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.
Keep in mind that when supplements contain a specific number of organisms, this number may not be what is actually within each capsule at the time of purchase. Probiotics are living organisms and can die out easily. Especially if that supplement sits on your drugstore or warehouse shelf for months or longer, the number of organisms you get may be far less than what the bottle claims. Hardier strains have a longer shelf life. Capsule strength decays faster if the probiotic has been sitting around at elevated temperatures during transport to the store. Companies actually have to produce probiotics with a much higher CFU (colony-forming units; see below) count in each capsule in order to guarantee the label potency by the expiration date.
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.
While raw probiotics tend to be the freshest (and most effective!) cultures on the market, it is important to ensure that you will store these properly in between each use. Cultures can die unrefrigerated in as little as a few hours, rendering them completely ineffective and, if you’re especially unlucky, even harmful to your body’s natural flora. Think about it, when has stale or moldy bread made your tummy feel better? The same thing goes for stale probiotic cultures!
CFU: This is the number of "colony forming units" present in each dose, which are measured in the billions. And while more isn't always better, "you want at least 20 to 50 billion CFU," says Dr. Nazareth. Just for reference, a very high dose is 400 CFU, which most experts agree is not necessary unless your health care practitioner specifically recommends this for you. It's also important to check for the guaranteed CFU upon expiration, which should be listed clearly. "Some products only guarantee the CFU number at the time of manufacturing, therefore will be less potent by the time the product reaches your home," she says.
Got your gut on your mind? Then you’re probably up on the health benefits of probiotics. From boosting immunity to improving digestion, probiotics have been touted as the “superhero” of the gut bacteria underworld. And yet, there’s a lot we still don’t know about probiotics because the research is just heating up. To date, most studies that have been done on probiotics are on the Lactobaccilus, Bifidobacterium and Streptococcus thermophilus strains. Meanwhile, there are, oh, upwards of 100 trillion gut-friendly bacteria out there — some of which are popping up in trendy new waters, chocolates, nut butters and more. Here’s what you need to know before giving your gut the royal treatment.
To boost the immune system, B. Lactis is a promising choice. One study had participants taking either a probiotic or a placebo for 6 weeks. At the end of the period, researchers measured antibody levels and found greater increases in antibodies of the B. Lactis group than in placebo participants, concluding that this probiotic may help improve immune function [1]. In addition, a 2009 study found that supplementation of the strain B. Lactis DN-173 led to self-reported improvements in digestive comfort [2].
If you get sick often, probiotics might be the immune booster you've been looking for. The Cleveland Clinic says they've been shown to strengthen immunity by enriching and replenishing the good bacteria in the body. And when you eat foods with probiotics regularly, it's easier for your body to produce vitamins and enzymes that help keep your intestines happy.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
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.”
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.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
The classic examples of probiotics are yogurt and kefir, which are great for a lot of people, though not if you have a dairy sensitivity. There a lot of yogurt and kefir alternatives, from water kefir and almond yogurt, to coconut yogurt, coconut kefir, and so on. Look at ingredients when you’re shopping for food like yogurt—you want to avoid sugar-filled products. I like plain coconut yogurt with fruit and little stevia on it.
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.
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.
The reason constipation is linked to disease is that it allows undigested food and bodily wastes to sit in the colon, putrefy, and dry out. As feces dry out, water from the feces is reabsorbed back into the body, and along with it toxins. Additionally, microbes that like those conditions can multiply, releasing their toxic products that are then absorbed into your bloodstream.
Probiotic therapy may also help people with Crohn's disease and irritable bowel syndrome. Clinical trial results are mixed, but several small studies suggest that certain probiotics may help maintain remission of ulcerative colitis and prevent relapse of Crohn's disease and the recurrence of pouchitis (a complication of surgery to treat ulcerative colitis). Because these disorders are so frustrating to treat, many people are giving probiotics a try before all the evidence is in for the particular strains they're using. More research is needed to find out which strains work best for what conditions.
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.
​​​​​​Every woman’s microbiota is different and so results will vary. However clinical studies using the blend of probiotic strains in AZO Complete Feminine BalanceTM demonstrated benefits in as little as 7 days. We suggest continuing with use of the product for a minimum of 30 days. Also, keep in mind that for regular maintenance, you may not SEE results but the product is still helping to protect and maintain a healthy vaginal flora.*
Some people prefer probiotic supplements over foods, but Dr. Cresci notes that probiotic foods are a better choice. In particular, fermented foods — like yogurt, kefir (a yogurt-like beverage), kombucha (fermented black tea), sauerkraut (refrigerated, not shelf-stable), kimchi (made from fermented cabbage) and tempeh and miso (made from fermented soybeans) — provide a nourishing environment in which healthful bacteria thrive and release an important byproduct: short-chain fatty acids.
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.
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.
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.”
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.
You dread stepping on the scale and avoid looking at your profile in the mirror because you know you gained weight and need to lose some. You tried every diet on the market to no avail. Your frustration level is high, but you do not need to give up hope. The first thing to do is to love yourself regardless of your weight so that your emotions and stress levels do not sabotage your efforts. You can love yourself while working toward self-improvement.
Make sure dosages are listed in CFU, colony forming units. (Most brands list CFU in billions now: so 30 billion CFU, 100 billion CFU, and so on.) For one, this means that the bacteria strains are living, which is essential. When you’re looking at the cost of products, be sure to look at the cost per unit. I spoke to a woman the other day who had bought probiotics that had 2 billion CFU per capsule. In comparison, to get the 30 billion CFU I recommend, she’d have to take essentially half of her bottle to get the same dosage as one of our capsules.
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.
By eating probiotic-rich foods and maintaining good intestinal flora, a person can also help to maintain a healthy immune system. And that has real world effects: for example, in one small study of students, those who were given a fermented dairy drink (instead of milk) displayed increased production from lymphocytes -- a marker of immune response.
It’s important to note that there are different types of strains of probiotics. The probiotics benefits of one probiotic strain may be completely different from the health benefits seen from another probiotic. If you want to use probiotics to address a specific health concern, it’s vital to select the right probiotic for the right condition — or you can consume a wide range of probiotics in your food to be covered.
Disclaimer: While we work to ensure that product information is correct, on occasion manufacturers may alter their ingredient lists. Actual product packaging and materials may contain more and/or different information than that shown on our Web site. We recommend that you do not solely rely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. For additional information about a product, please contact the manufacturer. Content on this site is for reference purposes and is not intended to substitute for advice given by a physician, pharmacist, or other licensed health-care professional. You should not use this information as self-diagnosis or for treating a health problem or disease. Contact your health-care provider immediately if you suspect that you have a medical problem. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease or health condition. Amazon.com assumes no liability for inaccuracies or misstatements about products.

