Other safety concerns relate to the unpredictability of immune modulation through change in intestinal flora in certain disease states. For example, worsening of Crohn’s disease (CD) in patients taking some probiotic formulations [Rolfe et al. 2006] or exacerbation of indomethacin-induced enteropathy in animal models by Lactobacillus GG [Kamil et al. 2007]. As rare as these complications appear to be, probiotic safety profile needs to be specifically studied, particularly in hospitalized patients. There are no formal clinical trials assessing the safety of probiotics as there are safety data on regulated medications. At this time, we can only rely on case reports, which is without a doubt suboptimal.
Side effects: Probiotics are considered safe overall for healthy people; short-term side effects may include mild gas and bloating. But risks may be greater in immunocompromised people. And a systematic review in the Annals of Internal Medicine in 2018 found that the reporting of adverse effects is often missing or inadequate. Also in 2018, an editorial in JAMA Internal Medicine by Dr. Pieter Cohen, a well-known critic of the supplements industry, called for the FDA to improve its regulatory standards for probiotics to match those of Canada and the EU.

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.
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.

Sauerkraut and kimchi are fermented foods that are rich in beneficial probiotics that provide a wide range of health benefits. Sauerkraut is fermented cabbage. If you buy sauerkraut at the store, purchase the unpasteurized variety. Pasteurization destroys beneficial bacteria. Probiotics in kimchi inhibit the growth of H pylori. They may also help prevent cancer, obesity, inflammatory bowel disease (IBD), dermatitis, food allergies, and obesity. Probiotics in kimchi produce valuable B vitamins, riboflavin and folic acid. These foods contain vitamins that boost immunity and help ward off infection.


Further complicating things is that the mix of bacteria in people’s guts varies widely — in fact, it’s probably unique to you, like a fingerprint. What’s more, your microbiome can change based on your diet or lifestyle, or due to illness, so what might work for one person with a certain condition or symptom might not won’t work for another, Dr. Rawls says.

A live formulation of lyophilized Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, Lactobacillus bulgaricus, and Streptococcus thermophilus (VSL#3) has shown effectiveness in the small clinical trials, some of which were not randomized nor double-blinded, that had been done as of 2015; more high-quality clinical trials are needed to determine safety and effectiveness.[102][103]

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.


Plus, thanks to its immune-modulating properties, it can also decrease inflammation and minimize symptoms of certain autoimmune disorders. For example, one study published in the journal BMC Complementary & Alternative Medicine showed that Bacillus coagulans was effective at reducing inflammation, relieving pain and improving the ability to perform regular daily activities in people with rheumatoid arthritis. (3)

Like adults, children also require the proper balance of flora in the stomach to remain in good health. A major health care study conducted by the American Academy of Pediatrics concluded that probiotic supplements could be beneficial for children under certain circumstances. More research is needed. However, the study indicates that children who take probiotics at the first signs of viral diarrhea exhibit symptoms for shorter periods of time than those who do not. The study also found positive evidence that probiotics reduce the chances of diarrhea caused by antibiotic use in kids. More research is required to confirm these results. However, many pediatricians already recommend probiotics to parents based on the data.
Antibiotics are a common treatment for children, with 11% to 40% of antibiotic-treated children developing diarrhea.[13] Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy.[13] These microbial community alterations result in changes in carbohydrate metabolism, with decreased short-chain fatty acid absorption and osmotic diarrhea as a result. A 2015 Cochrane review concluded that a protective effect of some probiotics existed for AAD in children.[13] In adults, some probiotics showed a beneficial role in reducing the occurrence of AAD and treating Clostridium difficile disease.[14]
“Clients with tummy troubles, especially diarrhea, gas, and bloating have good success with Florastor,” says Cheryl Harris, a dietitian in Fairfax, VA. “It contains Saccharomyces boulardii, a special strain of probiotic yeast. Most probiotics are killed by antibiotics, but because Florastor is a probiotic yeast that encourages healthy bacteria, it’s an ideal one to take along with antibiotics.” Don’t miss 11 diseases that can start with gut bacteria.
Some yogurts contain the aforementioned bacteria; however, because they are sensitive to oxygen, light, and dramatic temperature changes, make sure to look for yogurts with “live and active cultures.” Many commercial yogurts are heat-treated or pasteurized, resulting in the loss of these valuable cultures. Learn more about the smart way to shop for probiotics.
With the growing popularity of probiotics, there is a huge variety of supplements from which one can choose. The most important thing is to determine what type of probiotic microorganism you need for your condition. Do not just take the supplement that provides the most kinds of organisms. You need to do your research and be sure that there are scientific studies to support what you take. New research is emerging, so if you don't find what you need right now, keep looking. A doctor can help one decide if trying probiotics might be helpful for you and can advise you regarding the amount and type of probiotics that may be appropriate in your case.
If you have annoying tummy troubles... Allow your predominant symptoms to guide you. Bloated and constipated? Look for lactobacillus acidophilus or lactobacillus casei, which help restore gut flora. Can't stop going number two? Types with saccharomyces boulardii can ease antibiotic-associated diarrhea and even prevent extreme cases caused by infections.
When I polled friends and family about their personal experiences with probiotics, I got a real mixed bag of responses. Some called them a lifesaver and others felt no effects whatsoever. I put the anecdotes aside and talked to Ben Lebwohl, gastroenterologist and director of clinical research at Columbia University’s Celiac Disease Center, to get the straight poop on whether probiotics are miracle or myth.
Probiotics' side effects, if they occur, tend to be mild and digestive (such as gas or bloating). More serious effects have been seen in some people. Probiotics might theoretically cause infections that need to be treated with antibiotics, especially in people with underlying health conditions. They could also cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell).
Stability and organism types — Some probiotic strains need to be kept cold in order to preserve their potency. This applies to their production, transport, storage and sales. Others are shelf-stable and don’t require refrigeration. Unfortunately, most refrigerated probiotics never make it past the stomach because they aren’t stable. Instead, look for a shelf-stable product that contains soil-based organisms.
One review of probiotics benefits for necrotizing enterocolitis was bold enough to say, “The results confirm the significant benefits of probiotic supplements in reducing death and disease in preterm neonates. The … evidence indicate that additional placebo-controlled trials are unnecessary if a suitable probiotic product is available.” Regarding sepsis in developing countries (where it is overwhelmingly more common), a 2017 randomized, controlled trial claims that a large number of these cases “could be effectively prevented” if mothers are given a synbiotic (probiotic and prebiotic together) that contains the probiotic strain L. plantarum.
^ Altenhoefer, Artur; Oswald, Sibylle; Sonnenborn, Ulrich; Enders, Corinne; Schulze, Juergen; Hacker, Joerg; Oelschlaeger, Tobias A (April 2004). "The probiotic Escherichia coli strain Nissle 1917 interferes with invasion of human intestinal epithelial cells by different enteroinvasive bacterial pathogens". FEMS Immunology & Medical Microbiology. 40 (3): 223–229. doi:10.1016/S0928-8244(03)00368-7.

