When shopping for a probiotic, the first things to look at are CFUs count and probiotic strains. CFUs is the acronym for colony forming units, and is the measure of how many probiotic bacteria are capable of dividing to form colonies. In other words, the higher the CFUs, the higher the number of active, live good bacteria. Generally speaking, the higher the CFUs, the better, although there are exceptions.
In the past, probiotics have been proposed as part of a weight loss diet. However, a 2015 meta-analysis looked at available randomized, controlled trials investigating this effect and determined that the studies did not seem to support this hypothesis, as body weight and BMI were not consistently reduced. The researchers did point out the need for better designed trials, because they were not convinced the results were based on well-designed science.

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.


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.

B. Bifidum has also been shown to prevent intestinal pathogens or digestive disrupters from flourishing in the gut, essential in restoring the bacterial balance and optimizing digestion. Clinical research found it supports a significant reduction in IBS symptoms, an improvement in quality of life and even helps relieve occurrences of ulcerative colitis – a chronic inflammatory bowel disease. [1].
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. 

The authors discuss the need for “pscyhobiotics” (probiotics that impact brain function) in handling the development of these conditions. This anti-inflammatory quality is what seems to interest researchers most. While no studies have been conducted in humans, early research suggests that, in animals, probiotic supplements may help alleviate symptoms of anxiety by reducing inflammation along this gut-brain connection.

It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.
Within the past few years, the probiotics market has been EXPLODING. Doctors may have been prescribing them for a long time, but only recently have people started including these extraordinary supplements in their daily diets. Those who have started regularly taking probiotics have reported many improvements in their overall health. Here are some examples of the benefits thousands of daily users report:
Most recently, two back-to-back papers were published simultaneously on September 6 in the journal Cell showing that many people can’t successfully colonize standard probiotic microbiome in their gut. The scientists also found that consuming generic probiotic strains after taking antibiotics often delayed gut bacteria and gene expression from returning to their natural "naïve" state.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.
Probiotics produce enzymes that help break down chemicals the average human gut has a hard time with, like the oligosaccharides in legumes. That results in less gastrointestinal distress and better absorption of nutrients. Probiotics also elicit an immune response that helps your body deal with harmful pathogens and other GI problems. The hard research, especially on recommended CFU dosages, is minimal, but it’s expanding as interest in the product does.
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.
One of the best-studied effects of probiotics has been on the reduction in diarrhea severity and duration. Probiotics can prevent as well as reduce duration of several types of diarrhea. Lactobacillus has been found to be a safe and effective treatment for children with acute infectious diarrhea. Certain probiotics may also offer a safe and effective method to prevent traveler’s diarrhea, but research in this area is emerging.
Very few women know that one of the leading causes of infertility, difficulties getting pregnant, and even painful periods stem from thyroid dysfunction. That’s why infertility specialists, obstetricians, and gynecologists alike often order thyroid testing at the first sign of trouble. Poor thyroid function is also linked to joint pain, unplanned weight-loss or obesity and heart problems and thinning skin among many other signs and symptoms.
Side effects: Probiotics are considered safe overall for healthy people; short-term side effects may include mild gas and bloating. But risks may be greater in immunocompromised people. And a systematic review in the Annals of Internal Medicine in 2018 found that the reporting of adverse effects is often missing or inadequate. Also in 2018, an editorial in JAMA Internal Medicine by Dr. Pieter Cohen, a well-known critic of the supplements industry, called for the FDA to improve its regulatory standards for probiotics to match those of Canada and the EU.
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.
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.
Prebiotics and supplementary ingredients — For probiotic bacteria to grow, they also need prebiotics. High-quality probiotic supplements have both prebiotics and other ingredients designed to support digestion and immunity. Examples of these ingredients are (preferably fermented) flaxseed, chia seed, cañihua seed, astragalus, ashwagandha, hemp seed, pumpkin seed, milk thistle, peas, ginger, mung bean and turmeric.