Got your gut on your mind? Then you’re probably up on the health benefits of probiotics. From boosting immunity to improving digestion, probiotics have been touted as the “superhero” of the gut bacteria underworld. And yet, there’s a lot we still don’t know about probiotics because the research is just heating up. To date, most studies that have been done on probiotics are on the Lactobaccilus, Bifidobacterium and Streptococcus thermophilus strains. Meanwhile, there are, oh, upwards of 100 trillion gut-friendly bacteria out there — some of which are popping up in trendy new waters, chocolates, nut butters and more. Here’s what you need to know before giving your gut the royal treatment.
Every day, we’re exposed to toxins and inflammation-causing molecules from food and the environment that negatively impact digestion through pathways, such as leaky gut, known in the medical field as intestinal hyperpermeability. In leaky gut, the tight junctions that are supposed to keep disease-contributing compounds from leaving the digestive system are disrupted, allowing a lot of things through into the bloodstream that don’t belong there.
When reading a probiotic label, it should reveal the genus, species and strain of the probiotic. The product (usually in capsules or probiotics pills) should also give you the colony forming units (CFUs) at the time of manufacturing. Also, the majority of probiotics can die under heat, so knowing the company had proper storing and cooling of the facility is also important.
Many studies have been conducted about the benefits of probiotics on a large number of health issues and conditions. Here, I’ll focus on the more thoroughly researched probiotics benefits, largely by sharing the results and data of meta-analyses on the subjects. Then, I have listed several areas of emerging research on the benefits of probiotics, reflected in small or pilot studies with promising results on probiotic benefits, as well as ways probiotics can be accessed.
Dr. Vincent M. Pedre, medical director of Pedre Integrative Health and president of Dr. Pedre Wellness, is a board-certified internist in private practice in New York City since 2004. His philosophy and practices are a blend of both Western and Eastern medical traditions. He is a clinical instructor in medicine at the Mount Sinai School of Medicine and is certified in yoga and medical acupuncture. His unique methodology is best described as integrative or defined by a functional, systems-based approach to health. With his holistic understanding of both sides of the equation, he can help each patient choose the best course of action for their ailments to provide both immediate and long-term relief. His holistic approach incorporates positive, preventive health and wellness lifestyle choices. Dr. Pedre Wellness is a growing wellness platform offering health-enhancing programs along with informative social media and lifestyle products, such as dietary supplements, books, and weight-loss programs.
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:
Yes! Beneficial yeast is a probiotic, defined as a microorganism that supports human wellness. (Probiotic means “for life.”) Saccharomyces boulardii is a remarkable yeast that can significantly support your whole internal ecosystem. It helps reduce problematic yeasts, such as Candida, and replenishes healthy gut flora.* While many probiotic supplements only deliver friendly bacteria without yeast, Probiotic All-Flora contains 5 billion CFU of beneficial yeast for complete support.

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.
Yes. Probiotics are incredibly important and effective. We know there are more bacteria in us and on us than our own human cells. The body is almost like a puppet—it is bacteria that really runs the show: They turn on enzymes, turn off genes, and dictate much of our health. We need them to break down nutrients, like copper and magnesium, so we can better absorb them. Interestingly, studies show that conditions like anxiety, depression, and weight gain can be transferred via fecal transplants (with mice), suggesting the broad impact bacteria has on health.
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.

