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:
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
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.
Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis includes prescription medications, and in some cases, diverticulitis surgery.
It’s important to note that there are different types of strains of probiotics. The probiotics benefits of one probiotic strain may be completely different from the health benefits seen from another probiotic. If you want to use probiotics to address a specific health concern, it’s vital to select the right probiotic for the right condition — or you can consume a wide range of probiotics in your food to be covered.
Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
The bottom line: Stick to trusted whole food sources of probiotics if you don’t know a probiotic supplement brand you trust. “Kimchi, pickled beets, Greek yogurt and sauerkraut are great sources of probiotics. If you don’t like them, throw them into a food you do like, like a smoothie, and add your favorite fruit to help mask the flavor,” Taub-Dix says.
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You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.
CFU: This is the number of "colony forming units" present in each dose, which are measured in the billions. And while more isn't always better, "you want at least 20 to 50 billion CFU," says Dr. Nazareth. Just for reference, a very high dose is 400 CFU, which most experts agree is not necessary unless your health care practitioner specifically recommends this for you. It's also important to check for the guaranteed CFU upon expiration, which should be listed clearly. "Some products only guarantee the CFU number at the time of manufacturing, therefore will be less potent by the time the product reaches your home," she says.
Sugar is so easily accessible in Westernized cultures that it is easy to overindulge in it. But why do you crave it? There are several reasons. One, sugar usually means sucrose, which is composed of glucose and fructose. Glucose is the sugar in your blood, so consumption of sugar results in a temporary boost of energy. However, that blood-sugar spike causes insulin to be released to usher the sugar into cells for energy or fat storage, and shortly afterward your blood sugar drops. So then you feel a slump and reach for something to bring your blood sugar back up: more sugar.
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.
"This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement," study co-senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel, said in a statement. However, it may be possible to tailor probiotic treatments to the individual, based on the types of microbes already in his or her gut, as well as other factors, so that he or she gets the most benefit from probiotics, the researchers said.
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.
Most bacteria are included through the fermentation process. Fermentation helps extend the shelf life of perishable foods. It is a slow decomposition process of organic substances induced by microorganisms or enzymes that essentially convert carbohydrates to alcohols or organic acids. The lactic acid supplies the bacteria that then add the health benefits to the food. You can purchase foods that are fermented or ferment them yourself.
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
There are both probiotics and prebiotics in fermented foods. I differ from a lot of doctors in that I recommend that patients with infections like Candida and SIBO don’t eat prebiotics until they’ve cleared up the infection—because the prebiotics can feed those infections, too. I find that it’s better to get rid of those infections first, and then add in prebiotics to your diet after. [See here for more from Dr. Myers on treating yeast infections.]

Coming in at a close second, our runner-up as the best probiotic for women is the Culturelle Women’s Healthy Balance Probiotic. As the #1 recommended brand by pharmacists, it is easy to see why so many women are turning to Culturelle for their digestive health. Featuring the LGG culture and a laundry list of other healthy bacteria, this probiotic offers a wonderful balance between digestive and feminine health. The Culturelle Women’s Healthy Balance Probiotic is also taken in an easy, chewable tablet and can even be taken during pregnancy, making it one of the most versatile formulas we reviewed!
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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.


Probiotic supplements are not drugs (in the United States), although super potent forms may be obtained through prescription. As such, they are not intended to treat or cure any diseases, mental or physical. Probiotics benefit and complement a healthy way of life filled with nutritious food, adequate exercise, restorative sleep, beneficial social engagements, reduced exposure to toxins, and hydration with clean water.
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.

DNA-testing matches identity at a foundational, genetic level, so you know you’re getting the exact strains listed. New Chapter’s DNA-testing also verifies that you receive the specific strains researched for specific benefits: our strains boost immune defenses and enhance digestion, including bowel regularity and reducing occasional gas, bloating, diarrhea & constipation.*


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.”

That said, supplements with higher numbers of CFUs are sometimes used to treat conditions such as irritable bowel syndrome (IBS), allergies, and respiratory illness. While probiotics have generally been found to be safe for most people with normal immune systems, too much can cause gas and upset stomach. We narrowed our search to supplements with dosages between 1 billion and 100 billion CFUs.
To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
Hi and thanks for reaching out! We recommend you to try Bio-K+ probiotics. To maintain a healthy intestinal flora: we recommend taking ¼ bottle of drinkable Bio-K+ or 1 Bio-K+ 12.5 Billion capsule per day. To improve intestinal flora health: we recommend taking ½ bottle of drinkable Bio-K+ product or 1 Bio-K+ 25 Billion capsule per day and to optimize intestinal flora health: we recommend taking 1 bottle of drinkable Bio-K+ or 1 Bio-K+ Billion capsule. Thanks!
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.
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.
Certain brands, like Attune (attunefoods.com; available at Whole Foods), have pumped up the dessert by adding probiotics. (Attune boasts 6.1 billion CFUs, or "colony forming units," a measure of live, active microorganisms per serving. As a comparison, some probiotic supplements may contain 1 to 50+ billion CFUs.) Sounds crazy, but it's backed by science. One study in the International Journal of Food Microbiology found that probiotics added to chocolate were able to reach the GI tract where they could get to work colonizing the gut with healthy bacteria.
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
In addition to the prophylactic effect of stocking your gut with good bacteria, there are some probiotic strains that have also shown promise in treating symptoms of autoimmune disorders, including L. Paracasei and L. Acidophilus. Others, like B. Lactis, could help prevent respiratory infections. Renew Life Flora Extra Care has all three targeted bacteria strains at 30 billion CFUs per serving.
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.
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.

