The U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.
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.

Caution needs to be taken by everyone who chooses to take these supplements, but this is especially true for children, pregnant women, elderly people, and people with compromised immune systems. For people with compromised immune systems due to disease or treatment for a disease (such as cancer chemotherapy), taking probiotics may actually increase one's chances of getting sick. It has been shown that the use of various probiotics for immunocompromised patients or patients with a leaky gut has resulted in infections and sepsis (infection of the bloodstream). One case of bacteremia (bacteria in the bloodstream) was recently found when someone with active severe inflammatory bowel diseases with mucosal disruption was given Lactobacillus GG. Always speak with a doctor before taking any supplement under these circumstances.
Immunity and colds/flu.There’s a close connection between the bacteria in your colon and the immune system. Several studies, including one in 2012 in the British Journal of Nutrition, have found that certain probiotic strains boost measures of immune response—but whether this translates into any clinical benefits is uncertain. Studies have been inconsistent, for example, as to whether probiotics will actually curb colds and other upper respiratory infections. In 2014 a review in the British Journal of Nutrition, which looked at 20 clinical trials, linked probiotics to shorter duration of colds, but not necessarily reduced incidence or severity. Similarly, a 2015 Cochrane review of 12 clinical trials concluded that certain probiotics may help prevent or shorten such infections, though the quality of the studies was poor.
Billions Of CFU – One of the first things you will notice on a bottle of probiotics is the phrase “X Billion CFU.” Probiotics vary in the number of billions of cultures they pack in each capsule, but the lingo always stays the same. CFU stands for Colony Forming Units, so if the bottle reads 5 Billion CFU, it means that there are 5 Billion Colony Forming Units per capsule. The higher the number, the more flora contained in each pill.
About 60 to 80 percent of our immune system lives in our gut. Imbalances in the gut’s microbiome (which is primarily made up of bacteria) lead to digestive issues, while many many other potential effects can be felt throughout the body—from feelings of fatigue to depression, thyroid dysfunction, autoimmunity, and a host of skin issues. Conditions like rosacea, psoriasis, eczema, and acne are really inflammatory conditions, and often a manifestation of something that is happening deeper within the body. When you fix the gut (which, depending on your health, might include getting rid of an infection like Candida, eating a clean diet, and taking a probiotic), skin issues often resolve as well.

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.


The idea that consuming probiotics can boost the ability of already well-functioning native bacteria to promote general health is dubious for a couple of reasons. Manufacturers of probiotics often select specific bacterial strains for their products because they know how to grow them in large numbers, not because they are adapted to the human gut or known to improve health. The particular strains of Bifidobacterium or Lactobacillus that are typically found in many yogurts and pills may not be the same kind that can survive the highly acidic environment of the human stomach and from there colonize the gut.
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)
We also found strains linked to five other health benefits like weight loss and lowering cholesterol. We feature options for those cases below, but they aren’t top picks because those use cases aren’t as heavily researched as immune health or IBS relief. Still, chances are any probiotic supplement is going to make some improvement to your digestive health, so don’t be afraid to experiment.
Many avenues of research have examined probiotics benefits for skin, especially in children. Meta-analyses have found that probiotic supplements are effective in the prevention of pediatric atopic dermatitis and infant eczema. The integrity of gut bacteria is also connected to the development of acne, although the way this happens is still unclear.
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.
But before you start reaching for the calcium supplements, there may be a more effective way to support your bone health. Like many other parts of the body, the health of your bones is closely tied to the health of your gut, especially your intestines. Temporary intestinal inflammation can trigger an immune response in which your body releases interleukins, proteins that have an immune function but also absorb bone tissue. If the temporary inflammation remains unaddressed, these molecules can take a toll on your bones, eventually weakening them.14
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.
Some people prefer probiotic supplements over foods, but Dr. Cresci notes that probiotic foods are a better choice. In particular, fermented foods — like yogurt, kefir (a yogurt-like beverage), kombucha (fermented black tea), sauerkraut (refrigerated, not shelf-stable), kimchi (made from fermented cabbage) and tempeh and miso (made from fermented soybeans) — provide a nourishing environment in which healthful bacteria thrive and release an important byproduct: short-chain fatty acids.
Remember that dietary supplements are not tested by the U.S. Food and Drug Administration like medications. And the probiotic strains in the supplements may not be specific for the condition you're looking to treat. You may want to consult with a practitioner, like a registered dietitian, who is familiar with probiotics. Always tell your physician what you are doing that may affect your health.
In October 2013, the International Scientific Association for Probiotics and Prebiotics (ISAPP) organized a meeting of clinical and scientific experts on probiotics (with specialties in gastroenterology, pediatrics, family medicine, gut microbiota, microbiology of probiotic bacteria, microbial genetics, immunology, and food science) to reexamine the concept of probiotics. They define probiotics as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host." They also differentiated between products containing probiotics and those containing live or active cultures and established the following criteria:

What's nice about supplement company Care/of is that it allows you to design personalized daily vitamin and supplement packs containing everything you need, including probiotics. Its vegan, gluten-free probiotic formula has one billion lactobacillus acidophilus and four billion bifidobacterium lactis per dose, popular strains thought to help promote digestive and immune health.
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.

