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.
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.
Better Health Review ranks Ultimate Flora as the most effective probiotic supplement. It contains 30 billion active bifidobacteria for colon health, and 20 billion lactobacilli and lactococcus cultures for the small intestine. According to Better Health Review, it contains all natural ingredients. It earns a perfect 5 score from Better Health Review, and the magazine “Vitamin Retailer” voted it best two years in a row.
Thankfully, most causes of constipation can be improved with dietary and lifestyle interventions. One of probiotics benefits is constipation relief. Probiotics of many kinds can help with constipation because they can keep the digestive contents moving along through different mechanisms such as short-chain fatty acid production, influences on the nerves of the digestive tract, electrolyte balance, pathogen control, and others. Think of probiotic foods and pills as an addition to other dietary and lifestyle interventions to relieve constipation and return your digestive system to its normal functions.
This is one of the newer areas of probiotic research. Described as the “gut-brain axis,” researchers believe that the communication between the gut and the brain affects not just physical but also mental health and behavior. For example, a recent study found that probiotics can reduce anxiety, relieve stress and improve mental outlook. Another study found that the probiotics L. helveticus and Bifidobacterium longum reduced depression, anger, hostility and self-blame and improved problem-solving ability. Another study showed a difference in brain activity between women consuming yogurt and those consuming a placebo. More research needs to be done to confirm the effect of probiotics on mental and emotional health.
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.
That doesn't mean that all probiotics, or probiotic-containing foods are created equal. So what should you look for? "There is a lot of 'noise' in this space as more and more 'food products' are coming out with Probiotics," Dr. Shekhar K. Challa, a gastroenterologist and the author of Probiotics For Dummies tells The Huffington Post. "Unfortunately it is impossible to quantitate the CFU's of probiotics in most food products."
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.
Sure, why the hell not? Lebwohl says: "Essentially a yeast infection is an overgrowth of a kind of fungus. In theory, a probiotic could potentially have an effect of the microbiome of the vagina, though proof of its effectiveness hasn’t really been established.” No harm in giving it a try as long as you don't succumb to the temptation to put yogurt in your vagina.
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.
However, it is not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. Bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. Acidophilus and B. Bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].

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.

There are many health benefits of probiotics, but there are also a few cautions to heed as well. First, if you are immune compromised (catheters, cancer treatments, HIV, trauma, and so on), please consult your physician to check if there are any contraindications for using probiotics. Second, if you never used probiotics or a particular type of probiotic before, and/or never ate much raw food or indulged in fermented probiotic-rich foods and drinks (such as sauerkraut, kimchi, kefir, or kombucha), please proceed slowly with probiotic supplements and use. Although probiotics are tiny organisms, they can have very potent effects on your body.
All probiotic strains are manufactured through fermentation, and are then freeze-dried before blending with fructooligosaccharides (FOS). The result is a shelf-stable (two years at room temperature), nitrogen-filled probiotic of human origin: a probiotic that easily adapts to your body, and is both acid- and bile-resistant to survive the acidic environment of the human stomach. In other words, a probiotic that fulfills its promises.
Bacteria in your digestive tract can be good or bad, according to the website Best Probiotic. It quotes the Royal Academy of Medicine England as blaming an imbalance between good and bad bacteria for causing 80 percent of all degenerative diseases. Probiotic supplements with "good" bacteria have become increasingly popular. They can aid the immune system, digestion and vitamin absorption, as well as prevent diarrhea and irritable bowel syndrome. The website Women to Women recommends probiotics that combine saccharomyces, lactobacillus acidophilus and bifidobacteria in the billions. MayoClinic.com also recommends lactobacillus and advises looking for products that contain live, active cultures. You should always check with your doctor before adding any supplements to your diet.
Taking relatively high doses of these probiotic strains before, during, and after antibiotic treatment can help your microbiome get back on its feet: B. Lactis, B. Infantis, L. Acidophilus, L. Casei, L. Bulgaricus, L. Paracasei, L. Rhamnosus GG, and S. Boulardii. Our antibiotic combatant MegaFood MegaFlora has six of these strains, as well as eight others. One serving contains 20 billion CFUs to replenish the good bacteria. 

