Hi Joan, it’s possible, but not ideal because most pill form probiotic supplements are designed to be protected from stomach acid until the capsule reaches the intestines. It’s impossible to say how many probiotic microorganisms would survive by taking them this way, but certainly less than if you swallow the pills. I would recommend trying a probiotic gummy product or some other probiotic that comes in something other than pill form rather than opening up the capsules.
The other way that probiotics help is the impact that they have on our immune system. Some believe that this role is the most important. Our immune system is our protection against germs. When it doesn't function properly, we can suffer from allergic reactions, autoimmune disorders (for example, ulcerative colitis, Crohn's disease, and rheumatoid arthritis), and infections (for example, infectious diarrhea, H. pylori, skin infections, and vaginal infections). By maintaining the correct balance from birth, the hope would be to prevent these ailments. Our immune system can benefit anytime that balanced is restored, so it's never too late.
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Next time you pack your travel beauty bag, slip a shelf-stable probiotic in there to preempt bathroom emergencies, Fasig says. Look for one that contains Lactobacillus acidophilus, Lactobacillus sporogenes, Bifidophilus bifidum, and Sacchromyces boulardii strains ($20, amazon.com), which Fasig says can improve your intestinal health to fix issues with constipation or diarrhea.
We have to give a nod to the most famous probiotic food: yogurt. Whether you love Greek or regular, low-fat or full-fat, look for the phrase "live active cultures" on the label. And although choosing a plain yogurt has less added sugar than the flavored kinds, Tallmadge gives you the okay to choose a fruit-infused flavor if that's the only way you'll eat it. Just be sure to aim for fewer than 15 grams of the sweet stuff per serving; sugar can feed the bad bugs in your gut.
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].
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!
The side effects of antibiotic use are often not trivial. Many people experience discomfort and a change in bowel habits, but some experience more severe infections, such as opportunistic colonization of the gut with bacteria such as Clostridium difficile (C.diff), which affected half a million Americans in 2015 and was directly responsible for at least 15,000 deaths.
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.
Oral health. An increasing number of probiotic lozenges and gums are promoted for oral health—to reduce periodontal disease, throat infections, and bad breath, for example. There’s preliminary evidence that certain strains may have some benefits, but commercial products may not have the same strains and formulations as those tested in published studies.
Topping the probiotic market numbers at 100 Billion CFU divided between 34 probiotic strains, Garden of Life’s Ultimate Care probiotic was definitely a contender for our Best Probiotic of 2018. Free from preservatives and additives, RAW scored impressive marks across the board. Although this shortens the lifespan of the probiotics strains somewhat, buying in small quantities can easily solve this problem and – honestly – at CHR we always prefer purity to additives.

Probiotics stick around for a while, though for how long isn’t precisely clear. You have to keep taking them to continue to reap the benefits. Further, getting a wide variety of strains into your system is beneficial. “Periodically mixing up your probiotic supplement is also a good way to ensure that you get different health-building strains in your health regime,” says Dr. Cook.

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. 

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.
“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
The takeaway: Certain strains were found useful in preventing diarrhea among children being prescribed antibiotics. A 2013 review showed that after antibiotic use, probiotics help prevent Clostridium difficile-associated diarrhea. A review focused on acute infectious diarrhea found a benefit, again for certain strains of bacteria at controlled doses. There’s also evidence that they may help prevent necrotizing enterocolitis (a serious gastrointestinal condition) and death in preterm infants.
Overall, Align Probiotic is one of the better “daily” probiotics out there.  It’s easy to take, comes in convenient packaging and doesn’t require refrigeration.  And it has some research showing it helps with gas, bloating and constipation, especially in women with IBS.  Lots of things to like about this probiotic!  Read the full review here… or click here to go buy it now!
Bacteria die out over time. Some supplements list the potency when they were manufactured (before they rode in a truck, sat on the shelf at the grocery store, or hung out in the kitchen cupboard for a few months). In this case, there could be dramatically fewer viable bacteria by the time you consume them than when they were first encapsulated, and good bacteria are no good to you dead.
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Then, study participants were divided into one group that consumed a standard probiotic strain available in commercial supplements and a control group that was given a placebo. After two months of treatment, the researchers found that some people were so-called “resisters” who expelled the gut microbiomes in probiotics; others were identified as “persisters” who successfully colonized the generic probiotic strains in their GI tracts.
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.

What about prebiotics vs probiotics? Prebiotics are the food fibers that go through the gut unchanged and are then used by good colon bacteria as a food source for their own growth. Everyone already has most of these good bacteria present, but often in small quantities. Prebiotics are used to stimulate their growth. Simply stated, you already grow your own probiotics within your colon. You do not rely on them to make the passage through the stomach acid — acid that can destroy many probiotic bacteria. That’s why taking a probiotic supplement or adding probiotic foods to your diet does not always help your digestive system. You can eat as many probiotic bacteria as you want, but if they don’t survive the trip to the colon, your effort will be fruitless.
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. 

