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.


Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.
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.
Inside your body bacterial and other microbial cells live in close contact with your own cells, and in healthy conditions the thing that separates them from you is a layer of mucus. Between that layer of mucus and the inside of you is a layer of skin-like cells one-cell thick. One thing you have to understand about your gastrointestinal (GI) tract is that although it resides within you, it is really connected to the outside world, from your lips to your anus, and the things that protect you from the outside world are the mucus; the skin-like layer of cells with immune, nervous, and endocrine cells below it; and the beneficial microbes. At least 70 percent of your immune system is in your GI tract! This is why taking probiotics benefits the immune system greatly.
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.
This Korean staple relies on lactic acid fermentation (also called lacto-fermentation) to turn cabbage or other vegetables into a spicy, pungent side dish that's packed with vitamin C. Order it at Korean restaurants or buy it in the refrigerated section of your grocery store (King's Kimchi is widely available at Walmart). For some guidance on making your own, turn to The Art of Fermentation ($23; amazon.com). Then, use it to spike veggie-laden rice bowls, top on soup, or serve alongside meat.
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.
Further, there’s still a lot we don’t know. A recent study published in Cell compared how the microbiome of the gut reconstituted itself after antibiotic treatment with and without probiotic administration. The researchers found that probiotics (which might have improved diarrhea symptoms) led to a significant delay in microbiome reconstitution, if it occurred at all. And — again — this study was with purified strains of bacteria, which is not what you’re getting in probiotic-containing food.
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."

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.

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
​​​​​​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.*
While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.

4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.

Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.


Known as the most clinically proven effective probiotic strain, Lactobacillus rhamnosus GG (otherwise known as “LGG”) has been clinically proven to maintain healthy numbers of bacteria and yeast for optimal digestive health. This powerful probiotic is also paired with some of the best probiotic strains for feminine health, making it an ideal choice for any woman that is looking for complete care from her probiotic.
Large bodies of evidence suggest that probiotics are effective against several forms of diarrhea, including antibiotic-associated diarrhea, acute diarrhea, traveler’s diarrhea, infectious diarrhea and other associated diarrhea symptoms. They also help with constipation relief. Probiotics have also been found in meta-analyses to reduce the pain and severity of irritable bowel syndrome (IBS) symptoms, aid in the eradication of H. pylori and treat pouchitis, a condition that occurs after the surgical removal of the large intestine and rectum.
Most of the high-quality probiotics that are available on the market today share the same annoying pitfall: they need to be refrigerated. If losing your supplements in the abyss of your fridge isn’t exactly your idea of a good time, the Garden of Life Dr. Formulated Once Daily Women’s Probiotic is just for you! This probiotic comes with a Shelf Stable Potency Promise, meaning there is no need for refrigeration.
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.
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

The National Center for Complementary and Integrative Health (NCCIH) calls probiotics “live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut.” The NCCIH makes the point that we often think of bacteria as harmful “germs” — however, probiotic bacteria actually helps the body function properly.
"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects." 

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.”
In addition to the impact on our immune systems, our digestive systems are the second largest part of the neurological system. It’s called the enteric nervous system and is located in the gut. This is why it’s called the second brain — the gut is responsible for creating 95 percent of the serotonin and may have significant impact on brain function and mood.
Jigsaw Essential Blend Probiotics uses five of the most researched (and effective) live strains to promote a healthy digestive system, restore flora after antibiotics use, and help with optimal vitamin absorption. Jigsaw products are also third-party certified, so you can rest assured that each batch is safe and pure. The bottom line? If you’re looking for a vegan-friendly formula — the capsules are made from HPMC (Hypromellose - Hydroxypropyl Methylcellulose), gelling agent (Gellan gum), and water — with a high CFU count, this product is for you. There are 90 capsules per bottle.
You experience that afternoon slump and reach for a candy bar or a sugar-laden coffee. Or maybe you go through your day, starting with a breakfast of doughnuts or sugary cereal, and then proceed to sodas for drinks, cookies to snack on, dessert after dinner, and finally to a nighttime snack of ice cream. You know that feeling; it’s that I-have-to-have-something-sweet-and- I-have-to-have-it-NOW feeling.
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 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.
Myriad factors – antibiotics, diet, stress, and age, among them – affect the balance of diverse microbes present in your gut. While you can replenish your gut bacteria by eating well and incorporating natural probiotics (ex. yogurt and kefir) into a healthy diet, these processes can take weeks or months; taking a regular probiotic is an easy and effective way to ensure your gut (and immune system) stays healthy, always.

