The current probiotic push lends itself to the question, "If humans got along fine without taking a probiotic supplement for thousands of years, why are they so important now?" Although there is no definitive answer to this question, there have been some significant cultural changes that have had an impact on the gut flora (the population of organisms that populate our intestines). These include the use of antibiotics, diets lacking in gut-healthy plant food, refrigeration and improved sterilization of foods. What we don't yet know is true is if probiotics actually turn around these changes and support the health of your gut flora.


Probiotics' side effects, if they occur, tend to be mild and digestive (such as gas or bloating). More serious effects have been seen in some people. Probiotics might theoretically cause infections that need to be treated with antibiotics, especially in people with underlying health conditions. They could also cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell).
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:
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.

Despite the uncertainty, foods enriched with probiotics and probiotic supplements are increasingly popular in the U.S. Finding probiotic supplements in grocery and health food stores is easy. For example, you may already know that yogurt contains probiotic bacteria such as lactobacillus and bifidobacteria. Many clinical studies suggest these bacteria relieve symptoms related to lactose intolerance.
"People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial; we wanted to determine whether probiotics such as the ones you buy in the supermarket do colonize the gastrointestinal tract like they're supposed to, and then whether these probiotics are having any impact on the human host," Eran Elinav said in a statement. "Surprisingly, we saw that many healthy volunteers were actually resistant in that the probiotics couldn't colonize their GI tracts. This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement. Instead, they could be tailored to the needs of each individual."
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047

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.
Next the researchers measured what happens to the microbiome of people who take probiotics in the hope of restoring their microbiome after antibiotics. Twenty-one volunteers took an identical course of antibiotics and were then assigned to one of three groups. The microbiome of the first group was allowed to recover by itself, whereas the second group was given probiotics. The third group was treated with a dose of their own original pre-antibiotic microbiome by a faecal microbiota transplant (FMT).
Thankfully, most causes of constipation can be improved with dietary and lifestyle interventions. One of probiotics benefits is constipation relief. Probiotics of many kinds can help with constipation because they can keep the digestive contents moving along through different mechanisms such as short-chain fatty acid production, influences on the nerves of the digestive tract, electrolyte balance, pathogen control, and others. Think of probiotic foods and pills as an addition to other dietary and lifestyle interventions to relieve constipation and return your digestive system to its normal functions.
To avoid those and other problems, I strongly recommend buying a professional brand from a reputable health care professional or other vendor who stands by their products and undergoes third-party testing. Some of these professional brands have created advanced technology that preserves a probiotic supplement’s survival on the shelf and in your gut.
Probiotics and raw fermented foods and drinks, such as sauerkraut and kefir that contain probiotic-like microbes, are very helpful for digestion. They help to keep your gastrointestinal tract at the proper pH for optimal digestion and help to break down foods. They also regulate the motion of your intestines so that food moves through at the proper pace.
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.
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!
However, these quality of life improvements are varied, and some improvements are quite mild. Sample group, types of allergies, symptoms, and results are across a broad spectrum. For example, numerous studies have shown that allergic rhinitis responses to the household dust mite decrease significantly in adults and children when probiotics were used. However, people allergic to birch pollen saw neither a decrease in general allergic responses to birch pollen or to apple food.
Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits. Further, getting a wide variety of strains into your system is beneficial. “Periodically mixing up your probiotic supplement is also a good way to ensure that you get different health-building strains in your health regime,” says Dr. Cook.

Sugar is so easily accessible in Westernized cultures that it is easy to overindulge in it. But why do you crave it? There are several reasons. One, sugar usually means sucrose, which is composed of glucose and fructose. Glucose is the sugar in your blood, so consumption of sugar results in a temporary boost of energy. However, that blood-sugar spike causes insulin to be released to usher the sugar into cells for energy or fat storage, and shortly afterward your blood sugar drops. So then you feel a slump and reach for something to bring your blood sugar back up: more sugar.
If that's not enough, your doctor may also suggest a probiotic supplement. But don't go and grab just anything off the pharmacy shelf. Probiotic supplements are not all the same, and they often contain different strains to serve different needs, says naturopathic physician Amy Fasig. Example: What one person gets to battle strep throat is different from what would be prescribed for someone suffering from Irritable Bowel Syndrome, she says.
Quick note about some formulations with multiple strains (including this one): Take a look at the label below and you’ll see that the supplement contains a mix of strains, but the label just says there is a total of 20 billion CFUs (how they measure the amount of bacteria). This does not tell us how much of each particular strain there is, and we want to know that there are at least 1 billion CFUs per strain to get a beneficial effect.

