Stability and organism types — Some probiotic strains need to be kept cold in order to preserve their potency. This applies to their production, transport, storage and sales. Others are shelf-stable and don’t require refrigeration. Unfortunately, most refrigerated probiotics never make it past the stomach because they aren’t stable. Instead, look for a shelf-stable product that contains soil-based organisms.
​​​​​​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.*
​​​​​​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.*

Most recently, two back-to-back papers were published simultaneously on September 6 in the journal Cell showing that many people can’t successfully colonize standard probiotic microbiome in their gut. The scientists also found that consuming generic probiotic strains after taking antibiotics often delayed gut bacteria and gene expression from returning to their natural "naïve" state.
You know antibiotics can help fight off bacterial infections, but overusing them can actually deplete the good bacteria in your body, reports Harvard Medical School. (That's why doctors recommend you don't take antibiotics unless you really need them.) If you must go on meds, talk with your doctor about taking probiotics afterward, as the NCCIH says they can help recover beneficial microorganisms afterward and help keep the ratio of good to bad bacteria in balance.

Florastor uses the unique strain Saccharomyces boulardii lyo, which works to strengthen digestive balance and boost immunity. To boost immunity, Florastor stimulates the production of immunoglobulin A — an antibody that helps defend your body against infection. If you’re on long-term antibiotics, this will be a good option for you as Florastor is genetically resistant to antibiotics. When taking a probiotic supplement at the same time as an antibiotic, Gans advises waiting at least two hours in between. Each box contains 50 capsules. Take one to two capsules per day.
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.
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.
Probiotics are officially defined by the Joint Food and Agricultural Organization of the United Nations/World Health Organization Working Group as “Live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” Basically, probiotics at this point in time are live bacteria and yeasts that provide health benefits to you if you take them in adequate quantities.

Lactobacillus predominantly live in your small bowel (the portion of your gut that follows the stomach). Probiotics containing Lactobacillus sp. help to repopulate the small intestine with friendly organisms that aid in supporting digestion and immune function. The most beneficial are L. acidophilus, L. plantarum, and L. paracasei. One study found Lactobacillus acidophilus could reduce gut inflammation. L. rhamnosus helps increase GABA expression (an inhibitory neurotransmitter that helps you feel relaxed) in the brain, resulting in lower anxiety and depression-related behavior. Another found that a combination of Lactobacillus and Bifidobacteria (which we'll talk about next) improved symptoms of bloating in patients with functional bowel disorders, and yet another found that when people took the Lactobacillus rhamnosus GG strain, it significantly reduced the risk for antibiotic-associated diarrhea.
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.
While past studies have investigated similar questions, they have all used patients' excrement as a proxy for microbe activity in the GI tract. Instead, Elinav, his colleague Eran Segal, (a computational biologist at the Weizmann Institute), and their teams spearheaded by Niv Zmora, Jotham Suez, Gili Zilberman Schapira, and Uria Mor of the Elinav lab collaborated with Zamir Halpern, Chief of Gastroenterology at the Tel Aviv Medical Center to measure gut colonization directly.
There are a lot of factors that play a role in how well probiotics survive before it actually hits your system. How long a store keeps the product in storage before selling it, the temperature at which you store the probiotic, the foods you eat the probiotic with, or the medications you take can affect the effectiveness of the probiotic. If you’re buying a product closer to its “Sell By” date, you might not reap the full benefits because that probiotic may not be as strong.

Clinically shown to work in 7 days§, AZO Complete Feminine BalanceTM works differently because it contains the power of INTELLIFLORA,TM the only clinically proven blend with the 4 vaginal lactobacilli species most commonly found in healthy women.* Specially designed to restore the vagina’s microflora, it’s a safe and beneficial probiotic for women’s health—including pregnant women.*§ Add it to your daily regimen for help with protection and ongoing vaginal health support.*

To avoid those and other problems, I strongly recommend buying a professional brand from a reputable health care professional or other vendor who stands by their products and undergoes third-party testing. Some of these professional brands have created advanced technology that preserves a probiotic supplement’s survival on the shelf and in your gut.
Renew Life Ultimate Flora offers 30 billion CFUs with 10 scientifically studied strains of Bifidobacterium and Lactobacillus, which according to current scientific research, are the two most prevalent good bacteria found in a healthy gut. In other words, you might choose these if you’re seeking a careful balance designed to re-establish proper immune health and digestive equilibrium.

