Since the effects of individual bacteria strains vary, the first thing to consider when choosing a probiotic supplement is the reason you are taking it. Certain strains, for example, may help with weight loss, lower cholesterol or reduce allergy symptoms, while others have been shown to help with digestive issues, such as diarrhea from antibiotics and irritable bowel syndrome. The uses and evidence for various strains are summarized in a reference table in the Probiotic Supplements Review (be aware that certain strains should be avoided by people with milk allergies or people taking certain medications).
Notions don’t equal evidence though, and Lebwohl cautioned against thinking of probiotics as a cure-all, and examining the ways in which they’ve been proven to work as well as the ways in which they really haven’t. So which medical conditions have probiotics actually shown promise in treating and which claims have the credibility of a used car salesman on acid?
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.
There are foods with health halos. And then there are probiotics, which have practically been canonized. The word itself means—no big whoop—"to give life." Probiotics are now a nearly $37 billion industry in the U.S. Sales of probiotic-rich yogurt and kefir surged nearly 30 percent in the past three years. And just slapping "contains probiotics" on a product helps it sell better, says San Diego attorney Tim Blood, who specializes in consumer protection in advertising. Not too shabby for bacteria, right?
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].
Research suggests probiotics work better as a team. Even pairs are more effective than individuals. Take the strains Lactobacillus Acidophilus and Bifidobacterium Bifidum BB-12, for example. When combined, this duo-force has been shown to help treat GI-specific ailments. In fact, one survey found 75 percent of studies that compared the effect of a strain mixture with a single-strain supplement showed a mixture was more effective at improving irritable bowel symptoms, immune function, and digestive health.
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
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]
Did someone say chocolate? Yes, you can have your probiotics and eat your chocolate too with these Digestive Advantage probiotic bites from Schiff. Easy to pop, they contain BC20, a probiotic that the manufacturer says survives stomach acid better than other probiotics and even yogurt. Made with dark chocolate, they contain just 30 calories per serving (one chew) and no artificial colors, flavors or preservatives.
However, it’s 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].
How is it that probiotics are such a ubiquitous trend in the wellness scene but subject to tons of misinformation all the same? Consider the myth, for example, that the only appeal of replenishing your good bacteria is smoother digestion. On the contrary, the benefits of probiotics abound: from a boosted mood and better skin to a healthier immune system.
A healthy digestive system is vital to good health. The food that you eat is processed and the nutrients you consume are absorbed in the digestive system. However, it is also home to much of your immune system. This makes it important for helping you fight off illnesses. Probiotic supplements may help to balance the gut to promote increased digestive health and improved overall health as a result. However, more studies are needed.
Most scientific studies suggest the pills do very little to help our stomachs and may not provide any measurable benefits to overall health. That may be at least partially a result of the fact that very few of the beneficial bacteria in the supplements make it to our guts or stick around long enough to have an effect, Ian Orme, a professor of microbiology at Colorado State University, told Business Insider.
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While Lebwohl isn't comfortable endorsing a specific brand publicly, he did say "a widely used brand in which the compound is bifidobacteria or lactobaccilus seems like a reasonable way to go in a patient who is eager to give this a try, but would be best done under the supervision of a healthcare professional.” He does advise looking for a supplement with between 1 billion and 10 billion colony-forming units, or CFUs.

^ Shane AL, Cabana MD, Vidry S, Merenstein D, Hummelen R, Ellis CL, Heimbach JT, Hempel S, Lynch SV, Sanders ME, et al. (2010). ": Guide to designing, conducting, publishing and communicating results of clinical studies involving probiotic applications in human participants". Gut Microbes. 1 (4): 243–253. doi:10.4161/gmic.1.4.12707. PMC 3023606. PMID 21327031.
Irritable bowel syndrome (IBS) is a multisymptom GI disorder with unclear etiology and pathogenesis. Changes in GI microflora in IBS patients have been reported by a number of investigators [Kassinen et al. 2007; Shanahan, 2007]. Recently, reports on variable prevalences of small intestinal bacterial overgrowth (SIBO) in IBS have been published [Posserud et al. 2007; Lin, 2004]. IBS symptoms such as bloating or flatulence have been attributed to possible alterations in the intestinal microflora and probiotics have been used empirically to treat these difficult symptoms [Kim et al. 2003, 2005]. Postinfectious IBS may begin after a bout of acute gastroenteritis suggesting that altered microflora or induction of an altered inflammatory or immune state in the bowel may lead to altered bowel function and IBS symptoms [Collins et al. 2009]. An increase in lymphocytes and an increase in pro-inflammatory cytokines have been described [Spiller et al. 2000].
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)
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.