Uh, no. “There have been studies that suggest a theoretical link between the microbiome and even changing the microbiome, and changes in the brain,” Lebwohl tells me. He specifically points to this study, in which healthy women with no gastrointestinal issues had their brains imaged before and after a month of consuming yogurt products containing probiotics twice daily.

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.


But what if investigators could design probiotics to treat specific individuals? Many researchers think personalized probiotics are the most promising path forward for patients with compromised gut microbiomes. Last year Jens Walter of the University of Alberta and his colleagues published a study that gives a glimpse of this potential future. The researchers decided to see what it would take to get the bacteria in a probiotic to successfully colonize the intestines of 23 volunteers. They chose a particular strain of Bifidobacterium longum that earlier studies had indicated could survive in the human intestine. In the study, the volunteers consumed either a drink containing 10 billion live B. longum bacteria or a placebo in the form of a glucose-based food additive (maltodextrin) each day for two weeks. Periodic fecal samples revealed higher than typical levels of B. longum in participants who did not consume the placebo.
Thankfully, most causes of constipation can be improved with dietary and lifestyle interventions. One of probiotics benefits is constipation relief. Probiotics of many kinds can help with constipation because they can keep the digestive contents moving along through different mechanisms such as short-chain fatty acid production, influences on the nerves of the digestive tract, electrolyte balance, pathogen control, and others. Think of probiotic foods and pills as an addition to other dietary and lifestyle interventions to relieve constipation and return your digestive system to its normal functions.
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.
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.
Keep in mind that when supplements contain a specific number of organisms, this number may not be what is actually within each capsule at the time of purchase. Probiotics are living organisms and can die out easily. Especially if that supplement sits on your drugstore or warehouse shelf for months or longer, the number of organisms you get may be far less than what the bottle claims. Hardier strains have a longer shelf life. Capsule strength decays faster if the probiotic has been sitting around at elevated temperatures during transport to the store. Companies actually have to produce probiotics with a much higher CFU (colony-forming units; see below) count in each capsule in order to guarantee the label potency by the expiration date.
You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.
Probiotics are generally considered safe8 for most healthy people, but may cause gastrointestinal discomfort (abdominal tenderness, pain, gas, and/or diarrhea) if intake exceeds individual needs. People with certain health conditions like suppressed immunity or sensitivity to probiotics may experience more severe side effects9. Probiotics can also interact with some medications. Please consult your doctor before starting any new supplement.
B. Longum is one of the first types of bacteria to colonize our bodies at birth. These important microorganisms ferment sugars into lactic acid, helping to stabilize the acidity of the GI tract and inhibit growth of harmful bacteria. For a group of adults prone to constipation, taking a mix of B. Longum BB536 with milk or yogurt for 2 weeks increased bowel movements [1].
In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.

A 2014 review by Cochrane—an independent network of experts who serve as rigorous arbiters of medical research—found that probiotics may be particularly useful in a hospital's neonatal intensive care unit. The addition of beneficial bacteria to a nutritional regimen seems to significantly reduce the likelihood of developing necrotizing enterocolitis, which is a devastating, poorly understood and often fatal gut disease that primarily afflicts preterm infants—especially the smallest and most premature among them. Researchers think that many cases of the disease begin with an opportunistic bacterial infection in the not yet fully developed intestine of an infant. As the illness progresses, gut tissue becomes increasingly inflamed and often starts to die, which can, in turn, rupture the intestine and flood the abdominal cavity with pathogenic microbes that proliferate to dangerous levels. Researchers estimate that 12 percent of preterm infants weighing less than 3.3 pounds will develop necrotizing enterocolitis and that 30 percent of them will not survive. Standard treatment involves a combination of antibiotics, feeding via intravenous tubes, and surgery to remove diseased and dead tissue. Probiotics probably prevent the disorder by boosting the numbers of beneficial bacteria, which may deter the harmful ones.
There are both probiotics and prebiotics in fermented foods. I differ from a lot of doctors in that I recommend that patients with infections like Candida and SIBO don’t eat prebiotics until they’ve cleared up the infection—because the prebiotics can feed those infections, too. I find that it’s better to get rid of those infections first, and then add in prebiotics to your diet after. [See here for more from Dr. Myers on treating yeast infections.]

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.”

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.”
"There is an increasing interest in probiotic interventions," wrote the authors of one of the most recent studies, a meta-analysis of previous research in a recent issue of the Journal of the American Medical Association. Those researchers found that probiotics were particularly useful against a common gastrointestinal problem: antibiotic-associated diarrhea (AAD).

Bacteria in your digestive tract can be good or bad, according to the website Best Probiotic. It quotes the Royal Academy of Medicine England as blaming an imbalance between good and bad bacteria for causing 80 percent of all degenerative diseases. Probiotic supplements with "good" bacteria have become increasingly popular. They can aid the immune system, digestion and vitamin absorption, as well as prevent diarrhea and irritable bowel syndrome. The website Women to Women recommends probiotics that combine saccharomyces, lactobacillus acidophilus and bifidobacteria in the billions. MayoClinic.com also recommends lactobacillus and advises looking for products that contain live, active cultures. You should always check with your doctor before adding any supplements to your diet.
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