Vitamin Bounty’s probiotic contains a variety of well-studied strains and a competitive 25 Billion CFU. It also contains a natural prebiotic resistant starch, rice flour, to fuel the strains this probiotic supplies. Over 95% of Pro 25’s strains were still active and viable, the second highest observed strain viability out of all probiotics reviewed-to-date!


Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
Made by fermenting the juice of young coconuts with kefir grains, this dairy-free option for kefir has some of the same probiotics as traditional dairy kefir but is typically not as high in probiotics. Still, it has several strains that are great for your health. Coconut kefir has a great flavor, and you can add a bit of stevia, water and lime juice to it to make a great-tasting drink.
Dr. Vincent M. Pedre, medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. His philosophy and practices are a blend of both Western and Eastern medical traditions. He is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture. His unique methodology is best described as integrative or defined by a functional, systems-based approach to health. With his holistic understanding of both sides of the equation, he can help each patient choose the best course of action for their ailments to provide both immediate and long-term relief. His holistic approach incorporates positive, preventive health and wellness lifestyle choices. Dr. Pedre Wellness is a growing wellness platform offering health-enhancing programs along with informative social media and lifestyle products, such as dietary supplements, books, and weight-loss programs.
If you’re new to Bio-K+, know that each bottle contains 50 billion live and active probiotic bacteria. Probiotics are good for a wide variety of digestive issues, so it’s best to customize your dosage based on what your specific needs are. If you are looking to take a preventative dosage to support the health of your microbiome, start with a ¼ bottle per day. If you suffer from digestive health issues or regularly take antacids, start with a ½ bottle of Bio-K+ per day. If you have more serious gastrointestinal issues or have had to take antibiotics, Bio-K+ probiotics are great for getting your system back on track. Start with a full bottle per day and see how you feel (we’ve had amazing results from our fans!)
Yeast Infections and Bacterial Vaginosis (BV) – If you’ve ever experienced the discomfort of a yeast infection or BV, then you are probably aware that an overgrowth of bacteria causes these unfortunate episodes. While your reproductive system is supposed to foster a healthy environment for yeast, sometimes these levels can increase causing the pain and discomfort of a yeast infection or bacterial infection. By taking a probiotic that contains prebiotics and feminine health probiotics, you can treat and prevent recurrent symptoms!
Because chronic inflammation is at the root of many diseases and health conditions, the fact that probiotics exert this effect in the gut, where 80 percent of the immune system lies, is crucial. The immune-boosting benefits of probiotics seem to be particularly helpful for the quality of life of seniors. Currently, research is underway to test whether probiotics can “reduce inflammation and improve gut immune health in HIV-positive individuals” who haven’t yet undergone treatment.
Today, most of the Japanese population begins the day with a warm bowl of miso soup, believed to stimulate the digestive system and energize the body. Made from fermented soybeans, rice or barley, adding a tablespoon of miso to some hot water makes an excellent, quick, probiotic-rich soup. The fermentation process can take anywhere from a few days to a couple of years to complete, and the end result is a red, white or dark brown paste with a buttery texture.
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.
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.
Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits. Further, getting a wide variety of strains into your system is beneficial. “Periodically mixing up your probiotic supplement is also a good way to ensure that you get different health-building strains in your health regime,” says Dr. Cook.
More than 80 years later, probiotics have become wildly popular and incredibly profitable. A 2012 survey by the National Institutes of Health showed that 3.9 million Americans stated they had used some form of probiotics or prebiotics (a type of dietary fiber thought to feed the friendly bacteria in your gut) in the last 30 days—3 million more people than in the previous study in 2007. Probiotics are now available for consumption in almost every imaginable form—pills, tablets, yogurts, juices, cereals, and energy bars. They have been touted as having benefits not only for digestive health, but also mood disorders, cancer, cold and flu prevention, and reproductive health issues.

