Probiotics are found in everything from chocolate and pickles to hand lotion and baby formula, and millions of people buy probiotic supplements to boost digestive health. But new research suggests they might not be as effective as we think. Through a series of experiments looking inside the human gut, researchers show that many people's digestive tracts prevent standard probiotics from successfully colonizing them. Furthermore, taking probiotics to counterbalance antibiotics could delay the return of normal gut bacteria and gut gene expression to their naïve state. The research publishes as two back-to-back papers on September 6 in the journal Cell.
We started our search with the most popular products from major supplement retailers like Amazon, Drugstore.com, GNC, and Whole Foods. That gave us over 200 supplements. With so many options, we then narrowed our search to 70 probiotics whose purity, potency, and projected efficacy have been vetted by an independent lab like ConsumerLab, Labdoor or the National Science Foundation (NSF). Those labs test — among other things — supplements’ actual composition against labels, verifying ingredient lists are truthful and that contaminants aren’t present. Because supplement claims aren’t regulated by the Food and Drug Administration (FDA), we wanted to make sure someone was testing whether they worked as described.
With the growing popularity of probiotics, there is a huge variety of supplements from which one can choose. The most important thing is to determine what type of probiotic microorganism you need for your condition. Do not just take the supplement that provides the most kinds of organisms. You need to do your research and be sure that there are scientific studies to support what you take. New research is emerging, so if you don't find what you need right now, keep looking. A doctor can help one decide if trying probiotics might be helpful for you and can advise you regarding the amount and type of probiotics that may be appropriate in your case.
The recent buzz has helped bring probiotics into the main stream. Due to being covered on major news sites and television personalities, probiotic supplements are now more accessible than ever. The main benefits of probiotics begin within the gut and digestive system. The gut plays such an important role, that the level of healthy bacteria in our bodies can actually alter our mood. It’s true! What we eat actually affects how we feel. This is why the gut has been called our “second brain”.
"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.
Lactobacilli dominate a healthy vaginal microbiota. Menstrual cycles, sexual activity, diet, certain medications, hygiene, and other factors can occasionally disrupt the vaginal microbiome. AZO Feminine Balance Daily Probiotic has been clinically demonstrated to contribute to the colonization of these important lactobacilli in the vagina.* The result: restoring the natural balance of good bacteria and yeast to maintain vaginal health.*
Kimchi: This fermented vegetable is made from Chinese cabbage (beachu), radish, green onion, red pepper powder, garlic, ginger, and fermented seafood (jeotgal). Many bacteria have been found to be present and can include any of the following: Leuconostoc mesenteroides and Lactobacillus plantarum, L. mesenteroides, L. citreum, L. gasicomitatum, L. brevis, L. curvatus, L. plantarum, L. sakei, L. lactis, Pediococcus pentosaceus, Weissella confusa, and W. koreensis. A recent review linked the health benefits of kimchi to anticancer, antiobesity, anticonstipation, colon health promotion, cholesterol reduction, antioxidative and antiaging properties, brain health promotion, immune promotion, and skin health promotion.
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.
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.
"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).
Diversity of strains - research has demonstrated that bacteria prefer to colonize in different parts of your digestive tract, where there are various ecological niches. The more probiotic strains you ingest, the more coverage you’ll provide for each of these niches. Each strain of bacteria also has its own different purpose, so choosing a formula with many different strains gives you that many more benefits.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.
An imbalance between good bacteria and pathogenic bacteria, yeasts or fungi, or a change in the bacteria species that colonize the digestive tract is called dysbiosis. It can have short and long-term effects on our body functions. These disruptions can reduce the immune system’s effectiveness, create unpleasant digestive symptoms (diarrhea, constipation, gas, etc.), be a contributor to certain chronic illnesses like obesity, and participate in producing pro-inflammatory metabolites.
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.
If you’re giving probiotics to a baby under two years old, you want to look for specific strains, though, that are better suited to such young microbiomes. For babies, these are the strains of Lactobacillus to look for: rhamnosus, casei, paralisei, gasseri, salvarius. And for Bifidobacterium: infantis, bifidum, longum, breve, lactis. If you’re breastfeeding, you can put probiotics on your breast, or you can heat up formula and put probiotics in it, or wet your finger and dip it in the probiotics powder and let your baby suck on your finger.
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.
For example, yogurt is made with two “starter” bacterial cultures — Streptococcus thermophilus and Lactobacillus bulgaricus — but these bacteria are often destroyed by your stomach acid and provide no beneficial effect, Dr. Cresci explains. Some companies, though, add extra bacteria into the product, so check the labeling and choose products with bacteria added to the starter cultures, she advises.
"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," says Segal. "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. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
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.
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.)
Probiotics are “friendly” bacteria that inhabit your body. Sound strange? These microscopic roommates can be your best buds if you show them a little love. One surefire way to do that is with probiotic supplements. Probiotics support the right ratio of good to bad bacteria in your gut. For bonus points, call on digestive enzymes. These unique blends offer specific nutritional support to assist digestion and nutrient absorption. Your healthy body will quickly appreciate these lifelong friends.
