We are clearly getting to the strain level by going beyond “Saccharomyces boulardii” and to “Saccharomyces boulardii CNCM I-745”. They did a great job by actually putting it on the label so you don’t even have to contact the company to see exactly what strain you’re getting. (P.S. this is a well-researched strain that I highly recommend, especially for preventing antibiotic-associated diarrhea.)

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.
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.
In 2019, dietary restrictions have become so mainstream that it is virtually impossible to step into a restaurant without spotting a specialized menu for dairy, gluten, vegan, and vegetarian eaters. The supplement industry is no exception and the majority of high-quality probiotics available on the market today include vegan or vegetarian capsules. Many brands are also gluten-free these days as well, and several are dedicated to keeping their formulas free of dairy, soy, and many other common allergens.
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.
Fermenting a cucumber into a pickle amps up a cuke's powers, infusing the crunchy veggie with probiotics. Like sauerkraut, not all pickles offer the good bacteria, though. Look for those made with brine (salt and water) rather than vinegar. These brands will list "live cultures" on the label (like Bubbies). You can also use water, salt, and spices to naturally culture pickles and other veggies—like beets, green beans, and carrots—at home with delicious results. One warning: remember that pickles are salty—one dill can easily offer up more than 10% of your sodium needs in a day.

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.


What about prebiotics vs probiotics? Prebiotics are the food fibers that go through the gut unchanged and are then used by good colon bacteria as a food source for their own growth. Everyone already has most of these good bacteria present, but often in small quantities. Prebiotics are used to stimulate their growth. Simply stated, you already grow your own probiotics within your colon. You do not rely on them to make the passage through the stomach acid — acid that can destroy many probiotic bacteria. That’s why taking a probiotic supplement or adding probiotic foods to your diet does not always help your digestive system. You can eat as many probiotic bacteria as you want, but if they don’t survive the trip to the colon, your effort will be fruitless.
The classic examples of probiotics are yogurt and kefir, which are great for a lot of people, though not if you have a dairy sensitivity. There a lot of yogurt and kefir alternatives, from water kefir and almond yogurt, to coconut yogurt, coconut kefir, and so on. Look at ingredients when you’re shopping for food like yogurt—you want to avoid sugar-filled products. I like plain coconut yogurt with fruit and little stevia on it.
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 (First published: September 6, 2018) DOI: 10.1016/j.cell.2018.08.041
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.
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.
"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.
The gut microbiota has been implicated in diseases ranging from obesity to Parkinson's disease and depression. Little wonder then that commercial probiotics have gained widespread popularity and are now estimated to command a US$37 billion market worldwide. But with research into the microbiome still in its infancy, increasing evidence suggests that both commercial and clinical use of probiotics is outpacing the science.
You'd be right. Lebwohl said there are no current studies supporting probiotics for cancer, and further, that he’d be concerned about anyone with a compromised immune system using probiotics. “It has not been adequately studied for cancer and I would be concerned about widespread probiotic use in someone who might have a suppressed immune system due to cancer, because of the rare but documented instances of actual infections arising from probiotic use."
Digestive tract conditions. Probiotic supplements may be useful in treating and preventing inflammatory conditions, such as pouchitis (which affects people who have their colons removed), inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease), and chronic stomach inflammation and ulcers caused by Helicobacter pylori bacterium. They may also be helpful in treating constipation, irritable bowel syndrome, acid reflux, spastic colon; shortening the duration of infectious diarrhea; and reducing the recurrence of bladder and colorectal cancer. Some studies suggest that yogurt is helpful in preventing diarrhea - a common side effect of treatment with antibiotics. It has also been shown to prevent or treat urinary tract infections and vaginal yeast infections in women.
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.
I currently have stage 1 breast cancer; history of pseudo inflammatory eye tumor, stroke, digestion issues, constipation, candida and toenail fungus. No one can tell me cause of inflammation throughout my body. Would BlueBiotics be my best choice? Does it have lactose? Tried about everything on market but need something that targets the above. Thank you.
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.
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.
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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].


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.
Nearly 75% of all women will have at least one yeast infection during their lifetime, and over 50% of women are likely to experience the inexplicable pain of a urinary tract infection as well. With the recurrence of urinary tract infections and yeast infections on the rise, women all around the world began searching for a more effective and natural solution to antibiotics.
Best Probiotic says that Suprema Dophilus, manufactured and distributed by Vitabase, enjoys the highest customer rating in the market. Specially coated to help the bacteria spread through your entire digestive tract, its website claims over four billion viable cells per capsule, including five lactobacillus strains and three bifidobacteria cultures. Best Probiotic says that Suprema Dophilus also contains fructo-oligosaccarides to increase the life span of the bacteria.
The price is great on these, but definitely BEWARE! I do not recommend taking 2 pills in the beginning if you have not taken probiotics in the past! I had been eating very clean for a couple months, but got a sinus infection and was recommended by a nutritionist to take a probiotic to boost gut health since I was on antibiotics. Anyway-taking 2 pulls a day gave me horrible diarrhea, until I figured out they were causing the issue and cut back the pills to one a day! Everything fine since then, will try to build back up to 2 a day...I also take at bedtime just in case there would be any stomach issues!
Make sure dosages are listed in CFU, colony forming units. (Most brands list CFU in billions now: so 30 billion CFU, 100 billion CFU, and so on.) For one, this means that the bacteria strains are living, which is essential. When you’re looking at the cost of products, be sure to look at the cost per unit. I spoke to a woman the other day who had bought probiotics that had 2 billion CFU per capsule. In comparison, to get the 30 billion CFU I recommend, she’d have to take essentially half of her bottle to get the same dosage as one of our capsules.

