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.
Survival past stomach acids - probiotic powder in capsule form is ill prepared when it comes to protecting the delicate bacteria from being pulverized by the harsh environment of the stomach acids. Worse, most of the organisms tend to die off before they reach their intended destination due to moisture that gets trapped between the capsule shell and the powder.
If you decide to use a probiotic supplement and get clearance from your doctor for doing so, be sure to read the label carefully. You want to be sure that the supplement contains live strains of the bacteria or yeast, and that the life of these strains is guaranteed at the time of use, and not at the time of manufacture. Other points of comparison are the number of bacteria strains and the number of colony-forming units, although this does not necessarily guarantee results.
“It’s been proposed—but not proven—that regular probiotic intake may help prevent this change [with age],” says Emeran A. Mayer, M.D., a professor of medicine and psychiatry at the David Geffen School of Medicine at UCLA and author of “The Mind-Gut Connection” (Harper Wave, 2016). “We’re just starting to scratch the surface of this area of research.”
Although probiotics have been around since the early 1900s, they have recently gained popularity due to their ability to treat a wide range of ailments. Research also suggests that probiotics can help you lose weight and maintain a healthy body-mass index, according to a meta-analysis that reviewed 20 studies that was published in May 2016 in the International Journal of Food Sciences and Nutrition.

Additionally, it's a good idea to take note of the number of colony-forming units (CFUs) that are in the supplement you're considering, Angelone says. CFU count tells you the number of viable, active bacteria present in a tablet, she explains, and one billion (yes, seriously) is a typical dose. However, if you're struggling with a specific health condition, you may need more than that, Warren says. Your doctor can help you decide whether that's the case and may be able to steer you toward a good supplement to get you started. Here are a few to consider if you decide that probiotics are right for you.
Several large-scale studies and two meta-analyses have confirmed that probiotics should be a major consideration in determining natural remedies for diabetes. In a massive study involving almost 200,000 subjects and a total of 15,156 cases of type 2 diabetes, researchers confirmed that a higher intake of probiotic-rich yogurt reduced the risk of developing diabetes.

Add in a naturally derived prebiotic, which feeds probiotics to boost both potency and effectiveness, and you have a slow-release capsule that delivers beneficial bacteria exactly where it’s needed. What’s more, Hyperbiotics Pro-15 has a long shelf life (18 months from the date of manufacture) and requires no refrigeration, which makes it as portable as it is tiny. This product is made in the USA, an NSF- and GMP-certified facility.
Supplements play an important role when the diet is not adequate to supply our needs. In the case of probiotics, one's diet is the ideal source for probiotics. These are live bacteria and need to be carefully monitored, stored, and combined for the health benefits that one would be taking them for. At this time, supplements are not monitored in the U.S. the way that food or medication is. They fall under the Dietary Supplement Health and Education Act of 1994 (DSHEA). This requires that the dietary supplement or dietary ingredient manufacturer be responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. The only time that the U.S. Food and Drug Administration (FDA) may get involved is if action is needed to be taken against a manufacturer after the supplement is marketed and then found to be unsafe. This means that as much as we may know about probiotics, we can't be certain of the safety or content of the supplements available to us.
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.

