What's more, there's still a lot more to learn about the microbiome and probiotics, in general. "Truth be told, the research area of probiotics and health is still pretty much in its infancy," says registered dietitian Kate Scarlata. Research is growing in the area of gut microbiome daily—but it is much more complicated than first thought." With all these options and major gaps in the available information, where are you supposed to start? Here, gut experts narrow it down to three simple tips for picking the right probiotic for you.

There is also promising research on this species for supporting skin. Ceramides are natural lipids that make up the surface of the skin structure. Depleted ceramide levels are clinically linked with dry and damaged skin. S. Thermophilus was shown to have a beneficial effect on the level of ceramides in the barrier of the skin, which protects underlying tissue from infection, dehydration and chemicals. These skin-supporting microbes also act as antioxidants in the body, trapping reactive forms of oxygen that dry, damage and age the skin [1].


The concept of probiotics is credited to Élie Metchnikoff, a Russian scientist born in the mid-1800s, whose work provided profound insights into immunology and microbes. He developed a theory about aging that over the years had been forgotten in mainstream medicine but is now embraced by many scientists: namely, that health is influenced by toxic bacteria in the gastrointestinal (GI) tract. He is said to have noticed that people who lived to be over 100 years old in the Balkan States and Russia drank sour milk, which we now call yogurt or kefir, every day. In fact, Bulgarian yogurt cultures even today are regarded as highly therapeutic.
The high quality supplement comes in veggie capsule form, and no refrigeration is necessary. This probiotic is made in an FDA registered facility (in the US), and it meets GMP standards. It’s an all natural supplement, that’s free of lactose, soy and gluten. It also contains no artificial coloring. DNA Shift probiotic also offers prebiotic fiber for an extra healthy brain and gut.
Yet that’s how probiotics are often offered. They can be distributed in the United States as food, supplements or drugs. The regulations for each are very different. Most people looking for probiotics don’t see the distinctions. Ideally, the ways in which we use and consume probiotics would conform to the data and evidence that back them up. That rarely happens.
"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. "
The National Institute of Health (NIH) is sponsoring the Human Microbiome Project (HMP), which is developing research resources to enable the study of the microbial communities that live in and on our bodies and the roles they play in human health and disease. The NIH has funded many more medical studies using HMP data and techniques, including the role of the gut microbiome in Crohn's disease, ulcerative colitis, and esophageal cancer; skin microbiome in psoriasis, atopic dermatitis, and immunodeficiency; urogenital microbiome in reproductive and sexual history and circumcision; and a number of childhood disorders, including pediatric abdominal pain, intestinal inflammation, and necrotizing enterocolitis, a severe condition in premature infants in which the intestine tissue dies due to lack of oxygen.

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.
Self-dosing with bacteria isn't as outlandish as it might seem. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. These microorganisms (or microflora) generally don't make us sick; most are helpful. Gut-dwelling bacteria keep pathogens (harmful microorganisms) in check, aid digestion and nutrient absorption, and contribute to immune function.
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.
Better Health Review ranks Ultimate Flora as the most effective probiotic supplement. It contains 30 billion active bifidobacteria for colon health, and 20 billion lactobacilli and lactococcus cultures for the small intestine. According to Better Health Review, it contains all natural ingredients. It earns a perfect 5 score from Better Health Review, and the magazine “Vitamin Retailer” voted it best two years in a row.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.
Clinically shown to work in 7 days§, AZO Complete Feminine BalanceTM works differently because it contains the power of INTELLIFLORA,TM the only clinically proven blend with the 4 vaginal lactobacilli species most commonly found in healthy women.* Specially designed to restore the vagina’s microflora, it’s a safe and beneficial probiotic for women’s health—including pregnant women.*§ Add it to your daily regimen for help with protection and ongoing vaginal health support.*

