If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
Many Lactobacillus and Bifidobacterium species are naturals at protecting and improving gut health. Additionally, research in animals and humans has shown that probiotics decrease scores on depression assessments, thereby alleviating depression. As a matter of fact, there is a new term, psychobiotics, for these microbes that influence mental health conditions like depression.
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.
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.
What’s more, RAW Probiotics are exactly what they purport to be – raw! They’re uncooked, untreated and unadulterated, and have no fillers or binders. You also won’t find any displeasing carriers, such as maltodextrin or dextrose. And since RAW Probiotics are kept in temperature-controlled cold storage through delivery and until they make it into your fridge, you can be sure your probiotics “arrive alive.”
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.∗
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.
That said, supplements with higher numbers of CFUs are sometimes used to treat conditions such as irritable bowel syndrome (IBS), allergies, and respiratory illness. While probiotics have generally been found to be safe for most people with normal immune systems, too much can cause gas and upset stomach. We narrowed our search to supplements with dosages between 1 billion and 100 billion CFUs.
The probiotic industry is booming, but the benefits of probiotic products and the quantity of viable bacteria they contain can vary. So, instead of adding bacteria from an outside source, you might be better off consuming prebiotics, like fermentable fiber, which support your own beneficial bacteria, Dr. Cresci says. Good dietary sources of prebiotics include dried beans and other legumes, garlic, asparagus, onions, leeks, certain artichokes, green bananas and wheat. Prebiotic supplements are available, as well.
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.

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.
We’ll start with the headliner: the BIO-tract peral, which packs the equivalent of 75 billion CFUs into one tiny, filler-free, 5-billion CFUs pearl. The trick is in protecting those 5 billion CFUs over an 8 to 10-hour period, so they bypass your acidic stomach and reach your intestinal tract, alive and well, allowing you to experience the full and multitudinous benefits of plentiful and beneficial gut bacteria.
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.
"Probiotics are live microorganisms which when administered in adequate amounts, confer a health benefit." 1 In general, probiotics are similar to the beneficial bacteria that live naturally in your digestive tract. When taken daily, probiotics can help support digestive and immune health. You may think of bacteria as something harmful to your body. But it's important to have a balance of good bacteria in your digestive tract, which can be negatively impacted from factors such as diet and travel. Probiotics are beneficial bacteria your body may need to support good digestive health.∗
The probiotic industry is booming, but the benefits of probiotic products and the quantity of viable bacteria they contain can vary. So, instead of adding bacteria from an outside source, you might be better off consuming prebiotics, like fermentable fiber, which support your own beneficial bacteria, Dr. Cresci says. Good dietary sources of prebiotics include dried beans and other legumes, garlic, asparagus, onions, leeks, certain artichokes, green bananas and wheat. Prebiotic supplements are available, as well.
Although some probiotics have shown promise in research studies, strong scientific evidence to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.
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.
Culturelle Probiotics, although very basic, is still a great probiotic supplement.  The results I got from trying it were positive– I felt pretty good throughout the entire trial period. Although this product only contains one strain of probiotic, the one they chose is a solid one.  The cell count is 10 billion, which is a good number for a daily probiotic.  Lastly, Culturelle doesn’t contain any frequently-irritating ingredients like milk, dairy or gluten.  Read the full review here… or click here to go buy it now!
We found the most evidence linking strains to antibiotic recovery, immune health, and IBS/IBD relief. We made checklists of the most researched strains that treat those issues (10 strains known to boost general health, six for immune health, seven for antibiotic recovery, and seven for IBS/IBD relief) and dug into ingredient lists to find the supplements containing the highest number of effective strains for each use case.

