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.
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.
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.
While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.

Whether a brand of probiotics works really depends on its quality and your body's own gut. Everyone has a different set of gut flora so try several to see what works for you. Using a brand of at least 40 billion CFU is best. There seems to be some debate as to whether one should use refrigerated or unrefrigerated probiotics. I went with the side that claims unrefrigerated are sturdier and less prone to die off. 

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.
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of goop, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
Remember, while bacteria gets a bad rap, not all bacteria is bad: As New York City-based certified dietitian-nutritionist Gina Keatley tells Allure, plenty of microorganisms, including probiotics, actually help your body function. "Probiotics may help stabilize the protective barrier in our gut so bad microorganisms don't take root, stimulate the immune response, and aid in production of vitamins, such as vitamin K," she says. Sonya Angelone, a registered dietitian and Academy of Nutrition and Dietetics spokeswoman, adds that while we have more to learn about the role of probiotics, beneficial bacteria is understood to help crowd out harmful bacteria in our bodies. This good bacteria may also help lower cholesterol, aid in reducing colds and acute respiratory infections, and reduce the occurrence of vaginal yeast infections, she says.
In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and
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.
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."
"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.

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.

Probiotics also seem to ameliorate irritable bowel syndrome, a chronic disease characterized by abdominal pain, bloating, and frequent diarrhea or constipation (or a mix of the two). A 2014 review of more than 30 studies, published in the American Journal of Gastroenterology by an international team of researchers, determined that in some cases, probiotics help to relieve the symptoms of irritable bowel syndrome for reasons that are not entirely clear, although it may be that they impede the growth of harmful microbes. The researchers concluded, however, that they did not have enough data to recommend any particular strains of bacteria. Microbiologists often caution that a promising study on a single strain of a particular species of bacteria should not be taken as proof that all probiotics work equally well. “Bacterial strains are so genetically different from one another, and everybody has a different gut microbiota,” Allen-Vercoe says. “There will probably never be a one-size-fits-all probiotic.”

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.
Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, laxative abuse, and hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.
Probiotics also seem to ameliorate irritable bowel syndrome, a chronic disease characterized by abdominal pain, bloating, and frequent diarrhea or constipation (or a mix of the two). A 2014 review of more than 30 studies, published in the American Journal of Gastroenterology by an international team of researchers, determined that in some cases, probiotics help to relieve the symptoms of irritable bowel syndrome for reasons that are not entirely clear, although it may be that they impede the growth of harmful microbes. The researchers concluded, however, that they did not have enough data to recommend any particular strains of bacteria. Microbiologists often caution that a promising study on a single strain of a particular species of bacteria should not be taken as proof that all probiotics work equally well. “Bacterial strains are so genetically different from one another, and everybody has a different gut microbiota,” Allen-Vercoe says. “There will probably never be a one-size-fits-all probiotic.”
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.
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.
Scientists are investigating probiotics, and their combined effects, by trying to classify the probiotic benefits of ingesting specific probiotic strains and understanding their role in the digestive tract. At present, the methodological and ethical limitations of human studies still make it difficult to fully understand the mechanisms of action of probiotics, but some explanations are available. Nevertheless, benefits linked to the consumption of probiotic strains have already been suggested (e.g. helping to support the immune system, help support digestive health), and others are still being investigated.
Jigsaw Essential Blend Probiotics uses five of the most researched (and effective) live strains to promote a healthy digestive system, restore flora after antibiotics use, and help with optimal vitamin absorption. Jigsaw products are also third-party certified, so you can rest assured that each batch is safe and pure. The bottom line? If you’re looking for a vegan-friendly formula — the capsules are made from HPMC (Hypromellose - Hydroxypropyl Methylcellulose), gelling agent (Gellan gum), and water — with a high CFU count, this product is for you. There are 90 capsules per bottle.
B. Bifidum has also been shown to prevent intestinal pathogens or digestive disrupters from flourishing in the gut, essential in restoring the bacterial balance and optimizing digestion. Clinical research found it supports a significant reduction in IBS symptoms, an improvement in quality of life and even helps relieve occurrences of ulcerative colitis – a chronic inflammatory bowel disease. [1].
That doesn't mean that all probiotics, or probiotic-containing foods are created equal. So what should you look for? "There is a lot of 'noise' in this space as more and more 'food products' are coming out with Probiotics," Dr. Shekhar K. Challa, a gastroenterologist and the author of Probiotics For Dummies tells The Huffington Post. "Unfortunately it is impossible to quantitate the CFU's of probiotics in most food products."
Topping the probiotic market numbers at 100 Billion CFU divided between 34 probiotic strains, Garden of Life’s Ultimate Care probiotic was definitely a contender for our Best Probiotic of 2018. Free from preservatives and additives, RAW scored impressive marks across the board. Although this shortens the lifespan of the probiotics strains somewhat, buying in small quantities can easily solve this problem and – honestly – at CHR we always prefer purity to additives.
Some yogurts contain the aforementioned bacteria; however, because they are sensitive to oxygen, light, and dramatic temperature changes, make sure to look for yogurts with “live and active cultures.” Many commercial yogurts are heat-treated or pasteurized, resulting in the loss of these valuable cultures. Learn more about the smart way to shop for probiotics.

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 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.
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.
​​​​​​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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