Given that you can get probiotics from the food you eat, you don't necessarily need to take a supplement, and Keatley says she prefers food sources of probiotics to supplements. However, she adds that "There are times when you really need a boost." One example might be during or after a course of antibiotics, as long as you have your doctor's OK, since antibiotics kill both good and bad bacteria: "Seeding your gut with good bacteria can lay the groundwork for a faster recovery and less constipation and diarrhea," Keatley points out. Angelone echoes Keatley's emphasis on food sources of probiotics, but also says that supplements can also play a useful role in "maintaining a healthy gut bacteria colony."
If you have an immune system problem or another serious health condition, you may have a greater chance of issues. Some reports have linked probiotics to serious infections and other side effects. The people most likely to have trouble are those with immune system problems, people who've had surgery, and others who are critically ill. Don't take probiotics if you have any of those issues.

Animals, including humans, have microbes inside them that benefit them in multiple ways. These microbes are in a loose sense like probiotics, but the definition of probiotics was established to designate those microbes that have been isolated, studied, tested in a laboratory dish and/or clinically in animals and/ or humans, and proven to have beneficial properties. In many cases their genetic fingerprints were sequenced for identification purposes and also to check for potentially harmful genetic components. The official term “probiotics” established specific criteria for scientific studies and probiotic supplements, foods, and drinks.
Third-party testing: Lastly, it's important to remember that probiotics are an unregulated supplement. "Find out whether there is third-party data verifying the potency, purity, and effectiveness of the product," suggests Dena Norton, a registered dietitian and holistic nutrition coach. "Remember that dietary supplements aren't regulated, so you can't necessarily just trust the claims on the label." Check out AEProbio, a site that has compiled research on specific brands of probiotics available in the U.S., recommends Scarlata, and an NSF seal is always a good marker to look for.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Probiotics' side effects, if they occur, tend to be mild and digestive (such as gas or bloating). More serious effects have been seen in some people. Probiotics might theoretically cause infections that need to be treated with antibiotics, especially in people with underlying health conditions. They could also cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell).
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Probiotics are live bacteria that are present in yogurt, other fermented foods, and in pills. They are promoted as a benefit to the human digestive system. Normally you have trillions upon trillions of bacteria within the colon. Normally we ingest bacteria every time we swallow. Many of these swallowed bacteria may be beneficial while most are simply innocuous and cause no problems. The question for everyone who takes a probiotic much beyond yogurt is whether they really are a health benefit. Here is what we know medically about probiotics.
Because poor gut health is related to autoimmune responses like those found in rheumatoid arthritis (RA), probiotics have been a proposed treatment option for the condition. Only a few studies have been conducted in humans, and only one testing L. casei 01, a particular probiotic strain, was able to find a decrease in RA inflammation and progression of the disease.
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.

We’ll start with the headliner: the BIO-tract peral, which packs the equivalent of 75 billion CFUs into one tiny, filler-free, 5-billion CFUs pearl. The trick is in protecting those 5 billion CFUs over an 8 to 10-hour period, so they bypass your acidic stomach and reach your intestinal tract, alive and well, allowing you to experience the full and multitudinous benefits of plentiful and beneficial gut bacteria.
The scientists discovered that the probiotics successfully colonized the GI tracts of some people, called the "persisters," while the gut microbiomes of "resisters" expelled them. Moreover, the persister and resister patterns would determine whether probiotics, in a given person, would impact their indigenous microbiome and human gene expression. The researchers could predict whether a person would be a persister or resister just by examining their baseline microbiome and gut gene expression profile.
Proponents claim that probiotics (meaning “for life,” as opposed to antibiotics) confer health benefits primarily by rebalancing the normal microflora in the large intestine (colon). There are many general types of bacteria used as probiotics (two common ones are Lactobacillus and Bifidobacterium), and many different species as well as strains within species. They have different physiological effects—and thus possibly different health benefits (as well as possible risks). Some yeasts, such as Saccharmyces, can also act as probiotics.
This Korean staple relies on lactic acid fermentation (also called lacto-fermentation) to turn cabbage or other vegetables into a spicy, pungent side dish that's packed with vitamin C. Order it at Korean restaurants or buy it in the refrigerated section of your grocery store (King's Kimchi is widely available at Walmart). For some guidance on making your own, turn to The Art of Fermentation ($23; amazon.com). Then, use it to spike veggie-laden rice bowls, top on soup, or serve alongside meat. 

More and more evidence shows that the gut microbiota may play an important role in the development of obesity, obesity-associated inflammation and insulin resistance. Obesity and Type 2 diabetes are associated with changes in gut microbiota. Several studies describe differences between the microbiota of lean individuals and those who are obese. The potential for using probiotics in weight management and obesity and diabetes prevention is exciting.
Research suggests probiotics work better as a team. Even pairs are more effective than individuals. Take the strains Lactobacillus Acidophilus and Bifidobacterium Bifidum BB-12, for example. When combined, this duo-force has been shown to help treat GI-specific ailments. In fact, one survey found 75 percent of studies that compared the effect of a strain mixture with a single-strain supplement showed a mixture was more effective at improving irritable bowel symptoms, immune function, and digestive health.
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
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