There’s preliminary evidence that some probiotics are helpful in preventing diarrhea caused by infections and antibiotics and in improving symptoms of irritable bowel syndrome, but more needs to be learned. We still don’t know which probiotics are helpful and which are not. We also don’t know how much of the probiotic people would have to take or who would most likely benefit from taking probiotics. Even for the conditions that have been studied the most, researchers are still working toward finding the answers to these questions.
This cabbage condiment can frequently be found atop a mighty hot dog, but its roots trace all the way back to the 4th century B.C. Cabbage was fermented to preserve the veggie, resulting in what we all know as sauerkraut. Palmer points out that modern techniques for canning sauerkraut results in a product packed in a vinegar solution without live, active bacteria in the mix. For most probiotic power, eat fresh sauerkraut (look for live cultures on the label or buy it in the refrigerated section) or make it yourself at home.
The benefits of probiotics don't stop at internal health. Research from the American Academy of Dermatology found that, whether applied topically or taken orally, probiotics can potentially help patients with skin issues such as acne, rosacea, and eczema. More studies need to be done though, so talk to your dermatologist before changing your regular routine.

The foods that are highest in prebiotic fiber are also difficult to find and prepare. Jerusalem artichoke — not the average artichoke sold in your local grocery store — and chicory root contain the highest amounts of inulin and oligofructose. The good news is that Prebiotin offers an easy solution: with our simple supplement, you can get enough prebiotic fiber through normal dietary intake instead of eating a high amount of chicory root a day. Prebiotin is also low in calories. Unlike other fiber supplements, Prebiotin does not have an unpleasant taste or texture. It is slightly sweet and easily combines with beverages such as coffee. You can also sprinkle it on top of food.
As a world-renowned neurologist and nutritionist, Dr. David Perlmutter has become somewhat of a household name when it comes to the linkage between what we eat and how we feel. He is known as “The Empowering Neurologist” and has been featured on the Doctor Oz Show, CNN, and NPR as well as in prominent publications like The New York Times, Forbes, Time Magazine, and the Wall Street Journal. If that wasn’t enough to spark your interest, Dr. Perlmutter is also the award-winning author of the Grain Brain Whole Life Plan, Brain Maker, and Grain Brain, all of which have become international bestsellers. 

In the new study, the researchers analyzed information from 15 healthy volunteers who took either a probiotic product containing 11 strains of bacteria, or a placebo, for four weeks. The participants also underwent colonoscopies and upper endoscopies before they took the probiotics or the placebo, and again after the four-week treatment period. (An upper endoscopy looks at the upper part of the digestive tract.) During these procedures, the researchers took samples from inside participants' guts.
Quality matters for any supplement, and that goes triple for probiotics. Many commercial brands lack the technology to identify specific strains and how much of that strain each dose contains. That could mean you get an ineffective or potentially harmful dose. It's a great sign if the company is using strains that have been used specifically in clinical trials at a dose similar to or the same as that used in the study. This is one of the only ways to guarantee a probiotic's clinical effectiveness.
The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.
As the best-selling author of Happy Gut and a medical doctor who specializes in gut health and once suffered from IBS (irritable bowel syndrome), I have experienced for myself, as well as see on a daily basis, how a disrupted gut flora opens the door for unfriendly microbes to step in and take over, creating all sorts of pandemonium that causes patients to gain weight, feel sick and tired, and become more disease-prone.

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.


Although people often think of bacteria and other microorganisms as harmful “germs,” many microorganisms help our bodies function properly. For example, bacteria that are normally present in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins. Large numbers of microorganisms live on and in our bodies. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.
“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.”
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)
The label should also specify that the living microbes are viable through end of shelf life or best by date rather than at time of manufacture to ensure the bacteria are still live when you take them and able to reach your colon. Quality trumps everything- supplements that are a bargain are typically not of quality. A good probiotic (depending on strands) can cost anywhere from $25-$60.
An imbalance in the gut microbiota is believed to contribute to a number of health problems, particularly gastrointestinal issues, as well as immune dysfunction and infections. The bacterial balance can be disrupted by medical conditions, emotional and physical stress, and, most notably, use of antibiotics, which destroy the good bacteria along with the bad.

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.
More common than diarrhea is the opposite problem — constipation. In a search for studies on the benefits of probiotics in treating constipation, researchers found that probiotics slowed "gut transit time" by 12.4 hours, increases the number of weekly bowel movements by 1.3, and helped to soften stools, making them easier to pass. But the jury is still out on specific recommendations when it comes to the benefits of probiotics for constipation.

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.


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."

Depression often goes hand in hand with anxiety. Both conditions can have origins in the gastrointestinal (GI) tract, which typical antidepressants and benzodiazepine medications do not address. Since there is a connection between the health of the GI tract and the health of the nervous system/brain, directly through the vagus nerve and also via indirect chemical effects, improving the former can positively affect the latter.
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.”
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.
In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
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. 

Yes! Beneficial yeast is a probiotic, defined as a microorganism that supports human wellness. (Probiotic means “for life.”) Saccharomyces boulardii is a remarkable yeast that can significantly support your whole internal ecosystem. It helps reduce problematic yeasts, such as Candida, and replenishes healthy gut flora.* While many probiotic supplements only deliver friendly bacteria without yeast, Probiotic All-Flora contains 5 billion CFU of beneficial yeast for complete support.
Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a "folk" remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn't enough evidence yet to recommend it over conventional approaches. (Vaginosis must be treated because it creates a risk for pregnancy-related complications and pelvic inflammatory disease.) Probiotic treatment of urinary tract infections is under study.
In a food allergy, there is an immediate immune reaction to the offensive food. Classic allergic symptoms such as tingling lips, burning/tightness in the mouth/throat, gastrointestinal upset, difficulty breathing, rashes, hives, and even anaphylaxis may be present. Although any food can cause an allergic reaction, the most common offenders are peanuts, tree nuts, dairy, fish, shellfish, eggs, soy, and wheat.

Make sure to keep them away from moisture and heat which can kill off some of the microbes. I recommend taking on an empty stomach, ideally right when you wake up. You should always store supplements in a cool, dark place but refrigeration is best. Most of the strains of probiotics are fragile and should be protected from heat- so refrigeration is ideal. I recommend the probiotic Gut Instinct from HUM Nutrition for transparency and high quality.


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.
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.
When the digestive tract is healthy, it filters out and eliminates things that can damage it, such as harmful bacteria, toxins, chemicals, and other waste products. The healthy balance of bacteria assists with the regulation of gastrointestinal motility and maintenance of gut barrier function. Research has shown some benefits for the use of probiotics for infectious diarrhea, antibiotic-associated diarrhea, gut transit, IBS, abdominal pain and bloating, ulcerative colitis, Helicobacter pylori infection, nonalcoholic fatty liver disease (NAFLD), and necrotizing enterocolitis.
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.
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:
What's more, there's still a lot more to learn about the microbiome and probiotics, in general. "Truth be told, the research area of probiotics and health is still pretty much in its infancy," says registered dietitian Kate Scarlata. Research is growing in the area of gut microbiome daily—but it is much more complicated than first thought." With all these options and major gaps in the available information, where are you supposed to start? Here, gut experts narrow it down to three simple tips for picking the right probiotic for you.
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.
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.
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