Sick of fighting off cold after cold? The Align Daily Immune Support Probiotic Supplement is a great way to give your immune system a boost while protecting your gut bacteria. Align is one of the most popular probiotic brands out there and is trusted by both doctors and nutritionists. The Daily Immune Support has Bifidobacterium lactis BB-12, a probiotic strain thought to be most beneficial to your immune health. It’s a lactic acid bacteria that can also help to fight lactose intolerance. This probiotic contains five billion CFUs (generally, most adults should take at least one billion CFUs in a probiotic) and is meant to be taken once a day.
There are four significant takeaways from this study: (1) murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics, (2) Human gut mucosal probiotic colonization is significantly enhanced by antibiotics, (3) After taking antibiotics, probiotics delay gut microbiome and transcriptome reconstitution in mice and humans, (4) Autologous fecal microbiome transplant (aFMT) restores mucosal microbiome and gut transcriptome reconstitution. 
When seeking out the best probiotic for you, consider your overall health, dietary needs, antibiotic use, GI challenges, and similar concerns. Then, review our list of the ten best probiotic supplements, which offer everything from raw probiotics, which must be refrigerated, to shelf-stable, slow-release probiotics that concentrate fewer CFUs in tiny, once-daily capsules.
From upset tummies to the common cold and everything in between, it seems as though the entire world is exclaiming, “there’s a supplement for that!” these days. Call it a symptom of the Aquarian Age, the fact that Amazon recently bought out Whole Foods, or simply that Western society is catching up with what other parts of the world have known for centuries but, for better or worse, everyone seems to be ditching the traditional meds in favor of a more holistic approach to wellness.
A slightly more surprising result, however, seems to be the way that probiotics may impact some of the symptoms of autism. Autism and gut health have been discussed for some time, as patients with the disorder typically suffer from a large number of digestive issues. However, based on animal studies, it seems possible that altering the quality of gut bacteria might benefit not only the digestive system, but the abnormal behaviors in autism, too. In 2016, a case study of a boy with severe autism was reported. While being treated with probiotics for digestive problems, the patient spontaneously improved on the ADOS scale, a diagnostic rating system for people with autism. The score dropped from 20 down three points to a stable 17, and according to the report, ADOS scores do not “fluctuate spontaneously along time” and are “absolutely stable.”
Most recently, two back-to-back papers were published simultaneously on September 6 in the journal Cell showing that many people can’t successfully colonize standard probiotic microbiome in their gut. The scientists also found that consuming generic probiotic strains after taking antibiotics often delayed gut bacteria and gene expression from returning to their natural "naïve" state.
You'd be right. Lebwohl said there are no current studies supporting probiotics for cancer, and further, that he’d be concerned about anyone with a compromised immune system using probiotics. “It has not been adequately studied for cancer and I would be concerned about widespread probiotic use in someone who might have a suppressed immune system due to cancer, because of the rare but documented instances of actual infections arising from probiotic use."
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.

These statistics are staggering, yet poor gut health actually affects much greater numbers than these statistics illustrate because your digestive health affects every physiological system in your body. How is this such a complex system? Well, for one, the human microbiome contains 360 times more protein-coding genes than human genes themselves contain.

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.
A number of probiotic products are on the market, including yogurts containing probiotics, as well as supplements and skin creams, and an estimated 3.9 million Americans use such products. Some studies suggest that probiotics may help with diarrhea or symptoms of irritable bowel syndrome (IBS), but strong evidence to support their use for most health conditions is lacking, according to the National Center for Complementary and Integrative Health.

