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.”
On my recent trip to Japan, one thing I noticed was the inclusion of pickled vegetables in almost every traditional Japanese meal. Unfortunately, many Americans don’t consume enough of these probiotic-rich foods and drinks. Even when they do, restoring equilibrium oftentimes requires therapeutic doses of these microorganisms, because most everyone has been on several rounds of antimicrobials. That’s where a probiotic supplement comes in.
In these cases, IBS is essentially just TMI. “For the colon to be functioning properly, it needs to be contracting and relaxing in a way that is conducive to regular bowel movements that occur at predictable times and don’t occur too frequently or too rarely," Lebwohl says. "And the bowel needs to be giving infrequent feedback to the brain. People should not be getting updates from their bowel in terms of cramps or the feeling of having to have a bowel movement too often. Yet, people with IBS get very frequent unsolicited ‘progress reports’ from the bowel.”
If you suffer from recurrent urinary tract infections and are interested in giving cranberries a try, pay close attention to labels! As tasty as they may be, cranberry juice cocktails are chock full of sugar and very rarely include the D-Mannose your body needs. Instead, look for all-natural and organic cranberry juices or opt for cranberry extract pills if the pure juice isn’t exactly your cup of tea.
Of course, your gut microbiome can only do this when it’s healthy and in balance, which is where probiotics come in. Since so many factors can deplete your beneficial bacteria—including everything from exposure to antibiotics in food or medication to spending too much time inside—supplementing with a premium probiotic is almost always necessary to maintain balance.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
"In fact," she continues, "80% of immune system cells are found in the gut. In addition to the well-known GI benefits of minimizing bloat, gas, constipation, and diarrhea, probiotics aid in digestion by extracting nutrients, helping your body absorb minerals, produce vitamins, and make brain chemicals, including over 30 neurotransmitters along with mood-enhancing serotonin. A healthy person has over 100 trillion microbes, generally a five to one ratio of helpful to harmful."
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.)
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047
Nevertheless, the presence of certain bacteria in the lower gut benefits overall health, not only digestion. The science on the role of the lower gut is changing every day and has advanced significantly — even over the past 10 years. Research strongly suggests that a favorable bacterial balance in the lower gut positively affects the factors influencing heart disease, immunity, bone strength, depression, and obesity and weight loss. Science has only just begun to determine the roles that bacteria play in human health, but it seems clear that healthier people have healthier bacterial balances. People with poorly balanced bacteria levels are more likely to suffer serious health problems.
Most probiotics designed for women are designed to target feminine health conditions like yeast infections and urinary tract infections OR overall digestive health. While this may not be a concern for some women, the fact is that most of us can benefit from probiotics that keep our reproductive systems in check while also promoting overall digestive and immune health. That’s why we love the Culturelle Women’s Healthy Balance Probiotic: this women’s probiotic was specially designed to maintain feminine health without sacrificing the digestive and immune support of traditional probiotics!

The right resident strains - quite a few probiotics on the market contain things like active yeasts or soil based organisms. While these ingredients may be helpful to some, if you want to optimize your gut health, you need to look for strains that are resident to the human gut like those from the Lactobacillus, Bifidobacterium, and Streptococcus families.
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.
Importantly, patients with gastrointestinal conditions are not the only ones taking probiotics. 3·9 million people in the USA alone regularly take probiotic supplements, with promised benefits ranging from improved digestion and immune function to improved mental health and prevention of heart disease. However, evidence for these benefits is lacking, and because probiotics are often sold as supplements, manufacturers in many countries are not required to provide evidence of their safety and efficacy to regulatory bodies. The ubiquity of probiotic products would suggest that, at worst, they are harmless. Nevertheless, some safety concerns have been raised, including the risk of contamination, possibility of fungaemia or bacteraemia (particularly in immune-compromised, elderly, or critically ill individuals), small intestinal bacterial overgrowth, and antibiotic resistance. Adding to concerns, clinical trials of probiotics have not consistently reported safety outcomes.
“Highly recommend –There are quite a few probiotics manufactured specifically for women. Some are decent while others are not so good. For me, I require one on a daily basis to maintain my feminine health. When I try a new probiotic that is made specifically for women, it makes me a bit nervous because I will end up with yeast or bladder infection if it is not effective. With AZO, I am happy to report it is a great probiotic and highly recommend it to all women! It works great.” – Vicki

Eating foods rich in good bacteria and using probiotic supplements may help provide protection from inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease. The evidence is stronger, however, for an improvement in ulcerative colitis, while Crohn’s disease may not benefit as greatly. In addition, there is ongoing research studying the role of probiotics in gluten issues, including celiac disease.

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.
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