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.
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.”
This is also known as S. boulardii and is the only yeast probiotic. Some studies have shown that it is effective in preventing and treating diarrhea associated with the use of antibiotics and traveler's diarrhea. It has also been reported to prevent the reoccurrence of C. difficile, to treat acne, and to reduce side effects of treatment for H. pylori.
If you have a tendency to forget to take your probiotics (which, let’s be honest, we all have), try storing them in a place that you look at directly each and every day. We recommend somewhere like your bathroom sink near your toothbrush or even on your kitchen counter, so you never miss a dosage! This one can be taken with or without food, and it doesn’t have to be stored in the fridge – perfect!
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.
The label should also specify that the living microbes are viable through end of shelf life or best by date rather than at time of manufacture to ensure the bacteria are still live when you take them and able to reach your colon. Quality trumps everything- supplements that are a bargain are typically not of quality. A good probiotic (depending on strands) can cost anywhere from $25-$60.
Vitamin Bounty’s probiotic contains a variety of well-studied strains and a competitive 25 Billion CFU. It also contains a natural prebiotic resistant starch, rice flour, to fuel the strains this probiotic supplies. Over 95% of Pro 25’s strains were still active and viable, the second highest observed strain viability out of all probiotics reviewed-to-date!
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.

Jo A. Panyko is a Master Nutrition Therapist and author of two books about probiotics. She is a professional member of the National Association of Nutrition Professionals (NANP) and works as a functional medicine nutrition therapist (nutritionist) at her company, Chrysalis Nutrition and Health. She writes about how to be healthy with probiotics on her website, powerofprobiotics.com.


Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.
Research suggests probiotics work better as a team. Even pairs are more effective than individuals. Take the strains Lactobacillus Acidophilus and Bifidobacterium Bifidum BB-12, for example. When combined, this duo-force has been shown to help treat GI-specific ailments. In fact, one survey found 75 percent of studies that compared the effect of a strain mixture with a single-strain supplement showed a mixture was more effective at improving irritable bowel symptoms, immune function, and digestive health.
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
When shopping for a probiotic, the first things to look at are CFUs count and probiotic strains. CFUs is the acronym for colony forming units, and is the measure of how many probiotic bacteria are capable of dividing to form colonies. In other words, the higher the CFUs, the higher the number of active, live good bacteria. Generally speaking, the higher the CFUs, the better, although there are exceptions.
Although these capsules are more expensive than other options on the market, if you suffer from ulcerative colitis, irritable bowel syndrome, or pouchitis, this probiotic will help manage your symptoms. VSL contains eight different probiotic strains (and more good bacteria than other brands) to alleviate symptoms such as bloating, cramping, and diarrhea. There are 60 capsules per bottle.
Probiotics and raw fermented foods and drinks, such as sauerkraut and kefir that contain probiotic-like microbes, are very helpful for digestion. They help to keep your gastrointestinal tract at the proper pH for optimal digestion and help to break down foods. They also regulate the motion of your intestines so that food moves through at the proper pace.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects."
After the antibiotics had cleared the way, the standard probiotics could easily colonize the gut of everyone in the second group, but to the team's surprise, this probiotic colonization prevented the host's normal microbiome and gut gene expression profile from returning to their normal state for months afterward. In contrast, the aFMT resulted in the third group's native gut microbiome and gene program returning to normal within days.
When shopping for a probiotic, the first things to look at are CFUs count and probiotic strains. CFUs is the acronym for colony forming units, and is the measure of how many probiotic bacteria are capable of dividing to form colonies. In other words, the higher the CFUs, the higher the number of active, live good bacteria. Generally speaking, the higher the CFUs, the better, although there are exceptions.
"The proprietary formula in this lotion supports a healthy microbiome of your skin promoting a more hydrated, stronger barrier function and protection from pathogens without harming the good stuff. Throw away your antibacterial soap and hand sanitizer and use this all over after your shower and after washing your hands," says Astarita, who is also a fan of the Nerium Prolistic Powder Pre & Probiotic Plus Vitamins ($45) and Be Well Probiotic Powder ($46) by Dr. Frank Lipman.
Drinkable Bio-K+ probiotics are unique in the world of probiotics. The innovative manufacturing makes Bio-K+ both a supplement and a fermented food, containing three strains of probiotic bacteria that you won’t find anywhere else. What does this mean for your health? It means that drinkable Bio-K+ probiotics are good for providing health benefits from your mouth to large intestine, working synergistically together from your first sip to improve your microbiota and support any instance of gut dysbiosis. 
The National Yogurt Association, who created this seal of approval, requires all yogurt manufacturers to include it on products that meet the standard of having a sufficient number of probiotics. The probiotics in store-bought yogurt need to meet this standard in order to be shelf-stable and reach your body alive. But even then, this standard isn’t all that useful in practice. The number just refers to the total number of live cultures and not the levels for each of those microbes. It’s possible, Taub-Dix says, that a product won’t have high enough levels of a certain probiotic to have any effect.
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."
This makes it harder for your immune system to work properly and leaves you open to feeling under the weather unnecessarily. The good news is that taking probiotics can help replenish your gut microbiome, and since 80% of your immune system is in your gut, this inevitably has a very supportive effect on your immunity. Probiotics also specifically support your mucosal immune systems, found in your ear, nose, and throat area and your lungs, helping you to maintain respiratory health.4