However, it is not just digestive woes that probiotics can help address. A clinical case series followed 300 patients who took a probiotic mixture of L. acidophilus and L. Bulgaricus. They documented that 80% of acne patients had some degree of clinical improvement, particularly effective in inflammatory acne. Later, an Italian study involving 40 patients found L. Acidophilus and B. Bifidum supplementation produced better clinical outcomes in acne as well as better tolerance and compliance with antibiotics [2].

Most people with diverticulosis have few if any symptoms at all. When people do experience signs and symptoms of diverticulosis (diverticular disease) they may include abdominal pain, abdominal cramps, diarrhea, constipation, and bloating. Diverticulitis is a condition in which diverticuli in the colon rupture. The rupture results in infection in the tissues that surround the colon. Treatment methods for diverticulitis includes prescription medications, and in some cases, diverticulitis surgery.
This high-potency (25 billion CFU) supplement blends 12 different strains in a base of inulin. The Ther-Biotic Complete capsules are vegetarian (made from hydroxypropyl methylcellulose, water) and the formula is free of common allergens, such as milk, eggs, fish, tree nuts, peanuts, wheat, gluten, and soy so it’s perfect for those with allergies. There are 60 capsules per bottle.
After the antibiotics had cleared the way, the standard probiotics could easily colonize the gut of everyone in the second group, but to the team's surprise, this probiotic colonization prevented the host's normal microbiome and gut gene expression profile from returning to their normal state for months afterward. In contrast, the aFMT resulted in the third group's native gut microbiome and gene program returning to normal within days.
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!
The high quality supplement comes in veggie capsule form, and no refrigeration is necessary. This probiotic is made in an FDA registered facility (in the US), and it meets GMP standards. It’s an all natural supplement, that’s free of lactose, soy and gluten. It also contains no artificial coloring. DNA Shift probiotic also offers prebiotic fiber for an extra healthy brain and gut.
Until recently, testing of probiotics by ConsumerLab.com found that some products had far lower amounts of live organisms than claimed on the labels. But in 2018, it found that 17 out of 18 products tested contained the amounts listed; none exceeded limits for heavy metal contaminants. In contrast, in 2016, a study in Pediatric Research found that only one out of 16 Bifidobacterium longum supplements tested contained the species named on the label.
This story has played out before, most notably with vitamin supplements, which decades of research have revealed to be completely unnecessary for most adults and, in some cases, dangerous, correlating with higher rates of lung, breast and prostate cancers. But that has not stopped marketers from pushing another nutritional craze. According to a National Institutes of Health survey, the number of adults in the U.S. taking probiotics or their cousins, prebiotics (typically nondigestible fibers that favor the development of gut bacteria), more than quadrupled between 2007 and 2012, from 865,000 people to nearly four million. San Francisco–based business consulting firm Grand View Research estimates that the global probiotics market exceeded $35 billion in 2015 and predicts that it will reach $66 billion by 2024.
Most bacteria are included through the fermentation process. Fermentation helps extend the shelf life of perishable foods. It is a slow decomposition process of organic substances induced by microorganisms or enzymes that essentially convert carbohydrates to alcohols or organic acids. The lactic acid supplies the bacteria that then add the health benefits to the food. You can purchase foods that are fermented or ferment them yourself.
For example, yogurt is made with two “starter” bacterial cultures — Streptococcus thermophilus and Lactobacillus bulgaricus — but these bacteria are often destroyed by your stomach acid and provide no beneficial effect, Dr. Cresci explains. Some companies, though, add extra bacteria into the product, so check the labeling and choose products with bacteria added to the starter cultures, she advises.
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.

Many women are prone to yeast infections during or after antibiotic use. If you are one of these unlucky few, try taking a probiotic like the vH Probiotics with Prebiotics and Cranberry immediately before taking your antibiotics. (You may want to check with your doctor first though). These cultures may help with stomach upset and can also prevent a dreaded yeast infection!


