In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
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Today, most of the Japanese population begins the day with a warm bowl of miso soup, believed to stimulate the digestive system and energize the body. Made from fermented soybeans, rice or barley, adding a tablespoon of miso to some hot water makes an excellent, quick, probiotic-rich soup. The fermentation process can take anywhere from a few days to a couple of years to complete, and the end result is a red, white or dark brown paste with a buttery texture.

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.

One thing that is often overlooked is gut health and the benefits of probiotics for weight loss. Gut microbiota can affect food intake choices, appetite, and body weight and composition. Dysbiosis, an imbalance in the gut microbiota with a shift favoring pathogens and opportunists, is common in overweight people. The pathogens and opportunists create an inflammatory situation that affects insulin and other hormones, resulting in the inability to lose weight.
MegaFood is our only top pick that’s certified vegan, as well as being gluten free and dairy free, making it a good choice for any food-sensitive or vegan probiotic seeker. It has fewer of our wishlist “general health” strains than Vita Miracle, but it still contains five. This could be a go-to if you eat vegan, even if you’re not recovering post-antibiotic.

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.
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 usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.
Afif Ghannoum said the key insight, one that he called groundbreaking, is that his father’s team found that fungi and microbes were cooperating in the construction of the plaques.  He said election microscope images show the filaments of the fungi being incorporated into the carbohydrate ‘armor’ that the bacteria start to secrete once enough individual cells have gathered at a certain location. Without the addition of the digestive enzyme to their product, he said that the plaques, once adhered to the intestinal wall, would be difficult to attack.
It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.

Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.

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.
Although most studies have shown few, if any, negative side effects, it is important to keep in mind that research on probiotics is still in a preliminary phase. There may be some risk for people who have certain health conditions. As with any supplement, it is essential that before you begin to take a probiotic supplement, that you speak with your physician first to help to ensure that you will not be putting your health at risk.
Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats.
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.
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.

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.

Afif Ghannoum said the key insight, one that he called groundbreaking, is that his father’s team found that fungi and microbes were cooperating in the construction of the plaques.  He said election microscope images show the filaments of the fungi being incorporated into the carbohydrate ‘armor’ that the bacteria start to secrete once enough individual cells have gathered at a certain location. Without the addition of the digestive enzyme to their product, he said that the plaques, once adhered to the intestinal wall, would be difficult to attack.


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.
The latest two-part research on probiotics was spearheaded by researchers at the Elinav Lab of Immunology at the Weizmann Institute of Science in Israel and colleagues at the Tel Aviv Medical Center. Eran Elinav served as a senior author for both studies along with Eran Segal and his lab of computational biologists who focus on health and disease related to microbiome, nutrition, genetics, and gene regulation. 

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.
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