Better Health Review ranks Ultimate Flora as the most effective probiotic supplement. It contains 30 billion active bifidobacteria for colon health, and 20 billion lactobacilli and lactococcus cultures for the small intestine. According to Better Health Review, it contains all natural ingredients. It earns a perfect 5 score from Better Health Review, and the magazine “Vitamin Retailer” voted it best two years in a row.
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.
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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.
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.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.

“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.
Method of delivery: "The probiotic needs to be able to survive the acidic environment of the stomach and reach the intestine," explains Dr. Nazareth. This can be optimized through the way you take the probiotic and what's included in the formula. "Some delivery systems to consider are time-released tablet/caplet, capsules with an enteric coating and/or microcapsules, and ones that contain prebiotics and the optimal combination of probiotics," says Lori Chang, a registered dietitian with Kaiser Permanente in West Los Angeles.
If you don’t have a specific health goal in mind and want to bolster the number of good bacteria floating around your system, Perlmutter recommends starting with a minimum of eight to 10 different bacterial species. He included a core five (L. Plantarum, L. Acidophilus, L. Brevis, B. Lactis, and B. Longum) and we added five more highly researched and universally beneficial strains for a general health pick. Vita Miracle, formerly Islands Miracle, has nine of those 10, plus 30 billion CFUs per serving.
Notions don’t equal evidence though, and Lebwohl cautioned against thinking of probiotics as a cure-all, and examining the ways in which they’ve been proven to work as well as the ways in which they really haven’t. So which medical conditions have probiotics actually shown promise in treating and which claims have the credibility of a used car salesman on acid?
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.

“I’d probably stay away from store brands and pay a little extra for the name brand that’s been studied,” Dr. Cresci adds. “Ideally, look for a product that’s been tested for whatever you’re looking to address. It might say it helps with IBS, but you wouldn’t take that same product if you were taking antibiotics. You would want a product that helps with immunity. That’s where a lot of people get confused.”
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.

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How can something as small as a microscopic organism be so important for health? The reason is that there is not just one microbe, nor a handful; there are approximately 1 trillion microbes per gram of feces. Microbes within you are found on your mucous membranes, spanning from your mouth to your anus, from your nasal passages to your lungs, in your urinary tract, and even on your eyes. In fact, in your digestive tract alone, it is calculated that for every cell of yours that is human, there are an equal number of bacterial cells.
Garden of Life RAW Probiotics are some of the most popular out there – and for good reason. Let’s start with the basics: You’ll get 85 billion CFUs and 31 to 33 probiotic strains out of your daily, whole-food, gluten-free, soy-free probiotic, which helps support the immune system, a healthy thyroid, nutrient absorption, digestive function, and a healthy microbial balance.
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.
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.
Although probiotics have been around since the early 1900s, they have recently gained popularity due to their ability to treat a wide range of ailments. Research also suggests that probiotics can help you lose weight and maintain a healthy body-mass index, according to a meta-analysis that reviewed 20 studies that was published in May 2016 in the International Journal of Food Sciences and Nutrition.

Step No. 1 is consume more sour foods — it’s the top way probiotics benefits can be accessed. Embrace what I call “the power of sour” with sour foods like apple cider vinegar and fermented vegetables. They contain some probiotics, but also they contain certain types of acids like gluconic acid and acetic acid, healthy acids that support the function of probiotics (even functioning like prebiotics in some cases).
However, these naturally-occurring bacteria can easily become imbalanced causing a variety of symptoms from stomach upset to feminine health problems. Probiotics can help get things back on track. Taken in supplement form, probiotics are either live or dormant strains of the same bacteria that your body wants and needs to stay healthy. Over time, these supplements can restore your body’s natural bacteria and prevent some of the most common stomach symptoms, yeast infections, and even urinary tract infections.
"Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," says Segal. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."

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Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
While taking a daily probiotic supplement may seem like an easy answer to cure common gut ailments, it’s always best to try for a food first approach, since you can get probiotics from the foods you eat. Probiotics can be found in foods such as yogurt, cheese, miso, sauerkraut, and kimchi. But, adding a supplement into the mix if you haven’t achieved the desired effect through diet alone can be effective.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
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.
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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