There’s good and bad bacteria in there (fascinating fact: an estimated 100 trillion bacteria live inside your digestive tract): When the good outweighs the bad, your immune health soars; when the bad overpowers good, you get sick. You have diarrhea. Your immune system tanks. Your IBS, lactose intolerance, and other gut problems are exacerbated. It throws your entire system out of whack.

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.


They can break down substances in foods that keep you from absorbing the micronutrients inside. They not only protect against the consequences of rogue molecules passing through a leaky gut, but they assist your intestinal cells in staying healthy to optimize nutrient absorption. In addition, some of the metabolic by-products of probiotics, such as short-chain fatty acids and vitamin production, are very nourishing to your GI tract.
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. 

Many women eat yogurt or insert it into the vagina to treat recurring yeast infections, a "folk" remedy for which medical science offers limited support. Oral and vaginal administration of Lactobacilli may help in the treatment of bacterial vaginosis, although there isn't enough evidence yet to recommend it over conventional approaches. (Vaginosis must be treated because it creates a risk for pregnancy-related complications and pelvic inflammatory disease.) Probiotic treatment of urinary tract infections is under study. 

Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and

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.
That’s why adding probiotics and prebiotics to your diet provide the best possible outcome from a bacterial perspective. It isn’t always easy to eat naturally prebiotic-enriched foods, however, because they are often distasteful to eat in quantity. Would you enjoy eating several cups of raw onion or garlic every day? Probably not. Other foods that contain prebiotic fiber, such as bread and bananas, are high in calories. Consuming hundreds of calories of these foods every day is counterproductive if you’re trying to lose weight.
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:

Taking probiotics can also help keep your urinary system working properly. While you might think that yeast imbalances or urinary tract issues are primarily women's problems, both are common in men as well, especially in those whose bacterial balance is off-kilter. Taking probiotics can help address these issues by encouraging the growth of good bacteria to crowd out unwanted yeast.10


A popular dish in Japan consisting of fermented soybeans, natto contains the extremely powerful probiotic bacillus subtilis, which has been proven to bolster your immune system, support cardiovascular health and enhance digestion of vitamin K2. Natto can also contain vitamin B12, which is usually lacking in vegan diets. It’s also one of the highest plant-based proteins.

Unfortunately, the U.S. has no federal standards for probiotic supplements. Therefore, you run the risk of purchasing a product without any guarantee that it contains its advertised probiotic strains, that the strains are alive, or that the product is free from unhealthy ingredients. Therefore, it may be best to choose a brand-name probiotic that has research backing their effectiveness. Here are some examples:
Pure Therapeutics Power Probiotic 100B offers 100 billion CFUs of 4 powerful probiotic strains, including science darling, the HN019 strain of Bifidobacterium lactis. Since environmental factors, including moisture, oxygen and heat, can degrade the stability of your probiotics, Pure Therapeutics 100B is delivered in nitrogen-purged aluminum blister pacts, which ensure viability until the probiotic hits your system. No refrigeration is required.
Most probiotics are like what is already in a person's digestive system. Some probiotics have been used for a very long time throughout history, such as in fermented foods and cultured milk products. These don't appear to cause illness. But more study is needed on the safety of probiotics in young children, the elderly, and people who have weak immune systems.
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What's nice about supplement company Care/of is that it allows you to design personalized daily vitamin and supplement packs containing everything you need, including probiotics. Its vegan, gluten-free probiotic formula has one billion lactobacillus acidophilus and four billion bifidobacterium lactis per dose, popular strains thought to help promote digestive and immune health.
If you've tried a probiotic after following these steps and it doesn't seem to be working for you (or you just want some extra guidance in choosing one), head to your doctor (or a dietitian) to get a recommendation. "Have a thorough discussion with your doctor to make sure you are taking the appropriate bacterial strain for the appropriate reason," advises Dr. Ivanina. "Then, follow up after taking the probiotic to make sure it is having the intended effect."

