Those who took probiotics did replenish gut microbiome more successfully than the “watch-and-wait” group. That said, there was also an unexpected backlash to probiotic use. The researchers were alarmingly surprised to discover that successful microbiome colonization via probiotics actually prevented the host's pre-antibiotic microbiome and gut gene expression profile from returning to its natural state for months after the treatment. But there is good news: Using aFMT resulted in the third group's native gut microbiome and gene expression profiles returning to normal within days after they stopped taking antibiotics.

Dr. Tobias responded with Deep Immune Support, a shelf-stable capsule that does not require refrigeration and employs four acid-resistant probiotic strains. One such strain: DE111, a highly effective spore-forming probiotic, which complements and balances the non-spore strains most commonly found today, and also supports the proliferation of beneficial bacteria. The patented, delayed-release capsules are made in the USA and are both kosher and vegetarian.
Literally the best thing you can get for your body! I was having bad stomach problems and it vanished after two days of taking these regularly. Keep in mind that if you are putting junk into your body, you need good bacteria in your gut. It's crucial, roughly 80% of your immune system originates from your digestive tract. This WILL help you get your health back in order.
Selecting a multi-strain probiotic is also consistent with the theory that filling your gut with enough good bacteria outcompetes any bad bacteria for the same space and resources. In your gut, the more diversified the good bacteria, the harder it is for the baddies to gain a foothold. With all this in mind, we only looked at supplements containing multiple strains of bacteria.

Unless you know that your body is lacking in a particular type of probiotic, you should just look for broad-spectrum probiotics that contain a mix of different strains of bacteria, Warren says: "We have billions of bacteria in our gut, so by taking a supplement with a range of different strains, you will ensure you are not overdoing or missing one type." Keatley also stresses the importance of finding a supplement with a diversity of bacteria strains to keep overgrowth of any one strain in check. "Providing too much of an advantage to one strain of probiotic may push out another strain we didn't know was important until it's too late," she points out.
Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a "folk" remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn't enough evidence yet to recommend it over conventional approaches. (Vaginosis must be treated because it creates a risk for pregnancy-related complications and pelvic inflammatory disease.) Probiotic treatment of urinary tract infections is under study.
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."
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.
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We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)

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.
That's because issues that can be treated with probiotics stem from specific imbalances in the amount of certain bacterial strains, according to Elena Ivanina, M.D., a gastroenterologist at Lenox Hill Hospital. "Therefore, if someone decides to supplement a particular strain of Lactobacillus, but they already have enough of that strain in their gut and their disease does not stem from a lack of Lactobacillus, then they will not have a response." Makes sense, right?
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.

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.
Diversity of strains - research has demonstrated that bacteria prefer to colonize in different parts of your digestive tract, where there are various ecological niches. The more probiotic strains you ingest, the more coverage you’ll provide for each of these niches. Each strain of bacteria also has its own different purpose, so choosing a formula with many different strains gives you that many more benefits.

A number of probiotic products are on the market, including yogurts containing probiotics, as well as supplements and skin creams, and an estimated 3.9 million Americans use such products. Some studies suggest that probiotics may help with diarrhea or symptoms of irritable bowel syndrome (IBS), but strong evidence to support their use for most health conditions is lacking, according to the National Center for Complementary and Integrative Health.


