In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
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."
Your gut is diverse, so your probiotic should be too. Look for a supplement that contains multiple strains, sometimes listed as a proprietary blend. Inferior brands might only contain one probiotic strain such as Lactobacillus acidophilus. Aside from Lactobacillus and Bifidobacterium strains, probiotics may contain Strep. thermophilus and Saccharomyces boulardii, among others.
You also want to look at the guarantee fine print: If the CFU number is guaranteed at time of manufacturing, but not at the time of expiration, you could be taking a less potent dose of probiotics than you think because potency fades over time. I made this mistake when I was traveling once and went to the grocery store to pick up probiotics. On the bottle label it said guaranteed at 20 billion CFU at the time of manufacturing. This doesn’t tell you the CFU for when I was actually taking the probiotics. For instance, our probiotics are manufactured at 60 billion and 200 billion CFU, and guaranteed at 30 billion and 100 billion CFU, respectively, at time of expiration.
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.
If you get sick often, probiotics might be the immune booster you've been looking for. The Cleveland Clinic says they've been shown to strengthen immunity by enriching and replenishing the good bacteria in the body. And when you eat foods with probiotics regularly, it's easier for your body to produce vitamins and enzymes that help keep your intestines happy.
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.

Cynthia is the assistant editor and frequent contributor. She’s originally from California, but has lived in many countries including South Korea, China and Germany. She currently lives with her husband in Minnesota. Cynthia is passionate about helping families find the best advice for family life and safety. Cynthia also has experience in early childhood education and holds a TEFL-C certificate from Teachers College, Columbia University. She has been writing about family-focused topics, advice and trends since 2014.

Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
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, 2018; 174 (6): 1388 DOI: 10.1016/j.cell.2018.08.041
Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.
This is also known as S. boulardii and is the only yeast probiotic. Some studies have shown that it is effective in preventing and treating diarrhea associated with the use of antibiotics and traveler's diarrhea. It has also been reported to prevent the reoccurrence of C. difficile, to treat acne, and to reduce side effects of treatment for H. pylori.

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.


In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science.
A 2017 survey of cancer patients showed that more than 80 percent were taking some sort of dietary supplement, vitamin, mineral, or herb to treat digestive issues they were experiencing due to chemotherapy. Researchers noted that while supplements can be beneficial in some cases, they can also change the metabolism of anti-cancer drugs, or lead to life-threatening conditions like sepsis because of the patient’s compromised immune system.
Every person's microbiome is different, which means what worked for others might not work for you. "What you eat, whether you were born by C-section or vaginally, what antibiotics you have been exposed to, and whether or not you have ever developed food-borne illness are just some of the many factors that impact your gut microbiome," explains Scarlata. And while research can help you determine which strains to take at which dosages, there may still be several different formulations to choose from.
Back to the question of what are probiotics: There are five main types, each in its own classification called a genus. Within each genus there are multiple species, and within those species there are multiple strains. For example, Lactobacillus is a very common genus of probiotics. Within that genus are numerous species, such as rhamnosus. The genus and species of a microbe are always italicized, making it easy to know that a microbe is involved. In a species such as Lactobacillus rhamnosus (often abbreviated L. rhamnosus), there are many strains. An example of the name of a strain is L. rhamnosus GR-1.
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. 

Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.


Probiotic supplements and foods can play a major positive role in brain fog. Lactobacillus, in particular, can produce neurotransmitters used for brain neuron-to-neuron transmission to facilitate thinking. Probiotics can interact with the vagus nerve to the brain, with the enteric nervous system that can communicate with the brain, and with the brain via chemical messengers.
Probiotics have also been researched for how they support the immune system. Studies suggest that probiotics can improve how the immune system functions such as by decreasing upper respiratory tract infections in adults and reducing the need for antibiotics. Studies in children show that a regular diet including probiotics reduces colds and flu-like symptoms and improves attendance in preschool and day care settings.
"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," says Segal. "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."
Suez and colleagues investigated the recovery of the gut microbiota after antibiotic treatment and found that probiotics might perturb rather than aid this process. The probiotics rapidly colonised the gut but prevented the normal microbiota from repopulating for up to 5 months. While likely to be considerably less appealing, the group who received autologous faecal microbiota transplantation recovered their microbiota the quickest, with the composition of the microbiota returning to normal within days. Furthermore, Zmora and colleagues showed that colonisation occurred in highly individualised patterns, with some people's gastrointestinal tracts rejecting probiotics and others allowing colonisation by the probiotic strain, meaning that many individuals taking probiotic supplements are simply wasting their money.
I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?
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.

If you have a tendency to forget to take your probiotics (which, let’s be honest, we all have), try storing them in a place that you look at directly each and every day. We recommend somewhere like your bathroom sink near your toothbrush or even on your kitchen counter, so you never miss a dosage! This one can be taken with or without food, and it doesn’t have to be stored in the fridge – perfect!
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.
This content is strictly the opinion of Dr. Josh Axe and is for informational and educational purposes only. It is not intended to provide medical advice or to take the place of medical advice or treatment from a personal physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding specific health questions. Neither Dr. Axe nor the publisher of this content takes responsibility for possible health consequences of any person or persons reading or following the information in this educational content. All viewers of this content, especially those taking prescription or over-the-counter medications, should consult their physicians before beginning any nutrition, supplement or lifestyle program.
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.
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.
Probiotic bacteria readily colonised the gut of everyone in the second group after antibiotics had cleared the way. However, the researchers were surprised to find that this prevented the return of the person’s normal microbiome for up to six months. “The probiotics very potently and persistently prevented the original microbiome returning to its original situation,” says Elinav. “This was very surprising and alarming to us. This adverse effect has not been described to date.”

