Women’s health expert Dr. Amy Myers is a goop-trusted authority on subjects from autoimmunity and Candida to thyroid dysfunction; and she’ll be speaking IRL at our first wellness summit on June 10. Here, Myers helps us evaluate the increasing buzz around probiotics, and outlines the ins and outs of selecting a particular supplement (whether hers or other brands). Plus, we’ve rounded up our probiotic essentials, from inner beauty powders to favorite fermentation recipes, in one guide:

Have you ever baked bread and had to proof the yeast? Proofing the yeast allows it to become active in the conditions it prefers the most: warm and moist with access to sugar. Baker’s and brewer’s yeast are both forms of Saccharomyces yeasts, as is Saccharomyces boulardii, but these yeasts are usually helpful to you and noninfectious, except in immunocompromised people or people with yeast allergies.
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.”
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.
Unlike many of the probiotics on the market today for women, Vitamin Bounty’s formula is fermented naturally and encased in a delayed-release capsule for more efficient digestion. Specifically, this capsule helps to protect the micro-organism strains from stomach acid, which can dissolve them before your gut has a chance to absorb all of their healthy goodness. With this Women’s Pro-Daily Probiotic design, you can expect more cultures and, as a result, fewer stomach upsets and feminine health problems!
Uh, no. “There have been studies that suggest a theoretical link between the microbiome and even changing the microbiome, and changes in the brain,” Lebwohl tells me. He specifically points to this study, in which healthy women with no gastrointestinal issues had their brains imaged before and after a month of consuming yogurt products containing probiotics twice daily.
You know antibiotics can help fight off bacterial infections, but overusing them can actually deplete the good bacteria in your body, reports Harvard Medical School. (That's why doctors recommend you don't take antibiotics unless you really need them.) If you must go on meds, talk with your doctor about taking probiotics afterward, as the NCCIH says they can help recover beneficial microorganisms afterward and help keep the ratio of good to bad bacteria in balance.
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.
You also want to look at the guarantee fine print: If the CFU number is guaranteed at time of manufacturing, but not at the time of expiration, you could be taking a less potent dose of probiotics than you think because potency fades over time. I made this mistake when I was traveling once and went to the grocery store to pick up probiotics. On the bottle label it said guaranteed at 20 billion CFU at the time of manufacturing. This doesn’t tell you the CFU for when I was actually taking the probiotics. For instance, our probiotics are manufactured at 60 billion and 200 billion CFU, and guaranteed at 30 billion and 100 billion CFU, respectively, at time of expiration.
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The bottom line: Stick to trusted whole food sources of probiotics if you don’t know a probiotic supplement brand you trust. “Kimchi, pickled beets, Greek yogurt and sauerkraut are great sources of probiotics. If you don’t like them, throw them into a food you do like, like a smoothie, and add your favorite fruit to help mask the flavor,” Taub-Dix says.
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.

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.
Amy Shapiro, MS, RD, CDN, founder and director of Real Nutrition based in NYC, discusses the effect probiotics have on immune system issues. "Probiotics compete with pathogenic microorganisms and produce chemicals that inactivate or kill pathogens," says Shapiro. "They help prevent immune-mediated diseases by improving the gut mucosal immune system. Overall, probiotics protect the body from infections and allow the body to maintain homeostasis."

From Lactobacillus acidophilus to Bacillus Coagulans, the BlueBiotics blend is a veritable list of the most researched and proven probiotic bacteria known to science. And recent advances on the blend have made it the only full-spectrum probiotic supplement on the market, as it contains strains which are typically not available to the general public (Bacillus Coagulans and S. boulardii). The CFU count alone is remarkable enough, leaving most comparable spectrums in the dust… HOWEVER even more surprisingly our tests showed that a whopping 98% of the probiotic colonies in BlueBiotics were still alive, making this BY FAR the most effective probiotic supplement that we have ever reviewed. Also, because of the diverse pool of strains in BlueBiotics, users have reported a wide variety of benefits from weight loss, to increased energy, improved digestive health and cognitive function. Many of our staff switched to these probiotics, as well as myself and my family.
Also, it’s important to understand that probiotics are not a new idea. Throughout history, cultures have thrived on probiotics found in fermented foods and cultured foods, which were invented for food preservation long before the refrigerator. The process of fermentation has been lost in recent years, as it is no longer needed to preserve foods, meaning that we now lose out on those vital probiotics benefits.
If you’ve ever clicked on the 6:00 news or scrolled through the latest headlines on your smartphone, you probably know that supplements and vitamins are not typically backed by governmental entities like the FDA or the World Health Organization. This fact can leave supplement newbies a bit wary, which is exactly why we love the Garden of Life Dr. Formulated Once Daily Women’s Probiotic so much.
You experience that afternoon slump and reach for a candy bar or a sugar-laden coffee. Or maybe you go through your day, starting with a breakfast of doughnuts or sugary cereal, and then proceed to sodas for drinks, cookies to snack on, dessert after dinner, and finally to a nighttime snack of ice cream. You know that feeling; it’s that I-have-to-have-something-sweet-and- I-have-to-have-it-NOW feeling.
Before buying this, I didn't realize that some strains of bacteria used in probiotics produce histamines. When I discovered this, I looked up which ones do, and all three I discovered are used in this one. If you're sensitive to histamines or have leaky gut (which makes you sensitive to histamines), then this is not for you. According to an article on bullet proof, an overload of histamines "leads to increased inflammation and many other symptoms including: skin irritation, hives, throat tightening, increased heart rate, nasal congestion, migraines, fatigue, heartburn, reflux, and weight gain." I'm sure this can work for some people, but probably only despite the histamine-producing bacteria.
Florastor uses the unique strain Saccharomyces boulardii lyo, which works to strengthen digestive balance and boost immunity. To boost immunity, Florastor stimulates the production of immunoglobulin A — an antibody that helps defend your body against infection. If you’re on long-term antibiotics, this will be a good option for you as Florastor is genetically resistant to antibiotics. When taking a probiotic supplement at the same time as an antibiotic, Gans advises waiting at least two hours in between. Each box contains 50 capsules. Take one to two capsules per day.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