This Korean staple relies on lactic acid fermentation (also called lacto-fermentation) to turn cabbage or other vegetables into a spicy, pungent side dish that's packed with vitamin C. Order it at Korean restaurants or buy it in the refrigerated section of your grocery store (King's Kimchi is widely available at Walmart). For some guidance on making your own, turn to The Art of Fermentation ($23; amazon.com). Then, use it to spike veggie-laden rice bowls, top on soup, or serve alongside meat.
The benefits of probiotics don't stop at internal health. Research from the American Academy of Dermatology found that, whether applied topically or taken orally, probiotics can potentially help patients with skin issues such as acne, rosacea, and eczema. More studies need to be done though, so talk to your dermatologist before changing your regular routine.
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.
Probiotics are live bacteria that are present in yogurt, other fermented foods, and in pills. They are promoted as a benefit to the human digestive system. Normally you have trillions upon trillions of bacteria within the colon. Normally we ingest bacteria every time we swallow. Many of these swallowed bacteria may be beneficial while most are simply innocuous and cause no problems. The question for everyone who takes a probiotic much beyond yogurt is whether they really are a health benefit. Here is what we know medically about probiotics.
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.
Suez and colleagues investigated the recovery of the gut microbiota after antibiotic treatment and found that probiotics might perturb rather than aid this process. The probiotics rapidly colonised the gut but prevented the normal microbiota from repopulating for up to 5 months. While likely to be considerably less appealing, the group who received autologous faecal microbiota transplantation recovered their microbiota the quickest, with the composition of the microbiota returning to normal within days. Furthermore, Zmora and colleagues showed that colonisation occurred in highly individualised patterns, with some people's gastrointestinal tracts rejecting probiotics and others allowing colonisation by the probiotic strain, meaning that many individuals taking probiotic supplements are simply wasting their money.
Literally the best thing you can get for your body! I was having bad stomach problems and it vanished after two days of taking these regularly. Keep in mind that if you are putting junk into your body, you need good bacteria in your gut. It's crucial, roughly 80% of your immune system originates from your digestive tract. This WILL help you get your health back in order.

Thankfully, most causes of constipation can be improved with dietary and lifestyle interventions. One of probiotics benefits is constipation relief. Probiotics of many kinds can help with constipation because they can keep the digestive contents moving along through different mechanisms such as short-chain fatty acid production, influences on the nerves of the digestive tract, electrolyte balance, pathogen control, and others. Think of probiotic foods and pills as an addition to other dietary and lifestyle interventions to relieve constipation and return your digestive system to its normal functions.

Called probiotics, these good bacteria help break down food, synthesize vitamins, prevent bacteria that cause illness from getting a foothold, and bolster immunity. Some studies suggest that as we get older, the number and variety of good bacteria in our bodies decline. So taking probiotic supplements to replenish them might seem like a no-brainer.

The beneficial microbes, including probiotics, live with other microbes that are either benign, pathogenic (disease-causing), or opportunistic, meaning that they normally play nicely but can get out of control if given the opportunity. Actually, any microbe can cause you problems if it ends up in a place other than where it is supposed to be. Such a scenario can happen with intestinal permeability, commonly called leaky gut. Leaky gut happens when the layer of skin-like cells in your GI tract develops gaps in between the cells, allowing food particles, toxins, microbes, and other hazards to enter your bloodstream, if not stopped by the immune system. Since mucus, the thin layer of cells, and your immune system are your only defenses against the outside world within your digestive tract, it is very beneficial to you to have helpful microbes protecting you from potentially pathogenic microbes. These beneficial microbes can produce acids or antimicrobial products called bacteriocins, which hinder or kill pathogens. They can also stand in solidarity to prevent pathogens from taking up residence, or displace them if they do.
We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.) 

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!

Though rates of serious lung issues have been dropping among men in the Western world, they're still a major concern, with over three million men affected by ongoing respiratory conditions.1 While steroids and antibiotics are the go-to treatments for these conditions, they often fail to address the underlying issue, and they destroy bacteria indiscriminately, creating conditions in which undesirable bacteria can thrive.


How is it that probiotics are such a ubiquitous trend in the wellness scene but subject to tons of misinformation all the same? Consider the myth, for example, that the only appeal of replenishing your good bacteria is smoother digestion. On the contrary, the benefits of probiotics abound: from a boosted mood and better skin to a healthier immune system.
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
There are many health benefits of probiotics, but there are also a few cautions to heed as well. First, if you are immune compromised (catheters, cancer treatments, HIV, trauma, and so on), please consult your physician to check if there are any contraindications for using probiotics. Second, if you never used probiotics or a particular type of probiotic before, and/or never ate much raw food or indulged in fermented probiotic-rich foods and drinks (such as sauerkraut, kimchi, kefir, or kombucha), please proceed slowly with probiotic supplements and use. Although probiotics are tiny organisms, they can have very potent effects on your body.
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.”
"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."
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.
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.”