If you’ve ever clicked on the 6:00 news or scrolled through the latest headlines on your smartphone, you probably know that supplements and vitamins are not typically backed by governmental entities like the FDA or the World Health Organization. This fact can leave supplement newbies a bit wary, which is exactly why we love the Garden of Life Dr. Formulated Once Daily Women’s Probiotic so much.


The current probiotic push lends itself to the question, "If humans got along fine without taking a probiotic supplement for thousands of years, why are they so important now?" Although there is no definitive answer to this question, there have been some significant cultural changes that have had an impact on the gut flora (the population of organisms that populate our intestines). These include the use of antibiotics, diets lacking in gut-healthy plant food, refrigeration and improved sterilization of foods. What we don't yet know is true is if probiotics actually turn around these changes and support the health of your gut flora.
One thing that is often overlooked is gut health and the benefits of probiotics for weight loss. Gut microbiota can affect food intake choices, appetite, and body weight and composition. Dysbiosis, an imbalance in the gut microbiota with a shift favoring pathogens and opportunists, is common in overweight people. The pathogens and opportunists create an inflammatory situation that affects insulin and other hormones, resulting in the inability to lose weight.
B. Longum is one of the first types of bacteria to colonize our bodies at birth. These important microorganisms ferment sugars into lactic acid, helping to stabilize the acidity of the GI tract and inhibit growth of harmful bacteria. For a group of adults prone to constipation, taking a mix of B. Longum BB536 with milk or yogurt for 2 weeks increased bowel movements [1].

