Despite the uncertainty, foods enriched with probiotics and probiotic supplements are increasingly popular in the U.S. Finding probiotic supplements in grocery and health food stores is easy. For example, you may already know that yogurt contains probiotic bacteria such as lactobacillus and bifidobacteria. Many clinical studies suggest these bacteria relieve symptoms related to lactose intolerance.
Taking probiotics can also help keep your urinary system working properly. While you might think that yeast imbalances or urinary tract issues are primarily women's problems, both are common in men as well, especially in those whose bacterial balance is off-kilter. Taking probiotics can help address these issues by encouraging the growth of good bacteria to crowd out unwanted yeast.10
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.
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. 

We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
Studies have shown some benefits linked to Lactobacillus and treating and/or preventing yeast infections, bacterial vaginosis, urinary tract infection, irritable bowel syndrome, antibiotic-related diarrhea, traveler's diarrhea, diarrhea resulting from Clostridium difficile, treating lactose intolerance, skin disorders (fever blisters, eczema, acne, and canker sores), and prevention of respiratory infections.
Eating foods rich in good bacteria and using probiotic supplements may help provide protection from inflammatory bowel diseases, including ulcerative colitis and Crohn’s disease. The evidence is stronger, however, for an improvement in ulcerative colitis, while Crohn’s disease may not benefit as greatly. In addition, there is ongoing research studying the role of probiotics in gluten issues, including celiac disease.
Most of the prebiotics identified are oligosaccharides. They are resistant to the human digestive enzymes that work on all other carbohydrates. This means that they pass through the upper GI system without being digested. They then get fermented in the lower colon and produce short-chain fatty acids that will then nourish the beneficial microbiota that live there. Oligosaccharides can be synthesized or obtained from natural sources. These sources include asparagus, artichoke, bamboo shoots, banana, barley, chicory, leeks, garlic, honey, lentils, milk, mustards, onion, rye, soybean, sugar beet, sugarcane juice, tomato, wheat, and yacón. The health benefits from these oligosaccharides is a topic of ongoing research.

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)
Bifidobacteria is a family of bacteria that has been studied for its ability to prevent and treat various gastrointestinal disorders, including infections, irritable bowel syndrome and constipation. In addition to making lactic acid, it also makes some important short-chain fatty acids that are then absorbed and metabolized by the body. There is also some experimental evidence that certain bifidobacteria may actually protect the host from carcinogenic activity of other intestinal flora.

That’s why adding probiotics and prebiotics to your diet provide the best possible outcome from a bacterial perspective. It isn’t always easy to eat naturally prebiotic-enriched foods, however, because they are often distasteful to eat in quantity. Would you enjoy eating several cups of raw onion or garlic every day? Probably not. Other foods that contain prebiotic fiber, such as bread and bananas, are high in calories. Consuming hundreds of calories of these foods every day is counterproductive if you’re trying to lose weight.
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.
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.
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.

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.)


Probiotics are very promising and used quite often in practice. Many physicians, including myself, use them regularly for many gastrointestinal issues and other issues like infant colic, preventing diarrhea in patients taking antibiotics and for overall immune and respiratory health. There is still a lot more research that needs to be conducted but it is clear that they are here to stay, and the research base is likely only going to lead to increased use in many other conditions in both preventing and treating diseases.
Today, most of the Japanese population begins the day with a warm bowl of miso soup, believed to stimulate the digestive system and energize the body. Made from fermented soybeans, rice or barley, adding a tablespoon of miso to some hot water makes an excellent, quick, probiotic-rich soup. The fermentation process can take anywhere from a few days to a couple of years to complete, and the end result is a red, white or dark brown paste with a buttery texture.

Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits. Further, getting a wide variety of strains into your system is beneficial. “Periodically mixing up your probiotic supplement is also a good way to ensure that you get different health-building strains in your health regime,” says Dr. Cook.
We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
According to a 2014 meta-analysis, probiotics benefit diabetics by improving insulin sensitivity and decreasing the autoimmune response found in diabetes. The authors suggest that the results were significant enough to conduct large, randomized, controlled trials (the “gold standard” of scientific studies) to find if probiotics may actually be used to prevent or manage diabetes symptoms. Combining probiotics with prebiotics may also help manage blood sugar, particularly when blood sugar levels are already elevated. (87)

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.


