you the piece of mind that the money you’re spending on probiotics isn’t being wasted at the first sign of stomach acid.  Read the full review here… or click here to go buy it now!
Add in a naturally derived prebiotic, which feeds probiotics to boost both potency and effectiveness, and you have a slow-release capsule that delivers beneficial bacteria exactly where it’s needed. What’s more, Hyperbiotics Pro-15 has a long shelf life (18 months from the date of manufacture) and requires no refrigeration, which makes it as portable as it is tiny. This product is made in the USA, an NSF- and GMP-certified facility.
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
Like other top probiotics available today, LEAN’s 50-Billion Probiotic is packaged in a handy, delayed-release capsule, designed to protect non-acid-resistant bacteria until they reach deep into your GI tract, where they’re most needed. The result is maximum effectiveness – better gut health, an immune boost, and relief of common digestive problems.
We’ll start with the headliner: the BIO-tract peral, which packs the equivalent of 75 billion CFUs into one tiny, filler-free, 5-billion CFUs pearl. The trick is in protecting those 5 billion CFUs over an 8 to 10-hour period, so they bypass your acidic stomach and reach your intestinal tract, alive and well, allowing you to experience the full and multitudinous benefits of plentiful and beneficial gut bacteria.
Historically, people had plenty of probiotics in their diets from eating fresh foods from good soil and by fermenting foods to keep them from spoiling. Over a century ago, the Russian Nobel Prize winner Elie Metchnikoff theorized that “health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt.” Metchnikoff was ahead of his time with his view of probiotics benefits, but he also was aware that most citizens had regular access to probiotic foods. 

Until recently, testing of probiotics by ConsumerLab.com found that some products had far lower amounts of live organisms than claimed on the labels. But in 2018, it found that 17 out of 18 products tested contained the amounts listed; none exceeded limits for heavy metal contaminants. In contrast, in 2016, a study in Pediatric Research found that only one out of 16 Bifidobacterium longum supplements tested contained the species named on the label.
Probiotics One Daily Support is easily one of our favorite probiotics right now and currently sits at #2 in our ranking of the best probiotics supplements.  There’s a number of reasons why I like it so much, but the main one is I just felt SO much better while taking it!  My stomach (which sometimes gives me issues due to IBS) felt great and I had a bit more energy than usual.  I was also able to digest all my meals without any problems, a major plus!  Further, Daily Support is very allergy-friendly, doesn’t require refrigeration and comes with a 60-day guarantee.  So all-in-all, we gave Probiotics One 5 out of 5 stars and truly think it’s a REALLY great probiotic.  Read the full review here… or click here to go buy it now!
​​​​​​Lactobacilli dominate a healthy vaginal microbiota. Menstrual cycles, sexual activity, diet, certain medications, hygiene, and other factors can occasionally disrupt the vaginal microbiome. AZO Feminine Balance Daily Probiotic has been clinically demonstrated to contribute to the colonization of these important lactobacilli in the vagina.* The result: restoring the natural balance of good bacteria and yeast to maintain vaginal health.*

As far as effectiveness, keep in mind that unlike medications, dietary supplements do NOT need to be approved by the FDA. This means that manufacturers can sell supplements simply with "claims" of safety and effectiveness. Currently, researchers are undecided if probiotic supplements are effective. Some say probiotics are effective; others believe they offer no benefit whatsoever. It also remains unclear which probiotics (or combination of probiotics) work to treat certain diseases. Despite these issues, some studies have shown positive results. Still, more research is needed to confirm that probiotics are safe and effective.
Scientists are investigating probiotics, and their combined effects, by trying to classify the probiotic benefits of ingesting specific probiotic strains and understanding their role in the digestive tract. At present, the methodological and ethical limitations of human studies still make it difficult to fully understand the mechanisms of action of probiotics, but some explanations are available. Nevertheless, benefits linked to the consumption of probiotic strains have already been suggested (e.g. helping to support the immune system, help support digestive health), and others are still being investigated.
If this ratio gets out of balance, the condition is known as dysbiosis, which means there’s an imbalance of too much of a certain type of fungus, yeast or bacteria that affects the body in a negative way. By consuming certain types of probiotics foods and dietary supplements (often in capsule form), you can help bring these ratios back into balance.

Made from fermented cabbage and other vegetables, sauerkraut is not diverse in probiotics but is high in organic acids (what gives food its sour taste) that support the growth of good bacteria. Sauerkraut is extremely popular in Germany today. It is high in vitamin C and digestive enzymes. It’s also a good source of natural lactic acid bacteria, such as lactobacillus.
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.