​​​​​​Lactobacilli dominate a healthy vaginal microbiota. Menstrual cycles, sexual activity, diet, certain medications, hygiene, and other factors can occasionally disrupt the vaginal microbiome. AZO Feminine Balance Daily Probiotic has been clinically demonstrated to contribute to the colonization of these important lactobacilli in the vagina.* The result: restoring the natural balance of good bacteria and yeast to maintain vaginal health.*
Bifidobacteria is a family of bacteria that has been studied for its ability to prevent and treat various gastrointestinal disorders, including infections, irritable bowel syndrome and constipation. In addition to making lactic acid, it also makes some important short-chain fatty acids that are then absorbed and metabolized by the body. There is also some experimental evidence that certain bifidobacteria may actually protect the host from carcinogenic activity of other intestinal flora.
Though capsules are ideal for quick, convenient consumption, powdered products are a great choice for anyone who wants to mix their probiotics with shakes or smoothies. The Hyperbiotics Organic Prebiotic Powder is a totally taste-free prebiotic powder that has inulin, FOS, resistant starch, and dietary fiber to help keep your gut health in line. Unlike probiotics, prebiotics works to nourish and grow the bacteria that is already in your body. This supplement also has acacia fiber, which is said to help suppress appetite and reduce gas and bloating. You can take between one and three scoops of powder a day, depending on how much microbial support you’re looking for. Each container comes with 375 grams or roughly 54 servings, and it doesn’t need to be refrigerated.
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
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.
According to a 2014 meta-analysis, probiotics benefit diabetics by improving insulin sensitivity and decreasing the autoimmune response found in diabetes. The authors suggest that the results were significant enough to conduct large, randomized, controlled trials (the “gold standard” of scientific studies) to find if probiotics may actually be used to prevent or manage diabetes symptoms. Combining probiotics with prebiotics may also help manage blood sugar, particularly when blood sugar levels are already elevated. (87)
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.
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.
Next time you pack your travel beauty bag, slip a shelf-stable probiotic in there to preempt bathroom emergencies, Fasig says. Look for one that contains Lactobacillus acidophilus, Lactobacillus sporogenes, Bifidophilus bifidum, and Sacchromyces boulardii strains ($20, amazon.com), which Fasig says can improve your intestinal health to fix issues with constipation or diarrhea.
Here’s a startling fact: For every one human cell we have, there are ten bacteria cells in our body to match it. That means that the majority of DNA in our body isn’t even human; it’s from the 500 bacteria species that call us home.1 Thinking about that much bacteria might have your skin crawling, but the relationship between human and bacteria is really a perfect synergy: we give bacteria room and board, and in return, they work hard to protect our intestinal health, which ultimately protects the health of our immune system and overall well-being. But if we have that much bacteria already living in our gut, you might be thinking to yourself, what are probiotics’ benefits?

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.


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 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.
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.
Probiotics are “friendly” bacteria that inhabit your body. Sound strange? These microscopic roommates can be your best buds if you show them a little love. One surefire way to do that is with probiotic supplements. Probiotics support the right ratio of good to bad bacteria in your gut. For bonus points, call on digestive enzymes. These unique blends offer specific nutritional support to assist digestion and nutrient absorption. Your healthy body will quickly appreciate these lifelong friends.
Yogurt: It can contain Streptococcus thermophilus, Lactobacillus bulgaricus, L. acidophilus, and Bifidobacterium bifidum. Research has shown links with yogurt to have positive effects on the gut microbiota and is associated with a reduced risk for gastrointestinal disease and improvement of lactose intolerance (especially among children), type 2 diabetes, cardiovascular disease, allergies and respiratory diseases, as well as improved dental and bone health.
Lacto-bacillus plantarum: If you’ve ever heard of the beneficial effects of fermented foods (pickles, sauerkraut, kimchi, etc.), then you’ve heard of this powerful probiotic, which may help improve the symptoms of IBS, gluten intolerance, soy allergies, and Crohn’s disease. This is also one of the most antibiotic-resistant probiotics, which is especially important if you have taken antibiotics recently.

Garden of Life RAW Probiotics are some of the most popular out there – and for good reason. Let’s start with the basics: You’ll get 85 billion CFUs and 31 to 33 probiotic strains out of your daily, whole-food, gluten-free, soy-free probiotic, which helps support the immune system, a healthy thyroid, nutrient absorption, digestive function, and a healthy microbial balance.