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.
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.
Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
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.
There are many health benefits of probiotics, but there are also a few cautions to heed as well. First, if you are immune compromised (catheters, cancer treatments, HIV, trauma, and so on), please consult your physician to check if there are any contraindications for using probiotics. Second, if you never used probiotics or a particular type of probiotic before, and/or never ate much raw food or indulged in fermented probiotic-rich foods and drinks (such as sauerkraut, kimchi, kefir, or kombucha), please proceed slowly with probiotic supplements and use. Although probiotics are tiny organisms, they can have very potent effects on your body.
They probably are. Lebwohl says probiotics may decrease the risk of getting diarrhea during the course of taking antibiotics, and may also play a role in specifically preventing the development of the dreaded antibiotic-related super diarrhea called C. difficile or C. diff. Antibiotics can wipe out the good bacteria that keep you from getting sick if you’re exposed to C. diff, or if you already have it in your system. C. diff symptoms can range from a moderate watery diarrhea several times a day to severe infections, which can be accompanied by fever, bloody stools, rapid heart rate, and can even lead to kidney failure. 500,000 Americans were infected with C. diff in 2015 and 15,000 died from it.
Eating more foods that are naturally rich in probiotics, like yogurt, kimchi and kefir, can help restore balance in your gut and create more “good” bacteria to fight off inflammation from “bad” bacteria. But what about food products that have probiotics infused into them? Indeed, manufacturers are banking on a new crop of gut-friendly products. From chocolates and granola bars to juices and tonics, nut butters, bottled water and even air sprays, you can’t escape the probiotic movement.
All probiotic strains are manufactured through fermentation, and are then freeze-dried before blending with fructooligosaccharides (FOS). The result is a shelf-stable (two years at room temperature), nitrogen-filled probiotic of human origin: a probiotic that easily adapts to your body, and is both acid- and bile-resistant to survive the acidic environment of the human stomach. In other words, a probiotic that fulfills its promises.
If you’ve ever clicked on the 6:00 news or scrolled through the latest headlines on your smartphone, you probably know that supplements and vitamins are not typically backed by governmental entities like the FDA or the World Health Organization. This fact can leave supplement newbies a bit wary, which is exactly why we love the Garden of Life Dr. Formulated Once Daily Women’s Probiotic so much.
The research also showed that while probiotics colonised the gastrointestinal tract of some people, the gut microbiome of others just expelled them. There was no way of telling from their stool sample which category people fell into. “Some people accept probiotics in their gut, while others just pass them from one end to the other,” says Elinav. They found that the probiotic colonisation patterns were highly dependent on the individual. That tells us that the concept that everyone can benefit from a universal probiotic bought from the supermarket is empirically wrong, he says.
Because there's a huge variety of probiotic products available on the market, many people struggle to find the right one for them. "There are many different strains of bacteria in different combinations within different probiotic supplements," explains Brooke Scheller, a clinical and functional nutritionist. "For example, a probiotic may contain a single strain of bacteria or many. It may also contain other vitamins, minerals, or other ingredients that may tout health benefits," she says. There are many different dosages, delivery systems (powder, tablets, capsules), and formulations (refrigerated vs. shelf-stable), and some probiotics also contain prebiotics, which basically act as fertilizer for the probiotics. (Related: Why Your Probiotic Needs a Prebiotic Partner)
Another study by Elinav and his colleagues suggests that not everyone’s gut reacts the same way to probiotic pills. They studied samples of microbiomes from antibiotic users before and after they took supplements for four weeks. The good bacteria were found in the digestive tracts of some people. But in others, the bacteria were present only in stool samples, not in their digestive tracts, where they’re thought to be needed to improve health.
I did the “milk test” on these New Rythm probiotics, along with Culturelle I had purchased in 2 different states (TX & MA, as I was traveling); my mother’s CVS brand acidophilus; and one “control” cup with milk only (so, 5 cups total in my experiment). The New Rythm became a solid yogurt consistency, while the other 4 remained liquids. I did the experiment twice, just to be sure of the results. I could not believe it!!! New Rhythm is my brand, hands down!!! I also would like to mention that my product usually arrives the day after it ships. So it will take a few days to ship when I select standard shipping, which is to be expected, but it doesn’t stay in transit long which is ideal for preserving the living cultures.
Sure, why the hell not? Lebwohl says: "Essentially a yeast infection is an overgrowth of a kind of fungus. In theory, a probiotic could potentially have an effect of the microbiome of the vagina, though proof of its effectiveness hasn’t really been established.” No harm in giving it a try as long as you don't succumb to the temptation to put yogurt in your vagina.
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
Garden of Life RAW Probiotics are some of the most popular out there – and for good reason. Let’s start with the basics: You’ll get 85 billion CFUs and 31 to 33 probiotic strains out of your daily, whole-food, gluten-free, soy-free probiotic, which helps support the immune system, a healthy thyroid, nutrient absorption, digestive function, and a healthy microbial balance.