Although these capsules are more expensive than other options on the market, if you suffer from ulcerative colitis, irritable bowel syndrome, or pouchitis, this probiotic will help manage your symptoms. VSL contains eight different probiotic strains (and more good bacteria than other brands) to alleviate symptoms such as bloating, cramping, and diarrhea. There are 60 capsules per bottle.
Your gut is diverse, so your probiotic should be too. Look for a supplement that contains multiple strains, sometimes listed as a proprietary blend. Inferior brands might only contain one probiotic strain such as Lactobacillus acidophilus. Aside from Lactobacillus and Bifidobacterium strains, probiotics may contain Strep. thermophilus and Saccharomyces boulardii, among others.

Probiotics are live microorganisms that are thought to have health benefits, as the National Institutes of Health (NIH) reports. These bacteria and yeast are believed to help populate our guts with beneficial microbes, according to Mayo Clinic, and can be found in fermented or unpasteurized foods including yogurt, kefir, sauerkraut, and kimchi, as well as, yes, supplements.

Once the GI microbiome is disrupted, and especially if an infection is treated with antibiotics, it can take time for the resident microbiota to recover, if it ever does. A disrupted gut microbiome sets the stage for altered motility, intestinal hypersensitivity, gut immune activation, leaky gut, altered bile, mental disorders, and a host of other factors that can play a role in IBS. Good probiotics, along with a proper diet, can help the GI tract get the microbes it needs to function normally.
In addition to the prophylactic effect of stocking your gut with good bacteria, there are some probiotic strains that have also shown promise in treating symptoms of autoimmune disorders, including L. Paracasei and L. Acidophilus. Others, like B. Lactis, could help prevent respiratory infections. Renew Life Flora Extra Care has all three targeted bacteria strains at 30 billion CFUs per serving.
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.
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 (First published: September 6, 2018) DOI: 10.1016/j.cell.2018.08.041

Even for those without an urgent problem, probiotics can help with overall digestive management. Challa argues in his book, Probiotics For Dummies, that good bacteria help "crowd out" bad bacteria. That's because the intestine is lined with adherence sites where bacteria latches on. If the sites are populated with good-for-you microbes, there's no place for a harmful bacterium to latch on.


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)
★50 BILLION 20 STRAINS TARGETED RELEASE FORMULA★NewRhythm 50Billion Probiotics Capsules is Scientifically Backed and Clinically Proven, Formulated by Doctor with 50 Billion Living Organisms Per Serving, Featuring Targeted Release Technology to Help Probiotics Survive Stomach Acids and Reach Your Intestinal Track. Organic Prebiotics Fiber is also Included In the Formula.

They can break down substances in foods that keep you from absorbing the micronutrients inside. They not only protect against the consequences of rogue molecules passing through a leaky gut, but they assist your intestinal cells in staying healthy to optimize nutrient absorption. In addition, some of the metabolic by-products of probiotics, such as short-chain fatty acids and vitamin production, are very nourishing to your GI tract.
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.
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.
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.*
Undaunted, researchers looked into whether probiotics might be beneficial in a host of disorders, even when the connection to gut health and the microbiome was tenuous. Reviews show that there is insufficient evidence to recommend their use to treat or prevent eczema, preterm labor, gestational diabetes, bacterial vaginosis, allergic diseases or urinary tract infections.
Better Health Review named Dr. Ohhira’s Probiotics 12 Plus on its list of the top probiotic supplements on the market. It contains less than a billion active probiotic cells per dosage, but it adds vitamins, minerals and other micronutrients for optimal health. It claims to be 100 percent vegetarian. Better Health Review gives Dr. Ohhira’s Probiotics 12 Plus a rating of 3.5 on a scale of 5.