The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.


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.
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.
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.
Yes, they may help. Lebwohl says there are reputable studies that show a link between the use of probiotics and the reduction in IBS symptoms, citing this meta-analysis. It's estimated that 11 percent of the world population complains of symptoms like abdominal cramps, diarrhea, constipation, excessive gas and/or mucus in their stools. While for some the condition can be attributed to certain dietary triggers, others appear to be stress-related, which brings us to the heart of where many claims about the effectiveness of probiotics lie—in the gut-brain axis.
Dr. Tobias responded with Deep Immune Support, a shelf-stable capsule that does not require refrigeration and employs four acid-resistant probiotic strains. One such strain: DE111, a highly effective spore-forming probiotic, which complements and balances the non-spore strains most commonly found today, and also supports the proliferation of beneficial bacteria. The patented, delayed-release capsules are made in the USA and are both kosher and vegetarian.
Consuming probiotics regularly will reduce the risk of this. "The concept is that if we have an unhealthy, unbalanced gut environment, toxins can be released into the bloodstream and cause inflammation throughout the body," Engelman adds. "This shift in gut flora and the subsequent inflammation can cause a flare-up in the skin of those who are predisposed to acne, eczema, or rosacea."
Many women are prone to yeast infections during or after antibiotic use. If you are one of these unlucky few, try taking a probiotic like the vH Probiotics with Prebiotics and Cranberry immediately before taking your antibiotics. (You may want to check with your doctor first though). These cultures may help with stomach upset and can also prevent a dreaded yeast infection!
Probiotics are clearly incredibly supportive, but they can't do their work alone. To make sure that you're getting the most out of your microbes, it's important that you give them the support they need to work. You've got lots of options for supporting your gut health, from dietary changes to probiotic supplementation, but make sure you're at least covering the following bases.
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Directions Take 2 Vegetarian Capsules with or without food. As a dietary supplement, take two (2) capsules once daily. For best results, take one (1) capsule during the day and one (1) capsules in the evening. Repeat the process daily. Do not exceed two capsules per day. As a dietary supplement, take one (1) veggie probiotic capsule once daily. Because our probiotic uses delayed release capsules, do not chew or crush. Our capsules help ensure the active probiotic strains reach your intestinal tract. Adults take 1 capsule daily. May be taken with or without food. Capsules can be opened. Contents can be taken directly with water or juice. Not intended for children.
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Many everyday things can throw off your balance (stress, sex, pregnancy, aging, even medications! This product supports your feminine health and maintain a healthy pH so that you can own your day! It contains INTELLIFLORATM: a probiotic blend of four lactobacilli that are associated with vaginal health* (Lactobacillus crispatus LBV 88, Lactobacillus rhamnosus LBV 96, Lactobacillus jensenii LBV 116, and Lactobacillus gasseri LBV 150.)  The INTELLIFLORATM blend has been shown in clinical studies to help restore and maintain the healthy balance of the vaginal microbiota.*
Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another. For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.
Called probiotics, these good bacteria help break down food, synthesize vitamins, prevent bacteria that cause illness from getting a foothold, and bolster immunity. Some studies suggest that as we get older, the number and variety of good bacteria in our bodies decline. So taking probiotic supplements to replenish them might seem like a no-brainer.
What’s more, RAW Probiotics are exactly what they purport to be – raw! They’re uncooked, untreated and unadulterated, and have no fillers or binders. You also won’t find any displeasing carriers, such as maltodextrin or dextrose. And since RAW Probiotics are kept in temperature-controlled cold storage through delivery and until they make it into your fridge, you can be sure your probiotics “arrive alive.”
This story has played out before, most notably with vitamin supplements, which decades of research have revealed to be completely unnecessary for most adults and, in some cases, dangerous, correlating with higher rates of lung, breast and prostate cancers. But that has not stopped marketers from pushing another nutritional craze. According to a National Institutes of Health survey, the number of adults in the U.S. taking probiotics or their cousins, prebiotics (typically nondigestible fibers that favor the development of gut bacteria), more than quadrupled between 2007 and 2012, from 865,000 people to nearly four million. San Francisco–based business consulting firm Grand View Research estimates that the global probiotics market exceeded $35 billion in 2015 and predicts that it will reach $66 billion by 2024.
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.
The National Yogurt Association, who created this seal of approval, requires all yogurt manufacturers to include it on products that meet the standard of having a sufficient number of probiotics. The probiotics in store-bought yogurt need to meet this standard in order to be shelf-stable and reach your body alive. But even then, this standard isn’t all that useful in practice. The number just refers to the total number of live cultures and not the levels for each of those microbes. It’s possible, Taub-Dix says, that a product won’t have high enough levels of a certain probiotic to have any effect.
​​​​​​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.*
Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
Update: I think this product is being smeared by a competitor! Look at all the reviews in April. Suddenly, a butt ton of not just negative but 1 star reviews. It's uncanny. So, what would compel a competitor to do such a thing? Well, it was the only 50 CFU, enteric coated & 20 strain probiotic on Amazon & it cost about 15 bucks. That, while products far inferior to it were priced for - often times - 2 or 3x as much.
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