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.
For example, yogurt is made with two “starter” bacterial cultures — Streptococcus thermophilus and Lactobacillus bulgaricus — but these bacteria are often destroyed by your stomach acid and provide no beneficial effect, Dr. Cresci explains. Some companies, though, add extra bacteria into the product, so check the labeling and choose products with bacteria added to the starter cultures, she advises.
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.

"The skin and the gut go hand in hand," explains Shapiro. "Since probiotics help improve the gut microbiome and aid in reducing inflammation, skin conditions will also improve. When eating a healthy, whole food diet as well, skin conditions get better over time. When the gut is not intact, other parts of the body also start to break down and become toxic. With probiotics, your gut becomes healthier and therefore, your skin problems start to disappear. "


"I recommend supplementing with the species lactobacillus and bifidobacterium, and there are different strains within those species that are each beneficial. Garden of Life and Align probiotics contain bacteria that help the gut microbiome and maintain digestive balance, and 1MD's Complete Probiotics Platinum is one of the best probiotics with over 50 billion live cultures that help with gut and digestive health."
Probiotics contain 'good' bacteria, and that's exactly why we need them; because it's not just 'good' bacteria calling our gut home. Taking a probiotic supplement (along with a healthy diet) increases the number of good bacteria, reduces the number of bad bacteria and creates an environment that’s suitable for beneficial microorganisms, which improves our overall health.

Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats.
Made from aged, fermented soybeans, this paste is brimming with probiotics. You can buy miso paste in a bunch of varieties (white, yellow, red, brown) and the darker the color, the deeper the taste. Miso is a great way to add a burst of earthy, savory flavor for few calories (only 25 to 30 per tablespoon), plus protein, fiber, and bone-strengthening vitamin K, says Sharon Palmer, RDN, author of Plant-Powered for Life. "While we need more research about how these types of fermented foods contribute to health, it's a good idea to introduce more of them into your diet," she says. Use miso to glaze fish or chicken before cooking, mix into a stir-fry recipe, or add to liquid to make a miso broth. One caveat: Miso is very high in sodium. One teaspoon, enough to make a cup of miso soup, has 473 mg of sodium, 21% of the daily recommended limit and 32% of the daily limit for those with high blood pressure.

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.∗
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT." Cell (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047

The two main species you want to look for are: Lactobacillus and Bifidobacterium. Within these two species, there are a lot of different strains. The strains we chose for our probiotic—Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium longum—have been shown to help modulate the immune system, help with autoimmunity conditions (which affect most of my patients), and counter infections in the gut.
You dread stepping on the scale and avoid looking at your profile in the mirror because you know you gained weight and need to lose some. You tried every diet on the market to no avail. Your frustration level is high, but you do not need to give up hope. The first thing to do is to love yourself regardless of your weight so that your emotions and stress levels do not sabotage your efforts. You can love yourself while working toward self-improvement.

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The National Center for Complementary and Integrative Health (NCCIH) calls probiotics “live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut.” The NCCIH makes the point that we often think of bacteria as harmful “germs” — however, probiotic bacteria actually helps the body function properly.
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.
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
Niv Zmora, Gili Zilberman-Schapira, Jotham Suez, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Eran Kotler, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Yotam Cohen, Raquel Linevsky, Daphna Rothschild, Andreas E. Moor, Shani Ben-Moshe, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Hagit Shapiro, Meirav Pevsner-Fischer, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. "Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features." Cell (First published: September 6, 2018) DOI: 10.1016/j.cell.2018.08.041
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.

Experts agree that this is the most important factor to consider in choosing a probiotic. "You should absolutely choose a probiotic based on what you are looking to address," says Chang. "Because strain specificity will impact outcomes, it is important to consider that one strain that works for one condition will not necessarily be effective for other conditions."


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].
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.
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.

Most of the prebiotics identified are oligosaccharides. They are resistant to the human digestive enzymes that work on all other carbohydrates. This means that they pass through the upper GI system without being digested. They then get fermented in the lower colon and produce short-chain fatty acids that will then nourish the beneficial microbiota that live there. Oligosaccharides can be synthesized or obtained from natural sources. These sources include asparagus, artichoke, bamboo shoots, banana, barley, chicory, leeks, garlic, honey, lentils, milk, mustards, onion, rye, soybean, sugar beet, sugarcane juice, tomato, wheat, and yacón. The health benefits from these oligosaccharides is a topic of ongoing research.
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.​”​
Very few women know that one of the leading causes of infertility, difficulties getting pregnant, and even painful periods stem from thyroid dysfunction. That’s why infertility specialists, obstetricians, and gynecologists alike often order thyroid testing at the first sign of trouble. Poor thyroid function is also linked to joint pain, unplanned weight-loss or obesity and heart problems and thinning skin among many other signs and symptoms.
When looking at the list of possible causes, it is no surprise that gut function plays a role in brain fog. The gastrointestinal (GI) tract is in direct and indirect communication with the brain, and microbes in the gut can affect, for better or for worse, the types of communication that occur between the GI tract and the brain. Additionally, harmful products from pathogens in the gut can travel to the liver, overloading the liver and causing toxins to be circulated to the brain and contributing to brain fog.

Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.
Made from fermented cabbage and other vegetables, sauerkraut is not diverse in probiotics but is high in organic acids (what gives food its sour taste) that support the growth of good bacteria. Sauerkraut is extremely popular in Germany today. It is high in vitamin C and digestive enzymes. It’s also a good source of natural lactic acid bacteria, such as lactobacillus.
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.
Ultimate Flora tested significantly higher than the majority of general probiotic blends. Critical Care is composed of very well-documented probiotic strains and is an effective addition to any lifestyle, capable of conferring a wide variety of health benefits. The probiotic strains are not only diverse, they were also resilient to outside influences and, in many cases, were successful in establishing colonies within the digestive tracts of study participants.
Lebwohl says IBS isn’t just about intestinal distress. For many IBS sufferers, it’s about the way our brain receives messages about pain. He describes the human colon as “almost reptilian” in the way that it contracts and relaxes throughout the day, but says these contractions are usually happening way below our threshold of consciousness, so we don’t even notice. In people with IBS, the neurotransmitters in our gut (yes, we have them in there too) may be sending severe distress signals to the brain about benign contractions happening in digestive tract.
Many studies have shown that probiotics reduce diarrhea associated with taking antibiotics in both adults and children. In fact, it is common for physicians and pharmacists to recommend eating a probiotic-fortified yogurt every day during a course of antibiotics to prevent diarrhea. More research is needed to determine which probiotics are associated with the greatest effect for specific antibiotics.
Hi Joan, it’s possible, but not ideal because most pill form probiotic supplements are designed to be protected from stomach acid until the capsule reaches the intestines. It’s impossible to say how many probiotic microorganisms would survive by taking them this way, but certainly less than if you swallow the pills. I would recommend trying a probiotic gummy product or some other probiotic that comes in something other than pill form rather than opening up the capsules.
Even if you’re not sensitive to dairy, though, probiotics that require refrigeration can be inconvenient; but there are now some that don’t need to be kept cold. For example, our probiotics are sealed in nitrogen blister packs to protect them from heat, as well as moisture and oxygen because the air can’t get in. Look for probiotics that are individually packed to protect the live cultures. If they just come in a bottle they could be losing potency from air getting in.
A popular dish in Japan consisting of fermented soybeans, natto contains the extremely powerful probiotic bacillus subtilis, which has been proven to bolster your immune system, support cardiovascular health and enhance digestion of vitamin K2. Natto can also contain vitamin B12, which is usually lacking in vegan diets. It’s also one of the highest plant-based proteins.
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