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)

You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.


Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," Eran Segal said in a statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
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.

It seems like one minute you have diarrhea (D) and the next minute you are constipated (C). Abdominal pain, cramping, and bloating come and go. You are tired of running to the bathroom frequently, or spending a long time in the bathroom waiting for something to happen. Irritable bowel syndrome (IBS) is a diagnosis of exclusion. Infections and other causes of your IBS-C dominant or IBS-D dominant symptoms have to be ruled out, but in many cases the diagnosis of IBS doesn’t really provide answers. You may be on a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, which helps, but is restrictive. 

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.
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.

The price is great on these, but definitely BEWARE! I do not recommend taking 2 pills in the beginning if you have not taken probiotics in the past! I had been eating very clean for a couple months, but got a sinus infection and was recommended by a nutritionist to take a probiotic to boost gut health since I was on antibiotics. Anyway-taking 2 pulls a day gave me horrible diarrhea, until I figured out they were causing the issue and cut back the pills to one a day! Everything fine since then, will try to build back up to 2 a day...I also take at bedtime just in case there would be any stomach issues!
"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.
Probi is continuously thriving to develop and investigate new possible indications where probiotics may have positive and efficient effects to improve health. We are science-driven, and investigate new possibilities to find the Next Generation Probiotics. This concept involves new bacterial strains that has never before been cultivated and used for health-purposes. 
Experts agree that this is the most important factor to consider in choosing a probiotic. "You should absolutely choose a probiotic based on what you are looking to address," says Chang. "Because strain specificity will impact outcomes, it is important to consider that one strain that works for one condition will not necessarily be effective for other conditions."
You may have heard some questions over whether SBOs are safe: The NIH has a presumed case report, which hasn’t been 100 percent verified, of someone with Lymphoma getting septicemia from taking a SBO (the organism B. subtilis). Some say that if you have leaky gut, you should heal it before supplementing with SBOs. If you are immunocompromised or have cancer, you can consult with a physician first to be safe.
Gut flora makes up 70 to 80 percent of the human immune system. Too much bad bacteria can inflame and destroy intestinal walls, enter the bloodstream, and trigger a multitude of health issues — constipation, depression, skin problems, autoimmune disease, and even bad breath. Adding good bacteria protects the digestive tract from the harmful bacteria in sugars, pesticides, and saturated fats.
Hi Joan, it’s possible, but not ideal because most pill form probiotic supplements are designed to be protected from stomach acid until the capsule reaches the intestines. It’s impossible to say how many probiotic microorganisms would survive by taking them this way, but certainly less than if you swallow the pills. I would recommend trying a probiotic gummy product or some other probiotic that comes in something other than pill form rather than opening up the capsules.
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
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.
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.
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.
I really like your article as it contains a lot of valuable information. the only thing id like to hear more about is the how your rating stacks up to the probiotics geared towards women specifically. I read the listing in, “what to look for” as you suggested but again it doesn’t discuss any findings along the lines of womens specific strands or brands that highlight aiding women more than another. Id love to hear your opinion on the matter or if you might be able to shed any light on the subject at hand. Thanks Julia!
Taking a probiotic every day is a good way to help prevent getting sick and having to go on antibiotics in the first place. Preventative measures, of course, are preferred. Another that is believed to help is upping your vitamin D intake when your immune system needs a boost. Diet is also huge in terms of preventing sickness. Studies show that you can change your microbiome within hours of adjusting your diet. If you’re not into sauerkraut, even just cutting back on sugar and eating more whole foods can make a difference.
Improving the health of your GI tract involves removing foods, drinks, and toxins that are irritating to it and your nervous, immune, and endocrine systems. Experiencing the benefits of foods and probiotics for depression also involves finding out what nutrients and substances you are low in or missing, and re-inoculating with beneficial microbes such as good probiotics.
"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.
The Number of CFUs The quality of a probiotic supplement has more to do with strains and how many CFUs it provides. (CFU stands for colony forming units, and it refers to the amount of live microorganisms in your supplement.) Although recommendations may vary, Gans says to look for probiotics with at least 1 billion CFUs: “Doses will typically range from 1 billion to 10 billion CFUs for adults; although doses for children are often under 1 billion.”
Uh, no. “There have been studies that suggest a theoretical link between the microbiome and even changing the microbiome, and changes in the brain,” Lebwohl tells me. He specifically points to this study, in which healthy women with no gastrointestinal issues had their brains imaged before and after a month of consuming yogurt products containing probiotics twice daily.

“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.”
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.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047

Pure Therapeutics Power Probiotic 100B offers 100 billion CFUs of 4 powerful probiotic strains, including science darling, the HN019 strain of Bifidobacterium lactis. Since environmental factors, including moisture, oxygen and heat, can degrade the stability of your probiotics, Pure Therapeutics 100B is delivered in nitrogen-purged aluminum blister pacts, which ensure viability until the probiotic hits your system. No refrigeration is required.
Cleaning up your diet to remove things that bother you and to add nutrients you and your microbiota need, physical activity to reduce stress and increase feel-good neurotransmitters, mindfulness to discover how your thoughts affect your feelings, and daily consumption of probiotic pills and foods are easy ways to improve your mental health outlook.
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