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


Once you have identified the right strain or strains, it's important to find a product that provides a dose that's been shown to be effective, and that contains it's labeled dose (ConsumerLab.com tests have found some probiotic supplements to contain less than half the amount of organisms claimed on the label!) To get test results for popular products, plus additional tips for choosing a probiotic supplement, see the Probiotic Supplements Review >>
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.
Probiotics, like all strategies for helping promote your health, might not work for everyone. People have different diets, the microbes colonizing their gut are specific to each of us and everyone’s physiology is unique. Research often shows that some people respond to a specific probiotic strain and others do not. So if you feel a probiotic is something you’d like to use, one strategy is to try a product for about a month. If you don’t see a benefit, then perhaps it’s not the right one for you.
Probiotics are generally considered safe8 for most healthy people, but may cause gastrointestinal discomfort (abdominal tenderness, pain, gas, and/or diarrhea) if intake exceeds individual needs. People with certain health conditions like suppressed immunity or sensitivity to probiotics may experience more severe side effects9. Probiotics can also interact with some medications. Please consult your doctor before starting any new supplement.
Antibiotics are a common treatment for children, with 11% to 40% of antibiotic-treated children developing diarrhea.[13] Antibiotic-associated diarrhea (AAD) results from an imbalance in the colonic microbiota caused by antibiotic therapy.[13] These microbial community alterations result in changes in carbohydrate metabolism, with decreased short-chain fatty acid absorption and osmotic diarrhea as a result. A 2015 Cochrane review concluded that a protective effect of some probiotics existed for AAD in children.[13] In adults, some probiotics showed a beneficial role in reducing the occurrence of AAD and treating Clostridium difficile disease.[14]
If you are thinking about taking a probiotic or prebiotic and are unsure where to start or what to take, ask for help from a specialist. There are so many products available on the market it can be difficult to decide which to choose. The evidence is very much linked to the supplement so whether it’s a powder, tablet or drink you’re looking for, choosing the right one should depend on the symptoms you’re experiencing.
If you’re seeking the best probiotic for women and men, you want a combination of proven effectiveness and excellent quality. Probiotic All-Flora is formulated with probiotics in clinically relevant amounts that work. A revolutionary approach to total microbiome health, Probiotic All-Flora delivers two types of clinical strength flora: friendly bacteria and beneficial yeast. Our probiotics are DNA-tested to assure quality and identity by delivering the exact, researched strains every time. The rebalancing yeast provides a more complete approach to supporting gut flora than just having friendly bacteria alone—since our gut is home to both bacteria and yeast species.
Bottom line: Probiotics are a promising field of research and may one day be used to treat or help prevent many disorders. But there’s not enough solid evidence to recommend their widespread use. Vague claims that probiotics "support good digestive health" are meaningless. Larger, longer and better studies are needed to test specific strains for specific conditions and to determine the proper doses and regimens.
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