Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
If that's not enough, your doctor may also suggest a probiotic supplement. But don't go and grab just anything off the pharmacy shelf. Probiotic supplements are not all the same, and they often contain different strains to serve different needs, says naturopathic physician Amy Fasig. Example: What one person gets to battle strep throat is different from what would be prescribed for someone suffering from Irritable Bowel Syndrome, she says.
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.
Made from aged, fermented soybeans, this paste is brimming with probiotics. You can buy miso paste in a bunch of varieties (white, yellow, red, brown) and the darker the color, the deeper the taste. Miso is a great way to add a burst of earthy, savory flavor for few calories (only 25 to 30 per tablespoon), plus protein, fiber, and bone-strengthening vitamin K, says Sharon Palmer, RDN, author of Plant-Powered for Life. "While we need more research about how these types of fermented foods contribute to health, it's a good idea to introduce more of them into your diet," she says. Use miso to glaze fish or chicken before cooking, mix into a stir-fry recipe, or add to liquid to make a miso broth. One caveat: Miso is very high in sodium. One teaspoon, enough to make a cup of miso soup, has 473 mg of sodium, 21% of the daily recommended limit and 32% of the daily limit for those with high blood pressure.
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.

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The classic examples of probiotics are yogurt and kefir, which are great for a lot of people, though not if you have a dairy sensitivity. There a lot of yogurt and kefir alternatives, from water kefir and almond yogurt, to coconut yogurt, coconut kefir, and so on. Look at ingredients when you’re shopping for food like yogurt—you want to avoid sugar-filled products. I like plain coconut yogurt with fruit and little stevia on it.
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.
Probiotic therapy may also help people with Crohn's disease and irritable bowel syndrome. Clinical trial results are mixed, but several small studies suggest that certain probiotics may help maintain remission of ulcerative colitis and prevent relapse of Crohn's disease and the recurrence of pouchitis (a complication of surgery to treat ulcerative colitis). Because these disorders are so frustrating to treat, many people are giving probiotics a try before all the evidence is in for the particular strains they're using. More research is needed to find out which strains work best for what conditions.
One thing that is often overlooked is gut health and the benefits of probiotics for weight loss. Gut microbiota can affect food intake choices, appetite, and body weight and composition. Dysbiosis, an imbalance in the gut microbiota with a shift favoring pathogens and opportunists, is common in overweight people. The pathogens and opportunists create an inflammatory situation that affects insulin and other hormones, resulting in the inability to lose weight.
"Probiotics applied topically sit on the skin's surface and prevent the skin cells from seeing the bad bacteria and parasites that can cause this immune system response," confirms Engelman. "This is known as 'bacterial interference,' as probiotics protect the skin and interfere with the ability of bad bugs like bacteria and parasites to provoke an immune reaction.
Probiotics seem to be all the rage these days. With many purported benefits and a relatively low risk of side effects, manufacturers are taking advantage of booming business opportunities. Rather than leave your health in the hands of big business, it is important that you be as educated as possible about the best types of probiotics so you can choose what is right for you and your family.