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.
Probiotics for allergies are fast becoming a preferred treatment method because they are understood to be much safer than traditional allergic rhinitis medication. A nasal spray for allergies is often a ‘go to’ treatment, for example, but allergy nose spray medications often contain corticosteroids, like Beclometasone dipropionate, which could affect bone metabolism, blood cells, and the pituitary gland.
It seems like one minute you have diarrhea (D) and the next minute you are constipated (C). Abdominal pain, cramping, and bloating come and go. You are tired of running to the bathroom frequently, or spending a long time in the bathroom waiting for something to happen. Irritable bowel syndrome (IBS) is a diagnosis of exclusion. Infections and other causes of your IBS-C dominant or IBS-D dominant symptoms have to be ruled out, but in many cases the diagnosis of IBS doesn’t really provide answers. You may be on a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet, which helps, but is restrictive.
However, this particular probiotic does not contain any additional vitamins, minerals, or plant extracts like some of the other brands we have reviewed. The Probiotic Pearls are a great option for women looking for an introductory probiotic or one with less fuss, but likely won’t pack the same punch as probiotics that include mineral blends and added vitamins in their formulas. This probiotic was also not designed to treat or prevent urinary tract problems, and may not be as suitable as other brands for women with recurrent urinary tract infections.
If you’re new to Bio-K+, know that each bottle contains 50 billion live and active probiotic bacteria. Probiotics are good for a wide variety of digestive issues, so it’s best to customize your dosage based on what your specific needs are. If you are looking to take a preventative dosage to support the health of your microbiome, start with a ¼ bottle per day. If you suffer from digestive health issues or regularly take antacids, start with a ½ bottle of Bio-K+ per day. If you have more serious gastrointestinal issues or have had to take antibiotics, Bio-K+ probiotics are great for getting your system back on track. Start with a full bottle per day and see how you feel (we’ve had amazing results from our fans!)
CFU: This is the number of "colony forming units" present in each dose, which are measured in the billions. And while more isn't always better, "you want at least 20 to 50 billion CFU," says Dr. Nazareth. Just for reference, a very high dose is 400 CFU, which most experts agree is not necessary unless your health care practitioner specifically recommends this for you. It's also important to check for the guaranteed CFU upon expiration, which should be listed clearly. "Some products only guarantee the CFU number at the time of manufacturing, therefore will be less potent by the time the product reaches your home," she says.
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.

Immunity and colds/flu.There’s a close connection between the bacteria in your colon and the immune system. Several studies, including one in 2012 in the British Journal of Nutrition, have found that certain probiotic strains boost measures of immune response—but whether this translates into any clinical benefits is uncertain. Studies have been inconsistent, for example, as to whether probiotics will actually curb colds and other upper respiratory infections. In 2014 a review in the British Journal of Nutrition, which looked at 20 clinical trials, linked probiotics to shorter duration of colds, but not necessarily reduced incidence or severity. Similarly, a 2015 Cochrane review of 12 clinical trials concluded that certain probiotics may help prevent or shorten such infections, though the quality of the studies was poor. 

The large intestine is home to hundreds of trillions of bacteria. Fortunately, most are neutral or even beneficial, performing many vital body functions. For example, they help keep “bad” bacteria at bay, play a role in immunity, help us digest food and absorb nutrients and may even have anticancer effects. But will consuming them as probiotics in foods or capsules make a notable difference to your health—especially if you are already healthy? Here’s a look at the evidence.
If these issues and many others are connected to gut health, then what elements are essential for digestive health? Consider this: According to the National Institute of Diabetes and Digestive and Kidney Diseases, upward of 60 million to 70 million Americans are affected by digestive diseases. In addition, digestive disease and disorders cost the United States over $100 billion per year.
Jotham Suez, Niv Zmora, Gili Zilberman-Schapira, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Max Horn, Yotam Cohen, Andreas E. Moor, David Zeevi, Tal Korem, Eran Kotler, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Meirav Pevsner-Fischer, Hagit Shapiro, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Post-Antibiotic Gut Mucosal Microbiome Reconstitution Is Impaired by Probiotics and Improved by Autologous FMT. Cell, 2018; 174 (6): 1406 DOI: 10.1016/j.cell.2018.08.047

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.


The beneficial microbes, including probiotics, live with other microbes that are either benign, pathogenic (disease-causing), or opportunistic, meaning that they normally play nicely but can get out of control if given the opportunity. Actually, any microbe can cause you problems if it ends up in a place other than where it is supposed to be. Such a scenario can happen with intestinal permeability, commonly called leaky gut. Leaky gut happens when the layer of skin-like cells in your GI tract develops gaps in between the cells, allowing food particles, toxins, microbes, and other hazards to enter your bloodstream, if not stopped by the immune system. Since mucus, the thin layer of cells, and your immune system are your only defenses against the outside world within your digestive tract, it is very beneficial to you to have helpful microbes protecting you from potentially pathogenic microbes. These beneficial microbes can produce acids or antimicrobial products called bacteriocins, which hinder or kill pathogens. They can also stand in solidarity to prevent pathogens from taking up residence, or displace them if they do.

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.


​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
But sometimes you need a little help from outside sources in order to secure those benefits, which is why a lot of experts recommend getting an extra hit of probiotics through food. Fermented options — think keffir, sauerkraut, and kimchi — are a great place to start, says the International Scientific Association of Probiotics and Prebiotics, as are these other surprising foods with probiotics.
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Researchers that formulated the blend started by selecting species that are dominant in the healthy vaginal microbiota. Then they further refined the formula by selecting strains of probiotics that flourish in the vagina. The blend is clinically proven to help protect vaginal/feminine health.*
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