Reviews looking at the treatment or prevention of vulvovaginal candidiasis in women, pneumonia in patients hooked up to respirators, and colds in otherwise healthy people show some positive results. But the authors note that the studies are almost all of low quality, small in size, and often funded by companies with significant conflicts of interest.
A large analysis reviewed available research and determined that probiotics help lower blood pressure by improving lipid profiles, reducing insulin resistance, regulating renin levels (a protein and enzyme secreted by the kidneys to lower blood pressure) and activating antioxidants. Researchers consider them valuable prospects in the treatment of high blood pressure because their side effects are generally minimal or nonexistent. (82, 83)

Doctors recommend that vaginal and oral administration of Lactobacilli help in the treatment of bacterial vaginosis. There is still some evidence required to recommend it over other medical approaches. However, women who consume probiotics report improved vaginal health and are also likely to encounter fewer pregnancy-related complications resulting due to bacterial vaginosis.

Along with about 30 other neurotransmitters, your gut manufactures about 95 percent of serotonin, the feel-good neurotransmitter that SSRIs keep circulating. (Worth noting: SSRIs prolong the time serotonin stays stimulating the neurons. These drugs don’t actually make serotonin. They falsely elevate the serotonin that is already there, leading to greater depletions down the road.)


"Probiotics applied topically sit on the skin's surface and prevent the skin cells from seeing the bad bacteria and parasites that can cause this immune system response," confirms Engelman. "This is known as 'bacterial interference,' as probiotics protect the skin and interfere with the ability of bad bugs like bacteria and parasites to provoke an immune reaction.
If you struggle with post-meal gas, bloating, and other problems, your body might not be making sufficient digestive enzymes. Gut imbalances, stress, and age are among the factors that inhibit the digestive process. For many patients, supplements that replenish digestive enzymes can reduce or eliminate those problems, especially while you’re healing your gut.
If you’re most interested in taking a probiotic supplement for overall gut health, I suggest starting with 30 to 50 billion CFUs. Take probiotics on an empty stomach once or twice a day for at least three months. After that time, reassess and decide if the benefits warrant continuing a maintenance dose of the probiotic supplement. However, if you have SIBO, beware of starting a probiotic too soon after your treatment. In this case, it’s best to work with a health practitioner on which probiotic is right for each stage of the treatment.
The National Center for Complementary and Integrative Health (NCCIH) calls probiotics “live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut.” The NCCIH makes the point that we often think of bacteria as harmful “germs” — however, probiotic bacteria actually helps the body function properly.
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.
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Previous studies have been contradictory, with some yielding more positive results about the benefits of probiotics, but most of them looked at probiotics in stool samples, not directly in the gut itself. In the new research, the scientists used more invasive methods to take samples of gut bacteria directly from different areas of the digestive system.

The discovery of the benefits of probiotics began with sour milk. Today we have many other options to get various bacteria from our foods, although it's not as simple as just adding them to the food. For there to be health benefits, the microorganism has to be able to survive the passage through the gastrointestinal tract, survive the food manufacturing process, and grow and survive during the ripening or storage period. Also, the bacteria must not negatively affect product quality and be included on the Generally Recognized as Safe (GRAS) list.
Even with antibiotic-associated diarrhea, which has the best evidence, "you could have seven people take the same probiotic and only have one report a definite difference," says gastroenterologist Matthew Ciorba, M.D., a medical professor who studies human gut microbiota at Washington University School of Medicine in St. Louis. That's because each person's microbial makeup is as unique as a fingerprint, influenced by age, genetics, and gender. For example, animal research from the University of Texas at Austin found the microbes living in the guts of males and females react differently to the same diet. Scientists are now studying ways to harness a person's own microbes to treat illnesses, rather than going for a mass approach.
In the United States, most probiotics are sold as dietary supplements, which do not undergo the testing and approval process that drugs do. Manufacturers are responsible for making sure they're safe before they're marketed and that any claims made on the label are true. But there's no guarantee that the types of bacteria listed on a label are effective for the condition you're taking them for. Health benefits are strain-specific, and not all strains are necessarily useful, so you may want to consult a practitioner familiar with probiotics to discuss your options. As always, let your primary care provider know what you're doing.
The bottom line: Stick to trusted whole food sources of probiotics if you don’t know a probiotic supplement brand you trust. “Kimchi, pickled beets, Greek yogurt and sauerkraut are great sources of probiotics. If you don’t like them, throw them into a food you do like, like a smoothie, and add your favorite fruit to help mask the flavor,” Taub-Dix says.
What is the difference between prebiotics and probiotics? Prebiotics and probiotics work together to encourage the growth of beneficial bacteria that can improve digestion and support the immune system. Both prebiotics and probiotics occur naturally in many foods. Here, learn more about the differences between them, their benefits, and how to incorporate them into the diet. Read now
It was at that time known that milk fermented with lactic-acid bacteria inhibits the growth of proteolytic bacteria because of the low pH produced by the fermentation of lactose. Metchnikoff had also observed that certain rural populations in Europe, for example in Bulgaria and the Russian steppes, who lived largely on milk fermented by lactic-acid bacteria were exceptionally long lived. Based on these observations, Metchnikoff proposed that consumption of fermented milk would "seed" the intestine with harmless lactic-acid bacteria and decrease the intestinal pH, and that this would suppress the growth of proteolytic bacteria. Metchnikoff himself introduced in his diet sour milk fermented with the bacteria he called "Bulgarian Bacillus" and believed his health benefited. Friends in Paris soon followed his example and physicians began prescribing the sour-milk diet for their patients.[55]
L. casei also made headlines when a study found it beneficial in relieving anxiety. The randomized, double-blind, placebo-controlled pilot study found supplementation with 24 billion units of the L. casei strain Shirota led to a rise in probiotics lactobacillus and bifidobacterium, as well as a significant decrease in symptoms of anxiety and depression [2].
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.
Naturally fermented pickles, the type in which vinegar is not used in the pickling process, are rich sources of good bacteria. Sea salt and water are used in a fermentation process that results in the growth of good bacteria. Make sure vinegar was not used in the pickling process as pickles made in this way will not be rich in bacteria that boosts healthy gut flora. Beneficial bugs in fermented foods like pickles boost gut health and encourage a diverse microbiome. Eating foods that are rich in probiotic bacteria such as pickles retards the growth of harmful bacteria and it boosts the body's defenses against infection.
The newest trend in probiotics is customized formulations that are said to be based on your unique microbiome needs. Companies develop them after testing your stool sample for different microbes, and then selecting probiotics they say you lack in your gut. “While it may be a step in the right direction, the science and technology have a long way to go before this is a viable option,” says Dr. Rawls.
In 2015, the global retail market value for probiotics was US$41 billion, including sales of probiotic supplements, fermented milk products, and yogurt, which alone accounted for 75% of total consumption.[42] Innovation in probiotic products in 2015 was mainly from supplements, which produced US$4 billion and was projected to grow 37% globally by 2020.[42] Consumption of yogurt products in China has increased by 20% per year since 2014.[43]
Bifidobacteria is a family of bacteria that has been studied for its ability to prevent and treat various gastrointestinal disorders, including infections, irritable bowel syndrome and constipation. In addition to making lactic acid, it also makes some important short-chain fatty acids that are then absorbed and metabolized by the body. There is also some experimental evidence that certain bifidobacteria may actually protect the host from carcinogenic activity of other intestinal flora.

