33 of 37 passed all purity tests, indicating an absence of harmful contaminant yeast, mold residues and bacteria, including the pathogenic strain of E. coli (E. coli O157:H7), Salmonella spp., and Staphylococcus aureus. The U.S. Pharmacopeia6 recommends a microbial limit of 100 CFU/g of combined yeast and mold in dietary supplements and non-detectable limits of E.coli, Salmonella, and Staphylococcus aureus. If a product met these standards, it received a full score.
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.
Though rates of serious lung issues have been dropping among men in the Western world, they're still a major concern, with over three million men affected by ongoing respiratory conditions.1 While steroids and antibiotics are the go-to treatments for these conditions, they often fail to address the underlying issue, and they destroy bacteria indiscriminately, creating conditions in which undesirable bacteria can thrive.
If you have a tendency to forget to take your probiotics (which, let’s be honest, we all have), try storing them in a place that you look at directly each and every day. We recommend somewhere like your bathroom sink near your toothbrush or even on your kitchen counter, so you never miss a dosage! This one can be taken with or without food, and it doesn’t have to be stored in the fridge – perfect!

In the second study, the researchers questioned whether patients should be taking probiotics to counter the effects of antibiotics, as they are often told to do in order to repopulate the gut microbiota after it's cleared by antibiotic treatment. To look at this, 21 volunteers were given a course of antibiotics and then randomly assigned to one of three groups. The first was a "watch-and-wait" group that let their microbiome recover on its own. The second group was administered the same generic probiotics used in the first study. The third group was treated with an autologous fecal microbiome transplant (aFMT) made up of their own bacteria that had been collected before giving them the antibiotic.
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.
"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.
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:
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.
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.

While this feature contributes to the efficiency of the product, it is unclear whether this product is vegetarian like some of the other probiotics we reviewed. Therefore, if you have any dietary restrictions or needs, this may not be the best probiotic for you and may, in fact, cause additional stomach upset or irritation. It is however gluten-free.


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.
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.
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.

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.


To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
You also want to look at the guarantee fine print: If the CFU number is guaranteed at time of manufacturing, but not at the time of expiration, you could be taking a less potent dose of probiotics than you think because potency fades over time. I made this mistake when I was traveling once and went to the grocery store to pick up probiotics. On the bottle label it said guaranteed at 20 billion CFU at the time of manufacturing. This doesn’t tell you the CFU for when I was actually taking the probiotics. For instance, our probiotics are manufactured at 60 billion and 200 billion CFU, and guaranteed at 30 billion and 100 billion CFU, respectively, at time of expiration.

However, it is not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. Bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. Acidophilus and B. Bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].
While one 2009 study did show some evidence for reducing cold and flu symptoms in children ages three to five and a 2015 analysis showed probiotics to be better than placebo in preventing acute upper respiratory infections, neither were enough to convince the National Institutes of Health of the efficacy of probiotics for colds and flu. The NIH confirms, “the evidence is weak and the results have limitations.”

"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."
Flora offers a high potency blend of eight super strain probiotics for general gut health and immune system support including multiple varieties of Lactobacillus and Bifidobacterium, among others. Containing up to 42 billion CFUs per capsule, this powerful health-boosting blend uses only strains found naturally in the human body, which increases its effectiveness.

DNA-testing matches identity at a foundational, genetic level, so you know you’re getting the exact strains listed. New Chapter’s DNA-testing also verifies that you receive the specific strains researched for specific benefits: our strains boost immune defenses and enhance digestion, including bowel regularity and reducing occasional gas, bloating, diarrhea & constipation.*
Animals, including humans, have microbes inside them that benefit them in multiple ways. These microbes are in a loose sense like probiotics, but the definition of probiotics was established to designate those microbes that have been isolated, studied, tested in a laboratory dish and/or clinically in animals and/ or humans, and proven to have beneficial properties. In many cases their genetic fingerprints were sequenced for identification purposes and also to check for potentially harmful genetic components. The official term “probiotics” established specific criteria for scientific studies and probiotic supplements, foods, and drinks.
The second Elinav study, “Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT” involved a mouse model and human patients. One cohort of mice and a parallel human group was given the same probiotic strain used in the first study to see if they had more success repopulating their gut microbiota after a round of antibiotics. Another “watch-and-wait” cohort didn’t take probiotics to assist gut microbiome recovery after antibiotic-related depletion. A third cohort was given an “autologous fecal microbiome transplant” (aFMT) which consisted of a patient’s own gut microbiota that had been collected before he or she started a cycle of antibiotics.
“Some strains have been shown to help with GI complaints, some with immune function, and some even have been shown to have benefits outside the intestinal tract, such as with vaginal health or eczema,” says Gail Cresci, Ph.D., R.D., a Cleveland Clinic researcher who studies the microbiome. But there are few definitive conclusions from the current research.
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.

There is one Voluntary Certification Program by which a supplement manufacturer can choose to be evaluated. ConsumerLab.com (CL) is the leading provider of independent test results and information to help consumers and health-care professionals identify the best quality health and nutrition products. Products that have passed their testing for identity, strength, purity, and disintegration can print the CL Seal of Approval on their product. This is one step toward being confident that one is getting the amount and type of probiotic promised by the manufacturer.
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.
The U.S. Clinical Guide to Probiotic Products1, Canadian Guide to Probiotic Supplements2 and the WGO Global Guidelines for Probiotics and Prebiotics3 provide suggested effective amounts of specific strains for treating certain health conditions, such as constipation or IBS. All 37 products listed the species of bacteria they contained, but only 14 listed amounts of individual strains. We found that 9 of those 14 products provided beneficial bacteria at effective levels. The Center for Responsible Nutrition recommends4 the industry move toward specifying strains as a best-practice because whether a product works and for what purpose depends on its strains.

The Golive Berry Probiotic and Prebiotic Supplement Blend is perfect for tossing in your bag or keeping in your desk. Each packet includes 15 billion CFUs and 15 different probiotic strains. It also has a soluble fiber prebiotic to promote the growth of good bacteria in your body. Each packet contains 30 calories and comes in five flavors including pomegranate, melon cucumber, citrus blueberry, and a flavorless option. It can be mixed in any hot or cold drink, but we recommend tossing the flavored packet into a bottle of water. You’ll get 10 packets in each order.
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