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.
Importantly, patients with gastrointestinal conditions are not the only ones taking probiotics. 3·9 million people in the USA alone regularly take probiotic supplements, with promised benefits ranging from improved digestion and immune function to improved mental health and prevention of heart disease. However, evidence for these benefits is lacking, and because probiotics are often sold as supplements, manufacturers in many countries are not required to provide evidence of their safety and efficacy to regulatory bodies. The ubiquity of probiotic products would suggest that, at worst, they are harmless. Nevertheless, some safety concerns have been raised, including the risk of contamination, possibility of fungaemia or bacteraemia (particularly in immune-compromised, elderly, or critically ill individuals), small intestinal bacterial overgrowth, and antibiotic resistance. Adding to concerns, clinical trials of probiotics have not consistently reported safety outcomes.

In the new study, the researchers analyzed information from 15 healthy volunteers who took either a probiotic product containing 11 strains of bacteria, or a placebo, for four weeks. The participants also underwent colonoscopies and upper endoscopies before they took the probiotics or the placebo, and again after the four-week treatment period. (An upper endoscopy looks at the upper part of the digestive tract.) During these procedures, the researchers took samples from inside participants' guts.
They probably are. Lebwohl says probiotics may decrease the risk of getting diarrhea during the course of taking antibiotics, and may also play a role in specifically preventing the development of the dreaded antibiotic-related super diarrhea called C. difficile or C. diff. Antibiotics can wipe out the good bacteria that keep you from getting sick if you’re exposed to C. diff, or if you already have it in your system. C. diff symptoms can range from a moderate watery diarrhea several times a day to severe infections, which can be accompanied by fever, bloody stools, rapid heart rate, and can even lead to kidney failure. 500,000 Americans were infected with C. diff in 2015 and 15,000 died from it.
There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and in improving symptoms of irritable bowel syndrome, but more needs to be learned. We still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would most likely benefit from taking probiotics. Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.
Many studies have shown that probiotics reduce diarrhea associated with taking antibiotics in both adults and children. In fact, it is common for physicians and pharmacists to recommend eating a probiotic-fortified yogurt every day during a course of antibiotics to prevent diarrhea. More research is needed to determine which probiotics are associated with the greatest effect for specific antibiotics.
The Strand Similar to multivitamins, not all probiotics are created equal. Different probioitcs have different bacteria strains with varying benefits; and some probiotics may contain more than one strain, so it’s important to do your research. Some strains may help with gastrointestinal issues like diarrhea, while others may not have any effect on the GI tract at all, according to Keri Gans, RDN, author of The Small Change Diet. If you’ve made the decision to take a probiotic supplement but you’re unsure about which strain to take, ask your doctor or a registered dietitian for a recommendation. “You most likely will not have any negative side effects from using the wrong strain, but you may also not see any benefits,” says Gans.

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 Healthy Living section of the Hyperbiotics website is purely for informational purposes only and any comments, statements, and articles have not been evaluated by the FDA and are not intended to create an association between the Hyperbiotics products and possible claims made by research presented or to diagnose, treat, prevent, or cure any disease. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. This website contains general information about diet, health, and nutrition. None of the information is advice or should be construed as making a connection to any purported medical benefits and Hyperbiotics products, and should not be considered or treated as a substitute for advice from a healthcare professional. Always seek the advice of your physician or other qualified health professional with any questions you may have regarding a medical condition.

Some foods are made by adding bacteria — yogurt, pickles, cottage cheese, kombucha, and sauerkraut are good examples. Those foods work to provide the same probiotic benefits as supplements. However, most foods are so processed and pasteurized that it’s unlikely you’ll see the same benefits, let alone the right strains, as you would with a supplement. Regardless, it can’t hurt to get extra probiotics through your diet.
Because chronic inflammation is at the root of many diseases and health conditions, the fact that probiotics exert this effect in the gut, where 80 percent of the immune system lies, is crucial. The immune-boosting benefits of probiotics seem to be particularly helpful for the quality of life of seniors. Currently, research is underway to test whether probiotics can “reduce inflammation and improve gut immune health in HIV-positive individuals” who haven’t yet undergone treatment.
One overlooked mechanism that supports your innate immunity is gut health, specifically the role probiotics play. Good probiotics benefit your health by keeping your gut microbiota, inflammation, and immune system balanced preventively, as well as acutely when you are sick, so that no matter which flu strain comes along, your immune system is ready.

