When I polled friends and family about their personal experiences with probiotics, I got a real mixed bag of responses. Some called them a lifesaver and others felt no effects whatsoever. I put the anecdotes aside and talked to Ben Lebwohl, gastroenterologist and director of clinical research at Columbia University’s Celiac Disease Center, to get the straight poop on whether probiotics are miracle or myth.
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.
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
More common than diarrhea is the opposite problem — constipation. In a search for studies on the benefits of probiotics in treating constipation, researchers found that probiotics slowed "gut transit time" by 12.4 hours, increases the number of weekly bowel movements by 1.3, and helped to soften stools, making them easier to pass. But the jury is still out on specific recommendations when it comes to the benefits of probiotics for constipation.
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.
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.
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.
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.
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.
Common ailments like stomach upset, allergies, and inexplicable pain seem to be at an all-time high. You may be surprised to learn that the solution to many of you and your family’s everyday woes can be found right in your gut. No, we’re not talking about your intuition or those gut feelings you get on a weird first date, but instead, the millions of tiny bacteria that live in your digestive system. These micro-organisms, or cultures as we in the supplement biz’ like to refer to them as, help keep things moving (if you know what we mean) and can have added benefits for women of all ages!
Most probiotics designed for women are designed to target feminine health conditions like yeast infections and urinary tract infections OR overall digestive health. While this may not be a concern for some women, the fact is that most of us can benefit from probiotics that keep our reproductive systems in check while also promoting overall digestive and immune health. That’s why we love the Culturelle Women’s Healthy Balance Probiotic: this women’s probiotic was specially designed to maintain feminine health without sacrificing the digestive and immune support of traditional probiotics!
But what if investigators could design probiotics to treat specific individuals? Many researchers think personalized probiotics are the most promising path forward for patients with compromised gut microbiomes. Last year Jens Walter of the University of Alberta and his colleagues published a study that gives a glimpse of this potential future. The researchers decided to see what it would take to get the bacteria in a probiotic to successfully colonize the intestines of 23 volunteers. They chose a particular strain of Bifidobacterium longum that earlier studies had indicated could survive in the human intestine. In the study, the volunteers consumed either a drink containing 10 billion live B. longum bacteria or a placebo in the form of a glucose-based food additive (maltodextrin) each day for two weeks. Periodic fecal samples revealed higher than typical levels of B. longum in participants who did not consume the placebo.
Probiotics are live bacteria that are present in yogurt, other fermented foods, and in pills. They are promoted as a benefit to the human digestive system. Normally you have trillions upon trillions of bacteria within the colon. Normally we ingest bacteria every time we swallow. Many of these swallowed bacteria may be beneficial while most are simply innocuous and cause no problems. The question for everyone who takes a probiotic much beyond yogurt is whether they really are a health benefit. Here is what we know medically about probiotics.
Historically, people had plenty of probiotics in their diets from eating fresh foods from good soil and by fermenting foods to keep them from spoiling. Over a century ago, the Russian Nobel Prize winner Elie Metchnikoff theorized that “health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt.” Metchnikoff was ahead of his time with his view of probiotics benefits, but he also was aware that most citizens had regular access to probiotic foods.
Since feminine health is all about balance, it only makes sense that vH’s formula would also contain a healthy dose of probiotic cultures. These live bacteria work with the prebiotic formula and pre-existing bacteria in your system to create a thriving environment for your feminine health. These probiotics are particularly helpful at promoting vaginal and urinary tract health.
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, 2018; 174 (6): 1388 DOI: 10.1016/j.cell.2018.08.041
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.)
As a world-renowned neurologist and nutritionist, Dr. David Perlmutter has become somewhat of a household name when it comes to the linkage between what we eat and how we feel. He is known as “The Empowering Neurologist” and has been featured on the Doctor Oz Show, CNN, and NPR as well as in prominent publications like The New York Times, Forbes, Time Magazine, and the Wall Street Journal. If that wasn’t enough to spark your interest, Dr. Perlmutter is also the award-winning author of the Grain Brain Whole Life Plan, Brain Maker, and Grain Brain, all of which have become international bestsellers.
Probiotic bacteria actually compete against unfriendly flora for bacterial binding sites on the inside lining of your intestines, further protecting you from these harmful pathogens. One way to repopulate your gut with probiotics to restore harmony and get all their many benefits is with the right foods, which can support the growth and proliferation of good bacteria that crowd out the bad ones.
