The U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
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.
For example, yogurt is made with two “starter” bacterial cultures — Streptococcus thermophilus and Lactobacillus bulgaricus — but these bacteria are often destroyed by your stomach acid and provide no beneficial effect, Dr. Cresci explains. Some companies, though, add extra bacteria into the product, so check the labeling and choose products with bacteria added to the starter cultures, she advises.
A closer look at the science underlying microbe-based treatments, however, shows that most of the health claims for probiotics are pure hype. The majority of studies to date have failed to reveal any benefits in individuals who are already healthy. The bacteria seem to help only those people suffering from a few specific intestinal disorders. “There is no evidence to suggest that people with normal gastrointestinal tracts can benefit from taking probiotics,” says Matthew Ciorba, a gastroenterologist at Washington University in St. Louis. “If you're not in any distress, I would not recommend them.” Emma Allen-Vercoe, a microbiologist at the University of Guelph in Ontario, agrees. For the most part, she says, “the claims that are made are enormously inflated.”
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.
The National Institute of Health (NIH) is sponsoring the Human Microbiome Project (HMP), which is developing research resources to enable the study of the microbial communities that live in and on our bodies and the roles they play in human health and disease. The NIH has funded many more medical studies using HMP data and techniques, including the role of the gut microbiome in Crohn's disease, ulcerative colitis, and esophageal cancer; skin microbiome in psoriasis, atopic dermatitis, and immunodeficiency; urogenital microbiome in reproductive and sexual history and circumcision; and a number of childhood disorders, including pediatric abdominal pain, intestinal inflammation, and necrotizing enterocolitis, a severe condition in premature infants in which the intestine tissue dies due to lack of oxygen.
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.
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.

Literally the best thing you can get for your body! I was having bad stomach problems and it vanished after two days of taking these regularly. Keep in mind that if you are putting junk into your body, you need good bacteria in your gut. It's crucial, roughly 80% of your immune system originates from your digestive tract. This WILL help you get your health back in order.


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.
The scientists discovered that the probiotics successfully colonized the GI tracts of some people, called the "persisters," while the gut microbiomes of "resisters" expelled them. Moreover, the persister and resister patterns would determine whether probiotics, in a given person, would impact their indigenous microbiome and human gene expression. The researchers could predict whether a person would be a persister or resister just by examining their baseline microbiome and gut gene expression profile.
Our gut is home to over 500 bacterial species. These “visitors” form a bioreactor, which facilitates digestion, provides nutrients, and helps form the immune system. Some important nutrients made by this bioreactor include several B vitamins, vitamin K, folate, and some short-chain fatty acids. Up to 10% of an individual’s daily energy needs can be derived from the byproducts of the good bacteria in your gut.
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.
By eating probiotic-rich foods and maintaining good intestinal flora, a person can also help to maintain a healthy immune system. And that has real world effects: for example, in one small study of students, those who were given a fermented dairy drink (instead of milk) displayed increased production from lymphocytes -- a marker of immune response.
Several large-scale studies and two meta-analyses have confirmed that probiotics should be a major consideration in determining natural remedies for diabetes. In a massive study involving almost 200,000 subjects and a total of 15,156 cases of type 2 diabetes, researchers confirmed that a higher intake of probiotic-rich yogurt reduced the risk of developing diabetes.
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.

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.

According to the NIH, probiotic supplements contain many microorganisms that are the same as or similar to the ones that naturally live in your body, but there's still a lot of research to be done on probiotics and how they work. It's important to keep in mind that not all probiotics have the same effects and that taking probiotics isn't a guarantee of better health. And while they're generally safe for healthy people to take, with side effects being limited to mild digestive discomfort, they could interact with certain medications or pose health risks to people with underlying medical problems — that's why it's smart to talk to your doctor before getting started with a supplement.