Probiotics: Health benefits, facts, and research Every human on the planet has microbes living in their body. While bacteria get a bad reputation, many can promote good health. Probiotics are a type of 'good bacteria' that provide health benefits for the host. The health benefits of probiotics include treatment of diarrhea and irritable bowel syndrome. Read now
Next time you pack your travel beauty bag, slip a shelf-stable probiotic in there to preempt bathroom emergencies, Fasig says. Look for one that contains Lactobacillus acidophilus, Lactobacillus sporogenes, Bifidophilus bifidum, and Sacchromyces boulardii strains ($20, amazon.com), which Fasig says can improve your intestinal health to fix issues with constipation or diarrhea.
“Some strains have been shown to help with GI complaints, some with immune function, and some even have been shown to have benefits outside the intestinal tract, such as with vaginal health or eczema,” says Gail Cresci, Ph.D., R.D., a Cleveland Clinic researcher who studies the microbiome. But there are few definitive conclusions from the current research.
While past studies have investigated similar questions, they have all used patients' excrement as a proxy for microbe activity in the GI tract. Instead, Elinav, his colleague Eran Segal, (a computational biologist at the Weizmann Institute), and their teams spearheaded by Niv Zmora, Jotham Suez, Gili Zilberman Schapira, and Uria Mor of the Elinav lab collaborated with Zamir Halpern, Chief of Gastroenterology at the Tel Aviv Medical Center to measure gut colonization directly.
Most probiotics designed for women are designed to target feminine health conditions like yeast infections and urinary tract infections OR overall digestive health. While this may not be a concern for some women, the fact is that most of us can benefit from probiotics that keep our reproductive systems in check while also promoting overall digestive and immune health. That’s why we love the Culturelle Women’s Healthy Balance Probiotic: this women’s probiotic was specially designed to maintain feminine health without sacrificing the digestive and immune support of traditional probiotics!
Probi is continuously thriving to develop and investigate new possible indications where probiotics may have positive and efficient effects to improve health. We are science-driven, and investigate new possibilities to find the Next Generation Probiotics. This concept involves new bacterial strains that has never before been cultivated and used for health-purposes. 
If you’re looking for a great probiotic you can take every day to target everything from gut to skin health, the Culturelle Daily Probiotic is our top choice. Each capsule has 10 billion active cultures of 100 percent Lactobacillus GG, a probiotic that helps curb gas, bloating, and upset stomach, and works to boost your immune system. Each capsule has the probiotic equivalent of 10 cups of yogurt and is dairy-free, sugar-free, and gluten-free. This container comes with 30 pills to be taken just once a day (most recommend taking it at night, especially when you’re just starting on probiotics).
Many avenues of research have examined probiotics benefits for skin, especially in children. Meta-analyses have found that probiotic supplements are effective in the prevention of pediatric atopic dermatitis and infant eczema. The integrity of gut bacteria is also connected to the development of acne, although the way this happens is still unclear.
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.
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. 
What are bacteria and what do they do? Bacteria are single-celled organisms that exist in their millions, in every environment, inside or outside other organisms. Some are harmful, but others support life. They play a crucial role in human health and are used in medicine and industry. Learn about the types, lifecycles, uses, and hazards of bacteria here. Read now
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."
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.
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.

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.


★100% NATURAL, NON-GMO, GLUTEN FREE★NewRhythm 50 Billion Probiotics is Formulated with 100% Natural Ingredients and Independently Tested in 3rd Party Labs in USA. Our Turmeric Supplement is Verified NON-GMO, Gluten Free and Verified Free of Sugar, Soy, Yeast, Egg, Wheat, Corn, Peanuts, Fish, Shellfish, Magnesium Stearate, Artificial Ingredients, Fillers, Binders, Preservatives.
Dermatologist Dendy Engelman, MD, also points out the key role probiotics play in gut health and your body's immune system. "Probiotics are live microorganisms that may be able to help prevent and treat some illnesses," explains Engelman. "Probiotics can create 'holes' in bad bacteria and kill them. Similar to the way antibiotics work in the treatment of acne and rosacea, probiotics can help fight harmful bugs from triggering inflammation. In patients with acne and rosacea, living microorganisms on the skin are recognized as foreign by the body's immune system. The immune system springs into action to counter this potential threat resulting in the inflammation, redness, or bumps common in these skin conditions."
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.
With Prebiotin, you can easily add prebiotic fiber to your diet without worrying about eating huge amounts of troublesome foods or hunting down hard-to-find ingredients. You also won’t have to worry about loading up on high-calorie foods that can negatively affect any effort to lose weight. Combining Prebiotin prebiotic fiber with a diet enriched with probiotic foods can only help your effort to positively influence the bacterial balance in your lower gut.
The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn't function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn's disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, H. pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it's never too late.

Many women are prone to yeast infections during or after antibiotic use. If you are one of these unlucky few, try taking a probiotic like the vH Probiotics with Prebiotics and Cranberry immediately before taking your antibiotics. (You may want to check with your doctor first though). These cultures may help with stomach upset and can also prevent a dreaded yeast infection!

"Probiotics applied topically sit on the skin's surface and prevent the skin cells from seeing the bad bacteria and parasites that can cause this immune system response," confirms Engelman. "This is known as 'bacterial interference,' as probiotics protect the skin and interfere with the ability of bad bugs like bacteria and parasites to provoke an immune reaction.

As far as effectiveness, keep in mind that unlike medications, dietary supplements do NOT need to be approved by the FDA. This means that manufacturers can sell supplements simply with "claims" of safety and effectiveness. Currently, researchers are undecided if probiotic supplements are effective. Some say probiotics are effective; others believe they offer no benefit whatsoever. It also remains unclear which probiotics (or combination of probiotics) work to treat certain diseases. Despite these issues, some studies have shown positive results. Still, more research is needed to confirm that probiotics are safe and effective.
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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.

Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”


Although some probiotics have shown promise in research studies, strong scientific evidence to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.
CFU: This is the number of "colony forming units" present in each dose, which are measured in the billions. And while more isn't always better, "you want at least 20 to 50 billion CFU," says Dr. Nazareth. Just for reference, a very high dose is 400 CFU, which most experts agree is not necessary unless your health care practitioner specifically recommends this for you. It's also important to check for the guaranteed CFU upon expiration, which should be listed clearly. "Some products only guarantee the CFU number at the time of manufacturing, therefore will be less potent by the time the product reaches your home," she says. 

Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:
What’s more, your bacterial makeup does more than just boost or bully your immune system; the existence of good and bad bacteria affect your mood and energy levels, relieve (or contribute to) a sensitive stomach (including lactose intolerance and irritable bowel syndrome/IBS), affect your mood, and even support (or hinder) a healthy body weight. (Fascinating fact: Scientists can predict weight with 90% accuracy based on your gut’s bacterial makeup, but only with 58% accuracy based on your genes. Bacteria counts!)
Probiotics are officially defined by the Joint Food and Agricultural Organization of the United Nations/World Health Organization Working Group as “Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Basically, probiotics at this point in time are live bacteria and yeasts that provide health benefits to you if you take them in adequate quantities.

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.

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For Irritable Bowel Syndrome, patients who respond to a probiotic might take that in the long term, Lebwohl says, so as to maintain symptom control. With something like antibiotic-related diarrhea, you'd take it for a defined period of time until symptoms are gone. "This has been studied in children and adults and while study results have varied, meta-analyses suggest that probiotics can be protective in this context," he adds.
In a food allergy, there is an immediate immune reaction to the offensive food. Classic allergic symptoms such as tingling lips, burning/tightness in the mouth/throat, gastrointestinal upset, difficulty breathing, rashes, hives, and even anaphylaxis may be present. Although any food can cause an allergic reaction, the most common offenders are peanuts, tree nuts, dairy, fish, shellfish, eggs, soy, and wheat.
Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
Using probiotics benefits and balances immune function, influences hormone levels, aids in digestion and nutrient absorption, produces some vitamins, and balances blood sugar insulin responses. By preventing and reducing leaky gut and controlling levels of pathogens, probiotics reduce harmful bacterial by-products that can enter the brain and contribute to brain fog.
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.
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.
With the growing popularity of probiotics, there is a huge variety of supplements from which one can choose. The most important thing is to determine what type of probiotic microorganism you need for your condition. Do not just take the supplement that provides the most kinds of organisms. You need to do your research and be sure that there are scientific studies to support what you take. New research is emerging, so if you don't find what you need right now, keep looking. A doctor can help one decide if trying probiotics might be helpful for you and can advise you regarding the amount and type of probiotics that may be appropriate in your case.
BlueBiotics is a good product to start with and then evaluate from there. The cold is actually good for probiotics as freezing them extends the life of the cultures. Companies who freeze dry their probiotics (which if I’m not mistaken, each of these companies do), but having them shipped in very high temperatures can and does kill probiotic microorganisms so it’s definitely a concern. Ideally, it’s better to stock up during the winter so that you don’t have your product stuck in the back of a hot truck before it gets to you.
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 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.
Other uses. Many other claims are made for probiotics—that they lower cholesterol, alleviate allergic skin conditions (like eczema), treat ulcers and urinary tract infections, improve vaginal health, reduce the risk of colon cancer, ease anxiety and depression, and ward off traveler’s diarrhea. Good evidence to support these claims is lacking. Research on probiotics for weight loss has yielded inconsistent results, and even studies with positive results have mostly found very small benefits, as was seen in an analysis of 15 clinical trials in Obesity Reviews in 2018.
Consuming probiotics regularly will reduce the risk of this. "The concept is that if we have an unhealthy, unbalanced gut environment, toxins can be released into the bloodstream and cause inflammation throughout the body," Engelman adds. "This shift in gut flora and the subsequent inflammation can cause a flare-up in the skin of those who are predisposed to acne, eczema, or rosacea."
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).
I did the “milk test” on these New Rythm probiotics, along with Culturelle I had purchased in 2 different states (TX & MA, as I was traveling); my mother’s CVS brand acidophilus; and one “control” cup with milk only (so, 5 cups total in my experiment). The New Rythm became a solid yogurt consistency, while the other 4 remained liquids. I did the experiment twice, just to be sure of the results. I could not believe it!!! New Rhythm is my brand, hands down!!! I also would like to mention that my product usually arrives the day after it ships. So it will take a few days to ship when I select standard shipping, which is to be expected, but it doesn’t stay in transit long which is ideal for preserving the living cultures.
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.
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