All probiotic strains are manufactured through fermentation, and are then freeze-dried before blending with fructooligosaccharides (FOS). The result is a shelf-stable (two years at room temperature), nitrogen-filled probiotic of human origin: a probiotic that easily adapts to your body, and is both acid- and bile-resistant to survive the acidic environment of the human stomach. In other words, a probiotic that fulfills its promises.

If that's not enough, your doctor may also suggest a probiotic supplement. But don't go and grab just anything off the pharmacy shelf. Probiotic supplements are not all the same, and they often contain different strains to serve different needs, says naturopathic physician Amy Fasig. Example: What one person gets to battle strep throat is different from what would be prescribed for someone suffering from Irritable Bowel Syndrome, she says.


Sure, why the hell not? Lebwohl says: "Essentially a yeast infection is an overgrowth of a kind of fungus. In theory, a probiotic could potentially have an effect of the microbiome of the vagina, though proof of its effectiveness hasn’t really been established.” No harm in giving it a try as long as you don't succumb to the temptation to put yogurt in your vagina.

Another study by Elinav and his colleagues suggests that not everyone’s gut reacts the same way to probiotic pills. They studied samples of microbiomes from antibiotic users before and after they took supplements for four weeks. The good bacteria were found in the digestive tracts of some people. But in others, the bacteria were present only in stool samples, not in their digestive tracts, where they’re thought to be needed to improve health.
What are the benefits of taking probiotics? Bacteria have a reputation for causing disease, so the idea of tossing down a few billion a day for your health might seem — literally and figuratively — hard to swallow. But a growing body of scientific evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of live bacteria. Northern Europeans consume a lot of these beneficial microorganisms, called probiotics (from pro and biota, meaning "for life"), because of their tradition of eating foods fermented with bacteria, such as yogurt. Probiotic-laced beverages are also big business in Japan.
Topping the probiotic market numbers at 100 Billion CFU divided between 34 probiotic strains, Garden of Life’s Ultimate Care probiotic was definitely a contender for our Best Probiotic of 2018. Free from preservatives and additives, RAW scored impressive marks across the board. Although this shortens the lifespan of the probiotics strains somewhat, buying in small quantities can easily solve this problem and – honestly – at CHR we always prefer purity to additives.
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.
Digestive problems. The best evidence for probiotics is for reducing diarrhea, especially following antibiotic use. A 2010 review from the Cochrane Collaboration concluded that probiotics shorten episodes of acute infectious diarrhea. And in 2011, a Health Canada monograph stated that products containing certain probiotics (such as Lactobacillus rhamnosus GG) help manage acute infectious diarrhea and antibiotic-associated diarrhea. A 2012 research review in the Journal of the American Medical Association (JAMA) found that probiotics reduced the risk of antibiotic-associated diarrhea by 42 percent—but many of the studies had flaws, so these findings should be interpreted with caution. A 2013 Cochrane review of 23 trials also concluded that probiotics may be effective for preventing antibiotic-related diarrhea. However, two large, well-designed studies, in the Lancet in 2013 and the Annals of Internal Medicine in 2014, found that probiotics were no better than a placebo in preventing diarrhea in older people taking antibiotics. A review of 19 studies, published in Gastroenterology in 2017, found that probiotics reduce the risk of Clostridium difficile-related diarrhea in hospital patients, especially when the supplements were started during the first two days of antibiotic treatment.

As with other types of supplements, scientists are still discovering the full potential of probiotics. However, when taken regularly, it is believed that they help support digestive health by helping maintain the balance of beneficial and non-beneficial bacteria in your digestive tract. Having a natural balance of good bacteria in the digestive tract can help defend against occasional digestive issues. In addition, probiotics play an important role in supporting immune health, since 70% of the body's immune system is found in the digestive tract.∗

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