Align uses the patented probiotic strain Bifidobacterium, which helps to maintain a healthy digestive system and digestive balance. It contains 1 billion CFUs when manufactured, and 10 million CFUs when used by the best by date. (Very often, the number of CFUs in a product decreases over time.) If you have trouble digesting certain foods such as caffeine or dairy, this will be a good option for you.
What are the benefits of taking probiotics? Bacteria have a reputation for causing disease, so the idea of tossing down a few billion a day for your health might seem — literally and figuratively — hard to swallow. But a growing body of scientific evidence suggests that you can treat and even prevent some illnesses with foods and supplements containing certain kinds of live bacteria. Northern Europeans consume a lot of these beneficial microorganisms, called probiotics (from pro and biota, meaning "for life"), because of their tradition of eating foods fermented with bacteria, such as yogurt. Probiotic-laced beverages are also big business in Japan.
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.

Some digestive disease specialists are recommending probiotic supplements for disorders that frustrate conventional medicine, such as irritable bowel syndrome. Since the mid-1990s, clinical studies suggest that probiotic therapy can help treat several gastrointestinal ills, delay the development of allergies in children, and treat and prevent vaginal and urinary infections in women.


Flu is short for influenza, an upper respiratory viral infection. The main problem for you, and the main advantage for the survival of influenza viruses, is that there are many variations that can cause illness. Flu shots are based on virus strains that are anticipated to be widespread. Sometimes those assumptions are correct and other times they are not. This section will show you one overlooked way to fortify your body to best avoid becoming sick with the flu at all, or how to recover if you do succumb.
When I polled friends and family about their personal experiences with probiotics, I got a real mixed bag of responses. Some called them a lifesaver and others felt no effects whatsoever. I put the anecdotes aside and talked to Ben Lebwohl, gastroenterologist and director of clinical research at Columbia University’s Celiac Disease Center, to get the straight poop on whether probiotics are miracle or myth.
Made by fermenting the juice of young coconuts with kefir grains, this dairy-free option for kefir has some of the same probiotics as traditional dairy kefir but is typically not as high in probiotics. Still, it has several strains that are great for your health. Coconut kefir has a great flavor, and you can add a bit of stevia, water and lime juice to it to make a great-tasting drink.

The above line of probiotics is also a favorite of Engelman. "I like Nerium International's new Prolistic Pre & Probiotic Plus Vitamins ($45) because it combines prebiotics, probiotics, and vitamins," Engelman explains. "It supports overall health while targeting digestive function. It contains two types of prebiotics and two strains of probiotics to help enhance levels of beneficial microflora and balance levels of healthy bacteria in the digestive system. Additionally, it contains B vitamins, vitamin C, and vitamin D, which work to enhance the body's immune system and support natural energy production."
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 best probiotic manufacturers will list their potency (in CFUs) at the time of expiration, ensuring you get the dosage you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times bestsellers "Brain Maker" and "Grain Brain" puts it this way: “Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf life.” Each of our top picks clearly shows a specific “best by” or “expires on” date on its bottle.
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.
Dr. Michelle Schoffro Cook says there’s no single best strain of bacteria, though some strains, like L. Acidophilus or B. Bacterium, have wide-reaching effects. They often act as a starting point from which to add other strains with more specific impacts. Already have probiotics on hand or want to arm yourself with raw knowledge before you shop? The table below shows the research- and expert-backed strains we looked for in each use case:
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.
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.
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.

If this happens, it's time to consider switching to a new probiotic. Other reasons a probiotic may not be the right fit: SIBO or Candida. If you have either of these conditions, the strain of the probiotic could potentially make your symptoms worse. Remember, if you think a probiotic is not helping, seek the advice of a functional medicine provider to help you navigate the choices out there.


I’ve been taking a Jamieson Probiotic for weeks now for my IBS. I’m not really getting results. It has 10 billion cells and about 14 strains. I tried taking it every day but then I was crampy, bloated and almost constipated. A friend suggested taking every other day so I did that and it was just the opposite. I’ve been trying to eat a low fodmaps diet as well. Can you tell me how long its supposed to take to work and also if I should possibly try something else? This probiotic was inexpensive so I’m wondering if you get what you pay for.
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