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.

Billed as the most effective probiotic currently available on the market, Pro-25 combines 13 of the most powerful probiotic strains to deliver the most robust and well-rounded overall digestive health. Delayed-release capsules also protect live organisms from your stomach acid, delivering the right strains to the right location in your digestive system, ensuring maximum efficacy and benefits.
Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
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.
It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.
In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
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.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression. 

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.
Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
This dairy-free, gluten-free, vegetarian probiotic delivers live microorganisms, protected in stomach acid-resistant capsules to ensure effective delivery throughout your digestive system, from the stomach through your small intestines. The result is the repair and sustained maintenance of your intestinal micro-ecology, which in turn helps support healthy immune response and bowel regularity.

According to a 2014 meta-analysis, probiotics benefit diabetics by improving insulin sensitivity and decreasing the autoimmune response found in diabetes. The authors suggest that the results were significant enough to conduct large, randomized, controlled trials (the “gold standard” of scientific studies) to find if probiotics may actually be used to prevent or manage diabetes symptoms. Combining probiotics with prebiotics may also help manage blood sugar, particularly when blood sugar levels are already elevated. (87)
Cleaning up your diet to remove things that bother you and to add nutrients you and your microbiota need, physical activity to reduce stress and increase feel-good neurotransmitters, mindfulness to discover how your thoughts affect your feelings, and daily consumption of probiotic pills and foods are easy ways to improve your mental health outlook.
The label should also specify that the living microbes are viable through end of shelf life or best by date rather than at time of manufacture to ensure the bacteria are still live when you take them and able to reach your colon. Quality trumps everything- supplements that are a bargain are typically not of quality. A good probiotic (depending on strands) can cost anywhere from $25-$60.
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.

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.
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.]
Immunity and colds/flu.There’s a close connection between the bacteria in your colon and the immune system. Several studies, including one in 2012 in the British Journal of Nutrition, have found that certain probiotic strains boost measures of immune response—but whether this translates into any clinical benefits is uncertain. Studies have been inconsistent, for example, as to whether probiotics will actually curb colds and other upper respiratory infections. In 2014 a review in the British Journal of Nutrition, which looked at 20 clinical trials, linked probiotics to shorter duration of colds, but not necessarily reduced incidence or severity. Similarly, a 2015 Cochrane review of 12 clinical trials concluded that certain probiotics may help prevent or shorten such infections, though the quality of the studies was poor.
Bacteria in your digestive tract can be good or bad, according to the website Best Probiotic. It quotes the Royal Academy of Medicine England as blaming an imbalance between good and bad bacteria for causing 80 percent of all degenerative diseases. Probiotic supplements with "good" bacteria have become increasingly popular. They can aid the immune system, digestion and vitamin absorption, as well as prevent diarrhea and irritable bowel syndrome. The website Women to Women recommends probiotics that combine saccharomyces, lactobacillus acidophilus and bifidobacteria in the billions. MayoClinic.com also recommends lactobacillus and advises looking for products that contain live, active cultures. You should always check with your doctor before adding any supplements to your diet.
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.
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.
Digestive Advantage is one of the better probiotics available today. With 2 billion live cells in each capsule, it makes for a good daily probiotic for digestive and immune health. This probiotic claims that it can survive in your digestive system up to 10x better than yogurt. If this fact holds true, taking a supplement like this is much quicker and possibly more efficient than eating spoonfuls of yogurt everyday!  Overall, Digestive Advantage succeeds in being a great probiotic that’s a great value and can be taken every day!  Read the full review here… or click here to go buy it now!
"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 said in a statement. "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." Segal added, "This opens the door to diagnostics that would take us from an empiric universal consumption of probiotics, which appears useless in many cases, to one that is tailored to the individual and can be prescribed to different individuals based on their baseline features."
Fizzy, tangy, and even slightly vinegar-esque, kombucha has a cult following for a reason. The tea gets its natural carbonation from the "scoby" (that float-y thing you see in some bottled varieties), which is actually the bacteria and yeast that ferment the drink and creates the probiotics. "There's not much scientific evidence specifically on the benefits of kombucha, but it is another strategy to introduce more live, active bacteria into your lifestyle," says Palmer. Many are made with fruit juice for added flavor, so read the label to see what you're getting, she advises. Stick to store-bought kombucha; it's tough to keep the tea sanitary when you make it yourself, and homebrewed kombucha been linked to nausea and even toxicity. Also note that due to the fermentation process, kombucha contains trace amounts of alcohol, so it's best to stick to one 12-ounce bottle a day.
One review of probiotics benefits for necrotizing enterocolitis was bold enough to say, “The results confirm the significant benefits of probiotic supplements in reducing death and disease in preterm neonates. The … evidence indicate that additional placebo-controlled trials are unnecessary if a suitable probiotic product is available.” Regarding sepsis in developing countries (where it is overwhelmingly more common), a 2017 randomized, controlled trial claims that a large number of these cases “could be effectively prevented” if mothers are given a synbiotic (probiotic and prebiotic together) that contains the probiotic strain L. plantarum.

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.
"The proprietary formula in this lotion supports a healthy microbiome of your skin promoting a more hydrated, stronger barrier function and protection from pathogens without harming the good stuff. Throw away your antibacterial soap and hand sanitizer and use this all over after your shower and after washing your hands," says Astarita, who is also a fan of the Nerium Prolistic Powder Pre & Probiotic Plus Vitamins ($45) and Be Well Probiotic Powder ($46) by Dr. Frank Lipman.