Best Probiotic chose iFlora Multi-Probiotic by Sedona Labs as one of the best probiotic supplements. It is a blend that works well in both the large and small intestines and it can survive stomach acid to maintain effectiveness. According to Sedona Labs’ website, iFlora delivers 32 billion active cells through 16 probiotic strains, plus probiotic fiber.
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)
That's because issues that can be treated with probiotics stem from specific imbalances in the amount of certain bacterial strains, according to Elena Ivanina, M.D., a gastroenterologist at Lenox Hill Hospital. "Therefore, if someone decides to supplement a particular strain of Lactobacillus, but they already have enough of that strain in their gut and their disease does not stem from a lack of Lactobacillus, then they will not have a response." Makes sense, right?
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.

I’ve been taking probiotics for past couple of months. I must say I feel so much better like it’s been years since I felt this good. My head isn’t in a fog–my brain feels crisp & clear and less depression. My skin isn’t dry its actually getting soft & shiny again. Even my face looks younger. My hair also. I actually have energy. I’m 53 female with a few illnesses. I can feel my insides like alive again. I’ve had a bad rash from taking too many antibiotics for the past 8 yrs FINALLY it is clearing up all from probiotics. It’s amazing what a difference the probiotics are making in my life. I am truly amazed. They are life changing for me. I know it might sound crazy but I can’t believe the difference. I hope this helps someone out there like me who thought there’s no hope to feel better.
Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:
It has been suggested that probiotics be used to treat problems in the stomach and intestines. But only certain types of bacteria or yeast (called strains) have been shown to work in the digestive tract. It still needs to be proved which probiotics (alone or in combination) work to treat diseases. At this point, even the strains of probiotics that have been proved to work for a specific disease are not widely available.
If your child has a history of stomach problems that medicine doesn’t seem to help, adding a probiotic to his or her diet can help. We love the OLLY Kids Happy Tummy Gummy Supplements because they offer complete probiotic support in a kid-friendly gummy form. Each gummy has a blend of prebiotic, probiotic, and peppermint to help soothe upset stomachs. They contain 500 million CFU of Bacillus coagulans. This container comes with 30 gummies (to be taken once a day) and is recommended for children 2 years and older.
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
Made by fermenting the juice of young coconuts with kefir grains, this dairy-free option for kefir has some of the same probiotics as traditional dairy kefir but is typically not as high in probiotics. Still, it has several strains that are great for your health. Coconut kefir has a great flavor, and you can add a bit of stevia, water and lime juice to it to make a great-tasting drink.
The Number of CFUs The quality of a probiotic supplement has more to do with strains and how many CFUs it provides. (CFU stands for colony forming units, and it refers to the amount of live microorganisms in your supplement.) Although recommendations may vary, Gans says to look for probiotics with at least 1 billion CFUs: “Doses will typically range from 1 billion to 10 billion CFUs for adults; although doses for children are often under 1 billion.”
"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," co-senior author Eran Segal, a computational biologist at the Weizmann Institute, said in the statement. "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."
Some foods are made by adding bacteria — yogurt, pickles, cottage cheese, kombucha, and sauerkraut are good examples. Those foods work to provide the same probiotic benefits as supplements. However, most foods are so processed and pasteurized that it’s unlikely you’ll see the same benefits, let alone the right strains, as you would with a supplement. Regardless, it can’t hurt to get extra probiotics through your diet.
Until recently, testing of probiotics by ConsumerLab.com found that some products had far lower amounts of live organisms than claimed on the labels. But in 2018, it found that 17 out of 18 products tested contained the amounts listed; none exceeded limits for heavy metal contaminants. In contrast, in 2016, a study in Pediatric Research found that only one out of 16 Bifidobacterium longum supplements tested contained the species named on the label.

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.

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.
That’s why adding probiotics and prebiotics to your diet provide the best possible outcome from a bacterial perspective. It isn’t always easy to eat naturally prebiotic-enriched foods, however, because they are often distasteful to eat in quantity. Would you enjoy eating several cups of raw onion or garlic every day? Probably not. Other foods that contain prebiotic fiber, such as bread and bananas, are high in calories. Consuming hundreds of calories of these foods every day is counterproductive if you’re trying to lose weight.
As you progress with increasing dosages of probiotics internally, you may experience increased abdominal gas, upset digestion with diarrhea, headache, fever, muscle pain, brain fog, and/or anxiety. If the symptoms become too uncomfortable, decrease the dosage for a few days and try again. These symptoms are your body’s way of telling you that things—such as a die-off of pathogens or an awakened intestinal reflex—are changing.
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.

We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
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.
Pure Therapeutics Power Probiotic 100B offers 100 billion CFUs of 4 powerful probiotic strains, including science darling, the HN019 strain of Bifidobacterium lactis. Since environmental factors, including moisture, oxygen and heat, can degrade the stability of your probiotics, Pure Therapeutics 100B is delivered in nitrogen-purged aluminum blister pacts, which ensure viability until the probiotic hits your system. No refrigeration is required.
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