Lactobacillus predominantly live in your small bowel (the portion of your gut that follows the stomach). Probiotics containing Lactobacillus sp. help to repopulate the small intestine with friendly organisms that aid in supporting digestion and immune function. The most beneficial are L. acidophilus, L. plantarum, and L. paracasei. One study found Lactobacillus acidophilus could reduce gut inflammation. L. rhamnosus helps increase GABA expression (an inhibitory neurotransmitter that helps you feel relaxed) in the brain, resulting in lower anxiety and depression-related behavior. Another found that a combination of Lactobacillus and Bifidobacteria (which we'll talk about next) improved symptoms of bloating in patients with functional bowel disorders, and yet another found that when people took the Lactobacillus rhamnosus GG strain, it significantly reduced the risk for antibiotic-associated diarrhea.
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.
Probiotics have become buzzy in recent years: Celebrities including Lauren Conrad and Anna Paquin have been spotted carrying bottles of kombucha, a probiotic-containing fermented tea, and the probiotics market has been growing rapidly as more people pursue better health by taking probiotic supplements. Prebiotics are attracting notice too, but you may still be unsure of what exactly prebiotics and probiotics are. Here's what you need to know about them to decide whether taking supplements is right for you.
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 makes it harder for your immune system to work properly and leaves you open to feeling under the weather unnecessarily. The good news is that taking probiotics can help replenish your gut microbiome, and since 80% of your immune system is in your gut, this inevitably has a very supportive effect on your immunity. Probiotics also specifically support your mucosal immune systems, found in your ear, nose, and throat area and your lungs, helping you to maintain respiratory health.4
In the gastrointestinal tract L. Plantarum can help regulate immunity and control inflammation. A 2007 study found that the probiotic could suppress an inflammatory response in the gut. Perhaps most significantly, a double blind placebo-controlled study over 4 weeks concluded that L. Plantarum 299v provided effective symptom relief, especially of abdominal pain and bloating, in patients with Irritable Bowel Syndrome [1].

In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
Using probiotics benefits and balances immune function, influences hormone levels, aids in digestion and nutrient absorption, produces some vitamins, and balances blood sugar insulin responses. By preventing and reducing leaky gut and controlling levels of pathogens, probiotics reduce harmful bacterial by-products that can enter the brain and contribute to brain fog.
The vH Probiotics with Prebiotics and Cranberry are specifically designed to give you complete feminine tract care, and work to fight recurrent yeast infections and urinary symptoms. While this particular probiotic formula may provide some digestive relief, it is important to note that it is largely marketed towards women with these feminine health conditions. For that reason, women that are looking for more digestive care should consider a different probiotic that is more geared towards gut health.
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

If you’re most interested in taking a probiotic supplement for overall gut health, I suggest starting with 30 to 50 billion CFUs. Take probiotics on an empty stomach once or twice a day for at least three months. After that time, reassess and decide if the benefits warrant continuing a maintenance dose of the probiotic supplement. However, if you have SIBO, beware of starting a probiotic too soon after your treatment. In this case, it’s best to work with a health practitioner on which probiotic is right for each stage of the treatment.
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.

The prebiotic comes before and helps the probiotic, and then the two can combine to have a synergistic effect, known as synbiotics. A prebiotic is actually a nondigestible carbohydrate that acts as food for the probiotics and bacteria in your gut. The definition of the effect of prebiotics is the selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host. The health benefits have been suggested to include acting as a remedy for gastrointestinal (GI) complications such as enteritis, constipation, and irritable bowel disease; prevention and treatment of various cancers; decreasing allergic inflammation; treatment of nonalcoholic fatty liver disease (NAFLD), and fighting immune deficiency diseases. There has also been research showing that the dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase calcium absorption as well as bone calcium accretion and bone mineral density. The benefits for obesity and type 2 diabetes are growing as recent data, both from experimental models and from human studies, have shown particular food products with prebiotics have influences on energy homeostasis, satiety regulation, and body weight gain.

A Seal of Approval When looking for a good probiotic, Gans advises consumers to buy from a trusted retailer and look for a seal from a third-party certifier. “Reputable probiotic supplements should list the genus, species, and strain, in addition to the number of organisms that will be alive by the use-by date and the dose on the label,” says Gans. This transparency will help consumers understand what’s in their supplement and how to best use it.

What's more, people who have serious heart issues commonly have S. mutans in their heart valves—this is an undesirable type of bacteria that’s actually more often found in the mouth. If your oral microbiome is in balance, S. mutans are normally kept in control by more beneficial species, but if things get out of balance, they can reproduce and make their way into your bloodstream via openings in your gums, compromising your cardiovascular function.3
Deep Immune Support Probiotics started with a simple premise: Most probiotic strains present on the market today cannot survive the acidic environment of the human digestive system. Additionally, most of the most powerful probiotics require refrigeration, meaning they won’t survive standard delivery services or even room temperatures during your commute or travel.

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!
Probiotics seem to be all the rage these days. With many purported benefits and a relatively low risk of side effects, manufacturers are taking advantage of booming business opportunities. Rather than leave your health in the hands of big business, it is important that you be as educated as possible about the best types of probiotics so you can choose what is right for you and your family.
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.
×