Secondly, probiotics must have undergone controlled evaluation to document health benefits in the target host. Only products that contain live organisms shown in reproducible human studies to confer a health benefit can actually claim to be probiotic.[3][115][116] The correct definition of health benefit, backed with solid scientific evidence, is a strong element for the proper identification and assessment of the effect of a probiotic. This aspect represents a major challenge for scientific and industrial investigations because several difficulties arise, such as variability in the site for probiotic use (oral, vaginal, intestinal) and mode of application.[61]
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.
Similar to yogurt, this fermented dairy product is a unique combination of milk and fermented kefir grains. Kefir has been consumed for well over 3,000 years, and the term kefir was started in Russia and Turkey and means “feeling good.” It is created by the fermentation of milk by the bacteria, and yeasts in kefir starter break down lactose in the milk — that’s why kefir may be suitable for those who are otherwise lactose-intolerant.
In the past five years, for example, several combined analyses of dozens of studies have concluded that probiotics may help prevent some common side effects of treatment with antibiotics. Whenever physicians prescribe these medications, they know they stand a good chance of annihilating entire communities of beneficial bacteria in the intestine, along with whatever problem-causing microbes they are trying to dispel. Normally the body just needs to grab a few bacteria from the environment to reestablish a healthy microbiome. But sometimes the emptied niches get filled up with harmful bacteria that secrete toxins, causing inflammation in the intestine and triggering diarrhea. Adding yogurt or other probiotics—especially the kinds that contain Lactobacillus—during and after a course of antibiotics seems to decrease the chances of subsequently developing these opportunistic infections.

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.
Probiotic foods deliver beneficial bacteria into the gastrointestinal tract. Prebiotic foods promote healthy gut bacteria by feeding them what they need in order to thrive. Foods rich in prebiotics that feed good bacteria include dark chocolate, legumes, red wine, honey, bananas, maple syrup, Jerusalem artichokes, asparagus, and oatmeal. Having a diverse microbiome of good bacteria in the gut helps promote weight loss and confers other health benefits.

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.
For the generally healthy person, you can make a very good case to trust your own body to select and grow the best bacteria that are already in everyone. The foods you eat greatly influence your bacterial mix. Although probiotics offer many positive health benefits, there is no guarantee that they can make the trip from your mouth to your lower gut intact. Although adding more prebiotic fiber to your diet cannot guarantee safe passage of probiotics, it can influence the healthy bacteria that already live in your system. If probiotics help you, eating prebiotic foods or supplements will cause those healthy bacteria to flourish. 

For moms-to-be who supplement with probiotics during pregnancy, there’s an added bonus. A study suggests that taking a probiotic supplement during the first trimester of pregnancy through the end of exclusive breastfeeding may help you lose weight after your baby’s arrival. This is in addition to the multitude of probiotic benefits for your newborn as well!
I really like your article as it contains a lot of valuable information. the only thing id like to hear more about is the how your rating stacks up to the probiotics geared towards women specifically. I read the listing in, “what to look for” as you suggested but again it doesn’t discuss any findings along the lines of womens specific strands or brands that highlight aiding women more than another. Id love to hear your opinion on the matter or if you might be able to shed any light on the subject at hand. Thanks Julia!
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.
It’s great to get some healthy sour foods. I often add one tablespoon of apple cider vinegar to a drink, twice a day. Before breakfast and lunch or breakfast and dinner, add one tablespoon of apple cider vinegar in your meal, and then start consuming more fermented vegetables like sauerkraut and kimchi, or drinking kvass. Is apple cider vinegar a probiotic itself? No, but apple cider vinegar probiotic content makes it an excellent source of probiotics benefits.
Medications (especially antibiotics), stress, diet and other factors can alter the ratio of good to bad bacteria in your gut, causing infection and disease. This happens more often than you might think: antibiotics are one of the most prescribed medications in Canada and the US (and often prescribed unnecessarily… but that’s another story) (3;4). They’re important and effective in killing infection-causing bacteria, but they often end up killing a lot of good bacteria, upsetting that important balance and giving dangerous Clostridium difficile bacteria a chance to cause severe diarrhea and other bowel diseases, sometimes with fatal results (5).
However, it’s 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].
On my recent trip to Japan, one thing I noticed was the inclusion of pickled vegetables in almost every traditional Japanese meal. Unfortunately, many Americans don’t consume enough of these probiotic-rich foods and drinks. Even when they do, restoring equilibrium oftentimes requires therapeutic doses of these microorganisms, because most everyone has been on several rounds of antimicrobials. That’s where a probiotic supplement comes in.
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