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.
Unless you have a perfect gut and are already eating lots of fermented foods—which is rare, although you can work up to this point—it’s difficult to get all the probiotics you need from diet alone. Most of us don’t have perfect guts—everything from antibiotics to high-carbohydrate diets to being born via a C-section can compromise the balance of bacteria in our microbiome. Supplementing with a probiotic can help to restore imbalances, and it’s also just a great preventative health measure, helping to keep your microbiome in balance and your immune system healthy to ward off illnesses.
Gas (intestinal gas) means different things to different people. Everyone has gas and eliminates it by belching, burping, or farting (flatulence). Bloating or abdominal distension is a subjective feeling that the stomach is larger or fuller than normal. Belching or burping occurs when gas is expelled from the stomach out through the mouth. Flatulence or farting occurs when intestinal gas is passed from the anus.
Even for healthy people, there are uncertainties about the safety of probiotics. Because many research studies on probiotics haven’t looked closely at safety, there isn’t enough information right now to answer some safety questions. Most of our knowledge about safety comes from studies of Lactobacillus and Bifidobacterium; less is known about other probiotics. Information on the long-term safety of probiotics is limited, and safety may differ from one type of probiotic to another. For example, even though a National Center for Complementary and Integrative Health (NCCIH)-funded study showed that a particular kind of Lactobacillus appears safe in healthy adults age 65 and older, this does not mean that all probiotics would necessarily be safe for people in this age group.
The Strand Similar to multivitamins, not all probiotics are created equal. Different probioitcs have different bacteria strains with varying benefits; and some probiotics may contain more than one strain, so it’s important to do your research. Some strains may help with gastrointestinal issues like diarrhea, while others may not have any effect on the GI tract at all, according to Keri Gans, RDN, author of The Small Change Diet. If you’ve made the decision to take a probiotic supplement but you’re unsure about which strain to take, ask your doctor or a registered dietitian for a recommendation. “You most likely will not have any negative side effects from using the wrong strain, but you may also not see any benefits,” says Gans.
You'd be right. Lebwohl said there are no current studies supporting probiotics for cancer, and further, that he’d be concerned about anyone with a compromised immune system using probiotics. “It has not been adequately studied for cancer and I would be concerned about widespread probiotic use in someone who might have a suppressed immune system due to cancer, because of the rare but documented instances of actual infections arising from probiotic use."
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.
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.
Possibly the most popular probiotic food is live cultured yogurt or greek yogurt made from the milk of cows, goats or sheep. Yogurt, in most cases, can rank at the top of probiotic foods if it comes from raw, grass-fed animals. The problem is there is a large variation on the quality of yogurts on the market today. When buying yogurt, look for three things: First, that it comes from goat’s, sheep milk or A2 cows milk; second, that it’s grass-fed; and third, that it’s organic.
Overall, Enzymatic Therapy Acidophilus Pearls are a great daily probiotic supplement. They give you a ton of flexibility and is convenient since it doesn’t need to be refrigerated and can be taken with or without food! This probiotic makes on-the-go belly support a breeze. All in all, Enzymatic Therapy Acidophilus Pearls finally make it easy to travel with probiotics, are simple to take, and can give you the piece of mind that the money you’re spending on probiotics isn’t being wasted at the first sign of stomach acid.  Read the full review here… or click here to go buy it now!
Also, it’s important to understand that probiotics are not a new idea. Throughout history, cultures have thrived on probiotics found in fermented foods and cultured foods, which were invented for food preservation long before the refrigerator. The process of fermentation has been lost in recent years, as it is no longer needed to preserve foods, meaning that we now lose out on those vital probiotics benefits.
Diversity of strains - research has demonstrated that bacteria prefer to colonize in different parts of your digestive tract, where there are various ecological niches. The more probiotic strains you ingest, the more coverage you’ll provide for each of these niches. Each strain of bacteria also has its own different purpose, so choosing a formula with many different strains gives you that many more benefits.
The right resident strains - quite a few probiotics on the market contain things like active yeasts or soil based organisms. While these ingredients may be helpful to some, if you want to optimize your gut health, you need to look for strains that are resident to the human gut like those from the Lactobacillus, Bifidobacterium, and Streptococcus families.
Better Health Review named Dr. Ohhira’s Probiotics 12 Plus on its list of the top probiotic supplements on the market. It contains less than a billion active probiotic cells per dosage, but it adds vitamins, minerals and other micronutrients for optimal health. It claims to be 100 percent vegetarian. Better Health Review gives Dr. Ohhira’s Probiotics 12 Plus a rating of 3.5 on a scale of 5.
Since the bulk of your natural flora exists in your gut, it makes sense that this is the part of your body that feels it most when bacteria become imbalanced. Women, in particular, can experience all kinds of digestive problems, particularly during hormone fluctuations. These are just some of the digestive symptoms a high-quality probiotic can help reduce and even treat:
Align uses the patented probiotic strain Bifidobacterium, which helps to maintain a healthy digestive system and digestive balance. It contains 1 billion CFUs when manufactured, and 10 million CFUs when used by the best by date. (Very often, the number of CFUs in a product decreases over time.) If you have trouble digesting certain foods such as caffeine or dairy, this will be a good option for you.
Probiotics seem to be all the rage these days. With many purported benefits and a relatively low risk of side effects, manufacturers are taking advantage of booming business opportunities. Rather than leave your health in the hands of big business, it is important that you be as educated as possible about the best types of probiotics so you can choose what is right for you and your family.
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."

"Contrary to the current dogma that probiotics are harmless and benefit everyone, these results reveal a new potential adverse side effect of probiotic use with antibiotics that might even bring long-term consequences," Elinav says. "In contrast, replenishing the gut with one's own microbes is a personalized mother-nature-designed treatment that led to a full reversal of the antibiotics' effects."


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.


Yet that’s how probiotics are often offered. They can be distributed in the United States as food, supplements or drugs. The regulations for each are very different. Most people looking for probiotics don’t see the distinctions. Ideally, the ways in which we use and consume probiotics would conform to the data and evidence that back them up. That rarely happens.

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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.
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!