If you're healthy and want to stay that way... Shoot for 50 to 100 billion CFUs of a combo of lactobcillus and bifidobacterium. Starting with a large amount of CFUs will either keep you riding high (by supporting immunity) or trigger small but yucky reactions, like gas or nausea. If you notice those, scale back to 50 billion, then 20 bill, until you feel like your usual (but better) self.
Can you take one probiotic for digestive health and a different one for vaginal health? “Unless recommended otherwise by a healthcare professional, I would recommend staggering intake within a day,” says Anthony Thomas, PhD, director of scientific affairs at Jarrow Formulas. In other words, take one probiotic with breakfast and the other at lunchtime.
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.
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.
The Bifidobacteria (Bifidus) predominantly live in your colon or large intestine. They produce the very important short-chain fatty acid butyrate, which supplies energy to your colon cells to keep them functioning optimally. But butyrate also gets absorbed by the body, regulating a variety of metabolic processes, including your sensitivity to the hormone insulin (which regulates blood sugar) and even memory formation in the brain. The most beneficial of these are B. lactis and B. longum. Research shows the benefits for Bifidobacteria include reducing inflammatory bowel disease and several cancers, especially colon cancer. Another study showed that a specific strain of Bifidobacterium lactis helped control body fat mass and reduced waist circumference and food intake.
As one of the best probiotics for weight loss, there have been a slew of studies demonstrating just how powerful this strain of bacteria may be when it comes to your waistline. For instance, one study in the British Journal of Nutrition showed that taking Lactobacillus gasseri daily led to significant reductions in body weight and body fat compared to a control group, with participants losing up to 8.5 percent body fat over a 12-week period. (13)
What’s more, your bacterial makeup does more than just boost or bully your immune system; the existence of good and bad bacteria affect your mood and energy levels, relieve (or contribute to) a sensitive stomach (including lactose intolerance and irritable bowel syndrome/IBS), affect your mood, and even support (or hinder) a healthy body weight. (Fascinating fact: Scientists can predict weight with 90% accuracy based on your gut’s bacterial makeup, but only with 58% accuracy based on your genes. Bacteria counts!)
Although most studies have shown few, if any, negative side effects, it is important to keep in mind that research on probiotics is still in a preliminary phase. There may be some risk for people who have certain health conditions. As with any supplement, it is essential that before you begin to take a probiotic supplement, that you speak with your physician first to help to ensure that you will not be putting your health at risk.

Historically, people had plenty of probiotics in their diets from eating fresh foods from good soil and by fermenting foods to keep them from spoiling. Over a century ago, the Russian Nobel Prize winner Elie Metchnikoff theorized that “health could be enhanced and senility delayed by manipulating the intestinal microbiome with host-friendly bacteria found in yogurt.” Metchnikoff was ahead of his time with his view of probiotics benefits, but he also was aware that most citizens had regular access to probiotic foods.
^ Schlundt, Jorgen. "Health and Nutritional Properties of Probiotics in Food including Powder Milk with Live Lactic Acid Bacteria" (PDF). Report of a Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics in Food Including Powder Milk with Live Lactic Acid Bacteria. FAO / WHO. Archived from the original (PDF) on October 22, 2012. Retrieved 17 December 2012.

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.
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