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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.
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.
The side effects of antibiotic use are often not trivial. Many people experience discomfort and a change in bowel habits, but some experience more severe infections, such as opportunistic colonization of the gut with bacteria such as Clostridium difficile (C.diff), which affected half a million Americans in 2015 and was directly responsible for at least 15,000 deaths.
To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.

While the logic behind probiotics might seem sound, it is clear that we have a long way to go before understanding the complexity of the microbiota and the effects—both good and bad—that probiotics might have. All individuals have a unique gut microbiome, and the effects of different bacteria on different people are likely to be highly variable; as such, probiotic use might even need to be personalised for optimal benefits. Commercially available products might not contain the correct strains or quantities of bacteria to provide benefits, and most probiotic supplements contain only single strains, vastly oversimplifying the complexity of the microbiota. While taking a supplement for improved health is certainly an attractive prospect, those looking to aid their gut microbiota might be better served by consuming a healthy, varied diet. In the meantime, rigorous clinical trials are needed to substantiate potential health benefits and to confirm whether probiotics are elixirs or just empty promises.
Yes! Beneficial yeast is a probiotic, defined as a microorganism that supports human wellness. (Probiotic means “for life.”) Saccharomyces boulardii is a remarkable yeast that can significantly support your whole internal ecosystem. It helps reduce problematic yeasts, such as Candida, and replenishes healthy gut flora.* While many probiotic supplements only deliver friendly bacteria without yeast, Probiotic All-Flora contains 5 billion CFU of beneficial yeast for complete support.
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.
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.
In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
A Seal of Approval When looking for a good probiotic, Gans advises consumers to buy from a trusted retailer and look for a seal from a third-party certifier. “Reputable probiotic supplements should list the genus, species, and strain, in addition to the number of organisms that will be alive by the use-by date and the dose on the label,” says Gans. This transparency will help consumers understand what’s in their supplement and how to best use it.
Unfortunately, the U.S. has no federal standards for probiotic supplements. Therefore, you run the risk of purchasing a product without any guarantee that it contains its advertised probiotic strains, that the strains are alive, or that the product is free from unhealthy ingredients. Therefore, it may be best to choose a brand-name probiotic that has research backing their effectiveness. Here are some examples:

High cholesterol and triglyceride levels increase the risk of cardiovascular disease. Getting your cholesterol and triglyceride levels in an optimal range will help protect your heart and blood vessels. Cholesterol management may include lifestyle interventions (diet and exercise) as well as medications to get your total cholesterol, LDL, HDL, and triglycerides in an optimal range.


“Microbiome” refers to the trillions of bacteria and microorganisms that live on and in our individual bodies. “There’s increased recognition of the various ways that the microbiome affects our health,” Lebwohl tells me. “And with that recognition comes the true observation that many bacteria are good for us. This goes against the old idea that bacteria equal germs, which equal harm. It turns out that many bacteria keep us healthy and probiotics could potentially support that notion.”
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.

Probiotics are officially defined by the Joint Food and Agricultural Organization of the United Nations/World Health Organization Working Group as “Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Basically, probiotics at this point in time are live bacteria and yeasts that provide health benefits to you if you take them in adequate quantities.
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.
The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn't function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn's disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, H. pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it's never too late.
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.”
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.

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.


To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
The side effects of antibiotic use are often not trivial. Many people experience discomfort and a change in bowel habits, but some experience more severe infections, such as opportunistic colonization of the gut with bacteria such as Clostridium difficile (C.diff), which affected half a million Americans in 2015 and was directly responsible for at least 15,000 deaths.
While probiotics have been around as long as bacteria have, they were first officially identified for their health benefits in the early 20th century by Russian-born biologist Élie Metchnikoff. Metchnikoff believed that “good bacteria” like the microbes that produce lactic acid could prolong life and stave off senility, and actually recommended drinking sour milk daily for overall health. While Metchnikoff’s theories were pooh-poohed by many of his contemporaries, the first commercial probiotic, Yakult, hit the market in 1935 and is still on the shelves today.

Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
What exactly do probiotics do? They are believed to protect us in two ways. The first is the role that they play in our digestive tract. We know that our digestive tract needs a healthy balance between the good and bad bacteria, so what gets in the way of this? It looks like our lifestyle is both the problem and the solution. Poor food choices, emotional stress, lack of sleep, antibiotic overuse, other drugs, and environmental influences can all shift the balance in favor of the bad bacteria.
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:
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:
4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.
Unfortunately, the U.S. has no federal standards for probiotic supplements. Therefore, you run the risk of purchasing a product without any guarantee that it contains its advertised probiotic strains, that the strains are alive, or that the product is free from unhealthy ingredients. Therefore, it may be best to choose a brand-name probiotic that has research backing their effectiveness. Here are some examples:
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.

Pure Therapeutics Power Probiotic 100B offers 100 billion CFUs of 4 powerful probiotic strains, including science darling, the HN019 strain of Bifidobacterium lactis. Since environmental factors, including moisture, oxygen and heat, can degrade the stability of your probiotics, Pure Therapeutics 100B is delivered in nitrogen-purged aluminum blister pacts, which ensure viability until the probiotic hits your system. No refrigeration is required.
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