Our body normally has what we would call good or helpful bacteria and bad or harmful bacteria. Maintaining the correct balance between these bacteria is necessary for optimal health. Age, genetics, and diet may influence the composition of the bacteria in the body (microbiota). An imbalance is called dysbiosis, and this has possible links to diseases of the intestinal tract, including ulcerative colitis, irritable bowel syndrome, celiac disease, and Crohn's disease, as well as more systemic diseases such as obesity and type 1 and type 2 diabetes. How do you know if you need probiotics? This article will help you decide.
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.
Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way. However, the researchers were surprised to find that this prevented the return of the person’s normal microbiome for up to six months. “The probiotics very potently and persistently prevented the original microbiome returning to its original situation,” says Elinav. “This was very surprising and alarming to us. This adverse effect has not been described to date.”
Two large-scale clinical trials recently reported in the New England Journal of Medicine suggest that the situation in infectious diarrhoea might also be more complex than previously believed. Freedman and colleagues did a randomised controlled trial of a probiotic containing Lactobacillus rhamnosus and Lactobacillus helveticus in children presenting to the emergency department with gastroenteritis. Contrary to expectations, they found that the probiotic did not prevent development of moderate-to-severe gastroenteritis within 14 days after enrolment. In a separate study, Schnadower and colleagues found similar results with L rhamnosus GG alone. Both trials used probiotics that are available over the counter in North America and showed no significant difference from placebo in the duration of diarrhoea and vomiting, number of unscheduled health-care visits, or length of absence from day care. These results cannot be generalised to other probiotic strains or preparations, but they do show that we have some way to go in elucidating which probiotics might provide benefits in which clinical settings.

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.


Digestive tract conditions. Probiotic supplements may be useful in treating and preventing inflammatory conditions, such as pouchitis (which affects people who have their colons removed), inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease), and chronic stomach inflammation and ulcers caused by Helicobacter pylori bacterium. They may also be helpful in treating constipation, irritable bowel syndrome, acid reflux, spastic colon; shortening the duration of infectious diarrhea; and reducing the recurrence of bladder and colorectal cancer. Some studies suggest that yogurt is helpful in preventing diarrhea - a common side effect of treatment with antibiotics. It has also been shown to prevent or treat urinary tract infections and vaginal yeast infections in women.
Colic is crying or fussing that begins suddenly, lasting for a total of three hours a day and happening more than three days a week for about three weeks. Symptoms include the baby's face turning red, the belly is distended, the feet may be cold, the hands clenched, and the legs may alternate between being flexed or extended. Treatment may involve ruling out other causes of the fussing and the doctor prescribing anti-gas bubbly medicine.
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 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.


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.

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.
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.
Probiotics are very promising and used quite often in practice. Many physicians, including myself, use them regularly for many gastrointestinal issues and other issues like infant colic, preventing diarrhea in patients taking antibiotics and for overall immune and respiratory health. There is still a lot more research that needs to be conducted but it is clear that they are here to stay, and the research base is likely only going to lead to increased use in many other conditions in both preventing and treating diseases.
For most of my life, I thought of probiotics as something I’d only drink if I lost a bet. Then stress-induced irritable bowel syndrome (IBS) turned my intestinal tract into a nonstop river of shit—we’re talking weeks of everything I ate shooting straight out my butt in liquid form. The internet said probiotics were my best non-pharmaceutical bet to help my digestive system calm down, so I swallowed my pride (and my first kombucha ever) and kinda sorta saw the light. My IBS wasn’t cured, but probiotics did help me spend less time on the toilet wide-eyed with terror, and more time doing what’s really important in life—watching TV with my family.
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! 

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.
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.
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:
The idea that consuming probiotics can boost the ability of already well-functioning native bacteria to promote general health is dubious for a couple of reasons. Manufacturers of probiotics often select specific bacterial strains for their products because they know how to grow them in large numbers, not because they are adapted to the human gut or known to improve health. The particular strains of Bifidobacterium or Lactobacillus that are typically found in many yogurts and pills may not be the same kind that can survive the highly acidic environment of the human stomach and from there colonize the gut. 
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