Sugar is so easily accessible in Westernized cultures that it is easy to overindulge in it. But why do you crave it? There are several reasons. One, sugar usually means sucrose, which is composed of glucose and fructose. Glucose is the sugar in your blood, so consumption of sugar results in a temporary boost of energy. However, that blood-sugar spike causes insulin to be released to usher the sugar into cells for energy or fat storage, and shortly afterward your blood sugar drops. So then you feel a slump and reach for something to bring your blood sugar back up: more sugar.
As the best-selling author of Happy Gut and a medical doctor who specializes in gut health and once suffered from IBS (irritable bowel syndrome), I have experienced for myself, as well as see on a daily basis, how a disrupted gut flora opens the door for unfriendly microbes to step in and take over, creating all sorts of pandemonium that causes patients to gain weight, feel sick and tired, and become more disease-prone.
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.
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.

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.
While raw probiotics tend to be the freshest (and most effective!) cultures on the market, it is important to ensure that you will store these properly in between each use. Cultures can die unrefrigerated in as little as a few hours, rendering them completely ineffective and, if you’re especially unlucky, even harmful to your body’s natural flora. Think about it, when has stale or moldy bread made your tummy feel better? The same thing goes for stale probiotic cultures!
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.
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 bad news about constipation is that there can be many causes, from simple causes like dehydration and lack of fiber to complicated structural causes or disease. While constipation may seem to be only a nuisance that causes uncomfortable symptoms such as abdominal bloating or pain, the truth is that constipation increases the risks of several diseases.

Twenty-one volunteers were given a course of antibiotics and then split into three groups. The first group were left to let the microbiome recover without any interventions, the second group were given probiotics and the third were given a fecal transplant of their own gut bacteria which was collected before the antibiotic treatment. The study found that the probiotics easily colonized the gut of the second group, but worryingly, rather than aiding the return of the normal gut microbiome, the probiotics actually significantly delayed it for months compared to both the group that had no intervention and the people who received a transplant of their own gut bacteria.


"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.
Although some probiotics have shown promise in research studies, strong scientific evidence to support specific uses of probiotics for most health conditions is lacking. The U.S. Food and Drug Administration (FDA) has not approved any probiotics for preventing or treating any health problem. Some experts have cautioned that the rapid growth in marketing and use of probiotics may have outpaced scientific research for many of their proposed uses and benefits.
Evidence from clinical trials is mixed and often of low quality, but findings from meta-analyses suggest that probiotics can provide benefits in the treatment of some conditions, such as infectious and antibiotic-associated diarrhoea. As such, taking probiotics after antibiotic treatment is an increasingly common practice. However, two studies recently reported in Cell question whether taking highly concentrated supplements of so-called good bacteria aids the recovery of normal gut flora.
Don't assume that the only way you can get your probiotic yogurt fix is through dairy. Cultured soymilk, or soy yogurt, is a non-dairy alternative that also boasts live active cultures. Most of these products are fortified with calcium and vitamin D to make them comparable to dairy yogurts. It makes a great option if you're vegan or lactose intolerant. (And if you're looking for more variety, almond milk and coconut milk yogurts are also rich in probiotics.)
“Microbiome” refers to the trillions of bacteria and microorganisms that live on and in our individual bodies. “There’s increased recognition of the various ways that the microbiome affects our health,” Lebwohl tells me. “And with that recognition comes the true observation that many bacteria are good for us. This goes against the old idea that bacteria equal germs, which equal harm. It turns out that many bacteria keep us healthy and probiotics could potentially support that notion.”
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.
​​​​​​AZO Complete Feminine BalanceTM is a daily probiotic supplement designed for the unique needs of women. Many everyday things can throw off your balance (stress, sex, pregnancy, aging, even medications! This product supports your feminine health and maintain a healthy pH so that you can own your day! It contains INTELLIFLORATM: a probiotic blend of four lactobacilli that are associated with vaginal health* (Lactobacillus crispatus LBV 88, Lactobacillus rhamnosus LBV 96, Lactobacillus jensenii LBV 116, and Lactobacillus gasseri LBV 150.)  The INTELLIFLORATM blend has been shown in clinical studies to help restore and maintain the healthy balance of the vaginal microbiota.*
It’s important to note that there are different types of strains of probiotics. The probiotics benefits of one probiotic strain may be completely different from the health benefits seen from another probiotic. If you want to use probiotics to address a specific health concern, it’s vital to select the right probiotic for the right condition — or you can consume a wide range of probiotics in your food to be covered.