Consuming probiotics regularly will reduce the risk of this. "The concept is that if we have an unhealthy, unbalanced gut environment, toxins can be released into the bloodstream and cause inflammation throughout the body," Engelman adds. "This shift in gut flora and the subsequent inflammation can cause a flare-up in the skin of those who are predisposed to acne, eczema, or rosacea."
Even if you’re not sensitive to dairy, though, probiotics that require refrigeration can be inconvenient; but there are now some that don’t need to be kept cold. For example, our probiotics are sealed in nitrogen blister packs to protect them from heat, as well as moisture and oxygen because the air can’t get in. Look for probiotics that are individually packed to protect the live cultures. If they just come in a bottle they could be losing potency from air getting in.
Remember, while bacteria gets a bad rap, not all bacteria is bad: As New York City-based certified dietitian-nutritionist Gina Keatley tells Allure, plenty of microorganisms, including probiotics, actually help your body function. "Probiotics may help stabilize the protective barrier in our gut so bad microorganisms don't take root, stimulate the immune response, and aid in production of vitamins, such as vitamin K," she says. Sonya Angelone, a registered dietitian and Academy of Nutrition and Dietetics spokeswoman, adds that while we have more to learn about the role of probiotics, beneficial bacteria is understood to help crowd out harmful bacteria in our bodies. This good bacteria may also help lower cholesterol, aid in reducing colds and acute respiratory infections, and reduce the occurrence of vaginal yeast infections, she says.
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.

As far as effectiveness, keep in mind that unlike medications, dietary supplements do NOT need to be approved by the FDA. This means that manufacturers can sell supplements simply with "claims" of safety and effectiveness. Currently, researchers are undecided if probiotic supplements are effective. Some say probiotics are effective; others believe they offer no benefit whatsoever. It also remains unclear which probiotics (or combination of probiotics) work to treat certain diseases. Despite these issues, some studies have shown positive results. Still, more research is needed to confirm that probiotics are safe and effective.
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.
“Highly recommend –There are quite a few probiotics manufactured specifically for women. Some are decent while others are not so good. For me, I require one on a daily basis to maintain my feminine health. When I try a new probiotic that is made specifically for women, it makes me a bit nervous because I will end up with yeast or bladder infection if it is not effective. With AZO, I am happy to report it is a great probiotic and highly recommend it to all women! It works great.” – Vicki
“​You have all sorts of microbiomes in your body, in the lungs, the oral cavity, the vagina and of course the gut. Everybody was looking at the microbiome as just being about just good bacteria,​”​Afif Ghannoum said.  The elder Ghannoum, who is associated with Case Western Reserve University in Cleveland, OH, showed the importance of the fungal components of those microbiomes, he said.
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.

MegaFood is our only top pick that’s certified vegan, as well as being gluten free and dairy free, making it a good choice for any food-sensitive or vegan probiotic seeker. It has fewer of our wishlist “general health” strains than Vita Miracle, but it still contains five. This could be a go-to if you eat vegan, even if you’re not recovering post-antibiotic.


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.

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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.

Russian microbiologist Elie Metchnikoff (1845-1916) was the first to associate the large amounts of fermented dairy products with the good health and longevity of Bulgarians back in 1907. He proposed that the acid-producing organisms in fermented dairy products could prevent what he called "fouling" in the large intestine. He believed if eaten regularly, these foods could lead to a longer, healthier life. One version of the Old Testament even attributes Abraham's long life — 175 years — to the "consumption of sour milk." Fermented milk products may have also been used to treat illnesses of the digestive tract during Roman times.


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.
Probiotics One Daily Support is easily one of our favorite probiotics right now and currently sits at #2 in our ranking of the best probiotics supplements.  There’s a number of reasons why I like it so much, but the main one is I just felt SO much better while taking it!  My stomach (which sometimes gives me issues due to IBS) felt great and I had a bit more energy than usual.  I was also able to digest all my meals without any problems, a major plus!  Further, Daily Support is very allergy-friendly, doesn’t require refrigeration and comes with a 60-day guarantee.  So all-in-all, we gave Probiotics One 5 out of 5 stars and truly think it’s a REALLY great probiotic.  Read the full review here… or click here to go buy it now!
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