"Many chronic health problems and inflammatory diseases are caused by a damaged microbiome where the good bacteria is overrun by the harmful bacteria and can't reinforce the gut walls, which results in increased intestinal permeability where bacteria and toxins leak through the intestines into the bloodstream triggering a system-wide immune response of inflammation that is a part of our body's natural healing cycle."
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!
According to the NIH, probiotic supplements contain many microorganisms that are the same as or similar to the ones that naturally live in your body, but there's still a lot of research to be done on probiotics and how they work. It's important to keep in mind that not all probiotics have the same effects and that taking probiotics isn't a guarantee of better health. And while they're generally safe for healthy people to take, with side effects being limited to mild digestive discomfort, they could interact with certain medications or pose health risks to people with underlying medical problems — that's why it's smart to talk to your doctor before getting started with a supplement.
"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.

“Microbiome” refers to the trillions of bacteria and microorganisms that live on and in our individual bodies. “There’s increased recognition of the various ways that the microbiome affects our health,” Lebwohl tells me. “And with that recognition comes the true observation that many bacteria are good for us. This goes against the old idea that bacteria equal germs, which equal harm. It turns out that many bacteria keep us healthy and probiotics could potentially support that notion.”


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"People have thrown a lot of support to probiotics, even though the literature underlying our understanding of them is very controversial; we wanted to determine whether probiotics such as the ones you buy in the supermarket do colonize the gastrointestinal tract like they're supposed to, and then whether these probiotics are having any impact on the human host," Eran Elinav said in a statement. "Surprisingly, we saw that many healthy volunteers were actually resistant in that the probiotics couldn't colonize their GI tracts. This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement. Instead, they could be tailored to the needs of each individual."
Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.
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.
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.