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.
Selecting a multi-strain probiotic is also consistent with the theory that filling your gut with enough good bacteria outcompetes any bad bacteria for the same space and resources. In your gut, the more diversified the good bacteria, the harder it is for the baddies to gain a foothold. With all this in mind, we only looked at supplements containing multiple strains of bacteria.
B. Longum is one of the first types of bacteria to colonize our bodies at birth. These important microorganisms ferment sugars into lactic acid, helping to stabilize the acidity of the GI tract and inhibit growth of harmful bacteria. For a group of adults prone to constipation, taking a mix of B. Longum BB536 with milk or yogurt for 2 weeks increased bowel movements [1].
A large analysis reviewed available research and determined that probiotics help lower blood pressure by improving lipid profiles, reducing insulin resistance, regulating renin levels (a protein and enzyme secreted by the kidneys to lower blood pressure) and activating antioxidants. Researchers consider them valuable prospects in the treatment of high blood pressure because their side effects are generally minimal or nonexistent. (82, 83)
The reason constipation is linked to disease is that it allows undigested food and bodily wastes to sit in the colon, putrefy, and dry out. As feces dry out, water from the feces is reabsorbed back into the body, and along with it toxins. Additionally, microbes that like those conditions can multiply, releasing their toxic products that are then absorbed into your bloodstream.
"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."
Scientists are investigating probiotics, and their combined effects, by trying to classify the probiotic benefits of ingesting specific probiotic strains and understanding their role in the digestive tract. At present, the methodological and ethical limitations of human studies still make it difficult to fully understand the mechanisms of action of probiotics, but some explanations are available. Nevertheless, benefits linked to the consumption of probiotic strains have already been suggested (e.g. helping to support the immune system, help support digestive health), and others are still being investigated.
Side effects: Probiotics are considered safe overall for healthy people; short-term side effects may include mild gas and bloating. But risks may be greater in immunocompromised people. And a systematic review in the Annals of Internal Medicine in 2018 found that the reporting of adverse effects is often missing or inadequate. Also in 2018, an editorial in JAMA Internal Medicine by Dr. Pieter Cohen, a well-known critic of the supplements industry, called for the FDA to improve its regulatory standards for probiotics to match those of Canada and the EU.
Side effects: Probiotics are considered safe overall for healthy people; short-term side effects may include mild gas and bloating. But risks may be greater in immunocompromised people. And a systematic review in the Annals of Internal Medicine in 2018 found that the reporting of adverse effects is often missing or inadequate. Also in 2018, an editorial in JAMA Internal Medicine by Dr. Pieter Cohen, a well-known critic of the supplements industry, called for the FDA to improve its regulatory standards for probiotics to match those of Canada and the EU.
Previous studies have been contradictory, with some yielding more positive results about the benefits of probiotics, but most of them looked at probiotics in stool samples, not directly in the gut itself. In the new research, the scientists used more invasive methods to take samples of gut bacteria directly from different areas of the digestive system.
I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?
Make sure dosages are listed in CFU, colony forming units. (Most brands list CFU in billions now: so 30 billion CFU, 100 billion CFU, and so on.) For one, this means that the bacteria strains are living, which is essential. When you’re looking at the cost of products, be sure to look at the cost per unit. I spoke to a woman the other day who had bought probiotics that had 2 billion CFU per capsule. In comparison, to get the 30 billion CFU I recommend, she’d have to take essentially half of her bottle to get the same dosage as one of our capsules.
Third-party testing: Lastly, it's important to remember that probiotics are an unregulated supplement. "Find out whether there is third-party data verifying the potency, purity, and effectiveness of the product," suggests Dena Norton, a registered dietitian and holistic nutrition coach. "Remember that dietary supplements aren't regulated, so you can't necessarily just trust the claims on the label." Check out AEProbio, a site that has compiled research on specific brands of probiotics available in the U.S., recommends Scarlata, and an NSF seal is always a good marker to look for.
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.
Back to the question of what are probiotics: There are five main types, each in its own classification called a genus. Within each genus there are multiple species, and within those species there are multiple strains. For example, Lactobacillus is a very common genus of probiotics. Within that genus are numerous species, such as rhamnosus. The genus and species of a microbe are always italicized, making it easy to know that a microbe is involved. In a species such as Lactobacillus rhamnosus (often abbreviated L. rhamnosus), there are many strains. An example of the name of a strain is L. rhamnosus GR-1.
“I’d probably stay away from store brands and pay a little extra for the name brand that’s been studied,” Dr. Cresci adds. “Ideally, look for a product that’s been tested for whatever you’re looking to address. It might say it helps with IBS, but you wouldn’t take that same product if you were taking antibiotics. You would want a product that helps with immunity. That’s where a lot of people get confused.”

If that’s the case, I recommend steering clear. They either don’t want you to know that they’re using a poorly-researched strain of probiotics or they’re simply ignorant to the fact that the strain of probiotic really matters and determines the benefit that you’ll receive as the consumer. I usually want to give these companies the benefit of the doubt, but honestly, if you’re making a probiotic supplement you should know this stuff is important.
This high-potency (25 billion CFU) supplement blends 12 different strains in a base of inulin. The Ther-Biotic Complete capsules are vegetarian (made from hydroxypropyl methylcellulose, water) and the formula is free of common allergens, such as milk, eggs, fish, tree nuts, peanuts, wheat, gluten, and soy so it’s perfect for those with allergies. There are 60 capsules per bottle.
The science on what probiotics do is still emerging. There is some hard evidence that suggests eating probiotic foods and supplements can have a beneficial effect on health. Other evidence suggests probiotics benefits are limited to those individuals in good health and should be avoided by those who suffer from certain serious health conditions. There is no research that demonstrates the risks or the benefits of probiotic supplements on children.

Probiotics can also help offset the bacterial imbalance caused by taking antibiotics. Antibiotics kill good bacteria along with the harmful ones, often leading to gas, cramping or diarrhea. Potential benefits of probiotics have been seen in the treatment or prevention of many conditions such as diarrhea, irritable bowel syndrome, ulcerative colitis, and Crohn's disease.


Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.

What's nice about supplement company Care/of is that it allows you to design personalized daily vitamin and supplement packs containing everything you need, including probiotics. Its vegan, gluten-free probiotic formula has one billion lactobacillus acidophilus and four billion bifidobacterium lactis per dose, popular strains thought to help promote digestive and immune health.

Update: I think this product is being smeared by a competitor! Look at all the reviews in April. Suddenly, a butt ton of not just negative but 1 star reviews. It's uncanny. So, what would compel a competitor to do such a thing? Well, it was the only 50 CFU, enteric coated & 20 strain probiotic on Amazon & it cost about 15 bucks. That, while products far inferior to it were priced for - often times - 2 or 3x as much.
This mildly sour, chewy bread is made with a lactic acid starter that contains strains of lactobacillus, a friendly type of bacteria that adds good microbes into the bakery staple. Sourdough may be the healthiest bread choice if diabetes is a concern for you: one 2008 study found that people with pre-diabetes who ate sourdough bread had less of a blood sugar spike compared to when they ate bread made with baker's yeast. (Experts also say fiber-rich whole grain bread can also reduce a post-meal blood sugar spike.) The researchers credit the lactic acid for the favorable effect.
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.
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.

Probiotic supplements and foods can play a major positive role in brain fog. Lactobacillus, in particular, can produce neurotransmitters used for brain neuron-to-neuron transmission to facilitate thinking. Probiotics can interact with the vagus nerve to the brain, with the enteric nervous system that can communicate with the brain, and with the brain via chemical messengers.
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.
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.
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