​​​​​​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.*
Vitamin Bounty’s probiotic contains a variety of well-studied strains and a competitive 25 Billion CFU. It also contains a natural prebiotic resistant starch, rice flour, to fuel the strains this probiotic supplies. Over 95% of Pro 25’s strains were still active and viable, the second highest observed strain viability out of all probiotics reviewed-to-date!
Candida albicans is the most common species that causes yeast infections, but there are others. It is a normal inhabitant of the gastrointestinal tract and is often found in the female vaginal tract. Candida infections on the skin cause red, itchy rashes that often weep moisture, and in the vagina there is often a cottage-cheese-like discharge in addition to the skin symptoms.
Supplements play an important role when the diet is not adequate to supply our needs. In the case of probiotics, one's diet is the ideal source for probiotics. These are live bacteria and need to be carefully monitored, stored, and combined for the health benefits that one would be taking them for. At this time, supplements are not monitored in the U.S. the way that food or medication is. They fall under the Dietary Supplement Health and Education Act of 1994 (DSHEA). This requires that the dietary supplement or dietary ingredient manufacturer be responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. The only time that the U.S. Food and Drug Administration (FDA) may get involved is if action is needed to be taken against a manufacturer after the supplement is marketed and then found to be unsafe. This means that as much as we may know about probiotics, we can't be certain of the safety or content of the supplements available to us.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
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.)
Culturelle Probiotics, although very basic, is still a great probiotic supplement.  The results I got from trying it were positive– I felt pretty good throughout the entire trial period. Although this product only contains one strain of probiotic, the one they chose is a solid one.  The cell count is 10 billion, which is a good number for a daily probiotic.  Lastly, Culturelle doesn’t contain any frequently-irritating ingredients like milk, dairy or gluten.  Read the full review here… or click here to go buy it now!
Digestive tract conditions. Probiotic supplements may be useful in treating and preventing inflammatory conditions, such as pouchitis (which affects people who have their colons removed), inflammatory bowel diseases (such as ulcerative colitis and Crohn's disease), and chronic stomach inflammation and ulcers caused by Helicobacter pylori bacterium. They may also be helpful in treating constipation, irritable bowel syndrome, acid reflux, spastic colon; shortening the duration of infectious diarrhea; and reducing the recurrence of bladder and colorectal cancer. Some studies suggest that yogurt is helpful in preventing diarrhea - a common side effect of treatment with antibiotics. It has also been shown to prevent or treat urinary tract infections and vaginal yeast infections in women.

However, a 2003 pilot study and 2011 randomized, controlled trial both reported that RA activities remained unchanged, but the subjects treated with probiotics reported statistically significantly higher levels of “subjective well-being.” One suggested reason for this was that the trials were too short to establish changes in the observable changes in the internal earmarks of RA.
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.
The probiotic industry is booming, but the benefits of probiotic products and the quantity of viable bacteria they contain can vary. So, instead of adding bacteria from an outside source, you might be better off consuming prebiotics, like fermentable fiber, which support your own beneficial bacteria, Dr. Cresci says. Good dietary sources of prebiotics include dried beans and other legumes, garlic, asparagus, onions, leeks, certain artichokes, green bananas and wheat. Prebiotic supplements are available, as well.

As of now, the most comprehensive meta-study (a study of different studies) has not been able to decisively identify any particular strain of bacteria that is specifically useful to treat seasonal allergies. Some studies contradict each other on which bacteria can treat grass pollen, and other studies will find that those strains the first two studies examined weren’t nearly as effective in their own trials.

The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.


The second piece of research investigated whether patients should take probiotics to help the recovery of the natural gut bacteria after treatment with antibiotics. The evidence supporting this is not entirely clear and the FDA does not officially recommend it, but there are some reputable sources which discuss their use, such as this blog from Harvard Medical School. Research has suggested that up to 60% of healthcare professionals in the U.S. recommend taking probiotics, but is this justified and could it even be harmful?