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 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.
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.
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.

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 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.
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.
“If someone has disrupted his gut microbial balance, this is where a probiotic can be of benefit,” says Gail Cresci, PhD, RD, an intestinal microbe specialist with Cleveland Clinic’s Department of Gastroenterology, Hepatology and Nutrition. “But whether it’s really going to help and whether you’re taking the right one are the big questions out there.”
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Your gut is diverse, so your probiotic should be too. Look for a supplement that contains multiple strains, sometimes listed as a proprietary blend. Inferior brands might only contain one probiotic strain such as Lactobacillus acidophilus. Aside from Lactobacillus and Bifidobacterium strains, probiotics may contain Strep. thermophilus and Saccharomyces boulardii, among others.
Nearly 75% of all women will have at least one yeast infection during their lifetime, and over 50% of women are likely to experience the inexplicable pain of a urinary tract infection as well. With the recurrence of urinary tract infections and yeast infections on the rise, women all around the world began searching for a more effective and natural solution to antibiotics.
Our gut is home to over 500 bacterial species. These “visitors” form a bioreactor, which facilitates digestion, provides nutrients, and helps form the immune system. Some important nutrients made by this bioreactor include several B vitamins, vitamin K, folate, and some short-chain fatty acids. Up to 10% of an individual’s daily energy needs can be derived from the byproducts of the good bacteria in your gut.
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.
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.

This makes it harder for your immune system to work properly and leaves you open to feeling under the weather unnecessarily. The good news is that taking probiotics can help replenish your gut microbiome, and since 80% of your immune system is in your gut, this inevitably has a very supportive effect on your immunity. Probiotics also specifically support your mucosal immune systems, found in your ear, nose, and throat area and your lungs, helping you to maintain respiratory health.4
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.
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.

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.
Certain brands, like Attune (attunefoods.com; available at Whole Foods), have pumped up the dessert by adding probiotics. (Attune boasts 6.1 billion CFUs, or "colony forming units," a measure of live, active microorganisms per serving. As a comparison, some probiotic supplements may contain 1 to 50+ billion CFUs.) Sounds crazy, but it's backed by science. One study in the International Journal of Food Microbiology found that probiotics added to chocolate were able to reach the GI tract where they could get to work colonizing the gut with healthy bacteria.
Billions Of CFU – One of the first things you will notice on a bottle of probiotics is the phrase “X Billion CFU.” Probiotics vary in the number of billions of cultures they pack in each capsule, but the lingo always stays the same. CFU stands for Colony Forming Units, so if the bottle reads 5 Billion CFU, it means that there are 5 Billion Colony Forming Units per capsule. The higher the number, the more flora contained in each pill.
Yeast Infections and Bacterial Vaginosis (BV) – If you’ve ever experienced the discomfort of a yeast infection or BV, then you are probably aware that an overgrowth of bacteria causes these unfortunate episodes. While your reproductive system is supposed to foster a healthy environment for yeast, sometimes these levels can increase causing the pain and discomfort of a yeast infection or bacterial infection. By taking a probiotic that contains prebiotics and feminine health probiotics, you can treat and prevent recurrent symptoms!
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!
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.

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."


Notably, after someone was tagged a “persister” or “resister” clear patterns emerged on how probiotics would impact his or her indigenous microbiome and gut bacteria profile. "Although all of our probiotic-consuming volunteers showed probiotics in their stool, only some of them showed them in their gut, which is where they need to be," Eran Segal said in a statement. "If some people resist and only some people permit them, the benefits of the standard probiotics we all take can't be as universal as we once thought. These results highlight the role of the gut microbiome in driving very specific clinical differences between people."
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