Previous studies have been contradictory, with some yielding more positive results about the benefits of probiotics, but most of them looked at probiotics in stool samples, not directly in the gut itself. In the new research, the scientists used more invasive methods to take samples of gut bacteria directly from different areas of the digestive system.


This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.
If you've ever been to an Indian restaurant, then you've probably seen a lassi—a smoothie made of milk, yogurt, fruit, honey, and cardamom. The drink goes well with spicy Indian food because it helps extinguish the fiery feeling in your mouth. If you want to try it at home, you can pick up bottles from brands like Dahlicious, which contain 15 billion live probiotics per serving and are available in flavors like mango and turmeric. Or, try this mango lassi recipe.
Cleaning up your diet to remove things that bother you and to add nutrients you and your microbiota need, physical activity to reduce stress and increase feel-good neurotransmitters, mindfulness to discover how your thoughts affect your feelings, and daily consumption of probiotic pills and foods are easy ways to improve your mental health outlook.
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
In the new study, the researchers analyzed information from 15 healthy volunteers who took either a probiotic product containing 11 strains of bacteria, or a placebo, for four weeks. The participants also underwent colonoscopies and upper endoscopies before they took the probiotics or the placebo, and again after the four-week treatment period. (An upper endoscopy looks at the upper part of the digestive tract.) During these procedures, the researchers took samples from inside participants' guts.
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.

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 root of the word probiotic comes from the Greek word pro, meaning "promoting," and biotic, meaning "life." The discovery of probiotics came about in the early 20th century, when Elie Metchnikoff, known as the "father of probiotics," had observed that rural dwellers in Bulgaria lived to very old ages despite extreme poverty and harsh climate. He theorized that health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in sour milk. Since then, research has continued to support his findings along with suggesting even more benefits.
Candida yeast species, on the other hand, can cause numerous infections in and on you. Although they are usually present in controlled amounts, Candida overcomes your usual defenses and establishes itself when conditions are favorable, such as when you take antibiotics and many beneficial bacteria, which normally would control Candida, are killed. Unlike the Saccharomyces yeasts, which are not invasive, Candida species form hyphae, finger-like projections that penetrate tissues, causing deep infections that are difficult to eliminate. Candida is also able to weaken your immune defenses.

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
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.
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.
The idea that bacteria are beneficial can be tough to understand. We take antibiotics to kill harmful bacterial infections and use antibacterial soaps and lotions more than ever. The wrong bacteria in the wrong place can cause problems, but the right bacteria in the right place can have benefits. This is where probiotics come in. Probiotics are live microorganisms that may be able to help prevent and treat some illnesses. Promoting a healthy digestive tract and a healthy immune system are their most widely studied benefits at this time. These are also commonly known as friendly, good, or healthy bacteria. Probiotics can be supplied through foods, beverages, and dietary supplements.

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.” 

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.”
Some studies suggest that certain probiotic strains may also help in mild to moderate ulcerative colitis and possibly for bloating and gas in irritable bowel syndrome (IBS). Probiotic supplements, on the whole, “improve global symptoms, bloating, and flatulence in IBS,” by modifying the gut microbiome, according to a 2014 monograph from the American College of Gastroenterology. As IBS researchers said in a paper in Gastroenterology & Hepatology in 2015, “The concept of manipulating the microbiome is one of the most promising new ways in which to treat patients with IBS, but there is still much to learn.”
"When certain types of probiotics are placed in contact with skin cells, they calm the parts of the cells that may want to react to the presence of bad bacteria that they see as a threat. These healthy signals produced by the probiotics stop the skin cells from sending 'attack' messages to the immune system that result in flares of acne or rosacea."
Notions don’t equal evidence though, and Lebwohl cautioned against thinking of probiotics as a cure-all, and examining the ways in which they’ve been proven to work as well as the ways in which they really haven’t. So which medical conditions have probiotics actually shown promise in treating and which claims have the credibility of a used car salesman on acid?
Even if you’re not sensitive to dairy, though, probiotics that require refrigeration can be inconvenient; but there are now some that don’t need to be kept cold. For example, our probiotics are sealed in nitrogen blister packs to protect them from heat, as well as moisture and oxygen because the air can’t get in. Look for probiotics that are individually packed to protect the live cultures. If they just come in a bottle they could be losing potency from air getting in.
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.
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