Other foods without substantial research: miso (fermented soybean paste); tempeh; sauerkraut; aged soft cheese; sourdough bread; sour pickles; gundruk (nonsalted, fermented, and acidic vegetable product); sinki (indigenous fermented radish tap root food); khalpi (fermented cucumber); inziangsang (traditional fermented leafy vegetable product prepared from mustard leaves); soidonis (widespread fermented product prepared from the tip of mature bamboo shoots)
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:
Probiotics have become buzzy in recent years: Celebrities including Lauren Conrad and Anna Paquin have been spotted carrying bottles of kombucha, a probiotic-containing fermented tea, and the probiotics market has been growing rapidly as more people pursue better health by taking probiotic supplements. Prebiotics are attracting notice too, but you may still be unsure of what exactly prebiotics and probiotics are. Here's what you need to know about them to decide whether taking supplements is right for you.
While more research is necessary to truly understand the widespread benefits of different probiotic strains, we do know that not all probiotics are created equal. The Lactobacilli, for instance, live in our digestive, urinary and genital systems and can be found in some fermented foods like yogurt. Bifidobacteria normally live in the intestines as lactic acid bacteria, and are also found in fermented foods. According to nutrition expert Alex Caspero, RD, “For certain conditions, you want to ensure you are taking the strand that is most likely to benefit you.” Here is a simple breakdown to help you determine the best probiotic for you.
"This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement," study co-senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel, said in a statement. However, it may be possible to tailor probiotic treatments to the individual, based on the types of microbes already in his or her gut, as well as other factors, so that he or she gets the most benefit from probiotics, the researchers said.
For the generally healthy person, you can make a very good case to trust your own body to select and grow the best bacteria that are already in everyone. The foods you eat greatly influence your bacterial mix. Although probiotics offer many positive health benefits, there is no guarantee that they can make the trip from your mouth to your lower gut intact. Although adding more prebiotic fiber to your diet cannot guarantee safe passage of probiotics, it can influence the healthy bacteria that already live in your system. If probiotics help you, eating prebiotic foods or supplements will cause those healthy bacteria to flourish.
Historically, people had plenty of probiotics in their diets from eating fresh foods from good soil and by fermenting foods to keep them from spoiling. Over a century ago, the Russian Nobel Prize winner Elie Metchnikoff theorized that “health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt.” Metchnikoff was ahead of his time with his view of probiotics benefits, but he also was aware that most citizens had regular access to probiotic foods.
In the 2016 paper, Dr. Ghannoum and is research partners looked at parameters of microbiome makeup in Crohn’s Disease patients and healthy members of the same families in an area in Belgium.  The researchers said they “​identified positive interkingdom correlations between C.​ ​tropicalis​ (a fungus), E.​ ​coli, and S.​ ​marcescens​ (both microbial species) ​in CD patients and validated these correlations using in vitro biofilms​. These results provide insight into the roles of bacteria and fungi in CD.​”​
This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.

"There is an increasing interest in probiotic interventions," wrote the authors of one of the most recent studies, a meta-analysis of previous research in a recent issue of the Journal of the American Medical Association. Those researchers found that probiotics were particularly useful against a common gastrointestinal problem: antibiotic-associated diarrhea (AAD).
The bottom line: Stick to trusted whole food sources of probiotics if you don’t know a probiotic supplement brand you trust. “Kimchi, pickled beets, Greek yogurt and sauerkraut are great sources of probiotics. If you don’t like them, throw them into a food you do like, like a smoothie, and add your favorite fruit to help mask the flavor,” Taub-Dix says.
But sometimes you need a little help from outside sources in order to secure those benefits, which is why a lot of experts recommend getting an extra hit of probiotics through food. Fermented options — think keffir, sauerkraut, and kimchi — are a great place to start, says the International Scientific Association of Probiotics and Prebiotics, as are these other surprising foods with probiotics.
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.
If you go with a supplement, know that the FDA regulates these products but treats them like foods and not medications. Unlike drug manufacturers, supplement makers don’t have to show their products are safe or effective to sell them. That means that these firms are in charge of checking the safety and labeling of their products before they sell them to make sure they meet FDA rules.
Taking relatively high doses of these probiotic strains before, during, and after antibiotic treatment can help your microbiome get back on its feet: B. Lactis, B. Infantis, L. Acidophilus, L. Casei, L. Bulgaricus, L. Paracasei, L. Rhamnosus GG, and S. Boulardii. Our antibiotic combatant MegaFood MegaFlora has six of these strains, as well as eight others. One serving contains 20 billion CFUs to replenish the good bacteria.
Don't assume that the only way you can get your probiotic yogurt fix is through dairy. Cultured soymilk, or soy yogurt, is a non-dairy alternative that also boasts live active cultures. Most of these products are fortified with calcium and vitamin D to make them comparable to dairy yogurts. It makes a great option if you're vegan or lactose intolerant. (And if you're looking for more variety, almond milk and coconut milk yogurts are also rich in probiotics.)
Best Probiotic chose iFlora Multi-Probiotic by Sedona Labs as one of the best probiotic supplements. It is a blend that works well in both the large and small intestines and it can survive stomach acid to maintain effectiveness. According to Sedona Labs’ website, iFlora delivers 32 billion active cells through 16 probiotic strains, plus probiotic fiber.
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.
These are live microorganisms that will not provide the promised benefits if they don't remain alive. The manufacturer and consumer must pay close attention to the conditions of storage at which the particular microorganism will survive and the end of their shelf life. The potency will indicate the number of viable bacteria per dose, and the purity has to do with presence of contaminating or ineffective bacteria.
Others scientists are more hopeful. Finding out how exactly probiotics work in regards to allergies is an important step in that process. Some studies show that some strains of bacteria can affect how our T cells (an immune cell responsible for the big immune responses) function. Others suggest that they may reduce the production of a part of the immune system called immunoglobulin E, which is produced in excess during an allergic reaction.
Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," Eran Segal said in a statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
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