Some of their benefits are universal, no matter your age or gender: supporting gut health, healthy skin, weight management, and strong teeth. But gender-specific probiotic benefits also exist. For instance, women who take probiotic supplements may be more likely to maintain vaginal and breast health, and expecting mothers who take probiotics can get support with some of the less pleasant side effects of pregnancy.
"People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial; we wanted to determine whether probiotics such as the ones you buy in the supermarket do colonize the gastrointestinal tract like they're supposed to, and then whether these probiotics are having any impact on the human host," Eran Elinav said in a statement. "Surprisingly, we saw that many healthy volunteers were actually resistant in that the probiotics couldn't colonize their GI tracts. This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement. Instead, they could be tailored to the needs of each individual."
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Next time you pack your travel beauty bag, slip a shelf-stable probiotic in there to preempt bathroom emergencies, Fasig says. Look for one that contains Lactobacillus acidophilus, Lactobacillus sporogenes, Bifidophilus bifidum, and Sacchromyces boulardii strains ($20, amazon.com), which Fasig says can improve your intestinal health to fix issues with constipation or diarrhea.
"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."
Like some of the other probiotics we’ve reviewed, the HyperBiotics PRO-Women Probiotics with Cranberry Extract and D-Mannose do not need to be refrigerated in between uses. What sets this particular formula apart though is its longer shelf life made possible by the patented HyperBiotics ‘LiveBac’ manufacturing process. In fact, the HyperBiotics PRO-Women Probiotics formula can usually last for more than a year when stored in normal indoor conditions!
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. 

There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and in improving symptoms of irritable bowel syndrome, but more needs to be learned. We still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would most likely benefit from taking probiotics. Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
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."
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.
The research also showed that while probiotics colonised the gastrointestinal tract of some people, the gut microbiome of others just expelled them. There was no way of telling from their stool sample which category people fell into. “Some people accept probiotics in their gut, while others just pass them from one end to the other,” says Elinav. They found that the probiotic colonisation patterns were highly dependent on the individual. That tells us that the concept that everyone can benefit from a universal probiotic bought from the supermarket is empirically wrong, he says.
Having a healthy gut flora means an abundance for your health, digestion, wellbeing and even beauty! As we saw last week, there is ongoing communication between your GI and your brain known as the gut brain axis. This means a healthy gut can benefit the regularity of your digestion as well as cognitive function like mood and depression, and even the health and appearance of your skin.
While taking a daily probiotic supplement may seem like an easy answer to cure common gut ailments, it’s always best to try for a food first approach, since you can get probiotics from the foods you eat. Probiotics can be found in foods such as yogurt, cheese, miso, sauerkraut, and kimchi. But, adding a supplement into the mix if you haven’t achieved the desired effect through diet alone can be effective.
Flora offers a high potency blend of eight super strain probiotics for general gut health and immune system support including multiple varieties of Lactobacillus and Bifidobacterium, among others. Containing up to 42 billion CFUs per capsule, this powerful health-boosting blend uses only strains found naturally in the human body, which increases its effectiveness.
After suffering from liquid nighttime but painless diarrhea for over a year (which I semi-controlled with one Imodium/day), I had a colonoscopy that gave a diagnosis of microcolitis. After the colonoscopy, I developed for the first time excrutiatingly painful gas pain in the LLQ. Usually this pain started during aerobic activity such as walking, but not always. Sometimes I woke up with it. CT scan revealed nothing. Will a probiotic help and if so, which would be best? There are so many it is hard to choose.
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.
If you want to supercharge your probiotic friends, you may want to feed them with prebiotics. That’s P-R-E-biotics. They nourish the good bacteria in your gut in order to keep them healthy against the bad bacteria. They should go hand-in-hand with probiotics. Prebiotics are found in many foods, including bananas, whole grains, honey, garlic and onions. Try to get two to four servings of these prebiotic-rich foods a day.
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
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