Known as the most clinically proven effective probiotic strain, Lactobacillus rhamnosus GG (otherwise known as “LGG”) has been clinically proven to maintain healthy numbers of bacteria and yeast for optimal digestive health. This powerful probiotic is also paired with some of the best probiotic strains for feminine health, making it an ideal choice for any woman that is looking for complete care from her probiotic.

About 60 to 80 percent of our immune system lives in our gut. Imbalances in the gut’s microbiome (which is primarily made up of bacteria) lead to digestive issues, while many many other potential effects can be felt throughout the body—from feelings of fatigue to depression, thyroid dysfunction, autoimmunity, and a host of skin issues. Conditions like rosacea, psoriasis, eczema, and acne are really inflammatory conditions, and often a manifestation of something that is happening deeper within the body. When you fix the gut (which, depending on your health, might include getting rid of an infection like Candida, eating a clean diet, and taking a probiotic), skin issues often resolve as well.


Because there's a huge variety of probiotic products available on the market, many people struggle to find the right one for them. "There are many different strains of bacteria in different combinations within different probiotic supplements," explains Brooke Scheller, a clinical and functional nutritionist. "For example, a probiotic may contain a single strain of bacteria or many. It may also contain other vitamins, minerals, or other ingredients that may tout health benefits," she says. There are many different dosages, delivery systems (powder, tablets, capsules), and formulations (refrigerated vs. shelf-stable), and some probiotics also contain prebiotics, which basically act as fertilizer for the probiotics. (Related: Why Your Probiotic Needs a Prebiotic Partner)
Some companies have been around for years, and you may know their names. Those that have made probiotics for a while likely have tested and studied them over and over. It's smarter to choose a product from them over one from a maker you don't know. Check a third-party certifier (like ConsumerLab or the USP) to see if they have tested the product and found that it’s safe and reliable. If you're in doubt, ask your doctor.
Kefir: This could be the most ideal probiotic dairy product because it contains both bacteria and yeast working together to provide the numerous health benefits. In a recent eight-week study, people with diabetes were given kefir milk containing Lactobacillus casei, Lactobacillus acidophilus, and bifidobacteria vs. conventional fermented milk. The hemoglobin A1C levels were significantly lower in the group consuming the kefir.
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!
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.
The good news keeps stacking up for probiotics, the good-for-you bacteria that keep your GI system functioning in tip-top shape. "Research is finding that a healthy microbiome may play a role in reducing inflammation, a risk factor involved in illnesses ranging from colds to cancer, heart disease, arthritis, and cognitive decline," says Katherine Tallmadge, RD, author of Diet Simple. In addition, the bacteria may help burn body fat and reduce insulin resistance, she says. So to stay slim and healthy, consider adding more probiotic foods to your diet. Start with these truly yummy 13.
About 60 to 80 percent of our immune system lives in our gut. Imbalances in the gut’s microbiome (which is primarily made up of bacteria) lead to digestive issues, while many many other potential effects can be felt throughout the body—from feelings of fatigue to depression, thyroid dysfunction, autoimmunity, and a host of skin issues. Conditions like rosacea, psoriasis, eczema, and acne are really inflammatory conditions, and often a manifestation of something that is happening deeper within the body. When you fix the gut (which, depending on your health, might include getting rid of an infection like Candida, eating a clean diet, and taking a probiotic), skin issues often resolve as well.
Probiotics and raw fermented foods and drinks, such as sauerkraut and kefir that contain probiotic-like microbes, are very helpful for digestion. They help to keep your gastrointestinal tract at the proper pH for optimal digestion and help to break down foods. They also regulate the motion of your intestines so that food moves through at the proper pace.
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. 

The Number of CFUs The quality of a probiotic supplement has more to do with strains and how many CFUs it provides. (CFU stands for colony forming units, and it refers to the amount of live microorganisms in your supplement.) Although recommendations may vary, Gans says to look for probiotics with at least 1 billion CFUs: “Doses will typically range from 1 billion to 10 billion CFUs for adults; although doses for children are often under 1 billion.”
We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
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.
I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?
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:
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