L. Casei also made headlines when a study found it beneficial in relieving anxiety. The randomized, double-blind, placebo-controlled pilot study found supplementation with 24 billion units of the L. Casei strain Shirota led to a rise in probiotics Lactobacillus and Bifidobacterium, as well as a significant decrease in symptoms of anxiety and depression [2].
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 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.
Safety Warning In rare cases, some people may experience stomach upset due to Probiotics Cleansing Effect. This is positive sign as high potency probiotics removing waste or toxic substances from body. To avoid reaction, it's recommended to start with less dosage and slowly increase. Do not exceed recommended dose. Pregnant or nursing mothers, children under the age of 18, and individuals with a known medical condition should consult a physician before using this or any dietary supplement. May adversely affect existing medical conditions, including but not limited to: IBS (Irritable Bowel Syndrome), Gastritis, G.E.R.D. Please note: Probiotics may temporarily cause bloating, gas or gassy, stomach pain, hurt stomach or cramps (cramped, cramping), vomiting, nausea, diarrhea, constipation, changes in digestion, allergic reactions, heartburn, jitters, rashes, skin irritation, breakouts, headache, fatigue, changes in appetite, joints hurt, spike blood glucose, bad pains, terrible symptoms, tiredness, passed out or sick feeling or sickness. These possible side effects are rare and will vary from one person to another in occurrence and severity. This product does not contain Milk, Eggs, Soy, Wheat, Peanuts, Tree Nuts, Seafood, Fish. The Lactobacillus strain contained is grown on a dairy medium, but the dairy is removed in processing. People with severe allergies to dairy and those that are lactose intolerant should consult a medical professional before taking this product, as adverse reactions can occur. If for any reason you experience any adverse effects, immediately discontinue use of the product and consult with your doctor. Do not use if seal is missing or broken. Keep Out Of Reach of Children and Pets. KEEP OUT OF REACH OF CHILDREN. DO NOT USE IF SAFETY SEAL IS DAMAGED OR MISSING. STORE IN A COOL, DRY PLACE. Do not exceed recommended dose. Pregnant or nursing mothers, children under the age of 18 and individual with a known medical condition should consult a physician before using this or any other dietary supplement. Do not take this supplement if you are allergic to any of the listed ingredients. May adversely affect existing medical conditions, including but not limited to: G.E.R.D., IBS, Stomach Ulcer(s), asthma. Please note: Probiotics 60 Billion CFU may temporarily cause heartburn, gas, upset stomach, stomach cramps, stomach pain (hurt stomach), irritated stomach, burning stomach, acid reflux, bloating, constipation, increased chest congestion/mucus, insomnia, inflammation, fatigue, make your brain not feel right, nose bleeds, agitation, headaches, nausea, diarrhea (liquid stools, burning bowel movements, runs), intestinal issues, dry mouth, rash, itching, hives, dizziness, swollen tongue, vomiting, heart palpitations, fast heartbeat, unexpected issues or sickness. These possible side effects are rare and will vary from one person to another in occurrence and severity. If for any reason you experience any adverse effects, immediately discontinue use of the product and consult with your doctor. Do not use if seal is missing or broken. Keep Out Of Reach of Children and Pets. Caution: As with any dietary supplement, consult your healthcare practicioner before using this product, especially if you are pregnant, nursing, anticipate surgery, take medication on a regular basis or are otherwise under medical supervision. Keep out of reach of children. Do not use if safety seal is broken or missing. Contains no carriers, fillers, artificial colors . This product is labelled to United States standards and may differ from similar products sold elsewhere in its ingredients, labeling and allergen warnings
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.
Probiotics' side effects, if they occur, tend to be mild and digestive (such as gas or bloating). More serious effects have been seen in some people. Probiotics might theoretically cause infections that need to be treated with antibiotics, especially in people with underlying health conditions. They could also cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell).
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.
Many Lactobacillus and Bifidobacterium species are naturals at protecting and improving gut health. Additionally, research in animals and humans has shown that probiotics decrease scores on depression assessments, thereby alleviating depression. As a matter of fact, there is a new term, psychobiotics, for these microbes that influence mental health conditions like depression.
It is well known that people with lactose intolerance can often consume yogurt with few symptoms. This is because the probiotics in yogurt help digest the lactose in the small intestine, before it reaches the colon. In addition, the yogurt starter cultures L. bulgaricus and Streptococcus thermophilus help to break down the lactose. Because of its probiotics, yogurt is a good way for people with lactose intolerance to consume the recommended servings of dairy without experiencing uncomfortable symptoms they may get from other dairy products.
If you suffer from a food allergy or intolerance, make sure to check those labels! Probiotics with these dietary features often say so right on the front of the bottle, but you will also want to take a quick peek at the ingredients list as well. A word to the wise: anyone with a food allergy should also check the manufacturer’s information to ensure that cross-contamination is not likely to have occurred on-site in the packaging facility.
Dermatologist Dendy Engelman, MD, also points out the key role probiotics play in gut health and your body's immune system. "Probiotics are live microorganisms that may be able to help prevent and treat some illnesses," explains Engelman. "Probiotics can create 'holes' in bad bacteria and kill them. Similar to the way antibiotics work in the treatment of acne and rosacea, probiotics can help fight harmful bugs from triggering inflammation. In patients with acne and rosacea, living microorganisms on the skin are recognized as foreign by the body's immune system. The immune system springs into action to counter this potential threat resulting in the inflammation, redness, or bumps common in these skin conditions."

Whether a brand of probiotics works really depends on its quality and your body's own gut. Everyone has a different set of gut flora so try several to see what works for you. Using a brand of at least 40 billion CFU is best. There seems to be some debate as to whether one should use refrigerated or unrefrigerated probiotics. I went with the side that claims unrefrigerated are sturdier and less prone to die off.
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.
This dairy-free, gluten-free, vegetarian probiotic delivers live microorganisms, protected in stomach acid-resistant capsules to ensure effective delivery throughout your digestive system, from the stomach through your small intestines. The result is the repair and sustained maintenance of your intestinal micro-ecology, which in turn helps support healthy immune response and bowel regularity.
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
There is also promising research on this species for supporting skin. Ceramides are natural lipids that make up the surface of the skin structure. Depleted ceramide levels are clinically linked with dry and damaged skin. S. Thermophilus was shown to have a beneficial effect on the level of ceramides in the barrier of the skin, which protects underlying tissue from infection, dehydration and chemicals. These skin-supporting microbes also act as antioxidants in the body, trapping reactive forms of oxygen that dry, damage and age the skin [1].
Probiotics have been shown to help reduce duration of pediatric acute diarrhea, decrease symptoms associated with taking antibiotics, manage symptoms of irritable bowel syndrome, reduce crying time in infants with colic and reduce relapses of ulcerative colitis. Certain probiotics may also inhibit the growth of Helicobacter pylori, bacteria that colonize the stomach and can cause ulcers and stomach cancer.
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.
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