If you decide to use a probiotic supplement and get clearance from your doctor for doing so, be sure to read the label carefully. You want to be sure that the supplement contains live strains of the bacteria or yeast, and that the life of these strains is guaranteed at the time of use, and not at the time of manufacture. Other points of comparison are the number of bacteria strains and the number of colony-forming units, although this does not necessarily guarantee results.

Unfortunately, the U.S. has no federal standards for probiotic supplements. Therefore, you run the risk of purchasing a product without any guarantee that it contains its advertised probiotic strains, that the strains are alive, or that the product is free from unhealthy ingredients. Therefore, it may be best to choose a brand-name probiotic that has research backing their effectiveness. Here are some examples:
They can break down substances in foods that keep you from absorbing the micronutrients inside. They not only protect against the consequences of rogue molecules passing through a leaky gut, but they assist your intestinal cells in staying healthy to optimize nutrient absorption. In addition, some of the metabolic by-products of probiotics, such as short-chain fatty acids and vitamin production, are very nourishing to your GI tract.
For most of my life, I thought of probiotics as something I’d only drink if I lost a bet. Then stress-induced irritable bowel syndrome (IBS) turned my intestinal tract into a nonstop river of shit—we’re talking weeks of everything I ate shooting straight out my butt in liquid form. The internet said probiotics were my best non-pharmaceutical bet to help my digestive system calm down, so I swallowed my pride (and my first kombucha ever) and kinda sorta saw the light. My IBS wasn’t cured, but probiotics did help me spend less time on the toilet wide-eyed with terror, and more time doing what’s really important in life—watching TV with my family.
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.
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.
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:
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.

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.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Unlike MegaFood, the Renew Life label’s cold-storage recommendation is printed so small we nearly missed it (and it didn’t ship with a cold pack). If a probiotic requires refrigeration, be vigilant when buying it — the retailer that stores it or the company that ships it should keep it refrigerated until it gets to you. Otherwise, some of its potency might diminish in storage or transit.
Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
L. Casei also made headlines when a study found it beneficial in relieving anxiety. The randomized, double-blind, placebo-controlled pilot study found supplementation with 24 billion units of the L. Casei strain Shirota led to a rise in probiotics Lactobacillus and Bifidobacterium, as well as a significant decrease in symptoms of anxiety and depression [2].
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”.

Two large-scale clinical trials recently reported in the New England Journal of Medicine suggest that the situation in infectious diarrhoea might also be more complex than previously believed. Freedman and colleagues did a randomised controlled trial of a probiotic containing Lactobacillus rhamnosus and Lactobacillus helveticus in children presenting to the emergency department with gastroenteritis. Contrary to expectations, they found that the probiotic did not prevent development of moderate-to-severe gastroenteritis within 14 days after enrolment. In a separate study, Schnadower and colleagues found similar results with L rhamnosus GG alone. Both trials used probiotics that are available over the counter in North America and showed no significant difference from placebo in the duration of diarrhoea and vomiting, number of unscheduled health-care visits, or length of absence from day care. These results cannot be generalised to other probiotic strains or preparations, but they do show that we have some way to go in elucidating which probiotics might provide benefits in which clinical settings.
Although many manufacturers will make claims regarding the benefit of probiotics for all sorts of disorders, there is not always research to back up those claims. It can be difficult to conduct quality research on probiotics due to the wide variety of strains available. And many studies show mixed results. However, given that, there is some research support for the use of probiotics for the following health conditions:
Probiotics have been shown to help reduce duration of pediatric acute diarrhea, decrease symptoms associated with taking antibiotics, manage symptoms of irritable bowel syndrome, reduce crying time in infants with colic and reduce relapses of ulcerative colitis. Certain probiotics may also inhibit the growth of Helicobacter pylori, bacteria that colonize the stomach and can cause ulcers and stomach cancer.

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.)
Probiotics for allergies are fast becoming a preferred treatment method because they are understood to be much safer than traditional allergic rhinitis medication. A nasal spray for allergies is often a ‘go to’ treatment, for example, but allergy nose spray medications often contain corticosteroids, like Beclometasone dipropionate, which could affect bone metabolism, blood cells, and the pituitary gland. 
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