The two main species you want to look for are: Lactobacillus and Bifidobacterium. Within these two species, there are a lot of different strains. The strains we chose for our probiotic—Lactobacillus acidophilus, Lactobacillus plantarum, and Bifidobacterium longum—have been shown to help modulate the immune system, help with autoimmunity conditions (which affect most of my patients), and counter infections in the gut.
Many factors influence the proportion of each family; from the early years of your life (the type of birth you had, breastfed vs. formula-fed, exposed to antibiotics prenatally) to the later years, where more lifestyle factors like diet, smoking, alcohol consumption, stress, and sleep come into play. The bacteria species found in the digestive tract have a significant influence on overall health, both physical and mental, which is why it’s important to take care of them every day.
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.
4. Ohnmacht C, Park JH, Cording S, Wing JB, Atarashi K, Obata Y, Gaboriau-Routhiau V, Marques R, Dulauroy S, Fedoseeva M, Busslinger M, Cerf-Bensussan N, Boneca IG, Voehringer D, Hase K, Honda K, Sakaguchi S, Eberl G. The microbiota regulates type 2 immunity through RORγt+ T cells. Science. 2015 Jul 9. pii: aac4263. [Epub ahead of print] PubMed PMID: 26160380.
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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.
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.
Pinning down the exact causes of IBS is difficult because each person has his or her own combination of causes. One cause that is receiving much attention is that of a disrupted microbiome, as there is a strong association between having a gastrointestinal (GI) infection, like food poisoning, and the onset of IBS. Also, the FODMAP diet, and nonabsorbable antibiotics to kill gut microbiota, have provided relief in many patients, further supporting the suspicion of a disrupted microbiome as contributing to IBS.
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.
They can break down substances in foods that keep you from absorbing the micronutrients inside. They not only protect against the consequences of rogue molecules passing through a leaky gut, but they assist your intestinal cells in staying healthy to optimize nutrient absorption. In addition, some of the metabolic by-products of probiotics, such as short-chain fatty acids and vitamin production, are very nourishing to your GI tract.
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.
Probiotic supplements are not drugs (in the United States), although super potent forms may be obtained through prescription. As such, they are not intended to treat or cure any diseases, mental or physical. Probiotics benefit and complement a healthy way of life filled with nutritious food, adequate exercise, restorative sleep, beneficial social engagements, reduced exposure to toxins, and hydration with clean water.

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: 

Did you know that bacteria might actually keep you healthy? It all just depends on the type of bacteria. In this case, we’re talking about the benefits of probiotics. Probiotics benefits are some of the most widely researched natural solutions to gut health. For years, scientists and physicians have observed the many benefits of probiotics for not just the gut, but for the entire body.
What exactly do probiotics do? They are believed to protect us in two ways. The first is the role that they play in our digestive tract. We know that our digestive tract needs a healthy balance between the good and bad bacteria, so what gets in the way of this? It looks like our lifestyle is both the problem and the solution. Poor food choices, emotional stress, lack of sleep, antibiotic overuse, other drugs, and environmental influences can all shift the balance in favor of the bad bacteria.
There are four significant takeaways from this study: (1) murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics, (2) Human gut mucosal probiotic colonization is significantly enhanced by antibiotics, (3) After taking antibiotics, probiotics delay gut microbiome and transcriptome reconstitution in mice and humans, (4) Autologous fecal microbiome transplant (aFMT) restores mucosal microbiome and gut transcriptome reconstitution. 

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.
Unfortunately, many commercial brands don’t measure up. They are unstable in stomach acid. Quality control measures aren’t intact, including ensuring supplements have been handled correctly and maintain their freshness. Moisture slipping into probiotic supplements can reduce their efficacy. Companies that use bioshield capsules produce higher quality probiotic supplements that are able to endure the stomach acid, releasing their contents within the small intestine, where a more alkaline environment ensures the survival of the bacteria.

This dairy-free, gluten-free, vegetarian probiotic delivers live microorganisms, protected in stomach acid-resistant capsules to ensure effective delivery throughout your digestive system, from the stomach through your small intestines. The result is the repair and sustained maintenance of your intestinal micro-ecology, which in turn helps support healthy immune response and bowel regularity.
Whether a brand of probiotics works really depends on its quality and your body's own gut. Everyone has a different set of gut flora so try several to see what works for you. Using a brand of at least 40 billion CFU is best. There seems to be some debate as to whether one should use refrigerated or unrefrigerated probiotics. I went with the side that claims unrefrigerated are sturdier and less prone to die off.
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics. 

​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
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