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.

To avoid those and other problems, I strongly recommend buying a professional brand from a reputable health care professional or other vendor who stands by their products and undergoes third-party testing. Some of these professional brands have created advanced technology that preserves a probiotic supplement’s survival on the shelf and in your gut.

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.”
Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.
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.
As the best-selling author of Happy Gut and a medical doctor who specializes in gut health and once suffered from IBS (irritable bowel syndrome), I have experienced for myself, as well as see on a daily basis, how a disrupted gut flora opens the door for unfriendly microbes to step in and take over, creating all sorts of pandemonium that causes patients to gain weight, feel sick and tired, and become more disease-prone.
The best probiotic manufacturers will list their potency (in CFUs) at the time of expiration, ensuring you get the dosage you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times bestsellers "Brain Maker" and "Grain Brain" puts it this way: “Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf life.” Each of our top picks clearly shows a specific “best by” or “expires on” date on its bottle.
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.
Deep Immune Support Probiotics started with a simple premise: Most probiotic strains present on the market today cannot survive the acidic environment of the human digestive system. Additionally, most of the most powerful probiotics require refrigeration, meaning they won’t survive standard delivery services or even room temperatures during your commute or travel.
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 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.
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.
B. Longum is one of the first types of bacteria to colonize our bodies at birth. These important microorganisms ferment sugars into lactic acid, helping to stabilize the acidity of the GI tract and inhibit growth of harmful bacteria. For a group of adults prone to constipation, taking a mix of B. Longum BB536 with milk or yogurt for 2 weeks increased bowel movements [1].
Studies have shown some benefits linked to Lactobacillus and treating and/or preventing yeast infections, bacterial vaginosis, urinary tract infection, irritable bowel syndrome, antibiotic-related diarrhea, traveler's diarrhea, diarrhea resulting from Clostridium difficile, treating lactose intolerance, skin disorders (fever blisters, eczema, acne, and canker sores), and prevention of respiratory infections.
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.
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.
This story has played out before, most notably with vitamin supplements, which decades of research have revealed to be completely unnecessary for most adults and, in some cases, dangerous, correlating with higher rates of lung, breast and prostate cancers. But that has not stopped marketers from pushing another nutritional craze. According to a National Institutes of Health survey, the number of adults in the U.S. taking probiotics or their cousins, prebiotics (typically nondigestible fibers that favor the development of gut bacteria), more than quadrupled between 2007 and 2012, from 865,000 people to nearly four million. San Francisco–based business consulting firm Grand View Research estimates that the global probiotics market exceeded $35 billion in 2015 and predicts that it will reach $66 billion by 2024.
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.∗