The gut microbiota has been implicated in diseases ranging from obesity to Parkinson's disease and depression. Little wonder then that commercial probiotics have gained widespread popularity and are now estimated to command a US$37 billion market worldwide. But with research into the microbiome still in its infancy, increasing evidence suggests that both commercial and clinical use of probiotics is outpacing the science.
In a separate study involving 21 healthy volunteers, also published today in Cell, the same group of researchers found that taking probiotics after treatment with broad spectrum antibiotics may actually delay the return of people's normal gut microbiome. This goes against the idea that probiotics can help "repopulate" people's gut bacteria after antibiotics wipe them out.
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.
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.

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)
I did the “milk test” on these New Rythm probiotics, along with Culturelle I had purchased in 2 different states (TX & MA, as I was traveling); my mother’s CVS brand acidophilus; and one “control” cup with milk only (so, 5 cups total in my experiment). The New Rythm became a solid yogurt consistency, while the other 4 remained liquids. I did the experiment twice, just to be sure of the results. I could not believe it!!! New Rhythm is my brand, hands down!!! I also would like to mention that my product usually arrives the day after it ships. So it will take a few days to ship when I select standard shipping, which is to be expected, but it doesn’t stay in transit long which is ideal for preserving the living cultures.
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.
"I usually recommend Garden of Life, BioK or Megafoods brand," says Shapiro. "I also recommend starting with about 30 billion CFU and making sure your supplement has at least 12 different strains. And if you don't eat a diet high in fruits, vegetables, nuts, seeds, and whole grains that provide fiber for the probiotics to live off of, make sure you're the one you are taking contains prebiotics as well.

Prebiotics are fuel for the good bacteria (probiotics) in your gut; without prebiotics, probiotics can’t do their job. There are tons of prebiotics in whole fruits and vegetables, including onions, garlic, bananas, asparagus, and artichokes. If you’re worried you’re not getting five to 20 grams per day (more on prebiotic-rich foods here), consider taking a prebiotic supplement, usually a powder or drink mix.
In the first study, 25 human volunteers underwent upper endoscopies and colonoscopies to sample their baseline microbiome in regions of the gut. 15 of those volunteers were then divided into two groups. The first group consumed generic probiotic strains, while the second was administered a placebo. Both groups then underwent a second round of upper endoscopies and colonoscopies to assess their internal response before being followed for another 2 months.
After suffering from liquid nighttime but painless diarrhea for over a year (which I semi-controlled with one Imodium/day), I had a colonoscopy that gave a diagnosis of microcolitis. After the colonoscopy, I developed for the first time excrutiatingly painful gas pain in the LLQ. Usually this pain started during aerobic activity such as walking, but not always. Sometimes I woke up with it. CT scan revealed nothing. Will a probiotic help and if so, which would be best? There are so many it is hard to choose.
For women searching for a double-duty probiotic that can ease digestive symptoms while warding off urinary tract infections, look no further than the HyperBiotics PRO-Women Probiotics with Cranberry Extract and D-Mannose. Specifically designed to combat urinary symptoms while maintaining healthy gut bacteria, this formula is ideal for women of all ages that want to improve their urinary health.

Probiotics contain 'good' bacteria, and that's exactly why we need them; because it's not just 'good' bacteria calling our gut home. Taking a probiotic supplement (along with a healthy diet) increases the number of good bacteria, reduces the number of bad bacteria and creates an environment that’s suitable for beneficial microorganisms, which improves our overall health.
Probiotics also seem to ameliorate irritable bowel syndrome, a chronic disease characterized by abdominal pain, bloating, and frequent diarrhea or constipation (or a mix of the two). A 2014 review of more than 30 studies, published in the American Journal of Gastroenterology by an international team of researchers, determined that in some cases, probiotics help to relieve the symptoms of irritable bowel syndrome for reasons that are not entirely clear, although it may be that they impede the growth of harmful microbes. The researchers concluded, however, that they did not have enough data to recommend any particular strains of bacteria. Microbiologists often caution that a promising study on a single strain of a particular species of bacteria should not be taken as proof that all probiotics work equally well. “Bacterial strains are so genetically different from one another, and everybody has a different gut microbiota,” Allen-Vercoe says. “There will probably never be a one-size-fits-all probiotic.”
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.
In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.
"This suggests that probiotics should not be universally given as a 'one-size-fits-all' supplement," study co-senior author Eran Elinav, an immunologist at the Weizmann Institute of Science in Israel, said in a statement. However, it may be possible to tailor probiotic treatments to the individual, based on the types of microbes already in his or her gut, as well as other factors, so that he or she gets the most benefit from probiotics, the researchers said.
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."
Probiotics are clearly incredibly supportive, but they can't do their work alone. To make sure that you're getting the most out of your microbes, it's important that you give them the support they need to work. You've got lots of options for supporting your gut health, from dietary changes to probiotic supplementation, but make sure you're at least covering the following bases.
Although these capsules are more expensive than other options on the market, if you suffer from ulcerative colitis, irritable bowel syndrome, or pouchitis, this probiotic will help manage your symptoms. VSL contains eight different probiotic strains (and more good bacteria than other brands) to alleviate symptoms such as bloating, cramping, and diarrhea. There are 60 capsules per bottle.
 Do you ever feel like your thinking is clouded, where it is hard to think, hard to focus, and hard to recall events that happened recently? You may have a case of brain fog. Brain fog is a group of neurocognitive symptoms that make a person feel groggy and not quite “with it.” There are many causes, such as lack of sleep, a hangover, fever and illness, neurotoxins such as MSG, chronic inflammation, infections, autoimmune disease, heavy metals toxicity, consumption of reactive foods, vitamin deficiencies, blood sugar fluctuations, hormonal fluctuations, and bacterial by-products. The end result is neuroinflammation, which causes the clouded thinking.
If you get sick often, probiotics might be the immune booster you've been looking for. The Cleveland Clinic says they've been shown to strengthen immunity by enriching and replenishing the good bacteria in the body. And when you eat foods with probiotics regularly, it's easier for your body to produce vitamins and enzymes that help keep your intestines happy. 