These are live microorganisms that will not provide the promised benefits if they don't remain alive. The manufacturer and consumer must pay close attention to the conditions of storage at which the particular microorganism will survive and the end of their shelf life. The potency will indicate the number of viable bacteria per dose, and the purity has to do with presence of contaminating or ineffective bacteria.
Two dangerous diseases in newborns, necrotizing enterocolitis (NEC) and neonatal sepsis, may meet their match with well-designed probiotic supplements. Both of these conditions are common in premature babies and are most dangerous in low birth weight and very low birth weight infants. Research has confirmed that when a pregnant mother takes high-quality probiotics during pregnancy, her baby is significantly less likely to develop either NEC or sepsis, particularly when the baby is breastfed after birth (and mom is still taking the supplements) and/or when probiotics are added to formula. A probiotic supplement with multiple strains seems to be the most effective in these cases.

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.


Proponents claim that probiotics (meaning “for life,” as opposed to antibiotics) confer health benefits primarily by rebalancing the normal microflora in the large intestine (colon). There are many general types of bacteria used as probiotics (two common ones are Lactobacillus and Bifidobacterium), and many different species as well as strains within species. They have different physiological effects—and thus possibly different health benefits (as well as possible risks). Some yeasts, such as Saccharmyces, can also act as probiotics.

Jigsaw Essential Blend Probiotics uses five of the most researched (and effective) live strains to promote a healthy digestive system, restore flora after antibiotics use, and help with optimal vitamin absorption. Jigsaw products are also third-party certified, so you can rest assured that each batch is safe and pure. The bottom line? If you’re looking for a vegan-friendly formula — the capsules are made from HPMC (Hypromellose - Hydroxypropyl Methylcellulose), gelling agent (Gellan gum), and water — with a high CFU count, this product is for you. There are 90 capsules per bottle.
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.
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:
When reading a probiotic label, it should reveal the genus, species and strain of the probiotic. The product (usually in capsules or probiotics pills) should also give you the colony forming units (CFUs) at the time of manufacturing. Also, the majority of probiotics can die under heat, so knowing the company had proper storing and cooling of the facility is also important.
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.
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
Uncontrolled changes in blood sugar levels or a decreased ability to regulate insulin can have serious effects on your overall health, and since far more men than women are at risk for these changes, these issues are well worth paying attention to.5 Research indicates that regularly taking probiotic supplements containing Lactobacillus and Bifidobacterium can help your body maintain blood sugar levels already within a normal range, whether you're simply at risk for insulin-related challenges or you're already experiencing them.
If you have a tendency to forget to take your probiotics (which, let’s be honest, we all have), try storing them in a place that you look at directly each and every day. We recommend somewhere like your bathroom sink near your toothbrush or even on your kitchen counter, so you never miss a dosage! This one can be taken with or without food, and it doesn’t have to be stored in the fridge – perfect!
While more research is necessary to truly understand the widespread benefits of different probiotic strains, we do know that not all probiotics are created equal. The Lactobacilli, for instance, live in our digestive, urinary and genital systems and can be found in some fermented foods like yogurt. Bifidobacteria normally live in the intestines as lactic acid bacteria, and are also found in fermented foods. According to nutrition expert Alex Caspero, RD, “For certain conditions, you want to ensure you are taking the strand that is most likely to benefit you.” Here is a simple breakdown to help you determine the best probiotic for you.
Look for the probiotic yeast Saccharomyces boulardii (S. Boulardii)—you can take it as a separate supplement or find it in multi-strain probotics. Studies show that it is effective at preventing antibiotic-induced diarrhea and Clostridium diffcicile (C. difficile) infection, which a course of antibiotics can cause. Saccharomyces boulardii increases your secretory IgA—in other words, it strengthens the immune system in the gut. (Some people say that Saccharomyces boulardii is also the panacea for Candida—it’s a yeast that fights yeast—but while it’s helpful for some, other people do not tolerate it well, so I recommend trying it as an individual supplement first to see how you respond.)
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.
When shopping for a probiotic, the first things to look at are CFUs count and probiotic strains. CFUs is the acronym for colony forming units, and is the measure of how many probiotic bacteria are capable of dividing to form colonies. In other words, the higher the CFUs, the higher the number of active, live good bacteria. Generally speaking, the higher the CFUs, the better, although there are exceptions.
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.”
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.
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).
In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science.