Probiotics can also help offset the bacterial imbalance caused by taking antibiotics. Antibiotics kill good bacteria along with the harmful ones, often leading to gas, cramping or diarrhea. Potential benefits of probiotics have been seen in the treatment or prevention of many conditions such as diarrhea, irritable bowel syndrome, ulcerative colitis, and Crohn's disease.
Walk into any grocery store, and you will likely find more than a few “probiotic” products brimming with so-called beneficial bacteria that are supposed to treat everything from constipation to obesity to depression. In addition to foods traditionally prepared with live bacterial cultures (such as yogurt and other fermented dairy products), consumers can now purchase probiotic capsules and pills, fruit juices, cereals, sausages, cookies, candy, granola bars and pet food. Indeed, the popularity of probiotics has grown so much in recent years that manufacturers have even added the microorganisms to cosmetics and mattresses.
Next the researchers measured what happens to the microbiome of people who take probiotics in the hope of restoring their microbiome after antibiotics. Twenty-one volunteers took an identical course of antibiotics and were then assigned to one of three groups. The microbiome of the first group was allowed to recover by itself, whereas the second group was given probiotics. The third group was treated with a dose of their own original pre-antibiotic microbiome by a faecal microbiota transplant (FMT).
If you are seeking non-dairy yogurt options, there are several that contain live probiotic cultures. Yogurts made from rice, soy and coconut milk are available on the market and also contain added probiotics that can provide the same benefits. Other alternative sources of probiotics include eating fermented foods like Brewer’s yeast, miso, sauerkraut, or micro algae. Whatever the source, always look for “live and active cultures” on the label.
Probiotics may also be of use in maintaining urogenital health. Like the intestinal tract, the vagina is a finely balanced ecosystem. The dominant Lactobacilli strains normally make it too acidic for harmful microorganisms to survive. But the system can be thrown out of balance by a number of factors, including antibiotics, spermicides, and birth control pills. Probiotic treatment that restores the balance of microflora may be helpful for such common female urogenital problems as bacterial vaginosis, yeast infection, and urinary tract infection.
There are both probiotics and prebiotics in fermented foods. I differ from a lot of doctors in that I recommend that patients with infections like Candida and SIBO don’t eat prebiotics until they’ve cleared up the infection—because the prebiotics can feed those infections, too. I find that it’s better to get rid of those infections first, and then add in prebiotics to your diet after. [See here for more from Dr. Myers on treating yeast infections.]
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.”
Some foods are made by adding bacteria — yogurt, pickles, cottage cheese, kombucha, and sauerkraut are good examples. Those foods work to provide the same probiotic benefits as supplements. However, most foods are so processed and pasteurized that it’s unlikely you’ll see the same benefits, let alone the right strains, as you would with a supplement. Regardless, it can’t hurt to get extra probiotics through your diet.

There are two main types of probiotics; the first is the live cultures I describe above, like the strains of Lactobacillus and Bifidobacterium. You might have heard some naysaying about this kind of probiotic—the typical argument against them is that the classic form of live cultures is destroyed by the acidic environment in the stomach. To get around this, quality probiotics are made with an acid-resistant capsule so that they don’t get immediately broken down. (Which means you don’t have to take the probiotics with food, although I normally do. I’ll sometimes break the capsule and mix it into a smoothie, or use the powder form. You might lose a bit of potency but it’s not significant.)


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.
Niv Zmora, Gili Zilberman-Schapira, Jotham Suez, Uria Mor, Mally Dori-Bachash, Stavros Bashiardes, Eran Kotler, Maya Zur, Dana Regev-Lehavi, Rotem Ben-Zeev Brik, Sara Federici, Yotam Cohen, Raquel Linevsky, Daphna Rothschild, Andreas E. Moor, Shani Ben-Moshe, Alon Harmelin, Shalev Itzkovitz, Nitsan Maharshak, Oren Shibolet, Hagit Shapiro, Meirav Pevsner-Fischer, Itai Sharon, Zamir Halpern, Eran Segal, Eran Elinav. Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features. Cell, 2018; 174 (6): 1388 DOI: 10.1016/j.cell.2018.08.041 
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