According to the NIH, probiotic supplements contain many microorganisms that are the same as or similar to the ones that naturally live in your body, but there's still a lot of research to be done on probiotics and how they work. It's important to keep in mind that not all probiotics have the same effects and that taking probiotics isn't a guarantee of better health. And while they're generally safe for healthy people to take, with side effects being limited to mild digestive discomfort, they could interact with certain medications or pose health risks to people with underlying medical problems — that's why it's smart to talk to your doctor before getting started with a supplement.

The second Elinav study, “Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT” involved a mouse model and human patients. One cohort of mice and a parallel human group was given the same probiotic strain used in the first study to see if they had more success repopulating their gut microbiota after a round of antibiotics. Another “watch-and-wait” cohort didn’t take probiotics to assist gut microbiome recovery after antibiotic-related depletion. A third cohort was given an “autologous fecal microbiome transplant” (aFMT) which consisted of a patient’s own gut microbiota that had been collected before he or she started a cycle of antibiotics.
For adult use only, this supplement also encourages a healthy intestinal system. It relieves gas, bloating, and constipation. Other wonderful aspects of this product include the following: It assists in nutrient absorption, it guarantees quality, and it has no artificial flavor, color, sweetener, lactose, milk, sugar, starch, preservatives, sodium, fish, yeast, wheat, gluten, or soy.
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.  

A closer look at the science underlying microbe-based treatments, however, shows that most of the health claims for probiotics are pure hype. The majority of studies to date have failed to reveal any benefits in individuals who are already healthy. The bacteria seem to help only those people suffering from a few specific intestinal disorders. “There is no evidence to suggest that people with normal gastrointestinal tracts can benefit from taking probiotics,” says Matthew Ciorba, a gastroenterologist at Washington University in St. Louis. “If you're not in any distress, I would not recommend them.” Emma Allen-Vercoe, a microbiologist at the University of Guelph in Ontario, agrees. For the most part, she says, “the claims that are made are enormously inflated.”
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.
That said, supplements with higher numbers of CFUs are sometimes used to treat conditions such as irritable bowel syndrome (IBS), allergies, and respiratory illness. While probiotics have generally been found to be safe for most people with normal immune systems, too much can cause gas and upset stomach. We narrowed our search to supplements with dosages between 1 billion and 100 billion CFUs.
We’ll start with the headliner: the BIO-tract peral, which packs the equivalent of 75 billion CFUs into one tiny, filler-free, 5-billion CFUs pearl. The trick is in protecting those 5 billion CFUs over an 8 to 10-hour period, so they bypass your acidic stomach and reach your intestinal tract, alive and well, allowing you to experience the full and multitudinous benefits of plentiful and beneficial gut bacteria.
Vitamin Bounty’s probiotic contains a variety of well-studied strains and a competitive 25 Billion CFU. It also contains a natural prebiotic resistant starch, rice flour, to fuel the strains this probiotic supplies. Over 95% of Pro 25’s strains were still active and viable, the second highest observed strain viability out of all probiotics reviewed-to-date!
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.
When looking at the list of possible causes, it is no surprise that gut function plays a role in brain fog. The gastrointestinal (GI) tract is in direct and indirect communication with the brain, and microbes in the gut can affect, for better or for worse, the types of communication that occur between the GI tract and the brain. Additionally, harmful products from pathogens in the gut can travel to the liver, overloading the liver and causing toxins to be circulated to the brain and contributing to brain fog.
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.
Women’s health expert Dr. Amy Myers is a goop-trusted authority on subjects from autoimmunity and Candida to thyroid dysfunction; and she’ll be speaking IRL at our first wellness summit on June 10. Here, Myers helps us evaluate the increasing buzz around probiotics, and outlines the ins and outs of selecting a particular supplement (whether hers or other brands). Plus, we’ve rounded up our probiotic essentials, from inner beauty powders to favorite fermentation recipes, in one guide:
If that’s the case, I recommend steering clear. They either don’t want you to know that they’re using a poorly-researched strain of probiotics or they’re simply ignorant to the fact that the strain of probiotic really matters and determines the benefit that you’ll receive as the consumer. I usually want to give these companies the benefit of the doubt, but honestly, if you’re making a probiotic supplement you should know this stuff is important.