Yes, they may help. Lebwohl says there are reputable studies that show a link between the use of probiotics and the reduction in IBS symptoms, citing this meta-analysis. It's estimated that 11 percent of the world population complains of symptoms like abdominal cramps, diarrhea, constipation, excessive gas and/or mucus in their stools. While for some the condition can be attributed to certain dietary triggers, others appear to be stress-related, which brings us to the heart of where many claims about the effectiveness of probiotics lie—in the gut-brain axis.
Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another. For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.
This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.
As of now, the most comprehensive meta-study (a study of different studies) has not been able to decisively identify any particular strain of bacteria that is specifically useful to treat seasonal allergies. Some studies contradict each other on which bacteria can treat grass pollen, and other studies will find that those strains the first two studies examined weren’t nearly as effective in their own trials.
It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.
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.
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.
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.
Pinning down the exact causes of IBS is difficult because each person has his or her own combination of causes. One cause that is receiving much attention is that of a disrupted microbiome, as there is a strong association between having a gastrointestinal (GI) infection, like food poisoning, and the onset of IBS. Also, the FODMAP diet, and nonabsorbable antibiotics to kill gut microbiota, have provided relief in many patients, further supporting the suspicion of a disrupted microbiome as contributing to IBS.
As you progress with increasing dosages of probiotics internally, you may experience increased abdominal gas, upset digestion with diarrhea, headache, fever, muscle pain, brain fog, and/or anxiety. If the symptoms become too uncomfortable, decrease the dosage for a few days and try again. These symptoms are your body’s way of telling you that things—such as a die-off of pathogens or an awakened intestinal reflex—are changing.
There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.
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.

That doesn't mean that all probiotics, or probiotic-containing foods are created equal. So what should you look for? "There is a lot of 'noise' in this space as more and more 'food products' are coming out with Probiotics," Dr. Shekhar K. Challa, a gastroenterologist and the author of Probiotics For Dummies tells The Huffington Post. "Unfortunately it is impossible to quantitate the CFU's of probiotics in most food products."


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.
If this happens, it's time to consider switching to a new probiotic. Other reasons a probiotic may not be the right fit: SIBO or Candida. If you have either of these conditions, the strain of the probiotic could potentially make your symptoms worse. Remember, if you think a probiotic is not helping, seek the advice of a functional medicine provider to help you navigate the choices out there.
Once the GI microbiome is disrupted, and especially if an infection is treated with antibiotics, it can take time for the resident microbiota to recover, if it ever does. A disrupted gut microbiome sets the stage for altered motility, intestinal hypersensitivity, gut immune activation, leaky gut, altered bile, mental disorders, and a host of other factors that can play a role in IBS. Good probiotics, along with a proper diet, can help the GI tract get the microbes it needs to function normally.

While taking a daily probiotic supplement may seem like an easy answer to cure common gut ailments, it’s always best to try for a food first approach, since you can get probiotics from the foods you eat. Probiotics can be found in foods such as yogurt, cheese, miso, sauerkraut, and kimchi. But, adding a supplement into the mix if you haven’t achieved the desired effect through diet alone can be effective.

"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."
Oral health. An increasing number of probiotic lozenges and gums are promoted for oral health—to reduce periodontal disease, throat infections, and bad breath, for example. There’s preliminary evidence that certain strains may have some benefits, but commercial products may not have the same strains and formulations as those tested in published studies.
This high-potency (25 billion CFU) supplement blends 12 different strains in a base of inulin. The Ther-Biotic Complete capsules are vegetarian (made from hydroxypropyl methylcellulose, water) and the formula is free of common allergens, such as milk, eggs, fish, tree nuts, peanuts, wheat, gluten, and soy so it’s perfect for those with allergies. There are 60 capsules per bottle.
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.
Deep Immune Support Probiotics started with a simple premise: Most probiotic strains present on the market today cannot survive the acidic environment of the human digestive system. Additionally, most of the most powerful probiotics require refrigeration, meaning they won’t survive standard delivery services or even room temperatures during your commute or travel.
To boost the immune system, B. Lactis is a promising choice. One study had participants taking either a probiotic or a placebo for 6 weeks. At the end of the period, researchers measured antibody levels and found greater increases in antibodies of the B. Lactis group than in placebo participants, concluding that this probiotic may help improve immune function [1]. In addition, a 2009 study found that supplementation of the strain B. Lactis DN-173 led to self-reported improvements in digestive comfort [2].

Renew Life Ultimate Flora offers 30 billion CFUs with 10 scientifically studied strains of Bifidobacterium and Lactobacillus, which according to current scientific research, are the two most prevalent good bacteria found in a healthy gut. In other words, you might choose these if you’re seeking a careful balance designed to re-establish proper immune health and digestive equilibrium.

However, it is not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. Bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. Acidophilus and B. Bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].
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.)
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.
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!

The gut microbiota has been implicated in diseases ranging from obesity to Parkinson's disease and depression. Little wonder then that commercial probiotics have gained widespread popularity and are now estimated to command a US$37 billion market worldwide. But with research into the microbiome still in its infancy, increasing evidence suggests that both commercial and clinical use of probiotics is outpacing the science.
In October 2013, the International Scientific Association for Probiotics and Prebiotics (ISAPP) organized a meeting of clinical and scientific experts on probiotics (with specialties in gastroenterology, pediatrics, family medicine, gut microbiota, microbiology of probiotic bacteria, microbial genetics, immunology, and food science) to reexamine the concept of probiotics. They define probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They also differentiated between products containing probiotics and those containing live or active cultures and established the following criteria:

Most bacteria are included through the fermentation process. Fermentation helps extend the shelf life of perishable foods. It is a slow decomposition process of organic substances induced by microorganisms or enzymes that essentially convert carbohydrates to alcohols or organic acids. The lactic acid supplies the bacteria that then add the health benefits to the food. You can purchase foods that are fermented or ferment them yourself.
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label. 

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.
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