This story has played out before, most notably with vitamin supplements, which decades of research have revealed to be completely unnecessary for most adults and, in some cases, dangerous, correlating with higher rates of lung, breast and prostate cancers. But that has not stopped marketers from pushing another nutritional craze. According to a National Institutes of Health survey, the number of adults in the U.S. taking probiotics or their cousins, prebiotics (typically nondigestible fibers that favor the development of gut bacteria), more than quadrupled between 2007 and 2012, from 865,000 people to nearly four million. San Francisco–based business consulting firm Grand View Research estimates that the global probiotics market exceeded $35 billion in 2015 and predicts that it will reach $66 billion by 2024.
However, these quality of life improvements are varied, and some improvements are quite mild. Sample group, types of allergies, symptoms, and results are across a broad spectrum. For example, numerous studies have shown that allergic rhinitis responses to the household dust mite decrease significantly in adults and children when probiotics were used. However, people allergic to birch pollen saw neither a decrease in general allergic responses to birch pollen or to apple food.
About 60 to 80 percent of our immune system lives in our gut. Imbalances in the gut’s microbiome (which is primarily made up of bacteria) lead to digestive issues, while many many other potential effects can be felt throughout the body—from feelings of fatigue to depression, thyroid dysfunction, autoimmunity, and a host of skin issues. Conditions like rosacea, psoriasis, eczema, and acne are really inflammatory conditions, and often a manifestation of something that is happening deeper within the body. When you fix the gut (which, depending on your health, might include getting rid of an infection like Candida, eating a clean diet, and taking a probiotic), skin issues often resolve as well.
Probiotics are bacteria that help keep the natural balance of organisms (microflora) in the intestines. The normal human digestive tract contains about 400 types of probiotic bacteria that reduce the growth of harmful bacteria and promote a healthy digestive system. The largest group of probiotic bacteria in the intestine is lactic acid bacteria, of which Lactobacillus acidophilus, found in yogurt with live cultures, is the best known. Yeast is also a probiotic substance. Probiotics are also available as natural health products.
After the antibiotics had cleared the way, the standard probiotics could easily colonize the gut of everyone in the second group, but to the team's surprise, this probiotic colonization prevented the host's normal microbiome and gut gene expression profile from returning to their normal state for months afterward. In contrast, the aFMT resulted in the third group's native gut microbiome and gene program returning to normal within days.
If you've tried a probiotic after following these steps and it doesn't seem to be working for you (or you just want some extra guidance in choosing one), head to your doctor (or a dietitian) to get a recommendation. "Have a thorough discussion with your doctor to make sure you are taking the appropriate bacterial strain for the appropriate reason," advises Dr. Ivanina. "Then, follow up after taking the probiotic to make sure it is having the intended effect."

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.

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?


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."
Stability and organism types — Some probiotic strains need to be kept cold in order to preserve their potency. This applies to their production, transport, storage and sales. Others are shelf-stable and don’t require refrigeration. Unfortunately, most refrigerated probiotics never make it past the stomach because they aren’t stable. Instead, look for a shelf-stable product that contains soil-based organisms.
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.
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 other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn't function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn's disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, H. pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it's never too late.


From upset tummies to the common cold and everything in between, it seems as though the entire world is exclaiming, “there’s a supplement for that!” these days. Call it a symptom of the Aquarian Age, the fact that Amazon recently bought out Whole Foods, or simply that Western society is catching up with what other parts of the world have known for centuries but, for better or worse, everyone seems to be ditching the traditional meds in favor of a more holistic approach to wellness.
While more research is necessary to truly understand the widespread benefits of different probiotic strains, we do know that not all probiotics are created equal. The Lactobacilli, for instance, live in our digestive, urinary and genital systems and can be found in some fermented foods like yogurt. Bifidobacteria normally live in the intestines as lactic acid bacteria, and are also found in fermented foods. According to nutrition expert Alex Caspero, RD, “For certain conditions, you want to ensure you are taking the strand that is most likely to benefit you.” Here is a simple breakdown to help you determine the best probiotic for you.
“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 you’ve ever clicked on the 6:00 news or scrolled through the latest headlines on your smartphone, you probably know that supplements and vitamins are not typically backed by governmental entities like the FDA or the World Health Organization. This fact can leave supplement newbies a bit wary, which is exactly why we love the Garden of Life Dr. Formulated Once Daily Women’s Probiotic so much.
I’ve been taking a Jamieson Probiotic for weeks now for my IBS. I’m not really getting results. It has 10 billion cells and about 14 strains. I tried taking it every day but then I was crampy, bloated and almost constipated. A friend suggested taking every other day so I did that and it was just the opposite. I’ve been trying to eat a low fodmaps diet as well. Can you tell me how long its supposed to take to work and also if I should possibly try something else? This probiotic was inexpensive so I’m wondering if you get what you pay for.
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