Look for the probiotic yeast Saccharomyces boulardii (S. Boulardii)—you can take it as a separate supplement or find it in multi-strain probotics. Studies show that it is effective at preventing antibiotic-induced diarrhea and Clostridium diffcicile (C. difficile) infection, which a course of antibiotics can cause. Saccharomyces boulardii increases your secretory IgA—in other words, it strengthens the immune system in the gut. (Some people say that Saccharomyces boulardii is also the panacea for Candida—it’s a yeast that fights yeast—but while it’s helpful for some, other people do not tolerate it well, so I recommend trying it as an individual supplement first to see how you respond.)


The price is great on these, but definitely BEWARE! I do not recommend taking 2 pills in the beginning if you have not taken probiotics in the past! I had been eating very clean for a couple months, but got a sinus infection and was recommended by a nutritionist to take a probiotic to boost gut health since I was on antibiotics. Anyway-taking 2 pulls a day gave me horrible diarrhea, until I figured out they were causing the issue and cut back the pills to one a day! Everything fine since then, will try to build back up to 2 a day...I also take at bedtime just in case there would be any stomach issues!
It has been suggested that probiotics be used to treat problems in the stomach and intestines. But only certain types of bacteria or yeast (called strains) have been shown to work in the digestive tract. It still needs to be proved which probiotics (alone or in combination) work to treat diseases. At this point, even the strains of probiotics that have been proved to work for a specific disease are not widely available.
Because poor gut health is related to autoimmune responses like those found in rheumatoid arthritis (RA), probiotics have been a proposed treatment option for the condition. Only a few studies have been conducted in humans, and only one testing L. casei 01, a particular probiotic strain, was able to find a decrease in RA inflammation and progression of the disease.
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.
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.

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)


Overall, Align Probiotic is one of the better “daily” probiotics out there.  It’s easy to take, comes in convenient packaging and doesn’t require refrigeration.  And it has some research showing it helps with gas, bloating and constipation, especially in women with IBS.  Lots of things to like about this probiotic!  Read the full review here… or click here to go buy it now!
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.
If you suffer from recurrent urinary tract infections and are interested in giving cranberries a try, pay close attention to labels! As tasty as they may be, cranberry juice cocktails are chock full of sugar and very rarely include the D-Mannose your body needs. Instead, look for all-natural and organic cranberry juices or opt for cranberry extract pills if the pure juice isn’t exactly your cup of tea.
You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.
Kefir: This could be the most ideal probiotic dairy product because it contains both bacteria and yeast working together to provide the numerous health benefits. In a recent eight-week study, people with diabetes were given kefir milk containing Lactobacillus casei, Lactobacillus acidophilus, and bifidobacteria vs. conventional fermented milk. The hemoglobin A1C levels were significantly lower in the group consuming the kefir.
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The National Yogurt Association, who created this seal of approval, requires all yogurt manufacturers to include it on products that meet the standard of having a sufficient number of probiotics. The probiotics in store-bought yogurt need to meet this standard in order to be shelf-stable and reach your body alive. But even then, this standard isn’t all that useful in practice. The number just refers to the total number of live cultures and not the levels for each of those microbes. It’s possible, Taub-Dix says, that a product won’t have high enough levels of a certain probiotic to have any effect.
While one 2009 study did show some evidence for reducing cold and flu symptoms in children ages three to five and a 2015 analysis showed probiotics to be better than placebo in preventing acute upper respiratory infections, neither were enough to convince the National Institutes of Health of the efficacy of probiotics for colds and flu. The NIH confirms, “the evidence is weak and the results have limitations.”
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