Two large-scale clinical trials recently reported in the New England Journal of Medicine suggest that the situation in infectious diarrhoea might also be more complex than previously believed. Freedman and colleagues did a randomised controlled trial of a probiotic containing Lactobacillus rhamnosus and Lactobacillus helveticus in children presenting to the emergency department with gastroenteritis. Contrary to expectations, they found that the probiotic did not prevent development of moderate-to-severe gastroenteritis within 14 days after enrolment. In a separate study, Schnadower and colleagues found similar results with L rhamnosus GG alone. Both trials used probiotics that are available over the counter in North America and showed no significant difference from placebo in the duration of diarrhoea and vomiting, number of unscheduled health-care visits, or length of absence from day care. These results cannot be generalised to other probiotic strains or preparations, but they do show that we have some way to go in elucidating which probiotics might provide benefits in which clinical settings.
In the second study, the researchers questioned whether patients should be taking probiotics to counter the effects of antibiotics, as they are often told to do in order to repopulate the gut microbiota after it's cleared by antibiotic treatment. To look at this, 21 volunteers were given a course of antibiotics and then randomly assigned to one of three groups. The first was a "watch-and-wait" group that let their microbiome recover on its own. The second group was administered the same generic probiotics used in the first study. The third group was treated with an autologous fecal microbiome transplant (aFMT) made up of their own bacteria that had been collected before giving them the antibiotic.
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.
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!
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.”
Billed as the most effective probiotic currently available on the market, Pro-25 combines 13 of the most powerful probiotic strains to deliver the most robust and well-rounded overall digestive health. Delayed-release capsules also protect live organisms from your stomach acid, delivering the right strains to the right location in your digestive system, ensuring maximum efficacy and benefits.
Cynthia is the assistant editor and frequent contributor. She’s originally from California, but has lived in many countries including South Korea, China and Germany. She currently lives with her husband in Minnesota. Cynthia is passionate about helping families find the best advice for family life and safety. Cynthia also has experience in early childhood education and holds a TEFL-C certificate from Teachers College, Columbia University. She has been writing about family-focused topics, advice and trends since 2014.
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.
Flora offers a high potency blend of eight super strain probiotics for general gut health and immune system support including multiple varieties of Lactobacillus and Bifidobacterium, among others. Containing up to 42 billion CFUs per capsule, this powerful health-boosting blend uses only strains found naturally in the human body, which increases its effectiveness.
When seeking out the best probiotic for you, consider your overall health, dietary needs, antibiotic use, GI challenges, and similar concerns. Then, review our list of the ten best probiotic supplements, which offer everything from raw probiotics, which must be refrigerated, to shelf-stable, slow-release probiotics that concentrate fewer CFUs in tiny, once-daily capsules.
Uncontrolled changes in blood sugar levels or a decreased ability to regulate insulin can have serious effects on your overall health, and since far more men than women are at risk for these changes, these issues are well worth paying attention to.5 Research indicates that regularly taking probiotic supplements containing Lactobacillus and Bifidobacterium can help your body maintain blood sugar levels already within a normal range, whether you're simply at risk for insulin-related challenges or you're already experiencing them.
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.
Importantly, patients with gastrointestinal conditions are not the only ones taking probiotics. 3·9 million people in the USA alone regularly take probiotic supplements, with promised benefits ranging from improved digestion and immune function to improved mental health and prevention of heart disease. However, evidence for these benefits is lacking, and because probiotics are often sold as supplements, manufacturers in many countries are not required to provide evidence of their safety and efficacy to regulatory bodies. The ubiquity of probiotic products would suggest that, at worst, they are harmless. Nevertheless, some safety concerns have been raised, including the risk of contamination, possibility of fungaemia or bacteraemia (particularly in immune-compromised, elderly, or critically ill individuals), small intestinal bacterial overgrowth, and antibiotic resistance. Adding to concerns, clinical trials of probiotics have not consistently reported safety outcomes.
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.
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.*
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.
Following a healthy and active lifestyle and eating a balanced diet are the best ways to foster a bountiful gut flora. Taking care of your gut flora can help with things like irritable bowel syndrome and chronic constipation, among other things. Even if you’re not sold on pursuing probiotics for your allergies, they’re good to consider if you’re experiencing any gastrointestinal issues.