While probiotics have been around as long as bacteria have, they were first officially identified for their health benefits in the early 20th century by Russian-born biologist Élie Metchnikoff. Metchnikoff believed that “good bacteria” like the microbes that produce lactic acid could prolong life and stave off senility, and actually recommended drinking sour milk daily for overall health. While Metchnikoff’s theories were pooh-poohed by many of his contemporaries, the first commercial probiotic, Yakult, hit the market in 1935 and is still on the shelves today.
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.
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
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 (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047
Do you strain with infrequent bowel movements? Do the feces look like separate hard lumps or like bunches of hard lumps stuck together, or are they pencil-thin? You may have constipation. The Bristol stool chart (BSC) was developed by two doctors as a way to differentiate between states of constipation, normal elimination, a state of lacking fiber, and states of inflammation. Stools are supposed to be long and sausage-like, with few or no cracks in the surface.
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
Also, it’s important to understand that probiotics are not a new idea. Throughout history, cultures have thrived on probiotics found in fermented foods and cultured foods, which were invented for food preservation long before the refrigerator. The process of fermentation has been lost in recent years, as it is no longer needed to preserve foods, meaning that we now lose out on those vital probiotics benefits.
If you’re giving probiotics to a baby under two years old, you want to look for specific strains, though, that are better suited to such young microbiomes. For babies, these are the strains of Lactobacillus to look for: rhamnosus, casei, paralisei, gasseri, salvarius. And for Bifidobacterium: infantis, bifidum, longum, breve, lactis. If you’re breastfeeding, you can put probiotics on your breast, or you can heat up formula and put probiotics in it, or wet your finger and dip it in the probiotics powder and let your baby suck on your finger.

We also found strains linked to five other health benefits like weight loss and lowering cholesterol. We feature options for those cases below, but they aren’t top picks because those use cases aren’t as heavily researched as immune health or IBS relief. Still, chances are any probiotic supplement is going to make some improvement to your digestive health, so don’t be afraid to experiment.
Probiotics for allergies are fast becoming a preferred treatment method because they are understood to be much safer than traditional allergic rhinitis medication. A nasal spray for allergies is often a ‘go to’ treatment, for example, but allergy nose spray medications often contain corticosteroids, like Beclometasone dipropionate, which could affect bone metabolism, blood cells, and the pituitary gland.

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.
Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
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 (First published: September 6, 2018)  DOI: 10.1016/j.cell.2018.08.047
Even if some of the bacteria in a probiotic managed to survive and propagate in the intestine, there would likely be far too few of them to dramatically alter the overall composition of one's internal ecosystem. Whereas the human gut contains tens of trillions of bacteria, there are only between 100 million and a few hundred billion bacteria in a typical serving of yogurt or a microbe-filled pill. Last year a team of scientists at the University of Copenhagen published a review of seven randomized, placebo-controlled trials (the most scientifically rigorous types of studies researchers know how to conduct) investigating whether probiotic supplements—including biscuits, milk-based drinks and capsules—change the diversity of bacteria in fecal samples. Only one study—of 34 healthy volunteers—found a statistically significant change, and there was no indication that it provided a clinical benefit. “A probiotic is still just a drop in a bucket,” says Shira Doron, an infectious disease expert at Tufts Medical Center. “The gut always has orders of magnitude more microbes.”
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 can be found in some foods, such as yogurt and cheese, as well as dietary supplements. There are numerous probiotic supplements on the market that contain a variety of bacteria. The two most common types of bacteria found in probiotics belong to the groups known as Lactobacillus and Bifidobacterium. Phillips'® Colon Health® Probiotic Capsules contain 3 types of good bacteria, from both groups, to help defend against occasional constipation, diarrhea, gas and bloating.∗
Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another. For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.
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.

Remember that dietary supplements are not tested by the U.S. Food and Drug Administration like medications. And the probiotic strains in the supplements may not be specific for the condition you're looking to treat. You may want to consult with a practitioner, like a registered dietitian, who is familiar with probiotics. Always tell your physician what you are doing that may affect your health.
The best probiotic manufacturers will list their potency (in CFUs) at the time of expiration, ensuring you get the dosage you’re paying for. Dr. David Perlmutter, board-certified neurologist, American College of Nutrition Fellow, and author of The New York Times bestsellers "Brain Maker" and "Grain Brain" puts it this way: “Avoid products that indicate a specific number of bacteria ‘at the time of manufacture,’ and instead look for products that, like other supplements, have a shelf life.” Each of our top picks clearly shows a specific “best by” or “expires on” date on its bottle.
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.
Kefir: This could be the most ideal probiotic dairy product because it contains both bacteria and yeast working together to provide the numerous health benefits. In a recent eight-week study, people with diabetes were given kefir milk containing Lactobacillus casei, Lactobacillus acidophilus, and bifidobacteria vs. conventional fermented milk. The hemoglobin A1C levels were significantly lower in the group consuming the kefir.

​​​​​​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.*
Many women are prone to yeast infections during or after antibiotic use. If you are one of these unlucky few, try taking a probiotic like the vH Probiotics with Prebiotics and Cranberry immediately before taking your antibiotics. (You may want to check with your doctor first though). These cultures may help with stomach upset and can also prevent a dreaded yeast infection!
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