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.
Among their numerous health benefits, research shows these friendly microorganisms help prevent bowel diseases, improve your immune system, reduce traveler’s diarrhea, help you maintain a healthy weight, heal various skin conditions, improve bloating and other uncomfortable GI symptoms, and even boost your mood, helping to reduce the effects of anxiety and depression.
While the logic behind probiotics might seem sound, it is clear that we have a long way to go before understanding the complexity of the microbiota and the effects—both good and bad—that probiotics might have. All individuals have a unique gut microbiome, and the effects of different bacteria on different people are likely to be highly variable; as such, probiotic use might even need to be personalised for optimal benefits. Commercially available products might not contain the correct strains or quantities of bacteria to provide benefits, and most probiotic supplements contain only single strains, vastly oversimplifying the complexity of the microbiota. While taking a supplement for improved health is certainly an attractive prospect, those looking to aid their gut microbiota might be better served by consuming a healthy, varied diet. In the meantime, rigorous clinical trials are needed to substantiate potential health benefits and to confirm whether probiotics are elixirs or just empty promises.
The right resident strains - quite a few probiotics on the market contain things like active yeasts or soil based organisms. While these ingredients may be helpful to some, if you want to optimize your gut health, you need to look for strains that are resident to the human gut like those from the Lactobacillus, Bifidobacterium, and Streptococcus families.
I’m 65 years of age. I have been taking acid reflux medication daily for at least 15 years and recently my doctor said my kidneys were declining. I’ve read that acid reflux medications taken over a long period of time, can cause kidney damage. By taking a probiotic, will it help reduce stomach acid, where I may be able to stop taking my acid reflux medication altogether?

"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav said in a statement. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects." Segal added, "This opens the door to diagnostics that would take us from an empiric universal consumption of probiotics, which appears useless in many cases, to one that is tailored to the individual and can be prescribed to different individuals based on their baseline features."
The root of the word probiotic comes from the Greek word pro, meaning "promoting," and biotic, meaning "life." The discovery of probiotics came about in the early 20th century, when Elie Metchnikoff, known as the "father of probiotics," had observed that rural dwellers in Bulgaria lived to very old ages despite extreme poverty and harsh climate. He theorized that health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in sour milk. Since then, research has continued to support his findings along with suggesting even more benefits.
What's more, there's still a lot more to learn about the microbiome and probiotics, in general. "Truth be told, the research area of probiotics and health is still pretty much in its infancy," says registered dietitian Kate Scarlata. Research is growing in the area of gut microbiome daily—but it is much more complicated than first thought." With all these options and major gaps in the available information, where are you supposed to start? Here, gut experts narrow it down to three simple tips for picking the right probiotic for you.
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.
Probiotics have also been researched for how they support the immune system. Studies suggest that probiotics can improve how the immune system functions such as by decreasing upper respiratory tract infections in adults and reducing the need for antibiotics. Studies in children show that a regular diet including probiotics reduces colds and flu-like symptoms and improves attendance in preschool and day care settings.
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)

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.

On my recent trip to Japan, one thing I noticed was the inclusion of pickled vegetables in almost every traditional Japanese meal. Unfortunately, many Americans don’t consume enough of these probiotic-rich foods and drinks. Even when they do, restoring equilibrium oftentimes requires therapeutic doses of these microorganisms, because most everyone has been on several rounds of antimicrobials. That’s where a probiotic supplement comes in.
Like other top probiotics available today, LEAN’s 50-Billion Probiotic is packaged in a handy, delayed-release capsule, designed to protect non-acid-resistant bacteria until they reach deep into your GI tract, where they’re most needed. The result is maximum effectiveness – better gut health, an immune boost, and relief of common digestive problems.
Overall, Enzymatic Therapy Acidophilus Pearls are a great daily probiotic supplement. They give you a ton of flexibility and is convenient since it doesn’t need to be refrigerated and can be taken with or without food! This probiotic makes on-the-go belly support a breeze. All in all, Enzymatic Therapy Acidophilus Pearls finally make it easy to travel with probiotics, are simple to take, and can give you the piece of mind that the money you’re spending on probiotics isn’t being wasted at the first sign of stomach acid.  Read the full review here… or click here to go buy it now!

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.
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.
Overall, I really like TruBiotics as a daily probiotic. First of all, the capsules are easy to take and you only need one a day. I also like the choice of strains they used in this probiotic. Overall, TruBiotics is a great daily probiotic that’s quick and convenient and may be very effective with regards to many different digestive issues.   Read the full review here… or click here to go buy it now!
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.

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.
Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," Eran Segal said in a statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
Hi Julia. I am 71 (male) and have had digestive issues for most of my life and no specific diagnosis. I eat fairly well, am not overweight, get gassy from many different foods and beverages. I have been using Culturelle for 9 months and feel the benefit from taking it is small. Your review leads me to believe there may be better choices. They certainly are not cheap but I will gladly pay for them if they give me results. I am probably going to try BlueBiotics unless you have other suggestions. My main question is since I live in Minnesota I will receive shipments in the summer with temps of up to + 100F and winters down to – 15F. Will this cause a decrease in product viability for this or other brands you recommended? Thank you for your help.
Prebiotic fibers are the non-digestible parts of food that are typically found in fruits, vegetables, and legumes. These fibers act as food for the healthy bacteria in your gut, and are an essential part of the digestive process. That’s why the Vitamin Bounty Women’s Pro-Daily Probiotic contains prebiotics and probiotics for a truly complete formula that helps ease digestive issues while also maintaining proper feminine health.
For Irritable Bowel Syndrome, patients who respond to a probiotic might take that in the long term, Lebwohl says, so as to maintain symptom control. With something like antibiotic-related diarrhea, you'd take it for a defined period of time until symptoms are gone. "This has been studied in children and adults and while study results have varied, meta-analyses suggest that probiotics can be protective in this context," he adds.

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.
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.
Even for those without an urgent problem, probiotics can help with overall digestive management. Challa argues in his book, Probiotics For Dummies, that good bacteria help "crowd out" bad bacteria. That's because the intestine is lined with adherence sites where bacteria latches on. If the sites are populated with good-for-you microbes, there's no place for a harmful bacterium to latch on.
Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.
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.
Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," Eran Segal said in a statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
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