If you go with a supplement, know that the FDA regulates these products but treats them like foods and not medications. Unlike drug manufacturers, supplement makers don’t have to show their products are safe or effective to sell them. That means that these firms are in charge of checking the safety and labeling of their products before they sell them to make sure they meet FDA rules.

Back to the question of what are probiotics: There are five main types, each in its own classification called a genus. Within each genus there are multiple species, and within those species there are multiple strains. For example, Lactobacillus is a very common genus of probiotics. Within that genus are numerous species, such as rhamnosus. The genus and species of a microbe are always italicized, making it easy to know that a microbe is involved. In a species such as Lactobacillus rhamnosus (often abbreviated L. rhamnosus), there are many strains. An example of the name of a strain is L. rhamnosus GR-1.


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.
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.
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.
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.
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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.
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.
The second Elinav study, “Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT” involved a mouse model and human patients. One cohort of mice and a parallel human group was given the same probiotic strain used in the first study to see if they had more success repopulating their gut microbiota after a round of antibiotics. Another “watch-and-wait” cohort didn’t take probiotics to assist gut microbiome recovery after antibiotic-related depletion. A third cohort was given an “autologous fecal microbiome transplant” (aFMT) which consisted of a patient’s own gut microbiota that had been collected before he or she started a cycle of antibiotics.

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.
Given that you can get probiotics from the food you eat, you don't necessarily need to take a supplement, and Keatley says she prefers food sources of probiotics to supplements. However, she adds that "There are times when you really need a boost." One example might be during or after a course of antibiotics, as long as you have your doctor's OK, since antibiotics kill both good and bad bacteria: "Seeding your gut with good bacteria can lay the groundwork for a faster recovery and less constipation and diarrhea," Keatley points out. Angelone echoes Keatley's emphasis on food sources of probiotics, but also says that supplements can also play a useful role in "maintaining a healthy gut bacteria colony."
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.
The classic examples of probiotics are yogurt and kefir, which are great for a lot of people, though not if you have a dairy sensitivity. There a lot of yogurt and kefir alternatives, from water kefir and almond yogurt, to coconut yogurt, coconut kefir, and so on. Look at ingredients when you’re shopping for food like yogurt—you want to avoid sugar-filled products. I like plain coconut yogurt with fruit and little stevia on it.
The two main species you want to look for are: Lactobacillus and Bifidobacterium. Within these two species, there are a lot of different strains. The strains we chose for our probiotic—Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium longum—have been shown to help modulate the immune system, help with autoimmunity conditions (which affect most of my patients), and counter infections in the gut.
Overall, Garden of Life Primal Defense Ultra is one of my favorite probiotics! It uses a wide variety of potent probiotic strains that may help with daily digestion and specific stomach ailments. So it’s very flexible as far as probiotics are concerned. After personally testing out the product, my overall health felt improved, I wasn’t bloated, and I was digesting my food much better than normal.  Read the full review here… or click here to go buy it now!
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:
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
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