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Probiotics are live microorganisms that are thought to have health benefits, as the National Institutes of Health (NIH) reports. These bacteria and yeast are believed to help populate our guts with beneficial microbes, according to Mayo Clinic, and can be found in fermented or unpasteurized foods including yogurt, kefir, sauerkraut, and kimchi, as well as, yes, supplements.
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.
Another study by Elinav and his colleagues suggests that not everyone’s gut reacts the same way to probiotic pills. They studied samples of microbiomes from antibiotic users before and after they took supplements for four weeks. The good bacteria were found in the digestive tracts of some people. But in others, the bacteria were present only in stool samples, not in their digestive tracts, where they’re thought to be needed to improve health.
If you've ever been to an Indian restaurant, then you've probably seen a lassi—a smoothie made of milk, yogurt, fruit, honey, and cardamom. The drink goes well with spicy Indian food because it helps extinguish the fiery feeling in your mouth. If you want to try it at home, you can pick up bottles from brands like Dahlicious, which contain 15 billion live probiotics per serving and are available in flavors like mango and turmeric. Or, try this mango lassi recipe.
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.
Many factors influence the proportion of each family; from the early years of your life (the type of birth you had, breastfed vs. formula-fed, exposed to antibiotics prenatally) to the later years, where more lifestyle factors like diet, smoking, alcohol consumption, stress, and sleep come into play. The bacteria species found in the digestive tract have a significant influence on overall health, both physical and mental, which is why it’s important to take care of them every day.
We found the most evidence linking strains to antibiotic recovery, immune health, and IBS/IBD relief. We made checklists of the most researched strains that treat those issues (10 strains known to boost general health, six for immune health, seven for antibiotic recovery, and seven for IBS/IBD relief) and dug into ingredient lists to find the supplements containing the highest number of effective strains for each use case.
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.
Those who took probiotics did replenish gut microbiome more successfully than the “watch-and-wait” group. That said, there was also an unexpected backlash to probiotic use. The researchers were alarmingly surprised to discover that successful microbiome colonization via probiotics actually prevented the host's pre-antibiotic microbiome and gut gene expression profile from returning to its natural state for months after the treatment. But there is good news: Using aFMT resulted in the third group's native gut microbiome and gene expression profiles returning to normal within days after they stopped taking antibiotics.
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.
The research also showed that while probiotics colonised the gastrointestinal tract of some people, the gut microbiome of others just expelled them. There was no way of telling from their stool sample which category people fell into. “Some people accept probiotics in their gut, while others just pass them from one end to the other,” says Elinav. They found that the probiotic colonisation patterns were highly dependent on the individual. That tells us that the concept that everyone can benefit from a universal probiotic bought from the supermarket is empirically wrong, he says.
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.
Additionally, it's a good idea to take note of the number of colony-forming units (CFUs) that are in the supplement you're considering, Angelone says. CFU count tells you the number of viable, active bacteria present in a tablet, she explains, and one billion (yes, seriously) is a typical dose. However, if you're struggling with a specific health condition, you may need more than that, Warren says. Your doctor can help you decide whether that's the case and may be able to steer you toward a good supplement to get you started. Here are a few to consider if you decide that probiotics are right for you.
They probably are. Lebwohl says probiotics may decrease the risk of getting diarrhea during the course of taking antibiotics, and may also play a role in specifically preventing the development of the dreaded antibiotic-related super diarrhea called C. difficile or C. diff. Antibiotics can wipe out the good bacteria that keep you from getting sick if you’re exposed to C. diff, or if you already have it in your system. C. diff symptoms can range from a moderate watery diarrhea several times a day to severe infections, which can be accompanied by fever, bloody stools, rapid heart rate, and can even lead to kidney failure. 500,000 Americans were infected with C. diff in 2015 and 15,000 died from it.
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 .
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.