Although people often think of bacteria and other microorganisms as harmful “germs,” many microorganisms help our bodies function properly. For example, bacteria that are normally present in our intestines help digest food, destroy disease-causing microorganisms, and produce vitamins. Large numbers of microorganisms live on and in our bodies. Many of the microorganisms in probiotic products are the same as or similar to microorganisms that naturally live in our bodies.
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.

Although some probiotics have shown promise in research studies, strong scientific evidence to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.

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.


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.
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.

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.

Constipation is defined medically as fewer than three stools per week and severe constipation as less than one stool per week. Constipation usually is caused by the slow movement of stool through the colon. There are many causes of constipation including medications, poor bowel habits, low fiber diets, laxative abuse, and hormonal disorders, and diseases primarily of other parts of the body that also affect the colon.


Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to erdicate, and treatment is with two or more antibiotics.
EDITOR’S CHOICE: As the only probiotic formula we reviewed backed by a New York Times Bestselling author and expert in the human biome, the Garden of Life Dr. Formulated Once Daily Women’s Probiotic is our top choice for overall digestive and women’s health. With 50 billion cultures and 16 probiotic strains, this probiotic helps to promote women’s digestive, immune and vaginal health.
More than 80 years later, probiotics have become wildly popular and incredibly profitable. A 2012 survey by the National Institutes of Health showed that 3.9 million Americans stated they had used some form of probiotics or prebiotics (a type of dietary fiber thought to feed the friendly bacteria in your gut) in the last 30 days—3 million more people than in the previous study in 2007. Probiotics are now available for consumption in almost every imaginable form—pills, tablets, yogurts, juices, cereals, and energy bars. They have been touted as having benefits not only for digestive health, but also mood disorders, cancer, cold and flu prevention, and reproductive health issues.
While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.
These statistics are staggering, yet poor gut health actually affects much greater numbers than these statistics illustrate because your digestive health affects every physiological system in your body. How is this such a complex system? Well, for one, the human microbiome contains 360 times more protein-coding genes than human genes themselves contain.
“Some strains have been shown to help with GI complaints, some with immune function, and some even have been shown to have benefits outside the intestinal tract, such as with vaginal health or eczema,” says Gail Cresci, Ph.D., R.D., a Cleveland Clinic researcher who studies the microbiome. But there are few definitive conclusions from the current research.

The bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.


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.
"The proprietary formula in this lotion supports a healthy microbiome of your skin promoting a more hydrated, stronger barrier function and protection from pathogens without harming the good stuff. Throw away your antibacterial soap and hand sanitizer and use this all over after your shower and after washing your hands," says Astarita, who is also a fan of the Nerium Prolistic Powder Pre & Probiotic Plus Vitamins ($45) and Be Well Probiotic Powder ($46) by Dr. Frank Lipman.
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.
Digestive problems. The best evidence for probiotics is for reducing diarrhea, especially following antibiotic use. A 2010 review from the Cochrane Collaboration concluded that probiotics shorten episodes of acute infectious diarrhea. And in 2011, a Health Canada monograph stated that products containing certain probiotics (such as Lactobacillus rhamnosus GG) help manage acute infectious diarrhea and antibiotic-associated diarrhea. A 2012 research review in the Journal of the American Medical Association (JAMA) found that probiotics reduced the risk of antibiotic-associated diarrhea by 42 percent—but many of the studies had flaws, so these findings should be interpreted with caution. A 2013 Cochrane review of 23 trials also concluded that probiotics may be effective for preventing antibiotic-related diarrhea. However, two large, well-designed studies, in the Lancet in 2013 and the Annals of Internal Medicine in 2014, found that probiotics were no better than a placebo in preventing diarrhea in older people taking antibiotics. A review of 19 studies, published in Gastroenterology in 2017, found that probiotics reduce the risk of Clostridium difficile-related diarrhea in hospital patients, especially when the supplements were started during the first two days of antibiotic treatment.
In addition to the impact on our immune systems, our digestive systems are the second largest part of the neurological system. It’s called the enteric nervous system and is located in the gut. This is why it’s called the second brain — the gut is responsible for creating 95 percent of the serotonin and may have significant impact on brain function and mood.
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].
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.
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. 

"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," says Segal. "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."
Quick note about some formulations with multiple strains (including this one): Take a look at the label below and you’ll see that the supplement contains a mix of strains, but the label just says there is a total of 20 billion CFUs (how they measure the amount of bacteria). This does not tell us how much of each particular strain there is, and we want to know that there are at least 1 billion CFUs per strain to get a beneficial effect.
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.
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 National Yogurt Association, who created this seal of approval, requires all yogurt manufacturers to include it on products that meet the standard of having a sufficient number of probiotics. The probiotics in store-bought yogurt need to meet this standard in order to be shelf-stable and reach your body alive. But even then, this standard isn’t all that useful in practice. The number just refers to the total number of live cultures and not the levels for each of those microbes. It’s possible, Taub-Dix says, that a product won’t have high enough levels of a certain probiotic to have any effect.

While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.
Probiotics are live microorganisms (bacteria or yeast) that have been shown to have a health benefit for humans. They are available in supplement form or in probiotic foods and drinks. Probiotics are thought to be akin to (and to increase the level of) the "good" bacteria found in your intestines. These "good" bacteria are thought to enhance our health through their support of our immune systems.
But before you start reaching for the calcium supplements, there may be a more effective way to support your bone health. Like many other parts of the body, the health of your bones is closely tied to the health of your gut, especially your intestines. Temporary intestinal inflammation can trigger an immune response in which your body releases interleukins, proteins that have an immune function but also absorb bone tissue. If the temporary inflammation remains unaddressed, these molecules can take a toll on your bones, eventually weakening them.14
It has been suggested that probiotics be used to treat problems in the stomach and intestines. But only certain types of bacteria or yeast (called strains) have been shown to work in the digestive tract. It still needs to be proved which probiotics (alone or in combination) work to treat diseases. At this point, even the strains of probiotics that have been proved to work for a specific disease are not widely available.
Yes, they may help. Lebwohl says there are reputable studies that show a link between the use of probiotics and the reduction in IBS symptoms, citing this meta-analysis. It's estimated that 11 percent of the world population complains of symptoms like abdominal cramps, diarrhea, constipation, excessive gas and/or mucus in their stools. While for some the condition can be attributed to certain dietary triggers, others appear to be stress-related, which brings us to the heart of where many claims about the effectiveness of probiotics lie—in the gut-brain axis.

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.
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!
A 2017 survey of cancer patients showed that more than 80 percent were taking some sort of dietary supplement, vitamin, mineral, or herb to treat digestive issues they were experiencing due to chemotherapy. Researchers noted that while supplements can be beneficial in some cases, they can also change the metabolism of anti-cancer drugs, or lead to life-threatening conditions like sepsis because of the patient’s compromised immune system. 

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.
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.
She totally did, but you may have noticed that you don't see those yogurt commercials anymore. That’s because in 2010, the Federal Trade Commission in conjunction with 39 states' attorney generals banned those ads, finding that the Dannon Company had no scientific evidence to back up their claims,. Dannon had to pay $21 million to resolve the associated investigations.

To avoid those and other problems, I strongly recommend buying a professional brand from a reputable health care professional or other vendor who stands by their products and undergoes third-party testing. Some of these professional brands have created advanced technology that preserves a probiotic supplement’s survival on the shelf and in your gut.
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