Supplements play an important role when the diet is not adequate to supply our needs. In the case of probiotics, one's diet is the ideal source for probiotics. These are live bacteria and need to be carefully monitored, stored, and combined for the health benefits that one would be taking them for. At this time, supplements are not monitored in the U.S. the way that food or medication is. They fall under the Dietary Supplement Health and Education Act of 1994 (DSHEA). This requires that the dietary supplement or dietary ingredient manufacturer be responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed. The only time that the U.S. Food and Drug Administration (FDA) may get involved is if action is needed to be taken against a manufacturer after the supplement is marketed and then found to be unsafe. This means that as much as we may know about probiotics, we can't be certain of the safety or content of the supplements available to us.
Self-dosing with bacteria isn't as outlandish as it might seem. An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. These microorganisms (or microflora) generally don't make us sick; most are helpful. Gut-dwelling bacteria keep pathogens (harmful microorganisms) in check, aid digestion and nutrient absorption, and contribute to immune function.
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.
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.
If you’ve ever experienced the crippling pain of a urinary tract infection, you’ve probably encountered an article or two about the benefits of cranberries for warding off bacteria in the urinary tract. While it may seem like an old wives tale, cranberries contain D-Mannose that is naturally acidic. This compound has been said to prevent unwanted bacteria build-up, and some claim it can even stop a urinary tract infection dead in its tracks!

What's nice about supplement company Care/of is that it allows you to design personalized daily vitamin and supplement packs containing everything you need, including probiotics. Its vegan, gluten-free probiotic formula has one billion lactobacillus acidophilus and four billion bifidobacterium lactis per dose, popular strains thought to help promote digestive and immune health.
There are four significant takeaways from this study: (1) murine gut mucosal probiotic colonization is only mildly enhanced by antibiotics, (2) Human gut mucosal probiotic colonization is significantly enhanced by antibiotics, (3) After taking antibiotics, probiotics delay gut microbiome and transcriptome reconstitution in mice and humans, (4) Autologous fecal microbiome transplant (aFMT) restores mucosal microbiome and gut transcriptome reconstitution. 

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.)
If this happens, it's time to consider switching to a new probiotic. Other reasons a probiotic may not be the right fit: SIBO or Candida. If you have either of these conditions, the strain of the probiotic could potentially make your symptoms worse. Remember, if you think a probiotic is not helping, seek the advice of a functional medicine provider to help you navigate the choices out there.
Renew Life Ultimate Flora offers 30 billion CFUs with 10 scientifically studied strains of Bifidobacterium and Lactobacillus, which according to current scientific research, are the two most prevalent good bacteria found in a healthy gut. In other words, you might choose these if you’re seeking a careful balance designed to re-establish proper immune health and digestive equilibrium.

Others scientists are more hopeful. Finding out how exactly probiotics work in regards to allergies is an important step in that process. Some studies show that some strains of bacteria can affect how our T cells (an immune cell responsible for the big immune responses) function. Others suggest that they may reduce the production of a part of the immune system called immunoglobulin E, which is produced in excess during an allergic reaction.
The authors discuss the need for “pscyhobiotics” (probiotics that impact brain function) in handling the development of these conditions. This anti-inflammatory quality is what seems to interest researchers most. While no studies have been conducted in humans, early research suggests that, in animals, probiotic supplements may help alleviate symptoms of anxiety by reducing inflammation along this gut-brain connection.
Inside your body bacterial and other microbial cells live in close contact with your own cells, and in healthy conditions the thing that separates them from you is a layer of mucus. Between that layer of mucus and the inside of you is a layer of skin-like cells one-cell thick. One thing you have to understand about your gastrointestinal (GI) tract is that although it resides within you, it is really connected to the outside world, from your lips to your anus, and the things that protect you from the outside world are the mucus; the skin-like layer of cells with immune, nervous, and endocrine cells below it; and the beneficial microbes. At least 70 percent of your immune system is in your GI tract! This is why taking probiotics benefits the immune system greatly.
In 2019, dietary restrictions have become so mainstream that it is virtually impossible to step into a restaurant without spotting a specialized menu for dairy, gluten, vegan, and vegetarian eaters. The supplement industry is no exception and the majority of high-quality probiotics available on the market today include vegan or vegetarian capsules. Many brands are also gluten-free these days as well, and several are dedicated to keeping their formulas free of dairy, soy, and many other common allergens.

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.”
The above line of probiotics is also a favorite of Engelman. "I like Nerium International's new Prolistic Pre & Probiotic Plus Vitamins ($45) because it combines prebiotics, probiotics, and vitamins," Engelman explains. "It supports overall health while targeting digestive function. It contains two types of prebiotics and two strains of probiotics to help enhance levels of beneficial microflora and balance levels of healthy bacteria in the digestive system. Additionally, it contains B vitamins, vitamin C, and vitamin D, which work to enhance the body's immune system and support natural energy production."
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. 
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