Clinically shown to work in 7 days§, AZO Complete Feminine BalanceTM works differently because it contains the power of INTELLIFLORA,TM the only clinically proven blend with the 4 vaginal lactobacilli species most commonly found in healthy women.* Specially designed to restore the vagina’s microflora, it’s a safe and beneficial probiotic for women’s health—including pregnant women.*§ Add it to your daily regimen for help with protection and ongoing vaginal health support.*
Probiotic supplements and foods can play a major positive role in brain fog. Lactobacillus, in particular, can produce neurotransmitters used for brain neuron-to-neuron transmission to facilitate thinking. Probiotics can interact with the vagus nerve to the brain, with the enteric nervous system that can communicate with the brain, and with the brain via chemical messengers.

Ultimate Flora tested significantly higher than the majority of general probiotic blends. Critical Care is composed of very well-documented probiotic strains and is an effective addition to any lifestyle, capable of conferring a wide variety of health benefits. The probiotic strains are not only diverse, they were also resilient to outside influences and, in many cases, were successful in establishing colonies within the digestive tracts of study participants.
I’ve been taking a Jamieson Probiotic for weeks now for my IBS. I’m not really getting results. It has 10 billion cells and about 14 strains. I tried taking it every day but then I was crampy, bloated and almost constipated. A friend suggested taking every other day so I did that and it was just the opposite. I’ve been trying to eat a low fodmaps diet as well. Can you tell me how long its supposed to take to work and also if I should possibly try something else? This probiotic was inexpensive so I’m wondering if you get what you pay for.
To factor strain-specific benefits into our efficacy score, we referenced the information in these guides. Products were rewarded for containing strains on these lists. Additionally, measured levels of each strain were compared to what is thought to be effective based on these guides, and scores were scaled accordingly. In cases where products did not list strain-specific amounts, or their listed strains were not included in these guides, total measured CFUs were compared to a general effectiveness threshold of 1 billion CFUs cited by research published in the American Journal of Clinical Nutrition11.
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.
While past studies have investigated similar questions, they have all used patients' excrement as a proxy for microbe activity in the GI tract. Instead, Elinav, his colleague Eran Segal, (a computational biologist at the Weizmann Institute), and their teams spearheaded by Niv Zmora, Jotham Suez, Gili Zilberman Schapira, and Uria Mor of the Elinav lab collaborated with Zamir Halpern, Chief of Gastroenterology at the Tel Aviv Medical Center to measure gut colonization directly.
Jo A. Panyko is a Master Nutrition Therapist and author of two books about probiotics. She is a professional member of the National Association of Nutrition Professionals (NANP) and works as a functional medicine nutrition therapist (nutritionist) at her company, Chrysalis Nutrition and Health. She writes about how to be healthy with probiotics on her website, powerofprobiotics.com.
Renew Life offers a powerful, high potency blend of 10 specially selected Lactobacillus and Bifidobacterium strains designed to help restore your body’s good, natural ora. Their probiotics come in a special capsule designed to survive stomach acid and make it intact into the intestines to deliver the probiotics more effectively where they are most needed.

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.
That said, supplements with higher numbers of CFUs are sometimes used to treat conditions such as irritable bowel syndrome (IBS), allergies, and respiratory illness. While probiotics have generally been found to be safe for most people with normal immune systems, too much can cause gas and upset stomach. We narrowed our search to supplements with dosages between 1 billion and 100 billion CFUs.

The Golive Berry Probiotic and Prebiotic Supplement Blend is perfect for tossing in your bag or keeping in your desk. Each packet includes 15 billion CFUs and 15 different probiotic strains. It also has a soluble fiber prebiotic to promote the growth of good bacteria in your body. Each packet contains 30 calories and comes in five flavors including pomegranate, melon cucumber, citrus blueberry, and a flavorless option. It can be mixed in any hot or cold drink, but we recommend tossing the flavored packet into a bottle of water. You’ll get 10 packets in each order.
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