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

On my recent trip to Japan, one thing I noticed was the inclusion of pickled vegetables in almost every traditional Japanese meal. Unfortunately, many Americans don’t consume enough of these probiotic-rich foods and drinks. Even when they do, restoring equilibrium oftentimes requires therapeutic doses of these microorganisms, because most everyone has been on several rounds of antimicrobials. That’s where a probiotic supplement comes in.

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.
Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats. 

Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.


Nearly 75% of all women will have at least one yeast infection during their lifetime, and over 50% of women are likely to experience the inexplicable pain of a urinary tract infection as well. With the recurrence of urinary tract infections and yeast infections on the rise, women all around the world began searching for a more effective and natural solution to antibiotics.


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?

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

I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?
Of course, your gut microbiome can only do this when it’s healthy and in balance, which is where probiotics come in. Since so many factors can deplete your beneficial bacteria—including everything from exposure to antibiotics in food or medication to spending too much time inside—supplementing with a premium probiotic is almost always necessary to maintain balance.

“Highly recommend –There are quite a few probiotics manufactured specifically for women. Some are decent while others are not so good. For me, I require one on a daily basis to maintain my feminine health. When I try a new probiotic that is made specifically for women, it makes me a bit nervous because I will end up with yeast or bladder infection if it is not effective. With AZO, I am happy to report it is a great probiotic and highly recommend it to all women! It works great.” – Vicki


Prebiotics are fuel for the good bacteria (probiotics) in your gut; without prebiotics, probiotics can’t do their job. There are tons of prebiotics in whole fruits and vegetables, including onions, garlic, bananas, asparagus, and artichokes. If you’re worried you’re not getting five to 20 grams per day (more on prebiotic-rich foods here), consider taking a prebiotic supplement, usually a powder or drink mix.
Probiotics are very promising and used quite often in practice. Many physicians, including myself, use them regularly for many gastrointestinal issues and other issues like infant colic, preventing diarrhea in patients taking antibiotics and for overall immune and respiratory health. There is still a lot more research that needs to be conducted but it is clear that they are here to stay, and the research base is likely only going to lead to increased use in many other conditions in both preventing and treating diseases.
If you have an immune system problem or another serious health condition, you may have a greater chance of issues. Some reports have linked probiotics to serious infections and other side effects. The people most likely to have trouble are those with immune system problems, people who've had surgery, and others who are critically ill. Don't take probiotics if you have any of those issues.
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.

4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.
There’s hard science saying probiotics can help with certain kinds of diarrhea, but for other conditions, it’s a bit of a crapshoot (har har). Lebwohl says that one of the first things that needs to change for probiotics to go widespread legit in the medical community is their regulation. Since they’re currently marketed as dietary supplements, they’re not subjected to the same FDA standards that medications are. That means that not only have they not been proven to work, it also means there’s also no assurance that what’s on the labels of these products actually matches what’s inside the bottle.
"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."
The recent buzz has helped bring probiotics into the main stream.  Due to being covered on major news sites and television personalities, probiotic supplements are now more accessible than ever.  The main benefits of probiotics begin within the gut and digestive system.  The gut plays such an important role, that the level of healthy bacteria in our bodies can actually alter our mood.  It’s true!  What we eat actually affects how we feel.  This is why the gut has been called our “second brain”.

Caution needs to be taken by everyone who chooses to take these supplements, but this is especially true for children, pregnant women, elderly people, and people with compromised immune systems. For people with compromised immune systems due to disease or treatment for a disease (such as cancer chemotherapy), taking probiotics may actually increase one's chances of getting sick. It has been shown that the use of various probiotics for immunocompromised patients or patients with a leaky gut has resulted in infections and sepsis (infection of the bloodstream). One case of bacteremia (bacteria in the bloodstream) was recently found when someone with active severe inflammatory bowel diseases with mucosal disruption was given Lactobacillus GG. Always speak with a doctor before taking any supplement under these circumstances.

The other thing to remember is that these microorganisms are not all created equally. In fact, the genus, strain, and species all need to be the same for the results that found in the study to be the results that one hopes to achieve when taking it. For example, with the strain Lactobacillus rhamnosus GG, the genus is Lactobacillus, the species is rhamnosus, and the strain is GG. If any one of those is different in your supplement, you may not attain the same results.
"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.

The science on what probiotics do is still emerging. There is some hard evidence that suggests eating probiotic foods and supplements can have a beneficial effect on health. Other evidence suggests probiotics benefits are limited to those individuals in good health and should be avoided by those who suffer from certain serious health conditions. There is no research that demonstrates the risks or the benefits of probiotic supplements on children.
Following a healthy and active lifestyle and eating a balanced diet are the best ways to foster a bountiful gut flora. Taking care of your gut flora can help with things like irritable bowel syndrome and chronic constipation, among other things. Even if you’re not sold on pursuing probiotics for your allergies, they’re good to consider if you’re experiencing any gastrointestinal issues.
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